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PHOTODERMATOLOGY (B ADLER AND V DELEO, SECTION EDITORS)

Light-Based Devices for Wound Healing Christiane Fuchs 1,2 & Laisa B. Negri 1,2 & Linh Pham 1 & Joshua Tam 1,2

# Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Purpose of Review The goal of this review is to provide a broad overview of light-based treatments that have shown effectiveness in enhancing various aspects of wound healing, examine the drawbacks that have impeded the translation of some light-based therapies into clinical use, and highlight scenarios where these treatments may confer benefits over current standards in wound care. Recent Findings Several categories of light-based treatments, in particular laser debridement, fractional photothermolysis, and photodynamic therapy, have seen exciting recent clinical results that may justify expanding the use of these modalities in clinical wound care. Antimicrobial blue light is the subject of several ongoing clinical wound trials, the results of which could demonstrate the viability of this technology as a clinical treatment. Photobiomodulation, while conceptually promising, requires more rigorous development and validation before it can become a reliable wound therapy. Summary The technologies underlying light-based therapies are advancing rapidly, and in many cases, their utility in the wound care setting is still being actively explored. We anticipate that as these technologies mature and become optimized for wound applications, their utility in clinical wound care will continue to grow. Keywords Laser debridement . Fractional laser . Photobiomodulation . Antimicrobial blue light . Photodynamic therapy . Vascular laser

Introduction As the outermost tissue in the body, the skin is uniquely accessible to light-based therapies, which are characterized by a number of features distinguishing them from most other therapeutic modalities, including: high spatial precision (possibility of treatment zones at subcellular levels), temporal confinement of treatment effects (largely immune from the complicated kinetics of reagent uptake, metabolism, and disposition), generally low risk of undesirable interactions or interference with other treatment modalities, avoidance of systemic side effects, and, in some cases, very precise targeting of specific structures/cell types (e.g., hair, small blood vessels, and

This article is part of the Topical Collection on Photodermatology * Joshua Tam [email protected] 1

Wellman Center for Photomedicine, Thier 2, Massachusetts General Hospital, 50 Blossom Street, Boston, MA 02114, USA

2

Department of Dermatology, Harvard Medical School, Boston, MA, USA

tattoos) by exploiting their differential light-absorbing properties. All light-based treatments are governed by the first law of photochemistry—light must be absorbed by some substance within the tissue in order to have any effect. Different ways to exploit/manipulate the absorption characteristics of different targets have given rise to a wide variety of light-based treatments, which can