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In dogs does low level laser therapy reduce healing time?
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PICO question
In dogs with a surgical or open wound does low level laser therapy increase the speed of wound contracture and reduce the healing time?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Five papers were critically reviewed. Four were randomised controlled trials and one was a case report
Strength of evidence
Moderate
Outcomes reported
Three out of the five studies currently available assessing low level laser therapy to improve wound healing, suggest that low level laser therapy has no beneficial effect on the healing of open or incisional wounds. Of the papers that used statistical analysis, no statistical significance was found in wound surface area over time or tissue histological findings between wounds treated with laser therapy and those who were not. Two papers identified did find decreased wound healing times however the strength of evidence is far poorer for both, with only subjective assessment of the wound in the controlled trial and the other being a case report without control
Conclusion
Currently there is no strong evidence that low level laser therapy increases the speed of wound contracture and reduced healing time. More studies are recommended to provide stronger evidence towards the use of low level laser therapy in wound healing, preferably with a larger population of dogs and with laser settings which are consistent with previous studies for comparison
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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Appraisal, application and reflection
Only two out of the five papers conclude a positive effect of laser treatment on wounds whereas the remaining report no significant difference. Wardlaw et al. (2019) reports improved scar appearance for laser treatment, but was poorly designed with only three dogs treated and wounds assessed subjectively only and lack of standardisation of wound or treatment protocol. The case report by Lucroy et al. (1999) added very little to the weight of evidence and was especially hard to compare to the others as it looked at a chronic wound as opposed to acute wounds. The papers which contributed the most to strengthening the evidence available were by De Braekt et al. (1991), Kurach et al. (2015), and Gammel et al. (2018). All three papers had a good randomised control study design with objective as well as subjective assessment of standardised wounds. While the strongest studies assessed here did reach statistical significance, each study had a small number of dogs and different laser therapy protocols used in each analysis, making it difficult to compare them directly. More control studies preferably with a larger population of dogs and using laser settings from previous studies would be advisable to provide a stronger level of evidence for the effectiveness of low level laser therapy.
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