Viability of the random pattern dorsal skin flap in mice submitted to photobiomodulation and therapeutic ultrasound

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Laís Coan Fonanela
Jaquelini Betta Canever
Aderbal Silva Aguiar Júnior
Rafael Inácio Barbosa
Marisa de Cássia Registro Fonseca
Heloyse Uliam Kuriki
Lais Mara Siqueira das Neves
Alexandre Marcio Marcolino


Introduction: The skin flap is a surgical technique widely used in clinical practice and generally presents postoperative complications. Therefore, elucidating interventions that assist in tissue conservation is essential. Photobiomodulation (PBM) and therapeutic ultrasound (TUS) are non-invasive alternatives for assisting tissue repair, however, there is no consensus on the parameters used. Objective: To describe the effectiveness of the different parameters of PBM and TUS in the viability of the dorsal random pattern skin flap in mice. Methods: Fifty-five Swiss mice were used, distributed in eleven groups. The animals were submitted to surgical technique including revascularization of the area limited through a plastic barrier (polyester/polyethylene) with the same dimension as the flap. PBM or TUS was applied for five consecutive days. Photographic and thermographic recordings were performed with Cyber-Shot DSC-P72 and FlirC2 cameras and analyzed using the ImageJ® and FLIR Tools software, respectively. In the statistical analysis, the data were submitted to the GraphPad Prism® 8.0 software. Analysis of variance (ANOVA Two-way) and Tukey's post-test was performed, considering 5% significance level. Results: Groups 5 (PBM 830 nm; 10 J/cm²) and 6 (TUS 3 MHz; 0.4 W/cm²) showed percentages of viable tissue significantly higher on the third and fifth day of the experiment, when compared to the other groups. The temperature decreased significantly in group 1 when compared to the others in the postoperative period. Conclusion: The continuous TUS at 3 MHz and PBM 830 nm were more effective in improving the viability of the dorsal random pattern skin flap in mice.


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Fonanela, L. C., Canever, J. B., Aguiar Júnior, A. S., Barbosa, R. I., Fonseca, M. de C. R., Kuriki, H. U., Neves, L. M. S. das, & Marcolino, A. M. (2022). Viability of the random pattern dorsal skin flap in mice submitted to photobiomodulation and therapeutic ultrasound. ABCS Health Sciences, 47, e022227.
Original Articles


Ferreira LM. Manual de cirurgia plástica. São Paulo: Atheneu,1995.

Enshaei A, Masoudi N. Survey of early complications of primary skin graft and secondary skin graft (delayed) surgery after resection of burn waste in hospitalized burn patients. Glob J Health Sci. 2014;6(7):98-102.

Lucas JB. The physiology and biomechanics of skin flaps. Facial Plast Sur Clin North Am. 2017;25(3):303-11.

Emsen IM. The effect of ultrasound on flap survival: an experimental study in rats. Burns. 2007;33(3):369-71.

Freitas AD, Padrini Júnior AG, Tavares KE, Lima LAA. Retalhos antebraquiais pediculados para cobertura dos defeitos cutâneos da mão. Rev Bras Ortop. 1993;28(4):204-8.

Kubota J. Effects of diode laser therapy on blood flow in axial pattern flaps in the rat model. Lasers Med Sci. 2002;17(3):146-53.

Neves LMS, Marcolino AM, Prado RP, Thomazini JA. Laser 830nm na viabilidade do retalho cutâneo de ratos submetidos à nicotina. Acta Ortop Bras. 2011;19(6):342-5.

Neves LMS, Leite GPMF, Marcolino AM, Pinfildi CE, Garcia SB, Araújo JE, et al. Laser Photobiomodulation (830 and 660 Nm) in Mast Cells, VEGF, FGF, and CD34 of the musculocutaneous flap in rats submitted to nicotine. Lasers Med Sci. 2017;32(2):335-41.

Yadav A, Gupta A. Noninvasive red and near-infrared wavelength-induced photobiomodulation: promoting impaired cutaneous wound healing. Photodermatol Photoimmunol Photomed. 2017;33(1):4-13.

Freitas LF, Hamblin MR. Proposed mechanisms of photobiomodulation or low-level light therapy. IEEE J Sel Top Quantum Electron. 2016;22(3):7000417.

Guirro ECO, Montebelo MIL, Bortot BA, Torres MACB, Polacow MLO. Effect of Laser (670 Nm) on healing of wounds covered with occlusive dressing: a histologic and biomechanical analysis. Photomed Laser Surg. 2010;28(5)629-34.

Fortuna T, Gonzalez AC, Sá MF, Andrade ZA, Reis SRA, Medrado ARAP. Effect of 670 Nm laser photobiomodulation on vascular density and fibroplasia in late stages of tissue repair. Int Wound J. 2018;15(2)274-82.

Melo VA, Anjos DCS, Albuquerque Júnior R, Melo DB, Carvalho FUR. Effect of low level laser on sutured wound healing in rats. Acta Cir Bras. 2011;26(2):129-34.

Taşkan I, Ozyazgan I, Tercan M, Kardaş HY, Balkanli S, Saraymen R, et al. A comparative study of the effect of ultrasound and electrostimulation on wound healing in rats. Plast Reconstr Surg. 1997;100(4)966-72.

Chen YC, Wang PR, Lai TJ, Lu LH, Dai LW, Wang CH. Using therapeutic ultrasound to promote irritated skin recovery after surfactant-induced barrier disruption. Ultrasonics. 2019;91:206-12.

Carrer V, Setti JAP, Veronez DL, Moser AD. Ultra-som terapêutico contínuo no processo de cicatrização na pele de ratos. Fisioter Mov. 2015;28(4):751-8.

Wakabayashi N, Sakai A, Takada H, Hoshi T, Saco H, Ichinose S, et al. Noncontact phased-array ultrasound facilitates acute wound healing in mice. Plast Reconstr Surg. 2020;145(2):348e-59.

Matthews MJ, Stretanski MF. Ultrasound Therapy. StatPearls, 2020.

Pouremadi N, Motaghi A, Safdari R, Zarean P, Rashad A, Zarean P, et al. Clinical outcomes of low-level laser therapy in management of advanced implant surgery complications: a comparative clinical study. J Contemp Dent Pract. 2019;20(1):78-82.

Kami T, Yoshimura Y, Nakajima T, Ohshiro T, Fujino T. Effects of low-power diode lasers on flap survival. Anna Plast Surg. 1985;14(3):278-83.

Pinfildi CE, Liebano RE, Hochman BS, Ferreira LM. Helium-neon laser in viability of random skin flap in rats. Lasers Surge Med. 2005;37(1):74-7.

Prado R, Neves L, Marcolino A, Ribeiro T, Pinfildi C, Ferreira L, et al. Effect of low-level laser therapy on malondialdehyde concentration in random cutaneous flap viability. Photomed Laser Surg. 2010;28(3):379-84.

Souza TR, Souza AK, Garcia SB, Neves LMS, Barbosa RI, Guirro RRJ, et al. Photobiomodulation increases viability in full-thickness grafts in rats submitted to nicotine. Lasers Surg Med. 2020;52(5):449-55.

Kubota J. Defocused diode laser therapy (830 Nm) in the treatment of unresponsive skin ulcers: a preliminary trial. J Cosmet Laser Ther. 2004;6(2):96-102.

Calderhead RG, Kim WS, Ohshiro T, Trelles MA, Vasily DB. Adjunctive 830 nm light-emitting diode therapy can improve the results following aesthetic procedures. Laser Ther. 2015;24(4):277-89.

Kim WS, Calderhead RG. Is light-emitting diode phototherapy (LED-LLLT) really effective?. Laser Ther. 2011;20(3):205-15.

Hersant B, SidAhmed-Mezi M, Bosc R, Meningaud JP. Current indications of low-level laser therapy in plastic surgery: a review. Photomed Laser Surg. 2015;33(5):283-97.

Gonçalves AC, Barbieri CH, Mazzer N, Garcia SB, Thomazini JA. Can Therapeutic Ultrasound Influence the Integration of Skin Grafts?. Ultrasound Med Biol. 2007;33(9):1406-12.

Kitchen SS, Partridge CJ. A review of therapeutic ultrasound: I. Background, physiological effects and hazards. Physiotherapy. 1990;76:593.

Dyson M. Mecanisms Involved in therapeutic ultra sound. Physioterapy. 1987;73(3):116-30.

ter Haar G. Therapeutic ultrasound. Eur J Ultrasound. 1999;9(1):3-9.

Yücel S, Günay GK, Ünverdi ÖF. Effects of ultrasound-assisted preconditioning on critically ischemic skin flaps: an experimental study. Ultrasound Med Biol. 2020;46(3):660-6.

Gostishchev VK, Baĭchorov EK, Berchenko GN. Effect of low-frequency ultrasound on the course of the wound process. Vestn Khir Im I I Grek. 1984;133(10):110-3.

Belcik JT, Davidson BP, Xie A, Wu MD, Yadava M, Qi Y, et al. Augmentation of muscle blood flow by ultrasound cavitation is mediated by atp and purinergic signaling. Circulation. 2017;135(13):1240-52.

Planel E, Richter KE, Nolan CE, Finley JE, Liu L, Wen Y, et al. Anesthesia leads to tau hyperphosphorylation through inhibition of phosphatase activity by hypothermia. J Neurosci. 2007;27(12):3090-7.

Matsukawa T, Sessler DI, Sessler AM, Schroeder M, Ozaki M, Kurz A, et al. Heat flow and distribution during induction of general anesthesia. Anesthesiology. 1995;82(3):662-73.

Fiebig K, Jourdan T, Kock MH, Merle R, Thöne-Reineke C. Evaluation of Infrared Thermography for Temperature Measurement in Adult Male NMRI Nude Mice. J Am Assoc Lab Anim Sci. 2018;57(6)715-24.

Stadler I, Lanzafame RJ, Oskoui P, Zhang RY, Coleman J, Whittaker M. Alteration of skin temperature during low-level laser irradiation at 830 Nm in a mouse model. Photomed Laser Surg. 2004;22(3):227-31.