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A clinical study of photodynamic therapy for chronic skin ulcers in lower limbs infected with Pseudomonas aeruginosa.

Abstract
The objective of this study is to evaluate the antimicrobial activity and healing-promoting effect of topical photodynamic therapy (ALA-PDT) on chronic skin ulcers infected with Pseudomonas aeruginosa (PA). A total of 26 patients with chronic skin ulcers in lower limbs infected with PA were enrolled. The surface areas of the ulcers were treated with either δ-aminolevulinic acid (ALA)-mediated PDT (20% ALA solution, 1.5 h incubation, 630 nm red light, 80 J/cm(2)) or red light alone, both once a week for two weeks. Before treatment, the wound areas and the bacteria levels in these two groups were comparable (p > 0.05). Results indicated that the bacteria levels in the skin ulcers of the light only group of 24 h post-treatment (3.4 × 10(7) ± 7.1 × 10(7) CFU/cm(2)) and pre-treatment (5.5 × 10(7) ± 1.6 × 10(8) CFU/cm(2)) were not significantly different. In contrast, the bacteria levels on the surfaces of the ulcers in the PDT group of 24 h post-treatment (6.3 × 10(5) ± 1.7 × 10(6) CFU/cm(2)) and pre-treatment (8.9 × 10(7) ± 1.7 × 10(8) CFU/cm(2)) were significantly different (p < 0.01). At seven days post treatment, the mean ulcer area in the red light group was reduced from 11.85 ± 6.83 to 7.8 ± 4.9 cm(2) (p < 0.01), that of PDT group from 12.72 ± 8.58 to 3.4 ± 3.4 cm(2) (p < 0.01). Better healing was seen in PDT group (p < 0.01). In conclusion, ALA-PDT is a potential modality to control PA infection and promote healing of chronic skin ulcers in lower limbs.
AuthorsXia Lei, Bo Liu, Zheng Huang, Jinjin Wu
JournalArchives of dermatological research (Arch Dermatol Res) Vol. 307 Issue 1 Pg. 49-55 (Jan 2015) ISSN: 1432-069X [Electronic] Germany
PMID25410983 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Photosensitizing Agents
  • Aminolevulinic Acid
Topics
  • Adult
  • Aged
  • Aminolevulinic Acid (therapeutic use)
  • Bacterial Load
  • China
  • Chronic Disease
  • Colony Count, Microbial
  • Female
  • Humans
  • Leg Ulcer (diagnosis, drug therapy, microbiology)
  • Male
  • Middle Aged
  • Photochemotherapy
  • Photosensitizing Agents (therapeutic use)
  • Pseudomonas Infections (diagnosis, drug therapy, microbiology)
  • Pseudomonas aeruginosa (isolation & purification)
  • Skin Diseases, Bacterial (diagnosis, drug therapy, microbiology)
  • Time Factors
  • Treatment Outcome
  • Wound Healing
  • Wound Infection (diagnosis, drug therapy, microbiology)

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