Antimicrobial Photodynamic Therapy in Diabetic Amputation Ulcers: Case Series Evaluating Wound Healing Quality

Introduction

Diabetic foot ulcers affect approximately 15% of individuals with diabetes, compromising their quality of life and placing an additional burden on the public health system.

Objectives

This study aims to evaluate the effects of the antimicrobial photodynamic therapy (aPDT) in tissue repair through the analysis of two case studies involving individuals with diabetes-related foot lesions.

Methods

aPDT was performed using 1% methylene blue, a cluster of four red lasers (660 nm) with an average radiant power of 100 mW, and radiant energy per emitter of 6 J. The exposure time was 1 min, resulting in a total radiant energy per session of 24 J. Patients were evaluated on sessions 1, 3, 5, 10, and 30 days after the completion of treatment.

Results

Using the Bates-Jensen Wound Assessment Tool (BWAT) scale as a tool to assess wound progression, Patient 1 had an initial score of 37 points, which reduced to 24 points by the end of treatment, resulting in a decrease of 13 points on the scale. Patient 2 started with 36 points and finished with 14 points, achieving complete healing.

Conclusions

Treatment led to improved wound quality, evidenced by a reduction in BWAT scores, a 74.9% decrease in wound area in patient 1 with consistent healing progress, and complete wound closure in patient 2. Although limited by its case-series design, this study contributes preliminary clinical evidence suggesting the potential benefits of antimicrobial photodynamic therapy (aPDT) in the management of diabetic foot ulcers and highlights the need for larger, controlled trials to validate its efficacy. In conclusion, aPDT was effective across all evaluated outcomes in these two reported cases.

Trial Registration

NCT06416462 (initial release: 09/23).