Low-level photodynamic therapy in chronic wounds

Photodiagnosis Photodyn Ther. 2024 Apr:46:104085. doi: 10.1016/j.pdpdt.2024.104085. Epub 2024 Apr 11.

Abstract

Background: Chronic wounds refer to those that can't reconstruct anatomical and physical functional integrity, and are usually associated with signs of microbial infection. Current therapies include debridement and dressing change, local or systemic application of antibiotics, and medical dressing care, which are not ideal for the healing of chronic wounds.

Objective: To explore the efficacy and safety of photodynamic therapy (ALA-PDT) for the treatment of chronic infectious wounds.

Materials and methods: ALA-PDT was used in ten patients with persistent wound infections and systemic complications who did not respond to conventional treatment. 5 % ALA solution was applied to the wound surface after debridement, incubated for 3 h with light protection, and then irradiated with red light for 20 min. This procedure was repeated every two weeks, and any adverse reactions were recorded. After the end of three treatments, the patients were followed up for 3 months.

Results: Patients who exhibit resistance to traditional therapies demonstrate a favorable therapeutic outcome with ALA-PDT, although complications may impede wound healing. All participants successfully underwent ALA-PDT treatment and subsequent monitoring, with 90 % achieving complete healing. Common adverse reactions to ALA-PDT encompass treatment-related pain, temporary erythema, and swelling, all of which are well-tolerated by patients without enduring severe consequences.

Conclusions: ALA-PDT proves to be an efficacious intervention for managing chronic wounds, irrespective of the presence of localized infections or systemic complications.

Keywords: 5-aminolevulinic acid; Chronic wounds; Photodynamic therapy; Wound healing.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aminolevulinic Acid* / therapeutic use
  • Chronic Disease
  • Female
  • Humans
  • Male
  • Middle Aged
  • Photochemotherapy* / methods
  • Photosensitizing Agents* / therapeutic use
  • Wound Healing / drug effects
  • Wound Infection / drug therapy

Substances

  • Photosensitizing Agents
  • Aminolevulinic Acid