Kosmed Med (2013) 34(5): 208 – 215

Photodynamic therapy to improve wound healing in acute and chronic wounds:
Tricyclic dye combined with low level 810 nm diode laser irradiation

ANNETT BENNEWITZ1, MANFRED PRINZ2, UWE WOLLINA1

1 Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt
2 Institute of Clinical Chemistry and Laboratory Medicine, Department of Microbiology, Academic Teaching Hospital

KEY WORDS: Chronic leg ulcers, split skin harvesting sites, methylen blue, diode laser, wound healing.

SUMMARY:
Background: Antimicrobial photodynamic therapy is widely accepted in dentistry. We investigated the possible benefit of antimicrobial phototherapy in a pilot study for chronic and acute wounds.
Patients and methods: Sixteen patients with chronic leg ulcers and/or split skin harvesting site participated. Wounds were treated either by a-thermic 810 nm diode laser after topical application of methylen blue solution (BLUEbact) or laser alone. Wounds were scored by the Wollina Wound Score. Regular microbial swabs were taken for semiquantitative evaluation.
Results: Of 19 leg ulcers, 15 were treated by photodynamic therapy with BLUEbact, 3 only by diode laser. Of 6 split skin harvesting sites, 5 were treated by photodynamic therapy and one by laser only. Fluence per session was 60 J/cm2. Eleven leg ulcers received at least 3 treatments. Split harvesting sites received 3 to 5 sessions of treatment. In 8 of 13 leg ulcers partial improvement was seen by photodynamic therapy (62%). Five of 6 split skin harvesting sites (83%) responded well, most with a complete healing. Exudation was stopped early and inflammation was seen less pronounced as in untreated wounds. Although some ulcers showed a reduction in microbiological colonization evaluation of all leg ulcers did not argue for a significant antimicrobial effect of photodynamic therapy. Of the 3 leg ulcers treated by laser alone, 2 had not responded.
Conclusions: Photodynamic therapy of leg ulcers and split skin harvesting sites with a-thermic diode laser reduces clinical signs of inflammation and seems to improve re-epithelialization. Further studies are necessary.