Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds
Background: Chronic infected wounds present a significant clinical challenge due to bacterial biofilm formation and antibiotic resistance, which impede healing. Therefore, there is a need to find safe and effective methods to control infection and promote wound healing. Objective: The purpose of thi...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | Photodiagnosis and Photodynamic Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1572100025002406 |
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| author | Yinfeng Xia Yongsong Chen Han Luo Yu Zhu Qiang Tan Ping Wu Zhiyong Chen |
| author_facet | Yinfeng Xia Yongsong Chen Han Luo Yu Zhu Qiang Tan Ping Wu Zhiyong Chen |
| author_sort | Yinfeng Xia |
| collection | DOAJ |
| description | Background: Chronic infected wounds present a significant clinical challenge due to bacterial biofilm formation and antibiotic resistance, which impede healing. Therefore, there is a need to find safe and effective methods to control infection and promote wound healing. Objective: The purpose of this study was to evaluate the efficacy and safety of the combination of carbon dioxide laser and photodynamic therapy in the treatment of chronically infected wounds. Methods: A randomized controlled trial included 121 patients divided into four groups: combination therapy group (n = 31), photodynamic therapy (n = 29), CO2 laser alone (n = 30), and placebo group (n = 31). Wounds were assessed for healing rate, bacterial quantification, blood vessels, collagen content, interleukin-6, and C-reactive protein at baseline and after treatment. Mixed-effects models and repeated-measures ANOVA were used for analysis. Results: The combination group achieved the highest healing rate (80.1 ± 15.2 %, p < 0.001), significantly surpassing the photodynamic group (71.2 ± 19.1 %), laser group (66.0 ± 15.4 %), and placebo group (61.6 ± 18.2 %). Bacterial load reduction was most pronounced in the combination group (2.9 ± 0.9 × 10^9 CFU/mL vs. 5.4 ± 1.1 × 10^9 CFU/mL in placebo, p < 0.001), with photodynamic therapy showing comparable antimicrobial effects. Angiogenesis was markedly enhanced in the combination group (70.7 ± 6.1 vessels/mm² vs. all groups, p < 0.05), alongside reduced interleukin-6 and c-reactive protein levels (p < 0.05). Collagen content differences were nonsignificant overall (p = 0.081), though the combination group (58.5 ± 4.9 %) outperformed laser and placebo (p < 0.05). Conclusion: The efficacy of CO2 laser combined with photodynamic therapy in treating chronic infected wounds are effective, and photodynamic therapy dominates. It promotes wound healing by inhibiting wound bacterial reproduction, reducing inflammatory reactions, increasing the number of blood vessels in the wound, and promoting collagen synthesis. |
| format | Article |
| id | doaj-art-d3446e4e15fc4c5c9a2e077db38ab62a |
| institution | DOAJ |
| issn | 1572-1000 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Photodiagnosis and Photodynamic Therapy |
| spelling | doaj-art-d3446e4e15fc4c5c9a2e077db38ab62a2025-08-20T03:23:29ZengElsevierPhotodiagnosis and Photodynamic Therapy1572-10002025-08-015410470810.1016/j.pdpdt.2025.104708Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected woundsYinfeng Xia0Yongsong Chen1Han Luo2Yu Zhu3Qiang Tan4Ping Wu5Zhiyong Chen6Department of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaDepartment of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaDepartment of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaDepartment of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaDepartment of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaDepartment of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaCorresponding author at: Department of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, China, No. 2, gaosuntang Road, Fuling District.; Department of Burns, Plastic Surgery and Cosmetology, Chongqing University Fuling Hospital, Chongqing University, Chongqing, ChinaBackground: Chronic infected wounds present a significant clinical challenge due to bacterial biofilm formation and antibiotic resistance, which impede healing. Therefore, there is a need to find safe and effective methods to control infection and promote wound healing. Objective: The purpose of this study was to evaluate the efficacy and safety of the combination of carbon dioxide laser and photodynamic therapy in the treatment of chronically infected wounds. Methods: A randomized controlled trial included 121 patients divided into four groups: combination therapy group (n = 31), photodynamic therapy (n = 29), CO2 laser alone (n = 30), and placebo group (n = 31). Wounds were assessed for healing rate, bacterial quantification, blood vessels, collagen content, interleukin-6, and C-reactive protein at baseline and after treatment. Mixed-effects models and repeated-measures ANOVA were used for analysis. Results: The combination group achieved the highest healing rate (80.1 ± 15.2 %, p < 0.001), significantly surpassing the photodynamic group (71.2 ± 19.1 %), laser group (66.0 ± 15.4 %), and placebo group (61.6 ± 18.2 %). Bacterial load reduction was most pronounced in the combination group (2.9 ± 0.9 × 10^9 CFU/mL vs. 5.4 ± 1.1 × 10^9 CFU/mL in placebo, p < 0.001), with photodynamic therapy showing comparable antimicrobial effects. Angiogenesis was markedly enhanced in the combination group (70.7 ± 6.1 vessels/mm² vs. all groups, p < 0.05), alongside reduced interleukin-6 and c-reactive protein levels (p < 0.05). Collagen content differences were nonsignificant overall (p = 0.081), though the combination group (58.5 ± 4.9 %) outperformed laser and placebo (p < 0.05). Conclusion: The efficacy of CO2 laser combined with photodynamic therapy in treating chronic infected wounds are effective, and photodynamic therapy dominates. It promotes wound healing by inhibiting wound bacterial reproduction, reducing inflammatory reactions, increasing the number of blood vessels in the wound, and promoting collagen synthesis.http://www.sciencedirect.com/science/article/pii/S1572100025002406Chronic woundsPhotodynamic therapyCO2 laserBiofilm |
| spellingShingle | Yinfeng Xia Yongsong Chen Han Luo Yu Zhu Qiang Tan Ping Wu Zhiyong Chen Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds Photodiagnosis and Photodynamic Therapy Chronic wounds Photodynamic therapy CO2 laser Biofilm |
| title | Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds |
| title_full | Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds |
| title_fullStr | Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds |
| title_full_unstemmed | Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds |
| title_short | Efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds |
| title_sort | efficacy of carbon dioxide laser combined with photodynamic therapy in the treatment of chronically infected wounds |
| topic | Chronic wounds Photodynamic therapy CO2 laser Biofilm |
| url | http://www.sciencedirect.com/science/article/pii/S1572100025002406 |
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