A Prospective Study Of The Influence That Topical Steroid Exerts In Low Reactive Level Laser Therapy (LLLT) For The Treatment Of Hypertrophic Scars And Keloids.
K Sasaki, T Ohshiro, T Ohshiro, and Y Taniguchi
1) Keikoukai Ohshiro Clinic_2) Japan Medical Laser Laboratory
LASER THERAPY. 2009, Vol. 18, No. 3, p.151-159
Abstract: The application of Low reactive Level Laser Therapy (LLLT) for the treatment of hypertrophic scars and keloids has been already reported and investigated. According to these reports, LLLT for hypertrophic scars and keloids was accepted very quickly into routine practice. In this prospective study, we assessed LLLT for the treatment of hypertrophic scars and keloids and examined the influence of a topical steroid. Subjects comprised 20 patients who were treated for hypertrophic scars and keloids, 9 patients treated with LLLT but no topical steroid and 11 patients treated with LLLT plus a topical steroid. Clinical photography of the lesions was performed, and 5 items were assessed for each lesion, namely Itching, Pain, Erythema, Hardness and Pliability on an 11-point scale for each value. The actual measurement values in mm and cm2 of 2 items (Thickness and size) were used. Each treatment session consisted of direct local application of an 830nm, 60mW, continuous wave, GaAlAs diode laser (Oh-lase 3D1, JMLL Tokyo Japan) to the target area for 30 seconds to 2 minutes per lesion depending on the size and number of lesions existing on each patient. The attending clinician firmly pinched the lesion between fingers and thumb during laser therapy. In both groups, a significant difference (p‹0.01) between pretreatment and the 5th or 10th treatment session was recognized in the Erythema, Hardness and Pliability items. In the Itching and Thickness items, a significant difference (p‹0.05) between pretreatment and the 5th or 10th treatment session was also recognized. There were no statistically significant differences between the group with no topical steroid and the group with topical steroid in most of the items, but the topical steroid group achieved better improvement in the Erythema and Hardness items after 10th treatment session, compared to the group with no topical steroid.
Effects of Low-Level Laser Therapy on Pain and Scar Formation after Inguinal Herniation Surgery: A Randomized Controlled Single-Blind Study
de Paiva Carvalho RL, Alcâ ntara PS, Kamamoto F, Cressoni MD, Casarotto RA.
Postgraduate Program in Rehabilitation Sciences, University of Sã o Paulo, Sã o Paulo, Brazil.
Photomed Laser Surg. 2009 Oct 12. [PMID: 19821701]
Abstract Objective: The aim of this study was to investigate the efficacy of an infrared GaAlAs laser operating with a wavelength of 830 nm in the postsurgical scarring process after inguinal-hernia surgery.
Background: Low-level laser therapy (LLLT) has been shown to be beneficial in the tissue-repair process, as previously demonstrated in tissue culture and animal experiments. However, there is lack of studies on the effects of LLLT on postsurgical scarring of incisions in humans using an infrared 830-nm GaAlAs laser.
Method: Twenty-eight patients who underwent surgery for inguinal hernias were randomly divided into an experimental group (G1) and a control group (G2). G1 received LLLT, with the first application performed 24 h after surgery and then on days 3, 5, and 7. The incisions were irradiated with an 830-nm diode laser operating with a continuous power output of 40 mW, a spot-size aperture of 0.08 cm(2) for 26 s, energy per point of 1.04 J, and an energy density of 13 J/cm(2). Ten points per scar were irradiated. Six months after surgery, both groups were reevaluated using the Vancouver Scar Scale (VSS), the Visual Analog Scale, and measurement of the scar thickness.
Results: G1 showed significantly better results in the VSS totals (2.14 +/- 1.51) compared with G2 (4.85 +/- 1.87); in the thickness measurements (0.11 cm) compared with G2 (0.19 cm); and in the malleability (0.14) compared with G2 (1.07). The pain score was also around 50% higher in G2.
Conclusion: Infra-red LLLT (830 nm) applied after inguinal-hernia surgery was effective in preventing the formation of keloids. In addition, LLLT resulted in better scar appearance and quality 6 mo postsurgery.
Low Reactive Level Laser Therapy (LLLT) for the Treatment of Hypertrophic Scars and Keloids. A Re-Introduction
Shunji Fujii MD, Toshio Ohshiro MD Ph.D., Takafumi Ohshiro MD, Katsumi Sasaki MD, and Yuki Taniguchi MD
1) Ohshiro Clinic, Tokyo, Japan 2) Japan Medical Laser Laboratory, Tokyo, Japan
Abstract: Low reactive Level Therapy ( LLLT ) is now well into its 30th decade, and its beneficial effects such as pain attenuation, accelerated or enhanced wound healing have been very well reported and investigated. For clinics such as ours which utilizes LLLT for medical treatments, LLLT for hypertrophic scars and keloids very quickly became, and remains, routine. We believed that many facilities and institutions have also been using LLLT for the treatment of hypertrophic scars and keloids, but to our surprise there were very few medical facilities using LLLT and practically none for the treatment of scars. Recently, starting in the 1990‘s, there have been several reports where High reactive Laser Treatment (HLLT ) has been used in an attempt to treat hypertrophic scars and keloids. However no literature concerning LLLT for these lesions appears in MedLine, even though the treatment is safe and effective with no side effects and complications when compared to HLLT. The authors herein re-introduce the technique and protocol of LLLT which they have used for the past twenty years for the treatment of hypertrophic scars and keloids. We present a series of representative cases and discuss the most efficient treatment modality in combination with conventional treatment methods