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Low-Level Laser Therapy (LLLT) in Diabetes Mellitus for Wound Healing: Surgical Wound, Diabetic Ulcer and Burns

  • Raquel Gomes de Sousa FurtadoEmail author
  • Jonas Carvalho Gomes Furtado
  • Thayrine Rosa Damasceno
Part of the Recent Clinical Techniques, Results, and Research in Wounds book series


In diabetic people there are combinations of factors that complicate normal cure and delay wound healing, acting as a type of trigger for comorbidities and high mortality rates. In this context, low-level laser therapy (LLLT) is a therapeutic modality that may be very useful, since in addition to being a less invasive and reduced cost-benefit intervention, it has been shown promising especially when associated with specialized assistance, thus favouring health and decreasing socioeconomic impacts.


  1. 1.
    Ahmed AM (2002) History of diabetes mellitus. Saudi Med J 23(4):373–378Google Scholar
  2. 2.
    Figueiredo DM, Rabelo FLA (2009) Diabetes insipidus: principais aspectos e análise comparativa com diabetes mellitus. Semina, Ciências Biológicas e da Saúde Londrina 30(2):155–162Google Scholar
  3. 3.
    Ozougwu JC, Obimba KC, Belonwu CD, Unakalamba CB (2013) The pathogenesis and pathophysiology of type 1 and type 2 diabetes mellitus. J Physiol Pathophysiol 4(4):46–57Google Scholar
  4. 4.
    Guyton AC, Hall JE (2006) Tratado de Fisiologia Médica. Elsevier/Medicina Nacionais, Rio de Janeiro, Brasil, pp 11–25Google Scholar
  5. 5.
    World Health Organization. Global Report on Diabetes 2016. Accessed 27 Sept 2017
  6. 6.
    Grey JE, Enoch S, Harding KG (2006) Wound assessment. Br Med J 332(7536):285–288Google Scholar
  7. 7.
    Ayuk SM, Houreld NN, Abrahamse H (2012) Collagen production in diabetic wounded fibroblasts in response to low-intensity laser irradiation at 660nm. Diabetes Technol Ther 14(12):1110–1117Google Scholar
  8. 8.
    Dahmardehei M, Kazemikhoo N, Vaghardoost R, Mokmeli S, Momeni M, Nilforoushzadeh MA, Ansari F, Amirkhani A (2016) Effects of low level laser therapy on the prognosis of split-thickness skin graft in type 3 burn of diabetic patients: a case series. Lasers Med Sci 31(3):497–502Google Scholar
  9. 9.
    Dancáková L, Vasilenko T, Kováč I, Jakubčová K, Hollý M, Revajová V, Sabol F, Tomori Z, Iversen M, Gál P, Bjordal JM (2014) Low-level laser therapy with 810nm wavelength improves skin wound healing in rats with streptozotocin-induced diabetes. Photomed Laser Surg 32(4):198–204Google Scholar
  10. 10.
    Abbas AK, Lichtman AH, Pillai S (2008) Imunologia celular e molecular. Elsevier, Rio de Janeiro, Brasil, pp 3–17Google Scholar
  11. 11.
    Singer AJ, Clark RAF (1999) Cutaneous wound healing. N Engl J Med 341(10):738–746Google Scholar
  12. 12.
    Reinke JM, Sorg H (2012) Wound repair and regeneration. Eur Surg Res 49(1):35–43Google Scholar
  13. 13.
    Maiya AG, Kumar P, Nayak S (2009) Photo-stimulatory effect of low energy helium-neon laser irradiation on excisional diabetic wound healing dynamics in Wistar rats. Indian J Dermatol 54(4):323–329Google Scholar
  14. 14.
    Sharp A, Clark J (2011) Diabetes and its effects on wound healing. Nurs Stand 25(45):41–47Google Scholar
  15. 15.
    Damir A (2011) Why diabetic foot ulcers do not heal? J Int Med Sci Acad 24(4):205–206Google Scholar
  16. 16.
    Mishra M, Kumar H, Tripathi K (2008) Diabetic delayed wound healing and the role of silver nanoparticles. Dig J Nanomater Biostruct 3(2):49–54Google Scholar
  17. 17.
    Peppa M, Vlassara H (2005) Advanced glycation end products and diabetic complications: a general overview. Hormones 4(1):28–37Google Scholar
  18. 18.
    Catorze MG (2009) Laser: fundamentos e indicações em dermatologia. Med Cutan Ibero Lat Am 37(1):5–27Google Scholar
  19. 19.
    Maiman TH (1960) Stimulated optical radiation in ruby. Nature 187(4736):493–494Google Scholar
  20. 20.
    Mester E, Spiry T, Szende B, Tota JG (1971) Effect of laser rays on wound healing. Am J Surg 122(4):532–535Google Scholar
  21. 21.
    Passarella S, Casamassima E, Molinari S, Pastore D, Quagliariello E, Catalano IM, Cingolani A (1984) Increase of proton electrochemical potential and ATP synthesis in rat liver mitochondria irradiated in vitro by helium-neon laser. FEBS Lett 175(1):95–99Google Scholar
  22. 22.
    Karu T (1987) Photobiological fundamentals of low-power laser therapy. IEEE J Quantum Electron 23(10):1703–1717Google Scholar
  23. 23.
    Karu T (1989) Photobiology of low-power laser effects. Health Phys 56(5):691–704Google Scholar
  24. 24.
    Karu T (1999) Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 49(1):1–17Google Scholar
  25. 25.
    Andrade AG, Lima CF, Albuquerque AKB (2010) Efeitos do laser terapêutico no processo de cicatrização das queimaduras: uma revisão bibliográfica. Rev Bras Queimaduras 9(1):21–30Google Scholar
  26. 26.
    Eissa M, Salih WHM (2017) The influence of low-intensity he-ne laser on the wound healing in diabetic rats. Lasers Med Sci 32(6):1261–1267Google Scholar
  27. 27.
    Khoo NK, Shokrgozar MA, Kashani IR, Amanzadeh A, Mostafavi E, Sanati H, Habibi L, Talebi S, Abouzaripour M, Akrami SM (2014) In vitro therapeutic effects of low level laser at mRNA level on the release of skin growth factors from fibroblasts in diabetic mice. Avicenna J Med Biotechnol 6(2):113–118Google Scholar
  28. 28.
    Sharifian Z, Bayat M, Alidoust M, Farahani RM, Bayat M, Rezaie F, Bayat H (2014) Histological and gene expression analysis of the effects of pulsed low-level laser therapy on wound healing of streptozotocin-induced diabetic rats. Lasers Med Sci 29(3):1227–1235Google Scholar
  29. 29.
    Houreld N, Abrahamse H (2007) Irradiation with a 632.8 nm helium-neon laser with 5 J/ cm2 stimulates proliferation and expression of interleukin-6 in diabetic wounded fibroblast cells. Diabetes Technol Ther 9(5):451–459Google Scholar
  30. 30.
    Kilík R, Lakyová L, Sabo J, Kruzliak P, Lacjaková K, Vasilenko T, Vidová M, Longauer F, Radoňak J (2014) Effect of equal daily doses achieved by different power densities of low-level laser therapy at 635nm on open skin wound healing in normal and diabetic rats. Biomed Res Int 2014:269253Google Scholar
  31. 31.
    Houreld NN, Sekhejane PR, Abrahamse H (2010) Irradiation at 830nm stimulates nitric oxide production and inhibits pro-inflammatory cytokines in diabetic wounded fibroblast cells. Lasers Surg Med 42:494–502Google Scholar
  32. 32.
    Esmaeelinejad M, Bayat M, Darbandi H, Bayat M, Mosaffa N (2014) The effects of low-level laser irradiation on cellular viability and proliferation of human skin fibroblasts cultured in high glucose mediums. Lasers Med Sci 29(1):121–129Google Scholar
  33. 33.
    Dagogo-Jack S, Alberti KGMM (2002) Management of diabetes mellitus in surgical patients. Diabetes Spectr 15(1):44–48Google Scholar
  34. 34.
    Krafts KP (2010) Tissue repair: the hidden drama. Organogenesis 6(4):225–233Google Scholar
  35. 35.
    Lima ACG, Fernandes GA, Araújo RB, Gonzaga IC, Oliveira RA, Nicolau RA (2017) Photobiomodulation (laser and led) on sternotomy healing in hyperglycemic and normoglycemic patients who underwent coronary bypass surgery with internal mammary artery grafts: a randomized, double-blind study with follow-up. Photomed Laser Surg 35(1):24–31Google Scholar
  36. 36.
    Lever A, Mackenzie I (2007) Sepsis: definition, epidemiology, and diagnosis. BMJ 335(7625):879–883Google Scholar
  37. 37.
    Arno AI, Gauglitz GG, Barret JP, Jeschke MG (2014) Up-to-date approach to manage keloids and hypertrophic scars: a useful guide. Burns 40(7):1255–1266Google Scholar
  38. 38.
    McGoldrick RB, Sawyer A, Davis CR, Theodorakopoulou E, Murison M (2016) Lasers and ancillary treatments for scar management: personal experience over two decades and contextual review of the literature. Part I: burn scars. Scars Burn Heal 2:1–7Google Scholar
  39. 39.
    Güngörmüs M¸ Akyol UK. Effect of biostimulation on wound healing in diabetic rats. Photomed Laser Surg 2009;27(4):607–610Google Scholar
  40. 40.
    Tatmatsu-Rocha JC, Ferraresi C, Hamblin MR, Damasceno Maia F, do Nascimento NRF, Driusso P, Parizotto NA (2016) Low-level laser therapy (904 nm) can increase collagen and reduce oxidative and nitrosative stress in diabetic wounded mouse skin. J Photochem Photobiol B 164:96–102Google Scholar
  41. 41.
    Shaw JE, Boulton AJM (1997) The pathogenesis of diabetic foot problems: an overview. Diabetes 46(2):58–61Google Scholar
  42. 42.
    Hegde VN, Prabhu V, Rao SBS, Chandra S, Kumar P, Satyamoorthy K, Mahato KK (2011) Effect of laser dose and treatment schedule on excision wound healing in diabetic mice. Photochem Photobiol 87(6):1433–1441Google Scholar
  43. 43.
    Al-Watban FAH, Zhang XY, Andres BL (2007) Low-level laser therapy enhances wound healing in diabetic rats: a comparison of different lasers. Photomed Laser Surg 25(2):72–77Google Scholar
  44. 44.
    Carvalho PTC, Silva IS, Reis FA, Perreira DM, Aydos RD (2010) Influence of ingaalp laser (660nm) on the healing of skin wounds in diabetic rats. Acta Cir Bras 25(1):71–79Google Scholar
  45. 45.
    Rocha CLJV, Júnior AMR, Aarestrup BJV, Aarestrup FM (2012) Inibição da expressão de ciclooxigenase 2 em feridas cutâneas de camundongos NOD submetidos à terapia a laser de baixa intensidade. J Vasc Bras 11(3):175–181Google Scholar
  46. 46.
    Noudeh YJ, Shabani M, Vatankhah N, Hashemian SJ, Akbari K (2010) A combination of 670nm and 810nm diode lasers for wound healing acceleration in diabetic rats. Photomed Laser Surg 28(5):621–627Google Scholar
  47. 47.
    de Loura Santana C, Silva D de F, Deana AM, Prates RA, Souza AP, Gomes MT, de Azevedo Sampaio MP, Shibuya JF, Bussadori SK, Mesquita-Ferrari RA, Fernandes KP, França CM (2015) Tissue responses to postoperative laser therapy in diabetic rats submitted to excisional wounds. PLoS One 10(4):e0122042Google Scholar
  48. 48.
    Kajagar BM, Godhi AS, Pandit A, Khatri S (2012) Efficacy of low level laser therapy on wound healing in patients with chronic diabetic foot ulcers - a randomised control trial. Indian J Surg 74(5):359–363Google Scholar
  49. 49.
    Kaviani A, Djavid GE, Ataie-Fashtami L, Fateh M, Ghodsi M, Salami M, Zand N, Kashef N, Larijani B (2011) A randomized clinical trial on the effect of low-level laser therapy on chronic diabetic foot wound healing: a preliminary report. Photomed Laser Surg 29(2):109–114Google Scholar
  50. 50.
    Feitosa MCP, Carvalho AFM, Feitosa VC, Coelho IM, Oliveira RA, Arisawa EAL (2015) Effects of the low-level laser therapy (LLLT) in the process of healing diabetic foot ulcers. Acta Cir Bras 30(12):852–857Google Scholar
  51. 51.
    Sandoval Ortíz MC, Herrera Villabona E, Camargo Lemos DM, Castellanos R (2014) Effects of low level laser therapy and high voltage stimulation on diabetic wound healing. Rev Univ Ind Santander Salud 46(2):107–117Google Scholar
  52. 52.
    Santos MOD, Latrive A, De Castro PAA, De Rossi W, Zorn TMT, Samad RE, Freitas AZ, Cesar CL, Junior NDV, Zezell DM (2017) Multimodal evaluation of ultra-short laser pulses treatment for skin burn injuries. Biomed Opt Express 8(3):1575–1588Google Scholar
  53. 53.
    Evers LH, Bhavsar D, Mailänder P (2010) The biology of burn injury. Exp Dermatol 19(9):777–783Google Scholar
  54. 54.
    Shalom A, Friedman T, Wong L (2005) Burns and diabetes. Ann Burns Fire Disasters 18(1):31–33Google Scholar
  55. 55.
    Alharbi Z, Piatkowski A, Dembinski R, Reckort S, Grieb G, Kauczok J, Pallua N (2012) Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form. World J Emerg Surg 7(1):13Google Scholar
  56. 56.
    Cancio LC, Barillo DJ, Kearns RD, Holmes JH, Conlon KM, Matherly AF, Cairns BA, Hickerson WL, Palmieri T (2017) Guidelines for burn care under austere conditions: surgical and nonsurgical wound management. J Burn Care Res 38(4):203–214Google Scholar
  57. 57.
    Gauglitz GG, Jeschke MG (2012) Pathophysiology of burn injury. In: Jeschke MG, Kamolz LP, Sjöberg F, Wolf SE (eds) Handbook of burns, vol 1. Springer, Vienna, pp 131–149Google Scholar
  58. 58.
    Fantinati MS, Mendonça DEO, Fantinati AMM, Barbosa DA, Araújo LC, Afonso CL, Vinaud MC, Júnior RSL (2016) Activity of low level laser therapy on burning wounds in diabetic rats. Rev Bras Queimaduras 15(1):42–49Google Scholar
  59. 59.
    Ranjbar R, Takhtfooladi MA (2016) The effects of low level laser therapy on Staphylococcus aureus infected third-degree burns in diabetic rats. Acta Cir Bras 31(4):250–255Google Scholar
  60. 60.
    Al-Watban FAH, Zhang XY, Andres BL, Al-Anize A (2009) Visible lasers were better than invisible lasers in accelerating burn healing on diabetic rats. Photomed Laser Surg 27(2):269–272Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Raquel Gomes de Sousa Furtado
    • 1
    Email author
  • Jonas Carvalho Gomes Furtado
    • 1
  • Thayrine Rosa Damasceno
    • 1
  1. 1.Novo RepartimentoBrazil

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