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EN109-1633750-40 IFU
Protocol for the safe application of Low Level Laser Therapy
•
Check for contraindications
•
(Consider the risks = relative
CI’
s)
•
Position and instruct patient
Ensure comfortable body positioning, inform the patient that he / she may feel nothing during treatment
•
Prepare treatment area
Normal skin: cleanse the exposed skin with rubbing alcohol to remove impurities.
Shave excessive hair if necessary.
Wounded skin; wash and debride the wound. Wear protective gears like goggles, mask, gown, and gloves to
prevent contamination.
•
Estimate location, depth, and surface area of lesion.
Locate the pathologic soft-tissue lesion, estimate its depth (in centimeters) from the skin surface, and measure
its surface area (in square centimeters). lnformation about tissue depth will guide the selection of laser.
Measurement of lesion's surface area will guide the selection of applicator's size.
•
Select applicator type.
Choose between the available Laser Probes. Select the handheld single-beam for small, cluster probe for
medium treatment areas.
•
Select application technique.
•
Choose between stationary with contact, stationary with non-contact, gridding, and scanning.
•
Stationary with contact: the applicator makes contact with the skin and is kept in place for the entire
irradiating duration or treatment. This method eliminates photonic reflection off the skin surface and
minimizes beam divergence because of the probe's close proximity to the treated area.
•
Stationary with non-contact: the applicator makes no contact with the skin and is kept in place for the
entire irradiating duration or treatment. The applicator-irradiating surface is maintained at a few
millimeters (less than 1 cm from skin surface).
This method is recommended when patients cannot tolerate the pressure exerted by the applicator on the
treated surface.
•
Gridding: this technique, also called
‘
point-by-point
’
, consists in making a grid by mapping the entire
treatment surface area with 1 cm
2
squares to guide the point-by-point application. Each square
centimeter corresponds to one point, thus the related term point-by-point technique. The grid can be
made either visually or with a plastic sheet and a pen. Gridding is used with the handheld single-beam
probe, because its tip or irradiating area is about 1 cm
2
.
•
Scanning: the entire treatment surface area is scanned (non-contact) using handheld single-beam and
clustertype probes. This scanning action may be done by manipulating the probe (up-and-down and side-
to-side movements).
•
Set dosimetry.
Choose between continuous or pulsed mode of delivery. Determine the dose (J) of energy that you want to
deliver to the tissues per application. Use the dosage recommendations from the WALT (World Association
For Laser Therapy) as a guideline.
Treatment Considerations:
•
Darker skin pigmentation: absorbs photo energy, therefore use higher dose.
•
Small stature and frail patients: start at lower dose (e.g., elderly, children).
•
Deeper target tissue requires higher dose.
•
Tissue type: adipose does not absorb photo energy, while muscle does absorb photo energy.
•
Anti-inflammatory medications may potentially decrease effectiveness of LLLT. Consider reducing or
discontinuing anti-inflammatory medications.
•
Recent steroid injections (within 72 hours): may be counterproductive to LLLT; treat one week post
injection.
•
Put on protective laser goggles.
Both patients and practitioners must wear protective goggles, which filters the wavelength range emitted by
the laser device during therapy.
•
Position the applicator
Keep the laser beam as perpendicular as possible to the exposed treated surface area to minimize light
reflection. If non-contact is used, keep the distance separating the applicator and the exposed skin surface as
small as possible and constant from one application (=area just irradiated) to the next
.
