Pinheiro Antonio Luiz B, Pozza Daniel Humberto, Oliveira Marilia G de, Weissmann Ruben, Ramalho Luciana Maria Pedreira
Laser Center, School of Dentistry, Federal University of Bahia (UFBA), Bahia, Brazil.
Photomed Laser Surg. 2005 Oct;23(5):485-92. doi: 10.1089/pho.2005.23.485.
This study aimed to describe, through morphologic and cytochemical analysis, the healing process of wounds submitted (or not) to laser therapy (lambda685 nm) or polarized light (lambda400-2000 nm).
There are many reports on different effects of several types of phototherapies on the treatment of distinct conditions, amongst them, on wound healing. Laser therapy and the use of polarized light are still controversial despite successive reports on their positive effects on several biological processes.
Thirty male Wistar rats, approximately 4 months old, were used, and standardized excisional wounds were created on their dorsum. The wounds were irradiated in four equidistant points with laser light or illuminated with polarized light, both with doses of 20 or 40 J/cm2. Group 1 acted as untreated controls. Animals were irradiated every 48 h during 7 days, starting immediately after surgery, and were humanely killed on the 8th post-operative day. Specimens were taken and routinely processed and stained with H&E, and for descriptive analysis of myofibroblasts and collagen fibers, the specimens were imunnomarked by smooth muscle alpha-actin and picrosirius stain.
Control specimens showed the presence of ulceration, hyperemia, discrete edema, intense, and diffuse inflammation, collagen deposition was irregular, and myofibroblasts were seen parallel to the wound margins. Wounds treated by laser therapy with a dose of 20 J/cm2 showed mild hyperemia, inflammation varied from moderate to intense, the number of fibroblasts was large, and the distribution of collagen fibers was more regular. Increasing the dose to 40 J/cm2 evidenced exuberant neovascularization, severe hyperemia, moderate to severe inflammation, large collagen deposition, and fewer myofibroblasts. On subjects illuminated with polarized light with a dose of 20 J/cm2, mild to moderate hyperemia was detectable, and collagen matrix was expressive and unevenly distributed; a larger number of myofibroblasts was present and no re-epithelialization was seen. Increasing the dose resulted in mild to moderate hyperemia, no re-epithelialization was seen, edema was discrete, and inflammation was moderate.
The use of 685-nm laser light or polarized light with a dose of 20 J/cm2 resulted in increased collagen deposition and better organization on healing wounds, and the number of myofibroblast was increased when polarized light is used.
本研究旨在通过形态学和细胞化学分析,描述接受(或未接受)激光治疗(波长685nm)或偏振光(波长400 - 2000nm)的伤口愈合过程。
有许多关于几种光疗法对不同病症治疗的不同效果的报道,其中包括对伤口愈合的影响。尽管有连续报道称激光治疗和偏振光的使用对多种生物学过程有积极作用,但它们仍存在争议。
使用30只约4个月大的雄性Wistar大鼠,在其背部制造标准化切除伤口。在伤口的四个等距点用激光照射或用偏振光照明,剂量均为20或40J/cm²。第1组作为未治疗的对照组。动物在手术后立即开始,每48小时照射一次,持续7天,并在术后第8天进行人道处死。采集标本并进行常规处理,用苏木精和伊红染色,为描述成肌纤维细胞和胶原纤维,标本用平滑肌α - 肌动蛋白和苦味酸天狼星红染色进行免疫标记。
对照标本显示有溃疡、充血、轻微水肿、强烈弥漫性炎症,胶原沉积不规则,可见成肌纤维细胞与伤口边缘平行。用20J/cm²剂量的激光治疗的伤口显示轻度充血,炎症从中度到强烈不等,成纤维细胞数量多,胶原纤维分布更规则。将剂量增加到40J/cm²显示有旺盛的新生血管形成、严重充血、中度至重度炎症、大量胶原沉积和成肌纤维细胞减少。在用20J/cm²剂量的偏振光照亮的受试者中,可检测到轻度至中度充血,胶原基质明显且分布不均匀;存在大量成肌纤维细胞,未见再上皮化。增加剂量导致轻度至中度充血,未见再上皮化,水肿轻微,炎症为中度。
使用波长685nm的激光或20J/cm²剂量的偏振光可增加愈合伤口的胶原沉积并使其排列更有序,使用偏振光时成肌纤维细胞数量增加。