Manijeh Soleimanifar - PhD of Physiotherapy, Lifestyle medicine department, Medical Laser Research Center, ACECR, Tehran, Iran

Introduction: A wound is considered chronic when it does not heal, either because of a slow healing process, or because of its recurrence after a certain time period.Most diabetic wounds are categorized as chronic since take more than ۳ months to heal. The loss of mobility and the high cost of treatment makes the demand for an efficient and faster wound-healing process more desirable. The “TIME” principle is used as a general approach in the management of chronic wounds, involving tissue debridement, infection control, moisture balance, and edges of the wound. Following this assessment, other therapeutic modalities can be used to ensure effective healing.Methods of treatment: The principal objective in the treatment of chronic Diabetic Foot Ulcer (DFUs) is to achieve quick wound resolution and closure, and focus on preventing lower limb amputation. Photo biomodulation (PBM) as a knowledge in the science of photonics and bio photonics have led to the effective use of light in the treatment of DFUs. Numerous studies have demonstrated the therapeutic benefits low-level laser (light) therapy (LLLT), on diabetic wound healing which is considered as an effective therapeutic method in wound healing when used with the correct treatment parameters. Low-level laser therapy, when applied to skin wounds, is able to promote major physiological effects, such as anti-inflammatory resolution, neo angiogenesis, epithelial and fibroblasts proliferation, collagen synthesis and deposition, revascularization and wound contraction and alleviates the inflammatory phase in chronic wounds. In addition, high-intensity laser produces photochemical, photothermal, and photomechanical actions with a sufficient dose to reach the deep target tissue, which has a positive effect on reducing pain by penetrating deep tissues and providing functional improvement. High-intensity laser therapy is better than low-level laser therapy which takes much longer to deliver the same amount of energy to the tissues. High-intensity lasers, which are more potent, can penetrate more deeply than low level lasers. Conclusion: According to the literature review, doses of ۳- ۶ J/cm۲ appear to be more effective and doses above ۱۰ J/cm۲ are associated with deleterious effects. The wavelengths between ۶۳۲.۸ and ۱۰۰۰ nm remain as those having more satisfactory results in the wound healing process. Additionally, high-intensity lasers can treat a larger area than low-level lasers. This enables the healing light’s energy through the application of laser therapy at the plague level.