切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2025, Vol. 20 ›› Issue (06) : 533 -537. doi: 10.3877/cma.j.issn.1673-9450.2025.06.011

综述

激光疗法在慢性创面治疗中的研究进展
熊枫, 胡云刚, 刘子熙, 杜伟力()   
  1. 102200 首都医科大学附属北京积水潭医院烧伤整形与创面修复科
  • 收稿日期:2025-08-09 出版日期:2025-12-01
  • 通信作者: 杜伟力
  • 基金资助:
    北京市属医院科研培育计划(PX20240403); 北京积水潭医院学科骨干(XKGG202209)

Research progress on laser therapy in the treatment of chronic wounds

Feng Xiong, Yungang Hu, Zixi Liu, Weili Du()   

  1. Department of Burns and Plastic Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 102200,China
  • Received:2025-08-09 Published:2025-12-01
  • Corresponding author: Weili Du
引用本文:

熊枫, 胡云刚, 刘子熙, 杜伟力. 激光疗法在慢性创面治疗中的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(06): 533-537.

Feng Xiong, Yungang Hu, Zixi Liu, Weili Du. Research progress on laser therapy in the treatment of chronic wounds[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(06): 533-537.

慢性创面具有治疗周期长、截肢率高及复发率高等特点,目前仍为研究热点、难点。在慢性创面修复领域中,传统治疗方法存在恢复缓慢、创伤较大等不足,而激光疗法凭借损伤小、精准性高、安全性高、操作简便等突出优势,日益受到广泛关注。临床上常用的主要为低能量激光治疗,其核心机制为通过影响细胞代谢,进而实现促进创面愈合、缓解局部疼痛的效果。近年来,高能量激光治疗同样显示出在改善创面愈合方面的潜力。因此,有必要对激光类型、治疗参数的选择以及如何提高治疗成功率、减少并发症等问题展开研究。旨在为临床提供全面的理论依据与实践指导,以期减轻激光治疗的副作用,提高激光治疗的质量。

Chronic wounds are typically characterized by prolonged treatment durations, high rates of amputation, and high recurrence rates, making them a persistent challenge and focus in medical research. In the field of chronic wound repair, traditional therapeutic approaches are associated with several limitations, including slow recovery and considerable trauma. As a result, laser therapy has garnered increasing attention due to its advantages, such as minimal invasiveness, high precision, high safety, and ease of operation. Currently, low-level laser therapy is the most widely used modality in clinical settings, promoting wound healing and alleviating local pain by modulating cellular metabolism. Emerging studies suggest that high-intensity laser therapy has also demonstrated potential in enhancing the wound healing process. This article investigates the selection of laser types and treatment parameters, with the objective of improving treatment efficacy and minimizing complications. It aims to provide clinicians with a comprehensive theoretical foundation and practical guidance for reducing potential adverse effects and optimizing laser therapy outcomes.

[1]
Leyane TSJere SWHoureld NN. Cellular signalling and photobiomodulation in chronic wound repair[J]. Int J Mol Sci202122(20):11223.
[2]
Yan RYu FStrandlund K, et al. Analyzing factors affecting quality of life in patients hospitalized with chronic wound[J]. Wound Repair Regen202129(1):70-78.
[3]
Carter MJDaVanzo JHaught R, et al. Chronic wound prevalence and the associated cost of treatment in medicare beneficiaries: changes between 2014 and 2019[J]. J Med Econ202326(1):894-901.
[4]
Kapp SSantamaria N. The financial and quality-of-life cost to patients living with a chronic wound in the community[J]. Int Wound J201714(6):1108-1119.
[5]
Fernández-Guarino MBacci SPérez González LA, et al. The role of physical therapies in wound healing and assisted scarring[J]. Int J Mol Sci202324(8):7487.
[6]
Hu YYu LDai Q, et al. Multifunctional antibacterial hydrogels for chronic wound management[J]. Biomater Sci202412(10):2460-2479.
[7]
Wang KLiu YWang H, et al. Multi-functional nanofilms capable of angiogenesis, near-infrared-triggered anti-bacterial activity and inflammatory regulation for infected wound healing[J]. Biomater Adv2022142:213154.
[8]
Zhang YSun JLiu Y, et al. Multi-functional dressing with curcumin displays anti-inflammatory, antioxidant, angiogenic, and collagen regeneration effects in diabetic wound healing[J]. J Mater Sci202560(14):6217-6234.
[9]
张铭,于浩,陈铭锐. 压力性损伤创面治疗方法研究进展[J]. 中华整形外科杂志202440(11):1255-1262.
[10]
谭谦,徐晔. 慢性创面治疗的理论和策略[J]. 中华烧伤杂志202036(9):798-802.
[11]
Hu YZhao YWu H, et al. Global hotspots and trends of diabetic foot ulcer therapy: a bibliometric analysis from 2004 and 2023[J]. Int J Low Extrem Wounds2025:15347346241311065.
[12]
Elemek EGelmez YMHekimoğlu ER, et al. Clinical and histological comparison of healing by steel scalpel, diode laser, and radiofrequency in palatal wound: an animal study[J]. Niger J Clin Pract202326(9):1264-1272.
[13]
Jamalpour MRPouresmaeil NKhazai S. Enhanced wound closure in rabbit oral vestibule: a comparative analysis of suturing and laser tissue soldering[J]. BMC Oral Health202424(1):1215.
[14]
Wongchadakul PRattanadecho PJiamjiroch K. Experimental analysis of thermal transport in low-level laser therapy on skin tissue: the influence on therapeutic efficacy, pain sensation and dry skin wound[J]. Int J Therm Sci2024199.
[15]
Carroll JDMilward MRCooper PR, et al. Developments in low level light therapy (LLLT) for dentistry[J]. Dent Mater201430(5):465-475.
[16]
Nadhreen AAAlamoudi NMElkhodary HM. Low-level laser therapy in dentistry: extra-oral applications[J]. Niger J Clin Pract201922(10):1313-1318.
[17]
Ferro APde Jesus Guirro RROrellana MD, et al. Photobiomodulation with laser and LED on mesenchymal stem cells viability and wound closure in vitro[J]. Lasers Med Sci202439(1):205.
[18]
Lee YILee SGHam S, et al. Exploring the safety and efficacy of organic light-emitting diode in skin rejuvenation and wound healing[J]. Yonsei Med J202465(2):98-107.
[19]
Giannakopoulos EKatopodi ARallis M, et al. The effects of low power laser light at 661 nm on wound healing in a scratch assay fibroblast model[J]. Lasers Med Sci202238(1):27.
[20]
Huth SHuth LMarquardt Y, et al. MMP-3 plays a major role in calcium pantothenate-promoted wound healing after fractional ablative laser treatment[J]. Lasers Med Sci202237(2):887-894.
[21]
Jere SWHoureld NN. Regulatory processes of the canonical Wnt/β-catenin pathway and photobiomodulation in diabetic wound repair[J]. Int J Mol Sci202223(8):4210.
[22]
BangHong JYuKun WAo S, et al. Low-level laser activates Wnt/β-catenin signaling pathway-promoting hair follicle stem cell regeneration and wound healing: upregulate the expression of key downstream gene Lef 1[J]. Skin Res Technol202430(6):e13807.
[23]
Hu BZhao XLu Y, et al. A transient photoactivation of epidermal stem cells by femtosecond laser promotes skin wound healing[J]. J Biophotonics202215(12):e202200217.
[24]
Jere SWAbrahamse HHoureld NN. Interaction of the AKT and β-catenin signalling pathways and the influence of photobiomodulation on cellular signalling proteins in diabetic wound healing[J]. J Biomed Sci202330(1):81.
[25]
Kasowanjete PAbrahamse HHoureld NN. Photobiomodulation at 660 nm stimulates in vitro diabetic wound healing via the Ras/MAPK pathway[J]. Cells202312(7):1080.
[26]
Leyane TSJere SWHoureld NN. Effect of photobiomodulation at 830 nm on gene expression correlated with JAK/STAT signalling in wounded and diabetic wounded fibroblasts in vitro[J]. J Biophotonics202417(2):e202300230.
[27]
Mgwenya TNAbrahamse HHoureld NN. Modulatory effects of 830 nm on diabetic wounded fibroblast cells: an in vitro study on inflammatory cytokines[J]. Photobiomodul Photomed Laser Surg202442(11):676-692.
[28]
Rajendran NKHoureld NNAbrahamse H. In vitro wound healing potential of photobiomodulation is possibly mediated by its stimulatory effect on AKT expression in adipose-derived stem cells[J]. Oxid Med Cell Longev20212021:6664627.
[29]
Zhang GYi LWang C, et al. Photobiomodulation promotes angiogenesis in wound healing through stimulating the nuclear translocation of VEGFR2 and STAT3[J]. J Photochem Photobiol B2022237:112573.
[30]
Li HLiu YLi X, et al. A histological evaluation of the mice oral mucosal tissue wounds excised with diode laser, Er:YAG laser, and cold scalpel[J]. Lasers Med Sci202237(6):2707-2715.
[31]
Zuhayri HNikolaev VVLepekhina TB, et al. The in vivo quantitative assessment of the effectiveness of low-dose photodynamic therapy on wound healing using optical coherence tomography[J]. Pharmaceutics202214(2):399.
[32]
Astuti SDSulistyo ASetiawatie EM, et al. An in-vivo study of photobiomodulation using 403 nm and 649 nm diode lasers for molar tooth extraction wound healing in wistar rats[J]. Odontology2022110(2):240-253.
[33]
Morshedzadeh GAslroosta HVafaei M. Effect of GaAlAs 940 nm photobiomodulation on palatal wound healing after free gingival graft surgery: a split mouth randomized controlled clinical trial[J]. BMC Oral Health202222(1):202.
[34]
Tang DLiu CChen X, et al. The associations between diode laser (810 nm) therapy and chronic wound healing and pain relief: light into the chronic wound patient's life[J]. Wound Repair Regen202331(2):227-232.
[35]
Besser MSchaeler LPlattfaut I, et al. Pulsed low-intensity laser treatment stimulates wound healing without enhancing biofilm development in vitro[J]. J Photochem Photobiol B2022233:112504.
[36]
Dehghanpour HRParvin PGanjali P, et al. Evaluation of photobiomodulation effect on cesarean-sectioned wound healing: a clinical study[J]. Lasers Med Sci202338(1):171.
[37]
Yoon SHHuh BKAbdi S, et al. The efficacy of high-intensity laser therapy in wound healing: a narrative review[J]. Lasers Med Sci202439(1):208.
[38]
张瑞媞,唐文庆,殷稚飞. 高能量激光在康复中的应用进展[J]. 中华物理医学与康复杂志201941(11):874-876.
[39]
Frey RVarjonen K. A retrospective case series of the postoperative outcome for 30 dogs with inflammatory interdigital nodules, surgically treated with carbon dioxide laser and a nonantimicrobial wound-healing protocol[J]. Vet Dermatol202334(2):150-155.
[40]
Ezzati KLaakso ELSalari A, et al. The beneficial effects of high-intensity laser therapy and co-interventions on musculoskeletal pain management: a systematic review[J]. J Lasers Med Sci202011(1):81-90.
[41]
Jiang BTang RZheng D, et al. Evaluation of the efficacy of ultrapulsed CO2 laser in chronic wounds[J]. Lasers Surg Med202153(4):443-449.
[42]
Laranne JLagerstedt APukander J, et al. Wound healing and soft tissue effects of CO2, contact Nd: YAG and combined CO2-Nd: YAG laser beams on rabbit trachea[J]. Acta Otolaryngol1997117(6):909-917.
[43]
Hong SEHong MKKang SR, et al. Effects of neodymium-yttrium-aluminum garnet (Nd:YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model[J]. J Cosmet Laser Ther201618(8):432-437.
[44]
Lu QYin ZShen X, et al. Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial[J]. BMJ Open202111(7):e045866.
[45]
Fisher SEFrame JWBrowne RM, et al. A comparative histological study of wound healing following CO2 laser and conventional surgical excision of canine buccal mucosa[J]. Arch Oral Biol198328(4):287-291.
[46]
Guan HZhang DMa X, et al. Efficacy and safety of CO2 laser in the treatment of chronic wounds: a retrospective matched cohort trial[J]. Lasers Surg Med202254(4):490-501.
[47]
Zand NFateh MAtaie-Fashtami L, et al. Promoting wound healing in minor recurrent aphthous stomatitis by non-thermal, non-ablative CO2 laser therapy: a pilot study[J]. Photomed Laser Surg201230(12):719-723.
[48]
Fortune DSHuang SSoto J, et al. Effect of pulse duration on wound healing using a CO2 laser[J]. Laryngoscope1998108(6):843-848.
[49]
Cotomacio CCCalarga CCYshikawa BK, et al. Wound healing process with different photobiomodulation therapy protocols to treat 5-FU-induced oral mucositis in hamsters[J]. Arch Oral Biol2021131:105250.
[50]
de Oliveira LPde Lima Chagas Ade Souza TR, et al. Low-power laser in increasing doses improve wound healing process in rats[J]. Lasers Med Sci202338(1):60.
[51]
Timimi ZA. The impact of low-power therapeutic lasers at 904 nm on the healing process of wounds and the relationships between extracellular matrix components and myofibroblasts[J]. Int J Low Extrem Wounds2024:15347346241273179.
[52]
Zuhayri HSamarinova AABorisov AV, et al. Quantitative assessment of low-dose photodynamic therapy effects on diabetic wound healing using Raman spectroscopy[J]. Pharmaceutics202315(2):595.
[53]
Yoon JPark JHChoi JW, et al. Optimal fluence and duration of low-level laser therapy for efficient wound healing in mice[J]. Ann Dermatol202133(4):318-323.
[54]
Dhlamini THoureld NN. Clinical effect of photobiomodulation on wound healing of diabetic foot ulcers: does skin color needs to be considered?[J]. J Diabetes Res20222022:3312840.
[55]
Gogia PP. Physical therapy modalities for wound management[J]. Ostomy Wound Manage199642(1):46-54.
[56]
卫贞祺,王颖竹,傅海霞,等. 红光治疗对腹壁疝开放修补手术切口愈合的影响分析[J]. 中华疝和腹壁外科杂志(电子版)202115(5):517-520.
[57]
de Vasconcelos Catão MHNonaka CFde Albuquerque RL Jr, et al. Effects of red laser, infrared, photodynamic therapy, and green LED on the healing process of third-degree burns: clinical and histological study in rats[J]. Lasers Med Sci201530(1):421-428.
[58]
杨露倩,郑元义,李晓,等. 低强度脉冲超声治疗周围神经损伤的研究进展[J]. 中华超声影像学杂志202332(12):1101-1104.
[59]
徐城,刘丹彦. 低强度和高强度聚焦超声治疗慢性软组织损伤性疼痛效果的比较[J]. 中华麻醉学杂志201535(7):815-818.
[60]
Tkz CAngin ADemrel P, et al. Low-level laser therapy is more effective than pulse ultrasound treatment on wound healing: comparative experimental study[J]. Turkiye Klinikleri J Med Sci201030(1):135-143.
[61]
Demir HYaray SKirnap M, et al. Comparison of the effects of laser and ultrasound treatments on experimental wound healing in rats[J]. J Rehabil Res Dev200441(5):721-727.
[1] 杨琳, 尹如铁. 外阴白色病变病因研究及治疗现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(02): 157-165.
[2] 奎玉凤, 李毅. 糖尿病血管内皮细胞损伤机制的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 363-367.
[3] 邢天娇, 陈向军, 吴迪, 康淑霞, 姚尧. 吸脂术联合强脉冲光与非剥脱点阵激光治疗体表脂肪瘤的疗效观察[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 306-311.
[4] 余静雅, 石玉兰, 向利娟, 陈城, 罗钰堞. 老年慢性创面患者衰弱现状及影响因素分析[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(02): 141-147.
[5] 周涵, 武胡雯, 张培深, 邓晗彬, 范闻轩, 李嘉诚, 程少文. 蛋白质组学在慢性难愈合创面研究中的应用进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 536-540.
[6] 杨丽, 李文颖, 田园, 周林熙, 王伟. 脂质水胶体硫酸银敷料和蔗糖八硫酸盐敷料在糖尿病足溃疡中的应用进展[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(03): 271-275.
[7] 陈向军, 于丽, 王星, 梁俊青, 吴迪, 李志军. 采用不同方法联合放射治疗修复薄型瘢痕疙瘩的临床疗效分析[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(03): 215-222.
[8] 韩春茂. 解决慢性创面患者医疗服务最后一公里[J/OL]. 中华损伤与修复杂志(电子版), 2023, 18(05): 460-460.
[9] 谢挺. 疑难创面疾病的诊疗思路[J/OL]. 中华损伤与修复杂志(电子版), 2023, 18(04): 368-368.
[10] 祁焕康, 包俊杰, 张婧, 田琰, 卓么加, 祁万乐. 富血小板血浆联合微粒皮移植在高原地区老年慢性小创面中的临床研究[J/OL]. 中华损伤与修复杂志(电子版), 2023, 18(01): 32-38.
[11] 张苗苗, 付倩倩, 赵雅玫, 余小平, 周军利. 慢性创面伴自身免疫性疾病的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2022, 17(05): 445-449.
[12] 祁万乐, 卓么加, 马子英, 田琰, 达娃卓玛. 多学科联合会诊诊疗模式在青海地区慢性创面中的应用研究[J/OL]. 中华损伤与修复杂志(电子版), 2022, 17(02): 113-118.
[13] 张苗苗, 余小平, 付倩倩, 周军利. 外源性应用P物质促进糖尿病慢性创面愈合的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2022, 17(02): 159-162.
[14] 郝卓伦, 齐雯丽, 孙家明, 周牧冉, 郭能强. 脂肪干细胞促进慢性创面愈合的研究进展[J/OL]. 中华细胞与干细胞杂志(电子版), 2022, 12(04): 237-242.
[15] 邓哲. 急诊创面中心建设与思考[J/OL]. 中华卫生应急电子杂志, 2025, 11(02): 128-128.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?