ABSTRACT
Introdução: As úlceras de pé diabético representam uma importante causa de amputações não-traumáticas. A terapia com laser de baixa intensidade tem demonstrado bons resultados ao acelerar a cicatrização de feridas crônicas, sobretudo em condições de microcirculação reduzida. Portanto, o objetivo do estudo é avaliar os efeitos da laserterapia no tratamento dos pacientes com pé diabético.Metodologia: Tratou-se de uma revisão sistemática de estudos contidos nas bases de dados eletrônicos PubMed, LILACS e SciELO, sem restrição de ano, utilizando os descritores "Diabetes mellitus", "Hiperglicemia", "Lasers", "Pé diabético", "Lesão por pressão" nas línguas inglesa e portuguesa. Foram excluídos os estudos não-randomizados, relatos de caso, observações clínicas e revisões. A Cochrane Collaboration foi utilizada para analisar a qualidade metodológica dos estudos.Resultados: Foram encontrados 24 artigos, sendo excluídos 18 por não se adequarem ao objetivo do estudo. Os estudos trazem um resultado estatisticamente significativo da utilização do LLLT no processo de cicatrização das úlceras diabéticas. Apenas um estudo não teve relevância estatística quando comparado ao grupo controle. Ainda assim, todos os autores apresentam eficácia dessa conduta, mesmo de forma indireta.Conclusão: O uso da laserterapia é uma intervenção que promove efeitos importantes na melhora da cicatrização das feridas em pacientes com úlceras diabéticas. No entanto, não há congruência na literatura de quais são os parâmetros mais adequados para aplicação dessa técnica.
Introduction: Diabetic foot ulcers are a major cause of nontraumatic amputations. Low-level laser therapy (LLLT) has shown good results in accelerating chronic wound healing, especially in conditions of reduced microcirculation. Therefore, the objective this study was evaluate the effects of LLLT on the treatment of patients with diabetic foot.Methodology: We conducted a systematic review in the electronic databases PubMed, LILACS, and SciELO, with no restrictions on date of publication. The following terms were used: "Diabetes Mellitus", "Hyperglycemia", "Lasers", "Diabetic Foot", and "Pressure Ulcer", in English and Portuguese. We excluded nonrandomized studies, case reports, clinical observations, and reviews. The Cochrane Collaboration was used to evaluate the methodological quality of the studies.Results: The search yielded 24 articles, of which 18 were excluded because they did not fit the study objective. Study results on the use of LLLT for diabetic ulcer healing were statistically significant. Only one study had no statistical significance when compared to the control group. Still, all studies showed LLLT to be effective, even if indirectly.Conclusion: The use of LLLT promotes important effects on the improvement of wound healing in patients with diabetic ulcers. However, there is no consensus on the literature regarding the best parameters to apply this technique.
Subject(s)
Humans , Male , Female , Diabetic Foot/radiotherapy , Low-Level Light Therapy , Pressure Ulcer/radiotherapy , Diabetes Mellitus/physiopathologyABSTRACT
Abstract: The article discusses the results of a literature review on the application of low intensity laser therapy on the healing of wounds associated diabetes mellitus in the last 10 years. Objective: To determine the most effective parameter in healing wounds related to diabetes mellitus, as well as the most widely used type of laser. Methodology: consisted of bibliographic searching the databases Bireme, SciELO, PubMed/Medline and Lilacs by using the keywords related to the topic. Were selected from these keywords, papers discussing the use of laser on wounds associated with diabetes, published in the period 2005-2014, in Portuguese or English. Results: After analyzing the research, 12 studies consistent with the theme were selected. Conclusion: Based on this review, the studies that showed more satisfactory results in healing diabetic wounds were those who applied energy densities in the range of 3-5 J/cm2, power densities equal to or below 0.2 W/cm2 and continuous emission. The He-Ne laser with a wavelength of 632.8 nm was used more often.
Subject(s)
Humans , Animals , Male , Female , Wound Healing/radiation effects , Diabetic Foot/radiotherapy , Low-Level Light Therapy/methods , Diabetes Mellitus/physiopathology , Reproducibility of Results , Treatment Outcome , Dose-Response Relationship, RadiationABSTRACT
ABSTRACT PURPOSE: To evaluate the effects of the low-level laser therapy applying Laser on the tissue repair in ulcer carriers due to diabetes. METHODS: Sixteen type II diabetic patients, ulcer carriers in the lower limbs, participated in the research from which eight were in the control group and eight were submitted to the low-level laser therapy with a pulsed wave form, visible ray, wave length of 632.8 nm, 30 mW peak power, (Laser - HTM). The application time was of 80 (4J/cm2) seconds. The application was punctual without contact (approximately 1mm of distance), the pen being held in a perpendicular position related to the wound, in equidistant points. There were 12 appointments, of which three were done weekly in alternated days. Photograph records and an application of the brief inventory of pain were done before and after 30 days of follow-up. RESULTS: There was a significant decrease in the size of the wound when compared to the control group (p<0.05). The pain was also reported as having an intense improvement in the treated group. CONCLUSION: The low-level laser treatment seems to be an efficient method, viable, painless and of low costs concerning the tissue repair ulcers in a diabetic foot.