Effect of Pulsed Nd:YAG Laser in the Treatment of Neuropathic Foot Ulcers in Children with Spina Bifida: a Randomized Controlled Study

Objective: This study assessed the effects of pulsed Nd:YAG laser treatment of neuropathic foot ulcers in children with spina bifida.

Background Data: Children with spina bifida face increased risk for developing neuropathic foot ulcers.

Methods: In a randomized controlled trial, 39 children and adolescents (ages 6-15 years) with spina bifida and stage III neuropathic foot ulcers were randomly assigned to the laser group or the placebo laser group. The former received pulsed Nd:YAG laser treatments (i.e., total energy of 300-350 J during three sessions/week) plus standard wound care, and the latter received sham laser treatments plus standard wound care. Wound size and wound appearance were assessed for all patients at the beginning of the treatment, after 5 weeks, and after 10 weeks.

Results: The decrease in wound surface area at 5 and 10 weeks post- treatment was significantly greater in the laser group (i.e., 2.44 ± 0.33 and 0.29 ± 0.25 cm(2), respectively) than in the placebo group (i.e., 3.81 ± 0.18 and 3.24 ± 0.44 cm(2), respectively). Also, the decrease in the total score for the Pressure Sore Status Tool (PSST) at 5 and 10 weeks post-treatment was significantly different for the laser group (i.e., 32.76 ± 2.30 and 17.52 ± 1.66, respectively) than for the placebo group (i.e., 46.50 ± 2.12 and 38.11 ± 3.17, respectively).

Conclusions: Treatment with pulsed neodymium:yttrium aluminum garnet (Nd:YAG) laser combined with standard wound care decreases wound size and improves wound appearance for stage III neuropathic foot ulcers in children with spina bifida.