Role of neodymium laser in surgery: stimulation of postoperative surgical wounds healing. Results of clinical studies

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OBJECTIVE

To prove the effectiveness of the low-intensity laser radiation application in the treatment of wounds of different origin.

MATERIAL AND METHODS

The clinical study involved 110 persons, divided into 55 subjects in both the study and control groups. The patients of the study group were exposed to the long-wave short-pulse neodymium laser immediately and within 35 days after interventions with a skin incision using it, in a way that wound treated with laser received low-level laser therapy. The control group patients’ wounds were treated with standard methods by the means of topical drugs corresponding to the clinical manifestations of the wound process in each particular case. The study was carried out in the hospital of the department of maxillofacial and plastic surgery of the dental complex of the «Russian University of Medicine» from 2019 to 2022, and further conservative treatment was conducted in the department of dermatology and cosmetology of the University Hospital of the Medical Graduate School (Institute) of the RSSU. All wounds were classified into three groups for the convenience of systematization and formation of a generalized treatment protocol for postoperative surgical wounds.

RESULTS

The objectivity and optimality of the chosen by us actions were confirmed in the conducted work. The formed scars were visually assessed on the POSAS scale at the end of the treatment by patients and 4 independent doctors, as well as each scar was visually assessed by four independent doctors and patients. At the end of the study we formed and proposed an algorithm for the treatment of surgical wounds of various origins. The parameters of the Aerolase Neo Light Pod neodymium laser for the treatment of patients with different types of skin wounds were clinically determined. Experimentally proven properties of the Aerolase Neo Light Pod neodymium laser on accelerating the healing process of surgical wounds through photobiomodulation mechanism support their regeneration with the formation of negligible normotrophic scars, as well as reduce the length of patients’ treatment in surgical hospitals, as compared to patients receiving standard external drugs.

Keywords:

wound healing

LLLT

LILR

wound regeneration

wound process

Authors:

Prazdnikov E.N.

Russian University of Medicine

ORCID: 0000-0002-5817-0702

Evsyukova Z.A.

Russian University of Medicine

ORCID: 0000-0002-3480-6147

Received:

20.01.2024

Accepted:

15.02.2024

List of references:

De Bakker E, van der Putten MAM, Heymans MW, Spiekstra SW, Waaijman T, Butzelaar L, Negenborn VL, Beekman VK, Akpinar EO, Rustemeyer T, Niessen FB, Gibbs S. Prognostic tools for hypertrophic scar formation based on fundamental differences in systemic immunity. Clinical and Experimental Dermatology. 2021;30(1):169-178. https://doi.org/10.1111/exd.14139
Monavarian M, Kader S, Moeinzadeh S, Jabbari E. Regenerative Scar-Free Skin Wound Healing. Tissue Engineering. Part B, Reviews. 2019;25(4):294-311. https://doi:10.1089/ten.TEB.2018.0350
Dreno B, Amici JM, Demessant-Flavigny AL, Wright C, Taieb C, Desai SR, Alexis A. The Impact of Acne, Atopic Dermatitis, Skin Toxicities and Scars on Quality of Life and the Importance of a Holistic Treatment Approach. Clinical, Cosmetic and Investigational Dermatology. 2021;14(14):623-632. https://doi.org/10.2147/CCID.S315846
Gushiken LFS, Beserra FP, Bastos JK, Jackson CJ, Pellizzon CH. Cutaneous Wound Healing: An Update from Physiopathology to Current Therapies. Life. 2021;(7):665. https://doi.org/10.3390/life11070665
Karppinen SM, Heljasvaara R, Gullberg D, Tasanen K, Pihlajaniemi T. Toward understanding scarless skin wound healing and pathological scarring. F1000Research. 2019;8:F1000 Faculty Rev-787. https://doi.org/10.12688/f1000research.18293.1
Ikonnikova EV, Kruglova LS, Manturova NE, Petri MA. Comparative study of the efficacy and safety of injectable combination therapy of keloid and hypertrophic scars with 5-fluorouracil and betamethasone. Rossijskij zhurnal kozhny’x i venericheskix boleznej. 2020;23(6):432-442. (In Russ.). https://doi.org/10.17816/dv61469
Canedo-Dorantes L, Canedo-Ayala M. Skin acute wound healing: A comprehensive review. International Journal of Inflammation. 2019;2019:3706315. https://doi.org/10.1155/2019/3706315
Tottoli EM, Dorati R, Genta I, Chiesa E, Pisani S, Conti B. Skin Wound Healing Process and New Emerging Technologies for Skin Wound Care and Regeneration. Pharmaceutics. 2020;12(8):735. https://doi.org/10.3390/pharmaceutics12080735
Zomer HD, Trentin AG. Skin wound healing in humans and mice: Challenges in translational research. Journal of Dermatological Science. 2018;90(1):3-12. https://doi.org/10.1016/j.jdermsci.2017.12.009
Lee HJ, Jang YJ. Recent Understandings of Biology, Prophylaxis and Treatment Strategies for Hypertrophic Scars and Keloids. International Journal of Molecular Sciences. 2018;19(3):711. https://doi.org/10.3390/ijms19030711
Shapovalova EYu, Morozova MN, Baranovsky YuG, Boyko TA, Baranovsky AG. Comparative characteristics of the fibrous composition of the scar after the introduction of auto- and heterofibroblasts into the wound in mice. Zdorov’e i obrazovanie v XXI veke. 2017;19(3):100-104. (In Russ.).
Tai Y, Woods EL, Dally J, Kong D, Steadman R, Moseley R, Midgley AC. Myofibroblasts: Function, Formation, and Scope of Molecular Therapies for Skin Fibrosis. Biomolecules. 2021;11(8):1095. https://doi.org/10.3390/biom11081095
Ribatti D, Tamma R. Giulio Gabbiani and the discovery of myofibroblasts. Inflammation Research. 2019;68(3):241-245. https://doi.org/10.1007/s00011-018-01211-x
Rodrigues M, Kosaric N, Bonham CA, Gurtner GC. Wound Healing: A Cellular Perspective. Physiological Reviews. 2019;99(1):665-706. https://doi.org/10.1152/physrev.00067.2017
Sakhno LV, Shevela EYa, Chernykh ER. Phenotypic and functional features of alternatively activated macrophages: possible use in regenerative medicine. Immunologiya. 2015;36(4):242-246. (In Russ.).
Hunter P, Greco E, Cross K, Perry J. Topical Oxygen Therapy Shifts Microbiome Dynamics in Chronic Diabetic Foot Ulcers. Wounds. 2020;32(3):81-85.
Jusman SWA, Sari DH, Ningsih SS, Hardiany NS, Sadikin M. Role of Hypoxia Inducible Factor-1 Alpha (HIF-1α) in Cytoglobin Expression and Fibroblast Proliferation of Keloids. The Kobe Journal of Medical Sciences. 2019;65(1):E10-E18.
Kumar S, Tan Y, Berthiaume F. Neuropeptide Substance P Enhances Skin Wound Healing In Vitro and In Vivo under Hypoxia. Biomedicines. 2021;9(2):222. https://doi.org/10.3390/biomedicines9020222
Azmat CE, Council M. Wound closure methods. 2021 July 27. In: StatPearls [Internet]. Treasure Island Florida: StatPearls; 2021.
Jia SS, Wang HS, Jiao Yi, Jiang DI, Zhao J. [Advances in Research on Skin Closure Techniques and Their Clinical Applications]. Zhonghua Shao Shang Tza Zhi. 2021;37(11):1099-1104. https://doi.org/10.3760/cma.j.cn501120-20200701-00334
Ozgok Kangal MK, Regan JP. Wound Healing. 2021 May 9. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
Post H, Hundt JE, Zhang G, Depping R, Rose C, Langan EA, Paus R. Thyroxine restores severely impaired cutaneous re-epithelialisation and angiogenesis in a novel preclinical assay for studying human skin wound healing under «pathological» conditions ex vivo. Archives of Dermatological Research. 2021;313(3):181-192. https://doi.org/10.1007/s00403-020-02092-z
Subramaniam T, Fauzi MB, Lokanathan Y, Law JX. The Role of Calcium in Wound Healing. International Journal of Molecular Sciences. 2021;22(12):6486. https://doi.org/10.3390/ijms22126486
Kolchina EJ, Bagaev VG, Nalbandjan RT. Hyperbaric oxygenation in treatment of wound infections. Wounds and wound infections. Zhurnal im. prof. B.M. Kostyuchyonka. 2016;3(3):20-25. (In Russ.). https://doi.org/10.17650/2408-9613-2016-3-3-20-25
Savilov PN. Genetic mechanisms of hyperoxic sanogenesis. Byulleten’ giperbaricheskoi biologii i mediciny’. 2007;15(1-4):3-56. (In Russ.).
Zheng YH, Yin LQ, Xu HK, Gong X. Non-invasive physical therapy as salvage measure for ischemic skin flap: A literature review. World Journal of Clinical Cases. 2021;9(14):3227-3237. https://doi.org/10.12998/wjcc.v9.i14.3227
Koshelev VN. Lazer v lechenii ran. Saratov: Izd-vo Saratovskogo universiteta; 1980. (In Russ.).
Rakcheev AP. Primenenie lazernogo izlucheniya v dermatologicheskoj praktike: Dis. ... kand. med. nauk. M. 1973. (In Russ.).
Koshelev VN. Stimulyaciya lazerami regenerativny’x processov pri troficheskoj yazve i perelome dlinny’x trubchaty’x kostej. Materialy’ 1-go s’ezda xirurgov RSFSR. Perm’. 1973;338-340. (In Russ.).
Moskvin SV, Agasarov LG. Laser acupuncture: basic principles, methodological approaches and parameters of techniques. Vestnik novy’x medicinskix texnologij. E’lektronnoe izdanie. 2019;1. Publikaciya 3-6. Accessed March 20, 2024. (In Russ.). https://www.medtsu.tula.ru/VNMT/Bulletin/E2019-1/3-6.pdf
Chekurov PR. Vliyanie MKS na regeneraciyu dlinny’x trubchaty’x kostej. Svet gelij-neonovy’x lazerov v biologii i medicine. Alma-Ata. 1970;44-47. (In Russ.).
Solomos L, Bouthour W, Malclès A, Thumann G, Massa H. Meibomian Gland Dysfunction: Intense Pulsed Light Therapy in Combination with Low-Level Light Therapy as Rescue Treatment. Medicina. 2021;57(6):619. https://doi.org/10.3390/medicina57060619
Kulikova NG, Konchugova TV, Moskvin SV, Zhilokov ZG, Tkachenko AS. Laser therapy effect on endothelial dysfunction in patients after the surgery for orthognathic disorders. Voprosy’ kurortologii, fizioterapii i lechebnoj fizicheskoj kul’tury’. 2022;99(1):28-33. (In Russ.). https://doi.org/10.17116/kurort20229901128
Askhadullin EV, Geynits AV, Moskvin SV. Combined laser therapy in patients with trophic ulcer of the lower extremities on the background of chronic venous insufficiency. Lazernaya medicina. 2016;20(3):21-21. (In Russ.). https://doi.org/10.37895/2071-8004-2016-20-3-21-21
Mazurin VYa. Medicinskaya termografiya. M.: Medicina; 1989;56-60. (In Russ.).

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