Treatment of diabetic foot ulcers in a frail population with severe co-morbidities using at-home photobiomodulation laser therapy: a double-blind, randomized, sham-controlled pilot clinical study

Amir Haze, Lilach Gavish*, Ofer Elishoov, Dorit Shorka, Tamir Tsohar, Yechiel N. Gellman, Meir Liebergall

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Purpose: To evaluate the safety and efficacy of an at-home photobiomodulation (PBM) device for the treatment of diabetic foot ulcers (DFUs) in a frail population with severe comorbidities. Methods: Prospective, randomized, double-blind, sham-controlled pilot study. Patients (age = 63 ± 11 years, male:female 13:7) with insulin-dependent diabetes type 2, neuropathy, peripheral artery disease, significant co-morbidities, and large osteomyelitis-associated DFUs (University of Texas grade ≥ III) were randomized to receive active (n = 10) or sham (n = 10) at-home daily PBM treatments (pulsed near-infrared 808 nm Ga-Al-As laser, 250 mW, 8.8 J/cm2) for up to 12 weeks in addition to standard care. The primary outcome was the %wound size reduction. The secondary was adverse events. Results: With the numbers available, PBM-treated group had significantly greater %reduction compared to sham (area [cm2], baseline vs endpoint: PBM 10[20.3] cm2 vs 0.2[2.4] cm2; sham, 7.9 [12.0] cm2 vs 4.6 [13.8] cm2, p = 0.018 by Mann–Whitney U test). Wound closure > 90% occurred in 7 of 10 PBM-treated patients but in only 1 of 10 sham patients (p = 0.006). No adverse device effects were observed. Conclusions: Photobiomodulation at home, in addition to standard care, may be effective for the treatment of severe DFUs in frail patients with co-morbidities and is particularly relevant at these times of social distancing. Our preliminary results justify the conduction of a larger clinical trial. ClinicalTrials.gov: NCT01493895.

Original languageAmerican English
Pages (from-to)919-928
Number of pages10
JournalLasers in Medical Science
Volume37
Issue number2
DOIs
StatePublished - Mar 2022

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.

Keywords

  • Diabetic foot ulcer
  • Frail elderly
  • Low-level laser therapy
  • Photobiomodulation
  • Wound healing
  • Prospective Studies
  • Double-Blind Method
  • Humans
  • Middle Aged
  • Male
  • Frail Elderly
  • Wound Healing
  • Diabetes Mellitus
  • Morbidity
  • Pilot Projects
  • Lasers
  • Diabetic Foot/radiotherapy
  • Female
  • Aged
  • Low-Level Light Therapy/methods

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