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Journal of Nursing ›› 2019, Vol. 26 ›› Issue (22): 27-32.doi: 10.16460/j.issn1008-9969.2019.22.027

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Efficacy and Safety of Low-level Laser Therapy for Chronic Wounds: A Meta-analysis

DENG Bo1, LI Fei1, WU Xiu-li2, LI Xian-rong2   

  1. 1. School of Nursing, Southwest Medical University, Luzhou 646000, China;
    2. Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
  • Received:2019-07-22 Published:2020-07-27

Abstract: Objective To evaluate the efficacy and safety of low-level laser therapy for chronic wounds. Methods Randomized controlled trials (RCTs) of low-level laser therapy for chronic wounds were collected from PubMed, Medline, EMbase, Cochrane Library, Web of Science, BMJ Best Practice, CBM, China Knowledge Network, Wanfang data and VIP data by computer from the inception to December of 2018. The quality of the included studies was evaluated using Cochrane Review Handbook 5.1.0 and performed using RevMan 5.3 software. Results Sixteen RCTs and 509 patients were included in the study. Meta-analysis showed that the area of non-healing wounds in the low-level laser group [MD=-0.63, 95%CI (-0.97, -0.29), P<0.01], mean reduction in wound area [MD=22.17, 95%CI(19.34, 25.00), P<0.01 ], the number of wounds cured [OR=2.04, 95%CI (1.33, 3.12), P=0.01] and the value of wound pain [MD=-4.34, 95%CI (-4.92, -3.75), P<0.01] in the observation group were significantly different from those of the control group, but the incidence of adverse events [OR=0.66,95%CI(0.24, 1.81), P=0.42] was not statistically significant. Conclusion Low-level laser can accelerate wound healing, effectively alleviate pain during wound treatment, and it is safe. Subject to the limitations of the number and quality of studies included, the above conclusions are yet to be verified by more high-quality studies.

Key words: low-level laser, varicose ulcer, diabetic foot, pressure ulcer, Meta-analysis

CLC Number: 

  • R473.5
[1] 中华医学会创伤学分会组织修复专业委员会.慢性伤口诊疗指导意见[M].北京:人民卫生出版社,2011.
[2] De Moraes J M, Eterno D O, Moura V B, et al. Anti-inflammatory Effect of Low-intensity Laser on the Healing of Third-degree Burn Wounds in Rats[J].Lasers Med Sci, 2013,28(4):1169-1176. DOI:10.1007/s10103-012-1213-1.
[3] Machado R S, Viana S, Sbruzzi G.Low-Level Laser Therapy in the Treatment of Pressure Ulcers: Systematic Review[J]. Lasers Med Sci,2017, 32(4):937-944.DOI:10.1007/s10103-017-2150-9.
[4] Schubert V.Effects of Phototherapy on Pressure Ulcer Healing in Elderly Patients after a Falling Trauma. A Prospective, Randomized, Controlled Study[J]. Photodermatol Photoimmunol Photomed,2001,17(1):32-38.DOI:10.1034/j.1600-0781.2001.017001032.
[5] Lagan K M, McKenna T A, Witherow, et al. Low-Intensity Laser Therapy/Combined Phototherapy in the Management of Chronic Venous Ulceration: A Placebo-controlled Study[J]. J Clin Laser Med Surg, 2002, 20(3):109-116. DOI:10.1089/104454702760090173.
[6] Lucas C, Van M J, Gemert R J.Efficacy of Low-level Laser Therapy in the Management of Stage III Decubitus Ulcers: A Prospective, Observer-blinded Multicentre Randomised Clinical Trial[J]. Lasers Med Sci,2003, 18(2):72-77. DOI:10.1007/s10103-003-0259-5.
[7] Kopera D, Kokol R, Berger C, et al.Does the Use of Low-level Laser Influence Wound Healing in Chronic Venous Leg Ulcers?[J]. J Wound Care,2005,14(8):391-394. DOI: 10.12968/jowc.2005.14.8.26825.
[8] Caetano K S, Frade M A, Minatel D G, et al.Phototherapy Improves Healing of Chronic Venous Ulcers[J]. Photomed Laser Surg,2009,27(1):111-118.DOI:10.1089/pho.2008.2398.
[9] Barreto J G, Salgado C G.Clinic-Epidemiological Evaluation of Ulcers in Patients with Leprosy Sequelae and the Effect of Low-level Laser Therapy on Wound Healing: A Randomized Clinical Trial[J]. BMC Infect Dis,2010,10(1):237. DOI:10.1186/1471-2334-10-237.DOI10.1186/1471-2334-10-237.
[10] Leclère F M, Puechguiral I R, Rotteleur G, et al.A Prospective Randomized Study of 980 Nm Diode Laser-assisted Venous Ulcer Healing on 34 Patients[J]. Wound Repair Regen,2010, 18(6):580-585.DOI:10.1111/j.1524-475X.2010.00637.
[11] Kaviani A, Djavid G E, Ataie F L, et al.A Randomized Clinical Trial on the Effect of Low-level Laser Therapy on Chronic Diabetic Foot Wound Healing: A Preliminary Report[J]. Photomed Laser Surg,2011,29(2):109-114. DOI: 10.1089/pho.2009.2680.
[12] Erchonia Corporation. Efficacy Study of the Application of Low-level Laser Light to Treat Venous Stasis Ulcers[EB/OL].(2011-06-20)[2019-05-22].http://clinicaltrials.gov/ct2/show/nct01376050.
[13] Sandoval O, Herrera V E, Camargo L, et al.Effects of Low-level Laser Therapy and High Voltage Stimulation on Diabetic Wound Healing[J]. Revista Salud UIS, 2014,46(2):107-117.
[14] Feitosa M, Carvalho A, Feitosa V C, et al.Effects of The Low-Level Laser Therapy (LLLT) in the Process of Healing Diabetic Foot Ulcers[J]. Acta Cirurgica Brasileira,2015,30(12):852-857. DOI:10.1590/S0102-865020150120000010.
[15] Carvalho A F, Feitosa M C, Coelho N P, et al.Low-level Laser Therapy and Calendula Officinalis in Repairing Diabetic Foot Ulcers[J]. Rev Esc Enferm USP, 2016, 50(4):628-634. DOI:10.1590/S0080-623420160000500013.
[16] Mathur R K, Sahu K, Saraf S, et al.Low-level Laser Therapy as an Adjunct to Conventional Therapy in the Treatment of Diabetic Foot Ulcers[J]. Lasers Med Sci,2017,32(2):275-282. DOI:10.1007/s10103-016-2109-2.
[17] Vitse J, Bekara F, Byun S, et al.A Double-blind, Placebo-controlled Randomized Evaluation of the Effect of Low-Level Laser Therapy on Venous Leg Ulcers[J]. Int J Low Extrem Wounds, 2017,16(1):29-35.DOI:10.1177/1534734617690948.
[18] De Alencar Fonseca Santos J, Campelo M B, de Oliveira R A, et al. Effects of Low-power Light Therapy on the Tissue Repair Process of Chronic Wounds in Diabetic Feet[J]. Photomed Laser Surg,2018,36(6):298-304.DOI:10.1089/pho.2018.4455.
[19] Tantawy S A, Abdelbasset W K, Kamel D, et al.A Randomized Controlled Trial Comparing Helium-neon Laser Therapy and Infrared Laser Therapy in Patients with Diabetic Foot Ulcer[J]. Lasers Med Sci, 2018,33(9):1901-1906. DOI:10.1007/s10103-018-2553-2.
[20] 赵敏,冯金法,杨娜娜,等.氦氖激光联合阿托伐他汀钙治疗糖尿病足的疗效观察[J].影像研究与医学应用, 2017,1(11):173-174. DOI:10.3969/j.issn.2096-3807.2017.11.114.
[21] 夏飞飞,王利君,王军辉.半导体激光照射治疗下肢静脉性溃疡临床观察及护理[J].中国激光医学杂志,2016,25(1):47-49. DOI:10.13480/jissn1003-9430.2016.0047.
[22] Houreld N N, Ayuk S M, Abrahamse H.Expression of Genes in Normal Fibroblast Cells (WS1) in Response to Irradiation at 660nm[J]. J Photochem Photobiol B,2014,130:146-152. DOI:10.1016/j.jphotobiol.2013.11.018.
[23] Steven L, Percival, Katja E.A Review of the Scientific Evidence for Biofilms in Wounds[J].Wound Repair Regen.2012.20.647-657. DOI:10.1111/j.1524-475X.2012.00836.
[24] 李彦红,张继刚,徐艳峰,等.发光二极管630 nm红光和460 nm蓝光照射对日本大耳白兔皮肤创面愈合的影响[J].中国医学科学院学报, 2017,39(3):301-306. DOI:10.3881/j.issn.1000-503X.2017.03.001.
[25] 毛和水,姚敏,俞为荣,等.630~650 nm光照射对糖尿病小鼠创面愈合的影响[J].上海交通大学学报, 2013,33(9):1209-1214.
[26] Wu X, Alberico S, Saidu E, et al.Organic Light Emitting Diode Improves Diabetic Cutaneous Wound Healing in Rats[J]. Wound Repair Regen, 2015,23(1):104-114. DOI:10.1111/wrr.12258.
[27] Myakishev R, Stadler M I, Brondon P, et al.A Preliminary Study of the Safety of Red Light Phototherapy of Tissues Harboring Cancer[J].Photomed Laser Surg,2012,30(9):551-558. DOI:10.1089/pho.2011.3186.
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