The Role of Botulinum Toxins in Wound Management and Scar Revision
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USE OF BOTULINUM TOXIN IN OTORHINOLARYNGOLOGY (A D’SOUZA AND CL NG, SECTION EDITORS)
The Role of Botulinum Toxins in Wound Management and Scar Revision Ivy W. Maina 1
&
Oren Friedman 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Botulinum toxin A (BoTA) has proven a safe and effective treatment across a wide variety of medical and cosmetic applications. Recently, studies have explored the use of BoTA to optimize scar formation by reducing the dynamic tension under which traumatic and surgical wounds heal via chemodenervation of underlying muscles. This article reviews advances focusing on the use of BoTA in wound management and scar revision. Recent Findings Several prospective randomized controlled trials provide evidence that BoTA has a positive effect on wound healing and scar formation. This effect extends beyond its chemodenervative properties to include reducing pro-fibrotic factors and minimizing fibroblast growth and differentiation to better prevent pathological scarring. Summary Botulinum toxin is a safe and efficacious adjunct to other interventions intended to optimize scar appearance in traumatic or surgical wounds. Questions remain regarding the optimal technique, timing, and dosing for BoTA administration for ideal wound healing. Keywords Botulinum toxin . Wound management . Scar revision . Scarring . Chemodenervation . Wound healing
Introduction Scar formation is an inevitable consequence of the wound healing process after both unintentional trauma and surgical repair. Pathological scarring can lead to functional limitation and can also cause significant psychosocial distress that manifests in various ways [1]. Poor scar formation is associated with anxiety and depression [2]. Obvious, unsightly, or
This article is part of the Topical collection on Use of Botulinum Toxin in Otorhinolaryngology * Ivy W. Maina [email protected] Oren Friedman [email protected] 1
Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
2
Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 800 Walnut Street, Philadelphia, PA 19104, USA
disfiguring scars can be stigmatizing and may promote avoidant behaviors aimed at their concealment ranging from limiting clothing selection to garments that hide the offending scar to avoidance of social interactions. Given the persistent nature of scars and the fact that interventions for scar revision vary in success rates and can themselves lead to additional scarring, patients dissatisfied with their scars are often left feeling hopeless [3•]. Because of these factors, a significant amount of research has been dedicated to exploring medical, surgical, and procedural measures to optimize wound healing and minimize scar formation. This review focuses on the use of botulinum toxin to aid in the process of wound healing and scar
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