English Polski
Vol 30, No 2 (2024)
Research paper
Published online: 2024-08-13

open access

Page views 474
Article views/downloads 169
Get Citation

Connect on Social Media

Connect on Social Media

Crossing the boundaries of traditional therapy: a study of the potential of laserobaria in wound healing — basis of this therapy — a systematic review

Dominik Jan Dziadek1, Kinga Kostera1, Aleksander Sieroń2, Dominik Sieroń3
Acta Angiologica 2024;30(2):45-59.

Abstract

Introduction: Faced with the challenges of treating diabetic foot complications and other hard-to-heal wounds, this systematic review sheds light on a new technology — the Laserobaria treatment method. Focusing on therapeutic modalities such as Topical Oxygen, Topical Ozone Therapy, Extremely Low-Frequency Pulsed Electromagnetic Fields, and Low-Level Red and UV Light Therapy, we analyze their efficacy and safety.
Material and methods: Conducted in accordance with PRISMA guidelines, our review includes an in-depth literature search across PubMed, Wiley Online Library, and Google Scholar, covering publications from 2017 to 2021. The study used PICO strategies to compare the results of studies where we considered meta-analyses, systematic reviews and RCTs examining the effect of individual therapeutic agents and their combinations. We identified 31 studies conducted on a total of n = 3821 patients including n = 354 patients treated with Laserobaria.
Results: Our analysis reveals promising results: accelerated wound healing, improved blood circulation, and enhanced quality of life for patients, highlighting the benefits of combined therapies using the Laserobaria treatment method. Findings indicate the safety and cost-effectiveness of this approach, without reporting any adverse events.
Conclusions: This review not only confirms the potential of the Laserobaria treatment method in regenerative medicine but also underscores the need for further research to optimize therapeutic parameters. The evidence provided by our study adds to the state of the art in the field of physical therapy and demonstrates its contribution to improving wound healing outcomes.

Article available in PDF format

View PDF Download PDF file

References

  1. Andersen C. Topical oxygen therapy-hocus pocus or science? J Wound Care. 2021; 30(Sup5): S6.
  2. Bomfim TL, Gomes IA, Meneses Dd, et al. Effectiveness of ozone therapy as an adjunct treatment for lower-limb ulcers: a systematic review. Adv Skin Wound Care. 2021; 34(10): 1–9.
  3. Howell RS, Criscitelli T, Woods JS, et al. A perioperative approach to increase limb salvage when treating foot ulcers in patients with diabetes. AORN J. 2018; 107(4): 431–440.
  4. Henshaw FR, Brennan L, MacMillan F. Perceptions of hyperbaric oxygen therapy among podiatrists practicing in high-risk foot clinics. Int Wound J. 2018; 15(3): 375–382.
  5. Golledge J, Singh TP. Systematic review and meta-analysis of clinical trials examining the effect of hyperbaric oxygen therapy in people with diabetes-related lower limb ulcers. Diabet Med. 2019; 36(7): 813–826.
  6. Chen CY, Wu RW, Hsu MC, et al. Adjunctive hyperbaric oxygen therapy for healing of chronic diabetic foot ulcers: a randomized controlled trial. J Wound Ostomy Continence Nurs. 2017; 44(6): 536–545.
  7. Joshi VS, Joshi SS. Systemic and local effects of warm oxygen exposure to the lower extremities in healthy volunteers. J Clin Diagn Res. 2017; 11(4): CC01–CC03.
  8. Lipsky BA, Senneville É, Abbas ZG, et al. International Working Group on the Diabetic Foot (IWGDF). Guidelines on the diagnosis and treatment of foot infection in persons with diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020; 36 Suppl 1: e3280.
  9. Löndahl M, Boulton AJM. Hyperbaric oxygen therapy in diabetic foot ulceration: Useless or useful? A battle. Diabetes Metab Res Rev. 2020; 36 Suppl 1: e3233.
  10. Oropallo AR, Serena TE, Armstrong DG, et al. Molecular biomarkers of oxygen therapy in patients with diabetic foot ulcers. Biomolecules. 2021; 11(7).
  11. Vas P, Rayman G, Dhatariya K, et al. Effectiveness of interventions to enhance healing of chronic foot ulcers in diabetes: a systematic review. Diabetes Metab Res Rev. 2020; 36 Suppl 1: e3284.
  12. Tentolouris A, Tentolouris N. Methods of Ulcer Healing. In: Atlas of the Diabetic Foot [Internet]. 2020 [cited 2022 Oct 7]. p. 205–28. Available from:. (https://doi.org/10.1002/9781119255314.ch13).
  13. Braidy N, Izadi M, Sureda A, et al. Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain. J Cell Physiol. 2018; 233(4): 2705–2714.
  14. Grande R, Fiori G, Russo G, et al. A multistage combined approach to promote diabetic wound healing in COVID-19 era. Int Wound J. 2020; 17(6): 1863–1870.
  15. Isler SC, Uraz A, Guler B, et al. Effects of laser photobiomodulation and ozone therapy on palatal epithelial wound healing and patient morbidity. Photomed Laser Surg. 2018; 36(11): 571–580.
  16. Morberg BM, Malling AS, Jensen BR, et al. Effects of transcranial pulsed electromagnetic field stimulation on quality of life in Parkinson's disease. Eur J Neurol. 2018; 25(7): 963–e74.
  17. Mohajerani H, Tabeie F, Vossoughi F, et al. Effect of pulsed electromagnetic field on mandibular fracture healing: A randomized control trial, (RCT). J Stomatol Oral Maxillofac Surg. 2019; 120(5): 390–396.
  18. Miller CP, Prener M, Dissing S, et al. Transcranial low-frequency pulsating electromagnetic fields (T-PEMF) as post-concussion syndrome treatment. Acta Neurol Scand. 2020; 142(6): 597–604.
  19. McLaughlin P, Hurley M, Chowdary P, et al. Physiotherapy interventions for pain management in haemophilia: A systematic review. Haemophilia. 2020; 26(4): 667–684.
  20. Khooshideh M, Latifi Rostami SS, Sheikh M, et al. Pulsed electromagnetic fields for postsurgical pain management in women undergoing cesarean section: a randomized, double-blind, placebo-controlled trial. Clin J Pain. 2017; 33(2): 142–147.
  21. Galli C, Pedrazzi G, Guizzardi S. The cellular effects of pulsed electromagnetic fields on osteoblasts: a review. Bioelectromagnetics. 2019; 40(4): 211–233.
  22. Bone Healing Stimulator: External. In: Compendium of Biomedical Instrumentation [Internet]. 2019 [cited 2022 Oct 13]. p. 303–8. Available from:. https://doi.org/10.1002/9781119288190.ch57.
  23. Zhu S, He H, Zhang C, et al. Effects of pulsed electromagnetic fields on postmenopausal osteoporosis. Bioelectromagnetics. 2017; 38(6): 406–424.
  24. Vadalà M, Palmieri B, Malagoli A, et al. High-power magnetotherapy: a new weapon in urinary incontinence? Low Urin Tract Symptoms. 2018; 10(3): 266–270.
  25. Troy KL, Davis IS, Tenforde AS. A narrative review of metatarsal bone stress injury in athletic populations: etiology, biomechanics, and management. PM R. 2021; 13(11): 1281–1290.
  26. Tenuta M, Tarsitano MG, Mazzotta P, et al. Therapeutic use of pulsed electromagnetic field therapy reduces prostate volume and lower urinary tract symptoms in benign prostatic hyperplasia. Andrology. 2020; 8(5): 1076–1085.
  27. Pesqueira T, Costa-Almeida R, Gomes ME. Magnetotherapy: The quest for tendon regeneration. J Cell Physiol. 2018; 233(10): 6395–6405.
  28. Peng L, Fu C, Wang Lu, et al. The effect of pulsed electromagnetic fields on angiogenesis. Bioelectromagnetics. 2021; 42(3): 250–258.
  29. Lv H, Liu J, Zhen C, et al. Magnetic fields as a potential therapy for diabetic wounds based on animal experiments and clinical trials. Cell Prolif. 2021; 54(3): e12982.
  30. Bensadoun RJ, Epstein JB, Nair RG, et al. World Association for Laser Therapy (WALT). Safety and efficacy of photobiomodulation therapy in oncology: A systematic review. Cancer Med. 2020; 9(22): 8279–8300.
  31. Brunke MW. Laser Therapy and Injury Rehabilitation. In: Laser Therapy in Veterinary Medicine [Internet]. 2018 [cited 2022 Oct 24]. p. 252–66. Available from:. https://doi.org/10.1002/9781119220190.ch23.
  32. Fekrazad R, Sarrafzadeh A, Kalhori KAM, et al. Improved wound remodeling correlates with modulated TGF-beta expression in skin diabetic wounds following combined red and infrared photobiomodulation treatments. Photochem Photobiol. 2018; 94(4): 775–779.
  33. Silva LM, Zamuner LF, David AC, et al. Photobiomodulation therapy on bothrops snake venom-induced local pathological effects: A systematic review. Toxicon. 2018; 152: 23–29.
  34. Lasers and Wound Healing [Internet]. Advanced Laser Surgery in Dentistry. 2021. p. 41–56. Available from:. https://onlinelibrary.wiley.com/doi/abs/10.1002/9781119583318.ch2.
  35. Vitoriano NA, Mont'Alverne DG, Martins MI, et al. Comparative study on laser and LED influence on tissue repair and improvement of neuropathic symptoms during the treatment of diabetic ulcers. Lasers Med Sci. 2019; 34(7): 1365–1371.
  36. Oyebode O, Houreld NN, Abrahamse H. Photobiomodulation in diabetic wound healing: A review of red and near-infrared wavelength applications. Cell Biochemistry and Function. 2021 Jul 1. ; 39(5): 596–612.
  37. Fallah A, Mirzaei A, Gutknecht N, et al. Clinical effectiveness of low-level laser treatment on peripheral somatosensory neuropathy. Lasers Med Sci. 2017; 32(3): 721–728.
  38. de Smet GHJ, Kroese LF, Menon AG, et al. Oxygen therapies and their effects on wound healing. Wound Repair Regen. 2017; 25(4): 591–608.
  39. Rayman G, Vas P, Dhatariya K, et al. International Working Group on the Diabetic Foot (IWGDF). Guidelines on use of interventions to enhance healing of chronic foot ulcers in diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020; 36 Suppl 1: e3283.
  40. Kasprzyk-Kucewicz T, Cholewka A, Englisz-Jurgielewicz B, et al. Thermal effects of topical hyperbaric oxygen therapy in hard-to-heal wounds-a pilot study. Int J Environ Res Public Health. 2021; 18(13).
  41. An observational clinical trial examining the effect of topical oxygen therapy (NATROX™) on the rates of healing of chronic diabetic foot ulcers. Case Medical Research. 2019.
  42. Bomfim TL, Gomes IA, Meneses Dd, et al. Effectiveness of ozone therapy as an adjunct treatment for lower-limb ulcers: a systematic review. Adv Skin Wound Care. 2021; 34(10): 1–9.
  43. Fitzpatrick E, Holland OJ, Vanderlelie JJ. Ozone therapy for the treatment of chronic wounds: A systematic review. Int Wound J. 2018; 15(4): 633–644.
  44. Wen Q, Liu D, Wang X, et al. A systematic review of ozone therapy for treating chronically refractory wounds and ulcers. Int Wound J. 2022; 19(4): 853–870.
  45. Peng L, Fu C, Xiong F, et al. Effectiveness of pulsed electromagnetic fields on bone healing: a systematic review and meta-analysis of randomized controlled trials. Bioelectromagnetics. 2020; 41(5): 323–337.
  46. Multanen J, Häkkinen A, Heikkinen P, et al. Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study. Bioelectromagnetics. 2018; 39(5): 405–413.
  47. Liu W, Jin X, Guan Z, et al. Pulsed electromagnetic field affects the development of postmenopausal osteoporotic women with vertebral fractures. Biomed Res Int. 2021; 2021: 4650057.
  48. Gomes Gobbi R, Pastore E Silva AL, Kawamura Demange M, et al. Clinical results of pulsed signal therapy on patellofemoral syndrome with patellar chondropathy. Bioelectromagnetics. 2019; 40(2): 83–90.
  49. Dos Santos Mendes-Costa L, de Lima VG, Barbosa MP, et al. Photobiomodulation: systematic review and meta-analysis of the most used parameters in the resolution diabetic foot ulcers. Lasers Med Sci. 2021; 36(6): 1129–1138.
  50. Zhou J, Gao YuH, Zhu BY, et al. The frequency window effect of sinusoidal electromagnetic fields in promoting osteogenic differentiation and bone formation involves extension of osteoblastic primary cilia and activation of protein kinase A. Cell Biol Int. 2021; 45(8): 1685–1697.
  51. Huang J, Li Yi, Wang L, et al. Combined effects of low-frequency pulsed electromagnetic field and melatonin on ovariectomy-induced bone loss in mice. Bioelectromagnetics. 2021; 42(8): 616–628.
  52. Petz Fd, Félix JV, Roehrs H, et al. Effect of Photobiomodulation on Repairing Pressure Ulcers in Adult and Elderly Patients: A Systematic Review. Photochem Photobiol. 2020; 96(1): 191–199.
  53. Frangež I, Nizič-Kos T, Frangež HB. Phototherapy with LED shows promising results in healing chronic wounds in diabetes mellitus patients: a prospective randomized double-blind study. Photomed Laser Surg. 2018; 36(7): 377–382.
  54. Frangez I, Cankar K, Ban Frangez H, et al. The effect of LED on blood microcirculation during chronic wound healing in diabetic and non-diabetic patients-a prospective, double-blind randomized study. Lasers Med Sci. 2017; 32(4): 887–894.
  55. Kurtti A, Nguyen JK, Weedon J, et al. Light emitting diode-red light for reduction of post-surgical scarring: Results from a dose-ranging, split-face, randomized controlled trial. J Biophotonics. 2021; 14(7): e202100073.
  56. Perper M, Eber A, Lindsey SF, et al. Blinded, randomized, controlled trial evaluating the effects of light-emitting diode photomodulation on lower extremity wounds left to heal by secondary intention. Dermatol Surg. 2020; 46(5): 605–611.
  57. Pasek J, Szajkowski S, Pietrzak M, et al. Comparison of the efficacy of topical hyperbaric oxygen therapy alone vs a combination of physical methods including topical hyperbaric oxygen therapy, magnetotherapy, and low-energy light therapy in the treatment of venous leg ulcers. Dermatol Ther. 2020; 33(6): e14474.
  58. Pietrzak M, Pasek J, Szajkowski S, et al. Is combined physical therapy more effective than topical hyperbaric oxygen therapy in the treatment of venous leg ulcers? Preliminary study. Postępy Higieny i Medycyny Doświadczalnej. 2022; 76(1): 199–208.
  59. Pasek J, Szajkowski S, Cieślar G. Therapeutic efficacy of physical combined therapy in the treatment of venous crural ulcers. Phlebology. 2021; 36(6): 481–488.
  60. Pasek J, Szajkowski S, Pietrzak M, et al. The influence of combined physical therapy procedures on oxygen partial pressure in tissues surrounding ulcer in patients with venous leg ulcers. Int J Low Extrem Wounds. 2023; 22(1): 11–18.
  61. Sieroń A, Sieroń D, Dziadek D, Application of Laserobaria 2.0_S device in the treatment of hard-to-heal wounds of mixed etiology — own experience. Acta Angiol 2023; 29 (3): 61–67. .