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Biological Effects of Laser Therapy

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Research Studies on Laser Therapy

 

WOUND HEALING / DIABETIC ULCER RESEARCH STUDIES

A HISTOPATHOLOGICAL STUDY OF THE EFFECTS OF LOW-POWER LASER IRRADIATION ON WOUND HEALING OF EXPOSED DENTAL PULP TISSUES IN DOGS, WITH SPECIAL REFERENCE TO LECTINS AND COLLAGENS.

J Endod. 1998; (3):187-193.
Utsunomiya T

This study investigated the effects of low-power laser irradiation on exposed pulp tissue in dogs. GaAlAs laser (300 mW) irradiation was applied to the exposed surface of the pulp, and histopathological changes were observed at 1, 3, and 7 wk after the operation. In addition, the lectin, binding pattern and distribution of collagens (type I, III, and V) were examined to determine the histochemical and immunohistochemical nature of wound healing. The fibrous matrix formation and the continuing changes in the dentin bridge formation of the irradiation group were observed earlier (1 wk after the operation) than in the nonirradiation control group. Lectin histochemistry and collagen immunohistochemistry showed that concanavalin A, peanut agglutinin, wheat germ agglutinin, and collagens (types I, III, and V) were distributed in the fibrous matrix and dentin bridge. The expression of these lectins and collagens occurred earlier in the laser irradiation group than in the control group. These results suggest that laser irradiation accelerates wound healing of the pulp and the expression of the lectins and collagens. Furthermore, D-glucose-, D-mannose-, N-acetyl-D-galactosamine-, and N-acetyl-neuraminic acid-binding sugars and type I, III, and V collagens play an important role in the healing of pulp wounds.

LASER PHOTOSTIMULATION ACCELERATES WOUND HEALING IN DIABETIC RATS.

Wound Repair and Regeneration. 2001; 9 (3): 248-255.
Reddy G K, Stehno-Bittel L, Enwemeka C S.

In this study the hypothesis that laser photostimulation can facilitate healing of impaired wounds in experimental diabetes using a rat model was studied. Diabetes was induced in male rats by streptozotocin injection and two 6 mm diameter circular wounds were created on either side of the spine. The left wound of each animal was treated with a 632.8 nm He:Ne laser at a dose of 1.0 J/cm2 for five days a week until the wounds closed (three weeks). Measurements of the biomechanical properties of the laser-treated wounds indicated there was a marginal increase in maximum load (16%), stress (16%), strain (27%), energy absorption (47%) and toughness (84%) compared to control wounds of diabetic rats. Biochemical assays revealed that the amount of total collagen was significantly increased in laser treated wounds (274 +/- 8.7 microg) over the control wounds (230 +/- 8.4 microg). Sequential extractions of collagen from healing wounds showed that laser treated wounds had significantly greater concentrations of neutral salt soluble (15%) and insoluble collagen (16%) than control wounds, suggesting accelerated collagen production in laser treated wounds. There was an appreciable decrease in pepsin soluble collagen (19%) in laser treated wounds over control wounds, indicating higher resistance to proteolytic digestion. In conclusion, the biomechanical and biochemical results collectively suggest that laser photostimulation promotes the tissue repair process by accelerating collagen production and promoting overall connective tissue stability in healing wounds of diabetic rats.

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THE USE OF LOW ENERGY PHOTON THERAPY (LEPT) IN VENOUS LEG ULCERS: A DOUBLE BLIND, PLACEBOCONTROLLED STUDY

Dermatol Surg 1998;24:1383-1386
From the Division of Dermatology, Department of Medicine, University of Toronto; International Medical Instruments Inc.; and Selye-Toffler University, Toronto, Ontario, Canada. Adltya K. Gupta, MD, FRCP(C)), Natalia Filonenko, PhD, Norman Salansky, PhD, flms, Daniel N. Sadder, MD, FRCP(C)

BACKGROUND. Venous ulcers are estimated to be present in 0.2 to 0.4% of the population. Although new therapies have significant promise, nonhealing ulcers still represent a significant problem. Objective. To evaluate the efficacy of low energy photon therapy (LEPT) in the treatment of venous leg ulcers.

METHODS. A placebo-controlled, double-blind study using low energy photon therapy was performed in nine patients with 12 venous ulcers. Treatment was given three times a week for 10 weeks, using two monochromatic optical sources. One source provided a wavelength (A) of 660 nm (red) while the second source delivered a wavelength of 880 nm (infrared). Two optical probes were used, one consisted of an array of 22 monochromatic sources, operating at a wavelength of 660 nm and covering an area 6 x 10 cm2. The second probe had seven infrared sources, operating at a wavelength of 880 nm and covering an area of 4 cm2 The above configuration of optical probes was selected to cover the majority of the ulcer area being treated. The patients who were randomized to placebo treatment received sham therapy from an identical-appearing light source from the same delivery system.

RESULTS. Nine patients with 12 venous ulcers were randomized to receive LEPT or placebo therapy. At the conclusion of the study, the percentage of the initial ulcer area remaining unhealed in the LEPT and placebo groups was 24.4% and 84.7%, respectively (P = 0.0008). The decrease in ulcer area (compared to baseline) observed in the LEPT and placebo groups was 193.0 mm2 and 14.7 222, respectively (P = 0.0002). One patient dropped out of the study, complaining of lack of treatment efficacy; he was found to be randomized to the placebo group. There were no adverse effects.
CONCLUSION. In this placebo-controlled, double-blind study LEPT was an effective modality for the treatment of venous leg ulcers.

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EFFECTS OF PHOTOTHERAPY (LLLT) ON PRESSURE ULCER HEALING IN ELDERLY PATIENTS AFTER A FALLING TRAUMA. A PROSPECTIVE, RANDOMIZED, CONTROLLED STUDY.

Photodermatol Photoimmunol Photomed. 2001 Feb;17(1):32-8.

Schubert V. - Karolinska Institute, Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Huddinge University Hospital, Stockholm, Sweden.

BACKGROUND: The effects of infrared and red pulsed monochromatic light, with varied pulsations and wavelengths, on the healing of pressure ulcers were evaluated in this prospective, randomized, controlled study.

METHODS: Elderly patients (> or =65 years) with Stage 2 or 3 skin ulcers were enrolled and assigned to one of two groups. Both groups were given the same standard ulcer therapy. One group was also given phototherapy with pulsed monochromatic infrared (956 nm) and red (637 nm) light. Treatments lasted 9 min each time using a regimen with pulse repetition frequency varied between 15.6 Hz and 8.58 kHz. Patients were followed for 10 weeks or until the ulcer was healed, whichever occurred first. The ulcer surface area was traced weekly.

RESULTS: Patients treated with pulsed monochromatic light had a 49% higher ulcer healing rate, and a shorter time to 50% and to 90% ulcer closure compared with controls. Their mean ulcer area was reduced to 10% after 5 weeks compared with 9 weeks for the controls.

CONCLUSION: The results are encouraging as pulsed monochromatic light increased healing rate and shortened healing time. This will positively affect the quality of life in elderly patients with pressure ulcer.

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LOW LEVEL LASER THERAPY (LLLT) IN AMBULATORY PATIENTS WITH VENOUS STASIS ULCERS

Laser Therapy Vol 11 - 2
D. Lichtenstein FICA, B Morag, Maccabi Health Care Services and Department of Vascular Surgery, Sourasky Medical Center, Sakler Faculty of Medicine, Tel Aviv Israel

The effectiveness of Laser Therapy (LLLT) in accelerating wound healing has been clinically well documented. We used two devices: one, a He-Ne laser with a wavelength of 632.8nm and power output of 120mW. The indication for treatment was stasis ulcers (Ulcer cruris) due to chronic venous insufficiency syndrome. Sixty-two patients were treated in this study. The challenge of obtaining good results when treating patients with long-standing vascular ulcers and wounds caused us to explore this technique. We achived complete healing, classified as good, in 53 patients (85.48%) of the patients during a two week period of treatment, and moderate partial wound closure with clinical improvement in 4 patients (6.46%) with chronic long-term venous leg ulcers. The efficacy of the treatment was (91.94%). No patient had to stop treatment because of adverse side effects. Two patients (3.2%) had recurrent ulcers. These findings indicate that appropriate doses of laser can be beneficial in promoting tissue repair.

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THE USE OF INFRARED LASER THERAPY (LLLT) IN THE TREATMENT OF VENOUS ULCERATION

(Ann Vasc Surg 1990;4:179-181).
M.E. Sugrue, FRCSI, J. Carolan, BSc, E.J. Leen, MB, T.M. Feeley, FRCSI, D.J. Moore, FRCSI, G.D. Shanik, FRCSI, Dublin Ireland.

Management of intractable venous ulceration remains an unrewarding task, which is increasingly delegated to the realm of the vascular surgeon. The purpose of this pilot study was to assess the ulcer-healing effects of the newest form of biostimilation—the low power laser (LLLT). Twelve patients with chronic venous ulcers unresponsive to conservative measures were treated with infrared laser irradiation for twelve weeks. Two ulcers healed completely and there was a 27% (p<0.01) reduction in size of the remaining ulcers. Treatment resulted in a 44% (p<0.01) increase in ulcer floor area occupied by healthy granulation tissue. The most dramatic effect of laser treatment was the reduction in ulcer pain, from 7.5 to 3.5 (linear analogue scale) (p<0.001). Laser irradiation had no effect on TcPO2, number of skin capillaries of pericapillary fibrin deposition in the lipodermatosclerotic area around the ulcer. The results of this pilot study are encouraging and a carefully controlled randomized study is indicated to compare low power laser irradiation to conventional treatment in the management of venous ulcers.

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THE USE OF LOW INTENSITY LASER THERAPY (LLLT) FOR THE TREATMENT OF OPEN WOUNDS IN PSYCHOGERIATRIC PATIENTS: A PILOT STUDY.

Physical and Occupational Therapy in Geriatrics. 2000, 18/2 (1-19)
Verdote-Robertson-R, Munchua-M-M, Reddon-J-R.

The effect of low intensity laser therapy (LLLT) on wound healing in a largely psychogeriatric population was assessed over a period of 6 years (1991-1996). In total, 84 psychiatric patients were referred for the treatment of open wounds of varying severity and etiology. The wound status, nutritional status, walking status, and psychiatric condition of each patient were assessed prior to the administration of laser therapy treatment. Traditional wound care management was also used in addition to laser therapy. According to laser therapy treatment protocol for open wounds, a single diode laser probe was used for biostimulation of the wound bed and the wound periphery. Pre- and post-treatment measurements of wound size were obtained periodically for a total of 188 open wounds. 84% of these wounds completely healed, 11.2% partially healed, 2.1% did not change, and 2.7% got worse. The number of treatments for the 158 completely-healed wounds ranged from 3 to 133 (mean 18.5) and the treatment period ranged from 5 to 383 days (mean 47.7). Wound healing was found to be related to nutritional status but neither walking status nor wound size. Results indicate that LILT is effective in the treatment of open wounds when it is used as a component of a total wound management program.

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