A Study on the Macroscopic Morphometry of the Lesion Area on Diabetic Ulcers in Humans Treated with Photodynamic Therapy Using Two Methods of Measurement.

BACKGROUND: Diabetes Mellitus is a chronic disease that can lead to lower-limb ulceration. The photodynamic therapy (PDT) is based on light interaction with a photosensitizer capable to promote bacterial death and acceleration of wound healing. OBJECTIVE: This study aims to accomplish a macroscopic morphometry evaluation on diabetic ulcer area in humans that were under PDT. MATERIALS AND METHODS: A clinical study was conducted by convenience sample, experimental, controlled, and blinded, composed of 12 patients of both sexes with diabetic ulcers in lower limbs that were divided into two groups, control (n = 6) and PDT (n = 6). They were all treated with collagenase/chloramphenicol during the experimental period, in which six of them had received PDT with Methylene Blue dye (0.01%) associated with laser therapy (660 nm, 30 mW, 8 sec, 6 J/cm2, beam area of 0.04 mm2), three times per week, totaling 10 sessions. Ulcer areas were analyzed by their nominal area and photographed for analysis through the ImageJ® software. Then, the Ulcer Healing Index and the wound area reduction were calculated for both groups. RESULTS: Data from the UHI and wound area reduction parameters show that there is a statistically significant difference (p < 0.05) between the control group and PDT group, with the PDT group showing a greater reduction of the diabetic ulcer area than the control group. In the ImageJ software area analysis, both patient groups presented significant differences (p < 0.05) between pre and post-treatment in relation to lesion reduction area, the PDT being better. CONCLUSIONS: Results show that PDT accelerates the closure of ulcer wounds and to evaluate the wound area, different measurement methods can be used to follow-up the tissue repair process.

Comparative study of the efficacy of the topical application of hydrocortisone, therapeutic ultrasound and phonophoresis on the tissue repair process in rat tendons.

The purpose of this study was to compare the treatment efficacy of topical application of hydrocortisone, therapeutic ultrasound (US) and phonophoresis on the rat's Achilles tendon (tendo calcaneus) repair process after tenotomy. The two treated groups with US were made in a pulsed mode. The irradiation of US was performed at a frequency of 1 MHz and an intensity of 0.5 W/cm2 (SATA), for 5 min each session. The tendons were analyzed using the polarized light microscopy. The results showed that the treated group with the topical application of hydrocortisone has not been delivered transdermally and that the molecule of collagen responds to the ultrasonic stimulation. The treatment with phonophoresis was the more efficient method. These findings allow us to conclude that the US stimulates the acceleration of tissue repair processes and induces the transdermal delivery of hydrocortisone in a therapeutic concentration on the tendon.