Blue Light as therapy for peristomal skin disorders

SUMMARY

Peristomal skin disorders are common postoperative complications in people who undergo surgical procedures resulting in enterostomal formation. Complications range from mild irritation to full thickness ulcerations, and they represent a significant problem both for stoma patients’ quality of life and for the health care system, as peristomal skin lesions are the main reason for which stoma patients visit outpatient clinics.

One of the main limitations in the treatment of peristomal skin disorders is the lack of appropriate topical therapies since the topical medications available are cream- based or ointment type formulations that don’t allow for perfect adhesion of the pouching system to the abdomen’s skin.

The Authors aimed to evaluate the effectiveness of Blue Light Photobiomodulation as non-invasive, contactless therapy, on patients under treatment for peristomal skin disorders at San Giuseppe Hospital, Empoli, Italy.

11 patients carrying ostomy with skin complications of types L2, L3, L4, LX (SACS 2.0 classification7) that had not experienced an improvement in 4 weeks of standard therapy were included. Treatment was performed in addition to standard therapy, twice a week, for 120 seconds in cases of inflammatory lesions (such as pyoderma gangrenous) or for 60 seconds in all other cases; Blue Light therapy duration was 4 weeks. Tissue repair was evaluated through two parameters: Wound Bed Score (WBS) and pain. Pain was measured through the Visual Analogue Scale (VAS). Data and photographic images were collected at the enrollment visit and during the check-up visit, 3 days after the last Blue Light treatment.

All patients responded to Blue Light treatment with an average WBS improvement of 8.3 points and a significant reduction in pain. At the check-up visit the average WBS had increased to 14.2 (range 10-16), where the maximum possible score (best score) is 16, and the average VAS value had dropped to 1.9 (range 0-3).

Three patients had developed pyoderma gangrenosum, a very painful ulcerations requiring a specific topical approach; according to the Authors, in all three cases, Blue Light Photobiomodulation proved decisive in activating the healing process.