The Treatment of vasculer circuration on flaps with Diode Laser irradiation

Abstract

In plastic and reconstructive surgery, various models have been employed for flaps. But distal end necrosis is entirely due to inadequate dlood supply, arterial inflow and venous outflow. We have use various method that improving the blood circurasion. Since 1983, we have used low powered Ga-Al-As diode laser in improving the vasculer circuration on flap survival in rat models and clinical cases. Caudal based random pattern flaps were raised on the back of two groups of male Wistar rats. 30 animals in each group. One group acted as control, with no irradiation. The second group received radiation from diode laser (830nm, 20mW, 60 sec.) on the flap base in the non-contact·method. Immediately after irradiation, a fluorescein test revealed a longer dye distance in laser group than in control. Seven days later, the laser group also showed the longer survival length. On the second rat model, axcial pattern flaps were raised on the abdominal wall of two groups. 20 animals in each group. One group acted as control. The second group was irradiated diode laser (830 nm, 60mW, 60 sec.) on the flap pedicules. Laser doppler readings were taken before and after each irradiation session. Both blood flow and mass showed a significant increase following low powered diode laser irradiation and seven days later, the laser group showed greater survived area than the control group.
The clinical applications of diode laser were for the enhanced healing of ulcer ornecrosis on the distal end of flaps. The patients who had the questionabule take were given diode laser irradiation (830nm, 60mW, 10 minutes) that was applied in the noncontact method to the pedicule of the flaps and around necrotic area. In all cases both blood flow and mass showed an increase. 10 incidents of possible necrosis were treated in 10 patients. Five patients were showed good take and recovered in 10 to 30 days. Five patients were required surgical operation, a small ulser was seen on the distal end of flap. Diode laser irradiation is effective raethod that stimulate flap survival and vasculer circulation.