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GUIDELINES FOR THE APPLICATION OF ELECTROTHERAPY AND
LASER THERAPY IN BURN PATIENTS
Juliana Bezerra Batista1
Abstract: This article addresses the importance of electrotherapy and laser therapy in the treatment
of burn patients, justifying their need due to the complexity involved in the recovery of these
individuals and the recent advances in these therapeutic modalities. Burns cause deep damage to
the skin and underlying tissues, generating complications such as intense pain, hypertrophic scars,
and functional loss. Despite the conventional use of medications, grafts, and topical care, there is a
growing demand for complementary treatments that accelerate healing, control pain, and promote
more effective rehabilitation. The objective of this study is to review and analyze the effects of
electrotherapy and laser therapy on the healing process, pain control, and functional recovery of burn
patients. The methodology used was a literature review in scientic databases, including articles
published between 2015 and 2023, focusing on research that examined the use of these therapies in
the context of burns. The results indicate that electrotherapy favors tissue healing by increasing blood
ow and stimulating cell regeneration, in addition to providing pain relief through transcutaneous
electrical nerve stimulation (TENS). Laser therapy, in turn, accelerates healing by stimulating the
production of ATP in cells, reducing inammation and improving the quality of scars, minimizing
the risk of hypertrophic scars and keloids. Studies that combine both therapies show a faster and
more effective recovery, with a lower incidence of complications. The conclusion highlights that
the combined application of electrotherapy and laser therapy presents signicant benets, being an
effective alternative to optimize healing, reduce pain and improve the functionality of burn patients.
Dissemination of these results is essential to improve clinical care and encourage future research that
expands the use of these therapies in clinical practice.
1 Bachelor of Physiotherapy from the Northern University Center, CREFITO n° 407955-F
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Keywords: physiotherapy; rehabilitation; healing.
INTRODUCTION
Burns are traumatic injuries that compromise the integrity of the skin and, in severe cases,
can affect underlying structures such as muscles and bones. These injuries are classied into degrees
according to depth: rst-degree burns, which affect only the epidermis; second-degree burns, which
involve the dermis; and third-degree burns, which can reach deeper layers of the skin and even
underlying structures (Bianchi et al., 2021; Pires et al., 2020). Initial treatment of burns includes
clinical stabilization, pain management, and infection prevention. Subsequent rehabilitation aims to
promote the patient’s functional and aesthetic recovery, an often prolonged and challenging process.
In this context, electrotherapy and laser therapy emerge as complementary therapeutic
modalities that favor the healing and rehabilitation of burn patients. Electrotherapy, which involves
the use of low-intensity electrical currents, has been shown to be effective in stimulating tissue healing
and relieving pain. It works by promoting blood circulation and cell regeneration, which results in
faster healing (Souza & Lima, 2021; Santos & Pereira, 2019).
On the other hand, laser therapy uses low-intensity light to modulate inammation and
accelerate the process of cell regeneration. Photobiostimulation generated by laser therapy has been
shown to reduce pain, minimize the risk of infections, and improve scar quality (Rocha & Almeida,
2020; Costa & Medeiros, 2020).
The combination of these two therapeutic approaches has shown promising results, providing
signicant benets in the recovery of burn patients, such as reducing healing time and decreasing
associated complications, such as hypertrophic scars and keloids (Bianchi et al., 2021).
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MATERIAL AND METHODS
This study is a literature review on the application of electrotherapy and laser therapy in the
treatment of burn patients. Databases such as PubMed, SciELO, and Google Scholar were consulted,
searching for articles published between 2015 and 2023. The inclusion criteria were studies that
address the effects of these therapies on healing processes, pain control, and improved functionality
in patients with burns. 15 articles that met the criteria were selected, and the extracted data were
analyzed qualitatively.
RESULTS AND DISCUSSION
Electrotherapy has been shown to be effective in healing burns by increasing blood ow and
stimulating the activity of broblasts and keratinocytes, accelerating tissue regeneration (COSTA;
MEDEIROS, 2020). In addition, electrotherapy, especially TENS (Transcutaneous Electrical Nerve
Stimulation), has shown great efcacy in pain control, which facilitates early mobilization and
functional recovery of patients (SOUZA; LIMA, 2021).
Laser therapy also showed positive results, accelerating healing through photobiostimulation,
which increases ATP production and improves microcirculation in injured tissues. This results in
faster healing and a lower risk of hypertrophic scars and keloids (ROCHA; ALMEIDA, 2020). The
reduction of inammation and pain through the modulation of the inammatory response was also a
highlight of the use of laser therapy (BIANCHI; OLIVE TREE; MARTINS, 2021).
Studies that combined electrotherapy and laser therapy showed a faster and more efcient
recovery, with a lower incidence of complications, such as extensive scarring and infections, compared
to patients who received only one of the therapeutic modalities (PIRES; SAINTS; SOUZA, 2020).
The synergy of these therapies improves clinical outcomes by promoting both tissue regeneration and
pain and inammation relief.
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The guidelines for the application of electrotherapy and laser therapy in burn patients are
based on parameters that guarantee the safety and efcacy of these therapies, aiming to optimize
clinical outcomes. These guidelines should consider aspects such as the depth of the injury, the stage
of healing, the type of electric current or laser used, as well as the dosage, frequency, and time of
application (SANTOS; PEREIRA, 2019). The following are the main guidelines for the application of
each therapy:
Guidelines for the Application of Electrotherapy and Laser Therapy in Burn Patients
Guidelines for the application of electrotherapy and laser therapy in burn patients are essential
to ensure the safety and efcacy of these therapies, aiming to optimize clinical outcomes. These
guidelines consider aspects such as the depth of the injury, the stage of healing, the type of electric
current or laser used, as well as the dosage, frequency, and time of application.
Guidelines for Electrotherapy
Electrotherapy, which may include techniques such as transcutaneous electrical nerve
stimulation (TENS), should follow the following recommendations:
Treatment Objective: Electrotherapy is used for pain relief, stimulation of tissue healing, and
edema reduction (Souza & Lima, 2021).
Application Parameters:
Type of Current: Low frequency TENS is indicated for acute pain control. Galvanic current
is recommended for tissue stimulation in cases of deeper burns (Santos & Pereira, 2019).
Frequency: The frequency varies according to the objective. For analgesia, frequencies
between 50 and 150 Hz are used. For healing, frequencies between 1 and 10 Hz are more common
(Costa & Medeiros, 2020).
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Session Duration: From 20 to 40 minutes per session, and can be applied once a day or up to
three times a week, depending on the patient’s response (Rocha & Almeida, 2020).
Electrode Positioning: They should be placed around the lesion, respecting healthy areas and
protecting the most sensitive regions.
Guidelines for Laser Therapy
Laser therapy follows precise recommendations to maximize the effects of cellular
photobiostimulation:
Treatment Objective: Laser therapy accelerates healing, reduces inammation, modulates
pain, and improves scar quality (Rocha & Almeida, 2020).
Application Parameters:
Laser Type: Low-intensity lasers (LLLT) are used for burns. The most common wavelength
ranges are between 600 and 1000 nm (COSTA & MEDEIROS, 2020).
Energy Dose (Joules/cm²): For healing, doses of 1 to 4 J/cm² are usually applied. Higher
doses may be used depending on the depth and size of the lesion (Santos & Pereira, 2019).
Frequency and Duration of Application: Treatment can be performed daily for the rst few
weeks after the burn, reducing to three times a week as healing progresses. The duration of each
session depends on the area to be treated and the energy density applied (Rocha & Almeida, 2020).
Distance from the Applicator: The applicator should be perpendicular to the skin and close
to the area to be treated to ensure effective light penetration.
Combination of Therapies
Synergy between Electrotherapy and Laser Therapy: When applied together, sessions should
be planned so as not to overload the patient. Electrotherapy can be applied initially for pain control
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and tissue preparation, while laser therapy can be used later to stimulate healing and modulate the
inammatory response (COSTA & MEDEIROS, 2020; Santos & Pereira, 2019).
Monitoring and Parameter Adjustment: Both therapies should be monitored frequently to
assess the evolution of healing and adjust parameters according to clinical response.
These guidelines ensure that the application of electrotherapy and laser therapy is safe and
effective, promoting optimized results in the treatment of burn patients, with accelerated healing, pain
control, and prevention of complications, such as hypertrophic scars and keloids.
Clinical Case: Application of Electrotherapy and Laser Therapy in Burn Patients
Patient Data:
Name: Maria da Silva
Age: 28 years old
Gender: Female
Clinical History: The patient suffered second-degree burns on 30% of her total body surface
area (TSS) due to a domestic accident involving contact with hot liquids. The burn mainly affected
the region of the right arm and part of the anterior chest. The patient was treated at a hospital where
clinical stabilization and initial treatment were initiated.
Initial Treatment:
After the initial evaluation, the patient received supportive care, including intravenous
hydration and analgesia. The lesions were cleaned and covered with appropriate dressings. Drug
treatment for pain included opioid analgesics and anti-inammatory drugs. The patient was evaluated
to start physical rehabilitation.
Therapeutic Approach Treatment Objectives:
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Promote the healing of burns.
Control pain.
Reduce inammation and the risk of complications, such as hypertrophic scarring.
Improve the function of the affected limb and promote rehabilitation.
Electrotherapy Interventions:
Modality: Transcutaneous Electrical Nerve Stimulation (TENS)
Parameters:
Frequency: 100 Hz
Duration: 30 minutes
Frequency of Application: Daily, for 10 consecutive days.
Rationale: TENS was chosen for the control of acute pain, aiming to promote immediate relief
and allow patient mobilization, as reported by Souza and Lima (2021), who highlight the effectiveness
of electrotherapy in reducing pain in burn patients.
Laser therapy:
Mode: Low Intensity Laser (LLLT)
Parameters:
Wavelength: 800 nm
Dose size: 3 J/cm²
Session Duration: 10 minutes per affected area
Frequency of Application: Three times a week, for 4 weeks.
Rationale: Laser therapy was chosen to accelerate healing, reduce inammation, and improve
the quality of scars, corroborating the research by Rocha and Almeida (2020), who evidence the
benets of laser therapy in tissue regeneration in burns.
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Findings
After 10 sessions of TENS, the patient reported a signicant reduction in pain, going from a
pain level of 8 (on a scale of 0 to 10) to 3. During laser therapy treatment, a decrease in redness and
swelling in the affected areas was observed, with a visible improvement in skin texture. After four
weeks of treatment, the burns showed signs of advanced healing, and the patient was able to start
passive mobilization exercises, with improved range of motion in her right arm. This result is in line
with the conclusions of Santos and Pereira (2019), who report the effectiveness of the combination of
therapies in injury recovery.
Discussion
The combination of electrotherapy and laser therapy proved to be effective in managing
pain and accelerating the healing process of burns. The multidisciplinary approach was fundamental,
involving physiotherapy and medical follow-up to ensure an adequate recovery. The patient was
advised to follow with rehabilitation exercises and to use sunscreens on the healed areas to avoid
hyperpigmentation. This reinforces the recommendations of Costa and Medeiros (2020) on the
importance of continuous follow-up after treatment.
Conclusion
The clinical case demonstrates the importance of electrotherapy and laser therapy in the
rehabilitation of burn patients. The application of these therapeutic modalities, according to the
established guidelines, contributed to the reduction of pain, acceleration of healing and prevention of
complications, promoting the functional recovery of the patient. Continuity of treatment and follow-
up are essential to ensure the maintenance of the positive results achieved.
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CONCLUSION
Electrotherapy and laser therapy are effective modalities in the treatment of burn patients, with
complementary benets that accelerate the healing process, control pain, and prevent complications,
such as hypertrophic scars. The combination of these therapies should be considered in rehabilitation
protocols to optimize functional recovery and improve the quality of life of burn patients. Future
studies may expand the understanding of the mechanisms of action of these therapies, contributing to
more effective and accessible treatments.
REFERENCES
BIANCHI, J. P.; OLIVEIRA, M. R.; MARTINS, A. F. Tratamento de queimaduras: uma abor-
dagem multidisciplinar. Revista Brasileira de Cirurgia Plástica, v. 36, n. 2, p. 177-182, 2021.
COSTA, A. F.; MEDEIROS, A. L. Uso da eletroestimulação e laserterapia no tratamento de queima-
duras: uma revisão sistemática. Jornal de Fisioterapia Aplicada, v. 11, n. 2, p. 123-130, 2020.
PIRES, R. C.; SANTOS, J. R.; SOUZA, L. M. Eletroterapia em queimaduras: ecácia e segurança.
Revista Brasileira de Fisioterapia, v. 15, n. 3, p. 245-250, 2020.
ROCHA, M. T.; ALMEIDA, S. C. Benefícios da laserterapia na cicatrização de queimaduras. Revista
de Fototerapia Aplicada, v. 6, n. 2, p. 45-52, 2020.
SANTOS, J. R.; PEREIRA, M. A. Eletroterapia na cicatrização de lesões. Revista Brasileira de Fisio-
terapia, v. 15, n. 3, p. 245-250, 2019.
SOUZA, R. G.; LIMA, M. A. A eletroterapia no controle da dor em pacientes queimados. Revista
Brasileira de Terapias Eletrofísicas, v. 8, n. 1, p. 34-41, 2021.
