Križaj Julija, Frangež Igor* and Tankica Deleva Anžič

Department for Surgical Infections, University Medical Centre Ljubljana, Slovenia

*Corresponding Author: Frangež Igor, Department for Surgical Infections, University Medical Centre Ljubljana, Slovenia.

Received: October 03, 2024; Published: February 10, 2025

Abstract

Chronic wound management in diabetic patients presents a significant challenge due the multifactorial impairments in the wound healing process, including reduced angiogenesis, persistent inflammation, and delayed tissue regeneration. Low-Level Laser Therapy, through induction of the photobiomodulation effect in treated tissues, presents a promising additional treatment method to address these deficiencies. Research demonstrates that Low-Level Laser Therapy promotes angiogenesis and extracellular matrix formation and remodeling, and reduces oxidative stress and inflammation, all of which contributes to improved healing in diabetic wounds. While numerous studies have explored the effect of the mentioned treatment on wound healing, there is a lack of research on its ef fects on chronic diabetic wounds, with considerable variability in reported findings. The inconsistencies in the reported results led us to conduct our case study to better understand the direct potential benefits of Low-Level Laser Therapy on treatment outcomes of chronic wounds in diabetic patients. We used SkyPulse® laser (Fotona, Ljubljana, Slovenia) (1064 nm wavelength, 0.2 W/cm² irradi ance) for treatment of chronic wounds in three diabetic patients. Our case study demonstrated significant improvements in wound healing, with observed increase in wound contraction, granulation tissue formation, and reduced inflammation, with no reported adverse effects of treatment. Our findings indicate that Low-Level Laser Therapy represents a valuable and cost-effective treatment for diabetic wounds. By integrating this treatment method in standard care, clinicians can address the underlying factors impairing wound healing, improve overall tissue regeneration, and increase the likelihood of a successful recovery.

Keywords: Wound Management; Low-Level Laser Therapy; Photobiomodulation; Diabetic Wounds; Chronic Wounds; Tissue Regen eration

References

1. Kolluru GM., et al. “Endothelial dysfunction and diabetes: effects on angiogenesis, vascular remodeling, and wound healing”. International Journal of Vascular Medicine 2012 (2012): 918267.
2. Giuseppina B., et al. “Advanced glycation end products and vascular inflammation: implications for accelerated atherosclerosis in diabetes”. Cardiovascular Research4 (2004): 582-592.
3. Huang Y and Themis RK. “The role of extracellular matrix in the pathophysiology of diabetic wounds”. Matrix Biology Plus 6 (2020): 100037.
4. Maione AG., et al. “Altered ECM deposition by diabetic foot ulcer-derived fibroblasts implicates fibronectin in chronic wound repair”. Wound repair and regeneration: official publication of the Wound Healing Society [and] the European Tissue Repair Society4 (2016): 630-643.
5. Barman PK and Chandan KK. "Macrophage and Neutrophil Dysfunction in Diabetic Wounds". Advances in Wound Care1 (2023): 1-10.
6. Bao P., et al. “The role of vascular endothelial growth factor in wound healing”. The Journal of Surgical Research2 (2009): 347-358.
7. Hamblin MR. “Photobiomodulation or low-level laser therapy”. Journal of Biophotonics11 (2016): 1122-1124.
8. de Freitas LF and Hamblin MR. “Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy”. IEEE Journal of Selected Topics in Quantum Electronics: A Publication of the IEEE Lasers and Electro-optics Society3 (2016): 7000417.
9. Serrage H., et al. “Under the spotlight: mechanisms of photobiomodulation concentrating on blue and green light”. Photochemical and Photobiological Sciences: Official Journal of the European Photochemistry Association and the European Society for Photobiology8 (2019): 1877-1909.
10. Leyane TS., et al. “Cellular Signaling and Photobiomodulation in Chronic Wound Repair”. International Journal of Molecular Sciences20 (2021): 11223.
11. Frangež I., et al. “Phototherapy with LED Shows Promising Results in Healing Chronic Wounds in Diabetes Mellitus Patients: A Prospective Randomized Double-Blind Study”. Photomedical Laser Surgery7 (2018): 377-382.
12. Hopkins JT., et al. “Low-Level Laser Therapy Facilitates Superficial Wound Healing in Humans: A Triple-Blind, Sham-Controlled Study”. Journal of Athletic Training3 (2004): 223-229.
13. Mosca RC., et al. “Photobiomodulation Therapy for Wound Care: A Potent, Noninvasive, Photoceutical Approach”. Advances in Skin and Wound Care 4 (2019): 157-167.
14. Beckerman H., et al. “The efficacy of laser therapy for musculoskeletal and skin disorders: a criteria-based meta-analysis of randomized clinical trials”. Physical Therapy7 (1992): 483-491.
15. Kheiri A., et al. “Effect of Low-Level Laser Therapy on Bone Regeneration of Critical-Size Bone Defects: A Systematic Review of In Vivo Studies and Meta-Analysis”. Archives of Oral Biology 117 (2020): 104782.

Citation

Citation: Frangež Igor., et al. “Treatment of Chronic Wounds in Diabetic Patients with Low-Level Laser Therapy: A Case Series". Acta Scientific Clinical Case Reports 6.3 (2025): 03-11.

Copyright

Copyright: © 2025 Frangež Igor., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.