Department of Science of Human Movement, University Federal of São Paulo-UNIFESP, Campus Baixada Santista, Santos, São Paulo, Brazil.
Lasers Med Sci. 2013 May;28(3):755-61. doi: 10.1007/s10103-012-1130-3. Epub 2012 Jun 22.
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.
低水平激光疗法（LLLT）已被用于提高皮肤和肌皮瓣的血管灌注。本研究评估了 LLLT 对横行腹直肌肌皮瓣（TRAM）活力、血管生成和 VEGF 释放的影响。84 只 Wistar 大鼠随机分为 7 组，每组 12 只。第 1 组接受假激光治疗；第 2 组，1 点 3 J/cm(2)；第 3 组，24 点 3 J/cm(2)；第 4 组，1 点 72 J/cm(2)；第 5 组，1 点 6 J/cm(2)；第 6 组，24 点 6 J/cm(2)；第 7 组，1 点 144 J/cm(2)。所有实验组均在 TRAM 手术后立即接受 LLLT，并在接下来的 2 天内接受治疗；因此，动物接受了 3 天的治疗。术后第 4 天，采用纸模板法计算皮瓣坏死面积的百分比，并采集 2 个 1cm(2)的皮肤样本，以评估血管中的α平滑肌肌动蛋白（1A4）和 VEGF 水平。坏死百分比有显著差异，第 1 组的坏死百分比高于其他组。组 3 至 7 之间无统计学差异（p<0.292）。组 5 和 7 的 VEGF 水平明显高于其他组。与其他组相比，组 3 和 5 的血管水平增加。能量密度为 6 至 144 J/cm(2)的 LLLT 可有效增加血管生成和 VEGF 水平，提高大鼠 TRAM 皮瓣的活力。
