Pilot study in neonates using low-level laser therapy in the immediate postoperative period of myelomeningocele

Abstract

Objective: To analyze the tissue repair behavior after corrective surgical incision in neonates submitted to low-level laser therapy, in an attempt to diminish the incidence of postoperative dehiscence following the surgery for myelomeningocele performed immediately after birth. Methods: It is a prospective pilot study with 13 myelomeningocele patients submitted to surgery at birth who received adjuvant treatment with low-level laser therapy (Group A). Diode laser C.W., λ = 685t nm, p = 21 mW, E = 0.19 J was punctually applied along the surgical incision, summing up 4 to 10 J energy delivered per patient, according to the surgical wound area and, then, compared with the previous results, which were obtained from 23 patients undergoing surgery without laser therapy (Group B). results: This pilot study showed a significant decline in dehiscence of surgical wounds in neonates submitted to low-level laser therapy as compared to controls (7.69 versus 17.39%, respectively), demonstrating this is an effective, safe and noninvasive treatment method. conclusion: This new adjuvant therapeutic proposal with low-level laser therapy aided healing of surgical wounds, preventing morbidities, as well as decreasing hospital stay, which implies cost of reduction for patients and for the institution.Keywords: Infant, newborn; Congenital, hereditary, and neonatal diseases and abnormalities/surgery; Laser therapy, low-level; Surgical wound dehiscence/ prevention & control; Meningomyelocele/surgery; Guided tissue regeneration/methods; Postoperative complications reSUMO Objetivo: Analisar o comportamento da reparação tecidual de incisão cirúrgica corretiva em neonatos submetidos ao laser de baixa intensidade, auxiliando a redução de incidência de deiscência pós-operatória de correção cirúrgica de mielomeningocele realizada imediatamente após o nascimento. Métodos: Estudo piloto, prospectivo, com 13 pacientes operados ao nascimento de mielomeningocele e submetidos ao laser de baixa intensidade como adjuvante. Foi aplicado, ao longo da incisão cirúrgica, o laser de diodo C.W., λ = 685 nm, p = 21 mW, com E = 0,19 J por ponto, totalizando valores de energia entregue por paciente entre 4 e 10 J, de acordo com a área da cicatriz cirúrgica, e comparando com os resultados obtidos previamente de 23 pacientes operados sem a terapia com o laser (Grupo B). resultados: Este estudo revelou significativa redução de deiscências no pós-operatório de neonatos, quando submetidos ao laser de baixa intensidade comparados ao controle (7,69 versus 17,39%, respectivamente), evidenciando ser um método de tratamento eficaz, seguro e não-invasivo. conclusão: Esta nova proposta terapêutica adjuvante com o laser de baixa intensidade auxiliou na reparação tecidual da ferida operatória, evitando morbidades, além de diminuir o tempo de internação, sinalizando possível redução de custos tanto para os pacientes quanto para a instituição.Descritores: Recém-nascido; Doenças congênitas, hereditárias e neonatais e anormalidades/cirurgia; Terapia a laser de baixa i...

Laser-Assisted Management of a Rare Presentation of Peripheral Ossifying Fibroma in an Infant

“…Excision of soft tissue lesions with laser offers better precision, hemostasis, clear operating field, minimal anesthesia, no requirement of sutures, superior patient acceptance, lesser procedure time, reduced healing time, and lower postoperative discomfort [ 10 , 18 , 19 ]. The postoperative requirements of analgesics are usually minimal, and the bactericidal effects of lasers on tissue minimize the need for antibiotics [ 20 ].…”

Terapia a laser de baixa potência na cicatrização de feridas

“…20 It was verified that, in eight articles of this review, the LPLT action is linked to cellular modulation, that is, the final phase of epithelization. 8,11,13,15,17,34 In these studies, there was an important difference in the remodeling of collagen, with improved scar appearance due to maturation and alignment of the fibers, better underlying skin condition and shorter recovery time, and fewer dehiscences. It is noteworthy that laser was an agent that facilitated the healing of acute injuries, such as that of a patient with surgical wound dehiscence due to Bypass, with complete wound healing and pain improvement after nine applications.…”

“…It was pointed out, in a study with patients in the postoperative period of myelomeningocele, a lower incidence of dehiscence when compared to the conventional therapeutic responses. 15 It is known that this effect produces a lower risk of infection in the child's central nervous system and, therefore, better chances of recovery. 15 It was evidenced that there are favorable actions also in chronic wounds, in which one study showed reduction in the dimensions of pressure injury in a patient with paraplegia, with increased epithelial tissue, decreased secretion and odor after conventional therapy plus LPLT.…”

“…15 It is known that this effect produces a lower risk of infection in the child's central nervous system and, therefore, better chances of recovery. 15 It was evidenced that there are favorable actions also in chronic wounds, in which one study showed reduction in the dimensions of pressure injury in a patient with paraplegia, with increased epithelial tissue, decreased secretion and odor after conventional therapy plus LPLT. 8 In a prospective study, improvement in the appearance of the scar and skin condition, reduction of symptoms such as edema, ecchymosis and recovery time after grafting on chronic cervical-facial and contractile atrophic scars in the abdominal region and legs were observed.…”

Evaluación de la relación de los signos y síntomas durante el período de erupción de los dientes primarios

“…1,2 La erupción de los dientes primarios se inicia entre los 4 a 10 meses después del nacimiento, quedando completa con 20 dientes, en general en el 30º mes. [3][4][5] El proceso eruptivo está bajo fuerte control genético con menor influencia de factores ambientales. 6 Ha sido asociado a algunos signos y síntomas que incluyen irritabilidad, irritación gingival, aumento de la salivación, sueño agitado, diarrea, pérdida de apetito y fiebre.…”