Skip to main content

Photobiomodulation Improved the First Stages of Wound Healing Process After Abdominoplasty: An Experimental, Double-Blinded, Non-randomized Clinical Trial

Aesthetic Plastic Surgery volume 43, pages 147–154 (2019)Cite this article

Abstract

Background

Photobiomodulation is widely studied for its potential benefits in the wound healing process. Numerous scientific studies have highlighted its effect on various phases of wound repair, but clinical validations are few. This comparative trial aims to evaluate the influence of photobiomodulation on the post-abdominoplasty healing process.

Methods

Seventeen Caucasian women (aged 18–55) who underwent an abdominoplasty were enrolled in this double-blinded, controlled clinical trial. The postoperative scars were divided into two areas; the right side of the scars was treated with ten sessions of photobiomodulation (consisting in three types of wavelengths). The other part of the scars was used as control and did not receive any additional treatment. Clinical assessments of both parts of the scars were scheduled at 1, 6 and 12 months postoperative.

Results

Within six months following surgery, significantly improved quality of the scars on the treated side compared with the untreated side was reported by patients and experienced professionals according to Vancouver Scar Scale, Patient and Observer Scar Assessment Scale (p < 0.05) and standardized photographs (p < 0.05). At 1 year of follow-up, patients observed no differences between the treated and untreated sides of the scars. This suggests that photobiomodulation appears to play an early role in the wound healing process, accelerating the first stages of cicatrization.

Conclusion

This study statistically validates the positive impact of photobiomodulation treatment on the first stages of the postoperative healing process. Carried out on Caucasians participants only, this study should, however, be performed on a more heterogeneous population to definitively confirm these effects on an international population.

Clinical trial registry

Registro Brasileiro de ensaios clínicos: http://www.ensaiosclinicos.gov.br, Trial RBR-49PK78.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3

References

  1. Capon A, Iarmarcovai G, Gonnelli D, Degardin N, Magalon G, Mordon S (2010) Scar prevention using Laser-Assisted Skin Healing (LASH) in plastic surgery. Aesthetic Plast Surg 34(4):438–446

    PubMed  Article  Google Scholar 

  2. Jin R, Huang X, Li H, Yuan Y, Li B, Cheng C, Li Q (2013) Laser therapy for prevention and treatment of pathologic excessive scars. Plast Reconstr Surg 132(6):1747–1758

    CAS  PubMed  Article  Google Scholar 

  3. Kim DH, Ryu HJ, Choi JE, Ahn HH, Kye YC, Seo SH (2014) A comparison of the scar prevention effect between carbon dioxide fractional laser and pulsed dye laser in surgical scars. Dermat Surg 40(9):973–978

    CAS  Article  Google Scholar 

  4. Ojea AR, Madi O, Neto RM, Lima SE, de Carvalho BT, Ojea MJ, Marcos RL, da Silva FS, Zamuner SR, Chavantes MC (2016) Beneficial effects of applying low-level laser therapy to surgical wounds after bariatric surgery. Photomed Laser Surg 34(11):580–584

    PubMed  Article  Google Scholar 

  5. Casanova D, Alliez A, Baptista C, Gonelli D, Lemdjadi Z, Bohbot S (2017) A 1-year follow-up of post-operative scars after the use of a 1210-nm laser-assisted skin healing (LASH) technology: a randomized controlled trial. Aesthet Plast Surg 41:938–948

    CAS  Article  Google Scholar 

  6. de Barros Araújo R Jr., Gonzaga ICA, Fernandes GA, Lima ACG, Cortelazzi PST, de Oliveira RA, Nicolau RA (2018) Low-intensity LED therapy (λ 640 ± 20 nm) on saphenectomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study. Lasers Med Sci 33(1):103–109

    Article  Google Scholar 

  7. Karu T (2006) Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol, B 49(1):1–17

    Article  Google Scholar 

  8. de Freitas LF, Hamblin MR (2017) Proposed mechanisms of photobiomodulation or low-level light therapy. IEEE J Sel Top Quantum Electron 22(3):348–364

    Article  Google Scholar 

  9. Elad S, Arany P, Bensadoun RJ, Epstein JB, Barasch A, Raber-Durlacher J (2018) Photobiomodulation therapy in the management of oral mucositis: search for the optimal clinical treatment parameters. Support Care Cancer 26:3319–3321

    PubMed  Article  Google Scholar 

  10. Khan I, Arany P (2014) Biophysical approaches for oral wound healing: emphasis on photobiomodulation. Adv Wound Care (New Rochelle) 4(12):724–737

    Article  Google Scholar 

  11. Tacon KC, Santos HC, Parente LM, Cunha LC, Lino-Júnior Rde S, Ribeiro-Rotta RF, Tacon FS, Amaral WN (2011) Healing activity of laser InGaAlP (660 nm) in rats. Acta Cir Bras 26(5):373–378

    PubMed  Article  Google Scholar 

  12. Komine N, Ikeda K, Tada K, Hashimoto N, Sugimoto N, Tomita K (2010) Activation of the extracellular signal-regulated kinase signal pathway by light emitting diode irradiation. Lasers Med Sci 25(4):531–537

    PubMed  Article  Google Scholar 

  13. de Moraes JM, de Oliveira Eterno, Mendonça D, Moura VB, Oliveira MA, Afonso CL, Vinaud MC, Bachion MM, de Souza Lino R Jr. (2013) Anti-inflammatory effect of low-intensity laser on the healing of third-degree burn wounds in rats. Lasers Med Sci 28(4):1169–1176

    PubMed  Article  Google Scholar 

  14. Trajano ET, da Trajano LA, Dos Santos Silva MA, Venter NG, de Porto LC, de Fonseca A, Monte-Alto-Costa A (2015) Low-level red laser improves healing of second-degree burn when applied during proliferative phase. Lasers Med Sci 30(4):1297–1304

    PubMed  Article  Google Scholar 

  15. de Medeiros ML, Araújo-Filho I, da Silva EM, de Sousa Queiroz WS, Soares CD, de Carvalho MG, Maciel MA (2017) Effect of low-level laser therapy on angiogenesis and matrix metalloproteinase-2 immunoexpression in wound repair. Lasers Med Sci 32(1):35–43

    PubMed  Article  Google Scholar 

  16. Chaves ME, Araújo AR, Piancastelli AC, Pinotti M (2014) Effects of low-power light therapy on wound healing: LASER × LED. An Bras Dermatol 89(4):616–623

    PubMed  PubMed Central  Article  Google Scholar 

  17. Spitler R, Berns MW (2014) Comparison of laser and diode sources for acceleration of in vitro wound healing by low-levellight therapy. J Biomed Opt 19(3):38001

    PubMed  Article  Google Scholar 

  18. Burland M, Paris L, Quintana P, Bec JM, Diouloufet L, Sar C, Boukhaddaoui H, Charlot B, Braga Silva J, Chammas M, Sieso V, Valmier J, Bardin F (2015) Neurite growth acceleration of adult dorsal root ganglion neurons illuminated by low-level light emitting diode light at 645 nm. J Biophotonics 8(6):480–488

    CAS  PubMed  Article  Google Scholar 

  19. Truong PT, Lee JC, Soer B, Gaul CA, Olivotto IA (2007) Reliability and validity testing of the patient and observer scar assessment scale in evaluating linear scars after breast cancer surgery. Plast Reconstr Surg 119(2):487–494

    CAS  PubMed  Article  Google Scholar 

  20. Martins P, Uebel C, Machado D, Braga Silva J (2011) Uso de células-tronco adultas de tecido adiposo na cicatrização da pele: estudo controlado, randomizado. Rev Bras Cir Plást 26(3):394–401

    Article  Google Scholar 

  21. Winocour J, Gupta V, Ramirez JR, Shack RB, Grotting JC, Higdon KK (2015) Abdominoplasty: risk factors, complication rates, and safety of combined procedure. Plast Reconstr Surg 136(5):597e–606e

    CAS  PubMed  Article  Google Scholar 

  22. Vercelli S, Ferriero G, Sartorio F, Stissi V, Franchignoni F (2009) How to assess postsurgical scars: a review of outcome measures. Disabil Rehabil 31(25):2055–2063

    PubMed  Article  Google Scholar 

  23. Nguyen TA, Feldstein SI, Shumaker PR, Krakowski AC (2015) A review of scar assessment scales. Semin Cutan Med Surg 34(1):28–36

    PubMed  Article  Google Scholar 

  24. Bae SH, Bae YC (2014) Analysis of frequency of use of different scar assessment scales based on the scar condition and treatment method. Arch Plast Surg 41(2):111–115

    PubMed  PubMed Central  Article  Google Scholar 

  25. Bianchi FA, Roccia F, Fiorini P, Berrone S (2010) Use of patient and observer scar assessment scale for evaluation of facial scars treated with self-drying silicone gel. J Craniofac Surg 21(3):719–723

    PubMed  Article  Google Scholar 

  26. Fleisher J, Khalifeh A, Pettker C, Berghella V, Dabbish N, Mackeen AD (2018) Patient satisfaction and cosmetic outcome in a randomized study of cesarean skin closure. J Matern Fetal Neonatal Med 24:1–6

    Google Scholar 

  27. Matiasek J, Kienzl P, Unger LW, Grill C, Koller R, Turk BR (2018) An intra-individual surgical wound comparison shows that octenidine-based hydrogel wound dressing ameliorates scar appearance following abdominoplasty. Int Wound J 15:1–7

    Article  Google Scholar 

Download references

Acknowledgements

There was no funding from either public, private or third sector sources. The company Biolux Medical—France granted the LED devices, and they did not participate in the research protocol, patient’s selection or surgical procedures.

Author information

Affiliations

  1. Plastic Surgery Division of São Lucas Hospital of Pontificia, Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil

    Renato Matta Ramos, Lauren Marquardt Burman, Leticia Manoel Debom & Carlos Oscar Uebel

  2. Biolux Institute, Phare de la méditerranée, 34250, Palavas Les Flots, Montpellier, France

    Marion Burland & Jean Michel Bec

  3. Inserm U1051, University of Montpellier, Montpellier, France

    Marion Burland & Jean Valmier

  4. Hand and Reconstructive Microsurgery Division of São Lucas Hospital of Pontificia, Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil

    Jefferson Braga Silva

  5. School of Medicine, PUCRS University, Montpellier Cedex 5, Montpellier, France

    Jefferson Braga Silva

  6. Universidade Federal de Ciências da Saúde de Porto Alegre, San Isidro, Lima, Peru

    Marco Smiderle Gelain

  7. Inserm U1051., INM, Hôpital St Eloi, University Hospital Center of Montpellier, 80 rue Augustin Fliche, 34091, Montpellier Cedex 5, France

    Mohsen Alirezai & Jean Valmier

  8. Bliss Plastic Surgery, Private Clinic, Libertadores Street. 125. Postal Code: Lima 14, San Isidro Lima, Peru

    Renato Matta Ramos

Authors
  1. Renato Matta Ramos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marion Burland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jefferson Braga Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lauren Marquardt Burman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marco Smiderle Gelain
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leticia Manoel Debom
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jean Michel Bec
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mohsen Alirezai
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Carlos Oscar Uebel
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jean Valmier
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Renato Matta Ramos.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Ramos, R.M., Burland, M., Silva, J.B. et al. Photobiomodulation Improved the First Stages of Wound Healing Process After Abdominoplasty: An Experimental, Double-Blinded, Non-randomized Clinical Trial. Aesth Plast Surg 43, 147–154 (2019). https://doi.org/10.1007/s00266-018-1271-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-018-1271-2

Keywords

  • Wound healing
  • Photobiomodulation
  • Phototherapy
  • Abdominoplasty
  • Surgical scar