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Photodynamic therapy for treating infected skin wounds: A systematic review and meta-analysis from randomized
Analú Barros de Oliveira1, Túlio Morandin Ferrisse2, Carla Raquel Fontana3
1São Paulo State University (UNESP), School of Dentistry - Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Araraquara, São Paulo, Brazil.
Background:
Infected skin wounds represent a public health problem that effects 20 million people worldwide. Photodynamic therapy (PDT) is a treatment option with excellent results against several infections.
Objective:
This study aimed to perform a systematic review and meta-analysis on PDT efficacy for treating infected wounds based on randomized clinical trials (RCTs).
Methods:
PubMed, Scopus, Web of Science, SciELO, and the Cochrane library were searched. The Delphi List criteria and the Revised Cochrane risk-of-bias (Rob 2) were used for evaluating the quality of clinical trials. Meta-analyses were performed with the random-effect model. The odds ratio was the effect measure for binary outcomes, while the standard mean difference was used for continuous outcomes. The trim-and-fill method was used to detect small-study effects. The quality of evidence was verified for each outcome.
Results:
Only four out of 573 articles were selected for the qualitative and quantitative analyses. The most frequent cause of infected wounds was impaired venous circulation (75%). All studies used red LED light. PDT reduced healing time and improved the healing process and wound oxygenation. Patients treated with PDT showed 15% to 17% (p = 0.0003/ I2=0%) lower microbial cell viability in the wound and a significantly smaller wound size (0.72 cm2/p = 0.0187/I2=0%) than patients treated with placebo or red-light exposure. There was a high level of evidence for each meta-analysis outcome.
Conclusion:
PDT can be an excellent alternative treatment for infected skin wounds, though larger trials are needed.
Insights
Photodynamic therapy (PDT) effectively treats infected skin wounds, reducing healing time and microbial load. This systematic review highlights PDT as a promising alternative for wound care.
Area of Science:
- Dermatology
- Photomedicine
- Wound Healing
Background:
- Infected skin wounds affect millions globally, posing a significant public health challenge.
- Photodynamic therapy (PDT) shows promise as an effective treatment for various infections.
Approach:
- Systematic review and meta-analysis of randomized clinical trials (RCTs) on PDT for infected wounds.
- Searched major databases (PubMed, Scopus, Web of Science, SciELO, Cochrane).
- Assessed trial quality using Delphi List and Cochrane risk-of-bias (Rob 2) tools.
Key Points:
- Four RCTs were analyzed, with impaired venous circulation being the most common cause of wounds.
- PDT, using red LED light, accelerated healing, improved wound oxygenation, and reduced microbial cell viability by 15-17%.
- PDT significantly decreased wound size (0.72 cm²), with high-level evidence supporting these outcomes.
Conclusions:
- Photodynamic therapy is a viable and effective treatment option for infected skin wounds.
- Further large-scale clinical trials are warranted to solidify PDT's role in wound management.
