Chronic wounds pose significant challenges to patients and potentially reduce patients' quality of life. A prospective randomised control trial (RCT) was conducted in Russia between 2018 and 2021 to assess the effectiveness of treating chronic wounds with a high-intensity Erbium: Yttrium Aluminium Garnet (Er:YAG with RecoSMA (Reconstructive Spatially Modulated Ablation module for distributing laser radiation into microbeams) laser technology versus sharp debridement in 144 patients (treatment group N = 71; control N = 73) with diabetic foot, venous and arterial leg ulcers. The median ulcer size at baseline in the treatment and control group was 11 cm² and 10 cm² with median ulcer duration of 16 months and 15 months, respectively. The endpoints were the time to achieve a clean wound bed, time to granulation, extent of complete and marginal epithelialisation, change in wound area, presence of bacteria, levels of topical wound pain, and the patients' tolerance of debridement. A difference at p < 0.05 was considered statistically significant. After a 30-day observation period, complete epithelialisation occurred in more than twice as many wounds in the treatment group (56.3%) compared to the control group (26%). The Er:YAG laser was more effective than sharp debridement in clearing wounds of microbial flora, stimulating tissue regeneration, promoting early granulation, marginal epithelialisation and wound healing, suggesting that Er:YAG laser therapy may offer greater benefits than conventional methods of sharp debridement of slow healing wounds.

Keywords: RecoSMA treatment; chronic wounds; debridement; laser therapy; ulcers.

© 2025 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

慢性伤口给患者带来了重大挑战，可能降低患者的生活质量。一项前瞻性随机对照试验（RCT）于2018年至2021年在俄罗斯进行，评估了使用高能铒钇铝石榴石（Er:YAG，带有RecoSMA模块的激光技术，用于将激光辐射分配成微束）治疗糖尿病足、静脉性和动脉性腿部溃疡患者的慢性伤口的有效性。试验组包括71名患者，对照组包括73名患者。基线时，治疗组和对照组的中位伤口面积分别为11平方厘米和10平方厘米，中位伤口持续时间分别为16个月和15个月。研究终点包括实现干净创面的时间、肉芽组织形成的时间、完全上皮化和边缘上皮化的范围、伤口面积的变化、细菌的存在、局部伤口疼痛的水平以及患者对清创术的耐受性。p < 0.05 的差异被认为具有统计学意义。在为期30天的观察期后，治疗组中超过两倍数量的伤口实现了完全上皮化（56.3%），而对照组为26%。Er:YAG激光比锐器清创术更有效地清除微生物菌群、刺激组织再生、促进早期肉芽组织形成和边缘上皮化及伤口愈合，表明Er:YAG激光疗法可能比传统的锐器清创方法对慢性难治性伤口具有更大的益处。

关键词：RecoSMA治疗；慢性伤口；清创术；激光治疗；溃疡。