Evidence-Based Complementary and Alternative Medicine / 2014 / Article / Tab 2

Review Article

Low Level Laser Therapy for the Treatment of Diabetic Foot Ulcers: A Critical Survey

Table 2

Clinical trials on leg ulcer treatment with LLLT in diabetic ulcers.

StudyStudy designParticipantsInterventionOutcome measuresTreatment outcome

Schindl et al., 1998 [13] Randomized, double-blinded, placebo- controlled trial30 diabetic subjects with foot ulcer/gangreneSingle treatment HeNe laser 632.8 nm, 30 J/cm2 , 50 minTemperature Increase of microcirculation due to athermic laser irradiation

Schindl et al., 1999 [14] Case studies20 patients with diabetes ( ), arterial insufficiency ( ), radio damage ( ), and autoimmune vasculitis ( )30 mW helium neon laser 632.8 nm, 30 J/cm2, 3 times weekly, 16–24 weeks until wound closureNecessary treatments until wound closureUlcers due to radio damage healed significantly faster than those caused by diabetes autoimmune vasculitis and required lower time than that in radiodermatitis (nonsignificant);wound size was a predicting parameter but not wound depth and prior treatment

Saltmarche, 2008 [15]Prospective comparative clinical trial 21 open wounds and 4 “at risk” closed areas, and chronic (> or =3 months) and acute (<3 months) ulcers due to pressure, venous insufficiency, and diabetes 5 times per week in first week, 3 times a week for more 8 weeks, 785 nmReduction of size61.9% of open wounds had significant reduction of size, 42.8% had 100% closure, 14.3% had some improvement, and 23.8% had no change no significant difference between chronic and acute wounds

Zhou et al., 2008 [16]Randomized, molecular-biological analysis60 patients with 84 chronic dermal ulcers in diabetes patients and othersDaily till healing Helium neon (HeNe) laser, 632.8 nmHealing rate, immunohistochemical analysis: HSP70, HSF1Expression of HSF1, HSP70, and RNA levels of HSF1 and HSP70 in laser group was significantly higher

Minatel et al., 2009 [17]Randomized, placebo-controlled, double-blinded trial14 patients with 23 chronic diabetic ulcersTwice a week till healing, at most 90 days, 660 nm and 890 nm, 3 J/cm2, 30 sec/5 cm2Healing rate and granulationTreatment group had more granulation (day 30: 56%) and faster healing (day 30: 79.2%), 58.3% healed fully (1 ulcer placebo group); 75% ulcer healed 90–100% day 90 (one ulcer placebo group)

Kaviani et al., 2011 [18]Randomized, placebo-controlled, double-blinded trial23 patients, diabetic foot wounds for at least three months2 times a week for 2 weeks then every second day till healing, 685 nm, 10 J/cm2  200 secReduction of ulcer size and healing timeSignificant reduction of ulcer size of %   in laser group to %   two weeks after treatment; healing time of treatment group: 11 weeks, placebo: 14 weeks, but not significant

Kajagar et al., 2012 [19]Randomized controlled trial68 patients with chronic diabetic foot ulcers, conventional care + LLLT ( ) versus conventional care aloneDaily treatment for 15 days, 2–4 J/cm2  Power, 60 mW Frequency, 5 kHzUlcer sizeSignificant reduction of percentage of ulcer area LLLT group

Landau et al., 2011 [20]Randomized, placebo-controlled, double-blinded trial14 patients with diabetic ulcers, 2 patients with venous ulcersTwice daily for 12 weeks broadband (400–800 nm) 43.2 J/cm2,  4 minutesHealing rate Reduction of size Wound closure timeTreatment group Healing: 90%, reduction of size: 89%, mean/median Wound closure time: 7.14/11.16 weeks Placebo group Healing: 33%, reduction of size: 54%, mean/median Wound closure time: 11.5 weeks