Phototherapy (cluster multi-diode 630 nm and 940 nm) on the healing of pressure injury: A pilot study

Randomized clinical trial of the efficacy of the EmoLED medical device in the treatment of stage 2 and stage 3 pressure ulcers: The RISE_UP study

AIM OF THE STUDY

Pressure ulcers are an important public health issue, impacting quality of life and causing health deterioration. Blue light photobiomodulation has been shown promoting wound healing in vascular, diabetic, rheumatologic ulcers and lesions in spinal cord injury patients. Based on these preliminary results, this study was developed to assess the effectiveness of blue light therapy in second and third stage pressure ulcers.

MATERIALS AND METHODS

This study was a randomized controlled trial enrolling hospitalized patients with poor mobility. The intervention group included blue light treatment in addition to standard care, three times a week, for 4 consecutive weeks. The primary objective is the difference in the healing process by measuring the average difference of the lesion's PUSH score between the first and the last visit.

RESULTS

The analysis shows that the mean PUSH reduction and the probability of belonging to responder patients were higher in the treatment group. A latent profile analysis that identifies two trajectory classes based on treatment response, shows an association in the probability of following best trajectory for the treatment group (30 % vs 2 %).

CONCLUSIONS

The result shows that blue light photobiomodulation promotes recovery of tissue repair in pressure ulcers, and in stabilizing wounds that would otherwise worsen despite standard of care treatment. This therapy may be a valuable contribution to the daily management of pressure lesions since it has an excellent safety profile and the addition of this therapy to a treatment program may speed healing, improving the quality of life. (Clinicaltrials.gov Ref. numb.: NCT05130814).

Photobiomodulation and photodynamic therapy in the treatment of pressure injuries: a scoping review

OBJECTIVE

to map the scientific literature on photobiomodulation and photodynamic therapy in the treatment of pressure injuries.

METHOD

this was a scoping review, as recommended by the Joanna Briggs Institute. It included primary and secondary studies available in full in Portuguese, English and Spanish, published in the last 10 years, from 2014 to 2024, in nine databases.

RESULTS

24 studies were included according to the eligibility criteria. The findings suggest that photobiomodulation and photodynamics can play an important role in tissue repair, size reduction and improvement of clinical indicators in the management of pressure injuries. A diversity of laser types used in photobiomodulation was observed and the most common wavelengths used included 658 nm, 660 nm, 808 nm and 980 nm.

CONCLUSION

the studies identified show that photobiomodulation and photodynamic therapies have promising results in healing, reducing the size of lesions and improving clinical indicators in the treatment of pressure injuries.

BACKGROUND

(1) Light therapies are effective in treating pressure injuries. (2) Optimized healing is a promising result of the therapies studied. (3) Reduction in lesion size is a positive effect of the therapies used. (4) There is clinical improvement shown in the indicators in the studies reviewed.

Preclinical Study of Dual-Wavelength Light-Emitting Diode Therapy in an Osteoarthritis Rat Model

OBJECTIVE

To evaluate the efficacy of light-emitting diode (LED) and their dual-wavelengths as a treatment strategy for osteoarthritis.

METHODS

We induced osteoarthritis in male Sprague-Dawley rats by intra-articular injection of sodium iodoacetate into the right rear knee joint. The animals with lesions were divided into an untreated group and an LED-treated group (n=7 each). In the LED-treated group, the lesioned knee was irradiated with lasers (850 and 940 nm) and dose (3.15 J/cm2) for 20 minutes per session, twice a week for 4 weeks. Knee joint tissues were stained and scanned using an in vivo micro-computed tomography (CT) scanner. Serum interleukin (IL)-6 and IL-18 levels were determined using enzyme-linked immuno-sorbent assay. Several functional tests (lines crossed, rotational movement, rearing, and latency to remain rotating rod) were performed 24 hours before LED treatment and at 7, 14, 21, and 28 days after treatment.

RESULTS

LED-treated rats showed improved locomotor function and suppressed matrix-degrading cytokines. Micro-CT images indicated that LED therapy had a preserving effect on cartilage and cortical bone.

CONCLUSION

LED treatment using wavelengths of 850 and 940 nm resulted in significant functional, anatomical, and histologic improvements without adverse events in a rat model. Further research is required to determine the optimal wavelength, duration, and combination method, which will maximize treatment effectiveness.

Dual-NIR wavelength (pulsed 810 nm and superpulsed 904 nm lasers) photobiomodulation therapy synergistically augments full-thickness burn wound healing: A non-invasive approach

A thermal burn is the most frequent, distressing form of trauma. Globally, there is a critical necessity to explore novel therapeutic strategies for burn wound care. Combination therapy has marked therapeutic efficacy in positively regulating various phases of wound repair. Photobiomodulation (PBM) is a biophysical, non-thermal therapeutic healing modality to treat chronic non-healing wounds. It hypothesized that PBM using combined NIR wavelengths may absorb through different cellular photoacceptors with varying degrees of tissue penetration, which can potentially regulate the pace of healing. Therefore, the current study investigates the efficacy of dual-NIR wavelength treatment employing pulsed 810 nm and superpulsed 904 nm lasers PBM on transdermal burn repair in rats and unveils the associated molecular mechanistic insights. Rats were randomized into five groups: uninjured skin, burn control (sham-exposed), standalone treatment with pulsed 810 nm laser, superpulsed 904 nm laser, and dual combination groups. The present findings revealed that PBM with dual-NIR wavelength synergistically augmented burn wound healing compared to control and standalone treatments. The efficacy of combined treatment was exhibited by significantly enhanced wound area contraction (α-smooth muscle actin), proliferation (PCNA, cytokeratin-14, TGF-β2), angiogenesis (HIF-1α, CD31), ECM accumulation/ organization (collagen type 3, fibronectin), dermal hydration (AQP3), calcium homeostasis (TRPV3, calmodulin), and bioenergetics activation (CCO, AMPK-α, ATP). Collectively, PBM with dual-NIR wavelength (pulsed/ superpulsed-mode) treatment accelerates full-thickness burn wound healing, which could be used as a non-invasive translational approach in clinical significance in conjunction with existing burn wound care management.