Clinical Wound Management Approaches Incorporating Photobiomodulation Therapy
John C. Castel, PhD
Carewear Corp., Reno, NV, USA
BACKGROUND The impact of light on Wound healing has been documented extensively since Dr. Andre Mester first began his research work in 1965. In 1985 our research group at Harbor UCLA began investigating the use of red 632 nm and Infrared at 904 nm on collagen synthesis in vitro and in Vivo on hairless mouse and porcine models. These were some of the first publications indicating that light had the ability to influence healing rates. Since then many hundreds of articles have been published indicating that PBM is effective in various stages of wound healing.
METHODS An analysis of the current literature and review by clinical experts with direct clinical experience in wound healing will be used to present proposed wound management approaches using Photobiomodulation therapy.
RESULTS The wound healing process consists of three basic phases inflammation, proliferation and remodeling. Many clinical trials fail to take into consideration the optimal wavelengths and dose based on the stage of healing, wound infection, level of exudate and patient co-morbidities. In addition, good wound management involves wound debridement and the appropriate dressing choices for the stage of healing as well as identification of factors inhibiting wound healing. The type of wound and chronicity is also a determinant factor for consideration in the treatment approach. Post-surgical wounds (with or without infection or sepsis), pressure ulcers, arterial or venous insufficiency and diabetic ulcers are generally managed with specific clinical pathways. Deep tissue injury and contusions are an important part of wound healing which require a different treatment approach.
CONCLUSIONS Key elements involved in wound healing such as light transmission considerations, fluence and irradiance, pulsed vs CW modes and complimentary therapies will be discussed with presentations of proposed clinical pathways for treatment of various wound types.
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