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

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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/cm2 at 1 point; group 3, 3 J/cm2 at 24 points; group 4, 72 J/cm2 at 1 point; group 5, 6 J/cm2 at 1 point; group 6, 6 J/cm2 at 24 points; and group 7, 144 J/cm2 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-cm2 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/cm2 was efficient to increase angiogenesis and VEGF levels and promote viability in TRAM flaps in rats.

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Acknowledgments

The authors gratefully acknowledge funding from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.

Conflict of interest

I have no conflict of interest.

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Authors and Affiliations

  1. Department of Science of Human Movement, University Federal of São Paulo—UNIFESP, Campus Baixada Santista, Santos, São Paulo, Brazil

    Carlos Eduardo Pinfildi

  2. Department of Plastic Surgery, Universidade Federal de São Paulo—UNIFESP, São Paulo, Brazil

    Carlos Eduardo Pinfildi, Bernardo S. Hochman, Michele Akemi Nishioka, Tatiana Rodrigues Sheliga, Marco Aurélio Invaldi Neves, Richard Eloin Liebano & Lydia Masako Ferreira

  3. Alm. Saldanha da Gama Av, 89 Ponta da Praia, Santos, São Paulo, 11030-400, Brazil

    Carlos Eduardo Pinfildi

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  1. Carlos Eduardo Pinfildi
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  2. Bernardo S. Hochman
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  3. Michele Akemi Nishioka
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  4. Tatiana Rodrigues Sheliga
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  5. Marco Aurélio Invaldi Neves
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  6. Richard Eloin Liebano
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  7. Lydia Masako Ferreira
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Correspondence to Carlos Eduardo Pinfildi.

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Pinfildi, C.E., Hochman, B.S., Nishioka, M.A. et al. What is better in TRAM flap survival: LLLT single or multi-irradiation?. Lasers Med Sci 28, 755–761 (2013). https://doi.org/10.1007/s10103-012-1130-3

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  • DOI: https://doi.org/10.1007/s10103-012-1130-3

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