Botulinum Toxin-A and Scar Reduction: A Review

2018 ◽  
Vol 35 (4) ◽  
pp. 165-176
Author(s):  
Adam Honeybrook ◽  
Walter Lee ◽  
Julie Woodward ◽  
Charles Woodard
Keyword(s):  
Botulinum Toxin ◽  
Clinical Studies ◽  
Botulinum Toxin A ◽  
Case Series ◽  
Management Approach ◽  
Randomized Control Trials ◽  
Measurement Scales ◽  
Toxin A ◽  
Randomized Control ◽  
Scar Reduction

Pathologic scars remain a therapeutic enigma. Several therapeutic modalities have been described for the prevention and treatment of hypertrophic and keloid scars, but the optimal management approach has not yet been defined. This article reviews the newly emerging, off-label treatment, botulinum toxin-A (BTXA) for scar reduction. Eight in vitro, 9 in vivo animal, and 23 human clinical studies were deemed relevant to this review. Studies were conducted between 2000 and 2018. Clinical studies were of various methodologic qualities and comprised of 8 blinded randomized control trials, 7 cohort studies, and 7 case series/reports. Across all 23 human clinical studies, 521 patients were recruited, 20 studies were in favor of BTXA to reduce scars, 2 studies had equivocal results, and 1 study showed no benefit. The efficacy of BTXA to reduce scars appears promising and the clinical literature currently favors its use over placebo controls as a safe scar reduction alternative. The efficacy of this modality in comparison with other more widely accepted scar reduction methods is less clear. Further understanding of the molecular mechanism of action of BTXA upon scars and treatment modality cost-effectiveness comparisons remain to be explored. Large-scale randomized control trials of high methodologic quality, using objective measurement scales, must be produced to truly determine the efficacy of this innovative treatment.

Botulinum toxin A injection into corrugator muscle for frontally localised chronic daily headache or chronic tension-type headache

2008 ◽  
Vol 123 (4) ◽  
pp. 412-417 ◽  
Author(s):  
J A de Ru ◽  
J Buwalda
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Injection ◽  
Botulinum Toxin Type A ◽  
Effective Means ◽  
Case Series ◽  
Botulinum Toxin Type ◽  
Toxin A ◽  
Tertiary Referral Centre ◽  
Corrugator Supercilii

AbstractObjective:To describe our results with botulinum toxin type A injection for headache in carefully selected patients, and to present the rationale behind this therapy.Setting:Tertiary referral centre.Patients and methods:This article describes a case series of 10 consecutive patients with frontally localised headache, whose pain worsened when pressure was applied at the orbital rim near the supratrochlear nerve. The patients received a local anaesthetic nerve block with Xylocaine 2 per cent at this site. If this reduced the pain, they were then offered treatment with botulinum toxin.Intervention:Injection with 12.5 IU of botulinum toxin A into the corrugator supercilii muscle on both sides (a total of 25 IU).Main outcome measure:Pain severity scoring by the patients, ranging from zero (no pain) to 10 (severe pain) on a verbal scale.Results:Following injection, all patients had less pain for approximately two months. This treatment did not appear to have lasting side effects.Conclusion:Xylocaine injection is a good predictor of the effectiveness of botulinum toxin injection into the corrugator muscle as treatment of frontally localised headache. We hypothesise that this pain is caused by entrapment of the supratrochlearis nerve in the corrugator muscle. Furthermore, we found botulinum toxin injection to be a safe and effective means of achieving pain relief in this patient group.

scholarly journals Botulinum Toxin A Injection for Treatment of Chronic Skin Ulcer: A Case Series and Literature Review

2019 ◽  
Vol 18 (1) ◽  
pp. 97-103
Author(s):  
Jiaojiao Zhong ◽  
Yu Lan ◽  
Shuying Fu ◽  
Jing Zhang ◽  
Sha Lu ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Case Series ◽  
Skin Ulcer ◽  
Review Of The Literature ◽  
Toxin A ◽  
Subcutaneous Injections ◽  
Skin Ulcers ◽  
Chronic Skin ◽  
Ulcer Treatment

Chronic skin ulcer (CSU) often combines with a variety of refractory factors that respond poorly to routine treatments. Botulinum toxin A (BTX-A) can be injected subcutaneously to improve the local blood supply, to reduce pain, and to promote wound healing. At present, few reports have mentioned BTX-A injection for chronic skin ulcer treatment. We observed the effect of four cases that used BTX-A to treat CSU and provided a brief review of the literature. Four cases of CSUs with 4 different causes were treated with BTX-A injection (4 U/cm2). The specific operation is as follows: local, multipoint, cyclic, equidistant, and subcutaneous injections with a depth of 6 to 8 mm. The ulcer area was significantly reduced. Subsequently, the ulcer healed within 20 to 48 days. Botulinum toxin A is recommended as an important treatment for chronic skin ulcer that can improve healing of skin ulcers with various etiologies.

scholarly journals Botox or the new face of the fight against depression - literature review

2021 ◽  
Vol 11 (8) ◽  
pp. 268-275
Author(s):  
Martyna Nowińska ◽  
Magdalena Kozyra ◽  
Przemysław Raczkiewicz ◽  
Marlena Kaczerska ◽  
Natalia Śmiech ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Psychiatric Comorbidity ◽  
Acetylcholine Release ◽  
Botulinum Toxin A ◽  
Randomized Control Trials ◽  
Facial Feedback ◽  
Mortality And Morbidity ◽  
Symptoms Of Depression ◽  
Randomized Control ◽  
Patients Experience

Introduction: Depression is a common psychiatric disorder leading to high burden especially for some other psychiatric comorbidity. Annually over 43 billion dollars are expended for patients with depression among them 28% are directly for depression and other costs are related to mortality and morbidity due to depression. The aim of the study: Paying attention to new options for treating depression – a disease that affects more and more people.Material and method: The research was done by the usage of the PubMed and Google Scholar articles about the topic of: botulinum toxin; depression; treatment.Description of the state of knowledge: Injecting Botox into the muscles responsible for expression of anguish or sadness may potentially decrease the patients experience of feelings. Botox reversibly blocks acetylcholine release from neuronal axons into the synapse, inhibiting neuromuscular transmission. If the facial feedback hypothesis is correct, by injecting Botox into the corrugator and procerus muscles, it will reversibly inhibit frown facial expressions and have the capability of propagating or enhancing sad and depressed feelings.Summary: The results from all randomized control trials proved that botulinum toxin A injection in the glabellar region was associated with significant improvement mood and may be a safe and effective treatment to reduce symptoms of depression.

Botulinum toxin A: a new option for treatment of drooling in children with cerebral palsy. Presentation of a case series

2001 ◽  
Vol 160 (8) ◽  
pp. 509-512 ◽  
Author(s):  
Peter H. Jongerius ◽  
Jan J. Rotteveel ◽  
Frank van den Hoogen ◽  
Fons J. M. Gabre�ls ◽  
Karen van Hulst ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Botulinum Toxin ◽  
Botulinum Toxin A ◽  
Case Series ◽  
Toxin A ◽  
Children With Cerebral Palsy

scholarly journals The Effects of Botulinum Toxin-A Injection on Lateral Pterygoid Muscle in Patients with Painful Temporomandibular Joint Click: A Randomized Clinical Trial Study

2021 ◽  
Author(s):  
Fahimeh Rezazadeh ◽  
Negin Esnaashari ◽  
Azita Azad ◽  
Sara Emad
Keyword(s):  
Botulinum Toxin ◽  
Temporomandibular Joint ◽  
Repeated Measures ◽  
Botulinum Toxin A ◽  
Temporomandibular Disorder ◽  
Medical Science ◽  
Case Series ◽  
Pain Severity ◽  
Toxin A ◽  
Significant Difference

Abstract Background: The aim of this study was to investigate the effect of Botulinum toxin-A (BTX-A) injection in lateral pterygoid (LP) muscle and analyze the efficacy of this treatment modality in reducing Temporomandibular disorder (TMD) symptoms. TMD is the main cause of nondental pain in the orofacial area. The most common symptoms of temporomandibular disorder are joints pain and sound and limitation of jaw function. Botulinum toxin (BTX) injection in LP temporarily paralysesis the muscle. BTX injection is considered as a potential treatment for TMD, due to its pain relieving characteristic and its ability to reduce muscle activity. However, these evidences are mostly case series and more studies are required to prove its efficacy. Methods: Thirty-eight patients (19 women and 19 men, mean age: 26.53 years) with painful unilateral temporomandibular joint click and LP muscle tenderness entered the study. They were divided into two groups; one received extraoral Botax injection in LP muscle, and the other was injected by placebo. Pain severity, jaw’s range of movement, click severity and Helkimo-Index, were taken recorded at first and also in follow upin first visit and in one week, one month and three months after intervention. Data were analyzed using Repeated measures ANOVA and t-test.Results: The result showed that click severity was not significantly different between BTX and placebo groups (p=0.07). Pain and Helkimo index were decreased significantly in BTX group (p=0.00 and P=0.006 respectively); however, there was no significant difference when compared between the two groups (P=0.22 and p=1 respectively). There was a significant difference in lateral movements between the groups (p=0.00) but not in protrusion movement (p=0.095).Conclusions: It can be concluded that although some studies state that BTX injection can make the click sound disappear, in this study we did not find a significant difference between two groups. Furthermore, our results showed that click and pain severity were decreased, but the difference was not statistically significant. Therefore, further studies with more dosage of BTX and higher participants seem to be necessary.Trial registration: The local Ethics Committee of Shiraz University of Medical Science approved this research under Ethics code: IR.SUMS.REC. 2018/10/01 and IRCT number: IRCT20130521013406N3.

scholarly journals P128 BOTULINUM TOXIN A IN CONJUNCTION WITH NEGATIVE PRESSURE WOUND THERAPY AND MESH-MEDIATED FASCIAL TRACTION PROVIDES HIGH RATE OF FASCIAL CLOSURE IN PATIENTS WITH OPEN ABDOMEN

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Irene Schmidt ◽  
Hans Friis Andersen ◽  
Nellie Zinther
Keyword(s):  
Botulinum Toxin ◽  
Open Abdomen ◽  
Botulinum Toxin A ◽  
Case Series ◽  
High Rate ◽  
Fascial Closure ◽  
Toxin A ◽  
Fascial Defect ◽  
The Mean

Abstract Aim Presentation of our data on Vacuum-Assisted Wound Closure and Permanent Onlay Mesh-Mediated Fascial Traction (VAWCPOM) in combination with Botulinum Toxin A (BTX-A) injection in the lateral abdominal wall as a treatment of the open abdomen (OA). Material and Methods This is a retrospective case series including patients treated for OA from January 2017 till March 2021 with VAWCPOM and BTX-A. Patient records were collected from medical charts, incl. age, sex, body mass index (BMI), comorbidity, initial fascial defect size, time until fascial closure, complications and, when available, outpatient follow-up. Results A total of 33 patients with OA were included. The mean age was 62,5 years, male/female ratio was 15:18, with a mean BMI of 35,4 kg/m2. The mean width of the fascial defect was 13,5 cm (5 - 25cm). The rate of fascial closure was 96,9%, achieved within a mean of 22,7 days. Fascial closure was not attainable in one patient who developed enterocutaneous fistula under treatment. 22 patients experienced in-hospital complications. Short-term follow-up was conducted in 22 patients, with hernia recurrences in three. Conclusions Treatment of OA remains a surgical challenge. This case series shows promising results with a high rate of fascial closure using a combination of VAWCPOM and BTX-A and an acceptable rate of postoperative complications in this severely challenging patient group. The rate of primary closure indicates that this may be the future management of open abdomen.

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