Defocused diode laser therapy (830 nm) in the treatment of unresponsive skin ulcers: a preliminary trial.

BACKGROUND: Skin ulcers with compromised healing remain a major problem for plastic and dermatological surgeons. Low incident levels of laser energy have been shown to increase the blood flow rate and volume and to accelerate the wound healing process, thus raising the possibility in augmenting treatment for skin ulcers. METHODS: Preliminary controlled experiments with a 830 nm GaAlAs diode laser in axial pattern flap survival in the rat model showed statistically significant improvement in survival for the irradiated versus unirradiated control animals. In the present study, a newly developed defocused GaAlAs diode laser (830 nm, continuous wave, 669 mW/cm(2)) was applied once or twice per week in an uncontrolled study of five patients (aged between 5 and 81 years old, average 46.6 years old, doses from 6.3 J/cm(2) to 21 J/cm(2)) with previously unresponsive ulcers of various aetiologies. RESULTS: In all five patients, the ulcers healed completely between 3 weeks and 7 months (22.8 +/- 19.3 weeks), without recurrence during a minimum 12-month follow-up. CONCLUSIONS: Defocused 830 nm diode laser therapy was well tolerated, and was very effective in the treatment of this small number of compromised skin ulcers of different aetiologies and in a large range of patient ages. Further controlled studies in larger populations are required. Defocused diode laser therapy nonetheless appears to be a very useful adjunctive method in the treatment of slow-to-heal and non-healing skin ulcers.