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Low-level laser therapy in the treatment of pressure ulcers: systematic review

Lasers in Medical Science volume 32, pages 937–944 (2017)Cite this article

Abstract

The aim of this study was to evaluate the effects of low-level laser therapy (LLT) in pressure ulcers (PU) in humans through a systematic review of randomized studies. The search includes the databases MEDLINE, PEDro, Cochrane CENTRAL, and Lilacs, as well a manual search until May, 2016. This included randomized clinical trials of LLT compared with other interventions, different types of LLT, LLT placebo, or control in the treatment of PU. The outcomes evaluated were the ulcer area, healing rate, and overall healing rate. The risk of bias was evaluated using the tool of the Cochrane Collaboration, and the results were analyzed descriptively. From the 386 articles identified, only four studies were included, with two LLT used with single wavelength (1: 904 nm vs. control and 2: 940 nm vs. 808 nm vs. 658 nm vs. placebo) and two LLT used to probe cluster. One study compared to different single wavelengths showed a significant 71% reduction of the PU and an improved healing rate in which 47% of PU healed completely after 1 month of therapy with the use of LLT with a wavelength of 658 nm compared with other lengths. The other analyzed wavelengths were not significant in the assessed outcomes. Significant results were observed in the use of LLT with a 658 nm wavelength, and no evidence was found for use of wavelengths above that for the treatment of PU. Therefore, we also found no evidence in the laser used to probe the cluster.

Registration number: CRD42016036648.

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References

  1. Costa MP, Sturtz G, Costa FPP, Ferreira MC, Barros Filho TEP (2005) Epidemiologia e tratamento das úlceras de pressão: experiência de 77 casos. Acta Ortop Bras 13:124–133

    Article  Google Scholar 

  2. Blanes L, Duarte IS, Calil JA, Ferreira LM (2004) Avaliação clínica e epidemiológica das úlceras por pressão em pacientes internados no Hospital São Paulo. Rev Assoc Med Bras 50(2):182–187

    Article  PubMed  Google Scholar 

  3. Lima ACB, Guerra DM (2011) Avaliação do custo do tratamento de úlceras por pressão em pacientes hospitalizados usando curativos industrializados. Cien Saude Colet 16:267–277

    Article  PubMed  Google Scholar 

  4. Schue RM, Langemo DK (1998) Pressure ulcer prevalence and incidence and a modification of the Braden Scale for a rehabilitation unit. J Wound Ostomy Continence Nurs 25(1):36–43

    CAS  PubMed  Google Scholar 

  5. Graves N, Birrell F, Whitby M (2005) Effect of pressure ulcers on length of hospital stay. Infect Control Hosp Epidemiol 26(3):293–297

    Article  PubMed  Google Scholar 

  6. Qaseem A, Humphrey LL, Forciea MA, Starkey M et al (2015) Treatment of pressure ulcers: a clinical practice guideline from the American College of Physicians. Ann Intern Med 162:370–379

    Article  PubMed  Google Scholar 

  7. Schubert V (2001) Effects of phototherapy on pressure ulcer healing in elderly patients after a falling trauma. A prospective, randomized, controlled study. Photodermatol Photoimmunol Photomed 17:32–38

    CAS  Article  PubMed  Google Scholar 

  8. Iordanou P, Baltopoulos G, Giannakopoulou M, Bellou P, Ktenas E (2002) Effect of polarized light in the healing process of pressure ulcers. Int J Nurs Pract 8:49–55

    Article  PubMed  Google Scholar 

  9. Assis GM, Moser ADL (2013) Laserterapia em úlceras por pressão: limitações para avaliação de resposta em pessoas com lesão medular. Texto Contexto Enferm 22(3):850–856

    Article  Google Scholar 

  10. Gao X, Xing D (2009) Molecular mechanisms of cell proliferation induced by low power laser irradiation. J Biomed Sci 16:4

    Article  PubMed  PubMed Central  Google Scholar 

  11. Posten W, Wrone DA, Dover JS, Arndt KA, Silapunt S, Alam M (2005) Low-level laser therapy for wound healing: mechanism and efficacy. Dermatol Surg 31(3):334–340

    CAS  Article  PubMed  Google Scholar 

  12. Mester E, Jaszagi-Nagy E (1973) The effects of laser radiation on wound healing and collagen synthesis. Stud Biophys 35:227–230

    CAS  Google Scholar 

  13. Lanzafame RJ, Stadler I, Coleman J, Haerum B, Oskoui P, Whittaker M et al (2004) Temperature-controlled 830-nm low-level laser therapy of experimental pressure ulcers. Photomed Laser Surg 22(6):483

    Article  PubMed  Google Scholar 

  14. Taradaj J, Halski T, Kucharzewski M, Urbanek T, Halska U, Kucio C (2013) Effect of laser irradiation at different wavelengths (940, 808, and 658 nm) on pressure ulcer healing: results from a clinical study. Evid Based Complement Alternat Med 960240

  15. Lucas C, Gemert MJ, Haan RJ (2003) Efficacy of low-level laser therapy in the management of stage III decubitus ulcers: a prospective, observer-blinded multicentre randomised clinical trial. Lasers Med Sci 18:72–77. doi:10.1007/s10103-003-0259-5

    CAS  Article  PubMed  Google Scholar 

  16. Nussbaum EL, Biemann I, Mustard B (1994) Comparison of ultrasound/ultraviolet-C and laser for treatment of pressure ulcers in patients with spinal cord injury. Phys Ther 74(9):812–823, discussion 24–5

    CAS  Article  PubMed  Google Scholar 

  17. Taly AB, Sivaraman Nair KP, Murali T, John A (2004) Efficacy of multiwavelength light therapy in the treatment of pressure ulcers in subjects with disorders of the spinal cord: a randomized double-blind controlled trial. Arch Phys Med Rehabil 85(10):1657–1661

    Article  PubMed  Google Scholar 

  18. Tatarunas AC, Matera JM, Dagli MLZ (1998) Estudo clínico e anatomopatológico da cicatrização cutânea no gato doméstico: utilização do laser de baixa potência GaAs (904 nm). Acta Cir Bras 13

  19. Kolari PJ (1985) Penetration of unfocused laser light into the skin. Arch Dermatol Res 277(4):342–344

    CAS  Article  PubMed  Google Scholar 

  20. Alves AN, Fernandes KP, Melo CA, Yamaguchi RY, Franca CM, Teixeira DF et al (2014) Modulating effect of low level-laser therapy on fibrosis in the repair process of the tibialis anterior muscle in rats. Lasers Med Sci 29(2):813–821

    CAS  Article  PubMed  Google Scholar 

  21. Leal Junior EC, Lopes-Martins RA, Baroni BM, De Marchi T, Rossi RP, Grosselli D et al (2009) Comparison between single-diode low-level laser therapy (LLLT) and LED multi-diode (cluster) therapy (LEDT) applications before high-intensity exercise. Photomed Laser Surg 27(4):617–623

    Article  PubMed  Google Scholar 

  22. Leal Junior ECP, Lopes-Martins RÁB, Rossi RP, De Marchi T, Baroni BM, de Godoi V et al (2009) Effect of cluster multi-diode light emitting diode therapy (LEDT) on exercise-induced skeletal muscle fatigue and skeletal muscle recovery in humans. Lasers Surg Med 41(8):572–577

    Article  PubMed  Google Scholar 

  23. Enwemeka CS (2009) Intricacies of dose in laser phototherapy for tissue repair and pain relief. Photomed Laser Surg 27(3):387–393

    Article  PubMed  Google Scholar 

  24. Huang YY, Chen AC, Carroll JD, Hamblin MR (2009) Biphasic dose response in low level light therapy. Dose-Response 7(4):358–383

    Article  PubMed  PubMed Central  Google Scholar 

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Affiliations

  1. Posgraduate Program Ciências do Movimento Humano of Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Renata Saltiel Machado & Graciele Sbruzzi

  2. Porto Alegre, RS, Brazil

    Suane Viana

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  1. Renata Saltiel Machado
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  2. Suane Viana
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  3. Graciele Sbruzzi
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Correspondence to Graciele Sbruzzi.

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The authors declare that they have no competing interests.

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The study did not have funding source.

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Since this study is a systematic review, it was not necessary to have an approval from the ethics committee and informed consent.

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Machado, R.S., Viana, S. & Sbruzzi, G. Low-level laser therapy in the treatment of pressure ulcers: systematic review. Lasers Med Sci 32, 937–944 (2017). https://doi.org/10.1007/s10103-017-2150-9

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  • DOI: https://doi.org/10.1007/s10103-017-2150-9

Keywords

  • Lasers
  • Skin ulcer
  • Pressure ulcers
  • Review