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Equipment, Education and Resources for Clinical Excellence in Energetic Therapies

Scars

J Cosmet Laser Ther.  2013 Feb 5. [Epub ahead of print]

Evaluation of low-level laser therapy in rabbit oral mucosa after soft tissue graft application: A pilot study.

Kara C, Demir T, Ozbek E.

Source

Department of Periodontology, Faculty of Dentistry, Ordu University , Ordu , Turkey.

Abstract

The aim of the present study was to assess the histopathological effects of low-level laser therapy (LLLT) on healing of the oral mucosa after soft tissue graft operations. The alterations at the end of healing in normal and LLLT-applied oral mucosa were studied in two healthy adult New Zealand white rabbits by taking specimens for light microscopic inspection. There was no adverse event reported in the study and no post-operative complications, such as swelling, bleeding, or edema, were observed in the rabbits. Complete wound healing was faster in the LLLT-applied rabbit. Compared to the normal rabbit oral mucosa, thickening of the stratum corneum (hyperkeratosis) was found in the epithelia of the rabbits. A significant increase in the epithelial thickness was found in the samples of rabbits, suggesting increased scar tissue following the wound repair. Additionally, many mitotic figures were present in the epithelia of the LLLT-applied rabbit, indicating epithelial cell hyperplasia. Long and irregular connective tissue protrusions projecting into the undersurface of the epithelium and mononuclear cell infiltrations were noted in the rabbits. The results suggest that LLLT used for soft tissue operations provides better and faster wound healing and that LLLT enhances epithelization.

Lasers Surg Med. 2010 Aug;42(6):597-601.

Prophylactic low-level light therapy for the treatment of hypertrophic scars and keloids: a case series.

Barolet D, Boucher A.

RoseLab Skin Optics Research Laboratory, Montreal, Quebec, Canada. daniel.barolet@mcgill.ca

Abstract

BACKGROUND AND OBJECTIVES: Hypertrophic and keloid scars result from alterations in the wound healing process. Treating abnormal scars remains an important challenge. The aim of this case series was to investigate the effectiveness of near infrared (NIR) light emitting diode (LED) treatment as a prophylactic method to alter the wound healing process in order to avoid or attenuate the formation of hypertrophic scars or keloids.

STUDY DESIGN/PATIENTS AND METHODS: Three patients (age 27-57) of phototypes I-III with hypertrophic scars or keloids due to acne or surgery participated in this case series. Following scar revision by surgery or CO(2) laser ablation on bilateral areas, one scar was treated daily by the patient at home with non-thermal, non-ablative NIR LED (805 nm at 30 mW/cm(2)) for 30 days. Efficacy assessments, conducted up to a year post-treatment, included the Vancouver Scar scale (VSS), clinical global assessment of digital photographs, and quantitative profilometry analysis using PRIMOS. Safety was documented by adverse effects monitoring.

RESULTS: Significant improvements on the NIR-treated versus the control scar were seen in all efficacy measures. No significant treatment-related adverse effects were reported.

CONCLUSION: Possible mechanisms involved are inhibition of TGF-beta I expression. Further studies in larger group of patients are needed to evaluate this promising technique.

J Cosmet Laser Ther. 2010 Jul 14. [Epub ahead of print]

Low-level laser therapy for the treatment of epidermolysis bullosa: A case report.

Minicucci EM, Barraviera SR, Miot H, Almeida-Lopes L.

Department of Dermatology and Radiotherapy, Botucatu School of Medicine of São Paulo State University – UNESP, Brazil.

Abstract

Abstract Epidermolysis bullosa (EB) is a rare group of diseases characterized by skin fragility. There is no specific treatment, short of protection from trauma, currently available for these patients. Low-level laser therapy (LLLT) was effective as an analgesic and in accelerating cutaneous wound healing after six sessions of therapy in a child with dystrophic EB with cutaneous scarring and blisters on the limbs and trunk.

Photomed Laser Surg.  2010 Jun;28(3):417-22.

Effects of low-level laser therapy on pain and scar formation after inguinal herniation surgery: a randomized controlled single-blind study.

Carvalho RL, Alcântara PS, Kamamoto F, Cressoni MD, Casarotto RA.

Source

Postgraduate Program in Rehabilitation Sciences, University of São Paulo, São Paulo, Brazil.

Abstract

OBJECTIVE:

The aim of this study was to investigate the efficacy of an infrared GaAlAs laser operating with a wavelength of 830 nm in the postsurgical scarring process after inguinal-hernia surgery.

BACKGROUND:

Low-level laser therapy (LLLT) has been shown to be beneficial in the tissue-repair process, as previously demonstrated in tissue culture and animal experiments. However, there is lack of studies on the effects of LLLT on postsurgical scarring of incisions in humans using an infrared 830-nm GaAlAs laser.

METHOD:

Twenty-eight patients who underwent surgery for inguinal hernias were randomly divided into an experimental group (G1) and a control group (G2). G1 received LLLT, with the first application performed 24 h after surgery and then on days 3, 5, and 7. The incisions were irradiated with an 830-nm diode laser operating with a continuous power output of 40 mW, a spot-size aperture of 0.08 cm(2) for 26 s, energy per point of 1.04 J, and an energy density of 13 J/cm(2). Ten points per scar were irradiated. Six months after surgery, both groups were reevaluated using the Vancouver Scar Scale (VSS), the Visual Analog Scale, and measurement of the scar thickness.

RESULTS:

G1 showed significantly better results in the VSS totals (2.14 +/- 1.51) compared with G2 (4.85 +/- 1.87); in the thickness measurements (0.11 cm) compared with G2 (0.19 cm); and in the malleability (0.14) compared with G2 (1.07). The pain score was also around 50% higher in G2.

CONCLUSION:

Infra-red LLLT (830 nm) applied after inguinal-hernia surgery was effective in preventing the formation of keloids. In addition, LLLT resulted in better scar appearance and quality 6 mo postsurgery.

Photomed Laser Surg. 2009 Oct 12. [Epub ahead of print]

Effects of Low-Level Laser Therapy on Pain and Scar Formation after Inguinal Herniation Surgery: A Randomized Controlled Single-Blind Study.

de Paiva Carvalho RL, Alcântara PS, Kamamoto F, Cressoni MD, Casarotto RA.

1 Postgraduate Program in Rehabilitation Sciences , University of São Paulo, São Paulo, Brazil .

Abstract Objective: The aim of this study was to investigate the efficacy of an infrared GaAlAs laser operating with a wavelength of 830 nm in the postsurgical scarring process after inguinal-hernia surgery. Background: Low-level laser therapy (LLLT) has been shown to be beneficial in the tissue-repair process, as previously demonstrated in tissue culture and animal experiments. However, there is lack of studies on the effects of LLLT on postsurgical scarring of incisions in humans using an infrared 830-nm GaAlAs laser. Method: Twenty-eight patients who underwent surgery for inguinal hernias were randomly divided into an experimental group (G1) and a control group (G2). G1 received LLLT, with the first application performed 24 h after surgery and then on days 3, 5, and 7. The incisions were irradiated with an 830-nm diode laser operating with a continuous power output of 40 mW, a spot-size aperture of 0.08 cm(2) for 26 s, energy per point of 1.04 J, and an energy density of 13 J/cm(2). Ten points per scar were irradiated. Six months after surgery, both groups were reevaluated using the Vancouver Scar Scale (VSS), the Visual Analog Scale, and measurement of the scar thickness. Results: G1 showed significantly better results in the VSS totals (2.14 +/- 1.51) compared with G2 (4.85 +/- 1.87); in the thickness measurements (0.11 cm) compared with G2 (0.19 cm); and in the malleability (0.14) compared with G2 (1.07). The pain score was also around 50% higher in G2. Conclusion: Infra-red LLLT (830 nm) applied after inguinal-hernia surgery was effective in preventing the formation of keloids. In addition, LLLT resulted in better scar appearance and quality 6 mo postsurgery.

Lasers Surg Med. 2004;34(5):451-7.

Evaluation of the use of low level laser and photosensitizer drugs in healing.

Silva JC, Lacava ZG, Kuckelhaus S, Silva LP, Neto LF, Sauro EE, Tedesco AC.

IP&D, Instituto de Pesquisa e Desenvolvimento, Universidade do Vale do Paraiba, Av. Shishima Hifumi, 2911, Urbanova, 12244-000, Sao Josedos Campos, SP, Brasil.

BACKGROUND AND OBJECTIVES: In the last decade, many different kinds of therapies have emerged as a consequence of advances in the field of applied technology. It is known that low level laser therapy contributes to tissue healing; however, the use of photodynamic therapy (PDT) in healing and the scar formation processes has not been fully explored. The present study analyses the effect of low level laser InGaAIP (685 nm), radiation, either alone or combined with a phthalocyanine-derived photosensitizer (PS) in a gel base delivery (GB) system, on the healing process of cutaneous wounds in rats. STUDY DESIGN/MATERIALS AND METHODS: The rats were divided into six groups: control (untreated) (CG), gel base (GB), photosensitizer (PS), laser (LG), laser+photosensitizer (LPS), and laser+photosensitizer in a GB (LPSG). Standardized circular wounds were made on the dorsum of each rat with a skin punch biopsy instrument. After wounding, treatment was performed once daily and the animals were killed at day 8. Tissue specimens containing the whole wound area were removed and processed for histological analysis using conventional techniques. Serial cross-sections were analyzed to evaluate the organization of the dermis and epidermis as well as collagen deposition. RESULTS: The animals of groups LG, PS, LPS, and LPSG presented higher collagen content and enhanced re-epithelialization as compared to CG (control) and GB rats. Connective tissue remodeling was more evident in groups LPS and LPSG. CONCLUSIONS: The results clearly indicated a synergetic effect of light+photosensitizer+delivery drug on tissue healing. PDT did not cause any healing inhibition or tissue damage during the healing process. Copyright 2004 Wiley-Liss, Inc.

J Photochem Photobiol B. 2003 Apr;70(1):39-44.

The effect of 880 nm low level laser energy on human fibroblast cell numbers: a possible role in hypertrophic wound healing.

Webb C, Dyson M.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. rscwebb@inet.polyu.edu.hk

Low level lasers (LLLs) have been shown to induce therapeutic effects in wound healing. However, there have been few LLL studies on burn wounds which may become unsightly, hypertrophic and impair function. Inhibitory effects on the healing of fibrotic wounds, prone to hypertrophy may be expected to reasonably reduce the problems accompanying hypertrophic scarring. The effects of LLL wavelengths and treatment parameters on wound healing cells in vitro often demonstrate meaningful results and without concurrent ethical difficulties of clinical trials. This experiment investigated the effect of an 880 nm, 16 mW GaAlAs diode at 2.4 and 4 J/cm(2) on cell numbers of two human fibroblast cell lines, derived from hypertrophic scar (HF) and normal dermal explants (NF), respectively. After irradiation by 880 nm LLL, cell numbers were measured utilising methylene blue bioassay and read by the spectrophotometer in the same microculture plates. HF and NF exhibited decreased cell numbers as compared to sham-irradiated controls. HF cell number, after 2.4 J/cm(2), was significantly lower on day 5 (P<0.05). The NF cell numbers were significantly lower on day 4 and/or day 5 (P<0.05). The results have implications on hypertrophic wound healing and further studies are required.

Lasers Surg Med. 1998;22(5):294-301.

Stimulatory effect of 660 nm low level laser energy on hypertrophic scar-derived fibroblasts: possible mechanisms for increase in cell counts.

Webb C, Dyson M, Lewis WH.

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.

BACKGROUND AND OBJECTIVE: Varying effects of red light wavelengths on in vitro cells have been reported. Low level lasers (LLL) are employed to assist wound healing especially for indolent ulcers. On healing, burn wounds may become hypertrophic, resulting in excessive wound contraction, poor cosmesis, and functional impairment. This study enquired whether 660 nm LLL affected hypertrophic scar-derived fibroblasts. STUDY DESIGN/MATERIALS AND METHODS: The experiments investigated the effect of a 660 nm, 17 mW laser diode at dosages of 2.4 J/cm2 and 4 J/cm2 on cell counts of two human fibroblast cell lines, derived from hypertrophic scar tissue (HSF) and normal dermal (NDF) tissue explants, respectively. The protocol avoided transfer of postirradiated cells. Estimation of fibroblasts utilized the methylene blue bioassay. RESULTS/CONCLUSION: The post-660 nm-irradiated HSFs exhibited very significantly higher cell counts than controls P < 0.01 on days 1-4 (Mann-Whitney U-test), and P < 0.01 on days 1-3 for similarly irradiated NDFs.

This entry was added on September 20, 2010 and last updated February 7, 2013, filed under Laser Research Library. Bookmark the permalink.