THE EFFECTS OF DIODE LASER LOW REACTIVE-LEVEL LASER THERAPY (LLLT) 0N MUSCULOCUTANEOUS FLAPS
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The clinical application of low incident levels of laser energy, known as low reactive level laser therapy, or LLLT, is appearing more frequently in the literature. One application which has been researched with animal models, followed by clinical applications in man, is for the enhanced healing of flaps. The enhanced blood flow following LLLT has been reported by a number of researchers including the authors, but precise evaluation following multiple treatment sessions has not yet been presented. The authors have evaluated a series of irradiations in a preliminary group of four patients in whom musculocutaneous flaps were indicated following surgery related to circulatory disorders. The diode laser (830 nm, 60 mW, 16 J/cm2, continuous wave) was applied in the non-contact method to the pedicle or feeder artery of the flap, and to the distal portion of the flap for 10 min each. Laser Doppler readings were taken before and immediately after each irradiation session, Both blood flow and mass showed a significant increase following LLLT, not only for the first treatment session, but in subsequent sessions. This was accompanied by a subjective patient self-evaluation where a feeling of warmth was reported which in one case increased to the point that the patient perspired following LLLT. The results are examined especially from the point of view of the possible cumulative effect of successive treatment sessions. The authors conclude that, allowing for the fact that further detailed controlled studies are necessary, there is a significant rise in blood flow and mass following LLLT, and that this increased volume of blood must aid in the faster and better take of the musculocutaneous flap.
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