Induction of complete wound healing in recalcitrant ulcers by low-intensity laser irradiation depends on ulcer cause and size

Chronic skin ulcers still represent a therapeutic challenge in dermatology. Among the various non-invasive treatment modalities used for the improveme nt of impaired wound healing, low-intensity laser irradiations are gaining an increasing body of interest. We used low-intensity laser irradiations de livered by a 30 mW helium-neon laser at an energy density of 30 J/cm(2) thr ee times weekly for the induction of wound healing in ulcers of diverse cau ses. Twenty patients with the same number of ulcers, which had previously b een treated by conventional wound care for a median period of 34 weeks (ran ge: 3-120 weeks) without any significant evidence of healing, were included in the study. Concerning the underlying disorders, patients were divided i nto four groups: diabetes, arterial insufficiency, radio damage and autoimm une vasculitis. In all ulcers, complete epithelization could be induced by laser therapy. No amputation or any other surgical intervention was necessa ry and no adverse effects of any kind were noted during low-intensity laser treatment. Regarding the different diagnoses, a statistically significant difference was noted (P = 0.008): ulcers due to radio damage healed signifi cantly faster than those caused by diabetes (6 weeks [range: 3-10 weeks] vs . 16 weeks [range: 9-45 weeks], P=0.005). Wound healing in autoimmune vascu litis (24 weeks [range: 20-35 weeks]) required longer than in radiodermitis , although the difference was not significant. In addition to the diagnosis, wound size was found to be an important facto r influencing the duration of wound closure (P=0.028), whereas duration of previous conventional treatment (P=0.24) and depth (P=0.14) showed no effec t. Our results indicate that low-intensity laser irradiation could be a val uable non-invasive tool for the induction of wound healing in recalcitrant ulcers, and that healing time is correlated with the ulcer cause and size.