Local Injection of Botulinum Toxin Type A to Prevent Postoperative Scar

Background:Physical scars, especially those in the head and neck area, can cause emotional and psychological distress. Recent studies, have suggested that botulinum toxin type A (BTX-A), also known as Botox, may improve surgical scars by speeding up the wound healing process. Injection of BTX-A is generally considered a less invasive approach.Objectives:The purpose of this meta-analysis was to assess the efficacy and safety of BTX-A in the prevention of postoperative scars compared to placebo or no treatment.Materials and methods:Following databases were searched from inception to March 2019: Cochrane Library, EMBASE, Web of Science, PubMed, and Open grey. Five trials registers were searched for potentially related trials. The authors also searched reference lists of relevant articles and contacted the investigators to identify additional published and unpublished studies.Data collection and analysis:Two authors independently evaluated all potential studies that met the selection criteria. Two authors independently extracted and analyzed the data.Results:Analysis was conducted on 267 patients who were enrolled in trials and randomly assigned to receive local injection of BTX-A (184 patients) and placebo (182 patients). Improved Vancouver scar scale scores were noted among patients treated with BTX-A injections compared with the control group (P=.000). The visual analogue scale scores revealed a significant improvement in appearance for the BTX-A-treated scars (P=.000). In addition, lower increase in width of the wound was observed in the experimental group compared to the control group (P=.000).Recommendation:This systematic review provided preliminary evidence that supports the efficacy and safety of BTX-A for the prevention of postoperative scar.