Authors (including presenting author) :
Tam ST(1), Li YS(2), Yeung PS(2), Lam YC(1), Cheung PC(1), To WK(1)
Affiliation :
(1) Department of Physiotherapy, Pok Oi Hospital (2) Nursing Service Department (Wound Team),Pok Oi Hospital
Introduction :
Prolonged unhealed pressure injury has been one of the major reasons for prolonged-hospitalization which increases the economic costs in managing patients due to the extended length of stay. Promoting wound healing promotes patients’ discharge, leads to both reduced health expenditure and patient’s suffering from wound pain.
An interdisciplinary model was established in Pok Oi Hospital, emphasing collaboration between physiotherapy and wound nurse with integration of using electrical modalities for proactive management of stage 4 pressure ulcers. Negative Pressure Wound Therapy (NPWT) is used by wound nurse in promoting an ideal and clean environment for wound healing and at the same time phototherapy mainly Low Level Laser Therapy (LLLT)was used by physiotherapist to induce photo-biostimulation which includes increasing cellular metabolism to enhance cell proliferation and granulation.
Objectives :
The aim of this study is to evaluate the effect of LLLT in promoting wound healing.
Methodology :
Non healing stage 4 pressure Injury cases will be selected by wound nurse specialist. Necrotic tissues or sloughs were removed by conservative sharp wound debridement if needed before consulting physiotherapist for suitability of LLLT application. Cases were treated with NPWT and LLLT 2 times per week. Protocol of LLLT was as below: single probe with wavelength of 650nm, 5kHz, continuous mode was used. The treatment time was calculated as deliver 4-10J/cm2. Total treatment sessions required were decided by wound healing progress. Paired T Test and Wilcoxon Signed Rank Test were used for analysing outcomes of wound area, depth, undermining depth and Pressure Ulcer Scale for Healing (PUSH) Tool 3.0.
Result & Outcome :
10 patients were identified during September 2023 to September 2024. Mean age of patients was 72.4 years and 50% were males.5 patients (50%) were with Diabetes. 9 patients (90%) were bed-chairbound. Positive sacral wound swabs with bacteria were detected in 6 out of 10 patients (60%).Mean number of treatment sessions were 10 sessions.
All cases were shown to have significant wound size reduction in different dimensions after the intervention. There was a significant reduction in mean ulcer area (length X width) from 70.05 to 45.1cm2 (t=-3.3, p< 0.01). The mean depth of wound decreased from 1.7cm to 0.98cm (t=-4.529, p<0.01). All cases had decrease in undermining depth from 4.45cm to 1.55cm (t= -2.4232, p=0.04). Median Push score decreased from 17 to 13 (z=-2.6581, p<0.01).
To conclude, positive outcomes on accelerating wound healing in patients with prolonged unhealed pressure injury by using LLLT and NPWT were demonstrated. Hence interdisciplinary collaborative wound management model was crucial for quality wound care.
