Combined cold atmospheric plasma and photobiomodulation is associated with improved early macroscopic and ultrasonographic wound-healing parameters after unilateral mastectomy in female dogs: an exploratory randomized intra-individual controlled clinical study.

Abstract

Background: Postmastectomy complications remain relevant in veterinary surgery. Although cold atmospheric plasma (CAP) and photobiomodulation (PBM) may improve tissue repair, evidence on their combined use is limited. This exploratory pilot study evaluated CAP-PBM therapy in nine female dogs undergoing unilateral mastectomy.

Methods: A prospective, randomized, blinded, intra-individual controlled clinical study was conducted in nine female dogs with mammary neoplasia undergoing clinically indicated unilateral mastectomy. In each dog, one half of the surgical wound was randomly assigned to receive sequential CAP and PBM therapy, while the contralateral half remained untreated and served as an intra-individual control. Evaluations were performed on postoperative days 3, 7, and 14 (D3, D7, and D14) using macroscopic scoring systems, ultrasonography, and infrared thermography; histomorphometric analysis was performed only on D7.

Results: Treated regions showed significantly lower Modified Hollander Scar Scale (p < 0.001) and Modified Draize Scoring System (p = 0.001) scores. Ultrasonographic assessment demonstrated lower semiquantitative scores (p = 0.029) and reduced subcutaneous thickness (p = 0.034), especially during the early postoperative period. Thermographic findings did not differ significantly between groups. Histological analysis revealed numerically greater re-epithelialization in treated areas, although without statistical significance (p > 0.05).

Conclusions: In this exploratory pilot study, combined CAP + PBM therapy was associated with improved early macroscopic and ultrasonographic healing parameters after mastectomy in female dogs. These preliminary findings support further investigation of CAP + PBM as a promising non-invasive adjuvant strategy for postoperative wound management, pending confirmation in larger, adequately powered randomized studies.