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Avaliou-se qualitativa e quantitativamente (área em cm² e índicede cicatrização da úlcera - ICU) o uso da terapia a laser de baixapotência (LBP) associada à drenagem linfática manual (DLM) noreparo de úlceras de pele. Utilizaram-se dois protocolos de laser,o PI (0,0035W) aplicado em três pacientes e o PII (0,04W) emum paciente. Após assepsia da pele e DLM, foi aplicado laser semcontato, sequencial sobre a úlcera com área do feixe = 0,1cm², 3 x/semana, durante 16 semanas. O número de pontos foi calculadoindividualmente sendo, área/0,5 cm² para o PI e área/0,1 cm² parao PII. Seguem os parâmetros distintos para o PI e PII, respectivamente:energia radiante 0,28J e 0,48 J; irradiância 0,035 W/cm²e 0,4W/cm²; fluência 0,28 J/cm² e 4 J/cm²; tempo de tratamentopor ponto 80 s. e 12 s.; modo pulsado de emissão 2500Hz (cicloútil = 0,0175%) e 9500Hz (ciclo útil = 0,0571%). Observou-sefechamento das úlceras em todos os pacientes, porém a reepitelizaçãofoi quase total (ICU = 0,8) naquele tratado com o PII, enquantoque a média do ICU dos pacientes tratados com o PI foi de 0,3. Ouso do LBP associado à DLM estimulou o reparo tecidual e o PIImostrou-se mais efetivo.

This study evaluated qualitatively and quantitatively (area in cm²and ulcer healing rate – UHR) the use of low power laser (LPL) andmanual lymphatic drainage (MLD) in the healing of skin ulcers.Two laser protocols were used: the PI (0.0035W) was applied inthree patients and PII (0.04W) in one patient. After asepsis and aMLD, patients received sequential treatment of the target area usinga noncontact mode of application with a single probe (beam spot size= 0,1 cm²), 3 x/week, during 16 weeks. The number of points wascalculated differently for PI (area/0,5cm²) and PII (area/0,1 cm²).The following parameters were different for PI and PII, respectively:radiant energy 0.28 J and 0.48 J, irradiance 0.035 W/cm² and 0.4W/cm², fluence 0.28 J/cm² and 4 J/cm², treatment time per point80 sec and 12 sec, pulsing mode of emission 2500 Hz (duty cycle= 0.0175% and 9500 Hz (duty cycle = 0.0571%). It was observeda progressive wound healing in all patients, but the reepithelizationwas almost complete (UHR = 0.8) at the patient treated with PII,while the UHR mean of the patients treated with PI was 0.3. Theuse of LPL associated to MLD promotes wound healing and thePII showed to be the most effective.

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O objetivo deste estudo foi avaliar os efeitos do ultrassom pulsado (USp) no reparo muscular em um modelo experimental de lesão lacerativa do músculo gastrocnêmio medial em ratos Wistar. Vinte ratos foram tratados diariamente com USp (50%), 1MHz, 0,57W/cm² de intensidade por 5 min. formando os grupos tratados (GT), e 20 animais constituíram os grupos controle (CG). A análise histológica, morfométrica (usando o método estereológico) e biomecânica (teste de tensão) foi realizada aos 4, 7, 14 e 24 dias após a lesão. As lesões apresentaram um padrão de reparo similar tanto nos GT como nos GC. Os volumes absolutos da lesão (VL) e das zonas central e de regeneração (VZC e VZR) diminuíram progressivamente ao longo do processo de reparo tanto nos GT como nos GC. No GT, o VL diminuiu significativamente em todos os dias experimentais, sendo que VZC uma diminuição significante aos 4 e 7 dias pós-lesão e o VZR aos 14 dias pós-lesão. A fração de volume de vasos sanguíneos e a fração de superfície de vasos sanguíneos foi maior nos GT aos 4 e 7 dias pós-lesão em relação aos respectivos controles. Apesar de haver uma tendência a um maior volume absoluto de vasos sanguíneos nos GT, a análise estatística mostrou que existe uma maior volume de vasos somente aos 4 dias pós-lesão. Não houve diferença significante na área de superfície total de vasos sanguíneos na lesão quando se comparam os grupos entre si. Houve um aumento significante na fração de volume de fibras de colágeno na lesão nos GT aos 4,7 e 14 dias pós-lesão. Houve um aumento significante na tensão máxima e na rigidez nos GT aos 4 e 24 dias após a lesão. Não houve diferença significante na deformação relativa entre GC e GT. Os resultados sugerem que o USp otimiza a fase inflamatória e estimula as fases proliferativa e de remodelamento, promovendo uma diminuição mais acentuada no volume da lesão, estimulando a angiogênese, assim como, a deposição e a organização do colágeno fibrilar. Os achados histológicos...

The aim of this study was to evaluate the effect of the pulsed ultrasound therapy (PUT) in stimulating muscle repair in an experimental model of lacerative gastrocnemius medialis muscle lesion in 40 Wistar rats. Twenty rats were treated (TG) daily with 1MHz pulsed ultrasound (50%) at 0.57W/cm² for 5 min, and 20 were control animals (CG). Muscle samples were harvested up on postoperative days 4, 7, 14 and 24 for stereological, histological, and biomechanical analyses. The lesions presented similar repair pattern in both TG and CG. The lesion volume (VL) and the central and regenerative zones volumes (VCZ and VRZ) had a progressive deacrease through the post lesion period both in the TG and CG. The VL decrease was significantly greater in the TG in all experimental days, the VCZ decrease was significant in the TG at 4 and 7 days post lesion, and the VRZ decrease was significant at 14 days post lesion in the TG. Statistically significant increase was found in the blood vessels volume fraction and in the surface fraction of blood vessels in the TG at 4 and 7 days post lesion compared to respective CG. Although there was a tendency to have a greater blood vessels absolute volume within lesion in the TG, the statistical analysis showed that it was only larger at 4 days after surgery in US treated group. No statistically significant increase was found in the surface total area within lesion in all experimental days between CG and TG. There was a significant increase in the volume fraction of fibrilar collagen within the lesion in the TG at 4, 7 and 14 days post lesion. The biomechanical data showed a significant increase in the maximal stress and stiffness in the TG at 4 and 24 days after lesion, although there was a progressive increase of these variables both in the CG and TG. There was no significant difference in the maximal elongation, between CG and TG. Our data suggest that the PUT acts as an inflammatory optimizer and stimulates the proliferative and...

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The aim of this study was to evaluate the effect of the pulsed ultrasound therapy (PUT) in stimulating myoregeneration and collagen deposition in an experimental model of lacerative gastrocnemius muscle lesion in 30 Wistar rats. Fifteen rats were treated (TG) daily with 1 MHz pulsed ultrasound (50%) at 0.57 W/cm(2) for 5 min, and 15 were control animals (CG). Muscle samples were analyzed on postoperative days 4, 7 and 14 through H&E, Picrosirius-polarization and immunohistochemistry for desmin. The lesions presented similar inflammatory responses in both treated and control groups. The areal fraction of fibrillar collagen was larger in the TG at 4 days post-operatively (17.53+/-6.2% vs 6.79+/-1.3%, p=0.0491), 7 days (31.07+/-7.45% vs 12.57+/-3.6%, p=0.0021) and 14 days (30.39+/-7.3% vs 19.13+/-3.51%, p=0.0118); the areal fraction of myoblasts and myotubes was larger in the TG at 14 days after surgery (41.66+/-2.97% vs 34.83+/-3.08%, p=0.025). Our data suggest that the PUT increases the differentiation of muscular lineage cells, what would favor tissue regeneration. On the other hand, it is also suggested that there is a larger deposition of collagenous fibers, what could mean worse functional performance. However, the percentage of fibers seems to have stabilized at day 7 in TG and kept increasing in CG. Furthermore, the collagen supramolecular organization achieved by the TG is also significant according to the Sirius red staining results.

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