Deana Naira Figueiredo, Zaror Carlos, Del Sol Mariano, Bagnato Vanderlei Salvador, Alves Nilton
Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile; Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile; Doctoral Program in Morphological Sciences, Universidad de La Frontera, Temuco, Chile.
Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile; Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile; Faculty of Dentistry, Universidad San Sebastian, Puerto Montt, Chile.
Burns. 2023 Mar;49(2):261-274. doi: 10.1016/j.burns.2022.05.009. Epub 2022 May 13.
Laser photobiomodulation (laser PBM) is an effective means of accelerating burn wound contraction, however it is still unclear whether laser PBM produces greater benefit when applied directly to excised and unexcised burn wounds . The aim of this systematic review of preclinical studies was to determine the effectiveness of laser PBM in the wound contraction rate in excised and unexcised burn wounds.
A systematic search was conducted in the EMBASE, MEDLINE and LILACS databases. Preclinical studies were included that analysed the effectiveness of laser PBM in burn wound contraction, and assessed wound closure. The SYRCLE risk of bias tool was used. Random effects models were used to estimate the pooled effect.
Thirteen studies were included in the qualitative analysis and six in the quantitative analysis. Two weeks after the lesion, laser PBM favoured the wound contraction percentage, increasing the closure rate in excised burn wounds (SMD= 1.34, CI 95% 0.41 to 2.27, 0.41-2.27, I=0%, =0%, low certainty of evidence. In unexcised burns, it was uncertain whether laser PBM increased or diminished the wound contraction rate (SMD=1.22(SMD=1.22 CI 95% -0.05 to 2.49, I=68%; =68%; very low certainty of evidence).
In the animal model, laser PBM is effective in increasing the wound contraction rate in excised burns. However, due to the low certainty of the evidence, uncertainty remains about the true magnitude of the effect of laser on wound contraction in animals; our results should therefore be interpreted with caution.
激光光生物调节作用(激光PBM)是加速烧伤创面收缩的一种有效手段,然而,直接应用于切除和未切除的烧伤创面时,激光PBM是否能产生更大益处仍不明确。本系统综述临床前研究的目的是确定激光PBM对切除和未切除烧伤创面收缩率的有效性。
在EMBASE、MEDLINE和LILACS数据库中进行了系统检索。纳入分析激光PBM对烧伤创面收缩有效性并评估伤口闭合情况的临床前研究。使用SYRCLE偏倚风险工具。采用随机效应模型估计合并效应。
定性分析纳入13项研究,定量分析纳入6项研究。损伤后两周,激光PBM有利于提高创面收缩百分比,增加切除烧伤创面的闭合率(标准化均数差=1.34,95%置信区间0.41至2.27,I²=0%,τ²=0%,证据确定性低)。在未切除的烧伤中,不确定激光PBM是增加还是降低了创面收缩率(标准化均数差=1.22,95%置信区间-0.05至2.49;I²=68%;τ²=68%;证据确定性极低)。
在动物模型中,激光PBM可有效提高切除烧伤的创面收缩率。然而,由于证据确定性低,激光对动物创面收缩影响的真实程度仍存在不确定性;因此,对我们的结果应谨慎解读。