Figure 4.

Topical ozone treatment in a patient with skin necrosis after Doxorubicin extravasation. A 61-year old patient under treatment for a stage IIIA multiple myeloma suffered a skin necrosis secondary to Doxorubicin (DOX) extravasation in the left elbow flexure. Because adverse evolution with conservative management, a muscle flap with a cutaneous graft was required (by the Department of Plastic Surgery). A second surgery was planned because of a loss of tissue in the distal area of the graft. (Left): Picture at the 9th session of local ozone therapy (wound size 25 × 15 mm). Black arrows and dotted lines show the limits of the wound at the commencement of ozone therapy (wound size 60 × 30 mm). (Right): Picture at the end of local ozone therapy, after 20 sessions. The planned second graft was avoided.