Abstract
Early postoperative injection of botulinum toxin type A (BTxA) can reduce surgical scar hypertrophy. BTxA injection at different time points is associated with different levels of efficacy, but the efficacy of different doses of BTxA for scar management has not investigated. The purpose of this study was to investigate the effect of different doses of BTxA administered early after surgery on scar improvement through a split-scar experiment. The study included 22 patients who underwent surgery between September 2019 and October 2020. High- and low-dose BTxA was randomly administered into each half of the surgical wound closure immediately after surgery. One half of the incision was injected with a low dose (4 U) of BTxA, and the other half was injected with a high dose (8 U). The scars were then evaluated at postoperative 6 months using the modified Stony Brook Scar Evaluation Scale (mSBSES), and patient satisfaction was evaluated using the Visual Analogue Scale (VAS). The occurrence of complications or adverse events was also recorded. Twenty patients completed the study and were analyzed. Compared with the low-dose sides, the high-dose sides had significantly better mSBSES scores and significantly higher VAS scores (p < 0.01, respectively). No serious adverse reactions or post-injection complications were observed. Immediately after the operation, high-dose BTxA (that is within the therapeutic range) injection improved the appearance of postoperative scar more than low-dose injection.
Highlights
Postoperative injection of botulinum toxin type A (BTxA) can reduce surgical scar hypertrophy
In patients who undergo invasive surgical procedures, the cosmetic scars that appear after wound healing can cause distress[1]
In the last ten years, several studies have indicated that botulinum toxin type A (BTxA) has a positive effect on the prevention and treatment of scars, and these include human studies too[5,6,7,8]
Summary
Postoperative injection of botulinum toxin type A (BTxA) can reduce surgical scar hypertrophy. The purpose of this study was to investigate the effect of different doses of BTxA administered early after surgery on scar improvement through a split-scar experiment. High- and low-dose BTxA was randomly administered into each half of the surgical wound closure immediately after surgery. After the operation, high-dose BTxA (that is within the therapeutic range) injection improved the appearance of postoperative scar more than low-dose injection. Treatment of surgical scars can result in better appearance and decrease the need for treatment in later stages[3]. Various treatments, such as compression therapy, radiation therapy, silicone gel therapy, and laser therapy, have proven to be helpful, but most of these therapies have been unsatisfactory[4]. This prospective, splitscar, randomized controlled trial was performed to investigate the effect of different doses of paralesional BTxA administration on scar cosmesis after surgical excision
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