Skin Grafts

Lasers Med Sci. 2018 Jan 24. doi: 10.1007/s10103-017-2430-4. [Epub ahead of print]

Effect of low-level laser therapy on the healing process of donor site in patients with grade 3 burn ulcer after skin graft surgery (a randomized clinical trial).

Vaghardoost R1, Momeni M2, Kazemikhoo N3, Mokmeli S4, Dahmardehei M1, Ansari F5, Nilforoushzadeh MA3, Sabr Joo P1, Mey Abadi S1, Naderi Gharagheshlagh S1, Sassani S6.

Author information

1
Burn Research center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, Iran.
2
Burn Research center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, Iran. mah_momeni@yahoo.com.
3
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
4
Canadian Optic and Laser Center, Victoria, BC, Canada.
5
Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
6
Al Nasr Sport Club Medical Section, Dubai, United Arab Emirates.

Abstract

Skin graft is a standard therapeutic technique in patients with deep ulcers, but managing donor site after grafting is very important. Although several modern dressings are available to enhance the comfort of donor site, using techniques that accelerate wound healing may enhance patient satisfaction. Low-level laser therapy (LLLT) has been used in several medical fields, including healing of diabetic, surgical, and pressure ulcers, but there is not any report of using this method for healing of donor site in burn patients. The protocols and informed consent were reviewed according to Medical Ethics Board of Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1394.363) and Iranian Registry of Clinical Trials (IRCT2016020226069N2). Eighteen donor sites in 11 patients with grade 3 burn ulcer were selected. Donor areas were divided into 2 parts, for laser irradiation and control randomly. Laser area was irradiated by a red, 655-nm laser light, 150 mW, 2 J/cm2, on days 0 (immediately after surgery), 3, 5, and 7. Dressing and other therapeutic care for both sites were the same. The patients and the person who analyzed the results were blinded. The size of donor site reduced in both groups during the 7-day study period (P <0.01) and this reduction was significantly greater in the laser group (P =?0.01). In the present study, for the first time, we evaluate the effects of LLLT on the healing process of donor site in burn patients. The results showed that local irradiation of red laser accelerates wound healing process significantly.

KEYWORDS:

Low-level laser therapy; Skin graft; Wound healing

Lasers Med Sci. 2017 Apr;32(3):641-648. doi: 10.1007/s10103-017-2160-7. Epub 2017 Feb 2.

Photobiomodulation laser and pulsed electrical field increase the viability of the musculocutaneous flap in diabetic rats.

Leite GP1, das Neves LM1, Silva CA2, Guirro RR1, de Souza TR1, de Souza AK1, Garcia SB3, Guirro EC4,5.

Author information

1
Post-Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School-FMRP/USP, Ribeirão Preto, Brazil.
2
Post-Graduate Program in Human Movement Sciences, Methodist University of Piracicaba-UNIMEP, Piracicaba, Brazil.
3
Post-Graduate Program in Pathology, Ribeirao Preto Medical School-FMRP/USP, Ribeirão Preto, Brazil.
4
Post-Graduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School-FMRP/USP, Ribeirão Preto, Brazil. ecguirro@fmrp.usp.br.
5
Ribeirão Preto Medical School of the University of São Paulo (USP), Bandeirantes Avenue, 3900, Ribeirão Preto, SP, 14049-900, Brazil. ecguirro@fmrp.usp.br.

Abstract

The purpose of this study is to investigate the effect of pulsed electrical field (PEF) and photobiomodulation laser (PBM) on the viability of the TRAM flap in diabetic rats. Fifty Wistar rats were divided into five homogeneous groups: Group 1-control; Group 2-diabetics; Group 3-diabetics + PEF; Group 4-diabetic + laser 660 nm, 10 J/cm2, 0.27 J; Group 5-diabetic + laser 660 nm, 140 J/cm2, 3.9 J. The percentage of necrotic area was evaluated using software Image J®. The peripheral circulation of the flap was evaluated by infrared thermography FLIR T450sc (FLIR® Systems-Oregon USA). The thickness of the epidermis (haematoxylin-eosin), mast cell (toluidine blue), leukocytes, vascular endothelial growth factor, fibroblast and newly formed blood vessels were evaluated. For the statistical analysis, the Kruskal-Wallis test was applied followed by Dunn and ANOVA test followed by Tukey with critical level of 5% (p?<?0.05). The PEF reduced the area of necrosis, decreased the leukocytes, increased the mast cells, increased the thickness of epidermis and increased newly formed blood vessels when it was compared to the untreated diabetic group of animals. Laser 660 nm, fluence 140 J/cm2 (3.9 J) showed better results than the 10 J/cm2(0.27 J) related to reduction of the area of necrosis and the number of leukocytes, increased mast cells, increased thickness of the epidermis, increased vascular endothelial growth factor, increased fibroblast growth factor and increase of newly formed blood vessels in diabetic animals. The laser and pulsed electrical field increase the viability of the musculocutaneous flap in diabetic rats.

KEYWORDS:

Diabetes mellitus; Dosimetry; Fibroblast growth factor; Lowlevel laser therapy; Phototherapy; Physiotherapy; Vascular endothelial growth factor

Lasers Med Sci. 2017 Feb;32(2):335-341. doi: 10.1007/s10103-016-2118-1. Epub 2016 Dec 2.

Laser photobiomodulation (830 and 660 nm) in mast cells, VEGF, FGF, and CD34 of the musculocutaneous flap in rats submitted to nicotine.

das Neves LM1, Leite GP2, Marcolino AM2, Pinfildi CE3, Garcia SB4, de Araújo JE1, Guirro EC5.

Author information

1
Post-Graduate Program in Rehabilitation and Functional Performance of Ribeirão Preto Medical School of the University of São Paulo (FMRP/USP), Av. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
2
Post-Graduate Program in Rehabilitation Sciences, Federal University of Santa Catarina – Campus Araranguá – UFSC/SC, Florianópolis, Brazil.
3
Post-Graduate Program in Interdisciplinary Health Sciences, Federal University of Sao Paulo – Santos Campus – UNIFESP/SP, Sao Paulo, Brazil.
4
Post-Graduate Program in Pathology, Ribeirão Preto Medical School – FMRP/USP, Sao Paulo, Brazil.
5
Post-Graduate Program in Rehabilitation and Functional Performance of Ribeirão Preto Medical School of the University of São Paulo (FMRP/USP), Av. dos Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil. ecguirro@fmrp.usp.br.

Abstract

The aim of this study was to investigate the effect of laser photobiomodulation (PBM) on the viability of the transverse rectus abdominis musculocutaneous (TRAM) flap in rats subjected to the action of nicotine. We evaluated 60 albino Wistar rats, divided into six groups of ten animals. Group 1 (saline) underwent the surgical technique to obtain a TRAM flap; group 2 (laser 830 nm) underwent the surgical technique and was irradiated with a laser 830 nm; group 3 (laser 660 nm) underwent the surgical technique and was irradiated with a laser 660 nm; group 4 was treated with nicotine subcutaneously (2 mg/kg/2×/day/4 weeks) and underwent surgery; group 5 (nicotine?+?laser 830 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 830 nm; group 6 (nicotine?+?laser 660 nm) was exposed to nicotine, underwent the surgical technique, and was irradiated with a laser 660 nm. The application of PBM occurred immediately after surgery and on the two following days. The percentage of necrosis was assessed using the AxioVision® software. The number of mast cells (toluidine blue staining) was evaluated, and immunohistochemistry was performed to detect vascular endothelial growth factor expression (anti-VEGF-A), fibroblasts (anti-basic FGF), and neoformed vessels (anti-CD34). PBM with a wavelength of 830 nm increased the viability of the TRAM flap, with a smaller area of necrosis, increased number of mast cells, and higher expression of VEGF and CD34. PBM increases the viability of musculocutaneous flaps treated with to nicotine.

Lasers Med Sci. 2016 Apr;31(3):497-502. doi: 10.1007/s10103-016-1896-9. Epub 2016 Feb 11.

Effects of low level laser therapy on the prognosis of split-thickness skin graft in type 3 burn of diabetic patients: a case series.

Dahmardehei M1, Kazemikhoo N2, Vaghardoost R1, Mokmeli S3, Momeni M1, Nilforoushzadeh MA4,5, Ansari F4, Amirkhani A4.

Author information

1
Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.
2
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran. nooshakazemi@gmail.com.
3
Canadian Optic and Laser Center, Victoria, BC, Canada.
4
Skin and Stem Cell Research Center, Tehran University of Medical Sciences, Tehran, Iran.
5
Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Significant populations in burn centers are diabetic burn patients. Healing process in these patients is more difficult due to diabetes complications. The gold standard treatment for patients with grade 3 burn ulcer is split-thickness skin grafting (STSG), but in the diabetic patients, the rate of graft failure and amputation is high due to impaired tissue perfusion. The technique of low level laser therapy (LLLT) improves tissue perfusion and fibroblast proliferation, increases collagen synthesis, and accelerates wound healing. The purpose of this case report is introducing a new therapeutic method for accelerating healing with better prognosis in these patients. The protocols and informed consent were reviewed according to the Medical Ethics, Board of Shahid Beheshti Medical Sciences (IR.SBMU.RAM.REC.13940.363). Diabetic type 2 patients with 13 grade 3 burn ulcers, candidate for amputation, were enrolled in the study. We used a 650-nm red laser light, 2 J/Cm for the bed of the ulcer and an 810-nm infrared laser light 6 J/Cm(2) for the margins along with intravenous laser therapy with a 660-nm red light, before and after STSG for treating grade 3 burn ulcers in 13 diabetic ulcers. The results of this study showed complete healing in the last 8 weeks for all patients who were candidates for amputation. In this case series, we present 13 cases of diabetic ulcer with type 3 burn wound, candidate for amputation, who healed completely using LLLT and STSG. This is the first time that these two techniques are combined for treatment of burn ulcer in diabetic patients. Using LLLT with STSG might be a promising treatment for burn victims especially diabetic patients.

KEYWORDS:

Burn wound; Low level laser therapy; Skin transplantation

Plast Surg (Oakv). 2015 Spring;23(1):35-9.

Inhibitory effects of low-level laser therapy on skin-flap survival in a rat model.

Baldan CS1, Masson IF1, Esteves Júnior I1, Baldan AM1, Machado AF1, Casaroto RA1, Liebano RE1.

Author information

1
Paulista University, São Paulo, Brazil.

Abstract

in English, French

BACKGROUND:

Although several studies have demonstrated the effects of low-level laser therapy (LLLT) on skin flap viability, the role of higher doses has been poorly investigated.

OBJECTIVE:

To investigate the inhibitory effect of the LLLT (?=670 nm) on the viability of random skin flaps in a rat model using an irradiation energy of 2.79 J at each point.

METHODS:

Sixteen Wistar rats were randomly assigned into two groups: sham laser irradiation (n=8); and active laser irradiation (n=8). Animals in the active laser irradiation group were irradiated with a 670 nm diode laser with an energy of 2.79 J/point, a power output 30 mW, a beam area of 0.028 cm(2), an energy density of 100 J/cm(2), an irradiance of 1.07 W/cm(2) for 93 s/point. Irradiation was performed in 12 points in the cranial skin flap portion. The total energy irradiated on the tissue was 33.48 J. The necrotic area was evaluated on postoperative day 7.

RESULTS:

The sham laser irradiation group presented a mean (± SD) necrotic area of 47.96±3.81%, whereas the active laser irradiation group presented 62.24±7.28%. There was a significant difference in skin-flap necrosis areas between groups (P=0.0002).

CONCLUSION:

LLLT (?=670 nm) increased the necrotic area of random skin flaps in rats when irradiated with an energy of 2.79 J (100 J/cm(2)).

KEYWORDS:

Low-level laser therapy; Necrosis; Rats; Surgical flaps

Minerva Stomatol. 2014 Mar;63(3):77-83.

Histological assessment of nonablative laser stimulation of tissue repair in acellular dermal grafts.

Silveira V1, Cenci R, Oliveira M, Moraes J, Etges A, Zerbinatti L.

Author information

1
Oral and maxillofacial Department Pontifícia Universidade do Rio Grande do Sul (PUCRS) Porto Alegre, RS, Brazil – gerhardtoliveira@gmail.com.

Abstract

AIM:

The objective of this study was to compare integration of AlloDerm® acellular dermal grafts in animals subjected to non-ablative laserirradiation and animals not exposed to this therapy.

METHODS:

Standardized AlloDerm® fragments measuring 5 mm² were grafted into the subcutaneous tissue overlying the calvaria in 32 Wistar rats. Laser therapy (685 nm), at a dose of 4 J/cm2 per session, was applied immediately after surgical intervention and every 48 hours thereafter for a total of four applications.

RESULTS:

Analysis of histology slides revealed significantly greater edema in the control group. There was no neutrophil infiltration in the laser-irradiated group at any point during the study period, whereas such infiltration was present in control animals at three of the four points of observation. In the laser therapy group, lymphocyte infiltration was observed from day 1, whereas in the control group, it was only apparent from day 3. Vascularization was substantially greater in the control group. In the experimental group, the AlloDerm® graft was completely replaced by fibrous tissue.

CONCLUSION:

These findings suggest that add-on non-ablative laser therapy is an effective stimulator of healing and graft integration after placement of AlloDerm® acellular dermal grafts.

Lasers Med Sci. 2013 May;28(3):755-61. doi: 10.1007/s10103-012-1130-3. Epub 2012 Jun 22.

What is better in TRAM flap survival: LLLT single or multi-irradiation?

Pinfildi CE1, Hochman BS, Nishioka MA, Sheliga TR, Neves MA, Liebano RE, Ferreira LM.

Author information

1
Department of Science of Human Movement, University Federal of São Paulo-UNIFESP, Campus Baixada Santista, Santos, São Paulo, Brazil. cepinfildi@hotmail.com

Abstract

Lowlevel laser therapy (LLLT) has been used with the aim of improving vascular perfusion of the skin and musculocutaneous flaps. This study evaluated the effect of LLLT on transverse rectus abdominis musculocutaneous flap (TRAM) viability, vascular angiogenesis, and VEGF release. Eighty-four Wistar rats were randomly divided into seven groups with 12 rats in each group. Group 1 received sham lasertreatment; group 2, 3 J/cm(2) at 1 point; group 3, 3 J/cm(2) at 24 points; group 4, 72 J/cm(2) at 1 point; group 5, 6 J/cm(2) at 1 point; group 6, 6 J/cm(2) at 24 points; and group 7, 144 J/cm(2) at 1 point. All experimental groups underwent LLLT immediately after the TRAM operation and on the following 2 days; thus, animals underwent 3 days of treatment. The percentage of skin flap necrosis area was calculated on the fourth postoperative day using the paper template method, and two skin samples were collected using a 1-cm(2) punch to evaluate alpha smooth muscle actin (1A4) and VEGF levels in blood vessels. Significant differences were found in necrosis percentage, and higher values were seen in group 1 than in the other groups. Statistically significant differences were not found among groups 3 to 7 (p<0.292). Groups 5 and 7 showed significantly higher VEGF levels compared to other groups. Groups 3 and 5 had an increase in levels of blood vessels compared to other groups. LLLT at energy densities of 6 to 144 J/cm(2) was efficient to increase angiogenesis and VEGF levels and promote viability in TRAM flaps in rats.

Rev Col Bras Cir. 2013 Jan-Feb;40(1):44-8.

Macro and microscopic analysis of island skin grafts after lowlevel laser therapy.

[Article in English, Portuguese]
da Silva EB1, Maniscalco CL, Ésper GV, Guerra RR, Kerppers II.

Author information

1
Department of Agricultural and Environmental Sciences, State University of Santa Cruz – UESC, Ilheus, Bahia State – BA, Brazil. elisangelavet@yahoo.com.br

Abstract

OBJECTIVE:

To observe the effects of low intensity laser therapy in inflammation, wound healing and epithelialization of island skin grafts.

METHODS:

Twenty rats were subjected to this grafting technique and divided subsequently into two equal groups, one treated with laser and the other control.

RESULTS:

there was less inflammation, faster healing, epithelialization and keratinization in the laser-treated animals when compared to the untreated.

CONCLUSION:

Low intensity laser therapy is helpful to island skin grafting.

Lasers Med Sci. 2012 Sep;27(5):1045-50. doi: 10.1007/s10103-011-1042-7. Epub 2011 Dec 30.

LED (660 nm) and laser (670 nm) use on skin flap viability: angiogenesis and mast cells on transition line.

Nishioka MA1, Pinfildi CE, Sheliga TR, Arias VE, Gomes HC, Ferreira LM.

Author information

1
Post Graduation Plastic Surgery, Federal University of São Paulo, R. Napoleão de Barros, 715, 4º andar, CEP 04024-900, São Paulo, SP, Brazil.

Abstract

Skin flap procedures are commonly used in plastic surgery. Failures can follow, leading to the necrosis of the flap. Therefore, many studies use LLLT to improve flap viability. Currently, the LED has been introduced as an alternative to LLLT. The objective of this study was to evaluate the effect of LLLT and LED on the viability of random skin flaps in rats. Forty-eight rats were divided into four groups, and a random skin flap (10?×?4 cm) was performed in all animals. Group 1 was the sham group; group 2 was submitted to LLLT 660 nm, 0.14 J; group 3 with LED 630 nm, 2.49 J, and group 4 with LLLT 660 nm, with 2.49 J. Irradiation was applied after surgery and repeated on the four subsequent days. On the 7th postoperative day, the percentage of flap necrosis was calculated and skin samples were collected from the viable area and from the transition line of the flap to evaluate blood vessels and mast cells. The percentage of necrosis was significantly lower in groups 3 and 4 compared to groups 1 and 2. Concerning blood vessels and mast cell numbers, only the animals in group 3 showed significant increase compared to group 1 in the skin sample of the transition line. LED and LLLT with the same total energies were effective in increasing viability of random skin flaps. LED was more effective in increasing the number of mast cells and blood vessels in the transition line of random skin flaps.

Acta Cir Bras. 2012 Feb;27(2):155-61.

The effects of different doses of 670 nm diode laser on skin flap survival in rats.

Baldan CS1, Marques AP, Schiavinato AM, Casarotto RA.

Author information

1
Physical Therapy Department, UNIP and Sao Paulo Metodista University, Brazil. cristianobaldan@yahoo.com.br

Abstract

PURPOSE:

To investigate the effects of different low-level laser therapy (LLLT) doses on random skin flap rats.

METHODS:

Forty Wistar rats were randomly divided in four groups. The control group (CG) was not irradiated. The experimental groups were irradiated with a diode laser 670 nm with different energies per point: group 2 (G2) with 0.06 J; group 3 (G3) 0.15 J and group 4 (G4) 0.57 J. The three groups were irradiated in 12 equally distributed points in the cranial skin flap portion. They were submitted to the irradiation during the immediate, first and second postoperative days. The necrosis area was evaluated in the seventh postoperative day.

RESULTS:

The CG shows 49.35% of necrosis area in the skin flap; G2, 39.14%; G3, 47.01% and G4, 29.17% respectively. There was a significantly difference when G4 was compared with CG`s skin flap necrosis area.

CONCLUSION:

The low-level laser therapy diode 670 nm with 0.57 J energy per point increases the survival in randomic skin flap rats.

Photomed Laser Surg. 2010 Aug;28(4):483-8. doi: 10.1089/pho.2009.2500.

Influence of the use of laser phototherapy (lambda660 or 790 nm) on the survival of cutaneous flaps on diabetic rats.

Santos NR1, dos Santos JN, dos Reis JA Jr, Oliveira PC, de Sousa AP, de Carvalho CM, Soares LG, Marques AM, Pinheiro AL.

Author information

1
School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.

Abstract

OBJECTIVE:

The aim of this study was to assess and compare the effects of laser phototherapy (LPT) on cutaneous flaps on diabetic rats.

BACKGROUND:

Diabetes mellitus is characterized by high blood glucose levels. Its main complications are delayed wound healing, an impaired blood supply, and a decrease in collagen production. Cutaneous flaps are routinely used in several surgical procedures, and most failures are related to poor blood supply. LPT has been studied using several healing models.

ANIMALS AND METHODS:

Twelve Wistar rats were randomized into three groups: group 1 (G1; diabetic animals without treatment), group 2 (G2; diabetic animals irradiated with lambda680 nm), and group 3 (G3; diabetic animals irradiated with lambda790 nm). Diabetes was induced with streptozotocin. A 2- x 8-cm cutaneous flap was raised on the dorsum of each animal, and a plastic sheet was introduced between the flap and the bed to cause poor blood supply. Nonirradiated animals acted as controls. The dose per session was 40 J/cm(2). Laser light was applied transcutaneously and fractioned on 16 contact points at the wound margins (16 x 2.5 J/cm(2)). Animal death occurred on day 8 after surgery. Specimens were taken, processed, cut, stained with eosin (HE) and sirius red, and underwent histological analysis.

RESULTS:

It is shown that accute inflammation was mostly discrete for G3. Chronic inflammation was more evident for G2. Fibroblast number was higher for G3. Angiogenesis was more evident for G3. Necrosis was more evident for G2. Statistical analysis among all groups showed significant differences (p = 0.04) on the level of acute inflammation between G1 and G3, tissue necrosis between G1 and G2 (p = 0.03), chronic inflammation between (p = 0.04), fibroblastic proliferation between G2 and G3 (p = 0.05), and neovascularization between G2 and G3 (p = 0.04).

CONCLUSION:

LPT was effective in increasing angiogenesis as seen on irradiated subjects and was more pronounced when IR laser light was used.

Photomed Laser Surg. 2010 Jun;28(3):379-84. doi: 10.1089/pho.2009.2535.

Effect of low-level laser therapy on malondialdehyde concentration in random cutaneous flap viability.

Prado R1, Neves L, Marcolino A, Ribeiro T, Pinfildi C, Ferreira L, Thomazini J, Piccinato C.

Author information

1
Department of Surgery and Anatomy, University of São Paulo-FMRP-USP, Ribeirão Preto, Brazil. paschoalrp@hotmail.com

Abstract

OBJECTIVE:

The aim of this study was to assess the effects of 830 and 670 nm laser on malondialdehyde (MDA) concentration in random skin-flap survival.

BACKGROUND DATA:

Low-level laser therapy (LLLT) has been reported to be successful in stimulating the formation of new blood vessels and activating superoxide-dismutase delivery, thus helping the inhibition of free-radical action and consequently reducing necrosis.

MATERIALS AND METHODS:

Thirty Wistar rats were used and divided into three groups, with 10 rats in each one. A random skin flap was raised on the dorsum of each animal. Group 1 was the control group; group 2 received 830 nm laser radiation; and group 3 was submitted to 670 nm laser radiation. The animals underwent laser therapy with 36 J/cm(2) energy density immediately after surgery and on the 4 days subsequent to surgery. The application site of the laser radiation was 1 point, 2.5 cm from the flap’s cranial base. The percentage of the skin-flap necrosis area was calculated 7 days postoperative using the paper-template method, and a skin sample was collected immediately after as a way of determining the MDA concentration.

RESULTS:

Statistically significant differences were found between the necrosis percentages, with higher values seen in group 1 compared with groups 2 and 3. Groups 2 and 3 did not present statistically significant differences (p > 0.05). Group 3 had a lower concentration of MDA values compared to the control group (p < 0.05).

CONCLUSION:

LLLT was effective in increasing the random skin-flap viability in rats, and the 670 nm laser was efficient in reducing the MDA concentration.

Photomed Laser Surg. 2009 Jun;27(3):411-6. doi: 10.1089/pho.2008.2320.

Effect of application site of low-level laser therapy in random cutaneous flap viability in rats.

Prado RP1, Pinfildi CE, Liebano RE, Hochman BS, Ferreira LM.

Author information

1
Master of Basic Sciences in Plastic Surgery, São Paulo Federal University, São Paulo, SP, Brazil. paschoalrp@hotmail.com

Abstract

OBJECTIVE:

This study aimed to investigate the effect of diode laser (830 nm) irradiation on the viability of ischemic random skin flaps in rats, as well as to determine the most effective site for applying laser radiation to speed healing.

BACKGROUND DATA:

Low-level laser therapy (LLLT) has recently been used to improve the viability of ischemic random skin flaps in rats.

MATERIALS AND METHODS:

Seventy Wistar rats were used and divided into seven groups of 10 rats each: group 1, sham laser treatment; group 2, which received irradiation at 1 point 5 cm from the flap’s cranial base; group 3, which received irradiation at 2 points (5 and 7.5 cm from the flap’s base); group 4, which received irradiation at 3 points (2.5, 5 and 7.5 cm from the flap’s base); group 5, which received irradiation at 1 point 2.5 cm from the flap’s base; group 6, which received irradiation at 2 points (2.5 and 5 cm from the flap’s base); and group 7, which received irradiation at 1 point 7.5 cm from the flap’s base. The animals were subjected to laser therapy at an energy density of 36 J/cm(2) for 72 sec immediately after surgery, and one time on each of the four subsequent days. The percentage of necrotic skin flap area was calculated on the seventh postoperative day using a paper template.

RESULTS:

The results showed that the rats in group 5 had the highest increase in skin flap viability, with a statistically significant difference compared to the other groups. Statistically significant differences were not seen between any of the other groups.

CONCLUSION:

The diode laser was effective in increasing skin flap viability in rats, and laser irradiation of a point 2.5 cm from the cranial base flap was found to be the most effective.

Photomed Laser Surg. 2009 Apr;27(2):337-43. doi: 10.1089/pho.2008.2295.

Effect of low-level laser therapy on mast cells in viability of the transverse rectus abdominis musculocutaneous flap.

Pinfildi CE1, Liebano RE, Hochman BS, Enokihara MM, Lippert R, Gobbato RC, Ferreira LM.

Author information

1
Department of Plastic Surgery and IMES-FAFICA, São Paulo Federal University, São Paulo, SP, Brazil. cepinfildi@hotmail.com

Abstract

OBJECTIVE:

To assess the effect of low-level laser therapy (LLLT) on viability of mast cells of the transverse rectus abdominis musculocutaneous (TRAM) flap.

BACKGROUND DATA:

LLLT has been recently used on the TRAM flap to stimulate mast cells.

MATERIALS AND METHODS:

Eighty-four Wistar rats were randomly divided into seven groups of 12 rats in each: group 1 (sham laser therapy); group 2 received 3 J/cm(2) at one point; group 3 received 3 J/cm(2) at 24 points; group 4 received 72 J/cm(2) at 1 point; group 5 received 6 J/cm(2) at 1 point; group 6 received 6 J/cm(2) at 24 points; and group 7 received 144 J/cm(2) at 1 point. All experimental groups underwent LLLT immediately after TRAM surgery and on the next two following days, for three sessions in total. The percentage of the area of skin flap necrosis was calculated on the fourth postoperative day and two samples of skin were collected from each rat with a 1-cm(2) punch to perform mast cell evaluations with toluidine blue dye.

RESULTS:

Statistically significant differences were found in the percentage of necrosis, and higher values were seen in group 1 than in all other groups. Among groups 3-7 no statistically significant differences were found (p < 0.292). For mast cells, when group 1 was compared to groups 5 (6 J/cm(2) at 1 point) and 7 (144 J/cm(2) at 1 point), it had fewer mast cells.

CONCLUSION:

LLLT at a wavelength of 670 nm was effective at reducing the necrotic area, and we found that it can stimulate mast cells growth to increase vascular perfusion.

Ann Plast Surg. 1985 Mar;14(3):278-83.

Effects of low-power diode lasers on flap survival.

Kami T, Yoshimura Y, Nakajima T, Ohshiro T, Fujino T.

Abstract

We investigated the effect of low-power laser irradiation on the survival of experimental skin flaps in rats. A gallium-aluminum-arsenide diode laser that was developed by the Japan Medical Laser Laboratory was used. The laser power was 15 mW and the wavelength 830 nm. Irradiation was carried out, either before or after flap elevation, in two groups of 20 Wistar strain rats. A third group of 20 rats served as controls. A caudally based skin flap, 3 X 9 cm, was designed on the back of each rat. Laser irradiation therapy was performed for 5 consecutive days for 6 minutes per flap per day, preoperatively in one group and postoperatively in the other. Seven days postoperatively, the survival areas of the flaps were measured and compared. The survival area was increased significantly in both groups receiving laser therapy, probably due to the observed proliferation of blood vessels around the irradiated points and an increase in blood flow.

PMID:
3994272