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

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

Author Pinfildi, Carlos Eduardo Autor UNIFESP Google Scholar
Hochman, Bernardo S. Autor UNIFESP Google Scholar
Nishioka, Michele Akemi Autor UNIFESP Google Scholar
Sheliga, Tatiana Rodrigues Autor UNIFESP Google Scholar
Invaldi Neves, Marco Aurelio Autor UNIFESP Google Scholar
Liebano, Richard Eloin Autor UNIFESP Google Scholar
Ferreira, Lydia Masako Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Low-level 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 laser treatment; 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.
Keywords Phototherapy
Low-level laser therapy
Physical therapy
VEGF
Dosimetry
Plastic surgery
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Date 2013-05-01
Published in Lasers in Medical Science. London: Springer London Ltd, v. 28, n. 3, p. 755-761, 2013.
ISSN 0268-8921 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 755-761
Origin http://dx.doi.org/10.1007/s10103-012-1130-3
Access rights Closed access
Type Article
Web of Science ID WOS:000318184600008
URI http://repositorio.unifesp.br/handle/11600/36276

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