光生物调节与糖尿病足和小腿溃疡的愈合：叙事综合。

Photobiomodulation and diabetic foot and lower leg ulcer healing: A narrative synthesis.

机构信息

Faculty of Health Sciences, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada.

Department of Physical Therapy, MClSc Program in Wound Healing, Western University, Elborn College, Room 1588, London, ON, N6G 1H1, Canada; Department of Physical Therapy, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada; KITE, Toronto Rehab Institute, University Health Network, 550 University Ave, Toronto, ON, M5G 2A2, Canada.

出版信息

Foot (Edinb). 2021 Sep;48:101847. doi: 10.1016/j.foot.2021.101847. Epub 2021 Jul 9.

DOI:10.1016/j.foot.2021.101847

PMID:34390946

Abstract

PURPOSE

To provide a comprehensive narrative review and critical appraisal of research investigating photobiomodulation (PBM), formerly known as low level laser therapy which includes lasers and light emitting diodes (LEDs), as a treatment to promote diabetic foot and lower leg ulcer (DFU) healing for humans.

MATERIALS AND METHODS

Pubmed, CINAHL, Scopus, and OVID Medline databases were used to find relevant studies published between January 2000 and January 2020. Reference lists of identified articles were scanned for additional studies that might have been missed in the database searches.

RESULTS

A total of 13 studies, with a total of 417 participants, were included in this review.

DISCUSSION

The studies were critically appraised using the PEDro scale, which revealed weaknesses in study designs such as small sample sizes and problems with reproducibility with respect to the laser protocols. Characteristics of PBM that improved wound healing were wavelengths of 630 nm-660 nm and infrared wavelengths of 850 or 890 nm, and radiant exposure levels of 3 J/cm-7 J/cm. PBM was beneficial for superficial and deep DFUs. Controlled blood glucose levels and adherence to best practices (pressure off-loading, optimized wound dressing changes, appropriate debridement, etc.) could have been a factor in the beneficial outcomes.

CONCLUSION

Regardless of the laser characteristics chosen, in the majority of studies PBM as a treatment for DFUs improved healing rate when compared with standard wound care alone. However, weaknesses across the studies indicate that further research is required.

摘要

目的

对研究光生物调节（PBM）的文献进行全面叙述性综述和批判性评价，PBM 以前称为低水平激光疗法，包括激光和发光二极管（LED），作为一种治疗方法，以促进人类糖尿病足和小腿溃疡（DFU）的愈合。

材料和方法

使用 Pubmed、CINAHL、Scopus 和 OVID Medline 数据库，查找 2000 年 1 月至 2020 年 1 月期间发表的相关研究。扫描确定文章的参考文献列表，以查找可能在数据库搜索中遗漏的其他研究。

结果

本综述共纳入了 13 项研究，共有 417 名参与者。

讨论

使用 PEDro 量表对研究进行了批判性评价，该量表揭示了研究设计中的弱点，例如样本量小以及激光方案的可重复性问题。改善伤口愈合的 PBM 特征是 630nm-660nm 的波长和 850 或 890nm 的红外波长，以及 3J/cm-7J/cm 的辐射暴露水平。PBM 对浅表和深部 DFU 均有益。控制血糖水平和遵守最佳实践（减压、优化伤口敷料更换、适当清创等）可能是有益结果的一个因素。