Frangež Igor, Nizič-Kos Tea, Frangež Helena Ban
1 Department of Surgical Infections, University Medical Center Ljubljana , Ljubljana, Slovenia .
2 Division of Surgery, Institute of Oncology Ljubljana , Ljubljana, Slovenia .
Photomed Laser Surg. 2018 Jul;36(7):377-382. doi: 10.1089/pho.2017.4382. Epub 2018 Apr 18.
The study examined the influence of phototherapy with light-emitting diodes (LEDs) on chronic diabetic wound healing.
Chronic diabetic wounds are very difficult to treat due to underlying conditions such as angiopathy and neuropathy, resulting in slow healing rates. Conventional treatment options are often insufficient and do not provide satisfactory outcomes. Phototherapy with LED enhances the healing processes through mechanisms of energy exchange between incoming photons and their target, the main one being cytochrome-c oxidase in mitochondria.
A double-blind, randomized study included 60 patients with a chronic diabetic wound treated at the University Medical Center Ljubljana between October 1, 2012 and December 1, 2014. Patients were randomized into either an active group (LED group) or a control group (Co-group). The active group was treated with LED 2.4 J/cm (wavelengths 625, 660, 850 nm) three times a week for 8 weeks. The Co-group was treated with light that simulated LED. Healing was evaluated using the Falanga wound bed score and wound surface area.
The average baseline wound surface before treatment was 1315 mm in the LED group and 1584 mm in the Co-group (p = 0.80). After 8 weeks, the mean surface in the LED group was 56% of the baseline surface and 65% in the Co-group (p > 0.05). Falanga score evaluation showed significantly faster wound bed healing in the LED group compared with the Co-group (p < 0.05).
According to our results, LED significantly improves healing of chronic diabetic wounds and prepares the wound bed for further coverage options.
本研究探讨发光二极管(LED)光疗对慢性糖尿病伤口愈合的影响。
由于存在诸如血管病变和神经病变等潜在状况,慢性糖尿病伤口极难治疗,导致愈合速度缓慢。传统治疗方法往往不足,无法提供令人满意的结果。LED光疗通过入射光子与其靶标(主要是线粒体中的细胞色素c氧化酶)之间的能量交换机制来促进愈合过程。
一项双盲随机研究纳入了2012年10月1日至2014年12月1日在卢布尔雅那大学医学中心接受治疗的60例慢性糖尿病伤口患者。患者被随机分为活性组(LED组)或对照组(Co组)。活性组每周接受3次波长为625、660、850nm的2.4J/cm的LED治疗,持续8周。Co组接受模拟LED的光治疗。使用法伦加伤口床评分和伤口表面积评估愈合情况。
治疗前,LED组的平均基线伤口表面积为1315mm,Co组为1584mm(p = 0.80)。8周后,LED组的平均表面积为基线表面积的56%,Co组为65%(p > 0.05)。法伦加评分评估显示,与Co组相比,LED组的伤口床愈合明显更快(p < 0.05)。
根据我们的结果,LED显著改善慢性糖尿病伤口的愈合,并为伤口床的进一步覆盖选择做好准备。