The Efficacy and Safety of Early Postoperative Botulinum Toxin A Injection for Facial Scars.
BACKGROUND
Scars widen when the underlying musculature pulls apart suture lines, and scars oriented against relaxed skin tension lines are especially susceptible to these distraction forces. Because botulinum toxin A (BTA) induces complete muscle paralysis, the purpose of the current study was to evaluate the effects of BTA using both observer-dependent qualitative assessments and quantitative measurements to verify its beneficial effects on facial scarring.


METHODS
Patients with vertical forehead lacerations, treated by primary closure, were randomly assigned to two groups: one (n = 15) received BTA injections within 5 days of primary closure and the other (n = 15) received no further treatment. Vancouver scar scale (VSS) scores and wound width were determined at the 1-month and 6-month follow-up visits. Quantitative color differences between the scar and surrounding normal skin, using the Commission International d'Eclairage L*a*b* color coordinates, were measured and compared by analyzing photographs.


RESULT
Improved VSS scores, less increase in wound width, and less scar discoloration were noted among patients treated with BTA injections compared with the control group. These differences were observed at the 6-month visit, but not at the 1-month visit.


CONCLUSION
BTA injection improves scar quality when injected during the early postoperative days.


LEVEL OF EVIDENCE I
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['Lee|Seo H|SH|', 'Min|Hyung J|HJ|', 'Kim|Yang W|YW|', 'Cheon|Young W|YW|']
D000293:Adolescent D000328:Adult D019274:Botulinum Toxins, Type A D002921:Cicatrix D015331:Cohort Studies D016001:Confidence Intervals D004305:Dose-Response Relationship, Drug D004334:Drug Administration Schedule D005151:Facial Injuries D005260:Female D006801:Humans D015552:Injections, Intralesional D015601:Injury Severity Score D008297:Male D008875:Middle Aged D015588:Observer Variation D011182:Postoperative Care D011379:Prognosis D019651:Reconstructive Surgical Procedures D012189:Retrospective Studies D018570:Risk Assessment D018709:Statistics, Nonparametric D013997:Time Factors D016896:Treatment Outcome D014945:Wound Healing D055815:Young Adult
Botulinum toxin A Facial scarring Scar hyperpigmentation Scar maturation Wound healing