Abstract
Diabetic patients frequently develop chronic ulcers of the lower extremities, which are a frequent cause for hospitalization and amputation, placing strain on patients, their families, and healthcare systems. Present therapies remain a challenge, with high recurrence rates. Photobiomodulation (PBM), which is the non-invasive application of light at specific wavelengths, has been shown to speed up healing of chronic wounds, including diabetic foot ulcers (DFUs). PBM produces photophysical and photochemical changes within cells without eliciting thermal damage. It has been shown to promote tissue regeneration and speed up wound repair by reducing inflammation and oxidative stress, accelerating cell migration and proliferation, and promoting extracellular matrix production and release of essential growth factors. The shortage of rigorous, well-designed clinical trials makes it challenging to assess the scientific impact of PBM on DFUs, and lack of understanding of the underlying mechanisms also hinders the conventional use of this therapy. This review gives a glimpse into diabetic wound healing and PBM, and the effects of PBM on diabetic wound healing.
Highlights
The number of diabetic patients worldwide is on the rise, with a 2017 estimated global prevalence of 8.8% aged between 20 and 79 years (424.9 million), which is expected to increase to 9.9% (628.6 million) by the year 2045 [1]
Wound repair is an attempt of the biological system to restore tissue integrity and denotes the outcome of numerous sequential, time-based, interconnected biological events that are highly coordinated in response to injury and its microenvironment
The colossal economic and social impact of chronic wounds on modern day society calls for a higher level of consideration and improved treatments
Summary
The number of diabetic patients worldwide is on the rise, with a 2017 estimated global prevalence of 8.8% aged between 20 and 79 years (424.9 million), which is expected to increase to 9.9% (628.6 million) by the year 2045 [1]. Patients with DM commonly develop chronic, slow-to-heal ulcers that affect the lower extremities. These chronic wounds are a common and frequent cause for hospitalization and amputation, leading to incapacity and decreased quality of life, and affecting psychological wellbeing, contributing to depression and placing financial strain on individuals, families, and healthcare systems. It has been approximated that diabetic patients have a 25% lifetime risk of developing a foot ulcer, and are 100 times more likely to suffer from lower extremity amputation than. Once an amputation has occurred, half of patients will develop an ulcer in the contralateral limb within 5 years [5], placing a further burden on patients This personal and financial burden is expected to increase along with the anticipated increase in the prevalence of DM. DFUs, the use and further investigation of PBM is warranted
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