Adjuvant 904 nm Gallium Arsenide Laser Therapy Enhances Healing and Reduces Bacterial Burden in Chronic Wounds: A Randomized Controlled Trial

Chronic wounds, characterized by prolonged healing times and high complication rates, present significant challenges to healthcare systems. This randomized, double-blind, placebo-controlled clinical trial evaluated the adjunctive effect of 904 nm gallium arsenide (GaAs) laser therapy in the treatment of chronic venous and diabetic ulcers. The study adhered to the CONSORT 2025 guidelines to ensure transparency and quality in reporting. Seventy patients were randomly assigned to two groups: active laser (AL) group (laser + standard care) and placebo laser group (PL) (simulated laser + standard care). All participants were followed twice a week until complete wound healing or a maximum of 15 sessions. Outcomes assessed included wound area reduction, microbial load and histological analysis. Results showed that the AL group had a 53% reduction in wound area, while the PL group had a 9% reduction (p < 0.001), with complete closure observed in two AL patients. Laser therapy also significantly reduced bacterial colonization, particularly, of Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis (p ≤ 0.007). Histological analysis demonstrated enhanced angiogenesis, reduced inflammatory infiltrate and improved collagen organization at the wound edges in the AL group (p ≤ 0.042). These findings demonstrate that 904 nm GaAs laser therapy accelerates healing, reduces microbial burden and promotes favourable tissue remodelling. The integrative approach, combining clinical, microbiological and histological assessments, underscores its potential as a safe and effective adjunct in chronic wound management, offering a promising strategy to improve outcomes and reduce healthcare burdens.