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OBJECTIVE: To verify the effectiveness of low-intensity laser therapy (LLLT) on tissue repair following saphenectomy during postoperative period in patients having undergone coronary artery bypass graft (CABG). MATERIALS AND METHODS: A randomized clinical trial, controlled and double-blind study was conducted with 40 volunteers, divided into 2 groups: a placebo group (PG, n = 20) and a laser group (LG, n = 20). The patients in the LG group were irradiated with laser during saphenectomy (InGaAlP, λ 660 nm, energy density 6 J/cm2) daily from the first to the fourth postoperative day. The surgical incision was clinically evaluated and imaged at the beginning and at the end of the treatment. The areas of hematoma and hyperemia were evaluated using the software ImageJ 1.4©, and border closure was evaluated by three researchers, who were blinded concerning the allocation of the participants. RESULTS: The LG group presented a reduction of the areas of hematoma and hyperemia (p = 0.0003) and better border closure (p = 0.009), when compared with the PG group. CONCLUSIONS: The proposed LLLT protocol improved the tissue repair following saphenectomy in CABG patients.

Assuntos

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Myocardial revascularization surgery (CABG) is the most appropriate treatment for coronary artery disease. Currently, the great challenge is to reduce postoperative complications, such as wound infections, dehiscence, pain, and patients' quality of life. The saphenectomy is the target of complications in 10% of cases, which can cause greater morbidity, time, and cost of hospitalization. Studies show that low-intensity laser or light-emitted diode (LED) therapy promotes positive biomodulation of the tissue repair process, culminating in a lower incidence of dehiscence, pain reduction, and improvement in quality of life. The objective of the present study was to evaluate clinically the saphenous tissue repair after LED therapy. Forty subjects of both genders who underwent CABG with extracorporeal circulation were randomly divided into two groups: the placebo (PG) and experimental (EG). The experimental group underwent low-intensity LED therapy (λ 640 ± 20 nm, 6 J/cm2) on saphenectomy. The tissue repair was analyzed by digital photogrammetry on the first and fifth postoperative day. The border closure was blindly evaluated by three researchers. The hematoma and hyperemia area was quantitatively analyzed using ImageJ© software. The results showed that in the experimental group, there were less bleeding points and no dehiscence in saphenectomy, as compared to the placebo group. There was also a smaller area of hematoma and hyperemia in the experimental group (p < 0.0009). These data lead to the conclusion that the type of phototherapy protocol employed can assist in tissue repair.

Assuntos

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BACKGROUND: The aim of this study was to evaluate the efficacy of low-level laser therapy for reducing the acute pain of sternotomy in patients who underwent a coronary artery bypass graft (CABG). METHODS: This study was conducted with ninety volunteers who electively submitted to CABG. The volunteers were randomly allocated into three groups of equal size (n = 30): control, placebo, and laser (λ of 660 nm and spatial average energy fluency of 1.06 J/cm 2 ). Pain when coughing was assessed by a visual analog scale (VAS) and McGill Pain Questionnaire, according to sensory, affective, evaluative, and miscellaneous domains. The patients were followed for 1 month after the surgery. RESULTS: The laser group had a greater decrease in pain with analogous results, as indicated by both the VAS and the McGill questionnaire (P ≤ 0.05) on sensory and affective scores, on days 6 and 8 postsurgery compared to the placebo and control groups. CONCLUSION: Laser seems to be effective promoting pain reduction after coronary-arterial bypass grafting.

Assuntos

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BACKGROUND AND OBJECTIVE: This study aimed at analyzing the healing effects of low-level laser therapy (LLLT) (λ620 nm, 6 J/cm2) and light-emitting diode (LED) therapy (λ640 nm, 6 J/cm2) on the longitudinal sternotomy incisions of hyperglycemic and normoglycemic patients who underwent coronary artery bypass grafting (CABG). MATERIALS AND METHODS: 120 volunteers were electively submitted to CABG and were randomly allocated into four different groups of equal size (n = 30): control, placebo, laser (λ of 640 nm and spatial average energy fluency [SAEF] of 1.06 J/cm2), and LED (λ of 660 ± 20 nm and SAEF of 0.24 J/cm2). Laser and LED groups were irradiated from the second to eighth day postsurgery, and sternotomy incision was photographically registered. Then, participants were also separated into hyperglycemic and normoglycemic groups, according to their fasting blood glucose test before surgery. Three researchers blindly analyzed the incision photographs to determine hyperemia and wound closure at the first day of hospital discharge (eighth postoperative day). RESULTS: LLLT and LED groups had similarly less hyperemia and less incision bleeding or dehiscence (p ≤ 0.005) and the outcomes were also analogous between hyperglycemic and normoglycemic patients, which indicates no difference observed in an intragroup analysis (p ≥ 0.05). CONCLUSIONS: With the present therapy parameters, it may be assumed that both coherent light (laser) and non-coherent light (LED) are effective in promoting sternotomy and healing acceleration, which are evident on the eighth day postsurgery.

Assuntos

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The aim of this study was to analyze the healing effects of low-level laser therapy (LLLT) on the longitudinal sternotomy incisions of patients who underwent coronary artery bypass graft (CABG). The volunteers were randomized into three groups of equal size (n = 30): control, placebo, and laser (λ = 660 nm and spatial average energy fluency [SAEF] = 1.06 J/cm2). The patients in the laser group underwent irradiation on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were photographed immediately after the surgery and 8 days later for analysis. Three researchers who were blinded to the patient treatment groups analyzed the incision photographs to assess hyperemia and wound closure on the day of hospital discharge (eighth postoperative day). The sternotomy incisions in the LLLT group demonstrated less hyperemia, incisional bleeding, and dehiscence (p ≤ 0.005).

Assuntos

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OBJECTIVE: This study aimed to evaluate the efficacy of low-level laser therapy (LLLT) and light-emitting diodes (LEDs) for reducing pain in hyperglycemic and normoglycemic patients who underwent coronary artery bypass surgery with internal mammary artery grafts. METHODS: This study was conducted on 120 volunteers who underwent elective coronary artery bypass graft (CABG) surgery. The volunteers were randomly allocated to four different groups of equal size (n = 30): control, placebo, LLLT [λ = 640 nm and spatial average energy fluence (SAEF) = 1.06 J/cm(2)], and LED (λ = 660 ± 20 nm and SAEF = 0.24 J/cm(2)). Participants were also divided into hyperglycemic and normoglycemic subgroups, according to their fasting blood glucose test result before surgery. The outcome assessed was pain during coughing by a visual analog scale (VAS) and the McGill Pain Questionnaire. RESULTS: The patients were followed for 1 month after the surgery. The LLLT and LED groups showed a greater decrease in pain, with similar results, as indicated by both the VAS and the McGill questionnaire (p ≤ 0.05), on the 6th and 8th postoperative day compared with the placebo and control groups. The outcomes were also similar between hyperglycemic and normoglycemic patients. One month after the surgery, almost no individual reported pain during coughing. CONCLUSIONS: LLLT and LED had similar analgesic effects in hyperglycemic and normoglycemic patients, better than placebo and control groups.

Assuntos

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INTRODUCTION: Low-intensity laser (LILT) and LED therapy are indicated in repairing surgical incisions, which occur in cardiac surgery. One major concern in this case is the presence of metallic wire used for sternal sutures, its temperature may rise while using a laser or LED. This study aimed to analyze the tensiometric properties of the skin tissue with longitudinal incision and metallic wire implant used for sternal suture irradiated with LILT and LED. METHODS: Twenty-five subjects (Rattus norvegicus) were submitted to thoracic incision with implantation of metallic wire, and subsequently divided into five groups: GI (control group); GII (laser group 6J/cm²); GIII (laser group 10J/cm²); GIV (LED group 6 J/cm²); and GV (LED 10J/cm²). Photobiomodulation was performed on a daily basis for eight consecutive days and the local temperature was measured before and after phototherapy. After euthanasia the tissues were subjected to tensiometric and histological analysis. RESULTS: All irradiated groups showed increase in break strength (p = 0.009), and decrease in tissue deformation strength compared with the control group (p = 0.03). CONCLUSION: Both LILT and LED can promote wound healing at the tested doses with increased tissue resistance, although its elasticity is reduced. The imprecision of the assessing instruments precluded an accurate measurement of a possible local tissue heating post irradiation and future studies are need to elucidate this effect.