A型肉毒毒素在面部直线形瘢痕修复术中的应用

Application of Botox A in the repair of facial linear scar

目的探讨A型肉毒毒素在面部直线形瘢痕修复术中应用的合理性和可行性。方法选择2009年3月至2012年3月在我院整形科接受面部瘢痕修复术，术中应用A型肉毒毒素进行局部注射的39例患者作为治疗组；另选取2006年3月至2009年3月在我院整形科接受单纯面部瘢痕切除的42例患者作为对照组。采用国际推荐的OSAS瘢痕评价量表，由两位经验丰富的整形医师对两组患者术前及术后1年的瘢痕情况进行评估，分别从瘢痕颜色、平整度、弹性程度及瘢痕宽度4个方面对瘢痕的整体情况进行评估打分，对每组术前、术后及两组的情况进行对比，进行统计学分析。结果治疗组和对照组术前瘢痕的颜色、平整度、弹性和宽度4个方面相比，差异无统计学意义（P〉0．05）。对照组术后瘢痕的颜色、弹性与术前相比，差异无统计学意义（P〉0．05），平整度明显改善，宽度明显缩窄，与术前相比，差异具有统计学意义（P〈0．05）；治疗组术后与术前相比瘢痕的颜色、平整度、弹性和宽度均有明显的改善，差异具有统计学意义（P〈0．05）；治疗组术后和对照组术后相比，瘢痕颜色更淡、弹性更好、宽度明显缩窄，差异具有统计学意义（P〈0．05）。结论A型肉毒毒素用于面部瘢痕修复后切口两侧注射可以明显改善术后瘢痕的质地，修复效果比较理想，值得在临床上推广应用。

Objective To explore the feasibility and rationality of Botox A injection in the repair of facial linear scar. Methods From march 2009 to march 2012, 39 cases with facial linear scar as the experimental group were performed the scar resection and Botox A injection and 42 cases with only scar resection from 2006 to 2009 were selected as the control group. The scar color, smoothness, elasticity and width were assessed by two experienced plastic surgeries according to OSAS. The data were analyzed and compared. Results There was no significant difference between the experimental group and the control group before operation （ P 〉 0.05 ）. There was also no significant difference between the pre-operation and post-operation in the control group on the scar color and elasticity （ P 〉 0.05） except smoothness and width （ P 〈 0.05 ）. The postoperation scar in the experimental group was improved obviously. There was significantly statistical difference on the scar color, smoothness, elasticity and width （ P 〈 0.05）. There was significant difference between the postoperation groups on the scar color, elasticity and width except smoothness （ P 〈 0.05 ）. Conclusion Botox A injected in bilateral incision could improve obviously scar texture with a good result. It is worth of spreading in clinic.