The Healing Effect of Photobiomodulation on Venous Leg Ulcers: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 41889013 · doi:10.1111/wrr.70144
What was done
Systematic review and random-effects meta-analysis of randomized controlled trials (searched in PubMed, Embase, Web of Science, and Cochrane Library from 1990 to 2024) evaluating photobiomodulation for healing venous leg ulcers in adults. Risk of bias was evaluated using the Cochrane RoB 2 tool, and the primary pooled outcome was absolute change in ulcer area.
What was found
Eleven trials were included (615 total patients, of whom 340 had venous leg ulcers; 169 intervention and 167 control participants completed follow-up). All 11 trials had some concerns or high risk of bias. In the meta-analysis of 4 trials, photobiomodulation did not significantly reduce ulcer area compared to controls (mean difference: 3.77 cm², 95% CI: -4.45 to 11.99, p = 0.37), with substantial heterogeneity (I² = 96%, τ² = 65.37).
Why it matters
Despite interest in photobiomodulation as an adjuvant wound therapy, current randomized evidence fails to show a measurable benefit on venous leg ulcer healing.
Limits
Only 4 of the 11 identified trials contributed data to the quantitative meta-analysis. All included studies had methodological limitations resulting in some or high risk of bias, the total sample size was small, statistical heterogeneity was extreme, and treatment protocols lacked standardization.
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