Dehiscence Saphenectomy

Photomed Laser Surg.  2014 May 19. [Epub ahead of print]

Low-Level Laser Therapy Prevents Prodromal Signal Complications on Saphenectomy Post Myocardial Revascularization.

Pinto NC1, Pereira MH, Tomimura S, de Magalhães AC, Pomerantzeff PM, Chavantes MC.

Author information

  • 11 Cardiovascular and Thoracic Surgery Department of The Heart Institute, General Hospital, Medical School, University of São Paulo , São Paulo, SP, Brazil .

Abstract

Abstract Background and objective: One of the most frequent treatments for ischemic heart disease is myocardial revascularization, often applying the saphenous vein as a coronary graft. However, postoperative complications may occur, such as saphenous dehiscence. According to the literature, low-level laser therapy (LLLT) has been used in the treatment of several inflammatory processes in patients. Recently, its uses have expanded to include LLLT preventive therapy and postoperative treatment. Despite our department's successful application of LLLT in the treatment of saphenectomy incisions, many colleagues are still uncertain as to laser theraphy's benefits. Therefore, the study's purpose was to evaluate tissue repair of prodromal surgical incisions after the administration of LLLT.

Materials and methods: The pilot study included 14 patients, divided into two groups. Both groups of patients received the traditional treatment; additionally, the Laser Group (n=7) received diode laser treatment (λ=780 nm, fluence=19 J/cm2, pulse=25 mW, time=30 sec, energy=0.75 J, irradiance=625 mW/cm2, beam spot size 0.04 cm2), which was applied on the edges of the saphenectomy incision. The Control Group (n=7) received conventional treatment exclusively.

Results: In the Laser Group: all seven patients showed significant improvement, whereas the Control Group had twice as many complications, including critical rates of incisional dehiscence.

Conclusions: LLLT was valuable in preventing prodromal complications in saphenectomy post myocardial revascularization.

Rev Bras Cir Cardiovasc. 2009 Mar;24(1):88-91.

Low level laser therapy in acute dehiscence saphenectomy: therapeutic proposal.

[Article in English, Portuguese]

Pinto NC, Pereira MH, Stolf NA, Chavantes MC.

Service of Laser Medical Center, Heart Institute – InCor/HC – Faculty of Medicine of the Universitof São Paulo, São Paulo, Brasil. nathalicordeiro@hotmail.com

Dehiscence is a feared complication after major surgeries. Patient who had undergone coronary artery bypass grafting developed saphenectomy's dehiscence on lower limb with edema and pain on the 15th postoperative day. Conventional treatment had been initially performed without clinical improvement. On the 30th postoperative day only Low Level Laser Therapy (LLLT) was applied punctually around surgical wounds edge. The results revealed granulated tissue, reduction of inflammatory process and analgesic effect since the first application. In this pilot study, LLLT has shown a considerable role as a wound healing agent, through a new proposal for efficient, safe and noninvasive therapy.