Background/Aims: The use of low-level laser therapy (LLLT) in neurosurgery is still hardly disseminated and there are situations in which the effects of this therapeutic tool would be extremely relevant in this medical field. The aim of the present study is to analyze the effect of LLLT on tissue repair after the corrective surgical incision in neonates with myelomeningocele, in an attempt to diminish the incidence of postoperative dehiscences following surgical repair performed immediately after birth. Materials and Methods: Prospective pilot study with 13 patients submitted to surgery at birth who received adjuvant treatment with LLLT (group A). A diode laser CW, λ = 685 nm, p = 21 mW, was applied punctually along the surgical incision, with 0.19 J delivered per point, accounting for a total of 4–10 J delivered energy per patient, according to the surgical wound area and then compared with the results obtained in 23 patients who underwent surgery without laser therapy (group B). Results: This pilot study disclosed a significant decline in dehiscences of the surgical wounds in neonates who were submitted to LLLT (7.69 vs. 17.39%). Conclusion: This new adjuvant therapeutic modality with LLLT aided the healing of surgical wounds, preventing morbidities, as well as shortening the period of hospital stay, which implies a reduction of costs for patients and for the institution.

Keywords:
Laser therapy, Neurosurgery, Wound healing, Postoperative complications, Myelomeningocele
1.
Filgueiras MG, Dytz JL: Evaluation of the profile of newborn child carrying defects of the neural tube. Bras Med 2006;43:17–24.
2.
Pinto FC, Matushita H, Furlan AL, Alho EJ, Goldenberg DC, Bunduki V, Krebs VL, Teixeira MJ: Surgical treatment of myelomeningocele carried out at ‘time zero’ immediately after birth. Pediatr Neurosurg 2009;45:114–118.
3.
Chavantes MC: Laser in cardio-respiratory problems; in Chavantes MC: Laser em Bio-Medicina. São Paulo, Atheneu, 2008, pp. 149–181.
4.
Baptista IMC, Chavantes MC, Dallan LAO, Stolf NAG: Laser de Baixa Intensidade: Nova Tecnologia Para os Enfermeiros na Cicatrização Pós-Esternotomia. Rev Soc Cardiol Estado São Paulo 2009;19:3–8.
5.
Shoji N, Magacho TA, Chavantes MC: Low potency laser treatment for acute dehiscence saphenectomy process. WALT, Guaruja, 2005. Photomed Laser Surg 2005;1:110.
6.
Luiz MCRA, Chavantes MC, Mainam S: Immobility prevention in orthopedic surgery applying red light: laser therapy for arthroscopic reconstruction. WALT, Guaruja, 2005. Photomed Laser Surg 2005;1:91–92.
7.
Baptista IMC, Chavantes MC, Oliveira SA: Can the low level laser therapy prevent incisional dehiscence in sternotomy after cardiac surgery? Rev Soc Bras Laser 2006;3:10–16.
8.
Pinto NC, Pereira MHC, Stolf NAG, Chavantes MC: Low level laser therapy in acute dehiscence saphenectomy: therapeutic proposal. Rev Bras Cir Cardiovasc 2009;24:88–91.
9.
Pinto NC, Chavantes MC: Prevent complications in cardiovascular surgery: a successful method applying low level laser therapy. Proc 28th Annu Conf Am Soc for Laser Med Surg (ASLMS), Kissimmee 2008, p 58.
10.
Pugliese LS, Medrado AL, Reis S, Andrade ZA: The influence of low-level laser therapy on biomodulation of collagen and elastic fibers. Pesqui Odontol Bras 2003;17:307–313.
11.
Damante CA, Greghi SLA, Sant’Ana ACP, Passanezi E: Clinical evaluation of the effects of low-intensity laser (ga-al-as) on wound healing after gingivoplasty in humans. J Appl Oral Sci 2004;12:133–136.
12.
Karu TI: Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 1999;49:1–17.
13.
Lopes-Martins RAB, Labat RL, Ramos L, Pallota RC, Penna SC, Bjordal JM: New paradigms in the inflammatory process: possible mechanisms of action of the low level laser therapy and considerations on dosimetry. J Bras Laser 2007;1:12–19.
14.
Ailioaie C, Ailioaie L, Topoliceanu F: Self-organization phenomena at membrane levels and low level laser therapy of rhinitis. Proc SPIE 2000;416:309–315.
15.
Ailioaie C, Ailioaie LM, Chiran DA: Laser regeneration of nerve injuries triggered by low level laser therapy in children. OP1–05. 4th Int Congr World Assoc Laser Ther (WALT), Tokyo, 2002.
16.
Castilla EE, Orioli IM, Lopez-Camelo JS, Dutra Mda G, Nazer-Herrera J; Latin American Collaborative Study of Congenital Malformations (ECLAMC): Preliminary data on changes in neural tube defect prevalence rates after folic acid fortification in South America. Am J Med Genet A 2003;123:123–128.
17.
Pang D: Surgical complications of open spinal dysraphism. Neurosurg Clin N Am 1995;6:243–257.
18.
Braga MA: Neonatal Results in the Bifid Spine in Accordance with Marking of the Obstetric Ultrasound; diss Universidade Estadual Paulista, Botucatu, 2002.
19.
Agaiby AD, Ghali RL, Wilson R, et al: Laser modulation of angiogenic factor production by T-lymphocytes. Lasers Surg Med 2000;26:357–363.
20.
Bjordal JM, Johnson MI, Iversen V, Aimbire F, Lopes-Martins RAB: Low-level laser therapy in acute pain: a systematic review of possible mechanisms of action and clinical effects in randomized placebo-controlled trials. Photomed Laser Surg 2006;24:158–168.
21.
Carvalho FAS, Magalhães RG, Albertini R, Chavantes MC, Zangaro RA, Castro-Faria Neto HC: Effect of GaInAlP (685 mm) radiation on lipopolysaccharide induced rat trachea hyperreactivity. WALT, Guaruja, 2005. Photomed Laser Surg 2005;1:114.
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2010
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