Treatment of Wounds That Are Difficult to Heal with Photobiomodulation: A Pilot Study

Background/Objectives: Hard-to-heal wounds are resistant to standard treatments and significantly impact patients' quality of life and healthcare costs. Photobiomodulation with blue light has shown potential in wound healing, but evidence in wounds persisting for extended periods is limited. This pilot study evaluated the effectiveness of an accelerated photobiomodulation protocol in patients with hard-to-heal wounds in a nurse-led outpatient setting. Methods: Eleven patients with venous, lymphatic, diabetic, or mixed etiology wounds, unhealed for at least two years, were recruited from two clinics in the North District of the ASL Città di Torino. Participants received twice-weekly sessions of blue light photobiomodulation (EmoLED™, 400-430 nm lasting 60-120 s) for four weeks, in addition to standard care. The wound area was measured at baseline, week 4, and week 12 using the CutiMed Wound Navigator^® Version 2.2.8. The secondary endpoints included pain, wound exudate quantity and quality, and the surrounding skin condition. Results: All participants (average wound duration 5.9 years; mean area 13.1 cm², SD ± 14.4) completed the treatment; two were lost at follow-up due to unrelated clinical events. No adverse reactions were reported. At week 4, an area reduction was shown in 9 of 11 wounds (mean: 9.5 cm², SD ± 11.4), though not statistically significant (p = 0.240). At week 12, a significant reduction was observed (mean: 7.2 cm², SD ± 13; p = 0.04), with a mean percentage area decrease of 40.5%. Significant improvements were also noted in pain levels, exudate characteristics, and surrounding skin conditions over time. Conclusions: Accelerated blue light photobiomodulation appears to support long-term wound healing and symptom improvement in patients with hard-to-heal wounds. These findings warrant confirmation in larger, controlled studies.