Closure of chronic non healing ankle ulcer with low level laser therapy in a patient presenting with thalassemia intermedia: Case report

Abstract

In this single case study, the possible effect of low-level laser therapy (LLLT) was explored in the form of light emitting diodes on a chronic non-healing wound of 6 months duration in an 18-year-old male patient suffering from thalassemia intermedia. After irradiation, with LLLT dosage of 17.3 J/cm2 for 8 min for 2 weeks duration followed by proliferative dosage of 8.65-4.33 J/cm2 for 4 min from 3rd week to 6th week for 2 min along with antibiotics vancomycin (15 mg/kg) and a combination of amoxicillin and clavulanic acid (1 g). Proliferation of healthy granulation tissue was observed with decrease in score of pressure ulcer scale with complete re-epithelialization eventually LLLT irradiation could be a novel method of treatment for chronic non-healing wound in a thalassemia intermedia patient and an useful adjunct to standard care of treatment of pressure ulcers. It is postulated that LED irradiation augments wound healing with an early closure and no recurrence at the irradiated site even after follow up of 6 months.

Leg Ulcers: A Report in Patients with Hemoglobin E Beta Thalassemia and Review of the Literature in Severe Beta Thalassemia

“…One study suggested that iron overload plays a role in the pathophysiology of ulcers through generation of oxidative stress, as well as a factor perpetuating chronicity of the ulcer [14]. In our patients, serum ferritin concentration at diagnosis of ulcer was elevated at 1,108 ± 207 µg/L, similar to the serum ferritin concentration (1,045 ± 86 ng/mL) of the large cohort with HbE thalassemia [2] and that (1,247.0 ± 405.1 ng/mL) in the 5 studies of ulcers in thalassemia which have reported this variable [14, 28, 29, 31, 34].…”

“…This may increase a propensity for vascular perturbation, consistent with the observed increased risk of venous thromboembolism in splenectomized patients with HbE thalassemia [56], and of leg ulcers in splenectomized patients with nontransfusion-dependent thalassemia [57]. In our patients, more than half of whom had been splenectomized, platelet counts recorded at ulcer onset were elevated at 550.6 ± 53.24 × 10 9 , similar to that (587.2 ± 111.2 × 10 9 /L) in the 7 thalassemia ulcer studies in which this information was provided [14,15,26,28,31,32,34].…”

Comparison of Anti-Microbial Effects of Low-Level Laser Irradiation and Microwave Diathermy on Gram-Positive and Gram-Negative Bacteria in an In Vitro Model

“…Laser and microwave are electrotherapeutic devices that are commonly used for musculoskeletal related problems. Laser has been used previously in wound healing with evidence-based productive effects [14,15,16,17]. On the contrary, microwave diathermy has been used in wound healing with significant epithelialization of wound area [18], but little is known about their effect on organisms.…”

Contributions of Near Infrared Light Emitting Diode in Neurosurgery

“…Dixit et al observed the NIR LED GaAs improve a chronic ulcer on a 18 year old male patient with thalassemia intermedia. They credit the healing of the wound in part to the mitochondria stimulating effects, more specifically the cytochrome system [19].…”