The Efficacy and Safety of Botulinum Toxin Injections in Preventing Postoperative Scars and Improving Scar Quality: A Systematic Review and Meta-Analysis
Background Scars exposed on the body surface lead to a large psychological burden on patients. However, no satisfactory scar treatments exist. Botulinum toxin type A is a neurotoxin that has been widely applied in the plastic and cosmetic surgery field. The purpose of this meta-analysis was to asses...
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| Veröffentlicht in: | Aesthetic plastic surgery 2021-10, Vol.45 (5), p.2350-2362 |
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| creator | Qiao, Zhihua Yang, Haojun Jin, Lewei Li, Sandi Wang, Xiancheng |
| description | Background
Scars exposed on the body surface lead to a large psychological burden on patients. However, no satisfactory scar treatments exist. Botulinum toxin type A is a neurotoxin that has been widely applied in the plastic and cosmetic surgery field. The purpose of this meta-analysis was to assess the efficacy and safety of botulinum toxin in scar management.
Methods
PubMed, the Cochrane Library, EMBASE, MEDLINE, and Web of Science were searched for randomized controlled trials that evaluated the efficacy of botulinum toxin injections in preventing postoperative scars and improving scars quality and were published prior to Dec. 29, 2020. The outcome indicators were the visual analog scale score, Vancouver scar scale score, Stony Brook scar evaluation scales score, scar width, patient self-assessment results, and complications.
Results
Seventeen randomized controlled trials with a total of 633 cases were identified in this meta-analysis. The quantitative synthesis results showed that compared with the control group, the botulinum toxin group had a significantly lower VSS score (MD = −0.97, 95%CI = −1.56 to −0.39,
p
= 0.001), higher VAS score (MD = 1.26, 95%CI = 1.04 to 1.47,
p |
| doi_str_mv | 10.1007/s00266-021-02196-5 |
| format | Article |
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Scars exposed on the body surface lead to a large psychological burden on patients. However, no satisfactory scar treatments exist. Botulinum toxin type A is a neurotoxin that has been widely applied in the plastic and cosmetic surgery field. The purpose of this meta-analysis was to assess the efficacy and safety of botulinum toxin in scar management.
Methods
PubMed, the Cochrane Library, EMBASE, MEDLINE, and Web of Science were searched for randomized controlled trials that evaluated the efficacy of botulinum toxin injections in preventing postoperative scars and improving scars quality and were published prior to Dec. 29, 2020. The outcome indicators were the visual analog scale score, Vancouver scar scale score, Stony Brook scar evaluation scales score, scar width, patient self-assessment results, and complications.
Results
Seventeen randomized controlled trials with a total of 633 cases were identified in this meta-analysis. The quantitative synthesis results showed that compared with the control group, the botulinum toxin group had a significantly lower VSS score (MD = −0.97, 95%CI = −1.56 to −0.39,
p
= 0.001), higher VAS score (MD = 1.26, 95%CI = 1.04 to 1.47,
p
< 0.00001), thinner scar width (MD = −0.25, 95%CI = −0.37 to −0.12,
p
< 0.0001) and higher patient satisfaction (RR = 3.38 95%CI = 1.45 to 7.89,
p
= 0.005). There were no significant differences between the two groups in the number of adverse events.
Conclusions
This meta-analysis demonstrated that botulinum toxin injections can significantly improve cosmetic appearance and postoperative scar quality. At the therapeutic dose, no significant complications were observed, indicating that botulinum toxin injections are safe.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.</description><identifier>ISSN: 0364-216X</identifier><identifier>EISSN: 1432-5241</identifier><identifier>DOI: 10.1007/s00266-021-02196-5</identifier><identifier>PMID: 33674930</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Botulinum toxin ; Clinical trials ; Cosmetic surgery ; Medicine ; Medicine & Public Health ; Meta-analysis ; Otorhinolaryngology ; Patient satisfaction ; Plastic Surgery ; Postoperative period ; Review ; Scars</subject><ispartof>Aesthetic plastic surgery, 2021-10, Vol.45 (5), p.2350-2362</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2021</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-abe9200d621badbb7d1ed14a10e638867289a67c3e29449fed2f0867f6f30be23</citedby><cites>FETCH-LOGICAL-c375t-abe9200d621badbb7d1ed14a10e638867289a67c3e29449fed2f0867f6f30be23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00266-021-02196-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00266-021-02196-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27915,27916,41479,42548,51310</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33674930$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Qiao, Zhihua</creatorcontrib><creatorcontrib>Yang, Haojun</creatorcontrib><creatorcontrib>Jin, Lewei</creatorcontrib><creatorcontrib>Li, Sandi</creatorcontrib><creatorcontrib>Wang, Xiancheng</creatorcontrib><title>The Efficacy and Safety of Botulinum Toxin Injections in Preventing Postoperative Scars and Improving Scar Quality: A Systematic Review and Meta-Analysis</title><title>Aesthetic plastic surgery</title><addtitle>Aesth Plast Surg</addtitle><addtitle>Aesthetic Plast Surg</addtitle><description>Background
Scars exposed on the body surface lead to a large psychological burden on patients. However, no satisfactory scar treatments exist. Botulinum toxin type A is a neurotoxin that has been widely applied in the plastic and cosmetic surgery field. The purpose of this meta-analysis was to assess the efficacy and safety of botulinum toxin in scar management.
Methods
PubMed, the Cochrane Library, EMBASE, MEDLINE, and Web of Science were searched for randomized controlled trials that evaluated the efficacy of botulinum toxin injections in preventing postoperative scars and improving scars quality and were published prior to Dec. 29, 2020. The outcome indicators were the visual analog scale score, Vancouver scar scale score, Stony Brook scar evaluation scales score, scar width, patient self-assessment results, and complications.
Results
Seventeen randomized controlled trials with a total of 633 cases were identified in this meta-analysis. The quantitative synthesis results showed that compared with the control group, the botulinum toxin group had a significantly lower VSS score (MD = −0.97, 95%CI = −1.56 to −0.39,
p
= 0.001), higher VAS score (MD = 1.26, 95%CI = 1.04 to 1.47,
p
< 0.00001), thinner scar width (MD = −0.25, 95%CI = −0.37 to −0.12,
p
< 0.0001) and higher patient satisfaction (RR = 3.38 95%CI = 1.45 to 7.89,
p
= 0.005). There were no significant differences between the two groups in the number of adverse events.
Conclusions
This meta-analysis demonstrated that botulinum toxin injections can significantly improve cosmetic appearance and postoperative scar quality. At the therapeutic dose, no significant complications were observed, indicating that botulinum toxin injections are safe.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.</description><subject>Botulinum toxin</subject><subject>Clinical trials</subject><subject>Cosmetic surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Otorhinolaryngology</subject><subject>Patient satisfaction</subject><subject>Plastic Surgery</subject><subject>Postoperative period</subject><subject>Review</subject><subject>Scars</subject><issn>0364-216X</issn><issn>1432-5241</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc1uEzEUhS0EomnhBVggS6yn-GfGzrALVSmRilpIkNhZnpnr4ihjp7YndB6Ft8WTFLpjYVk-_u65V_cg9IaSc0qIfB8JYUIUhNHp1KKonqEZLTkrKlbS52hGuCgLRsWPE3Qa44YQyqQsX6ITzoUsa05m6Pf6J-BLY2yr2xFr1-GVNpBG7A3-6NOwtW7o8do_WIeXbgNtst5FnF-3AfbgknV3-NbH5HcQdLJ7wKtWh3iwWva74PcTMWn466C3No0f8AKvxpigz3yLv8Hewq8D_wWSLhZOb8do4yv0wuhthNeP9xn6_ulyffG5uL65Wl4srouWyyoVuoGaEdIJRhvdNY3sKHS01JSA4PO5kGxeayFbDqwuy9pAxwzJshGGkwYYP0Pvjr551vsBYlIbP4Q8RFSsklIQIdhEsSPVBh9jAKN2wfY6jIoSNaWhjmmonIQ6pKGqXPT20Xpoeuj-lfxdfwb4EYj5y91BeOr9H9s_5wyXFw</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Qiao, Zhihua</creator><creator>Yang, Haojun</creator><creator>Jin, Lewei</creator><creator>Li, Sandi</creator><creator>Wang, Xiancheng</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20211001</creationdate><title>The Efficacy and Safety of Botulinum Toxin Injections in Preventing Postoperative Scars and Improving Scar Quality: A Systematic Review and Meta-Analysis</title><author>Qiao, Zhihua ; Yang, Haojun ; Jin, Lewei ; Li, Sandi ; Wang, Xiancheng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-abe9200d621badbb7d1ed14a10e638867289a67c3e29449fed2f0867f6f30be23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Botulinum toxin</topic><topic>Clinical trials</topic><topic>Cosmetic surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Otorhinolaryngology</topic><topic>Patient satisfaction</topic><topic>Plastic Surgery</topic><topic>Postoperative period</topic><topic>Review</topic><topic>Scars</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Qiao, Zhihua</creatorcontrib><creatorcontrib>Yang, Haojun</creatorcontrib><creatorcontrib>Jin, Lewei</creatorcontrib><creatorcontrib>Li, Sandi</creatorcontrib><creatorcontrib>Wang, Xiancheng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Aesthetic plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Qiao, Zhihua</au><au>Yang, Haojun</au><au>Jin, Lewei</au><au>Li, Sandi</au><au>Wang, Xiancheng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Efficacy and Safety of Botulinum Toxin Injections in Preventing Postoperative Scars and Improving Scar Quality: A Systematic Review and Meta-Analysis</atitle><jtitle>Aesthetic plastic surgery</jtitle><stitle>Aesth Plast Surg</stitle><addtitle>Aesthetic Plast Surg</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>45</volume><issue>5</issue><spage>2350</spage><epage>2362</epage><pages>2350-2362</pages><issn>0364-216X</issn><eissn>1432-5241</eissn><abstract>Background
Scars exposed on the body surface lead to a large psychological burden on patients. However, no satisfactory scar treatments exist. Botulinum toxin type A is a neurotoxin that has been widely applied in the plastic and cosmetic surgery field. The purpose of this meta-analysis was to assess the efficacy and safety of botulinum toxin in scar management.
Methods
PubMed, the Cochrane Library, EMBASE, MEDLINE, and Web of Science were searched for randomized controlled trials that evaluated the efficacy of botulinum toxin injections in preventing postoperative scars and improving scars quality and were published prior to Dec. 29, 2020. The outcome indicators were the visual analog scale score, Vancouver scar scale score, Stony Brook scar evaluation scales score, scar width, patient self-assessment results, and complications.
Results
Seventeen randomized controlled trials with a total of 633 cases were identified in this meta-analysis. The quantitative synthesis results showed that compared with the control group, the botulinum toxin group had a significantly lower VSS score (MD = −0.97, 95%CI = −1.56 to −0.39,
p
= 0.001), higher VAS score (MD = 1.26, 95%CI = 1.04 to 1.47,
p
< 0.00001), thinner scar width (MD = −0.25, 95%CI = −0.37 to −0.12,
p
< 0.0001) and higher patient satisfaction (RR = 3.38 95%CI = 1.45 to 7.89,
p
= 0.005). There were no significant differences between the two groups in the number of adverse events.
Conclusions
This meta-analysis demonstrated that botulinum toxin injections can significantly improve cosmetic appearance and postoperative scar quality. At the therapeutic dose, no significant complications were observed, indicating that botulinum toxin injections are safe.
Level of Evidence III
This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors
www.springer.com/00266
.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33674930</pmid><doi>10.1007/s00266-021-02196-5</doi><tpages>13</tpages></addata></record> |
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| ispartof | Aesthetic plastic surgery, 2021-10, Vol.45 (5), p.2350-2362 |
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| language | eng |
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| subjects | Botulinum toxin Clinical trials Cosmetic surgery Medicine Medicine & Public Health Meta-analysis Otorhinolaryngology Patient satisfaction Plastic Surgery Postoperative period Review Scars |
| title | The Efficacy and Safety of Botulinum Toxin Injections in Preventing Postoperative Scars and Improving Scar Quality: A Systematic Review and Meta-Analysis |
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