Laser vermelho e infravermelho em diferentes fluências na viabilidade do retalho cutâneo randômico em ratos
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Skin flaps are widely used in plastic surgery, mainly in reconstruction surgeries (transference of skin graft, pre-made tissues). After the surgery one of the major complication is ischemia, which may cause necrosis of the flap. Several features have been studied with the aim of increasing the viability flaps. Among these features, the low laser therapy is an alternative treatment, since it can promote an increase in microcirculation and vascular neoformation. However, there are discrepancies in the literature of the parameters employed in the use of laser, especially the fluence used in treatment . The aim of this study was to investigate the effects of 2 different laser wavelengths (660nm e 780nm) at 30 and 40J/cm2, on the viability of skin flap in rats evaluated by the paper template, vessels blood counting, activity of matrix metalloproteinase-2 (MMP-2), evaluation of plasma levels of NO, and expression hypoxiainducible Factor 1_. Sixty male animals Wistar were used in this study and they were distributed into the following groups (n=12 each group): control group, group irradiated with 660nm, at 30J/cm2; group irradiated with 660nm, at 40J/cm2 group irradiated with 780nm, at 30J/cm2, and group irradiated with 780nm, at 40J/cm2. The skin flap was performed on the back of all animals studied, with a plastic sheet interposed between the flap and the donor site. The animals received laser irradiation immediately after surgery and within 4 days, using the technical point of contact, on 24 points on the skin surface and around it. On the seventh postoperative day was evaluated the percentage of necrotic area and collected samples of tissue for histological analysis, zymography and protein expression by Western blotting, animals were euthanized by exsanguination, and blood were evaluated plasma levels of NO. The data obtained from the evaluation by the method of the paper template showed no increase in the viability of skin flaps after laser treatment. For biochemical analysis we found that the laser modulates the activity of MMP-2 and expression of HIF-1_ and induced an increase in the number of vessels especially in the groups irradiated with 40J/cm2 Measurement plasma level of NO did not differ between groups. Molecular analysis showed that the application of laser parameters used here, although it stimulated angiogenesis by modulating HIF-1_ and activity of MMP-2 was not able to improve the viability of skin flaps. Thus, we conclude that to find the beneficial effects of laser therapy we need to understand their mechanisms of action and know the best parameters to use.