Low-level laser therapy and conventional treatment for diabetic foot ulcers: a case series

Diabetic foot ulcers (DFUs) are a serious complication of diabetes mellitus and are associated with prolonged healing, increased hospitalization, and risk of amputation. Low-level laser therapy (LLLT), a non-invasive and low-cost modality, has shown potential to accelerate wound healing by promoting tissue repair, cellular proliferation, and improved microcirculation. This study aimed to descriptively evaluate healing outcomes in patients with DFUs treated with LLT combined with conventional treatment care with conventional treatment alone. This prospective observational comparative study included 11 adults with diabetes and active neuropathic DFUs treated at a public podiatry outpatient clinic in Rio de Janeiro, Brazil (June 2023-July 2024). Participants were prospective screened and allocated to conventional treatment (CT, n = 5; 6 ulcers) or LLLT plus CT (n = 6; 9 ulcers). Healing progression was assessed using the Pressure Ulcer Scale for Healing (PUSH), evaluating wound area, tissue type, and exudate. In the CT group, 1 ulcer (17%) healed completely, 2 (33%) improved, 2 (33%) remained unchanged, and 1 (17%) worsened. In the LLLT group, 5 ulcers (55.5%) healed completely and 4 (44.5%) improved, with no lesions worsening. The LLLT group also demonstrated shorter mean healing time, fewer clinical visits, and greater tissue repair than CT alone. The descriptive findings suggest that adjunctive LLLT may represent a promising supportive strategy for DFU management in real world outpatient care. Due to the observational design, non-random allocation, and limited sample size, causal inference cannot be established. Future randomized controlled trials are needed to confirm these findings.