Evidence was limited by poor trial quality. Concerns centered on: randomization adequacy; group comparability at baseline and follow-up; use of complete healing as the primary endpoint; adjustment for confounders; and intention-to-treat analysis. Sample sizes were generally small, making it difficult to find statistically significant differences between groups.
The best available trial did not show a higher probability of complete healing at 6 weeks with the addition of low-level laser compared to sham laser treatment added to standard care. Study weaknesses were unlikely to have concealed existing effects. Future studies may determine whether different dosing parameters or other laser types may lead to different results.
Vacuum-assisted closure trials did not find a significant advantage for the intervention on the primary endpoint, complete healing, and did not consistently find significant differences on secondary endpoints and may have been insufficiently powered to detect differences. Ongoing RCT protocols may provide better evidence on outcomes of interest.
Given the sparse evidence for these two interventions, at the present time, it is not possible to find variables in these trials that may be associated with better results.