Photodynamic therapy as an alternative to antibiotic therapy for the treatment of infected leg ulcers

Kawczyk‐Krupka, Aleksandra; Pucelik, Barbara; Międzybrodzka, Anna; Sieroń, Aleksander; Dąbrowski, Janusz

doi:10.1016/j.pdpdt.2018.05.001

Cited by 39 publications

(28 citation statements)

References 121 publications

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“…The use of aPDT is well documented for many diseases and conditions such as infected leg ulcers, 20 diabetic foot, 21 and chronic skin ulcers. 22 With specific regard to the oral environment, its action includes the treatment of leukoplakia, 17 lichen planus, 23 periodontal pockets, 24 peri-implantitis, 25 and oral decontamination as well.…”

Section: Discussionmentioning

confidence: 99%

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Maya¹,

Ladeira

Maya

et al. 2020

J Lasers Med Sci

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Introduction: One of the unexpected side effects of the Haas type palatal expander is ulcers progressing to necrotic lesions in the palatal area due to poor hygiene. The use of antibiotic therapy is mandatory. However, long periods of healing/pain and the need for a systemic host response with the aid of metabolization, especially in children, are issues that should be taken into account in the management of this type of injury. Since phototherapy modalities (antimicrobial photodynamic therapy [aPDT] and photobiomodulation therapy [PBMT]) are able to enhance and accelerate the healing process and reduce the bacterial load, this case report aimed to describe the use of the above-mentioned therapies to treat palatal ulcers occurring during orthodontic expansion. Case Report: The patient, a 10-year-old boy, with a chief complaint of bleeding and continuous pain in the region of his expander was verified on a follow-up visit. After a dental examination, the expander was removed and two necrotic lesions which were in contact with the acrylic part of the tooth-tissue expander were found in the palatal region. The proposal was to use one aPDT session with methylene blue followed by 4 sessions of PBMT with a red laser diode. On the 5th day, reorganized tissue was verified, with the absence of bleeding, swelling, and pain. On the 20th day of follow-up, the area showed no signs of inflammation, healthy tissue without any pathological clinical symptoms, and complete wound healing. Conclusion: The concomitant use of PBMT and aPDT therapies may be considered feasible as an adjunct treatment to manage palatal ulcers resulting from the incorrect use of tooth-tissue types of expanders

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Section: Discussionmentioning

confidence: 99%

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Maya¹,

Ladeira

Maya

et al. 2020

J Lasers Med Sci

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“…Our preliminary observations showed that PDT can be used to treat leg ulcers as a minimally invasive and effective method with no serious side effects. It seems that the following mechanisms of action of photodynamic theotherapy lie at the heart of this process: antimicrobial effect, modulation of inflammatory process, and improving the oxygenation of ulcer tissue, resulting in a reduction in healing time and improved scarring results [ 30 , 31 ].The treatment is generally well tolerated; the side effects and tolerance of PDT are associated with wound size and degree of wound infection. Further studies on a larger group of patients are needed to confirm the beneficial role of PDT in the treatment of LUs and in potential applications of pH-responsive nanomaterials in anti-infective therapy [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Photodynamic Therapy for the Treatment of Infected Leg Ulcers—A Pilot Study

et al. 2021

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Chronic and infected leg ulcers (LUs) are painful, debilitating, resistant to antibiotics, and immensely reduce a patient’s quality of life. The purpose of our study was to demonstrate the efficacy of photodynamic therapy (PDT) for the treatment of infected chronic LUs. Patients were randomized into two experimental groups: the first group received 5-aminolevulinic acid photodynamic therapy (ALA-PDT) (10 patients), and the second group of 10 patients received local octenidine dihydrochloride (Octenilin gel) exposed to a placebo light source with an inserted filter that mimiced red light. In the PDT group, we used 20% ALA topically applied for 4 hrs and irradiation from a Diomed laser source with a wavelength of 630 nm at a fluency of 80 J/cm2. ALA-PDT was performed 10 times during a 14-day hospitalization in 10 patients of both sexes aged 40–85 years with chronic leg ulcers. Treatments were carried out at 3-week intervals for 3–5 cycles. At 8-month follow-up with the PDT group, complete remission (CR) was obtained in four patients (40%), partial response (>50% reduction in ulcer diameter) in four patients (40%), and no response in two patients (20%) who additionally developed deterioration of the local condition with swelling, erythema, and inflammation. To assess the degree of pain during the trials, we used a numeric rating scale (NRS). From the preliminary results obtained, we concluded that PDT can be used to treat leg ulcers as a minimally invasive and effective method with no serious side effects, although further studies on a larger group of patients with LUs are warranted.

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“…Nowadays, ulcers are one of the most challenging types of wounds, due to their association with persistent localized infections bringing a long-lasting process of healing and high monetary costs to the patient. Chronic ulcers affect around 1% of the adult population, thus being one of the focuses of the skin regeneration research field [77]. In 2011, another promising achievement related to the use of PDI mediated by 5-ALA to treat cutaneous leishmaniasis was reported by Evangelou and coworkers [76].…”

Section: -Aminolevulinic Acid and Derivatives As Precursors Of Endogenous Protoporphyrin-ixmentioning

confidence: 99%

“…Nowadays, ulcers are one of the most challenging types of wounds, due to their association with persistent localized infections bringing a long-lasting process of healing and high monetary costs to the patient. Chronic ulcers affect around 1% of the adult population, thus being one of the focuses of the skin regeneration research field [77]. Nowadays, ulcers are one of the most challenging types of wounds, due to their association with persistent localized infections bringing a long-lasting process of healing and high monetary costs to the patient.…”

Section: -Aminolevulinic Acid and Derivatives As Precursors Of Endogenous Protoporphyrin-ixmentioning

confidence: 99%

The Role of Porphyrinoid Photosensitizers for Skin Wound Healing

Vallejo

Moura

Gomes

et al. 2021

IJMS

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Microorganisms, usually bacteria and fungi, grow and spread in skin wounds, causing infections. These infections trigger the immune system and cause inflammation and tissue damage within the skin or wound, slowing down the healing process. The use of photodynamic therapy (PDT) to eradicate microorganisms has been regarded as a promising alternative to anti-infective therapies, such as those based on antibiotics, and more recently, is being considered for skin wound-healing, namely for infected wounds. Among the several molecules exploited as photosensitizers (PS), porphyrinoids exhibit suitable features for achieving those goals efficiently. The capability that these macrocycles display to generate reactive oxygen species (ROS) gives a significant contribution to the regenerative process. ROS are responsible for avoiding the development of infections by inactivating microorganisms such as bacteria but also by promoting cell proliferation through the activation of stem cells which regulates inflammatory factors and collagen remodeling. The PS can act solo or combined with several materials, such as polymers, hydrogels, nanotubes, or metal-organic frameworks (MOF), keeping both the microbial photoinactivation and healing/regenerative processes’ effectiveness. This review highlights the developments on the combination of PDT approach and skin wound healing using natural and synthetic porphyrinoids, such as porphyrins, chlorins and phthalocyanines, as PS, as well as the prodrug 5-aminolevulinic acid (5-ALA), the natural precursor of protoporphyrin-IX (PP-IX).

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Photodynamic therapy as an alternative to antibiotic therapy for the treatment of infected leg ulcers

Cited by 39 publications

References 121 publications

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report

Photodynamic Therapy for the Treatment of Infected Leg Ulcers—A Pilot Study

The Role of Porphyrinoid Photosensitizers for Skin Wound Healing

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