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

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.