The Journal of Practical Medicine >
A preliminary study on the treatment of refractory wounds by improved CO2 dot matrix laser combined with photodynamics
Received date: 2024-07-23
Online published: 2025-01-14
Objective Explored the clinical efficacy and mechanism of improved CO2 fractional laser on treatment for refractory wounds. Methods A total of 122 patients with refractory wounds who were admitted to the hospital from May 2022 to May 2024 were selected and randomly divided into a conventional group （conventional dressing change treatment + photodynamic therapy + conventional CO2 fractional laser treatment） and an improved group （conventional dressing change treatment + photodynamic therapy + improved CO2 fractional laser treatment） by lottery， with 61 cases in each group. The serum C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） levels， the number of wound bacteria before treatment and after 1， 2， and 3 weeks of treatment were compared between the two groups. The wound healing rates after 1， 2， and 3 weeks of treatment were compared between the two groups. The clinical efficacy of the two groups was compared. The levels of wound exudate basic fibroblast growth factor （bFGF） and angiopoietin-1 （Ang-1） before treatment and after 1， 2， and 3 weeks of treatment were compared. The adverse reactions of the two groups were compared. Results Repeated measures analysis of variance showed that there were an interaction effect between groups and over time in the serum CRP and ESR levels， the number of wound bacteria in both groups （P < 0.05）. There were no significant differences in the serum CRP and ESR levels and the number of wound bacteria between the two groups before treatment （P > 0.05）. The serum CRP and ESR levels and the number of wound bacteria in the improved group were lower than those in the conventional group after 1， 2， and 3 weeks of treatment （P < 0.05）. Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the wound healing rates of both groups （P < 0.05）. The wound healing rates in the improved group were higher than those in the conventional group after 1， 2， and 3 weeks of treatment （P < 0.05）. The total clinical effective rate of the improved group was higher than that of the conventional group （P < 0.05）. Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the levels of bFGF and Ang-1 in wound exudates of both groups （P < 0.05）. There was no significant difference in the levels of bFGF and Ang-1 in wound exudates between the two groups before treatment （P > 0.05）. The levels of bFGF and Ang-1 in wound exudates in the improved group were higher than those in the conventional group after 1， 2， and 3 weeks of treatment （P < 0.05）. There were no significant differences in the incidence of pain， pruritus and rash between the two groups （P > 0.05）. Conclusions In the treatment of refractory wounds， the combination of improved CO2 fractional laser and photodynamic therapy could promote the secretion of wound exudate growth factors， inhibit wound bacterial growth and inflammatory response， accelerate wound healing， and improve clinical efficacy， with high safety. The mechanism of action is related to the promotion of wound exudate growth factor secretion.
Mengxiao WANG , Zhiyong CHEN , Han LUO , Guanggang ZHANG . A preliminary study on the treatment of refractory wounds by improved CO2 dot matrix laser combined with photodynamics[J]. The Journal of Practical Medicine, 2025 , 41(1) : 53 -59 . DOI: 10.3969/j.issn.1006-5725.2025.01.009
| 1 | LV D， CAO X， ZHONG L， et al. Targeting phenylpyruvate restrains excessive NLRP3 inflammasome activation and pathological inflammation in diabetic wound healing［J］. Cell Rep Med， 2023， 4（8）：101129. doi:10.1016/j.xcrm.2023.101129 |
| 2 | 雷英， 高华伟， 刘鸿雁， 等. 老年慢性创面住院患者临床特征及流行病学分析［J］. 河北医药， 2022， 44（11）：1736-1738，1742. |
| 3 | PAGANO C， IBORRA C A V， PERIOLI L. Recent approaches to wound treatment-second edition［J］. Int J Mol Sci， 2024， 25（10）：5388. doi:10.3390/ijms25105388 |
| 4 | 李晨曦， 严冬梅， 张姣姣， 等. 氨基酮戊酸-光动力疗法联合CO2点阵激光治疗痤疮增生性瘢痕的效果［J］. 中华医学美学美容杂志， 2022， 28（2）：136-139. |
| 5 | 汪静文， 王静， 王娜， 等. CO2点阵激光预处理联合光动力疗法治疗日光性角化病临床疗效观察［J］. 蚌埠医学院学报， 2023， 48（7）：925-928. |
| 6 | 白子烨， 王怀谷， 张莉， 等. 局部氧疗联合重组牛碱性成纤维细胞生长因子合并负压引流技术应用在慢性难愈性创面的疗效［J］. 实用医学杂志， 2022， 38（20）：2561-2567. |
| 7 | CAO P， FLEMING D， MOUSTAFA D A， et al. A Pseudomonas aeruginosa small RNA regulates chronic and acute infection［J］. Nature， 2023， 618（7964）：358-364. doi:10.1038/s41586-023-06111-7 |
| 8 | DONG X M， PEI L L， LU P S， et al. Bacteriological investigation and drug resistance analysis of chronic refractory wound secretions［J］. J Craniofac Surg， 2022， 33（7）：2028-2030. doi:10.1097/scs.0000000000008473 |
| 9 | CHIN J D， ZHAO L， MAYBERRY T G， et al. Photodynamic therapy， probiotics， acetic acid， and essential oil in the treatment of chronic wounds infected with pseudomonas aeruginosa［J］. Pharmaceutics， 2023， 15（6）：1721. doi:10.3390/pharmaceutics15061721 |
| 10 | ABDEL KHALEK M A， ABDELHAMEED A M， ABDEL GABER S A. The use of photoactive polymeric nanoparticles and nanofibers to generate a photodynamic-mediated antimicrobial effect， with a special emphasis on chronic wounds［J］. Pharmaceutics， 2024， 16（2）：229. doi:10.3390/pharmaceutics16020229 |
| 11 | GUAN H， ZHANG D， MA X， et al. Efficacy and safety of CO2 laser in the treatment of chronic wounds： a retrospective matched cohort trial［J］. Lasers Surg Med， 2022， 54（4）：490-501. doi:10.1002/lsm.23490 |
| 12 | 田丽， 徐静， 王怀谷， 等. 优化脉冲技术联合低能量CO2点阵激光对面颈部瘢痕早期干预的临床效果［J］. 实用医学杂志， 2022， 38（15）：1919-1924. |
| 13 | SUWAN P T， AHN G R， SUMNER R， et al. Novel 40?μm spot size 3050/3200?nm DFG laser versus CO2 laser for laser-assisted drug delivery［J］. Lasers Surg Med， 2024， 56（2）：186-196. doi:10.1002/lsm.23755 |
| 14 | ZHOU H， LIAO Y， HAN X， et al. ROS-responsive nanoparticle delivery of mRNA and photosensitizer for combinatorial canCRP therapy［J］. Nano Lett， 2023， 23（9）：3661-3668. doi:10.1021/acs.nanolett.2c03784 |
| 15 | NKUNE N W， ABRAHAMSE H. Anti-hypoxia nanoplatforms for enhanced photosensitizer uptake and photodynamic therapy effects in canCRP cells［J］. Int J Mol Sci， 2023， 24（3）：2656. doi:10.3390/ijms24032656 |
| 16 | 王加芳， 李进， 汪云飞， 等. 艾司氯胺酮与舒芬太尼分别复合丙泊酚用于儿童鲜红斑痣光动力治疗麻醉效果的比较［J］. 实用医学杂志， 2023， 39（1）：109-113. |
| 17 | 王聪敏，袁瑱，徐晓敏，等. 脉冲CO2激光联合光动力治疗皮肤化脓性肉芽肿的护理体会［J］. 实用皮肤病学杂志， 2023， 16（5）：312-314. |
| 18 | 马晓静，杨志刚，施林林，等. CO2激光联合光动力治疗尿道口，肛周尖锐湿疣的临床效果［J］. 临床与病理杂志， 2023， 43（4）：761-766. |
| 19 | 王丽兵， 杨惠君， 杨正生， 等. CO2激光联合光动力疗法治疗鲍温样丘疹病的疗效［J］. 中国激光医学杂志， 2023， 32（4）：194-197. |
| 20 | YAN C， CHEN J， WANG C， et al. Milk exosomes-mediated miR-31-5p delivery accelerates diabetic wound healing through promoting angiogenesis［J］. Drug Deliv， 2022， 29（1）：214-228. doi:10.1080/10717544.2021.2023699 |
| 21 | PE?A O A， MARTIN P. Cellular and molecular mechanisms of skin wound healing［J］. Nat Rev Mol Cell Biol， 2024， 25（8）：599-616. doi:10.1038/s41580-024-00715-1 |
| 22 | AZARI Z， NAZARNEZHAD S， WEBSTER T J， et al. Stem cell-mediated angiogenesis in skin tissue engineering and wound healing［J］. Wound Repair Regen， 2022， 30（4）：421-435. doi:10.1111/wrr.13033 |
| 23 | ZARE R， ABDOLSAMADI H， SOLEIMANI ASL S， et al. The bFGF can improve angiogenesis in oral mucosa and accelerate wound healing［J］. Rep Biochem Mol Biol， 2023， 11（4）：547-552. doi:10.52547/rbmb.11.4.547 |
| 24 | LI L， MA Q， MOU J， et al. Basic fibroblast growth factor gel preparation induces angiogenesis during wound healing［J］. Int J Artif Organs， 2023， 46（3）：171-181. doi:10.1177/03913988221145525 |
| 25 | 杨筱， 吴本升， 何宗琦， 等. 紫黄生肌膏对慢性感染创面血管生成及血管内皮生长因子和血管生成素-1表达的影响［J］. 中国中西医结合外科杂志， 2022， 28（2）：179-184. |
| 26 | AL-EITAN L N， ALAHMAD S Z， ELMOTASEM M F M， et al. The synthetic cannabinoid 5F-MDMB-PICA enhances the metabolic activity and angiogenesis in human brain microvascular endothelial cells by upregulation of VEGF， ANG-1， and ANG-2［J］. Toxicol Res （Camb）， 2023， 12（5）：796-806. doi:10.1093/toxres/tfad068 |
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