Department of Professional Practice, Scarborough Health Network, Adjunct Lecturer Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
The Institute for Research in Military Medicine (IRMM) and The Institute for Medical Research - Israel-Canada (IMRIC), Faculty of Medicine of The Hebrew University of Jerusalem, Jerusalem, Israel.
Can J Diabetes. 2020 Jul;44(5):375-378. doi: 10.1016/j.jcjd.2020.01.010. Epub 2020 Feb 4.
Diabetic foot ulcers (DFUs) incidence is increasing with the rising global prevalence of diabetes. In spite of following best practice standard of care, most DFUs are slow to heal. Photobiomodulation (PBM), previously known as low-level laser therapy, has been shown to accelerate healing of acute or chronic wounds, and specifically DFUs. However, the frequent applications required translates to frequent visits at the clinic, which are difficult for patients with DFU. In the following case series, we present our preliminary experience with a recently approved (Health Canada) consumer home-use PBM device as an adjuvant to standard treatment. Four men presented at the clinic (67 to 84 years of age) with DFUs/diabetic leg ulcers. The PBM treatment (808 nm, 250-mW peak power, 15 KHz, 5 J/min, ray size 4.5×1.0 cm) was applied by the patients themselves at the clinic or at home. In the cases presented, all wounds closed within 1 to 3 weeks with no reported adverse events. Patients found the routine easy to follow and painless. In wounds that involved pain, patients reported pain reduction after 1 to 3 treatments. Based on our previous experience with these patients, self-applied PBM as an adjunct therapy led to accelerated healing and rapid pain alleviation compared with standard care alone. In summary, hard-to-heal diabetic wounds are a burden for patients, a burden for caregivers and costly for the health-care system. These observations support the view that the home-use device can be easily integrated as an adjuvant treatment to standard care at the clinic or home and, most importantly, encourage patient involvement in his or her own care.
糖尿病足溃疡(DFUs)的发病率随着全球糖尿病患病率的上升而不断增加。尽管遵循了最佳的护理标准,但大多数 DFUs 的愈合速度仍然很慢。光生物调节(PBM),以前称为低水平激光治疗,已被证明可以加速急性或慢性伤口的愈合,特别是 DFUs 的愈合。然而,频繁的应用意味着需要频繁到诊所就诊,这对于 DFU 患者来说很困难。在以下病例系列中,我们介绍了我们使用最近获得加拿大卫生部批准的消费者家庭用 PBM 设备作为标准治疗辅助手段的初步经验。四名男性因 DFU/糖尿病腿部溃疡到诊所就诊(年龄 67 至 84 岁)。PBM 治疗(808nm,250mW 峰值功率,15kHz,5J/min,射线尺寸 4.5×1.0cm)由患者在诊所或家中自行进行。在所介绍的病例中,所有伤口在 1 至 3 周内闭合,无不良反应报告。患者发现常规治疗易于遵循且无痛。在涉及疼痛的伤口中,患者报告在 1 至 3 次治疗后疼痛减轻。基于我们对这些患者的以往经验,与单独使用标准护理相比,自我应用 PBM 作为辅助治疗可加速愈合并迅速缓解疼痛。总之,难以愈合的糖尿病伤口给患者、护理人员带来了负担,也给医疗保健系统带来了负担。这些观察结果支持这样一种观点,即家庭使用的设备可以很容易地作为诊所或家庭标准护理的辅助治疗手段进行整合,最重要的是,鼓励患者参与自己的护理。