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Diabetes mellitus DM is a significant international health concern affecting more than 387 million individuals A diabetic person has a 25 lifetime risk of developing a diabetic foot ulcer DFU leading to limb amputation in up to one in six DFU patients Low-level light therapy LLLT uses low-power lasers or light-emitting diodes to alter cellular function and molecular pathways and may be a promising treatment for DFU The goal of this systematic review is to examine whether the clinical use of LLLT is effective in the healing of DFU at 12 and 20 weeks in comparison with the standard of care and to provide evidence-based recommendation and future clinical guidelines for the treatment of DFU using LLLT On September 30 2015 we searched PubMed EMBASE CINAHL and Web of Science databases using the following terms diabetic foot AND low level light therapy OR light emitting diode OR phototherapy OR laser The relevant articles that met the following criteria were selected for inclusion randomized control trials RCTs that investigated the use of LLLT for treatment of DFU Four RCTs involving 131 participants were suitable for inclusion based upon our criteria The clinical trials used sham irriadiation low dose or nontherapeutic LLLT as placebo or control in comparison to LLLT The endpoints included ulcer size and time to complete healing with follow-up ranging from 2 to 16 weeks Each article was assigned a level of evidence LOE and graded according to the Oxford Center for Evidence-based Medicine Levels of Evidence Grades of Recommendation criteria Limitations of reviewed RCTs include a small sample size N 100 unclear allocation concealment lack of screening phase to exclude rapid healers unclear inclusion exclusion criteria short 30 days follow-up period and unclear treatment settings wavelength and treatment time However all reviewed RCTs demonstrated therapeutic outcomes with no adverse events using LLLT for treatment of DFU This systematic review reports that LLLT has significant potential to become a portable minimally invasive easy-to-use and cost effective modality for treatment of DFU To enthusiastically recommend LLLT for treatment of DFU additional studies with comparable laser parameters screening period to exclude rapid healers larger sample sizes and longer follow-up periods are required We envision future stringent RCTs may validate LLLT for treatment of DFU Systematic review registration number PROSPERO CRD42015029825

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A systematic review of low-level light therapy for treatment of diabetic foot ulcer.