Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of Low Level Laser Therapy on Wound Healing in Patients with Chronic Diabetic Foot Ulcers—A Randomised Control Trial

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Foot ulcers are serious complications of Diabetes Mellitus (DM) and are known to be resistant to conventional treatment. They may herald severe complications if not treated wisely. Electromagnetic radiations in the form of photons are delivered to the ulcers in laser form to stimulate healing. This study was conducted to evaluate the efficacy of Low Level Laser Therapy (LLLT) in diabetic ulcer healing dynamics. To determine mean percentage reduction of wound area in study and control groups. Settings: KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Study Design: Randomized-Control Study. Methods: A total of 68 patients with Type 2 DM having Meggitt-Wagner Grade I foot ulcers of atleast more than 4 weeks duration, less than 6 × 6 cm2 with negative culture were studied. Patients were randomized into two groups of 34 each. Patients in study group received LLLT with conventional therapy and those in control group were treated with conventional therapy alone. Healing or percentage reduction in ulcer area over a period of 15 days after commencement of treatment was recorded. Statistical Analysis: Unpaired Student T Test and Mann Whitney U test. Mean age of the patients was 50.94 years in control group and 54.35 years in study group (p = 0.065). There was no significant difference between control and study group with respect to mean FBS and HbA1c levels (p > 0.05), suggesting no biochemical differences between two groups. Initial ulcer area was 2608.03 mm2 in study group and 2747.17 mm2 in control group (p = 0.361). Final ulcer area was 1564.79 mm2 in study group and 2424.75 mm2 in control group (p = 0.361). Percentage ulcer area reduction was 40.24 ± 6.30 mm2 in study group and 11.87 ± 4.28 mm2 in control group (p < 0.001, Z = 7.08). Low Level Laser Therapy is beneficial as an adjunct to conventional therapy in the treatment of diabetic foot ulcers (DFU).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Aboderin I, Kalache A, Ben-Shlomo Y, Lynch JW, Yajnik CS, Kuh D et al (2001) Life course perspectives on coronary heart disease, stroke and diabetes: key issues and implications for policy and research. World Health Organization, Geneva

    Google Scholar 

  2. Bal A, Das AK, Pendsey S, Suresh KR, Vishwanathan V, Ambardekar P (2005) Handbook of diabetic foot care. Diabetic Foot Society of India, Bangalore

    Google Scholar 

  3. Brem H, Sheehan P, Rosenberg HJ, Schneider JS, Boulton AJ (2006) Evidence-based protocol for diabetic foot ulcers. Plast Reconstr Surg 117(7):193S–209S

    Article  PubMed  CAS  Google Scholar 

  4. Centre for Disease Control and Prevention (2002) National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2002. US Dept of Health and Human Services, Atlanta

    Google Scholar 

  5. Eldor R, Raz I, Ben Yehuda A, Boulton AJ (2004) New and experimental approaches to treatment of diabetic foot ulcers: a comprehensive review of emerging treatment strategies. Diabet Med 21(11):1161–1173

    Article  PubMed  CAS  Google Scholar 

  6. Steed DL (1997) The role of growth factors in wound healing. Surg Clin N Am 77:575–586

    Article  PubMed  CAS  Google Scholar 

  7. Millington JT, Norris TW (2000) Effective treatment strategies for diabetic foot wounds. J Fam Pract 49(11):S40–S48

    PubMed  CAS  Google Scholar 

  8. Dyson M (2007) Adjuvant therapies; ultrasound, laser therapy, electrical stimulation, hyperbaric oxygen and VAC-therapy. In: Morrison MJ, Moffatt CJ, Franks PJ (eds) Leg ulcers: a problem-based learning approach. Mosby, Elsevier, Philadelphia, pp 429–451

    Google Scholar 

  9. Rinaldi F, Alberetto M, Pontiroli A (1993) The diabetic foot. General considerations and proposal of a new therapeutic and preventive approach. Diabetes Res Clin Pract 21(1):43–49

    Article  PubMed  CAS  Google Scholar 

  10. Baxter GD (1994) Therapeutic lasers: theory and practice. Churchill Livingstone, Edinburgh

    Google Scholar 

  11. Ferney R, Mauro T (1999) Using lasers in diabetic wound healing. Diabetes Technol Ther 1(2):189–192

    Article  Google Scholar 

  12. Van Damme H, Limet R (2005) The diabetic foot. Rev Med Liege 60(5–6):516–525

    PubMed  Google Scholar 

  13. Armstrong DG (2002) Clinical examination of diabetic foot and identification of at risk patient. In: Morrison MJ, Moffatt CJ, Franks PJ (eds) Leg ulcers: a problem-based learning approach. Mosby, Elsevier, Philadelphia, pp 163–176

    Google Scholar 

  14. Shobhana R, Rama Rao P, Lavanya A, Viswanathan V, Ramachandra A (2000) Cost burden to diabetic patients with foot complications—a study from southern India. JAPI 48:1147–1150

    PubMed  CAS  Google Scholar 

  15. Boulton M, Marshall J (1986) He-Ne laser stimulation of human fibroblast proliferation and attachment in vitro. Laser Life Sci 1:125–134

    Google Scholar 

  16. Landau Z, Schattner A (2001) Topical hyperbaric oxygen and low energy laser therapy for chronic diabetic foot ulcers resistant to conventional treatment. Yale J Biol Med 74(2):95–100

    PubMed  CAS  Google Scholar 

  17. Schindl A, Heinze G, Schindl M, Pernerstorfer-Schon H, Schindl L (2002) Systemic effects of low-intensity laser irradiation on skin microcirculation in patients with diabetic microangiopathy. Microvasc Res 64(2):240–246

    Article  PubMed  Google Scholar 

  18. Pereira AN, Eduardo Cde P, Matson E, Marques MM (2002) Effect of low power laser irradiation on cell growth and procollagen synthesis of cultured fibroblasts. Laser Surg Med 31:263–267

    Article  Google Scholar 

  19. Dyson M, Young S (1986) Effect of laser therapy on wound contraction and cellularity in mice. Lasers Med Sci 1:126–130

    Article  Google Scholar 

  20. Brem H, Sheehan P, Boulton AJM (2004) Protocol for treatment of diabetic foot ulcers. Am J Surg 187(5A):1S–10S

    Article  PubMed  Google Scholar 

  21. Schindl M, Kerschan K, Schindl A, Schon H, Heinzl H, Schindl L (1999) Induction of complete wound healing in recalcitrant ulcers by low-intensity laser irradiation depends on ulcer cause and size. Photodermatol Photoimmunol Photomed 15(1):18–21

    Article  PubMed  CAS  Google Scholar 

  22. Maiya GA, Kumar P, Rao L (2005) Effect of low intensity helium-neon (He-Ne) laser irradiation on diabetic wound healing dynamics. Photomed Laser Surg 23(2):187–190

    Article  PubMed  Google Scholar 

  23. Basford C (1989) Low energy laser therapy: controversies and new research findings. Lasers Surg Med 9:1–5

    Article  PubMed  CAS  Google Scholar 

  24. Haas AF, Isseroff RR, Wheeland RG, Rood PA, Graves PJ (1990) Low energy helium-neon laser irradiation increases the motility of human keratinocytes. J Invest Dermatol 94:822–826

    Article  PubMed  CAS  Google Scholar 

  25. Yu W, Naim JO, Lanzafame RJ (1994) The effects of photo-irradiation on the secretion of TGF and PDGF from fibroblasts in vitro. Laser Surg Med Suppl 6:8

    Google Scholar 

  26. Schindl A, Schindl M, Schon H, Knobler R, Havelec L, Schindl L (1998) Low-intensity laser irradiation improves skin circulation in participants with diabetic microangiopathy. Diabetes Care 21(4):580–584

    Article  PubMed  CAS  Google Scholar 

  27. Medrado AR, Pughese LS, Reis SR, Andrade ZA (2003) Influence of low level laser therapy on wound healing and its biological action on myofibroblasts. Laser Surg Med 32:179–184

    Article  Google Scholar 

  28. Koutam M, Janisch R, Veselska R (2003) Effects of low power laser irradiation on cell proliferation. Scr Med 73(3):163–172

    Google Scholar 

  29. Hopkins J, Todd A, Jeff G, Seegmiller G, Baxter D (2004) Low level laser therapy facilitates superficial wound healing in humans: a triple-blind, sham-controlled Study. J Athl Train 39(3):223–229

    PubMed  Google Scholar 

  30. Gupta AK, Filonenko N, Salansky N, Sadder DN (1998) The use of low energy photon therapy (LEPT) in venous leg ulcers: a double blind, placebo-controlled study. Dermatol Surg 24:1383–1386

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Jawaharlal Nehru Medical College, Nehru Nagar, Belgaum, 590 010, Karnataka, India

    Basavaraj M. Kajagar, Ashok S. Godhi & Archit Pandit

  2. KLE’S College of Physiotherapy, Nehru Nagar, Belgaum, 590 010, Karnataka, India

    S. Khatri

Authors
  1. Basavaraj M. Kajagar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashok S. Godhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Archit Pandit
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Khatri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Basavaraj M. Kajagar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kajagar, B.M., Godhi, A.S., Pandit, A. et al. Efficacy of Low Level Laser Therapy on Wound Healing in Patients with Chronic Diabetic Foot Ulcers—A Randomised Control Trial. Indian J Surg 74, 359–363 (2012). https://doi.org/10.1007/s12262-011-0393-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-011-0393-4

Keywords

Search

Navigation