Pinheiro Antonio Luiz Barbosa, Meireles Gyselle Cynthia Silva, de Barros Vieira Alessandro Leonardo, Almeida Darcy, Carvalho Carolina Montagn, dos Santos Jean Nunes
Laser Center, School of Dentistry, Federal University of Bahia, Salvador, BA, Brazil.
Braz Dent J. 2004;15 Spec No:SI21-8.
A wound represents the interruption of the continuity of tissue that is followed by damage or cellular death. Wound healing occurs due to a competitive mechanism between the synthesis and lysis of collagen. Any factor that increases collagen lysis or reduces its synthesis may result in changes in the healing process, i.e., nutritional deficiencies. Phototherapies have been suggested as an effective method to improve wound healing. This study evaluated, histologically, the differences in the healing of cutaneous wounds in nourished and undernourished rats following laser therapy or illumination by polarized light. Fifty nourished or undernourished Wistar rats had a standardized wound created on the dorsum and were divided into 6 subgroups: Group 1--Control (Standard diet; n=5); Group 2--Control (DBR; n=5); Group 3--Standard diet + laser therapy (lambda635nm; 20J/cm2, n=5; or 40J/cm2, n=5); Group 4--Standard diet + Bioptron (lambda400-2000nm; 20J/cm2, n=5; or 40 J/cm2, n=5); Group 5--DBR + laser therapy (lambda635nm; 20J/cm2, n=5; or 40J/cm2, n=5); Group 6--DBR + Bioptron (lambda400-2000nm; 20J/cm2, n=5; or 40 J/cm2, n=5). The first application of the treatment was carried out immediately after surgery and repeated every 24 h during 7 days. Specimens were routinely processed (wax, cut and stained with H&E and Picrosirius stain) and analyzed under light microscopy. Analysis included re-epithelization, inflammatory infiltrate, and fibroblastic proliferation. Picrosirius stained slides were used to perform descriptive analysis of the collagen fibers. The results showed the best results for nourished and undernourished groups treated with polarized light at a dose of 20J/cm2 and the undernourished groups irradiated with the laser light. It is concluded that the nutritional status influenced the progression of the healing process as well as the quality of the healed tissue and that the use of both modalities of phototherapy resulted in a positive biomodulatory effect in both nourished and undernourished subjects. The effect of the polarized light was more evident in nourished subjects and laser therapy more effective in the treatment of undernourished subjects, in both cases with a dose of 20J/cm2.
伤口代表组织连续性的中断,随后会发生损伤或细胞死亡。伤口愈合是由于胶原蛋白合成与分解之间的竞争机制所致。任何增加胶原蛋白分解或减少其合成的因素都可能导致愈合过程发生变化,即营养缺乏。光疗法已被认为是促进伤口愈合的有效方法。本研究从组织学角度评估了激光疗法或偏振光照射后,营养良好和营养不良大鼠皮肤伤口愈合情况的差异。五十只营养良好或营养不良的Wistar大鼠在背部制造标准伤口,并分为6个亚组:第1组——对照组(标准饮食;n = 5);第2组——对照组(DBR;n = 5);第3组——标准饮食 + 激光疗法(波长635nm;20J/cm²,n = 5;或40J/cm²,n = 5);第4组——标准饮食 + 生物光子治疗仪(波长400 - 2000nm;20J/cm²,n = 5;或40J/cm²,n = 5);第5组——DBR + 激光疗法(波长635nm;20J/cm²,n = 5;或40J/cm²,n = 5);第6组——DBR + 生物光子治疗仪(波长400 - 2000nm;20J/cm²,n = 5;或40J/cm²,n = 5)。治疗的首次应用在手术后立即进行,并在7天内每24小时重复一次。标本常规处理(包埋、切片并用苏木精 - 伊红和天狼星红染色),并在光学显微镜下分析。分析包括再上皮化、炎性浸润和成纤维细胞增殖。用天狼星红染色的玻片对胶原纤维进行描述性分析。结果显示,接受20J/cm²剂量偏振光治疗的营养良好和营养不良组以及接受激光照射的营养不良组效果最佳。结论是,营养状况影响愈合过程的进展以及愈合组织的质量,并且两种光疗法在营养良好和营养不良的受试者中均产生了积极的生物调节作用。在剂量为20J/cm²的情况下,偏振光的效果在营养良好的受试者中更明显,而激光疗法在治疗营养不良的受试者中更有效。