Comparison of the effects of the CO2 laser and chlorohexidine on the decontamination of infected cutaneous wounds: a histologic study in rats

OBJECTIVE: The aim of this study was to compare histologically the effects of CO2 laser and chlorohexidine gluconate (4%) on Staphylococcus aureus-infected cutaneous wounds. BACKGROUND DATA: Wound infection constitutes a big risk for patients, and it is usually associated with increased morbidity, mortality and hospital costs. It is accepted that local treatment of these infections is effective. MATERIALS AND METHODS: Standardized wounds created on the dorsum of 36 rats were infected with Staphylococcus aureus and treated during 6 days as follows: group I, chlorohexidine gluconate (4%) applied to the wound surface during 1 min during 6 days; group II, single CO2 laser irradiation (8 W, CW, unfocused, 8-cm focal distance, 81,530 W/cm(2)), maintaining surface debris; group III, single CO2 laser irradiation (8 W, CW, unfocused, 8-cm focal distance, 81,530 W/cm(2)), removing the surface debris. Seven days after wounding, the animals were killed and specimens taken for light microscopy. RESULTS: On control wounds, epithelial ulceration and neutrophylic and lymphoplasmocitary inflammatory infiltrate was observed. On group II, there was epithelial hyperplasia, areas of ulceration and intense neutrophylic and lymphoplasmocitary inflammatory infiltrate. In group III, there was a neutrophylic inflammatory infiltrate underneath the surface debris and below that intense lymphoplasmocitary inflammatory infiltrate. When the surface debris was removed (group IV), there was epithelial ulceration and mild lymphoplasmocitary inflammatory infiltrate and fibroblasts and collagen fibers. CONCLUSION: The results of this study show that infected wounds treated with 4% chlorohexidine show a more pronounced inflammatory reaction when compared to that observed when the CO2 laser is used, especially when surface debris are removed; surface debris removal on laser-treated wounds results in better and more rapid healing; the surface debris may act as a culture medium for bacterial growth or, because of its characteristics, it may act as a local irritant and delay healing.     

Assessment of the behavior of myofibroblasts on scalpel and CO(2) laser wounds: an immunohistochemical study in rats

OBJECTIVE: The aims of this study were to quantitative and statistically assess the presence of myofibroblasts on both conventional and CO(2) laser wounds. BACKGROUND DATA: Wound contraction of both traumatic and surgical origin may reduce or limit the function of the tissue. Myofibroblasts are cells involved in the process of wound contraction, which is smaller in CO(2) laser wounds. MATERIALS AND METHODS: Thirty-two animals (rattus norvegicus) were divided into four groups and treated using either the CO(2 )laser (groups 1 and 2) or conventional scalpel (groups 3 and 4). The animals were sacrificed eight days post-operatively (groups: 1 and 3) and 14 days after surgery (groups: 2 and 4). The specimens were routinely processed to wax and stained with alpha-smooth muscle actin (alpha SMA) and analyzed under light microscopy (40x) using a calibrated eyepiece and a graticule. Two standard areas around the wound of each slide were selected and used to count the number of myofibroblasts present. RESULTS: The results of this study show that it is possible to determine the number of myofibroblasts present in wounds produced by the laser or the scalpel at both eight and 14 days after surgery. However the number of myofibroblasts at day eight was significantly higher than at day 14 (laser, p = 0.007 and scalpel, p = 0.001). The number of cells present in group 3 was significantly higher than in group 1 (p = 0.001). However on the 14th day there was no such difference (p = 0.072). CONCLUSION: It is concluded that the small number of myofibroblasts at day eight after wounding with the CO(2) laser may be the reason that contraction on this wound is smaller than the one observed in conventional surgery.     

Necrotizing Fasciitis in the Adult Patient: Implications for Nurse Practitioners

Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. Nurse practitioners in both outpatient and inpatient settings should be vigilant for the hallmark signs and symptoms, such as pain out of proportion to the wound appearance and gray or “dishwasher”-colored discharge from the wound. Prompt recognition of these signs and symptoms, rapid surgical debridement, and early initiation of broad-spectrum antimicrobial management are necessary for optimizing patient outcomes and reducing hospital length of stay, cost, morbidity, and mortality.     

A Prospective Evaluation of Risk Factors for Infections from Dog-bite Wounds

Objective: To define risk factors for infections from dog-bite wounds and to model the probability of wound infection in patients presenting without infection who are treated as outpatients. Methods: A prospective survey of 769 consecutive dog-bite victims presenting over a two-year period to a community hospital emergency department (ED) with an emergency medicine residency program. A standardized wound-cleaning protocol was used, which included debride-ment and wound closure when indicated. Wounds were examined for infection at follow-up. Variables analyzed included demographic data (patient age, gender, race); wound information (wound age, type, number, location, depth); and treatment (prior to hospital, ED debridement, suturing, tetanus or rabies shots, antibiotics). Results: There were 734 patients with complete records. These patients had a mean age of 13.4 ± 13.2 years (range, 4 months to 71 years). Infection was evident in 2.5% of the wounds upon presentation. There were 704 patients (765 wounds) managed as outpatients and without wound infection at initial presentation. Wounds were distributed as follows: 26.7% head/neck, 20.4% hand, 15.7% arm, 10.1% trunk, 9.5% thigh, 15.9% leg, and 1.7% foot. There were 32.9% puncture, 39.9% full-thickness, and 60.1% partial-thickness wounds. Wound infections were diagnosed in 2.1% of these wounds at follow-up. Wounds requiring surgical debridement had a sevenfold higher infection rate (p = 0.01). Patients more than 50 years of age had a sixfold higher infection rate than younger patients (p = 0.05). Stepwise logistic regression found the following variables to be the best predictors for wound infection: full-thickness [p = 0.006, odds ratio (OR) = 6.23], female gender (p = 0.048, OR = 2.88), and wound debridement (p = 0.024, OR = 5.01). Combinations of these three variables predict infection rates from 0.35% to 23.9%. Conclusion: A low wound infection rate was seen in this cohort of dog-bite victims who were treated on an outpatient basts. Wound depth, patient gender, and wound debridement were the clinical variables that best predicted the likelihood of developing infection. Future intervention-al studies should concentrate on wounds with high probabilities of infection.     

真空负压吸引与绑鞋带技术修复小腿骨筋膜间室综合征：减张效果的比较

背景：目前认为负压吸引技术是治疗骨筋膜间室综合征切开减压切口较安全、有效的方法,但是治疗后创面往往不能自行闭合,需要植皮造成副损伤。有研究表明应用绑鞋带技术治疗小腿骨筋膜间室综合征减张切口取得良好的效果,但国内至今少有报道。目的：比较真空负压吸引技术与绑鞋带技术治疗小腿骨筋膜间室综合征切开减张切口的疗效。方法：将36例小腿骨筋膜室综合征患者患者（46个减张切口）随机分为负压吸引组和绑鞋带组,每组各23个减张切口,负压吸引组骨折复位后外固定架固定,切开减张后即行负压封闭引流治疗;绑鞋带组骨折患者复位后外固定架固定,切开减张治疗后创面敷贴负压封闭吸引材料-聚乙烯乙醇水化海藻盐泡沫,皮缘用皮肤吻合器作扣环采用硅橡胶袢充当缚带采用切口绑鞋带治疗技术。治疗后1个月比较两组患者切口大小、切口完全闭合切口所需时间、感染情况、需进一步干预的需求、日常治疗费用等情况。结果与结论：绑鞋带组切口闭合所需时间显著优于负压吸引组（P〈0.05）。负压吸引组中有8个减张切口需行进一步植皮,绑鞋带组无需行植皮;绑鞋带组中5个减张切口需要更换硅橡胶袢。两组中创面感染率比较差异无显著性意义,也均未出现治疗后筋膜间室压力增高及皮缘坏死等现象。结果提示,真空负压吸引技术和绑鞋带技术均为治疗小腿骨筋膜间室综合征切开减张切口安全、有效的治疗技术,其疗效可靠,已被临床使用;与真空负压吸引技术相比,绑鞋带技术伤口闭合时间短、创伤小、疗效更优。     

Dog-bite lacerations: a controlled trial of primary wound closure.

Dog-bite wounds are often left open because of their reputation for infection if primarily closed. A prospective randomized trial comparing primary closure with leaving the wound open was performed to assess infection and cosmesis. Ninety-six patients with 169 lacerations had thorough surgical debridement and irrigation of their wounds. Ninety-two wounds were sutured and 77 left open. No prophylactic antibiotics were given. A total of 13 wounds developed infection: seven sutured and six unsutured wounds (not statistically significant), giving an overall infection rate of 7.7%. Significantly (P less than 0.01), more wound infections occurred in the hand in both groups compared to the rest of the body, indicating that particular attention should be paid to management of such wounds. It was concluded that dog-bite wounds should receive thorough surgical treatment and can be safely sutured at presentation. Special care should be given to hand wounds.     

A cost analysis of a treatment policy of a deliberate perioperative increase in oxygen delivery in high risk surgical patients

Objective: To investigate the cost implications of a treatment policy of a deliberate perioperative increase of oxygen delivery in high risk surgical patients. Design: A cost-effectiveness analysis comparing ‘protocol’ high risk surgical patients in whom oxygen delivery was specifically targeted towards 600 ml/min/m² with ‘control’ patients. Interventions: In a randomised, controlled clinical trial we previously demonstrated a significant reduction in mortality (5.7% vs 22.2%, p=0.015) and morbidity (0.68±0.16 complications vs 1.35±0.20, p=0.008) in ‘protocol’ high risk surgical patients in whom oxygen delivery was specifically targeted towards 600 ml/min per m² compared with ‘control’ patients. This current study retrospectively analysed the medical care and National Health Service resource use of each patient in the trial. Departmental purchasing records and business managers were consulted to identify M28.9nthe unit cost of these resources, and thereby the cost of treating each patient was calculated. Results: The median cost of treating a protocol patient was lower than for a control patient (￡6,525 vs ￡7,784) and this reduction was due mainly to a decrease in the cost of treating postoperative complications (median ￡213 vs ￡668). The cost of obtaining a survivor was 31% lower in the protocol group. Conclusion: Perioperative increase of oxygen delivery in high risk surgical patients not only improves survival, but also provides an actual and relative cost saving. This may have important implications for the management of these patients and the funding of intensive care. Received: 29 February 1996 Accepted: 2 September 1996     

Efficacy of topically delivered moxifloxacin against wound infection by Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus

Wound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 10(5) CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing.     

Low-level laser therapy for wound healing: feasibility of wound dressing transillumination

OBJECTIVE: The purpose of this study was to assess the feasibility of exposing wounds during low-level laser therapy (LLLT) by transillumination of the wound dressings. BACKGROUND DATA: LLLT has been associated with accelerated wound healing in chronic ulcers. The usual approach is to remove wound dressings prior to exposure and to treat three to five times weekly. Frequent change of wound dressings is time consuming and costly; it disrupts the healing process, increases the risk of wound infection, and may be traumatic for the patient. METHODS: A double integrating sphere setup was employed to quantify the diffuse transmittance and reflectance of various wound dressings. Differences in transmittance for large area sources and point sources were demonstrated through the use of a diode laser and an incoherent light source. RESULTS: There were a number of gels and membrane style wound dressings with diffuse transmittance of more than 50%. Hence, for these dressings the prescribed radiant exposure to the wound surface could be achieved by increasing the exposure duration, while maintaining reasonable overall treatment times. CONCLUSIONS: Although LLLT by transillumination of wound dressings is feasible for a variety of wound dressings without significant commitments in additional treatment time, the specific transmission of products not included in this study needs to be determined at the intended treatment wavelength. A transillumination approach may facilitate a faster rate of wound healing than LLLT applied to exposed wounds by reducing trauma and the risk of infection.     

Recombinant human erythropoietin stimulates angiogenesis and healing of ischemic skin wounds

Wound healing in ischemic tissues such as flap margins due to inadequate blood supply is still a source of considerable morbidity in surgical practice. Adequate tissue perfusion is particularly important in wound healing. We investigated the effects of recombinant human erythropoietin (rHuEPO) on wound healing in an ischemic skin wound model. Sixty-three Sprague-Dawley rats were used. Normal incisional wound and H-shaped double flaps were used as the wound models. Animals were treated with rHuEPO (400 IU/kg) or its vehicle. Rats were killed on different days (3, 5, and 10 days after skin injury) and the wounded skin tissues were used for immunohistochemistry and for analysis of vascular endothelial growth factor content and collagen content. Tissue transglutaminase immunostaining of histological specimens was used as a vascular marker to determine the level of microvessel density. The results showed a higher level of vascular endothelial growth factor protein and an increased microvessel density in ischemic wounds with rHuEPO treatment than the normal incisional wounds and ischemic control wounds. Collagen content was higher in the incisional wounds and in the ischemic wounds with rHuEPO treatment compared with the ischemic control wounds. Our results suggest that erythropoietin may be an effective therapeutic approach in improving healing in ischemic skin wounds.     

应用络合碘外敷治疗感染伤口的效果观察

目的观察采用外科常规换药方法外加0.5%的络合碘外敷治疗感染伤口的疗效。方法对62例感染伤口的患者随机分为治疗组和对照组,各31例,治疗组采用外科常规换药方法外加0.5%的络合碘外敷1次/d,而对照组按外科常规换药法处理。结果治疗组疗效明显优于对照组(p<0.05),且治愈时间短(p<0.01)。结论采用外科常规换药方法加络合碘外敷治疗感染创面效果显著。     

Nurse practitioner sutured wounds: a quality assurance review.

This study found a low infection rate (3.1%) in occupationally related lacerations sutured by an on site nurse practitioner in a meat-packing plant where a high infection rate might be expected. This is compared to an overall infection rate of 1% to 30% of all sutured wounds cited in other studies. This review suggests that worksite availability of a nurse practitioner with expertise in suturing and aseptic technique is correlated to a low infection rate. Findings suggest that prophylactic antibiotics do not preclude good wound care, but may still be merited in wounds at high risk of subsequent infection. Infected wounds may cost anywhere from $2,000 to $150,000 per case depending on severity, in addition to other hidden costs. Clearly a decrease in the morbidity of wound care is significant in terms of decreased cost.     

Soft-tissue coverage for the treatment of osteomyelitis of the lower part of the leg

For treatment of chronic osteomyelitic wounds of the lower part of the leg, a three-stage approach is necessary: (1) adequate debridement of bone and soft tissue, (2) control of infection by open packing with frequent dressing changes and use of intravenously administered antibiotics, and (3) healthy soft-tissue coverage and obliteration of dead space. If the bone is unstable, it can be immobilized temporarily by means of external fixation. Bone grafting can be accomplished by use of conventional bone grafting after healing of the soft tissues, a vascularized bone graft, or open bone grafting. Soft-tissue coverage is provided by a local muscle flap or a free muscle flap. We prefer to cover the muscle with a skin graft. The muscle flaps described in this article obliterate dead space, provide soft-tissue coverage, act as a bed for skin grafts, and improve the vascularity of the wound.     

2170例门诊手术病人伤口情况调查分析

本文对2170例门诊手术室处理的多种多样的伤口情况采用前瞻性监测方法进行追踪调查,并对这些手术后伤口发生感染的情况和发生感染的危险因素进行了综合分析,提出了加强门诊手术室的消毒管理,逐步建立健全、严格执行清洁卫生和消毒灭菌的规章制度,把预防和控制交叉感染的措施落实到医护工作的各个环节的重要意义。从而不断提高手术质量,满足病人需要,降低手术感染率,达到更好的治疗效果。     

62例侧颅底肿瘤根治术后缺损重建方法分析

  目的  对侧颅底肿瘤根治术后不同修复重建方法进行分析、总结。  方法  本研究为回顾性分析。研究对象为2012年1月1日至2019年12月31日北京协和医院口腔科和耳鼻咽喉科行侧颅底肿瘤根治术及修复重建的患者。依据缺损情况(不伴皮肤缺损、伴皮肤缺损、伴下颌骨体部及升支缺损)进行不同方法的修复重建,并观察患者出院时伤口愈合情况及重建效果。  结果  共62例患者(63次缺损修复术)纳入本研究。其中不伴皮肤缺损34例、伴皮肤缺损23例、伴下颌骨体部及升支缺损5例,组织瓣成活率为98.41%(62/63),伤口一期愈合率为90.48%(57/63)。不伴皮肤缺损患者中,采取游离脂肪填充修复6例、颞肌瓣联合游离脂肪填充修复14例、胸锁乳突肌瓣或联合颞肌瓣修复13例、颞肌瓣联合颌下腺瓣修复1例;其中2例术后出现脑脊液漏,换药后延期愈合;34例患者术后均未发生感染与脂肪液化,组织瓣成活率为100%,伤口一期愈合率为94.12%(32/34)。伴皮肤缺损患者中,缺损直径≤3 cm者5例,均采用颈面部推进皮瓣联合颞肌瓣和/或胸锁乳突肌瓣修复,皮瓣成活率为100%,伤口一期愈合率为100%;缺损直径＞3 cm者18例(19次缺损修复术),其中行股前外侧肌皮瓣修复8例、胸大肌等带蒂皮瓣修复6例、前臂皮瓣联合带蒂皮瓣或局部组织瓣修复2例、胸大肌皮瓣或联合颈面部推进皮瓣及颌下腺瓣修复2例、腹直肌皮瓣修复1例,1例曾行大剂量放疗患者采用股前外侧肌皮瓣修复后3 d出现静脉栓塞,后改用胸大肌皮瓣救援修复后一期愈合;1例采用股前外侧肌皮瓣移植患者术后第2天出现血肿,清除血肿后伤口一期愈合;1例腹直肌皮瓣修复患者术后出现脑脊液漏,换药后皮损延期愈合;2例采用胸大肌等带蒂皮瓣修复后出现远端小面积坏死,经换药后伤口延期愈合;余患者的伤口均一期愈合,一期愈合率为84.21%(16/19),皮瓣成活率为94.74%(18/19)。伴下颌骨体部及升支缺损患者中,采用腓骨肌皮瓣、游离肋骨移植联合颞肌瓣、股前外侧-股骨肌皮瓣移植修复分别2例、2例、1例,皮瓣均完全成活、伤口一期愈合。10例患者累及硬脑膜造成颅内外沟通,其中7例无术后并发症患者一期愈合,3例脑脊液漏患者经换药后延期愈合。行一期面神经重建患者24例,其中采用耳大神经移植重建12例,舌下神经8例,咬肌神经(+/-)耳大神经3例,股外侧皮神经1例;13例获得随访,面神经功能均获得不同程度的恢复。  结论  侧颅底肿瘤根治性切除术后应根据缺损范围选用不同的重建方式。对于不伴皮肤缺损者,可采用颞肌瓣联合游离脂肪填充或局部组织瓣修复;伴皮肤缺损直径≤3 cm者,可采用颈面部推进皮瓣联合局部组织瓣修复;伴皮肤缺损直径＞3 cm者,股前外侧肌皮瓣是较佳的修复方法。多次手术和术前放疗血管状态不佳或无法进行显微外科手术的患者,可选用胸大肌等带蒂皮瓣;若缺损累及颧弓以上,则可联合颈面部推进皮瓣及局部组织瓣修复;较大范围骨缺损,应酌情修复骨缺损。如条件许可,应争取一期重建面神经缺损。     

Salvage of limb and function in necrotizing fasciitis of the hand: role of hyperbaric oxygen treatment and free muscle flap coverage

We report a case of necrotizing fasciitis of the hand treated by urgent debridement followed by serial debridements, hyperbaric oxygen, and delayed free muscle flap coverage. After control of the infection, a major soft-tissue defect remained on the dorsum of the wrist and hand, exposing all extensor tendons. A rectus muscle free flap was used for wound coverage and salvage of the exposed tendons; the muscle flap was covered with a delayed skin graft. The patient regained satisfactory function with ability to extend all digits. This case emphasizes the importance of aggressive debridement and hyperbaric oxygen treatment and shows the valuable role of free muscle flap wound coverage for preservation of function in cases of necrotizing fasciitis of the hand.     

Salvage of vascular graft infections via vacuum sealing drainage and rectus femoris muscle flap transposition: A case report

BACKGROUNDThe management of vascular graft infections continues to be a significant challenge in a clinical situation. The aim of this report is to illustrate the novel vacuum sealing drainage (VSD) technique and rectus femoris muscle flap transposition for vascular graft infections, and to evaluate the prospective of future testing of this surgical procedure.CASE SUMMARYWe report the case of a 32-year-old male patient, who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure. Using the VSD and muscle flap trans-position, the groin wound and vascular graft infection were finally treated successfully.CONCLUSIONOur case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure, especially in consideration of treatable conditions.     

The effect of Nd:YAG laser-induced hyperthermia on local tumor recurrence in experimental rat mammary tumors

The influence of Nd:YAG laser hyperthermia (45 degrees C for 20 min) on local tumor recurrence followed by CO 2 laser or scalpel excision was studied on 150 F344 female rats that were implanted with R3230AC mammary tumor in the mammary ridge. The development of local tumor recurrence was observed for 39 days postoperatively. All groups undergoing CO 2 laser excision showed a significant reduction in local tumor recurrence (p less than 0.05) compared with the scalpel technique. Animals that underwent CO 2 laser excision and wound sterilization 48 h following laser hyperthermia demonstrated the lowest recurrence when compared with scalpel excision (p less than 0.01). These results indicate that the local thermal effect achieved by laser hyperthermia or laser sterilization plays an important role in the reduction of local tumor recurrence and augments complete local tumor resection.     

Special issues in plastic and reconstructive surgery

Intensivists frequently collaborate with plastic and reconstructive surgeons in treating patients with major wounds, following significant reconstructive procedures, and following free-tissue transfers. Pressure ulcers are a significant source of morbidity and mortality in the intensive care unit; prevention, early recognition, and multidisciplinary treatment are critical components for successful management. Necrotizing fasciitis is an aggressive, soft-tissue infection that requires rapid diagnosis, early surgical intervention frequent operative debridements, and soft-tissue reconstruction Catastrophic abdominal injuries and infections can be treated with an open abdominal approach and require the expertise of a plastic surgeon to reconstruct the abdominal wall. The success of free-tissue transfers and complex reconstructive procedures requires a thorough understanding of the factors that improve flap survival.     

Wound healing of animal and human body sport and traffic accident injuries using low-level laser therapy treatment: a randomized clinical study of seventy-four patients with control group.

BACKGROUND AND OBJECTIVE: The main objective of current animal and clinical studies was to assess the efficacy of low level laser therapy (LLLT) on wound healing in rabbits and humans. STUDY DESIGN/MATERIALS AND METHODS: In the initial part of our research we conducted a randomized controlled animal study, where we evaluated the effects of laser irradiation on the healing of surgical wounds on rabbits. The manner of the application of LLLT on the human body are analogous to those of similar physiologic structure in animal tissue, therefore, this study was continued on humans. Clinical study was performed on 74 patients with injuries to the following anatomic locations: ankle and knee, bilaterally, Achilles tendon; epicondylus; shoulder; wrist; interphalangeal joints of hands, unilaterally. All patients had had surgical procedure prior to LLLT. Two types of laser devices were used: infrared diode laser (GaAlAs) 830 nm continuous wave for treatment of trigger points (TPs) and HeNe 632.8 nm combined with diode laser 904-nm pulsed wave for scanning procedure. Both were applied as monotherapy during current clinical study. The results were observed and measured according to the following clinical parameters: redness, heat, pain, swelling and loss of function, and finally postponed to statistical analysis via chi2 test. RESULTS: After comparing the healing process between two groups of patients, we obtained the following results: wound healing was significantly accelerated (25%-35%) in the group of patients treated with LLLT. Pain relief and functional recovery of patients treated with LLLT were significantly improved comparing to untreated patients. CONCLUSION: In addition to accelerated wound healing, the main advantages of LLLT for postoperative sport- and traffic-related injuries include prevention of side effects of drugs, significantly accelerated functional recovery, earlier return to work, training and sport competition compared to the control group of patients, and cost benefit.