• Maria Girlane Sousa Albuquerque Brandão, Maria Aline Moreira Ximenes, Danilo Ferreira de Sousa, Vivian Saraiva Veras, Lívia Moreira Barros, Soraia Assad Nasbine Rabeh, Idevania Geraldina Costa, and Thiago Moura de Araújo.
• Doctoral Student, Nursing School, Universidade de São Paulo (USP), Ribeirão Preto (SP), Brazil.
• Sao Paulo Med J. 2023 Jan 1; 141 (6): e2022476e2022476.

BackgroundUlceration of the feet in patients with diabetes is a frequent complication that increases morbidity, mortality, hospitalization, treatment costs, and non-traumatic amputations.ObjectiveTo present a systematic review of the treatment of patients with diabetes mellitus and infected foot ulcers using photodynamic therapy.Design And SettingA systematic review was performed in the postgraduate program in nursing at the Universidade da Integração Internacional da Lusofonia Afro-Brasileira, Ceará, Brazil.MethodsPubMed, CINAHL, Web of Science, EMBASE, Cochrane Library, Scopus, and LILACS databases were screened. The methodological quality, risk of bias, and quality of evidence of each study were assessed. Review Manager was used for the meta-analysis.ResultsFour studies were included. They highlighted significantly better outcomes in patient groups treated with photodynamic therapy than those in the control groups that were treated with topical collagenase and chloramphenicol (P = 0.036), absorbent (P < 0.001), or dry covers (P = 0.002). Significant improvements were noted in terms of the microbial load in the ulcers and tissue repair, with a reported reduction in the need for amputation by up to 35 times. Photodynamic therapy resulted in significantly better outcomes between the experimental and control groups (P = 0.04).ConclusionPhotodynamic therapy is significantly more effective in treating infected foot ulcers than standard therapies.Systematic Review RegistrationInternational Prospective Register of Systematic Reviews (PROSPERO) - CRD42020214187, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214187.

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