Irradiation Therapy

Our office uses a multifaceted approach to non-medical treatment of peripheral neuropathy. This includes many patients who have not been able to take medications such as Neurontin standard neuropathy, Lyrica and Cymbalta due to side effects. In addition, we see patients who initially were managed with these drugs, however, the treatment dose was increased to the maximum and the patient continues to have symptoms more. Thus, we see our share of diabetics and patients with kidney disease and diabetic ulcers wound care issues. Many treatment of diabetic ulcers and wounds slow to heal the wound care centers that may include hyperbaric oxygen therapy. However, they are unaware that laser therapy has been shown to accelerate tissue growth and repair, reduce inflammation, improve vascular activity, reduce scarring and improve healing by stimulating the development of fibroblasts and production of collagen. Here are two recent articles in the scientific literature on laser treatment and healing.

Laboratory of Experimental Pathology, Oswaldo Cruz Foundation, Rua Waldemar Falca£o, 121 Salvador, Bahia 40296-710, Brazil.

Modulation of collagen fibers during wound healing of experimental skin was studied in Wistar rats treated photobiomodulation 112 laser. A standardized injury 8mm in diameter was made on the dorsal skin of all animals. In half of them, 0.2 ml of silica suspension was injected along the border of the wound to improve the deposition of collagen and facilitate compliance. The others received saline vehicle. The treatment was performed using a laser semiconductor aluminum gallium-arsenide diode 9mW applied every two days (total dose = 4J/cm2) on the edges of the wound. The tissue sections obtained from four experimental groups representing sham-irradiated animals, laser, silica and a combination of both, were studied after 3, 7, 10, 15, 20, 30 and 60 days after the application of the laser. The area of damaged skin was surgically removed and subjected to histological, immunohistochemical, ultrastructural and immunofluorescence studies. Besides the degree and the arrangement of collagen fibers and their isotypes, the degree of edema, the presence of several cell types especially pericytes and myofibroblasts, have been described and evaluated. The observation of Sirius-red stained slides under polarized microscopy revealed to be a great help when analyzing morphological changes of collagen dynamics. It has been shown that the laser application was responsible for the regression of edema and decreased number of inflammatory cells (p <0.05). An obvious increase in the number of actin-positive cells was observed in wounds treated with the laser. collagen deposition was lower than expected in wounds treated silica, and laser treatment has contributed to its better differentiation and modulation in all irradiated groups. Thus, photobiomodulation laser was able to induce several changes in the skin healing process, particularly by promoting new collagen fibers formed to be better organized and compactedly eliminated.

The purpose of this study is to evaluate the effectiveness of laser therapy low level for the healing of wounds in combination with the prevention and Extendicare Wound Management Program. Sixteen residents in a nursing home Extendicare Canada had a total of 27 sites treated consisting of 23 open wounds and 4 'at risk' areas. Of the 23 open wounds, two wounds between the toes are not able to be "tracked" and considered "immeasurable 'wounds, resulting in 21 open, measured wounds. The four "at risk" (closed) areas were treated prophylactically. Pressure, venous insufficiency and diabetic wounds were included. The majority (12/21) or 57.1% of injuries were chronic (> or = 3.