EVALUATION OF LOW-LEVEL LASER THERAPY IN THE POSTOPERATIVE PERIOD OF OPEN PROCTOLOGICAL WOUNDS

Introduction The postoperative (PO) period of any proctological surgery is challenging. Healing by secondary intention of open wounds (OW) is a common reality in anorectal-sacral conditions. Consequently, pain and healing time are the primary difficulties in the PO period. Intraoperative techniques (mechanical anopexy, hemorrhoidopexy, CO2 and diode lasers), as well as PO interventions such as low-level infrared laser therapy and botulinum toxin, have emerged to minimize pain and accelerate healing. However, the efficacy of many of these techniques in proctology has yet to be proven. Low-level infrared laser therapy has analgesic, anti-inflammatory, wound-healing, and circulatory benefits.

Objective To compare the evolution of patients undergoing proctological surgeries resulting in OW who received conventional PO care versus those treated with infrared laser therapy. Additionally, to evaluate the overall healing time of hemorrhoidectomy procedures.

Methods This was a prospective, randomized, single-blind study conducted from 09/23 to 05/24. Patients with proctological conditions that resulted in OW following surgery were included. On the 7th PO day, patients were randomized into two groups: the conventional group received standard follow-up care, while the laser group received infrared laser therapy (9J) applied to OW. Patients were evaluated on the 7th, 14th, and 21st PO days using subjective parameters (pain, burning, edema, itching, and discharge) via a visual analog scale, as well as objective assessments through physical examinations (edema, discharge, and wound appearance). Subjective variables were analyzed using the general linear model (GLM), followed by Bonferroni post-hoc tests. Objective parameters were analyzed with a generalized linear model and chi-square tests (p < 0.05).

Results A total of 33 patients were included: 18 in the conventional group and 15 in the laser group. Gender, age, and diagnosis proportions did not differ between groups. GLM analysis showed improvement over time in all subjective parameters, except for itching, which worsened. No significant differences were found between groups in subjective parameters (pain p = 0.58; burning p = 0.43; edema p = 0.53; itching p = 0.80; discharge p = 0.71) or objective parameters (edema p = 0.08; discharge p = 0.52; wound appearance p = 0.34). In hemorrhoidectomy cases (10 conventional and 11 laser), complete healing occurred faster in the laser group but without statistical significance (conventional: 52.4 days vs. laser: 45.2 days, t = 0.019; p = 0.89).

Conclusion The use of infrared laser therapy did not demonstrate an impact on symptom improvement in the early PO period of patients with proctological OW, nor did it significantly affect early healing parameters.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025