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使用波长970纳米二极管激光制造的手术伤口的愈合情况,该激光与或不与激光光疗(波长655纳米)或偏振光(波长400 - 2000纳米)联合使用。

Healing of surgical wounds made with lambda970-nm diode laser associated or not with laser phototherapy (lambda655 nm) or polarized light (lambda400-2000 nm).

作者信息

Medeiros Juliana L, Nicolau Renata A, Nicola Ester M D, dos Santos Jean N, Pinheiro Antonio L B

机构信息

Center of Biophotonics, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.

出版信息

Photomed Laser Surg. 2010 Aug;28(4):489-96. doi: 10.1089/pho.2009.2592.

Abstract

OBJECTIVE

The aim of this study was to analyze the effect of two phototherapies, laser and polarized light, on diode laser (970lambda nm) wounds.

BACKGROUND DATA

Lasers have been used in surgery, and some wavelengths may cause thermal damage to the tissue and affect healing. Several studies have shown that some wavelengths are effective in improving healing. Coherent and noncoherent light have been successfully used on the modulation of biological phenomena of several origins.

ANIMALS AND METHODS

Thirty-one Wistar rats were divided into 3 groups (GI to GIII). A 20-mm x 2-mm wound was created on the dorsum of each animal with a diode laser (Sirolaser, Sirona, Bensheim, Germany). Group GI acted as control. On GII, laser light (lambda655 nm, 30 mW, phi approximately 3 mm, 12 J/cm(2)) was used and on GIII illumination with polarized light (lambda400-2000 nm, 40 mW, phi approximately 5.5 cm, 12 J/cm(2)) was used, every other day (GII) or daily (GIII) for 7 days. The animals were killed at 0, 7, and 14 days after surgery. Specimens were taken, routinely processed, stained and imunnomarked [HE (hematoxylin-eosin), sirius red, alpha-smooth muscle actin (SMA)], and underwent histological analysis.

RESULTS

GII showed better response at day 14 when re-epithelialization was in a more advanced stage. The number of myofibroblasts was significantly different over the healing time (7 to 14 days); this number was smaller than that observed on G1. On GIII at day 7, the number of myofibroblasts was significantly higher than for GII. At day 14, a more pronounced deposition of collagen matrix was also seen, and inflammation was discrete and more advanced for GIII.

CONCLUSION

The results of the present study showed that the effect of the use of laser light was more evident at early stages of healing and that the use of polarized light improved the resolution of the inflammatory reaction, increased the deposition of collagen, increased the number of myofibroblasts, and quickened re-epithelialization during the experimental time.

摘要

目的

本研究旨在分析激光和偏振光两种光疗法对二极管激光(970λ纳米)所致伤口的影响。

背景资料

激光已应用于外科手术,某些波长可能会对组织造成热损伤并影响愈合。多项研究表明,某些波长在促进愈合方面是有效的。相干光和非相干光已成功用于调节多种来源的生物现象。

动物与方法

31只Wistar大鼠被分为3组(GI至GIII)。用二极管激光(德国本斯海姆西诺德公司的Sirolaser)在每只动物的背部制造一个20毫米×2毫米的伤口。GI组作为对照组。GII组使用激光(波长655纳米,30毫瓦,光斑直径约3毫米,能量密度12焦/平方厘米),GIII组使用偏振光(波长400 - 2000纳米,40毫瓦,光斑直径约5.5厘米,能量密度12焦/平方厘米),GII组每隔一天、GIII组每天照射,持续7天。在术后0、7和14天处死动物。取标本,常规处理、染色并进行免疫标记[苏木精 - 伊红(HE)染色、天狼星红染色、α - 平滑肌肌动蛋白(SMA)染色],然后进行组织学分析。

结果

在第14天时,GII组表现出更好的反应,此时再上皮化处于更 advanced 阶段。在愈合过程中(7至14天),肌成纤维细胞的数量有显著差异;该数量比G1组观察到的要少。在第7天时,GIII组的肌成纤维细胞数量显著高于GII组。在第14天时,还观察到GIII组的胶原基质沉积更为明显,炎症轻微且更为 advanced。

结论

本研究结果表明,激光在愈合早期的作用更为明显,而偏振光的使用改善了炎症反应的消退,增加了胶原沉积,增加了肌成纤维细胞的数量,并在实验期间加快了再上皮化。

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