Effects of low-power light therapy on wound healing: LASER x LED*

Several studies demonstrate the benefits of low-power light therapy on wound healing. However, the use of LED as a therapeutic resource remains controversial. There are questions regarding the equality or not of biological effects promoted by LED and LASER. One objective of this review was to determine the biological effects that support the use of LED on wound healing. Another objective was to identify LED´s parameters for the treatment of wounds. The biological effects and parameters of LED will be compared to those of LASER. Literature was obtained from online databases such as Medline, PubMed, Science Direct and Scielo. The search was restricted to studies published in English and Portuguese from 1992 to 2012. Sixty-eight studies in vitro and in animals were analyzed. LED and LASER promote similar biological effects, such as decrease of inflammatory cells, increased fibroblast proliferation, stimulation of angiogenesis, granulation tissue formation and increased synthesis of collagen. The irradiation parameters are also similar between LED and LASER. The biological effects are dependent on irradiation parameters, mainly wavelength and dose. This review elucidates the importance of defining parameters for the use of light devices.

[1]  L. Lilge,et al.  A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources , 2003 .

[2]  C. Pinfildi,et al.  LED (660 nm) and laser (670 nm) use on skin flap viability: angiogenesis and mast cells on transition line , 2012, Lasers in Medical Science.

[3]  C. Enwemeka,et al.  Laser photostimulation accelerates wound healing in diabetic rats , 2001, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[4]  Noel T. Whelan,et al.  Effect of NASA light-emitting diode irradiation on wound healing. , 2001, Journal of clinical laser medicine & surgery.

[5]  Kenneth A. Arndt,et al.  Low‐Level Laser Therapy for Wound Healing: Mechanism and Efficacy , 2005, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[7]  I. F. L. Dias,et al.  Efeitos da luz em sistemas biológicos. , 2009 .

[8]  Vanderlei Salvador Bagnato,et al.  Photobiomodulation on the angiogenesis of skin wounds in rats using different light sources. , 2007, Photomedicine and laser surgery.

[9]  J. Naim,et al.  Effects of photostimulation on wound healing in diabetic mice , 1997, Lasers in surgery and medicine.

[10]  T. Karu,et al.  Exact action spectra for cellular responses relevant to phototherapy. , 2005, Photomedicine and laser surgery.

[11]  O. Kim,et al.  Effects of 635nm light‐emitting diode irradiation on angiogenesis in CoCl2‐exposed HUVECs , 2011, Lasers in surgery and medicine.

[12]  H. Abrahamse,et al.  Influence of broad-spectrum and infrared light in combination with laser irradiation on the proliferation of wounded skin fibroblasts. , 2007, Photomedicine and laser surgery.

[13]  R P Franke,et al.  Biostimulatory windows in low-intensity laser activation: lasers, scanners, and NASA's light-emitting diode array system. , 2001, Journal of clinical laser medicine & surgery.

[14]  Martha Simões Ribeiro,et al.  Effects of low-intensity polarized visible laser radiation on skin burns: a light microscopy study. , 2004, Journal of clinical laser medicine & surgery.

[15]  H. Abrahamse,et al.  Effect of multiple exposures of low-level laser therapy on the cellular responses of wounded human skin fibroblasts. , 2006, Photomedicine and laser surgery.

[16]  M. Ribeiro,et al.  Ultrastructural and autoradiographical analysis show a faster skin repair in He-Ne laser-treated wounds. , 2007, Journal of photochemistry and photobiology. B, Biology.

[17]  J. Rigau,et al.  Comparison of the low level laser therapy effects on cultured human gingival fibroblasts proliferation using different irradiance and same fluence * , 2001, Lasers in surgery and medicine.

[18]  G. Reddy.  Comparison of the photostimulatory effects of visible He-Ne and infrared Ga-As lasers on healing impaired diabetic rat wounds. , 2003, Lasers in surgery and medicine.

[19]  A. Schindl,et al.  Low-intensity laser therapy: a review. , 2000, Journal of investigative medicine : the official publication of the American Federation for Clinical Research.

[20]  S. Reis,et al.  The influence of low-level laser therapy on biomodulation of collagen and elastic fibers. , 2003, Pesquisa odontologica brasileira = Brazilian oral research.

[21]  M. M. Sarandy,et al.  Effect of gallium-arsenide laser, gallium-aluminum-arsenide laser and healing ointment on cutaneous wound healing in Wistar rats. , 2010, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[22]  S. Reis,et al.  Influence of laser photobiomodulation upon connective tissue remodeling during wound healing. , 2008, Journal of photochemistry and photobiology. B, Biology.

[23]  Y. Koyama,et al.  The effect of low reactive-level laser therapy (LLLT) with helium-neon laser on operative wound healing in a rat model. , 2007, The Journal of veterinary medical science.

[24]  Satoshi Itami,et al.  Green light emitting diodes accelerate wound healing: Characterization of the effect and its molecular basis in vitro and in vivo , 2012, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[25]  Iandara Schettert Silva,et al.  Analysis of the influence of low-power HeNe laser on the healing of skin wounds in diabetic and non-diabetic rats. , 2006, Acta cirurgica brasileira.

[26]  V S Letokhov,et al.  Comparison of the effects of visible femtosecond laser pulses and continuous wave laser radiation of low average intensity on the clonogenicity of Escherichia coli. , 1991, Journal of photochemistry and photobiology. B, Biology.

[27]  A. Pinheiro,et al.  Effect of LED phototherapy of three distinct wavelengths on fibroblasts on wound healing: a histological study in a rodent model. , 2010, Photomedicine and laser surgery.

[28]  Yasutaka Nakamura,et al.  Low Power Laser Therapy , 1986 .

[29]  O. Sorițău,et al.  Influence of three laser wavelengths on human fibroblasts cell culture , 2013, Lasers in Medical Science.

[30]  Patrícia M. do Nascimento,et al.  A preliminary report on the effect of laser therapy on the healing of cutaneous surgical wounds as a consequence of an inversely proportional relationship between wavelength and intensity: histological study in rats. , 2004, Photomedicine and laser surgery.

[31]  Tiina I. Karu,et al.  Photobiological fundamentals of low-power laser therapy , 1987 .

[32]  Ying-ying Huang,et al.  Low-level laser therapy: an emerging clinical paradigm , 2009 .

[33]  • Epidermis,et al.  WOUND healing. , 1959, The Medical journal of Australia.

[34]  R. Kirsner,et al.  Protocol for the successful treatment of venous ulcers. , 2004, American journal of surgery.

[35]  S. Molitor,et al.  Effects of near‐infrared laser exposure in a cellular model of wound healing , 2009, Photodermatology, photoimmunology & photomedicine.

[36]  Q. Ren,et al.  Investigation of irradiation by different nonablative lasers on primary cultured skin fibroblasts , 2011, Clinical and experimental dermatology.

[37]  E. Munin,et al.  Comparative analysis of coherent light action (laser) versus non-coherent light (light-emitting diode) for tissue repair in diabetic rats , 2009, Lasers in Medical Science.

[38]  E. Mester,et al.  Lasers in clinical practice. , 1968, Acta chirurgica Academiae Scientiarum Hungaricae.

[39]  A. Khojasteh,et al.  The effect of He-Ne and Ga-Al-As laser light on the healing of hard palate mucosa of mice , 2012, Lasers in Medical Science.

[40]  R. V. Gonçalves,et al.  Comparative study of the effects of gallium-aluminum-arsenide laser photobiomodulation and healing oil on skin wounds in wistar rats: a histomorphometric study. , 2010, Photomedicine and laser surgery.

[41]  S. H. Mandelbaum,et al.  Cicatrization: current concepts and auxiliary resources - Part II , 2003 .

[42]  Saif D. Salman,et al.  Low level diode laser accelerates wound healing , 2013, Lasers in Medical Science.

[43]  H Abrahamse,et al.  Biological effects of helium-neon laser irradiation on normal and wounded human skin fibroblasts. , 2005, Photomedicine and laser surgery.

[44]  T. Karu,et al.  Primary and secondary mechanisms of action of visible to near-IR radiation on cells. , 1999, Journal of photochemistry and photobiology. B, Biology.

[45]  J. N. dos Santos,et al.  Healing of surgical wounds made with lambda970-nm diode laser associated or not with laser phototherapy (lambda655 nm) or polarized light (lambda400-2000 nm). , 2010, Photomedicine and laser surgery.

[46]  A. Hussein,et al.  Effects of a low level laser on the acceleration of wound healing in rabbits , 2011, North American journal of medical sciences.

[47]  Ta Chih Cheng,et al.  Light-emitting diodes--Their potential in biomedical applications , 2010 .

[48]  A. Pinheiro,et al.  Effectiveness of laser photobiomodulation at 660 or 780 nanometers on the repair of third-degree burns in diabetic rats. , 2008, Photomedicine and laser surgery.

[49]  T. Karu,et al.  Changes in oxidative metabolism of murine spleen following laser and superluminous diode (660–950 nm) irradiation: Effects of cellular composition and radiation parameters , 1993, Lasers in surgery and medicine.

[50]  K. Cutting.  Electric stimulation in the treatment of chronic wounds , 2006 .

[51]  Maria Cristina Teixeira Cangussu,et al.  Laser and LED phototherapies on angiogenesis , 2013, Lasers in Medical Science.

[52]  K. Tomita,et al.  Effect of polarized light emitting diode irradiation on wound healing. , 2009, The Journal of trauma.

[53]  C. Enwemeka.  The place of coherence in light induced tissue repair and pain modulation. , 2006, Photomedicine and laser surgery.

[54]  Tiina I. Karu,et al.  The science of low-power laser therapy , 1998 .

[55]  E. Purón,et al.  [Evaluation of motor and sensory neuroconduction of the median nerve in patients with carpal tunnel syndrome treated with non-coherent light emitted by gallium arsenic diodes]. , 2001, Revista de neurologia.

[56]  D. Machado,et al.  Effect of low-level laser therapy on inflammatory reactions during wound healing: comparison with meloxicam. , 2007, Photomedicine and Laser Surgery.

[57]  M. L. Polacow,et al.  Effect of laser (670 nm) on healing of wounds covered with occlusive dressing: a histologic and biomechanical analysis. , 2010, Photomedicine and laser surgery.

[58]  Milene da Silva Melo,et al.  Comparison between wound healing in induced diabetic and nondiabetic rats after low-level laser therapy. , 2006, Photomedicine and laser surgery.

[59]  Istvan Stadler,et al.  Reciprocity of exposure time and irradiance on energy density during photoradiation on wound healing in a murine pressure ulcer model , 2007, Lasers in surgery and medicine.

[60]  Andrew Burd,et al.  Biostimulation of dermal fibroblast by sublethal Q-switched Nd:YAG 532 nm laser: collagen remodeling and pigmentation. , 2005, Journal of photochemistry and photobiology. B, Biology.

[61]  M. Ribeiro,et al.  The influence of red laser irradiation timeline on burn healing in rats , 2013, Lasers in Medical Science.

[62]  R. Waynant,et al.  Photobiomodulation improves cutaneous wound healing in an animal model of type II diabetes. , 2004, Photomedicine and laser surgery.

[63]  M. Güngörmüş,et al.  Effect of biostimulation on wound healing in diabetic rats. , 2009, Photomedicine and laser surgery.

[64]  T. Karu,et al.  [Molecular mechanism of the therapeutic effect of low-intensity laser irradiation]. , 1986, Doklady Akademii nauk SSSR.

[65]  C. Figueira,et al.  Effect of 670-nm laser therapy and dexamethasone on tissue repair: a histological and ultrastructural study. , 2008, Photomedicine and laser surgery.

[66]  Antonio L. B. Pinheiro,et al.  Effect of laser and LED phototherapies on the healing of cutaneous wound on healthy and iron-deficient Wistar rats and their impact on fibroblastic activity during wound healing , 2013, Lasers in Medical Science.

[67]  M. Ribeiro,et al.  Effects of a single near-infrared laser treatment on cutaneous wound healing: biometrical and histological study in rats. , 2007, Journal of photochemistry and photobiology. B, Biology.

[68]  R. Geronemus,et al.  Clinical trial of a novel non‐thermal LED array for reversal of photoaging: Clinical, histologic, and surface profilometric results , 2005, Lasers in surgery and medicine.

[69]  P. Gál,et al.  Effects of equal daily doses delivered by different power densities of low-level laser therapy at 670 nm on open skin wound healing in normal and corticosteroid-treated rats: a brief report , 2010, Lasers in Medical Science.

[70]  M. D. Lucroy,et al.  Effect of wavelength on low‐intensity laser irradiation‐stimulated cell proliferation in vitro , 2005, Lasers in surgery and medicine.

[71]  H. Abrahamse,et al.  In vitro exposure of wounded diabetic fibroblast cells to a helium-neon laser at 5 and 16 J/cm2. , 2007, Photomedicine and laser surgery.

[72]  Heinz Redl,et al.  Light therapy by blue LED improves wound healing in an excision model in rats. , 2011, Injury.

[73]  H. Abrahamse,et al.  Laser light influences cellular viability and proliferation in diabetic-wounded fibroblast cells in a dose- and wavelength-dependent manner , 2007, Lasers in Medical Science.

[74]  V. Bagnato,et al.  In Vitro Wound Healing Improvement by Low-Level Laser Therapy Application in Cultured Gingival Fibroblasts , 2012, International journal of dentistry.

[75]  R. D. Aydos,et al.  Influence of ingaalp laser (660nm) on the healing of skin wounds in diabetic rats. , 2010, Acta cirurgica brasileira.

[76]  Marcus Vinicius De Mello Pinto,et al.  Time-dependent effects of low-level laser therapy on the morphology and oxidative response in the skin wound healing in rats , 2013, Lasers in Medical Science.

[77]  L. E. Volpato,et al.  Viability of fibroblasts cultured under nutritional stress irradiated with red laser, infrared laser, and red light-emitting diode. , 2011, Journal of biomedical optics.

[78]  Alena R A P Medrado,et al.  Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts , 2003, Lasers in surgery and medicine.

[79]  D. Cambier,et al.  Increased fibroblast proliferation induced by light emitting diode and low power laser irradiation , 2003, Lasers in Medical Science.

[80]  H. Abrahamse,et al.  Low-intensity laser irradiation stimulates wound healing in diabetic wounded fibroblast cells (WS1). , 2010, Diabetes technology & therapeutics.

[81]  T. Karu,et al.  Cellular effects of low power laser therapy can be mediated by nitric oxide , 2005, Lasers in surgery and medicine.

[82]  Pramod Kumar,et al.  Effect of low intensity helium-neon (He-Ne) laser irradiation on diabetic wound healing dynamics. , 2005, Photomedicine and laser surgery.

[83]  Seong Hwan Kim,et al.  Low level light therapy by Red–Green–Blue LEDs improves healing in an excision model of Sprague–Dawley rats , 2012, Personal and Ubiquitous Computing.

[84]  D. Cambier,et al.  Green light emitting diode irradiation enhances fibroblast growth impaired by high glucose level. , 2005, Photomedicine and laser surgery.

[85]  E. Fred Schubert,et al.  Light Emitting Diodes , 1987 .

[86]  Cho-Pei Jiang,et al.  In vitro observations on the influence of copper peptide aids for the LED photoirradiation of fibroblast collagen synthesis. , 2007, Photomedicine and laser surgery.

[87]  A. Piryaei,et al.  Effect of low-level laser therapy on skin fibroblasts of streptozotocin-diabetic rats. , 2007, Photomedicine and laser surgery.

[88]  T. Watson,et al.  Transmission of Therapeutic Ultrasound by Wound Dressings. , 2007, Wounds : a compendium of clinical research and practice.

[89]  Maria Helena Sant Ana Mandelbaum,et al.  Cicatrização: conceitos atuais e recursos auxiliares - Parte I , 2003 .

[90]  R Lubart,et al.  Effects of visible and near-infrared lasers on cell cultures. , 1992, Journal of photochemistry and photobiology. B, Biology.

[91]  Ricardo Aurino Pinho,et al.  Effects of low-power laser irradiation (LPLI) at different wavelengths and doses on oxidative stress and fibrogenesis parameters in an animal model of wound healing , 2010, Lasers in Medical Science.

[92]  Márcia Martins Marques,et al.  Effect of low‐power laser irradiation on cell growth and procollagen synthesis of cultured fibroblasts , 2002, Lasers in surgery and medicine.