Integrated new therapy to usual care in management of not healing wounds and post-surgical ulcers

A. Tedeschi, C. Cosentino, E. Salutini, D. Fusilli and R. Anichini
Energy for Health [23], 2023

Managing foot ulcers in diabetes pose significant challenges and financial burdens on healthcare systems, and impact morbidity, mortality, and quality of life. 
In light of this, wound management principles such as debridement and wound bed preparation, alongside novel technologies, designed to alter wound physiology for facilitating healing, are essential when attempting to heal a chronic diabetic foot ulcer. [1-2]
If Standard Care remains a target of our actions, novel methods and therapies may improve outcomes.
Particular attention should be given to post-surgical lesions that do not heal in the first instance.  
Advanced medications, skin grafting (autologous, engineered or from a cadaveric donor), and physical therapies are available to enhance tissue regeneration, each with its own mechanisms.
At the San Jacopo Hospital DF UNIT in Pistoia (Italy), we use the following integrated protocol to improve wound healing in various conditions:

  • Surgical treatment (debridement, minor amputations, evacuation of abscesses)
  • Standard treatment of infections (antibiotic therapy, antiseptics)
  • Vascular access (diagnosis and possibly revascularization) to improve blood flow.

Finally, we are trying to improve outcomes with some new approaches such as Vacuum Assisted Closure Therapy (VAC) and physical therapies.
Among physical therapies for treating of diabetic foot ulcers, laser therapy has demonstrated potential and promising outcomes. [3-6]
The Multiwave locked system (MLS®) laser therapy is well known for its capacity to allow analgesic, antiinflammatory, anti-oedema and tissue repair effects in superficial and deep tissues through cellular and molecular mechanisms demonstrated in studies conducted with in vitro and animal models. [7, 8, 9] 
Based on the literature concerning the mechanisms of action of MLS® technology and its specific features, we have ascertained its appropriateness, for addressing patient issues, within our department.