Nussbaum Ethne L, Lilge Lothar, Mazzulli Tony
Rehabilitation Services, Mount Sinai Hospital and Department of Physical Therapy, University of Toronto, Toronto, Ontario M5G 1X5, Canada.
Lasers Surg Med. 2002;31(5):343-51. doi: 10.1002/lsm.10121.
Low intensity laser therapy may modify growth of wound bacteria, which could affect wound healing. This study compares the effects on bacteria of 810 nm laser using various delivery modes (continuous wave or frequency modulated light at 26, 292, 1000, or 3800 Hz).
STUDY DESIGN/MATERIALS AND METHODS: Staphylococcus (S.) aureus, Escherichia (E.) coli, and Pseudomonas (P.) aeruginosa were plated on agar and then irradiated (0.015 W/cm(2); 1-50 J/cm(2)) or used as controls (sham irradiated); growth was examined after 20 hours of incubation post exposure.
There were interactions of species and modulation frequency in the overall effects of irradiation (P = 0.0001), and in the radiant exposure mediated effects (P = 0.0001); thus individual frequencies and each bacterium were analysed separately. Bacteria increased following 3800 Hz (P = 0.0001) and 1000 Hz (P = 0.0001) pulsed irradiation; at particular radiant exposures P. aeruginosa proliferated significantly more than other bacteria. Pulsed laser at 292 and 26 Hz also produced species-dependent effects (P = 0.0001; P = 0.0005); however, the effects for different radiant exposures were not significant. Bacterial growth increased overall, independent of species, using continuous mode laser, significantly so at 1 J/cm(2) (P = 0.02). Analysis of individual species demonstrated that laser-mediated growth of S. aureus and E. coli was dependent on pulse frequency; for S. aureus, however, there was no effect for different radiant exposures. Further tests to examine the radiant exposure effects on E. coli showed that growth increased at a frequency of 1000 Hz (2 J/cm(2); P = 0.03). P. aeruginosa growth increased up to 192% using pulsed irradiation at 1000-3800 Hz; whereas 26-292 Hz laser produced only a growth trend.
The findings of this study point to the need for wound cultures prior to laser irradiation of infected wounds. Similar investigations using other common therapeutic wavelengths are recommended.
低强度激光疗法可能改变伤口细菌的生长,这可能会影响伤口愈合。本研究比较了810纳米激光在不同传输模式(连续波或26、292、1000或3800赫兹的调频光)下对细菌的影响。
研究设计/材料与方法:将金黄色葡萄球菌、大肠杆菌和铜绿假单胞菌接种在琼脂平板上,然后进行照射(0.015瓦/平方厘米;1 - 50焦/平方厘米)或作为对照(假照射);照射后培养20小时后检查细菌生长情况。
在照射的总体效应(P = 0.0001)和辐射暴露介导的效应(P = 0.0001)中存在菌种与调制频率的相互作用;因此对各个频率和每种细菌分别进行分析。在3800赫兹(P = 0.0001)和1000赫兹(P = 0.0001)脉冲照射后细菌数量增加;在特定辐射暴露下,铜绿假单胞菌的增殖明显高于其他细菌。292赫兹和26赫兹的脉冲激光也产生了菌种依赖性效应(P = 0.0001;P = 0.0005);然而,不同辐射暴露下的效应不显著。使用连续模式激光时,细菌生长总体上增加,与菌种无关,在1焦/平方厘米时显著增加(P = 0.02)。对单个菌种的分析表明,激光介导的金黄色葡萄球菌和大肠杆菌的生长取决于脉冲频率;然而,对于金黄色葡萄球菌,不同辐射暴露下没有影响。进一步检查辐射暴露对大肠杆菌影响的试验表明,在1000赫兹频率(2焦/平方厘米;P = 0.03)下生长增加。使用1000 - 3800赫兹的脉冲照射时,铜绿假单胞菌的生长增加高达192%;而26 - 292赫兹的激光仅产生生长趋势。
本研究结果表明,在对感染伤口进行激光照射之前需要进行伤口培养。建议使用其他常见治疗波长进行类似研究。