Effects of photobiomodulation in the treatment of pressure ulcers: Integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i2.12597

Keywords:

Pressure ulcer; Low level laser therapy; Photobiomodulation; Wound healing.

Abstract

Pressure ulcers (PU) are important causes of morbidity, in addition to having a high cost to the health system, it adds an additional risk to patients because it imposes the loss of the constitutional skin barrier. Photobiomodulation with low power laser (FBM) shows effective analgesic, anti-inflammatory and tissue repair actions. The aim of the present study was to evaluate the effectiveness of FBM in the treatment of PU based on an integrative review guided by the question “How effective is photobiomodulation in the treatment of pressure ulcers?”. The study included seven articles selected from the Scielo, PubMed and LILACS databases between 2015 and 2020. After reading, analyzing and interpreting the data, it was possible to verify that, although there are few recent studies on laser therapy on the subject of pressure injury, the articles elucidate that low-level laser therapy is a promising treatment modality, which reduces the healing time and improves the appearance of wounds. However, although several studies have demonstrated its beneficial effects, there is still no consensus and specific protocols defined that determine irradiation parameters, such as wavelength, energy, fluency, power, irradiance, pulse duration and intervals between treatment sessions.

References

Advisory, T. N. P. U. (1989). Pressure ulcers prevalence, cost and risk assessment: consensus development conference statement. Decubitus, 2(2), 24–28.

Bauer, K., Rock, K., Nazzal, M., Jones, O., & Qu, W. (2016). Pressure Ulcers in the United States’ Inpatient Population From 2008 to 2012: Results of a Retrospective Nationwide Study. Ostomy/Wound Management, 62(11), 30–38. http://www.ncbi.nlm.nih.gov/pubmed/27861135

Bhattacharya, S., & Mishra, R. K. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery, 48(01), 004–016. https://doi.org/10.4103/0970-0358.155260

Botelho, L. L. R., Cunha, C. C. de A., & Macedo, M. (2011). O Método Da Revisão Integrativa Nos Estudos Organizacionais. Gestão e Sociedade, 5(11), 121. https://doi.org/10.21171/ges.v5i11.1220

Brauncajs, M., Ksiąszczyk, K., Lewandowska-Polak, A., Gorzela, K., & Grzegorczyk, J. (2018). Impact of low-level laser therapy on the dynamics of pressure ulcer-induced changes considering an infectious agent and cathelicidin LL-37 concentration: a preliminary study. Advances in Dermatology and Allergology, 35(6), 582–586. https://doi.org/10.5114/ada.2018.77609

Cannon, B. C., & Cannon, J. P. (2004). Management of pressure ulcers. American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, 61(18), 1895–1905; quiz 1906–1907. http://www.ncbi.nlm.nih.gov/pubmed/15487879

Castro, M. F. de, Barbosa, L. R. P., & Silva, L. L. da. (2020). Ação da terapia a laser de baixa intensidade na cicatrização de ulcerações diabéticas. Research, Society and Development, 9(10), e6239109109. https://doi.org/10.33448/rsd-v9i10.9109

De Bortoli, I., Prato, A. L., & Kroth, A. (2016). A Efetividade Do Laser Associado A Diferentes Tipos De Curativos Na Cicatrização De Úlceras De Pressão. Evidência - Ciência e Biotecnologia, 16(1), 45–59. https://doi.org/10.18593/eba.v16i1.9774

De Oliveira Bernardes, L., & Regina Jurado, S. (2018). Efeitos da laserterapia no tratamento de lesões por pressão: uma revisão sistemática. Revista Cuidarte, 9(3), 1–12. https://doi.org/10.15649/cuidarte.v9i3.574

De Souza, Í. P., Androlage, J. S., Bellato, R., & Barsaglini, R. A. (2019). A qualitative approach to rare genetic diseases: An integrative review of the national and international literature. Ciencia e Saude Coletiva, 24(10), 3683–3700. https://doi.org/10.1590/1413-812320182410.17822019

García-Fernández, F. P., Agreda, J. J. S., Verdú, J., & Pancorbo-Hidalgo, P. L. (2014). A New Theoretical Model for the Development of Pressure Ulcers and Other Dependence-Related Lesions. Journal of Nursing Scholarship, 46(1), 28–38. https://doi.org/10.1111/jnu.12051

Health, W. K. (2019). Photobiomodulation Therapy for Wound Care: A Potent, Noninvasive, Photoceutical Approach. Adv Skin Wound Care, 32, ASWC0419.

Hernández, E., Khomchenko, V., Sola, A., Pikirenia, I. I., Alcolea, J. M., & Trelles, M. A. (2015). Tratamiento de las úlceras crónicas de las piernas con láser de Er: YAG y tecnología RecoSMA. Cirugía Plástica Ibero-Latinoamericana, 41(3), 271–282. https://doi.org/10.4321/S0376-78922015000300007

Higgins, J. P. T., & Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration. www.handbook.cochrane.org

Li, S., Wang, C., Wang, B., Liu, L., Tang, L., Liu, D., Yang, G., & Zhang, L. (2018). Efficacy of low-level light therapy for treatment of diabetic foot ulcer: A systematic review and meta-analysis of randomized controlled trials. Diabetes Research and Clinical Practice, 143, 215–224. https://doi.org/10.1016/j.diabres.2018.07.014

Lima, A. C. B., & Guerra, D. M. (2011). Avaliação do custo do tratamento de úlceras por pressão em pacientes hospitalizados usando curativos industrializados. Ciência & Saúde Coletiva, 16(1), 267–277. https://doi.org/10.1590/S1413-81232011000100029

Lucas, C., Van Gemert, M. J. C., & De Haan, R. J. (2003). Efficacy of low-level laser therapy in the management of stage III decubitus ulcers: A prospective, observer-blinded multicentre randomised clinical trial. Lasers in Medical Science, 18(2), 72–77. https://doi.org/10.1007/s10103-003-0259-5

Machado, R. S., Viana, S., & Sbruzzi, G. (2017). Low-level laser therapy in the treatment of pressure ulcers: systematic review. Lasers in Medical Science, 32(4), 937–944. https://doi.org/10.1007/s10103-017-2150-9

Mervis, J. S., & Phillips, T. J. (2019). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893–902. https://doi.org/10.1016/j.jaad.2018.12.068

Monteiro, D. da R., Báo, A. C. P., Souza, T. de C., & Tanaka, R. Y. (2020). Efeito da terapia a laser no tratamento de lesões por pressão em pacientes adultos: revisão integrativa. Research, Society and Development, 9(10), e6589109094. https://doi.org/10.33448/rsd-v9i10.9094

Mosca, R. C., Ong, A. A., Albasha, O., Bass, K., & Arany, P. (2019). Photobiomodulation Therapy for Wound Care. Advances in Skin & Wound Care, 32(4), 157–167. https://doi.org/10.1097/01.ASW.0000553600.97572.d2

Mustoe, T. A., O’Shaughnessy, K., & Kloeters, O. (2006). Chronic Wound Pathogenesis and Current Treatment Strategies: A Unifying Hypothesis. Plastic and Reconstructive Surgery, 117(SUPPLEMENT), 35S-41S. https://doi.org/10.1097/01.prs.0000225431.63010.1b

National Pressure Ulcer Advisory and Pan Pacific Pressure Injury Alliance. (2015). Prevention and Treatment of Pressure Ulcers : Quick Reference Guide. In Clinical Practice Guideline. https://www.epuap.org/wp-content/uploads/2016/10/quick-reference-guide-digital-npuap-epuap-pppia-jan2016.pdf

Palagi, S., Severo, I. M., Menegon, D. B., & Lucena, A. de F. (2015). Laser therapy in pressure ulcers: Evaluation by the Pressure Ulcer Scale for Healing and Nursing Outcomes Classification. Revista Da Escola de Enfermagem, 49(5), 826–833. https://doi.org/10.1590/S0080-623420150000500017

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Método Qualitativo, Quantitativo ou Quali-Quanti. In Metodologia da Pesquisa Científica. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1.

Polachini, C. R. N., Berni, V. B., Bellé, J. M., Oliveira, D. F. de, & Saccol, M. F. (2019). Efeitos da fotobioestimulação e estimulação elétrica na cicatrização e qualidade de vida de indivíduos com úlceras cutâneas: terapias isoladas e associadas. Saúde (Santa Maria), 45(3), 1–18. https://doi.org/10.5902/2236583439675

Qaseem, A., Humphrey, L. L., Forciea, M. A., Starkey, M., & Denberg, T. D. (2015). Treatment of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 370–379. https://doi.org/10.7326/M14-1568

Sardo, P. M. G., Simões, C. S. O., Alvarelhão, J. J. M., Simões, J. F. F. L., Machado, P. A. P., Amado, F. M. L., Amaro, A. J. M., & Melo, E. M. O. P. de. (2016). Analyses of pressure ulcer incidence in inpatient setting in a Portuguese hospital. Journal of Tissue Viability, 25(4), 209–215. https://doi.org/10.1016/j.jtv.2016.08.003

Strazzieri-Pulido, K. C., S. González, C. V., Nogueira, P. C., Padilha, K. G., & G. Santos, V. L. C. (2019). Pressure injuries in critical patients: Incidence, patient-associated factors, and nursing workload. Journal of Nursing Management, 27(2), 301–310. https://doi.org/10.1111/jonm.12671

Taly, A. B., Sivaraman Nair, K. P., Murali, T., & John, A. (2004). Efficacy of multiwavelength light therapy in the treatment of pressure ulcers in subjects with disorders of the spinal cord: A randomized double-blind controlled trial. Archives of Physical Medicine and Rehabilitation, 85(10), 1657–1661. https://doi.org/10.1016/j.apmr.2004.03.028

Taradaj, J., Shay, B., Dymarek, R., Sopel, M., Walewicz, K., Beeckman, D., Schoonhoven, L., Gefen, A., & Rosińczuk, J. (2018). Effect of laser therapy on expression of angio- and fibrogenic factors, and cytokine concentrations during the healing process of human pressure ulcers. International Journal of Medical Sciences, 15(11), 1105–1112. https://doi.org/10.7150/ijms.25651

Thomé Lima, A. M. C., da Silva Sergio, L. P., da Silva Neto Trajano, L. A., de Souza, B. P., da Motta Mendes, J. P., Cardoso, A. F. R., Figueira, C. P., dos Anjos Tavares, B., Figueira, D. S., Mencalha, A. L., Trajano, E. T. L., & de Souza da Fonseca, A. (2019). Photobiomodulation by dual-wavelength low-power laser effects on infected pressure ulcers. Lasers in Medical Science, 35(3), 651–660. https://doi.org/10.1007/s10103-019-02862-w

Wada, A., Teixeira Neto, N., & Ferreira, M. C. (2010). Úlceras por pressão. Revista de Medicina, 89(3/4), 170. https://doi.org/10.11606/issn.1679-9836.v89i3/4p170-177

Zhao, R., Liang, H., Clarke, E., Jackson, C., & Xue, M. (2016). Inflammation in Chronic Wounds. International Journal of Molecular Sciences, 17(12), 2085. https://doi.org/10.3390/ijms17122085

Published

17/02/2021

How to Cite

MACEDO, S. P. R. .; MOTA, M. S. de A. .; FAGUNDES, C. F. .; SOUZA, M. R. de .; NAVARRO, R. S. . Effects of photobiomodulation in the treatment of pressure ulcers: Integrative review. Research, Society and Development, [S. l.], v. 10, n. 2, p. e32810212597, 2021. DOI: 10.33448/rsd-v10i2.12597. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/12597. Acesso em: 23 nov. 2024.

Issue

Section

Health Sciences