A型肉毒毒素对减轻额部术后瘢痕增生的临床研究

Effect of botulinum toxin A on reducing forehead postoperative scar

目的:观察早期肉毒素A局部注射对降低额部瘢痕增生的效果。方法:40例需要行额部肿物切除手术的患者随机分成两组,在术后72h内注射或不注射肉毒素A(BTXA)。对患者进行为期1年的随访,使用患者瘢痕评估量表(PSAS)、温哥华瘢痕量表(VSS)以及视觉模拟量表(VAS)对术后切口瘢痕进行评估打分。结果:在1年的随访中,36例患者被复查,4例患者失访。两组之间在PSAS方面没有统计学差异(P>0.05)。而肉毒素A治疗组的VSS及VAS评分与对照组相比结果均具有统计学差异(P<0.05),表明术后肉毒素A注射有降低瘢痕增生的作用。结论:由于可以抑制肌肉收缩而降低伤口局部张力,因此注射肉毒素A可以降低瘢痕增生的程度从而改善额部伤口缝合后的美容效果。

Objective:To observe the effect of early local injection of botulinum toxin(BTA)A on reducing hypertrophic scar in the frontal area.Methods:Forty patients who required a nephrectomy surgery were enrolled in this study.They were divided into two groups,with or without BTA injection within 72 hours after surgery.The patients were followed for a period of one year.Postoperative scars were scored using the Patient Scar Rating Scale(PSAS),Vancouver scar scale(VSS)and the Visual Analogue Scale(VAS).Results:During the 1-year follow-up,36 patients were reviewed and 4 patients were lost.There was no statistically significant difference in the PAS between the two groups.However,the score of VAS and VSS between treatment group and the control group has a statistically significant difference,demonstrating that postoperative BTA injection has a role in reducing scar hyperplasia.Conclusion:By inhibiting muscle contraction and reducing the local tension of the wound,injection of BTA can reduce the scar hyperplasia and improve the cosmetic outcome of the forehead wound.