Evaluation of the Efficacy of Ultrapulsed CO₂ Laser in Chronic Wounds

Abstract

Background and Objectives Chronic wound repair is a major problem in wound treatment. Recently, several studies have suggested that carbon dioxide (CO2) laser can be used to improve the healing of chronic wounds. The aim of the present study was to preliminarily investigate the efficacy of laser debridement in treating chronic wound through a comparison of traditional instrument/surgical debridement with the ultrapulsed CO2 laser debridement in terms of wound healing, wound infection control, and wound blood perfusion. Study Design/Materials and Methods Patients with chronic wound admitted to the Wound Repair Clinic at The Affiliated Hospital of Southwest Medical University (Luzhou, China) between February 2019 and May 2019 were enrolled. They were randomly divided into two groups. The patients in one group were treated with traditional sharp instrument/surgical debridement (RT group; number of wounds: 28), while the patients in the other group were treated with ultrapulsed CO2 laser debridement (LT group; number of wounds: 26). An intergroup comparison was performed based on parameters, such as wound healing, wound infection control, and changes in wound blood perfusion. Results The wound healing rate and the total time to achieve healing were significantly better in the LT group versus the RT group at 7, 14, 21, and 28 days after treatment. The wound exudation scores were significantly higher in the LT group versus the RT group at 7, 14, and 28 days after treatment. The positive rate of pre‐debridement bacterial culture was significantly lower in the LT group versus the RD group at 14 and 28 days after treatment. The percentage of wound perfusion/normal periwound skin perfusion was significantly higher in the LT group versus the RT group at 1, 7, and 14 days after treatment. Conclusion For the treatment of chronic refractory wounds, the ultrapulsed CO2 laser exhibits higher accuracy, more effectively controls wound infection, promotes an increase in wound blood perfusion, and achieves faster wound healing compared with traditional sharp instrument/surgical debridement. Lasers Surg. Med. © 2020 Wiley Periodicals LLC

Efficacy and safety of CO2 laser in the treatment of chronic wounds: A Retrospective Matched Cohort Trial

“…It is also correlated with superior wound status and causes no adverse events. 23,26,27 CO 2 laser employs high levels of energy to vaporize biological tissues. Its wavelength is 10,600 nm for targeting water in the superficial tissues and rarely scatters or penetrates, depositing energy to a precise depth below the surface of the skin without affecting the deeper tissues.…”

“…Meanwhile, CO 2 laser may play an important role in controlling local infection in the wound bed. Jiang et al 23 found that CO 2 laser treatment reduces bacterial culture‐positive rate more than routine debridement. In a prospective study of 60 patients, Juri et al 21 also demonstrated a lower infection rate in a CO 2 laser group than a conventional surgery group.…”

“…Consistent with previous studies, we found that CO 2 laser debridement is correlated with a shorter time‐to‐heal than routine debridement treatment. It is also correlated with superior wound status and causes no adverse events 23,26,27 …”

“…[20][21][22] Nonetheless, clinical research on CO 2 laser debridement for chronic cutaneous wounds has been scant, and most has been in case reports or small-scale clinical trials. [23][24][25][26][27][28] Furthermore, some of these studies have focused on fractionated ablation, which is quite different from confluent laser debridement. Based on this premise, we conducted the present study to assess the efficacy and safety of CO 2 laser debridement in the treatment of chronic cutaneous wounds, as compared with routine mechanical debridement.…”

“…It may also increase fibroblast proliferation and stimulate growth factors secretion 20–22 . Nonetheless, clinical research on CO 2 laser debridement for chronic cutaneous wounds has been scant, and most has been in case reports or small‐scale clinical trials 23–28 . Furthermore, some of these studies have focused on fractionated ablation, which is quite different from confluent laser debridement.…”