The effect of combined pulsed wave low-level laser therapy and mesenchymal stem cell-conditioned medium on the healing of an infected wound with methicillin-resistant Staphylococcal aureus in diabetic rats

: This study aims to investigate the combined effects of Pulsed wave low-level laser therapy (PW LLLT) and human bone marrow mesenchymal stem cell-conditioned medium (hBM-MSC-CM) on the microbial flora and tensiometrical properties of an infected wound model with methicillin-resistant staphylococcal aureus (MRSA) in an experimental model for Type 1 diabetes mellitus (TIDM). TIDM was induced in rats by streptozotocin (STZ). One full-thickness excision was made on the backs of the rats. Next, the rats were divided into the following groups: Group 1 was the control (placebo) group; Group 2 received hBM-MSCs-CM four times; Group 3 were laser PWLLLT (890 nm, 80 Hz, 0.2 J/cm2 ); and Group 4 received hBM-MSCs-CM +LASER. Wounds were infected with MRSA. Microbiological examinations were performed on days 4, 7, and 15. Tensiometerical examinations were carried out on the 15th day. One-way analysis of variance showed that laser and CM alone and/or in combination significantly increases the tensiomerical properties of the repaired wounds compared with control wounds. A combination of PW laser and CM was statistically more effective than other treated groups. Two-way analysis of variance showed that laser and CM alone and/or in combination significantly decreases the colony-forming units (CFUs) compared with the control group. The application of hBM-MSC-CM and PWlaser alone and/or together significantly accelerates the wound-healing process in MRSA-infected cutaneous wounds in TI DM in rats. Additionally, a combined application of hBM-MSC-CM and PWlaser demonstrates a synergistic effect on the wound-healing process in MRSA-infected cutaneous wounds in Type I DM rats.