Objectives: Chronic ulcers and wounds are still a challenge for treatment, due to their multiple pathophysiology, but also due to their high rate of recurrence and their slow tissue deterioration. These lesions are now a real public health matter. As an example chronic ulcers account for up to 25 billions dollars in health care costs annually in the United States. Besides treating the original disease, it’s now consensus to provide also local treatment.
Introduction: Laser therapy for chronic ulcers has been practiced for more than thirty years, starting with photobiomodulation by LEDs, then followed by sub-ablative C02 and Erbium:Yag lasers. By targetting water, these lasers are able to provide a tissue vaporization, leading to skin improvement, but also to post-traumatic and burn scars improvement. Therefore many authors described successful cases of chronic wound healing with such technology. There are several proposed mechanisms of action : texture and pliability improvements leading to decreased tension, debridement and biofilm disruption, and molecul
Materials / method: Case Report
The patient is a 58 year-old caucasian male patient, who has suffered from leukemia. He underwent a few complications including a right knee osteitis, which needed a surgical treatment 3 years ago, causing a tissue loss. Sking graft was performed, but with poor outcomes. He’s now in remission for the leukemia, and complains mainly about his wound aspect (fig 1), which affects his daily life quality.
Results: Despite some healing mechanisms after laser wound healing remain unclear, the treatment definitely shows promising outcomes. New collagen is essential in the wound closure mechanism, such as active vascular neoformation. Many studies have concluded to an interest of classical CO2 and Er:Yag laser in scars, vascular ulcers and chronic wounds. This case looks very insolite, regarding the wound medical story, but mainly due to the laser acoustic mechanism, while other classical treatments use photothermic effects.
Conclusion: It is now well known laser induced healing is an interesting, effective and safe procedure. The mechanical-accoustic effect has been observed in skin rejuvenation and scar resurfacing indications, and more quality studies should be held about wound healing. These treatments could have an influence on healthcare costs by decreasing healing time. Gold standard in this indication remains indeed at the moment expensive specific bandages.
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