At-Home Self-Applied Photobiomodulation Device for the Treatment of Diabetic Foot Ulcers in Adults With Type 2 Diabetes: Report of 4 Cases

Abstract

Diabetic foot ulcers (DFUs) incidence is increasing with the rising global prevalence of diabetes. In spite of following best practice standard of care, most DFUs are slow to heal. Photobiomodulation (PBM), previously known as low-level laser therapy, has been shown to accelerate healing of acute or chronic wounds, and specifically DFUs. However, the frequent applications required translates to frequent visits at the clinic, which are difficult for patients with DFU. In the following case series, we present our preliminary experience with a recently approved (Health Canada) consumer home-use PBM device as an adjuvant to standard treatment. Four men presented at the clinic (67 to 84 years of age) with DFUs/diabetic leg ulcers. The PBM treatment (808 nm, 250-mW peak power, 15 KHz, 5 J/min, ray size 4.5×1.0 cm²) was applied by the patients themselves at the clinic or at home. In the cases presented, all wounds closed within 1 to 3 weeks with no reported adverse events. Patients found the routine easy to follow and painless. In wounds that involved pain, patients reported pain reduction after 1 to 3 treatments. Based on our previous experience with these patients, self-applied PBM as an adjunct therapy led to accelerated healing and rapid pain alleviation compared with standard care alone. In summary, hard-to-heal diabetic wounds are a burden for patients, a burden for caregivers and costly for the health-care system. These observations support the view that the home-use device can be easily integrated as an adjuvant treatment to standard care at the clinic or home and, most importantly, encourage patient involvement in his or her own care.

Keywords: diabetic foot ulcer; home-use; low-level laser therapy; photobiomodulation; thérapie laser de faible intensité; ulcère du pied diabétique; usage domestique.