Case Report

By Dr. Murtaza A Calcuttawala , Mr. Adnan Hashim , Dr. Mohit Bhatia
Corresponding Author Dr. Murtaza A Calcuttawala
Ganeral Surgery,Pad Dr D Y Patil Med College and Research Hosp., Building C4,Flat No 902,Bramha Avenue,Near Jyoti Restaurant,Kondwa khurd,Pune 411048 - India 411048
Submitting Author Dr. Murtaza A Calcuttawala
Other Authors Mr. Adnan Hashim
Alhaya Medical Company, Riyadh., Alhaya Medical Company,Riyadh,Saudia Arabia. - Saudi Arabia

Dr. Mohit Bhatia
Pad Dr D Y Patil Med College and Hospital,Pimpri,Pune., Pad Dr D Y Patil Med College and Hospital,Sant Tukaram Ngr,Pimpri,Pune. - India 411018


Diabetic ulcer, Venous ulcer, Laser

Calcuttawala MA, Hashim A, Bhatia M. Wound Healing Made Unlimited. WebmedCentral WOUND HEALING 2013;4(1):WMC003973
doi: 10.9754/journal.wmc.2013.003973

This is an open-access article distributed under the terms of the Creative Commons Attribution License(CC-BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Submitted on: 27 Jan 2013 09:56:25 AM GMT
Published on: 28 Jan 2013 11:03:09 AM GMT


Background: Ten patients of lower limb ulcer  admitted between  October 2011 and April 2012 were treated and studied

Material and Methods: All patients were diagnosed on the basis of clinical and radiological findings and after that laser therapy was performed. This was followed by accelerated healing of wound and in some cases by covering the wound by split thickness skin graft.

Results: All patients were male, maximum incidence was noted in the age group of 34 to 84 years.

Conclusion: The laser therapy resulted in enhanced healing as measured by wound contraction.


The concept of a non-invasive, non-thermal intervention that has the power to modulate regenerative processes of the human cells is the answer to therapist prayers in health care.

Venous ulcers, diabetic ulcers, and post-amputation wounds, are difficult to manage and often do not heal, even with aggressive medical management and patient compliance.  The lack of consistent and favourable outcomes, is a costly and painful problem for the patient and health care industry.

After more than 40 years of use, still no serious side effects of using laser radiation as a medical treatment modality have been observed.  Low energies of laser light affect the nature and basic mechanisms of our cells and restore their impaired function.  Some of these lead to accelerate wound healing, reduction of edema, healing of neurological injuries, increased microcirculation and pain relief.  Laser Therapy is a new approach applicable in different medical fields, inducing soft tissue healing, pain relief, bone and nerve regeneration.

The development of pharmaceuticals has dramatically contributed to improve global health. However, pharmaceuticals are also creating severe side effects for patient and the environment.

Laser therapy is a more effective method, stimulating cell activity to accelerate healing process than using different methods to facilitate the way for the healing process.

Case Report(s)

Material and Methods: All patients of lower limb ulcer and one patient of bed ulcer admitted under care of surgical units in various hospital in Riyadh (KSA) between October 2011 and April 2012, were treated and studied. All patients were initially managed with conventional wound care treatment. Diagnosis was made on the basis of clinical presentation of patient and radiological findings.

Distribution of lower limb ulcer in different age groups , gender,duration of ulcer and coexistant disease  were documented.
Prerequisites for laser therapy

1. Treatment area should be clean and ready
2. Exact laser dose and time should be set
3. Laser should be applied directly & vertically to skin, open area 5 mm away
4. Treatment should be given day after day with patient compliance until healing is achieved

Patient 1: Age 70 years old, patient diabetic and ischemic, amputations since 2 months and treatment method laser only, duration 6.30 minutes day after day.

Patient 2: Age 57, patient diabetic and ischemic, ulcers since 100 days, treatment method laser only, duration 6.30 minutes day after day.

Patient 3:  Age 70, patient diabetic since 1 month, treatment method laser only, duration 7 minutes day after day.

Patient 4:  Age 72, patient ischemic and diabetic type 2, amputation since 8 months, treatment method laser only, duration 7 minutes day after day.

Patient 5: Age 62, patient ischemic and diabetic type 2, amputation since 2 weeks, treatment method laser only, duration 10 minutes day after day.

Patient 6: Age 84, patient ischemic and diabetic, bed ulcers since 4 months, treatment method laser only, duration 7 minutes day after day.

Patient 7: Age 65, patient ischemic and diabetic, ulcer since 4 months, treatment method laser only, duration 7 minutes day after day.

Patient 8: Age 34, healthy, acid ulcers since 4 years, treatment method laser only, duration 20 minutes day after day.

Patient 9: Age 45, diabetic and hypertension, wound since 40 days, treatment method laser only, duration  5 minutes day after day.

Patient 10: Age 62, diabetic, Charcot foot since 6 months, treatment method laser plus oral antibiotic, duration 7 minutes day after day.

How to use the machine:  Switch ON from green button on the back.  Choose the treating tip

MS2, 7.5 mm for average wounds.

MS3, 13 mm for larger wounds.

Clean the wound with antiseptic solution.  Select from the screen Treatment to choose manually the frequencies and time.  You can save the values by pressing save, choose patient name or MRN, write down, then press Enter. You can call your data later by pressing  Call Data then Names. To change frequencies and time, press Call data, names, select the patient’s name, change then save.  To delete data, press Delete data,  names, then select  the patient’s name, then delete. You can use the programmed frequencies for specific indication from the screen by pressing Indications.  Select one then adjust time according to the surface areas as in Time Equation.  Clean the tip with alcohol swab, dry and cover it with Tegaderm.  Upon finishing the session, turn machine off, discard Tegaderm and clean the tip with alcohol swab. Reclean the wound and dress it with simple gauze. Repeat the session every other day for at least 13 sessions to achieve the desirable aim.  By the course of time, you change the frequencies and time according to the improvement in wound size and depth. Apply 75% of the time on 0.5 cm – 1cm margin of the wound in a back-forth manner keeping a distance to the skin between 5-10 mm, the remaining 25% of time on the wound bed itself in the same manner keeping a distance between 5-10 mm.

Treatment protocol: Low level laser therapy (LLLT) is the application of the light to pathology to promote tissue regeneration, reduce Inflammation and relieve pain.


Stage III and IV bedsores

Diabetic foot

Non healing wounds

Wounds with peripheral arterial disease


Patients with pace makers (at location of pace maker)

Patients with cancer

Pregnant women (at belly)


Epileptic patients

Undiagnosed skin lesions

No Radiation On

Open eyes


Child epiphysis

Open fontanel

Result: In our study all patients were male, and age group varied from 34 to 84 years. Six patients were found to be having diabetic and ischemic foot while 3 patients were diabetic only. One patient was a healthy adult male with acid ulcer over foot .Four patients were having amputation done previously. One patient was with a bed ulcer while other one was with charcot’s  joint. The duration of ulcer ranged from 2 weeks to 4 years in our study. The observation were

a) skin gain back it’s healthy color,
b) the Pain decreased to over 80%,
c) blood flow enhanced,
d) healing process triggered.


The exploitation of phototherapy in medicine and surgery is of great interest, and there is a growing interest in the use of lasers for the treatment of various conditions and disorders, including the treatment of diabetic wounds . Using lasers as a source of photobiostimulation looks to be an attractive branch of medicine for the future.  Due to disturbances of the circulation in people with diabetes, wounds heal slowly and are susceptible to infection. Laser therapy  has been shown to speed up the time needed for wound closure in people with diabetes and there is improved wound epithelialisation, increased cellular content, increased granulation tissue formation and increased collagen deposition. There is a decrease in the inflammatory reaction , and a stimulatory effect on the immune system . Laser therapy  has also been shown to increase microcirculation , enhance wound tensile strength, accelerate collagen production , and decrease free radical oxidation processes in people with diabetes. 


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Source(s) of Funding

No source of funding

Competing Interests

No competing interests


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1 review posted so far

Wound Healing Made Unlimited
Posted by Dr. Prasan K Hota on 30 Jan 2013 06:41:02 AM GMT

Sir, Thank you very much for your valuable review.In my study the number is ten as we wanted to know the effects first on these patents then try on other patents.I compared the effect of laser th... View more
Responded by Dr. Murtaza A Calcuttawala on 26 Apr 2013 09:59:37 AM GMT

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WebmedCentral Article: Wound Healing Made Unlimited

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