TY  - JOUR
A1  - Hoffmann, Gerd
T1  - Water-filtered infrared-A (wIRA) in acute and chronic wounds
T2  - GMS Krankenhaushygiene interdisziplinär
N2  - Water-filtered infrared-A (wIRA), as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA increases tissue temperature (+2.7°C at a tissue depth of 2 cm), tissue oxygen partial pressure (+32% at a tissue depth of 2 cm) and tissue perfusion. These three factors are decisive for a sufficient supply of tissue with energy and oxygen and consequently also for wound healing and infection defense.
wIRA can considerably alleviate pain (without any exception during 230 irradiations) with substantially less need for analgesics (52–69% less in the groups with wIRA compared to the control groups). It also diminishes exudation and inflammation and can show positive immunomodulatory effects. The overall evaluation of the effect of irradiation as well as the wound healing and the cosmetic result (assessed on visual analogue scales) were markedly better in the group with wIRA compared to the control group. wIRA can advance wound healing (median reduction of wound size of 90% in severely burned children already after 9 days in the group with wIRA compared to 13 days in the control group; on average 18 versus 42 days until complete wound closure in chronic venous stasis ulcers) or improve an impaired wound healing (reaching wound closure and normalization of the thermographic image in otherwise recalcitrant chronic venous stasis ulcers) both in acute and in chronic wounds including infected wounds. After major abdominal surgery there was a trend in favor of the wIRA group to a lower rate of total wound infections (7% versus 15%) including late infections following discharge from hospital (0% versus 8%) and a trend towards a shorter postoperative hospital stay (9 versus 11 days).
Even the normal wound healing process can be improved.
The mentioned effects have been proven in six prospective studies, with most of the effects having an evidence level of Ia/Ib.
wIRA represents a valuable therapy option and can generally be recommended for use in the treatment of acute as well as of chronic wounds.
KW  - water-filtered infrared-A (wIRA)
KW  - infrared-A radiation
KW  - wound healing
KW  - thermal and non-thermal effects
KW  - thermic and non-thermic effects
KW  - energy supply
KW  - oxygen supply
KW  - tissue oxygen partial pressure
KW  - tissue temperature
KW  - tissue blood flow
KW  - reduction of pain
KW  - wound exudation
KW  - inflammation
KW  - immunomodulatory effects
KW  - acute wounds
KW  - chronic wounds
KW  - chronic venous stasis ulcers of the lower legs
KW  - problem wounds
KW  - wound infections
KW  - infection defense
KW  - contact-free method
KW  - absent expenditure of material
KW  - prospective, randomized, controlled, double-blind studies
KW  - visual analogue scales (VAS)
KW  - quality of life
KW  - infrared thermography
KW  - thermographic image analysis
Y1  - 2012
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/22796
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-227960
SN  - 1863-5245
N1  - © 2009 Hoffmann. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.
VL  - 4
IS  - 2, Doc12
SP  - 1
EP  - 15
PB  - gms
CY  - Düsseldorf
ER  -