What is better in TRAM flap survival: LLLT single or multi-irradiation?
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.
Department of Science of Human Movement, University Federal of São Paulo-UNIFESP, Campus Baixada Santista, Santos, São Paulo, Brazil. cepinfildi@hotmail.com
Carlos Eduardo
CE
Pinfildi
Bernardo S
BS
Hochman
Michele Akemi
MA
Nishioka
Tatiana Rodrigues
TR
Sheliga
Marco Aurélio Invaldi
MA
Neves
Richard Eloin
RE
Liebano
Lydia Masako
LM
Ferreira
D000199:Actins / Q000378:metabolism; D000818:Animals; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D009336:Necrosis; D018919:Neovascularization, Physiologic / Q000528:radiation effects; D051381:Rats; D017208:Rats, Wistar; D017568:Rectus Abdominis / Q000098:blood supply / Q000528:radiation effects* / Q000637:transplantation*; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D000199:Actins; D042461:Vascular Endothelial Growth Factor A; C498862:Acta2 protein, rat; C467498:vascular endothelial growth factor A, rat