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Photodynamic therapy for treating infected skin wounds: A systematic review and meta-analysis from randomized clinical trials

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Autor(es):
de Oliveira, Analu Barros ; Ferrisse, Tulio Morandin ; Fontana, Carla Raquel ; Basso, Fernanda Goncalves ; Brigheti, Fernanda Lourencao
Número total de Autores: 5
Tipo de documento: Artigo Científico
Fonte: Photodiagnosis and Photodynamic Therapy; v. 40, p. 11-pg., 2022-12-01.
Resumo

Background: Infected skin wounds represent a public health problem that effects 20 million people worldwide. Photodynamic therapy (PDT) is a treatment option with excellent results against several infections.Objective: This study aimed to perform a systematic review and meta-analysis on PDT efficacy for treating infected wounds based on randomized clinical trials (RCTs).Methods: PubMed, Scopus, Web of Science, SciELO, and the Cochrane library were searched. The Delphi List criteria and the Revised Cochrane risk-of-bias (Rob 2) were used for evaluating the quality of clinical trials. Metaanalyses were performed with the random-effect model. The odds ratio was the effect measure for binary outcomes, while the standard mean difference was used for continuous outcomes. The trim-and-fill method was used to detect small-study effects. The quality of evidence was verified for each outcome.Results: Only four out of 573 articles were selected for the qualitative and quantitative analyses. The most frequent cause of infected wounds was impaired venous circulation (75%). All studies used red LED light. PDT reduced healing time and improved the healing process and wound oxygenation. Patients treated with PDT showed 15% to 17% (p = 0.0003/ I2=0%) lower microbial cell viability in the wound and a significantly smaller wound size (0.72 cm2/p = 0.0187/I2=0%) than patients treated with placebo or red-light exposure. There was a high level of evidence for each meta-analysis outcome.Conclusion: PDT can be an excellent alternative treatment for infected skin wounds, though larger trials are needed. (AU)

Processo FAPESP: 13/07276-1 - CEPOF - Centro de Pesquisa em Óptica e Fotônica
Beneficiário:Vanderlei Salvador Bagnato
Modalidade de apoio: Auxílio à Pesquisa - Centros de Pesquisa, Inovação e Difusão - CEPIDs
Processo FAPESP: 18/23015-7 - Terapia fotodinâmica antimicrobiana via irradiação em modo contínuo e chaveado contra Enterococcus faecalis e Cutibacterium acnes
Beneficiário:Carla Raquel Fontana
Modalidade de apoio: Auxílio à Pesquisa - Regular
Processo FAPESP: 21/01191-0 - Indução de tolerância e caracterização do biofime de Candida albicans submetido à terapia fotodinâmica antimicrobiana
Beneficiário:Túlio Morandin Ferrisse
Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 20/07110-0 - Potencial da terapia fotodinâmica na modulação da resposta inflamatória e nos fatores de virulência microbianos: avaliação em modelo de co-culturas tridimensionais de fibroblastos gengivais, Candida albicans e Staphylococcus aureus
Beneficiário:Analú Barros de Oliveira
Modalidade de apoio: Bolsas no Brasil - Doutorado
Processo FAPESP: 19/08375-0 - Potencialização do efeito anticárie e antibiofilme de substâncias convencionais: avaliação em modelo de biofilme polimicrobiano
Beneficiário:Fernanda Lourenção Brighenti
Modalidade de apoio: Auxílio à Pesquisa - Regular
Processo FAPESP: 18/18440-0 - Bioprospecção de produtos naturais em terapia fotodinâmica contra micro-organismos de interesse médico-odontológico
Beneficiário:Analú Barros de Oliveira
Modalidade de apoio: Bolsas no Brasil - Mestrado