Department of Dermatology, University Medical Center Freiburg, Hauptstrasse 7, D-79104 Freiburg, Germany.
Br J Dermatol. 2011 Sep;165(3):541-51. doi: 10.1111/j.1365-2133.2011.10410.x. Epub 2011 Aug 4.
Water-filtered infrared A (wIRA) radiation can improve the healing of acute and chronic wounds both by thermal and thermic as well as by nonthermal and nonthermic effects. wIRA increases tissue temperature, oxygen partial pressure and perfusion.
Investigation of the influence of wIRA on chronic venous stasis ulcers in an investigator-initiated, randomized, controlled, blinded study.
Fifty-one patients with nonhealing chronic venous stasis ulcers of the lower legs were treated with compression therapy, wound cleansing, nonadhesive wound dressings and 30 min irradiation [wIRA + visible light (VIS) or VIS alone], predominantly at home, five times per week over 9 weeks and an additional 4 weeks without irradiation.
Compared with the control group with VIS alone, the group with wIRA + VIS showed better wound healing [after 9 weeks 85 vs. 67·5 on a 0-100 visual analogue scale (VAS), median difference 15, 95% confidence interval (CI) 3-30, P = 0·012], a higher percentage of patients with a healing trend [after 9 weeks 21 of 25 (84%) vs. 13 of 26 (50%), P = 0·023], better granulation (after 9 weeks 90 vs. 80 on a 0-100 VAS, median difference 10, 95% CI 0-30, P = 0·036), a trend to less exudation (after 5 weeks 30 vs. 55 on a 0-100 VAS, P = 0·075) and to faster reduction of the wound area (after 7 weeks 39% vs. 19·5% reduction of wound area, median difference 20·5%, 95% CI -4-49%, P = 0·10; for wounds with an initial area < 10 cm(2): after 13 weeks 92% vs. 47% reduction of wound area, median difference 30%, 95% CI 0-68%, P = 0·11). The main variable 'Integral of relative ulcer area for each individual patient over time, standardized to an initial size of 1' did not reach significance. The application of wIRA at home was easily manageable.
For the treatment of chronic venous stasis ulcers, the application of wIRA combined with phlebological therapy, compression therapy and wound dressing can be useful and can be recommended.
水过滤红外线（wIRA）辐射可以通过热和热效应以及非热和非热效应来改善急性和慢性伤口的愈合。wIRA 会增加组织温度、氧气分压和灌注。
在一项由研究者发起的、随机的、对照的、盲法研究中，调查 wIRA 对慢性静脉淤滞性溃疡的影响。
51 例下肢非愈合性慢性静脉淤滞性溃疡患者接受压迫治疗、伤口清洁、非粘性伤口敷料和 30 分钟照射[wIRA+可见光（VIS）或仅 VIS]，主要在家中，每周 5 次，共 9 周，然后再进行 4 周无照射。
与仅接受 VIS 的对照组相比，wIRA+VIS 组的伤口愈合更好[9 周后，0-100 视觉模拟量表（VAS）评分为 85 比 67.5，中位数差值为 15，95%置信区间（CI）为 3-30，P=0.012]，有愈合趋势的患者比例更高[9 周后，25 例中有 21 例（84%）比 26 例中有 13 例（50%），P=0.023]，肉芽组织生长更好[9 周后，0-100 VAS 评分为 90 比 80，中位数差值为 10，95%CI 为 0-30，P=0.036]，渗出物减少趋势更明显[5 周后，0-100 VAS 评分为 30 比 55，P=0.075]，伤口面积缩小更快[7 周后，伤口面积缩小 39%比 19.5%，中位数差值为 20.5%，95%CI 为-4-49%，P=0.10；对于初始面积<10cm²的伤口：13 周后，伤口面积缩小 92%比 47%，中位数差值为 30%，95%CI 为 0-68%，P=0.11]。主要变量“每位患者的相对溃疡面积积分随时间的变化，标准化到初始大小为 1”没有达到显著性。在家中应用 wIRA 很容易管理。
对于慢性静脉淤滞性溃疡的治疗，应用 wIRA 联合静脉疾病治疗、压迫治疗和伤口敷料可能是有用的，并可以推荐。
