Efficacy and safety of CO2 laser in the treatment of chronic wounds: A Retrospective Matched Cohort Trial

Haonan Guan; Di Zhang; Xian Ma; Yechen Lu; Jiaoyun Dong; Yiwen Niu; Yingkai Liu; Shuliang Lu; Jiping Xu; Jiajun Tang

doi:10.1002/lsm.23490

Efficacy and safety of CO₂ laser in the treatment of chronic wounds: A Retrospective Matched Cohort Trial

Lasers Surg Med. 2022 Apr;54(4):490-501. doi: 10.1002/lsm.23490. Epub 2021 Nov 15.

Authors

Haonan Guan^{1

2}, Di Zhang^{1

2}, Xian Ma^{1

2}, Yechen Lu^{1

2}, Jiaoyun Dong^{1

2}, Yiwen Niu^{1

2}, Yingkai Liu^{1

2}, Shuliang Lu^{1

2}, Jiping Xu³, Jiajun Tang^{1

2}

Affiliations

¹ Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
² Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
³ Department of Orthopaedics, Shanghai Fengxian District Center Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

PMID: 34778981
DOI: 10.1002/lsm.23490

Abstract

Objectives: Treating chronic cutaneous wounds is challenging, and debridement is a central concept in treating them. Studies have shown that CO₂ laser debridement can control local infection and promote the wound healing process. The present study aimed to investigate the efficacy and safety of fully ablative CO₂ laser debridement compared to routine surgical debridement in the treatment of chronic wounds.

Methods: The retrospective cohort study was conducted on patients with chronic (>1 month) cutaneous wounds (≥1 cm² ) between December 1, 2017, and December 1, 2020, in the Wound Healing Center at Shanghai Ruijin Hospital, China. Patients treated with CO₂ laser debridement with a DEKA SmartXide2 C80 (DEKA) (the CO₂ laser group) were compared with matched control patients with similar baseline characteristics who had undergone routine surgical debridement (the routine group). The primary outcome was time-to-heal (days) for chronic wounds in two groups, and secondary outcomes included the wound area and BWAT (Bates-Jensen wound assessment tool) score before treatment, and at 1, 2, 3, and 4 weeks after treatment.

Results: The study included 164 patients (82 in the CO₂ laser group and 82 matched in the routine group). The time-to-heal for patients in the CO₂ laser group (41.30 ± 17.11) was significantly shorter than that of the patients in the routine group (48.51 ± 24.32) (p = 0.015). At 3 and 4 weeks after treatment, the absolute wound area of the CO₂ laser group was significantly smaller than that of the routine group. Also, the CO₂ laser group exhibited a significantly lower relative area at 2, 3, and 4 weeks after treatment. The CO₂ laser group yielded significantly lower BWAT scores at 2, 3, and 4 weeks after treatment. Additionally, the relative BWAT score was significantly lower in the CO₂ laser group than the relative scores in the routine group at 2, 3, and 4 weeks after treatment. No adverse events related to the treatments were observed in either group during the study period.

Conclusions: The present study has shown that fully ablative CO₂ laser debridement has several advantages over routine sharp surgical debridement. It is superior at ameliorating wound status and reducing wound area, and it also significantly reduces the time-to-heal for chronic wounds, without causing any adverse events.

Keywords: CO2 laser; chronic wounds; debridement.

Publication types

Case Reports
Clinical Trial

MeSH terms

Carbon Dioxide
China
Cohort Studies
Humans
Lasers, Gas* / adverse effects
Retrospective Studies
Treatment Outcome
Wounds and Injuries* / therapy

Substances

Carbon Dioxide