Photobiomodulation laser and pulsed electrical field increase the viability of the musculocutaneous flap in diabetic rats

Abstract

The purpose of this study is to investigate the effect of pulsed electrical field (PEF) and photobiomodulation laser (PBM) on the viability of the TRAM flap in diabetic rats. Fifty Wistar rats were divided into five homogeneous groups: Group 1-control; Group 2-diabetics; Group 3-diabetics + PEF; Group 4-diabetic + laser 660 nm, 10 J/cm, 0.27 J; Group 5-diabetic + laser 660 nm, 140 J/cm, 3.9 J. The percentage of necrotic area was evaluated using software Image J®. The peripheral circulation of the flap was evaluated by infrared thermography FLIR T450sc (FLIR® Systems-Oregon USA). The thickness of the epidermis (haematoxylin-eosin), mast cell (toluidine blue), leukocytes, vascular endothelial growth factor, fibroblast and newly formed blood vessels were evaluated. For the statistical analysis, the Kruskal-Wallis test was applied followed by Dunn and ANOVA test followed by Tukey with critical level of 5% (p < 0.05). The PEF reduced the area of necrosis, decreased the leukocytes, increased the mast cells, increased the thickness of epidermis and increased newly formed blood vessels when it was compared to the untreated diabetic group of animals. Laser 660 nm, fluence 140 J/cm (3.9 J) showed better results than the 10 J/cm (0.27 J) related to reduction of the area of necrosis and the number of leukocytes, increased mast cells, increased thickness of the epidermis, increased vascular endothelial growth factor, increased fibroblast growth factor and increase of newly formed blood vessels in diabetic animals. The laser and pulsed electrical field increase the viability of the musculocutaneous flap in diabetic rats.

The photobiomodulation (658, 830 and 904nm) on wound healing in histomorphometric analysis

“…Although the results of the epidermis presented greater thickness in the group that received 658 nm of radiation, the results were not significant in the epidermis between the groups that received the different wavelengths of the laser therapy or the control group. Conflicting with these results, studies have noted a greater re-epithelialization of the epidermis after applying laser wavelengths between 808 nm to 830 nm in immunosuppressed [18] and diabetic animals [39]. Moreover, Leite et al [39] observed positive results of increased epidermal thickness in radicular cutaneous flap with 660 nm laser therapy with fluency of 140 J/cm 2 .…”

“…Conflicting with these results, studies have noted a greater re-epithelialization of the epidermis after applying laser wavelengths between 808 nm to 830 nm in immunosuppressed [18] and diabetic animals [39]. Moreover, Leite et al [39] observed positive results of increased epidermal thickness in radicular cutaneous flap with 660 nm laser therapy with fluency of 140 J/cm 2 . Different animal models and different wavelength and fluency must explain the different effect observed in this work.…”

Fotobiomodulação com diodos emissores de luz (LED) no espectro vermelho e infravermelho na cicatrização de úlceras de pé diabético: um ensaio clínico randomizado controlado

“…Dessa forma, podem gerar modificações na função e forma da célula, migração e sinalização celular, agindo nas fases da cicatrização, acelerando o processo (DE ALENCAR et al, 2018) Estudos clínicos e experimentais mostram que a fotobiomodulação com comprimento de onda que vão desde do espectro vermelho ao infravermelho (600 -1000 nm), promove a reparação tecidual de feridas crônicas (LANDAU et al, 2011;MATHUR et al, 2017;VITSE et al, 2017), estimulam a angiogênese (CORAZZA et al, 2007;PARK et al, 2015) e síntese de colágeno (LAU et al, 2015), modulam as reações inflamatórias e a proliferação de fibroblastos (XAVIER et al, 2010;SHARIFIAN et al, 2013). Também aumentam a espessura da epiderme, reduz a área de necrose e aumenta o fator de crescimento do endotélio vascular (LEITE et al, 2017).…”