The use of botulinum toxin type A to minimize scarring in cleft lip repair: A literature review

Alhazmi, Bushra; Aldekhayel, Salah

doi:10.5999/aps.2018.01284

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…26 The tension acting on the wound edge is an important factor determining the appearance of scars after wound healing. 27 BTXA can cause temporary muscle paralysis in the wound and reduce the tension perpendicular to the edge of the wound 10,28 ; therefore, BTXA can partially eliminate the dynamic tension on the wound. It can also significantly reduce collagen deposition, thereby preventing the formation of scars.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis

Zhang

2020

J Cutan Med Surg

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Background Scars with poor cosmesis that develop after wound healing may affect normal life. Objective To assess the efficacy and safety of botulinum toxin type A (BTXA) in preventing postoperative hypertrophic scars or keloids. Methods A systematic review was performed by searching the PubMed, Cochrane Library, and EMBASE databases from their inception date up to February 2020 for randomized controlled trials (RCTs) evaluating the efficacy of BTXA in preventing hypertrophic scars or keloids. The primary outcome measures included the Vancouver Scar Scale (VSS) score, Visual Analog Scale (VAS) score, scar width, patient satisfaction, and adverse events. Results Twelve RCTs involving 497 cases (372 patients) were included. The meta-analysis showed significant differences in the VAS score (weighted mean difference [WMD] = 1.31, 95% CI = 1.06 to 1.55, P < .00001), VSS score (WMD = −1.02, 95% CI = −1.72 to −0.32, P = .004), scar width (WMD = −0.18, 95% CI = −0.29 to −0.08, P = .0008), and patient satisfaction (relative risk = 1.25, 95% CI = 1.06-1.49, P = .01). Four studies reported trivial adverse events. Conclusions This meta-analysis showed that BTXA was more effective than the control treatment in preventing postoperative scars and improving the cosmetic appearance of facial scars for East Asians, and no serious adverse events were found during the follow-up period. However, there was insufficient evidence to support the use of BTXA for the prevention of scars in patients from other ethnic groups and regions or scars in non-facial areas.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis

Zhang

2020

J Cutan Med Surg

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“…[35] It acts by inhibiting acetylcholine secretion in neuromuscular junctions which leads to the temporary paralysis of the muscles leading to muscle relaxation causing paralysis to underlying Orbicularis Oris muscle, eliminating muscular tension in the wound leading to narrower scar lasting for 3-6 months. [41,42] Surgical methods are applied to prevent scar by implementing specific surgical procedures to avoid wound tension as it is very important factor to avoid during the proliferative and remodeling phases of wound healing and this is achieved by the choice of incision design. [43] Extended Mohler repair, a popular modification of rotation advancement technique has been made which involved extending a back cut to the non-cleft side philtral column.…”

Section: Hypertrophic Scar Formation (Hts) Is a Common Postoperative ...mentioning

confidence: 99%

Dilemma of Postoperative Scarring in Cleft Lip and Palate: A Narrative Review

Ramzy,

Gaber,

El Kassaby

2023

OMX

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Clefts in lip and palate is a highly incident abnormality affecting the facial and oral region. It affects nearly 1 in 700 live births, with various geographic origin, racial groups, Clefts can occur in either two forms; syndromic or isolated, occurring in different forms either lip only or palate only or both lip and palate. Infants suffer from esthetic disfigurement and functional morbidity in swallowing, speech, hearing and growth. Clefts are multifactorial in etiology either from genetic or environmental causes. However, despite the cooperation of the multidisciplinary team appointed for treatment and the variety of surgeries that exist in the literature, scars evolve. The literature presents different and various methods to manage this scar whether in surgical or non-surgical forms. The purpose of this narrative review is to review the methods postulated for managing these postsurgical scars to eliminate their detrimental effects and to be of aid to the surgeon and patient welfare himself.

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“…BTA can alleviate tension around the scar possibly in two ways: (1) temporarily paralyzing the underlying muscle, as well as (2) modulating fibroblast activity and reducing expression of TGF-β in dermis ( 123 , 124 ). There is emerging evidence that early postoperative administration of BTA yields reduced scar, including cleft lip repair ( 125 , 126 ), thyroidectomy ( 127 ), etc. BTA also demonstrates efficacy to established HTS ( 124 ).…”

Section: Clinical and Potential Biological Strategies For Hts Prevent...mentioning

confidence: 99%

Mechanotransduction in skin wound healing and scar formation: Potential therapeutic targets for controlling hypertrophic scarring

et al. 2022

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Hypertrophic scarring (HTS) is a major source of morbidity after cutaneous injury. Recent studies indicate that mechanical force significantly impacts wound healing and skin regeneration which opens up a new direction to combat scarring. Hence, a thorough understanding of the underlying mechanisms is essential in the development of efficacious scar therapeutics. This review provides an overview of the current understanding of the mechanotransduction signaling pathways in scar formation and some strategies that offload mechanical forces in the wounded region for scar prevention and treatment.

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The use of botulinum toxin type A to minimize scarring in cleft lip repair: A literature review

Cited by 9 publications

References 24 publications

Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis

Efficacy and Safety of Botulinum Toxin Type A in Preventing Postoperative Scars and Improving the Cosmetic Appearance of Scars: A Systematic Review and Meta-Analysis

Dilemma of Postoperative Scarring in Cleft Lip and Palate: A Narrative Review

Mechanotransduction in skin wound healing and scar formation: Potential therapeutic targets for controlling hypertrophic scarring

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