Fotobiomodulação no tratamento de lesões por pressão: revisão sistemática com metanálise
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Data
2021
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Editor
Universidade Brasil
Resumo
Pressure sores (PS) are important causes of morbidity, especially in patients admitted
to intensive care units. Besides having a high cost to the health system, it adds an
additional risk for the patients because it imposes the loss of the skin constitutional
barrier. Photobiomodulation (PBM) with low-level laser has been shown to be effective
in the treatment of PS in different stages. There is no consensus on the protocols of
irradiation parameters, wavelength, energy, dose, intervals between sessions. The
objective of this study was to evaluate the effects of photobiomodulation in the
treatment of pressure sores from a systematic review of literature and meta-analysis.
This is a systematic review carried out according to the PRISMA guidelines, which
included studies without restrictions on year and language of publication, published
until January 2020. Randomized studies that compared the effects of low-level laser
therapy with a control group in patients with pressure ulcers were included. The studies
were analyzed, reported descriptively and combined in a meta-analysis, the
heterogeneity of the studies was assessed and the combined Odds Ratio for total PS
healing in the follow-up period and the combined mean percentage area reduction
were calculated. Six randomized clinical trials were included in the qualitative analysis
and five trials in the quantitative analysis. A total of 207 patients were randomized to
either FBM or control. The studies reported PBM with low-level laser with different
wavelengths within the therapeutic window, in the range of 600 nm (red), 800 nm and
900 nm (infrared). From these data, subgroup analysis was performed and the
combined Odds Ratio for each band was calculated, and no statistically significant
difference was found in the set of studies as a whole and in the subgroups (p> 0.05).
Only two studies described the percentage of reduction of the PS area. Analysis of
these combined data showed Odds Ratio values equal to 1.34 (95% CI 0.8 - 2.24; Z
1.11; p= 0.82) in favor of the PBM but without statistical significance (p> 0.05). Of the
included studies, only PBM with low-level laser therapy using red laser (660 nm)
promoted a significant difference in the reduction of PS (p< 0.05). It can be concluded
that in the studies included, photobiomodulation with red low-level laser was effective
in the healing process of pressure sores in stages 2 and 3. It is suggested to carry out
other randomized clinical trials to analyze the parameters of photobiomodulation.
Descrição
Palavras-chave
Reparação, Laser de baixa intensidade, Lesões Cutâneas, Úlceras por pressão, Metanálise