Botulinum Toxin Type A and the Prevention of Hypertrophic Scars on the Maxillofacial Area and Neck: A Meta-Analysis of Randomized Controlled Trials

Dai-Zun Zhang, Xiao-Ya Liu, Wen-Lin Xiao, Yao-Xiang Xu, Dai-Zun Zhang, Xiao-Ya Liu, Wen-Lin Xiao, Yao-Xiang Xu

Abstract

Background: The purpose of the meta-analysis was to evaluate the efficiency of therapeutic botulinum toxin type A (BTX-A) in the prevention of maxillofacial and neck scars.

Methods and findings: Information came from the following electronic databases: Medline, PubMed, Cochrane Library, and EMBASE (time was ended by August 31, 2015) to retrieve RCTs evaluating the effect of the BTX-A for hypertrophic scar on the maxillofacial or neck. All languages were included as long as they met the inclusion criteria. Here the effects of BTX-A were evaluated by comparing the width of the scar, patient satisfaction, and the visual analysis scores (VAS), respectively. Pooled weighted mean differences (WMDs), pooled odds ratios (ORs), and 95% confidence intervals (CI) were calculated. Nine RCTs covering a total of 539 patients were included. A statistically significant difference in scar width was identified between the BTX-A group and control group (non-BTX-A used) (WMD = -0.41, 95% CI = -0.68 to -0.14, P = 0.003). A statistically significant difference in patient satisfaction was observed between the BTX-A group and control group (OR = 25.76, 95% CI = 2.58 to 256.67, P = 0.006). And in patients regarding visual analysis scores (VAS), a statistically significant difference was also observed between the BTX-A group and control group (WMD = 1.30, 95% CI = 1.00 to 1.60, P < 0.00001).

Conclusions: This meta-analysis evaluates the efficacy of the BTX-A and confirms that BTX-A is a suitable potential therapy for the prevention of hypertrophic scars in patients in the maxillofacial and neck areas.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flow diagram for study selection.
Fig 1. Flow diagram for study selection.
Fig 2. The width of scar forest…
Fig 2. The width of scar forest plot (BTA vs. Placebo).
Fig 3. favorable vs. Unfavorable forest plot.
Fig 3. favorable vs. Unfavorable forest plot.
Fig 4. VAS forest plot (BTA vs.…
Fig 4. VAS forest plot (BTA vs. Placebo).
Fig 5. Quality assessment of each included…
Fig 5. Quality assessment of each included study.
(A) Risk of bias summary. (B) Risk of bias graph.

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