The effect of helium-neon laser combined with ultrasonic debridement on improving the wound microenvironment in pa-tients with chronic non-healing wounds

ZHOU Wei; ZHANG Ji; YANG Wanjun

doi:10.3969/j.issn.1673-7040.2026.02.011

Abstract：Objective To investigate the effects of combined helium-neon laser and ultrasonic debridement on the wound mi-croenvironment in patients with chronic non-healing wounds(CRW).Methods This study selected 140 patients with CRW who visited our hospital between May 2023 and May 2025.Patients were divided into a vacuum sealing drainag(VSD)group,an Ultrasonic Debride-ment+VSD group,and a Combined group based on their treatment methods.A 1∶1∶1 matching was performed using Propensity Score Matching(PSM).The general data and clinical efficacy of CRW patients in the three groups were compared.Differences in pain scores and wound microenvironment indicators before and after treatment in CRW patients were analyzed.Repeated measures ANOVA was used to examine the changes in wound tissue growth factors among the three groups of CRW patients.Generalized Estimating Equations(GEE)were employed to analyze the impact of different treatment methods on wound microenvironment indicators.Results After PSM,each group consisted of 30 patients,and the baseline sociodemographic characteristics of the three groups reached balance.The wound healing time and dressing change frequency in the combined group were lower than those in the VSD group and the ultrasound debridement+VSD group,while the completely healed wound area was bigger than that in the VSD group and the ultrasound debridement+VSD group.Two weeks after treatment,the visual analogue scale(VAS),vancouver scar scale(VSS),and total score in the combined group were lower than those in the VSD group and the ultrasound debridement+VSD group.The wound temperature in the combined group was higher than that in the VSD group and the ultrasound debridement+VSD group.Additionally,the levels of exudate pH,Staphylococcus aureus,Pseudomonas aeruginosa,Staphylococcus epidermidis,and Escherichia coli were lower in the combined group compared to the VSD group and the ultra-sound debridement+VSD group,while the tissue growth factor levels were higher,with all these differences being statistically significant(P<0.001).Results of repeated measures analysis of variance showed that the time effect,between-group effect,and interaction effect of platelet-derived growth factor(PDGF),vascular endothelial growth factor(VEGF),fibroblast growth factor(FGF),transforming growth factor(TGF),and insulin-like growth factor(IGF)among the three groups were all statistically significant(P<0.05).Generalized estimating equa-tions(GEE)analysis revealed that two weeks after treatment,wound temperature increased[β=1.687,95%CI(0.861～2.514)],while exudate pH,Staphylococcus aureus,Pseudomonas aeruginosa,Staphylococcus epidermidis,and Escherichia coli levels decreased[β=-0.957,95%CI(-1.193～-0.727);β=-9.568,95%CI(-10.143～-9.012);β=-9.540,95%CI(-10.667～-8.397);β=-4.711,95%CI(-5.126～-4.294);β=-2.623,95%CI(-2.814～-2.426)].Furthermore,in the combined group,wound temperature,exudate pH,Staphylococcus aureus,Pseu-domonas aeruginosa,Staphylococcus epidermidis,and Escherichia coli levels exhibited interactive effects two weeks after treatment,with all differences being statistically significant(P<0.001).Conclusion The combined use of VSD,helium-neon laser therapy with an ultra-sonic debridement device yields superior efficacy in treating chronic refractory wounds,resulting in shorter wound healing times and re-duced pain.This approach effectively improves the wound microenvironment,thereby promoting the healing of CRW.