Impact of ultra-pulse carbon dioxide laser on the treatment of chronic refractory ulcer with bone exposure.

BACKGROUND: Chronic refractory ulcers with bone exposure present significant challenges in wound management and necessitate effective treatment strategies to facilitate healing and alleviate patient discomfort. This study aimed to investigate the impact of ultra-pulse carbon dioxide laser on treating chronic refractory ulcers with bone exposure. METHODS: This retrospective observational study enrolled patients diagnosed with chronic refractory ulcers with bone exposure admitted to the wound repair clinic of the Affiliated Hospital of Southwest Medical University between July 2018 and July 2019. RESULTS: A total of 64 patients with chronic refractory ulcers and bone exposure were included, of which 32 patients underwent ultra-pulse carbon dioxide laser drilling. Compared with patients who did not receive ultra-pulse carbon dioxide laser treatment, those who experienced the procedure demonstrated significantly higher wound healing rates on the fourth, eighth, 12th, 16th, and 20th days after treatment (all P < .001), lower scores on the visual analog scale for pain after 20 days of debridement (0.24 ± 0.05 vs 0.58 ± 0.12, P < .001), lower granulation color observation scores on the 12th, 16th, and 20th days (all P = .001), as well as reduced treatment costs (8200 ± 1600 yuan vs 15400 ± 3800 yuan, P < .001). CONCLUSION: Ultra-pulse carbon dioxide laser treatment may enhance the growth of granulation tissue, improve wound healing rates, reduce pain, and lower treatment costs for patients with chronic bone exposure wounds compared to those without such treatment.

Evaluation of the Efficacy of Ultrapulsed CO2 Laser in Chronic Wounds.

BACKGROUND AND OBJECTIVES: Chronic wound repair is a major problem in wound treatment. Recently, several studies have suggested that carbon dioxide (CO2 ) laser can be used to improve the healing of chronic wounds. The aim of the present study was to preliminarily investigate the efficacy of laser debridement in treating chronic wound through a comparison of traditional instrument/surgical debridement with the ultrapulsed CO2 laser debridement in terms of wound healing, wound infection control, and wound blood perfusion. STUDY DESIGN/MATERIALS AND METHODS: Patients with chronic wound admitted to the Wound Repair Clinic at The Affiliated Hospital of Southwest Medical University (Luzhou, China) between February 2019 and May 2019 were enrolled. They were randomly divided into two groups. The patients in one group were treated with traditional sharp instrument/surgical debridement (RT group; number of wounds: 28), while the patients in the other group were treated with ultrapulsed CO2 laser debridement (LT group; number of wounds: 26). An intergroup comparison was performed based on parameters, such as wound healing, wound infection control, and changes in wound blood perfusion. RESULTS: The wound healing rate and the total time to achieve healing were significantly better in the LT group versus the RT group at 7, 14, 21, and 28 days after treatment. The wound exudation scores were significantly higher in the LT group versus the RT group at 7, 14, and 28 days after treatment. The positive rate of pre-debridement bacterial culture was significantly lower in the LT group versus the RD group at 14 and 28 days after treatment. The percentage of wound perfusion/normal periwound skin perfusion was significantly higher in the LT group versus the RT group at 1, 7, and 14 days after treatment. CONCLUSION: For the treatment of chronic refractory wounds, the ultrapulsed CO2 laser exhibits higher accuracy, more effectively controls wound infection, promotes an increase in wound blood perfusion, and achieves faster wound healing compared with traditional sharp instrument/surgical debridement. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.