The use of low-energy photon therapy in the treatment of leg ulcers - a preliminary study

Background: Leg ulcers affect 0.1 - 0.4% of the population and are a significant source of morbidity the world over. Many ulcers are chronic having responded poorly to conventional therapies. Objective: We evaluated low-energy laser therapy (LELT) (or low-energy photon therapy, LEPT) as a form of biostimulation for the treatment of venous leg ulcers. Methods: In this 24-week uncontrolled trial, we entered nine outpatients with 15 venous ulcers of 6 - 78 weeks duration, many of which had been unresponsive to conventional therapy. The leg ulcers were treated with two monochromatic optical sources. One provided a wavelength (lambda) of 660 nm and the second source delivered infrared irradiation of wavelength 880 nm. Two optical probes were used, one of which consisted of an array of 22 monochromatic sources, operating at a wavelength of 660 nm and covering an area of 6 x 10 cm(2). Each source had a power (P) of 6 mW and an energy density (D) of 4 J/cm(2), continuous wave mode. The second probe had seven infrared sources, operating at a wavelength of 880 nm and covering an area of 4 cm(2). Each source had a power of 12 mW and an energy density of 4 J/cm(2), pulse frequency 4 Hz. The above configuration of optical probes was selected to cover all or the majority of the ulcer being treated. The first course of therapy comprised 30 treatments given three times per week for 10 weeks. Those patients whose ulcers remained unhealed after 10 weeks applied wet to dry dressings to the ulcers for a period of 2-3 weeks during which time no LEPT was administered. At this point, patients received a second course of 30 further treatments over 10 weeks. Patients whose ulcers healed were discharged from the study at that point. For the duration of the study no treatment other than LELT was permitted. Results: Of 15 venous ulcers, 12 (75%) had healed or improved markedly (greater than 75% reduction in pretherapy area of ulcer) by the end of the study. Side-effects consisted of erythema at the ulcer site in one patient. Conclusion: The results of this preliminary study looking at the effectiveness of LEFT in venous leg ulcers are encouraging and suggest that double-blind trials are indicated.