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Efficacy of Botulinum Toxin in Healing of Posttraumatic Facial Lacerations: A Prospective, Randomized, Comparative Study

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Abstract Background: Posttraumatic facial scars are not only unaesthetic but also have a negative sociopsychological impact. Surgeons constantly try to achieve the most aesthetic scar by various suturing methods. The… Click to show full abstract

Abstract Background: Posttraumatic facial scars are not only unaesthetic but also have a negative sociopsychological impact. Surgeons constantly try to achieve the most aesthetic scar by various suturing methods. The tensile forces acting on the edges of the wound during healing are a major factor in determining the final appearance of a scar. Aim: Injecting botulinum toxin type A (BTX-A) locally to produce temporary muscular paralysis to relieve the tensile forces acting on suture line, thus improving the appearance of the scar. Materials and Methods: In this study, patients with posttraumatic facial lacerations were locally injected with BTX-A before suturing (with vicryl 4-0 and ethilon 5-0 in layers). BTX-A reformulated with local anesthetic with vasoconstrictive was used in this study for immediate action. Patients were followed for a duration of 6 months with standardized photographs of the scar for evaluation. Result: A total of 50 patients with traumatic facial lacerations were included in the study. This study demonstrated significantly less increase in scar width (P = 0.000) and irregularities (P = 0.017), and improved discoloration of the scar (P = 0.000) in patients who received BTX-A injection. The overall results showed significant (P < 0.05) improvement over the period of 6 months. Both visual analog scale scoring and patient self-assessment scale were favorable in the BTX-A group, showing statistically significant improvement (P < 0.05). Conclusion: Botulinum toxin-induced immobilization of the wound enhances healing and improves the eventual appearance of the scar.

Keywords: scar; posttraumatic facial; facial lacerations; botulinum toxin; study

Journal Title: Journal of Cutaneous and Aesthetic Surgery
Year Published: 2022

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