Tchanque-Fossuo CN, Ho D, Dahle SE, Koo E, Li CS, Isseroff RR, Jagdeo J, et al.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the Eur.... Date of publication 2016 Mar 1;volume 24(2):418-26.
1. Wound Repair Regen. 2016 Mar;24(2):418-26. doi: 10.1111/wrr.12399. Epub 2016 Mar
2.
A systematic review of low-level light therapy for treatment of diabetic foot
ulcer.
Tchanque-Fossuo CN(1)(2), Ho D(1), Dahle SE(2)(3), Koo E(1), Li CS(4), Isseroff
RR(1)(2), Jagdeo J(1)(2)(5).
Author information:
(1)Dermatology Service, Sacramento VA Medical Center, Mather, California.
(2)Department of Dermatology, University of California Davis, Sacramento,
California.
(3)Department of Surgery, Podiatry Section, Sacramento VA Medical Center, Mather,
California.
(4)Department of Public Health Sciences, Division of Biostatistics, University of
California Davis, Davis, California.
(5)Department of Dermatology, State University of New York Downstate Medical
Center, Brooklyn, New York.
Diabetes mellitus (DM) is a significant international health concern affecting
more than 387 million individuals. A diabetic person has a 25% lifetime risk of
developing a diabetic foot ulcer (DFU), leading to limb amputation in up to one
in six DFU patients. Low-level light therapy (LLLT) uses low-power lasers or
light-emitting diodes to alter cellular function and molecular pathways, and may
be a promising treatment for DFU. The goal of this systematic review is to
examine whether the clinical use of LLLT is effective in the healing of DFU at 12
and 20 weeks in comparison with the standard of care, and to provide
evidence-based recommendation and future clinical guidelines for the treatment of
DFU using LLLT. On September 30, 2015, we searched PubMed, EMBASE, CINAHL, and
Web of Science databases using the following terms: "diabetic foot" AND "low
level light therapy," OR "light emitting diode," OR "phototherapy," OR "laser."
The relevant articles that met the following criteria were selected for
inclusion: randomized control trials (RCTs) that investigated the use of LLLT for
treatment of DFU. Four RCTs involving 131 participants were suitable for
inclusion based upon our criteria. The clinical trials used sham irriadiation,
low dose, or nontherapeutic LLLT as placebo or control in comparison to LLLT. The
endpoints included ulcer size and time to complete healing with follow-up ranging
from 2 to 16 weeks. Each article was assigned a level of evidence (LOE) and
graded according to the Oxford Center for Evidence-based Medicine Levels of
Evidence Grades of Recommendation criteria. Limitations of reviewed RCTs include
a small sample size (N < 100), unclear allocation concealment, lack of screening
phase to exclude rapid healers, unclear inclusion/exclusion criteria, short (<30
days) follow-up period, and unclear treatment settings (wavelength and treatment
time). However, all reviewed RCTs demonstrated therapeutic outcomes with no
adverse events using LLLT for treatment of DFU. This systematic review reports
that LLLT has significant potential to become a portable, minimally invasive,
easy-to-use, and cost effective modality for treatment of DFU. To
enthusiastically recommend LLLT for treatment of DFU, additional studies with
comparable laser parameters, screening period to exclude rapid healers, larger
sample sizes and longer follow-up periods are required. We envision future
stringent RCTs may validate LLLT for treatment of DFU. Systematic review
registration number: PROSPERO CRD42015029825.
© 2016 by the Wound Healing Society.
DOI: 10.1111/wrr.12399
PMID: 26748691 [Indexed for MEDLINE]
