Hoffmann Gerd
Johann Wolfgang Goethe University Frankfurt/Main, Institute of Sports Sciences, Frankfurt/Main, Germany.
GMS Krankenhhyg Interdiszip. 2009 Dec 16;4(2):Doc12. doi: 10.3205/dgkh000137.
Water-filtered infrared-A (wIRA), as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA increases tissue temperature (+2.7 degrees C at a tissue depth of 2 cm), tissue oxygen partial pressure (+32% at a tissue depth of 2 cm) and tissue perfusion. These three factors are decisive for a sufficient supply of tissue with energy and oxygen and consequently also for wound healing and infection defense. wIRA can considerably alleviate pain (without any exception during 230 irradiations) with substantially less need for analgesics (52-69% less in the groups with wIRA compared to the control groups). It also diminishes exudation and inflammation and can show positive immunomodulatory effects. The overall evaluation of the effect of irradiation as well as the wound healing and the cosmetic result (assessed on visual analogue scales) were markedly better in the group with wIRA compared to the control group. wIRA can advance wound healing (median reduction of wound size of 90% in severely burned children already after 9 days in the group with wIRA compared to 13 days in the control group; on average 18 versus 42 days until complete wound closure in chronic venous stasis ulcers) or improve an impaired wound healing (reaching wound closure and normalization of the thermographic image in otherwise recalcitrant chronic venous stasis ulcers) both in acute and in chronic wounds including infected wounds. After major abdominal surgery there was a trend in favor of the wIRA group to a lower rate of total wound infections (7% versus 15%) including late infections following discharge from hospital (0% versus 8%) and a trend towards a shorter postoperative hospital stay (9 versus 11 days). Even the normal wound healing process can be improved. The mentioned effects have been proven in six prospective studies, with most of the effects having an evidence level of Ia/Ib.wIRA represents a valuable therapy option and can generally be recommended for use in the treatment of acute as well as of chronic wounds.
水过滤红外A（wIRA）作为一种特殊形式的热辐射，具有高组织穿透性和低皮肤表面热负荷，可通过热效应和非热效应促进急慢性伤口的愈合。wIRA可提高组织温度（在组织深度2厘米处升高2.7摄氏度）、组织氧分压（在组织深度2厘米处升高32%）和组织灌注。这三个因素对于组织获得充足的能量和氧气供应至关重要，因此对伤口愈合和抗感染也很关键。wIRA可显著减轻疼痛（在230次照射中无一例外），且镇痛药需求大幅减少（与对照组相比，wIRA组减少52 - 69%）。它还能减少渗出和炎症，并可显示出积极的免疫调节作用。与对照组相比，wIRA组在照射效果、伤口愈合及美容效果（通过视觉模拟量表评估）的总体评价上明显更好。wIRA可促进伤口愈合（wIRA组严重烧伤儿童伤口大小在9天后中位减少90%，而对照组为13天；慢性静脉淤滞性溃疡完全愈合平均时间为18天，而对照组为42天），或改善受损的伤口愈合（在原本难治的慢性静脉淤滞性溃疡中实现伤口闭合和热成像图像正常化），无论是急性伤口还是慢性伤口，包括感染伤口。腹部大手术后，wIRA组有降低总伤口感染率的趋势（7%对15%），包括出院后的晚期感染（0%对8%），且有缩短术后住院时间的趋势（9天对ll天）。甚至正常的伤口愈合过程也可得到改善。上述效果已在六项前瞻性研究中得到证实，大多数效果的证据级别为Ia/Ib。wIRA是一种有价值的治疗选择，总体上可推荐用于急性和慢性伤口的治疗。
