Authors (including presenting author) :
Wong HI, Ng TY, Chiang WY, Chung HY, Liu KM, Liu WT, Wong CY
Affiliation :
Department of Orthopaedics and Traumatology, Queen Mary Hospital
Introduction :
Diabetes mellitus (DM) affects 10.5% of the global population and is projected to rise to 12.2% by 2045. Up to 25% of diabetic patients will experience diabetic foot ulcers (DFUs), leading to high hospital admissions and significant healthcare costs. According to CDARS, between January 2023 and April 2024, among 123 patients treated for lower limb ulcers in Queen Mary Hospital, 48 of them had diabetes, with 37 of them requiring surgery or bedside local debridement. The average length of stay was 7.44 days, illustrating the burden on healthcare resources. Effective management is crucial for improving patient outcomes and salvaging limbs. This project aims to determine whether BLT with SoC is more effective than SoC alone in promoting wound healing for diabetic lower limb ulcers.
Objectives :
Aim: To determine that BLT with SoC is more effective in promoting wound healing for diabetic lower limb ulcers when compared with SoC alone; Primary objective: To explore whether BLT can promote wound epithelialization by reducing wound volume in patients with diabetic lower limb ulcers in 4 weeks; Secondary objective: To explore whether BLT can lower the inflammatory level in blood tests
Methodology :
A pilot study took place at Queen Mary Hospital's O&T department from June to August 2024. A non-probability sampling method was utilized, gathering all available participants during the designated study period. Baseline data, including demographic and wound parameters, were collected upon admission to establish participants' characteristics. The study targets patients over 16 years old with lower limb ulcers, specifically those with diabetes mellitus on medication or with impaired fasting glucose (HbA1c > 5.6 mmol/L) or random glucose levels (RG > 7 mmol/L). The intervention group received blue light therapy (BLT) alongside the standard of care (SoC) for wound management, while the control group only had SoC. BLT was applied according to a standardized protocol, conducted every three days (i.e., on Days 0, 3, 6, etc.) with each session lasting 120 seconds. Wound parameters, including the percentage of granulation tissue and wound volume, were measured and recorded using a 3D wound camera. Data collection was performed every three days (i.e., Day 0, 3, 6, etc.) following the application of BLT, with additional measurements taken upon discharge or transfer.
Result & Outcome :
Result: 21 patients participated in the study, with 11 receiving BLT in conjunction with standard care treatment. Two sample t-tests were performed with a level of significance of 0.05. Significant differences were found in wound volume (p-value = 0.01264) and CRP reduction (p-value = 0.01483) between the intervention and control groups in 4 weeks; the intervention group showed a mean decrease in wound volume of 44.7%, compared to 4.62% in the control group, which was linked to a faster wound healing rate. Furthermore, the intervention group experienced a mean CRP reduction of 11.21 mg/L, while the control group decreased by 2.62 mg/L, indicating that BLT can reduce inflammatory levels; Conclusion: This pilot study supports the use of blue light therapy (BLT) as an alternative therapy for diabetic lower limb ulcers, showing a significant reduction in wound volume and inflammation among Asian patients in 4 weeks. This study addressed the gap in the clinical application of BLT among the Asian population in local settings. Further studies are required to achieve significant sample sizes and extend the use of BLT to other wound types to explore the effectiveness of BLT in Asian ethnicity.
