Background: A pressure ulcer is defined as ＂an area of localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear＂. The term ＂pressure injury＂ replaces ＂pressure ulcer＂ in the National Pressure Injury Advisory Panel Pressure Injury Staging System according to NPUAP since 2016. The use of phototherapy that is, light (or laser) used as an adjuvant, nonsurgical intervention, with the aim of having a therapeutic effect on healing has increased recently. The objective of the study is to determine the effects of phototherapy on the healing of pressure injuries. Materials and Methods: The Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, EMBASE were searched up to 31 December 2016 with no restrictions on language or publication date. Randomized controlled trials (RCTs) comparing the effects of phototherapy (in addition to standard treatment) with sham phototherapy (in addition to standard treatment), another type of phototherapy (in addition to standard treatment) or standard or conventional treatment alone. Two review authors assessed studies for relevance according to pre-specified selection criteria, extracted data and evaluated study methodological quality. Attempts to obtain missing data were made by contacting study authors. Disagreement was resolved by consensus and discussion with a third review author. Results: A total of eight RCTs involving 477 participants were included. All the trials were assessed to be at unclear risk of bias. Trials compared the use of phototherapy with standard care only (seven trials) or sham phototherapy (one trial). Overall, there was insufficient evidence to determine the relative effects of phototherapy for healing pressure injuries. Time to complete healing was reported in three studies. Two studies showed the ultraviolet (UV) treated group had a shorter mean time to complete healing than the control group (mean difference -2.13 weeks (95% CI -3.53 to -0.72, P value 0.003)). One study reported that the laser group had a longer mean time to complete healing than the control group (mean difference 5.77 weeks; 95% CI -0.25 to 11.79). Adverse effects were reported in only two studies that compared phototherapy with control. Pooling was not undertaken because of differences in outcome measures reported. Conclusions: The effects of phototherapy in treating pressure injuries remain uncertain. The quality of evidence is low due to the unclear risk of bias and small number of trials available for analysis. The possibility of benefit or harm of this treatment cannot be ruled out. Further research is recommended.
背景：壓瘡是因為皮膚受到壓力或摩擦所造成的皮膚受傷，通常發生於臀部或尾骨。光療是利用特定波長的光，治療身體上可照射部位的疾病。在這篇統合分析中，希望研究標準褥瘡治療（減壓，清創，感染控制，敷料使用）加上光療，是否會更改善傷口的癒合。方法：本研究搜尋2016年12月31日之前的各資料庫，包含考科藍對照研究登錄中心(CENTRAL)，OVID MEDLINE，EMBASE。搜尋時沒有語言的限制。所選擇的研究包含了比較光療與假光療、另一類光療或是常規治療療效的隨機對照研究。兩位作者根據預先規定的篩選標準，萃取資料並且評估相關的研究，包含研究方法之品質。兩位作者意見若有分歧，將討論以取得共識，或是由第三個評論作者解決分歧。結果：共納入8個隨機對照研究，包含了477名參與者。所有的試驗的偏差風險，都被評為不確定等級。試驗比較了光療與標準照護（七個研究）或假光療（一個研究）的使用。總體來說，沒有足夠的證據來確定光療治療褥瘡的效用。三項研究報導了“完全癒合所需時間”。兩項研究顯示，紫外光治療組平均完成癒合時間比對照組短（平均差-2.13週(95% CI -3.53 to -0.72, P value 0.003)）。一項研究報導，雷射組的平均完成癒合時間比對照組長（平均差5.77週；95% CI -0.25 to 11.79）。結論：光療對於褥瘡的療效仍然不確定。原因包含了偏差風險不明確，可用於分析的研究數量少，證據品質不夠好。建議需要更進一步研究。