Wound Healing Made Unlimited
BACKGROUND
Ten patients of lower limb ulcer admitted between October 2011
and April 2012 were treated and studied
MATERIAL AND METHODS
All patients were diagnosed on the basis of clinical and radiological
findings and after that laser therapy was performed. This was
followed by accelerated healing of wound and in some cases by
covering the wound by split thickness skin graft.
RESULTS
All patients were male, maximum incidence was noted in the age
group of 34 to 84 years.
CONCLUSION
The laser therapy resulted in enhanced healing as measured by
wound contraction.
Keywords : Diabetic ulcer, venous ulcer, laser.
Introduction: The concept of a non-invasive, non-thermal
intervention that has the power to modulate regenerative processes
of the human cells is the answer to therapist prayers in health care.
Venous ulcers, diabetic ulcers, and post-amputation wounds, are
difficult to manage and often do not heal, even with aggressive
medical management and patient compliance. The lack of consistent
and favourable outcomes, is a costly and painful problem for the
patient and health care industry.
After more than 40 years of use, still no serious side effects of using
laser radiation as a medical treatment modality have been observed.
Low energies of laser light affect the nature and basic mechanisms of
our cells and restore their impaired function. Some of these lead to
accelerate wound healing, reduction of edema, healing
of
neurological injuries, increased microcirculation and pain relief.
Laser Therapy is a new approach applicable in different medical
fields, inducing soft tissue healing, pain relief, bone and nerve
regeneration.
The development of pharmaceuticals has dramatically contributed to
improve global health. However, pharmaceuticals are also creating
severe side effects for patient and the environment.
Laser therapy is a more effective method, stimulating cell activity to
accelerate healing process than using different methods to facilitate
the way for the healing process.
MATERIAL AND METHODS
All patients of lower limb ulcer and one patient of bed ulcer admitted
under care of surgical units in various hospital in Riyadh (KSA)
between October 2011 and April 2012, were treated and studied. All
patients were initially managed with conventional wound care
treatment. Diagnosis was made on the basis of clinical presentation
of patient and radiological findings.
Distribution of lower limb ulcer in different age groups ,
gender,duration of ulcer and coexistant disease were documented.
Prerequisites for laser therapy
1. Treatment area should be clean and ready
2. Exact laser dose and time should be set
3. Laser should be applied directly & vertically to skin, open area 5
mm away
4. Treatment should be given day after day with patient compliance
until healing is achieved
Patient 1: Age 70 years old, patient diabetic and ischemic,
amputations since 2 months and treatment method laser only,
duration 6.30 minutes day after day.
Patient 2: Age 57, patient diabetic and ischemic, ulcers since 100
days, treatment method laser only, duration 6.30 minutes day after
day.
Patient 3:
Age 70, patient diabetic since 1 month, treatment
method laser only, duration 7 minutes day after day.
Patient 4: Age 72, patient ischemic and diabetic type 2, amputation
since 8 months, treatment method laser only, duration 7 minutes
day after day.
Patient 5: Age 62, patient ischemic and diabetic type 2, amputation
since 2 weeks, treatment method laser only, duration 10 minutes day
after day.
Patient 6: Age 84, patient ischemic and diabetic, bed ulcers since 4
months, treatment method laser only, duration 7 minutes day after
day.
Patient 7: Age 65, patient ischemic and diabetic, ulcer since 4
months, treatment method laser only, duration 7 minutes day after
day.
Patient 8: Age 34, healthy, acid ulcers since 4 years, treatment
method laser only, duration 20 minutes day after day.
Patient 9: Age 45, diabetic and hypertension, wound since 40 days,
treatment method laser only, duration 5 minutes day after day.
Patient 10: Age 62, diabetic, Charcot foot since 6 months, treatment
method laser plus oral antibiotic, duration 7 minutes day after day.
How to use the machine: Switch ON from green button on the back.
Choose the treating tip
MS2, 7.5 mm for average wounds.
MS3, 13 mm for larger wounds.
Clean the wound with antiseptic solution. Select from the screen
Treatment to choose manually the frequencies and time. You can
save the values by pressing save, choose patient name or MRN, write
down, then press Enter. You can call your data later by pressing Call
Data then Names. To change frequencies and time, press Call data,
names, select the patient’s name, change then save. To delete data,
press Delete data, names, then select the patient’s name, then
delete. You can use the programmed frequencies for specific
indication from the screen by pressing Indications. Select one then
adjust time according to the surface areas as in Time Equation. Clean
the tip with alcohol swab, dry and cover it with Tegaderm. Upon
finishing the session, turn machine off, discard Tegaderm and clean
the tip with alcohol swab. Reclean the wound and dress it with
simple gauze. Repeat the session every other day for at least 13
sessions to achieve the desirable aim. By the course of time, you
change the frequencies and time according to the improvement in
wound size and depth. Apply 75% of the time on 0.5 cm – 1cm
margin of the wound in a back-forth manner keeping a distance to
the skin between 5-10 mm, the remaining 25% of time on the wound
bed itself in the same manner keeping a distance between 5-10 mm.
Treatment protocol
Low level laser therapy (LLLT) is the application of the light to
pathology to promote tissue regeneration, reduce Inflammation and
relieve pain.
INDICATIONS:
Stage III and IV bedsores
Diabetic foot
Non healing wounds
Wounds with peripheral arterial disease
CONTRAINDICATIONS:
Patients with pace makers (at location of pace maker)
Patients with cancer
Pregnant women (at belly)
Albiminism
Epileptic patients
Undiagnosed skin lesions
NO RADIATION ON
Open eyes
Thyroid
Child epiphysis
Open fontanel
RESULT:
In our study all patients were male, and age group varied from 34 to
84 years. Six patients were found to be having diabetic and ischemic
foot while 3 patients were diabetic only. One patient was a healthy
adult male with acid ulcer over foot .Four patients were having
amputation done previously. One patient was with a bed ulcer while
other one was with charcot’s joint. The duration of ulcer ranged
from 2 weeks to 4 years in our study. The observation were
a) skin gain back it’s healthy color,
b) the Pain decreased to over 80%,
c) blood flow enhanced,
d) healing process triggered .
CONCLUSION
The exploitation of phototherapy in medicine and surgery is of great
interest, and there is a growing interest in the use of lasers for the
treatment of various conditions and disorders, including the
treatment of diabetic wounds . Using lasers as a source of
photobiostimulation looks to be an attractive branch of medicine for
the future. Due to disturbances of the circulation in people with
diabetes, wounds heal slowly and are susceptible to infection. Laser
therapy has been shown to speed up the time needed for wound
closure in people with diabetes and there is improved wound
epithelialisation, increased cellular content, increased granulation
tissue formation and increased collagen deposition. There is a
decrease in the inflammatory reaction , and a stimulatory effect on
the immune system . Laser therapy has also been shown to
increase microcirculation , enhance wound tensile strength,
accelerate collagen production , and decrease free radical oxidation
processes in people with diabetes.
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