高强度激光治疗(HILT)最近已被纳入伤口管理治疗方案中(MoscaRC等人。(2019)伤口护理的光生物调节疗法:强效,非侵入性,光子学方法。Adv皮肤伤口护理32(4):157-167。https://doi.org/10.1097/01.ASW.0000553600.97572。d2)。激光治疗越来越多地用作临床实践中治疗性干预的辅助手段(DundarU等人。(2015)高强度激光治疗在治疗斜方肌筋膜疼痛综合征中的作用:双盲,安慰剂对照研究。激光医学科学30(1):325-332。https://doi.org/10.1007/s10103-014-1671-8)。本研究旨在评估HILT的疗效以及将联合干预措施与HILT结合在伤口管理中的潜在益处。截至2023年4月,搜索了以下数据库:Embase,MEDLINE,PubMed,还有Cinahl,以及手动搜索。搜索关键词包括高强度激光治疗,高功率激光治疗,激光治疗,伤口,溃疡,伤口愈合。主要措施是减少的伤口表面积(WSA)和改善的伤口外观(WA)或包含这两个值的其他客观伤口评估工具。选择了六项研究HILT在伤口愈合治疗中的人体研究和一项评估HILT在小鼠急性伤口中的伤口愈合效果的动物研究(ThabetAAE,马兰HG,EbidAA,AlshehriMA.脉冲高强度激光治疗对糖尿病妇女剖宫产愈合延迟的影响。JPhysTherSci.;30(4):570-575。doi:,EbidAA,ThabetA,HelalO(2018)(2011)脉冲高强度Nd:Yag激光治疗慢性糖尿病足溃疡的疗效。健康能源pp。25-30);(附件AA,El-KafyEM,AlayatMS(2013)脉冲Nd:YAG激光治疗小儿脊柱裂神经性足溃疡的疗效:一项随机对照研究。光子激光治疗31(12):565-570。https://doi.org/10.1089/pho.2013.3533);(HongSE等人。(2016)在实验动物模型中,钕-钇-铝石榴石(Nd:YAG)脉冲高强度激光治疗对全厚度伤口愈合的影响。JCosmetLaserTher18(8):432-437。https://doi.org/10.1080/14764172.2016.1202421);(LuQ等人。(2021)高强度激光治疗对慢性难治性伤口患者的临床效果:一项随机对照试验。英国医学杂志公开赛11(7):e045866。https://doi.org/10.1136/bmjopen-2020-045866);(PereiraFLC等人(2020)使用高功率激光进行伤口愈合:一例病例报告。J激光医学科学11(1):112-114。https://doi.org/10.15171/jlmss.2020.19);(ThabetAAE等人(2018)脉冲高强度激光治疗对糖尿病妇女剖宫产延迟愈合的影响。JPhysTherSci30(4):570-575。https://doi.org/10.1589/jptts.30.570);(NussbaumEL,巴克斯特GD,LilgeL(2003)回顾了激光技术和光-组织相互作用作为低强度激光器和其他光源治疗应用的背景。Phys治疗评论8(1):31-44。https://doi.org/10.1002/lsm.20769).这些有限数量的研究显示出不同的治疗参数,盲法程序,伤口病因,辐照协议,和测试区域(ThabetAAE,马兰HG,EbidAA,AlshehriMA.脉冲高强度激光治疗对糖尿病妇女剖宫产愈合延迟的影响。JPhysTherSci.;30(4):570-575。doi:,EbidAA,ThabetA,HelalO(2018)(2011)脉冲高强度Nd:Yag激光治疗慢性糖尿病足溃疡的疗效。健康能源pp。25-30);(附件AA,El-KafyEM,AlayatMS(2013)脉冲Nd:YAG激光治疗小儿脊柱裂神经性足溃疡的疗效:一项随机对照研究。光子激光治疗31(12):565-570。https://doi.org/10.1089/pho.2013.3533);(HongSE等人。(2016)在实验动物模型中,钕-钇-铝石榴石(Nd:YAG)脉冲高强度激光治疗对全厚度伤口愈合的影响。JCosmetLaserTher18(8):432-437。https://doi.org/10.1080/14764172.2016.1202421);(LuQ等人。(2021)高强度激光治疗对慢性难治性伤口患者的临床效果:一项随机对照试验。英国医学杂志公开赛11(7):e045866。https://doi.org/10.1136/bmjopen-2020-045866);(PereiraFLC等人(2020)使用高功率激光进行伤口愈合:一例病例报告。J激光医学科学11(1):112-114。https://doi.org/10.15171/jlmss.2020.19);(ThabetAAE等人(2018)脉冲高强度激光治疗对糖尿病妇女剖宫产延迟愈合的影响。JPhysTherSci30(4):570-575。https://doi.org/10.1589/jptts.30.570);(NussbaumEL,巴克斯特GD,LilgeL(2003)回顾了激光技术和光-组织相互作用作为低强度激光器和其他光源治疗应用的背景。Phys治疗评论8(1):31-44。https://doi.org/10.1002/lsm.20769).所有选定的研究都显示出改善伤口状况的良好结果(ThabetAAE,马兰HG,EbidAA,AlshehriMA.脉冲高强度激光治疗对糖尿病妇女剖宫产愈合延迟的影响。JPhysTherSci.;30(4):570-575。doi:,EbidAA,ThabetA,HelalO(2018)(2011)脉冲高强度Nd:Yag激光治疗慢性糖尿病足溃疡的疗效。健康能源pp。25-30);(附件AA,El-KafyEM,AlayatMS(2013)脉冲Nd:YAG激光治疗小儿脊柱裂神经性足溃疡的疗效:一项随机对照研究。光子激光治疗31(12):565-570。https://doi.org/10.1089/pho.2013.3533);(HongSE等人。(2016)在实验动物模型中,钕-钇-铝石榴石(Nd:YAG)脉冲高强度激光治疗对全厚度伤口愈合的影响。JCosmetLaserTher18(8):432-437。https://doi.org/10.1080/14764172.2016.1202421);(LuQ等人。(2021)高强度激光治疗对慢性难治性伤口患者的临床效果:一项随机对照试验。英国医学杂志公开赛11(7):e045866。https://doi.org/10.1136/bmjopen-2020-045866);(PereiraFLC等人(2020)使用高功率激光进行伤口愈合:一例病例报告。J激光医学科学11(1):112-114。https://doi.org/10.15171/jlmss.2020.19);(ThabetAAE等人(2018)脉冲高强度激光治疗对糖尿病妇女剖宫产延迟愈合的影响。JPhysTherSci30(4):570-575。https://doi.org/10.1589/jptts.30.570);(NussbaumEL,巴克斯特GD,LilgeL(2003)回顾了激光技术和光-组织相互作用作为低强度激光器和其他光源治疗应用的背景。Phys治疗评论8(1):31-44。https://doi.org/10.1002/lsm.20769).尽管在伤口管理中使用HILT的数据支持不足,有希望的结果鼓励进一步的研究。HILT似乎对伤口愈合有效,但是需要更多高质量的研究来确定最佳的激光方案。
High-intensity laser therapy (
HILT) has recently been incorporated into wound management therapeutic protocols (Mosca RC et al. (2019) Photobiomodulation Therapy for Wound Care: A Potent, Noninvasive, Photoceutical Approach. Adv Skin Wound Care 32(4):157-167. https://doi.org/10.1097/01.ASW.0000553600.97572.d2 ). Laser therapy is increasingly used as an adjunct to therapeutic interventions in clinical practice (Dundar U et al. (2015) Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study. Lasers Med Sci 30(1):325-332. https://doi.org/10.1007/s10103-014-1671-8 ). This study aimed to evaluate the efficacy of
HILT and the potential benefits of incorporating co- interventions alongside
HILT in wound management. The following databases were searched up to April 2023: Embase, MEDLINE, PubMed, and Cinahl, as well as manual searches. The search keywords included high- intensity laser therapy, high-power laser therapy, laser therapy, wound, ulcer, and wound healing. The primary measures were decreased wound surface area (WSA) and improved wound appearance (WA) or other objective wound assessment tools containing these two values. Six human studies investigating HILT in wound healing treatment and one animal study assessing the wound-healing effects of
HILT in acute wounds of mice were selected (Thabet AAE, Mahran HG, Ebid AA, Alshehri MA. Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci.;30(4):570-575. doi:, Ebid AA, Thabet A, Helal O (2018) (2011) Efficacy of pulsed high intensity Nd: Yag Laser in Treatment of Chronic Diabetic Foot Ulcer. Energy for Health pp. 25-30); (Ebid AA, El-Kafy EM, Alayat MS (2013) Effect of pulsed Nd: YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study. Photomed Laser Surg 31(12):565-570. https://doi.org/10.1089/pho.2013.3533 ); (Hong SE et al. (2016) Effects of neodymium-yttrium-aluminum garnet (Nd: YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model. J Cosmet Laser Ther 18(8):432-437. https://doi.org/10.1080/14764172.2016.1202421 ); (Lu Q et al. (2021) Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial. BMJ Open 11(7):e045866. https://doi.org/10.1136/bmjopen-2020-045866 ); (Pereira FLC et al. (2020) Use of a High-Power Laser for Wound Healing: A Case Report. J Lasers Med Sci 11(1):112-114. https://doi.org/10.15171/jlms.2020.19 ); (Thabet AAE et al. (2018) Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci 30(4):570-575. https://doi.org/10.1589/jpts.30.570 ); (Nussbaum EL, Baxter GD, Lilge L (2003) A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources. Phys Therapy Reviews 8(1):31-44. https://doi.org/10.1002/lsm.20769 ). This limited number of studies exhibited varying treatment parameters, blinding procedures, wound etiologies, irradiation protocols, and testing areas (Thabet AAE, Mahran HG, Ebid AA, Alshehri MA. Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci. ;30(4):570-575. doi:, Ebid AA, Thabet A, Helal O (2018) (2011) Efficacy of pulsed high intensity Nd: Yag Laser in Treatment of Chronic Diabetic Foot Ulcer. Energy for Health pp. 25-30); (Ebid AA, El-Kafy EM, Alayat MS (2013) Effect of pulsed Nd: YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study. Photomed Laser Surg 31(12):565-570. https://doi.org/10.1089/pho.2013.3533 ); (Hong SE et al. (2016) Effects of neodymium-yttrium-aluminum garnet (Nd: YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model. J Cosmet Laser Ther 18(8):432-437. https://doi.org/10.1080/14764172.2016.1202421 ); (Lu Q et al. (2021) Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial. BMJ Open 11(7):e045866. https://doi.org/10.1136/bmjopen-2020-045866 ); (Pereira FLC et al. (2020) Use of a High-Power Laser for Wound Healing: A Case Report. J Lasers Med Sci 11(1):112-114. https://doi.org/10.15171/jlms.2020.19 ); (Thabet AAE et al. (2018) Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci 30(4):570-575. https://doi.org/10.1589/jpts.30.570 ); (Nussbaum EL, Baxter GD, Lilge L (2003) A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources. Phys Therapy Reviews 8(1):31-44. https://doi.org/10.1002/lsm.20769 ). All selected studies demonstrated favorable results in improving wound conditions (Thabet AAE, Mahran HG, Ebid AA, Alshehri MA. Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci. ;30(4):570-575. doi:, Ebid AA, Thabet A, Helal O (2018) (2011) Efficacy of pulsed high intensity Nd: Yag Laser in Treatment of Chronic Diabetic Foot Ulcer. Energy for Health pp. 25-30); (Ebid AA, El-Kafy EM, Alayat MS (2013) Effect of pulsed Nd: YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study. Photomed Laser Surg 31(12):565-570. https://doi.org/10.1089/pho.2013.3533 ); (Hong SE et al. (2016) Effects of neodymium-yttrium-aluminum garnet (Nd: YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model. J Cosmet Laser Ther 18(8):432-437. https://doi.org/10.1080/14764172.2016.1202421 ); (Lu Q et al. (2021) Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial. BMJ Open 11(7):e045866. https://doi.org/10.1136/bmjopen-2020-045866 ); (Pereira FLC et al. (2020) Use of a High-Power Laser for Wound Healing: A Case Report. J Lasers Med Sci 11(1):112-114. https://doi.org/10.15171/jlms.2020.19 ); (Thabet AAE et al. (2018) Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci 30(4):570-575. https://doi.org/10.1589/jpts.30.570 ); (Nussbaum EL, Baxter GD, Lilge L (2003) A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources. Phys Therapy Reviews 8(1):31-44. https://doi.org/10.1002/lsm.20769 ). Although insufficient data support using HILT in wound management, the promising results encourage further research.
HILT appears effective in wound healing, but more high-quality studies are needed to identify optimal laser protocols.