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

AbstractBackgroundPhotobiomodulation 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.MethodsSeventeen 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.ResultsWithin 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.ConclusionThis 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 registryRegistro Brasileiro de ensaios clínicos: http://www.ensaiosclinicos.gov.br, Trial RBR-49PK78.Level of Evidence IIThis 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.

[1]  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.

[2]  Jefferson Braga Silva,et al.  Adipose tissue mature stem cells in skin healing : a controlled randomized study , 2011 .

[3]  R. Koller,et al.  An intra‐individual surgical wound comparison shows that octenidine‐based hydrogel wound dressing ameliorates scar appearance following abdominoplasty , 2018, International wound journal.

[4]  F. Franchignoni,et al.  How to assess postsurgical scars: A review of outcome measures , 2009 .

[5]  Qingfeng Li,et al.  Laser Therapy for Prevention and Treatment of Pathologic Excessive Scars , 2013, Plastic and reconstructive surgery.

[6]  S. Mordon,et al.  Scar Prevention Using Laser-Assisted Skin Healing (LASH) in Plastic Surgery , 2009, Aesthetic Plastic Surgery.

[7]  J. Epstein,et al.  Photobiomodulation therapy in the management of oral mucositis: search for the optimal clinical treatment parameters , 2018, Supportive Care in Cancer.

[8]  A. Piancastelli,et al.  Effects of low-power light therapy on wound healing: LASER x LED* , 2014, Anais brasileiros de dermatologia.

[9]  S. Berrone,et al.  Use of Patient and Observer Scar Assessment Scale for Evaluation of Facial Scars Treated With Self-Drying Silicone Gel , 2010, The Journal of craniofacial surgery.

[10]  Michael R. Hamblin,et al.  Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy , 2016, IEEE Journal of Selected Topics in Quantum Electronics.

[11]  S. Bae,et al.  Analysis of Frequency of Use of Different Scar Assessment Scales Based on the Scar Condition and Treatment Method , 2014, Archives of plastic surgery.

[12]  B. Chaput,et al.  Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures. , 2016, Plastic and reconstructive surgery.

[13]  P. Arany,et al.  Biophysical Approaches for Oral Wound Healing: Emphasis on Photobiomodulation. , 2015, Advances in wound care.

[14]  H. Ryu,et al.  A Comparison of the Scar Prevention Effect Between Carbon Dioxide Fractional Laser and Pulsed Dye Laser in Surgical Scars , 2014, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[15]  I. Olivotto,et al.  Reliability and Validity Testing of the Patient and Observer Scar Assessment Scale in Evaluating Linear Scars after Breast Cancer Surgery , 2007, Plastic and reconstructive surgery.

[16]  F. Franchignoni,et al.  How to assess postsurgical scars: A review of outcome measures , 2009, Disability and rehabilitation.

[17]  L. C. Pôrto,et al.  Low-level red laser improves healing of second-degree burn when applied during proliferative phase , 2015, Lasers in Medical Science.

[18]  N. Sugimoto,et al.  Activation of the extracellular signal-regulated kinase signal pathway by light emitting diode irradiation , 2010, Lasers in Medical Science.

[19]  Jefferson Braga Silva,et al.  Uso de células-tronco adultas de tecido adiposo na cicatrização da pele: estudo controlado, randomizado , 2011 .

[20]  S. Bohbot,et al.  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 , 2017, Aesthetic Plastic Surgery.

[21]  R. Nicolau,et al.  Low-intensity LED therapy (λ 640 ± 20 nm) on saphenectomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study , 2017, Lasers in Medical Science.

[22]  Michael W Berns,et al.  Comparison of laser and diode sources for acceleration of in vitro wound healing by low-level light therapy , 2014, Journal of biomedical optics.

[23]  M. M. Bachion,et al.  Anti-inflammatory effect of low-intensity laser on the healing of third-degree burn wounds in rats , 2013, Lasers in Medical Science.

[24]  B. Charlot,et al.  Neurite growth acceleration of adult Dorsal Root Ganglion neurons illuminated by low‐level Light Emitting Diode light at 645 nm , 2015, Journal of biophotonics.

[25]  R. OjeaAlecsander,et al.  Beneficial Effects of Applying Low-Level Laser Therapy to Surgical Wounds After Bariatric Surgery. , 2016 .

[26]  R. Shack,et al.  Abdominoplasty: Risk Factors, Complication Rates, and Safety of Combined Procedures , 2015, Plastic and reconstructive surgery.

[27]  M. G. Carvalho,et al.  Effect of low-level laser therapy on angiogenesis and matrix metalloproteinase-2 immunoexpression in wound repair , 2016, Lasers in Medical Science.

[28]  R. Ribeiro-Rotta,et al.  Healing activity of laser InGaAlP (660nm) in rats. , 2011, Acta cirurgica brasileira.

[29]  S. Feldstein,et al.  A review of scar assessment scales. , 2015, Seminars in cutaneous medicine and surgery.

[30]  R. L. Marcos,et al.  Beneficial Effects of Applying Low-Level Laser Therapy to Surgical Wounds After Bariatric Surgery. , 2016, Photomedicine and laser surgery.