Xiao Zhibo, Zhang Fengmin, Cui Ziwei
Department of Plastic Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, People's Republic of China.
Aesthetic Plast Surg. 2009 May;33(3):409-12. doi: 10.1007/s00266-009-9334-z. Epub 2009 Apr 9.
Hypertrophic scar is the abnormal appearance of wound healing that usually causes major physical, psychological, and cosmetic problems. Treatment of the hypertrophic scar still is a dilemma due to the lack of effective and excellent methods and agents. Recent reports show that botulinum toxin type A (BTX-A) improves wound healing. Therefore, the authors hypothesized that BTX-A may be favorable for the improvement of hypertrophic scars.
A total of 19 patients were randomly assigned to a prospective clinical study. At 1-month intervals, BTX-A (2.5 U per cubic centimeter of lesion) was injected in these patients for a total of 3 months. All the patients were followed up for at least half a year. Therapeutic satisfaction was recorded, and the lesions were assessed for erythema, itching sensation, and pliability.
The study was completed by 19 patients. At the half-year follow-up visits, all the patients showed acceptable improvement, and the rate of therapeutic satisfaction was very high. The erythema score, itching sensation score, and pliability score after the BTX-A injection all were significantly lower than before the BTX-A injection. The differences all were statistically significant (P < 0.01).
For the treatment of hypertrophic scars, doctors and patients both found BTX-A acceptable because of its better therapeutic results. Its effect of eliminating or decreasing hypertrophic scars was promising.
肥厚性瘢痕是伤口愈合的异常表现,通常会导致严重的生理、心理和美容问题。由于缺乏有效且出色的方法和药物,肥厚性瘢痕的治疗仍然是一个难题。最近的报告显示,A型肉毒杆菌毒素(BTX-A)可改善伤口愈合。因此,作者推测BTX-A可能有利于改善肥厚性瘢痕。
共19例患者被随机分配至一项前瞻性临床研究。每隔1个月,向这些患者注射BTX-A(每立方厘米病变组织2.5单位),共注射3个月。所有患者均随访至少半年。记录治疗满意度,并对病变部位的红斑、瘙痒感和柔韧性进行评估。
19例患者完成了该研究。在半年的随访中,所有患者均有可接受的改善,治疗满意度很高。注射BTX-A后的红斑评分、瘙痒感评分和柔韧性评分均显著低于注射BTX-A前。差异均具有统计学意义(P < 0.01)。
对于肥厚性瘢痕的治疗,医生和患者均因BTX-A较好的治疗效果而认为其可接受。其消除或减轻肥厚性瘢痕的效果很有前景。