PloS one
Can Photobiomodulation improve healing of category II-III pressure ulcers in frail older adults? A quasi-experimental 24-month follow-up study
By Degerman M, Bertilson BC, Öhman M and 3 others.
Abstract
Background
Frail older adults are particularly susceptible to pressure ulcer development due to complex health conditions and functional decline. Pressure ulcers category II and III involve partial- and full-thickness skin loss, and current treatment options often yield suboptimal outcomes. The study evaluated the effects of adjunctive photobiomodulation compared with standard-of-care in frail older adults, with category II and III pressure ulcers. The objectives were to assess: 1) ulcer healing 2) healing time; 3) factors associated with healing, and 4) ulcer recurrence following photobiomodulation.
Methods
Quasi-experimental study with two prospective intervention groups and matched registry-based control groups, conducted in accordance with TREND guidelines. Baseline differences analysed using Independent Samples T-test, Independent Samples Mann-Whitney U test or Pearson chi-square test. Times to healing evaluated using Kaplan-Meier analysis and log-rank tests. Age-stratified multivariable Cox proportional hazards models were applied to identify healing-associated factors. Ulcer recurrences were analysed descriptively. Participants and setting: Intervention groups comprised frail older adults (≥70 years) receiving municipal home healthcare: category II (n = 39) and category III (n = 37). Photobiomodulation was administered twice weekly, using GaAs laser (904 nm) and AlGaInP laser (635 nm). Control groups treated with standard-of-care were identified from the Swedish national registry RiksSår for ulcer treatment: category II (n = 117), and category III (n = 111).