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

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.

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.

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.

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).

Botulinum toxin-induced immobilization of the wound enhances healing and improves the eventual appearance of the scar.