Abstract
OBJECTIVE: To evaluate the efficacy of ozonated oil compared to conventional wound care in enhancing postoperative wound healing and cosmetic outcomes in bilateral breast surgery. The primary outcomes were pruritus, pain, and scar aesthetics (color, texture, and thickness) at six weeks. METHODS: A prospective, self-controlled pilot study was conducted on five female patients undergoing bilateral breast surgery (10 wounds). One breast received conventional care (cleaning with saline and topical antiseptics), while the contralateral breast was treated with topical ozonated oil (Ozoaqua®, Spain). Pain, pruritus, and scar appearance (color, texture, and thickness) were evaluated at six weeks using patient-reported scales (0-10). A blinded physician independently evaluated scar quality. Data were analyzed using paired t-tests and Wilcoxon tests. RESULTS: Wounds treated with ozonated oil demonstrated significantly lower pain (2.4 ± 1.1 vs. 4.0 ± 1.2; p = 0.011), reduced pruritus (median score 1 vs. 3; p = 0.042), and superior scar color (4.2 ± 0.8 vs. 3.4 ± 0.5; p = 0.05), texture (4.4 ± 0.5 vs. 3.2 ± 0.8; p = 0.03), and thickness (4.0 ± 0.7 vs. 3.0 ± 1.0; p = 0.04). The blinded evaluator favored ozonated oil-treated scars in four out of five cases. CONCLUSIONS: Ozonated oil significantly enhanced wound healing outcomes, reducing pain and pruritus and improving scar aesthetics compared to conventional care. These findings support further investigation through larger randomized trials. Given its low cost and ease of use, ozonated oil may be a valuable adjunct in rural plastic surgery settings where access to postoperative scar management resources is limited.