title: Water-filtered infrared A for the treatment of chronic venous stasis ulcers of the lower legs at home: a randomized controlled blinded study.
abstract: BACKGROUND
  Water-filtered infrared A (wIRA) radiation can improve the healing of acute and chronic wounds both by thermal and thermic as well as by nonthermal and nonthermic effects. wIRA increases tissue temperature, oxygen partial pressure and perfusion.
  
  
  OBJECTIVE
  Investigation of the influence of wIRA on chronic venous stasis ulcers in an investigator-initiated, randomized, controlled, blinded study.
  
  
  METHODS
  Fifty-one patients with nonhealing chronic venous stasis ulcers of the lower legs were treated with compression therapy, wound cleansing, nonadhesive wound dressings and 30 min irradiation [wIRA + visible light (VIS) or VIS alone], predominantly at home, five times per week over 9 weeks and an additional 4 weeks without irradiation.
  
  
  RESULTS
  Compared with the control group with VIS alone, the group with wIRA + VIS showed better wound healing [after 9 weeks 85 vs. 67·5 on a 0-100 visual analogue scale (VAS), median difference 15, 95% confidence interval (CI) 3-30, P = 0·012], a higher percentage of patients with a healing trend [after 9 weeks 21 of 25 (84%) vs. 13 of 26 (50%), P = 0·023], better granulation (after 9 weeks 90 vs. 80 on a 0-100 VAS, median difference 10, 95% CI 0-30, P = 0·036), a trend to less exudation (after 5 weeks 30 vs. 55 on a 0-100 VAS, P = 0·075) and to faster reduction of the wound area (after 7 weeks 39% vs. 19·5% reduction of wound area, median difference 20·5%, 95% CI -4-49%, P = 0·10; for wounds with an initial area < 10 cm(2): after 13 weeks 92% vs. 47% reduction of wound area, median difference 30%, 95% CI 0-68%, P = 0·11). The main variable 'Integral of relative ulcer area for each individual patient over time, standardized to an initial size of 1' did not reach significance. The application of wIRA at home was easily manageable.
  
  
  CONCLUSIONS
  For the treatment of chronic venous stasis ulcers, the application of wIRA combined with phlebological therapy, compression therapy and wound dressing can be useful and can be recommended.
authors.affiliation: Department of Dermatology, University Medical Center Freiburg, Hauptstrasse 7, D-79104 Freiburg, Germany. Hauke.Schumann@uniklinik-freiburg.de
authors.forename: H
authors.initials: H
authors.lastname: Schumann
authors.forename: T
authors.initials: T
authors.lastname: Calow
authors.forename: S
authors.initials: S
authors.lastname: Weckesser
authors.forename: M L
authors.initials: ML
authors.lastname: Müller
authors.forename: G
authors.initials: G
authors.lastname: Hoffmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001815:Bloodletting / Q000379:methods; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D005374:Filtration; D006699:Home Care Services; D006801:Humans; D007259:Infrared Rays / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000628:therapy*; D014867:Water; D014945:Wound Healing
chemical_list: D014867:Water