Abstract
<jats:p>Background. Diabetes mellitus is a major global health problem, and diabetic foot ulcers (DFU) represent one of its most serious chronic complications. DFUs are associated with impaired tissue repair, ischemia, neuropathy, and a high risk of infection, often leading to prolonged non-healing wounds and lower limb amputations. Effective management requires comprehensive therapy, including wound debridement; however, conventional methods may lack selectivity and cause additional tissue trauma. In recent years, laser technologies have been introduced into wound care. While CO2 and erbium-doped yttrium aluminum garnet lasers are well studied, diode lasers remain insufficiently investigated in ischemic DFU. The aim of this study was to assess the efficacy and safety of diode laser-assisted vaporization as an adjunctive local debridement method in the treatment of ischemic diabetic foot ulcers and to evaluate its effects on tissue perfusion and wound healing. Materials and methods. The study involved 120 patients with ischemic DFUs. The main group (n = 80) received standard therapy combined with laser vaporization using a 1470 nm diode laser, while the control group (n = 40) received standard treatment alone. All patients underwent Doppler ultrasound, ankle-brachial index assessment, and transcutaneous oxygen tension (TcpO2) measurement at baseline and after a 21-day treatment course. Laser parameters were individualized according to wound depth, location, and ischemia severity. Statistical analysis was performed using standard software, with significance set at p < 0.05. Results. Before treatment, patients in both groups exhibited ulcerative defects associated with moderate to severe ischemia. After therapy, accelerated reparative processes, active granulation tissue formation, and epithelialization were observed in 80 % of patients in the main group. The mean TcpO2 level increased from 30.8 ± 3.0 mmHg to 37.2 ± 3.0 mmHg in the main group, whereas in the control group, only from 31.2 ± 2.0 mmHg to 32.7 ± 1.0 mmHg. The mean increase in ΔTcpO2 was 6.4 versus 1.5 mmHg, respectively (p < 0.001). Improved tissue oxygenation was accompanied by restoration of microcirculation, shortened wound healing time, and reduced duration of hospitalization. Conclusions. Diode laser-assisted vaporization is an effective and safe adjunctive method of local debridement in ischemic DFUs. Its use in combination with standard therapy significantly improves tissue perfusion, accelerates wound healing, and enhances clinical outcomes. Further multicenter randomized studies are needed to confirm these results and optimize treatment protocols.</jats:p>