Abstract
Introduction (with objective): Introduction: Photodynamic therapy (PDT) is an approach that combines photosensitizers, light at specific wavelengths, and oxygen, generating reactive species with a local therapeutic effect. It has been investigated as an adjuvant strategy in wound management due to its antimicrobial potential, inflammation modulation, and tissue repair promotion. However, the variability in application protocols and evaluated outcomes limits the interpretation of its clinical effectiveness and its incorporation into practice. Objectives: To map the available evidence on efficacy, safety, quality of life, and to evaluate the quality of reporting of clinical studies that investigated PDT in wound healing. Material and Method: Methods: Scoping review conducted according to Joanna Briggs Institute recommendations and reported according to PRISMA-ScR (protocol: 10.17605/OSF.IO/R6VUK). Searches were conducted in PubMed, Scopus, and Web of Science, with supplementation in Google Scholar (October/2025). Interventional and observational clinical studies with a comparator group were included. The synthesis was descriptive, encompassing efficacy, safety, and quality of life outcomes. Reporting quality was assessed using CONSORT 2025, adapted for non-randomized studies. Results: Twenty clinical studies were included (13 randomized and 7 non-randomized), showing relevant heterogeneity in interventions, with variations in photosensitizers, irradiation parameters, and therapeutic regimens, as well as diversity in clinical outcomes. In randomized studies, only 38.5% (n=5) identified the design in the title or abstract, 46.2% (n=6) reported registration, and 30.8% (n=4) described blinding. In non-randomized studies, all structural items were adequately reported; however, no study reported sample size calculation, harm assessment, or patient involvement. Regarding efficacy, PDT was favorable for pain in 75% of studies (6/8) and for wound healing in 85.7% (6/7). Reduction in microbial load (n=6), wound area (n=6), swelling (n=3), and histological outcomes (n=5) was consistently observed in studies evaluating these outcomes. In contrast, results for periodontal parameters were neutral, and outcomes related to skin barrier and inflammatory response showed predominantly neutral or unfavorable results. Safety was favorable: non-serious adverse events were reported in 33.3% (2/6) of studies in the PDT group and 66.7% (4/6) in the comparators, mainly local, mild, and self-limiting, such as pain, erythema, edema, slight exudation, and burning sensation, resolving within three days. Serious adverse events were rare and reported in only one study, occurring in both groups, without detailed description or causal attribution to PDT. Quality of life outcomes (related to wound and oral health) were reported in 2 studies, both favorable to PDT. Conclusions: PDT presents favorable evidence of efficacy and safety as an adjuvant therapy in wound healing, with a positive impact on quality of life. However, the heterogeneity of the interventions and outcomes evaluated, associated with limitations in the quality of reporting, compromises the comparability of the findings and reinforces the need for greater methodological standardization and the development of clinical protocols.
