PMID- 23102873 OWN - NLM STAT- MEDLINE DCOM- 20130314 LR - 20220408 IS - 1878-0539 (Electronic) IS - 1748-6815 (Linking) VI - 66 IP - 2 DP - 2013 Feb TI - Use of botulinum toxin type A to improve treatment of facial wounds: a prospective randomised study. PG - 209-14 LID - S1748-6815(12)00548-7 [pii] LID - 10.1016/j.bjps.2012.09.012 [doi] AB - BACKGROUND: The tension vectors acting on the wound edges are transmitted to immature collagen fibres synthesised during the normal healing phase. This accounts for scar widening as well as hypertrophic and hyperpigmented scars. The aim of our study was to evaluate whether early injections of botulinum toxin type A (BTA), which induces temporary muscular paralysis, decreases tension vectors on wound edges and enhances scarring of facial wounds. PATIENTS AND METHODS: Thirty patients with facial wounds were enrolled in this study and randomised into two groups with or without injection of BTA within 72 h postoperatively. BTA was injected into the facial muscles directly or indirectly involved in scar widening. Scars were assessed at a 1-year follow-up visit by patients using the Patient Scar Assessment Scale (PSAS) scale, by an independent evaluator using the Observer Scar Assessment Scale (OSAS) and the Vancouver Scar Scale (VSS), and by a board of six experienced medical specialists using the Visual Analogue Scale (VAS) with standardised photographs. RESULTS: At the 1-year visit, 24 patients were reviewed and six patients were lost to follow-up. No statistically significant differences were found between the two groups for the PSAS, OSAS and VSS scores. However, the median VAS rated by the six evaluators was 8.25 for the botulinum toxin-treated group compared with 6.35 for the control group. This result was statistically different, demonstrating improved scarring with BTA. CONCLUSIONS: Thanks to chemoimmobilisation, injections of BTA appear to improve cosmesis of facial wounds. Accordingly, they would be beneficial for use in young patients for wounds without tissue loss, lying perpendicular to the reduced tension lines of the skin of the face. CI - Copyright (c) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. FAU - Ziade, Makram AU - Ziade M AD - Department of Plastic and Reconstructive Surgery, Lapeyronie University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France. m_ziade@hotmail.com FAU - Domergue, Sophie AU - Domergue S FAU - Batifol, Dominique AU - Batifol D FAU - Jreige, Riad AU - Jreige R FAU - Sebbane, Mustapha AU - Sebbane M FAU - Goudot, Patrick AU - Goudot P FAU - Yachouh, Jacques AU - Yachouh J LA - eng PT - Comparative Study PT - Journal Article PT - Randomized Controlled Trial DEP - 20121025 PL - Netherlands TA - J Plast Reconstr Aesthet Surg JT - Journal of plastic, reconstructive & aesthetic surgery : JPRAS JID - 101264239 RN - EC 3.4.24.69 (Botulinum Toxins, Type A) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Botulinum Toxins, Type A/*administration & dosage MH - Chi-Square Distribution MH - Cicatrix/*prevention & control MH - Dose-Response Relationship, Drug MH - Drug Administration Schedule MH - Esthetics MH - Facial Injuries/diagnosis/*drug therapy/surgery MH - Female MH - Follow-Up Studies MH - Humans MH - Injections, Intramuscular MH - Injury Severity Score MH - Male MH - Middle Aged MH - Postoperative Care/methods MH - Prospective Studies MH - Reference Values MH - Risk Assessment MH - Single-Blind Method MH - Statistics, Nonparametric MH - Treatment Outcome MH - Wound Healing/*drug effects/physiology MH - Young Adult EDAT- 2012/10/30 06:00 MHDA- 2013/03/15 06:00 CRDT- 2012/10/30 06:00 PHST- 2012/01/11 00:00 [received] PHST- 2012/08/06 00:00 [revised] PHST- 2012/09/13 00:00 [accepted] PHST- 2012/10/30 06:00 [entrez] PHST- 2012/10/30 06:00 [pubmed] PHST- 2013/03/15 06:00 [medline] AID - S1748-6815(12)00548-7 [pii] AID - 10.1016/j.bjps.2012.09.012 [doi] PST - ppublish SO - J Plast Reconstr Aesthet Surg. 2013 Feb;66(2):209-14. doi: 10.1016/j.bjps.2012.09.012. Epub 2012 Oct 25.