Shanghai, People's Republic of China.
From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Plast Reconstr Surg. 2018 Mar;141(3):646-650. doi: 10.1097/PRS.0000000000004110.
Early intervention might improve the quality of surgical scars. Botulinum toxin type A has been shown to improve surgical scars in the past decade. The purpose of this study was to evaluate the effect of botulinum toxin type A on surgical facial scars.
In this prospective, split-scar, double-blind, randomized controlled trial, 16 consecutive patients who underwent facial surgery between June and October of 2015 were enrolled. Botulinum toxin type A was injected randomly into half of each surgical wound closure immediately after surgery. The scars were assessed independently by two plastic surgeons at a 6-month follow-up visit using the Vancouver Scar Scale and the visual analogue scale. The scar width was also measured.
Fourteen patients completed the study. The visual analogue scale score and scar width measurements revealed a significant improvement in appearance and narrower scars for the botulinum toxin type A-treated halves of the scars (p = 0.046 and p = 0.001, respectively). The mean Vancouver Scar Scale score was 4.68 for the botulinum toxin type A-injected group and 5.24 for the control group (p = 0.15). In addition, the Vancouver Scar Scale height score was significantly different between the two groups (p = 0.008).
This study demonstrates that early postsurgical botulinum toxin injections can produce better, narrower, and flatter facial surgical scars.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
早期干预可能会改善手术疤痕的质量。在过去的十年中，A型肉毒毒素已被证明可以改善手术疤痕。本研究的目的是评估 A 型肉毒毒素对手术面部疤痕的影响。
在这项前瞻性、半疤痕、双盲、随机对照试验中，招募了 2015 年 6 月至 10 月期间接受面部手术的 16 名连续患者。手术后立即将肉毒毒素 A 随机注射到每个手术伤口闭合的一半。在 6 个月的随访中，两位整形外科医生使用温哥华疤痕量表和视觉模拟量表独立评估疤痕。还测量了疤痕的宽度。
14 名患者完成了研究。视觉模拟量表评分和疤痕宽度测量显示，肉毒毒素 A 治疗组的疤痕外观和疤痕宽度明显改善（p=0.046 和 p=0.001）。肉毒毒素 A 注射组的温哥华疤痕量表平均得分为 4.68，对照组为 5.24（p=0.15）。此外，两组温哥华疤痕量表高度评分差异有统计学意义（p=0.008）。
本研究表明，术后早期注射肉毒毒素可产生更好、更窄、更平坦的面部手术疤痕。
临床问题/证据水平：治疗，II 级。
