Botulinum Toxin Type A and the Prevention of Hypertrophic Scars on the Maxillofacial Area and Neck: A Meta-Analysis of Randomized Controlled Trials.

Dai-Zun Zhang,Xiao-Ya Liu,Yao-Xiang Xu,Wen-Lin Xiao,Michel R Popoff

doi:10.1371/journal.pone.0151627

Dai-Zun Zhang, Xiao-Ya Liu + Show 3 more

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https://doi.org/10.1371/journal.pone.0151627

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Abstract

BackgroundThe purpose of the meta-analysis was to evaluate the efficiency of therapeutic botulinum toxin type A (BTX-A) in the prevention of maxillofacial and neck scars.Methods and FindingsInformation came from the following electronic databases: Medline, PubMed, Cochrane Library, and EMBASE (time was ended by August 31, 2015) to retrieve RCTs evaluating the effect of the BTX-A for hypertrophic scar on the maxillofacial or neck. All languages were included as long as they met the inclusion criteria. Here the effects of BTX-A were evaluated by comparing the width of the scar, patient satisfaction, and the visual analysis scores (VAS), respectively. Pooled weighted mean differences (WMDs), pooled odds ratios (ORs), and 95% confidence intervals (CI) were calculated. Nine RCTs covering a total of 539 patients were included. A statistically significant difference in scar width was identified between the BTX-A group and control group (non-BTX-A used) (WMD = -0.41, 95% CI = -0.68 to -0.14, P = 0.003). A statistically significant difference in patient satisfaction was observed between the BTX-A group and control group (OR = 25.76, 95% CI = 2.58 to 256.67, P = 0.006). And in patients regarding visual analysis scores (VAS), a statistically significant difference was also observed between the BTX-A group and control group (WMD = 1.30, 95% CI = 1.00 to 1.60, P < 0.00001).ConclusionsThis meta-analysis evaluates the efficacy of the BTX-A and confirms that BTX-A is a suitable potential therapy for the prevention of hypertrophic scars in patients in the maxillofacial and neck areas.

Highlights

Patients are often disappointed if they have an ugly scar especially a hypertrophic scar on their face or neck [1]
This meta-analysis evaluates the efficacy of the botulinum toxin type A (BTX-A) and confirms that BTX-A is a suitable potential therapy for the prevention of hypertrophic scars in patients in the maxillofacial and neck areas
A broad body of literature has shown that BTX-A can lessen the intensity of tensile forces by inducing temporary paralysis of the muscles that injected into the wound edges [5,6,7]

Summary

Introduction

Patients are often disappointed if they have an ugly scar especially a hypertrophic scar on their face or neck [1]. In both western and eastern societies, hypertrophic scarring is often regarded as aesthetically displeasing [2]. It troubles many people by restricting the movements of their joints in one or more directions, reducing the functional performance of the face, which, given the role of facial expressions in everyday human interaction, can bring considerable physical and psychological harm [3]. The purpose of the meta-analysis was to evaluate the efficiency of therapeutic botulinum toxin type A (BTX-A) in the prevention of maxillofacial and neck scars

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Results

Conclusion