white paper

Efficacy and safety of red and infrared light in the adjunctive treatment on diabetic foot ulcers: A systematic review and meta-analysis

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Abstract

Background: The use of various adjunctive phototherapies for diabetic foot ulcers (DFUs) makes it difficult to fully understand their roles in current laser-based review studies. Red and infrared light have significant advantages for wound healing. To evaluate the impact of red and infrared light on the healing of DFUs and provide evidence-based recommendations for future clinical adjunctive treatments of DFUs.

Methods: Multiple databases, including PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, PEDro, CNKI, CBM, Wanfang, and VIP, were systematically searched for articles published until November 2023. The focus of the search was to identify randomised controlled trials that investigated the effects of red and infrared light on the treatment of DFUs. Data extraction, literature screening, and methodological quality assessment were conducted independently by two researchers. A meta-analysis was performed using RevMan5.4 and STATA16.0 software.

Results: A total of 28 studies, involving 1471 patients, were included. The meta-analysis showed that groups treated with red and infrared light had a significantly higher ulcer healing rate [risk ratio (RR) = 1.93, 95 % confidence interval (CI) (1.63, 2.28), P < 0.00001], shorter ulcer healing time [mean difference (MD) = 18.52, 95 % CI (8.58, 28.47), P < 0.00001], increased peak blood flow velocity in the dorsalis pedis artery [mean difference (MD) = 6.54, 95 % CI (4.01,9.08)], P < 0.00001), and reduced wound pain score [mean difference (MD) = −4.33, 95 % CI (−4.94, −3.71)], P < 0.00001) compared to the control group. However, there was no statistically significant difference in the incidence of adverse events [odds ratio (OR) = 0.32, 95 % CI (0.09, 1.17), P = 0.08] between the two methods.

Conclusion: The use of red and infrared light as an adjunctive treatment for DFUs is more beneficial than conventional wound care. However, due to limitations in the quality and sample size of the included studies, further high-quality research is needed to validate these conclusions.

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white paper

Unlocking the Power of Light on the Skin: A Comprehensive Review on Photobiomodulation

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Abstract

Photobiomodulation (PBM) is a procedure that uses light to modulate cellular functions and biological processes. Over the past decades, PBM has gained considerable attention for its potential in various medical applications due to its non-invasive nature and minimal side effects. We conducted a narrative review including articles about photobiomodulation, LED light therapy or low-level laser therapy and their applications on dermatology published over the last 6 years, encompassing research studies, clinical trials, and technological developments. This review highlights the mechanisms of action underlying PBM, including the interaction with cellular chromophores and the activation of intracellular signaling pathways. The evidence from clinical trials and experimental studies to evaluate the efficacy of PBM in clinical practice is summarized with a special emphasis on dermatology. Furthermore, advancements in PBM technology, such as novel light sources and treatment protocols, are discussed in the context of optimizing therapeutic outcomes and improving patient care. This narrative review underscores the promising role of PBM as a non-invasive therapeutic approach with broad clinical applicability. Despite the need for further research to develop standard protocols, PBM holds great potential for addressing a wide range of medical conditions and enhancing patient outcomes in modern healthcare practice.

Read more on pubmed.ncbi.nlm.nig.gov or download the PDF

white paper

Tailoring photobiomodulation to enhance tissue regeneration

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Abstract

Photobiomodulation (PBM), the use of biocompatible tissue-penetrating light to interact with intracellular chromophores to modulate the fates of cells and tissues, has emerged as a promising non-invasive approach to enhancing tissue regeneration. Unlike photodynamic or photothermal therapies that require the use of photothermal agents or photosensitizers, PBM treatment does not need external agents. With its non-harmful nature, PBM has demonstrated efficacy in enhancing molecular secretions and cellular functions relevant to tissue regeneration. The utilization of low-level light from various sources in PBM targets cytochrome c oxidase, leading to increased synthesis of adenosine triphosphate, induction of growth factor secretion, activation of signaling pathways, and promotion of direct or indirect gene expression. When integrated with stem cell populations, bioactive molecules or nanoparticles, or biomaterial scaffolds, PBM proves effective in significantly improving tissue regeneration. This review consolidates findings from in vitro, in vivo, and human clinical outcomes of both PBM alone and PBM-combined therapies in tissue regeneration applications. It encompasses the background of PBM invention, optimization of PBM parameters (such as wavelength, irradiation, and exposure time), and understanding of the mechanisms for PBM to enhance tissue regeneration. The comprehensive exploration concludes with insights into future directions and perspectives for the tissue regeneration applications of PBM.

 

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Effects of Photobiomodulation and Split-Thickness Skin Grafting in the Prognosis of Wound Healing in Children with Deep Burn Ulcers

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Abstract

Background: Split-thickness skin grafting (STSG) is a standard therapeutic technique in patients with extensive and deep ulcers. Hospitalization and surgery can result in complications, especially in children. Photobiomodulation (PBM) has been applied in a variety of conditions such as healing of surgical, venous, pressure, and diabetic wounds, but no clinical trial using this method for healing of burn ulcers in children was found on searching the literature. The aim of the study was to evaluate the effect of PBM on the outcome of burn ulcers in children.

Materials and methods: Informed consent and protocols were reviewed according to Shahid Beheshti University of Medical Sciences’ Medical Ethics Board (IR.SBMU.REC.1394.363) and the Iranian Registry of Clinical Trials (IRCT2016011726069N1). Forty children with deep burn ulcers, who were candidates for STSG, were divided into PBM and STSG groups. A 650-nm laser (power 150 mW, spot size 0.6 cm2, time 10 sec, and energy point 1.5 J) was used for irradiation over the burn area every other day until complete healing in the PBM group. STSG was performed in the STSG group. All other therapeutic care protocols were identical.

Results: Thirty-nine children completed the study. The mean ulcer size in the two groups was similar before treatment (PBM = 60.72 cm2 ± 13.8 and STSG = 63.74 ± 7.6). In the PBM group, all wounds healed within 10–12 sessions. Analysis of the burn area was performed 1, 3, and 6 months after injury. There was a significant difference (t test) in the burn area after 6 months in the PBM group compared with the STSG group (t test; p > 0.001).

Conclusions: This is the first study to compare PBM and STSG in burn ulcers in children. Results indicated that PBM was an effective alternative to STSG, significantly decreasing the rate of scar and hypertrophic scar formation. Potential mechanisms of PBM that may be involved in burn tissue repair are discussed.

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Clinical and radiological assessment of the effect of low level laser therapy on delayed bone fractures healing

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Low level laser has been conducted for treatment of bone fracture on animal and had shown positive results. If laser energy is delivered at optimal dose with appropriate parameters ,it might get best results however a little research in the literature has conducted on the effect of low level laser on human bone fracture. The aim of the study was to assess the radiological and clinical difference of the effect of low level laser therapy on the delayed bone healing of patients with different bone fractures.

 

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laser

New insight into how light therapy can speed up burn wound healing

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A compelling new study is offering an insight into the mechanism by which a novel form of light therapy can speed the healing of burn injuries. The research indicates the experimental therapy can activate a key protein that stimulates cell growth.

 

Read more on newatlas.com or download the PDF»

white paper

Photobiomodulation therapy assists rapid recovery from burns

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University at Buffalo project identifies mechanisms behind light-enhanced healing.

The therapeutic effects of incident light on wounds or sites of injury are known to be potentially beneficial in treatment regimes, and the mechanisms behind the effect are becoming increasingly understood.

A project at the University at Buffalo (UB) has now examined the effects of photobiomodulation (PBM) therapy specifically on burn wounds.

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white paper

Accelerated burn wound healing with photobiomodulation therapy involves activation of endogenous latent TGF-β1

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Abstract

The severity of tissue injury in burn wounds from associated inflammatory and immune sequelae presents a significant clinical management challenge. Among various biophysical wound management approaches, low dose biophotonics treatments, termed Photobiomodulation (PBM) therapy, has gained recent attention. One of the PBM molecular mechanisms of PBM treatments involves photoactivation of latent TGF-β1 that is capable of promoting tissue healing and regeneration. This work examined the efficacy of PBM treatments in a full-thickness burn wound healing in C57BL/6 mice. We first optimized the PBM protocol by monitoring tissue surface temperature and histology. We noted this dynamic irradiance surface temperature-monitored PBM protocol improved burn wound healing in mice with elevated TGF-β signaling (phospho-Smad2) and reduced inflammation-associated gene expression. Next, we investigated the roles of individual cell types involved in burn wound healing following PBM treatments and noted discrete effects on epithelieum, fibroblasts, and macrophage functions. These responses appear to be mediated via both TGF-β dependent and independent signaling pathways. Finally, to investigate specific contributions of TGF-β1 signaling in these PBM-burn wound healing, we utilized a chimeric TGF-β1/β3 knock-in (TGF-β1Lβ3/Lβ3) mice. PBM treatments failed to activate the chimeric TGF-β1Lβ3/Lβ3 complex and failed to improve burn wound healing in these mice. These results suggest activation of endogenous latent TGF-β1 following PBM treatments plays a key role in burn wound healing. These mechanistic insights can improve the safety and efficacy of clinical translation of PBM treatments for tissue healing and regeneration.

Scientific Reports | June 28, 2021

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Treatment of diabetic foot ulcers in a frail population with severe co-morbidities using at-home photobiomodulation laser therapy: a double-blind, randomized, sham-controlled pilot clinical study

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Photobiomodulation at home, in addition to standard care, may be effective for the treatment of severe DFUs in frail patients with co-morbidities and is particularly relevant at these times of social distancing. Our preliminary results justify the conduction of a larger clinical trial. ClinicalTrials.gov: NCT01493895.

—Springer Link

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Photobiomodulation Therapy for Wound Care: A Potent, Noninvasive, Photoceutical Approach

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Abstract

GENERAL PURPOSE:

To provide background and examine evidence for the therapeutic application of light energy treatments for wound healing.

TARGET AUDIENCE:

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be better able to:

1. Explain the basics of lasers, light-emitting diodes, and light-tissue interactions as they apply to photobiomodulation therapy.

2. Summarize the results of the authors’ literature review of the evidence regarding the therapeutic applications of photobiomodulation treatments for wound healing.

OBJECTIVE:

To provide background and examine evidence for the therapeutic applications of light energy treatments for wound healing.

METHODS:

A search was performed in PubMed for peer-reviewed scientific articles published in the last 5 years using the search terms “photobiomodulation therapy” and “low-level laser therapy,” and these terms combined with “wound,” using a “human species” filter. This search yielded 218 articles on photobiomodulation therapy or low-level laser therapy and wounds. Of these, only articles on in vivo wound care using light treatments were specifically included in this review (n = 11).

RESULTS:

The wound healing effects of low-dose laser treatments were first described over 50 years ago. Various doses ranging from 0.1 to 10 J/cm2 and wavelengths ranging from 405 to 1,000 nm appear to provide therapeutic benefits for a broad range of chronic wounds. A range of light energy sources from LEDs to lasers have been used and have specific advantages and limitations. There is a lack of consensus on standardized treatment parameters such as wavelengths, dose, and therapeutic outcomes in the reviewed studies, preventing direct comparison and clinical protocol recommendation. An expert opinion based on ongoing research studies and reported literature is offered.

CONCLUSIONS:

Noninvasive, economical, and multipurpose light devices are an attractive tool for wound management. However, there is an urgent need in the wound care community to develop optimal clinical protocols for use based on well-designed, rigorous clinical research studies.

—Advances in Skin and Wound Care

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