Laser therapy in wound healing associated with diabetes mellitus - Review

Sousa, Raquel Gomes de; Batista, Keila de Nazaré Madureira

doi:10.1590/abd1806-4841.20163778

Cited by 30 publications

(16 citation statements)

References 21 publications

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“…Laser therapy promotes reduction of inflammation, angiogenesis, and production of extracellular matrix components. 90 Specifically, CO 2 laser therapy was found to significantly reduce wound bacterial load. 91 The RCTs exploring the efficacy of laser therapy on wound healing are few, have small sample sizes, and show variable results.…”

mentioning

confidence: 99%

Update on management of diabetic foot ulcers

Everett

Mathioudakis

2018

Annals of the New York Academy of Sciences

494

315

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Diabetic foot ulcers (DFUs) are a serious complication of diabetes that results in significant morbidity and mortality. Mortality rates associated with the development of a DFU are estimated to be 5% in the first 12 months, and 5-year morality rates have been estimated at 42%. The standard practices in DFU management include surgical debridement, dressings to facilitate a moist wound environment and exudate control, wound off-loading, vascular assessment, and infection and glycemic control. These practices are best coordinated by a multidisciplinary diabetic foot wound clinic. Even with this comprehensive approach, there is still room for improvement in DFU outcomes. Several adjuvant therapies have been studied to reduce DFU healing times and amputation rates. We reviewed the rationale and guidelines for current standard of care practices and reviewed the evidence for the efficacy of adjuvant agents. The adjuvant therapies reviewed include the following categories: nonsurgical debridement agents, dressings and topical agents, oxygen therapies, negative pressure wound therapy, acellular bioproducts, human growth factors, energy-based therapies, and systemic therapies. Many of these agents have been found to be beneficial in improving wound healing rates, although a large proportion of the data are small, randomized controlled trials with high risks of bias.

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mentioning

confidence: 99%

Update on management of diabetic foot ulcers

Everett

Mathioudakis

2018

Annals of the New York Academy of Sciences

494

315

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“…These effects lead to increased cell proliferation and migration by fibroblasts; reduction in the levels of cytokines, growth factors, and inflammatory mediators; and increased tissue oxygenation, leading to enhanced control of the inflammatory process, reduced pain, and improved wound healing 56 – 59 . Studies with laser therapy have confirmed enhanced wound healing in both diabetic 60 and non-diabetic 59 , 61 , 62 patients. Applying LLLT within the first 5 days of herpes zoster eruption also significantly reduced the incidence of post-herpetic neuralgia 63 .…”

Section: Laser Therapymentioning

confidence: 98%

Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management

White

Elvir-Lazo

Galeas³

et al. 2017

F1000Res

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The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).

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“…A terapia a laser de baixa intensidade apresenta resultados significativos demonstrando eficácia terapêutica no processo de cicatrização de feridas, utilizando fatores e técnicas controladas, como dosagem, comprimento de onda e tempo, que quando bem utilizados favorecem a angiogênese e a produção de compostos na matriz extra-celular que promovem a reparação tecidual, entretanto, na literatura os parâmetros de utilização do laser são bastantes diversos como demonstra a Tabela 2 (Sousa & Batista, 2016 Research, Society and Development, v. 9, n. 10, e6239109109, 2020(CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i10.9109 Segundo Tchanque-Fossuo et al (2016, a TLBI pode promover o tratamento dos pés diabético por estabilizar o suporte nutricional extracelular fundamental para facilitar o processo de cicatrização de feridas em pacientes com DM, através do recrutamento de citocinas e fatores de crescimento importantes para estimular a cicatrização de ferimentos além da síntese de colágeno e de fibroblastos, estas respostas a esses estímulos podem ser evidenciados em Mathur et al (2016) visto que as úlceras em grupos tratados com TLBI apresentam mais tecido de granulação, além da porcentagem de redução da área da ferida 37,3 ± 9% em comparação com 15 ± 5% do grupo controle que também apresentou alguma quantidade de pus.…”

Section: Terapia a Laser De Baixa Intensidade E A Resposta Cicatricialunclassified

“…É fundamental compreender que o DM configura-se como um conjunto de alterações envolvendo a secreção da insulina pelo pâncreas na corrente sanguínea resultando em um estado hiperglicêmico prolongado danoso a hemostasia do organismo, afetando principalmente a função renal, cardiovascular e nervosa. Vale destacar que indivíduos diabéticos ocorre uma disfunção nas fases cicatriciais (inflamatória, proliferativa e remodelamento), especialmente na fase proliferativa, em função do estado de hiperglicemia crônico a qual promove uma disfunção endotelial que afeta o desempenho fisiológico das células responsáveis pelo processo de reparação tecidual ocasionando um prolongamento da proliferação, migração e angiogênese, retardando o processo de cicatrização, ressaltando que esse retardo cicatricial associado com neuropatia e redução da sensibilidade favorece o surgimento de úlceras diabéticas, comuns em membros inferiores e que representam um grave problema de saúde pública (Sousa & Batista, 2016).…”

Section: Introductionunclassified

Ação da terapia a laser de baixa intensidade na cicatrização de ulcerações diabéticas

Castro

Barbosa

Silva

2020

RSD

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Objetivou-se verificar evidências na literatura acerca da eficácia da terapia a laser de baixa intensidade na reparação tecidual de úlceras diabéticas dos pés. Realizou-se uma revisão integrativa de literatura, por meio das plataformas online de pesquisa Us national Library of Medicine (PUBMED) e Biblioteca Virtual em Saúde (BVS) nas bases de dados LILACS, MEDLINE E BDENF. Para a elaboração da questão de pesquisa da revisão integrativa, utilizou-se a estratégia PICO, fundamental para a melhora da especificidade e clareza conceitual da situação clínica a ser estudada retornando resultados de maior qualidade e precisão. Foram selecionados artigos indexados em periódicos nacionais e internacionais, disponibilizados na íntegra, pesquisas envolvendo seres humanos sem distinção de gênero, e estudos compreendidos nos últimos 5 anos em todos os idiomas encontrados. Os resultados obtidos demonstram eficácia comprovada no tratamento de ulcerações diabéticas através da estimulação celular proporcionada pelo laser, que resulta em uma maior proliferação celular, neovascularização, e síntese de colágeno. Portanto, o Laser faz-se importante por ser uma terapia de baixo-custo alternativa ao tratamento convencional das úlceras diabéticas, que oferece evidência científica no processo de reparação tecidual e redução da área lesionada.

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Laser therapy in wound healing associated with diabetes mellitus - Review

Cited by 30 publications

References 21 publications

Update on management of diabetic foot ulcers

Update on management of diabetic foot ulcers

Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management

Ação da terapia a laser de baixa intensidade na cicatrização de ulcerações diabéticas

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