PMID- 20204086
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20110714
LR  - 20200929
IS  - 1863-5245 (Electronic)
IS  - 1863-5245 (Linking)
VI  - 2
IP  - 2
DP  - 2008 Mar 5
TI  - Therapy of chronic wounds with water-filtered infrared-A (wIRA).
PG  - Doc52
LID - Doc52
AB  - The central portion of chronic wounds is often hypoxic and relatively 
      hypothermic, representing a deficient energy supply of the tissue, which impedes 
      wound healing or even makes it impossible. Water-filtered infrared-A (wIRA) is a 
      special form of heat radiation with a high tissue penetration and a low thermal 
      load to the skin surface. wIRA produces a therapeutically usable field of heat 
      and increases temperature, oxygen partial pressure and perfusion of the tissue. 
      These three factors are decisive for a sufficient tissue supply with energy and 
      oxygen and consequently as well for wound healing, especially in chronic wounds, 
      and infection defense. wIRA acts both by thermal and thermic as well as by 
      non-thermal and non-thermic effects. wIRA can advance wound healing or improve an 
      impaired wound healing process and can especially enable wound healing in 
      non-healing chronic wounds. wIRA can considerably alleviate the pain and diminish 
      wound exudation and inflammation and can show positive immunomodulatory 
      effects.In a prospective, randomized, controlled study of 40 patients with 
      chronic venous stasis ulcers of the lower legs irradiation with wIRA and visible 
      light (VIS) accelerated the wound healing process (on average 18 vs. 42 days 
      until complete wound closure, residual ulcer area after 42 days 0.4 cm(2) vs. 2.8 
      cm(2)) and led to a reduction of the required dose of pain medication in 
      comparison to the control group of patients treated with the same standard care 
      (wound cleansing, wound dressing with antibacterial gauze, and compression 
      garment therapy) without the concomitant irradiation. Another prospective study 
      of 10 patients with non-healing chronic venous stasis ulcers of the lower legs 
      included extensive thermographic investigation. Therapy with wIRA(+VIS) resulted 
      in a complete or almost complete wound healing in 7 patients and a marked 
      reduction of the ulcer size in another 2 of the 10 patients, a clear reduction of 
      pain and required dose of pain medication, and a normalization of the 
      thermographic image. In a current prospective, randomized, controlled, blinded 
      study patients with non-healing chronic venous stasis ulcers of the lower legs 
      are treated with compression garment therapy, wound cleansing, wound dressings 
      and 30 minutes irradiation five times per week over 9 weeks. A preliminary 
      analysis of the first 23 patients of this study has shown in the group with 
      wIRA(+VIS) compared to a control group with VIS an advanced wound healing, an 
      improved granulation and in the later phase of treatment a decrease of the 
      bacterial burden. Some case reports have demonstrated that wIRA can also be used 
      for mixed arterial-venous ulcers or arterial ulcers, if irradiation intensity is 
      chosen appropriately low and if irradiation is monitored carefully. wIRA can be 
      used concerning decubital ulcers both in a preventive and in a therapeutic 
      indication. wIRA can improve the resorption of topically applied substances also 
      on wounds. An irradiation with VIS and wIRA presumably acts with endogenous 
      protoporphyrin IX (or protoporphyrin IX of bacteria) virtually similar as a mild 
      photodynamic therapy (endogenous PDT-like effect). This could lead to improved 
      cell regeneration and wound healing and to antibacterial effects. In conclusion, 
      these results indicate that wIRA generally should be considered for the treatment 
      of chronic wounds.
FAU - von Felbert, Verena
AU  - von Felbert V
AD  - RWTH Aachen University Hospital, Department of Dermatology, Aachen, Germany.
FAU - Schumann, Hauke
AU  - Schumann H
FAU - Mercer, James B
AU  - Mercer JB
FAU - Strasser, Wolfgang
AU  - Strasser W
FAU - Daeschlein, Georg
AU  - Daeschlein G
FAU - Hoffmann, Gerd
AU  - Hoffmann G
LA  - eng
PT  - Journal Article
DEP - 20080305
PL  - Germany
TA  - GMS Krankenhhyg Interdiszip
JT  - GMS Krankenhaushygiene interdisziplinar
JID - 101313359
PMC - PMC2831243
OTO - NOTNLM
OT  - chronic venous stasis ulcers of the lower legs
OT  - chronic wounds
OT  - energy supply
OT  - infection defense
OT  - inflammation
OT  - infrared thermography
OT  - oxygen supply
OT  - problem wounds
OT  - prospective, randomized, controlled, blinded study
OT  - quality of life
OT  - reduction of pain
OT  - thermal and non-thermal effects
OT  - thermic and non-thermic effects
OT  - thermographic image analysis
OT  - tissue blood flow
OT  - tissue oxygen partial pressure
OT  - tissue temperature
OT  - visual analog scales (VAS)
OT  - water-filtered infrared-A (wIRA)
OT  - wound exudation
OT  - wound healing
OT  - wound infections
EDAT- 2008/01/01 00:00
MHDA- 2008/01/01 00:01
PMCR- 2008/03/05
CRDT- 2010/03/06 06:00
PHST- 2010/03/06 06:00 [entrez]
PHST- 2008/01/01 00:00 [pubmed]
PHST- 2008/01/01 00:01 [medline]
PHST- 2008/03/05 00:00 [pmc-release]
AID - dgkh000085 [pii]
PST - epublish
SO  - GMS Krankenhhyg Interdiszip. 2008 Mar 5;2(2):Doc52.