Terapia por fotobiomodulação no tratamento de lesão por pressão: mapa de evidências

Abstract

The study investigated the use of low-level laser therapy in the treatment of pressure ulcers. Its main objective was to map the evidence in order to systematize information on the clinical effectiveness of low-level laser therapy in the treatment of pressure ulcers. Its specific objectives were to track the evidence of the clinical effectiveness of low-level laser therapy in the tissue repair process in pressure ulcers; to identify the interventions and outcomes produced by the therapy in the treatment of pressure ulcers; to describe the evidence of therapy in pressure ulcers and to build a map of evidence about the clinical effectiveness of low-level laser therapy in the treatment of pressure ulcers. To achieve the objectives, an evidence map was constructed, according to the methodology developed by the International Initiative for Impact Evaluation (3ie adapted by BIREME/PAHO/WHO with the collaboration of CABSIN. A systematic review was developed, including selected systematic reviews according to their ability to answer the proposed question. Relevant systematic reviews were assessed for their methodological quality using the AMSTAR2 tool. The extracted data were organized into a matrix of interventions versus outcomes, and an evidence map was constructed. The process allowed identifying gaps in the available evidence. Although lasers have been used as complementary therapy for wound healing since the 1970s, the lack of robust evidence currently does not support their use for the treatment of pressure ulcers. The scarcity of studies on the topic highlights the need for additional research with significant samples for a more accurate assessment. Some therapeutic application proposals suggest benefits, such as the 658nm wavelength laser, but the results of the reviewed studies did not show significant improvements in the healing process of pressure ulcers. The study pointed out that, since pressure ulcers are influenced by various factors, there is difficulty in standardizing studies and comparative analysis of data. Therefore, although low-level laser therapy may be considered as an adjunct clinical practice in the treatment of pressure ulcers, it is necessary to expand the available evidence for a better understanding and planning of its clinical use. To advance research in this area, the adoption of similar standards is suggested, including the inclusion of assessment scales and staging of pressure ulcers, as well as larger and better methodological quality studies. Limitations of this study include the lack of access to full studies and the absence of information on the technique's effect, reinforcing the need for future research to fill evidence gaps and better inform clinical practice.