{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:21:45Z","timestamp":1781914905786,"version":"3.54.5"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,10,22]],"date-time":"2019-10-22T00:00:00Z","timestamp":1571702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Chronic wounds affect roughly 6.5 million patients in the US annually. Current standard of therapy entails weekly sharp debridement. However, the sharp technique is associated with significant pain, while having minimal impact on the bioburden. Our study proposes the Er:YAG laser as an alternative method of debridement that may decrease procedural pain, reduce bioburden, and potentially improve overall healing. This pilot study was performed as a prospective, randomized, controlled, crossover clinical trial, containing two groups: (1) one group underwent single laser debridement session first, followed by single sharp debridement session one week later; and (2) the other group underwent single sharp debridement session first, followed by single laser debridement session one week later. Variables analyzed included pain during debridement, pre\u2010 and post\u2010debridement wound sizes, pre\u2010 and post\u2010debridement bacterial loads and patient preference. Twenty\u2010two patients were enrolled (12 patients in Group 1, plus 10 patients in Group 2). The mean pain score for patients undergoing laser debridement was 3.0\u2009\u00b1\u20091.7 vs. 4.8\u2009\u00b1\u20092.6 for those undergoing sharp debridement (<jats:italic>p<\/jats:italic> = 0.003). The mean percent change in wound size 1\u2010week post\u2010laser debridement was \u221220.8%\u2009\u00b1\u200980.1%, as compared with \u221236.7%\u2009\u00b1\u200954.3% 1\u2010week post\u2010sharp debridement (<jats:italic>p<\/jats:italic> = 0.6). The percentage of patients who had a bacterial load in the low\/negative category increased from 27.3% to 59.1% immediately after laser debridement (<jats:italic>p<\/jats:italic> = 0.04), vs. 54.5% to 68.2% immediately after sharp debridement (<jats:italic>p<\/jats:italic> = 0.38). Moreover, there was a sustained decrease in bacterial load 1\u2010week post\u2010laser debridement, as compared with no sustained decrease 1\u2010week post\u2010sharp debridement (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02). Overall, 52.9% of patients preferred laser debridement vs. 35.3% for sharp debridement. We believe that Er:YAG laser serves as a promising technology in chronic wounds, functioning as a potentially superior alternative to sharp debridement, the current standard of therapy.<\/jats:p>","DOI":"10.1111\/wrr.12764","type":"journal-article","created":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T08:50:20Z","timestamp":1570351820000},"page":"118-125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Er:YAG laser vs. sharp debridement in management of chronic wounds: Effects on pain and bacterial load"],"prefix":"10.1111","volume":"28","author":[{"given":"Babak","family":"Hajhosseini","sequence":"first","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Department of Surgery, Stanford University School of Medicine  Stanford California"},{"name":"Advanced Wound Care Center Stanford University School of Medicine  Redwood City California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace J.","family":"Chiou","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery Department of Surgery, Stanford University School of Medicine  Stanford California"},{"name":"Advanced Wound Care Center Stanford University School of Medicine  Redwood City California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen","family":"Dori","sequence":"additional","affiliation":[{"name":"Advanced Wound Care Center Stanford University School of Medicine  Redwood City California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri","family":"Fukaya","sequence":"additional","affiliation":[{"name":"Advanced Wound Care Center Stanford University School of Medicine  Redwood City California"},{"name":"Division of Vascular Surgery Department of Surgery, Stanford University School of Medicine  Stanford 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