Scar Clinical Trial
Official title:
Botulinum Toxin A in the Healing of Surgical Wounds of the Neck: a Randomized, Prospective, Placebo-controlled Trial
The investigators hypothesize that Botox A will reduce scarring and improve healing of surgical neck wounds.
Botulinum Toxin A is a toxin produced by the anaerobic bacterial species Clostridium
botulinum. The toxin specifically inhibits release of the neurotransmitter Acetylcholine at
synaptic junctions, thus preventing neuromuscular transmission, and inducing paralysis of
the muscle.
Previous studies have indicated that tensile forces on the skin may affect the healing of a
wound. These forces act against the immature collagen laid down during wound healing and may
stimulate overgrowth, thereby contributing to the formation of hypertrophic scars or
keloids.
Using botox to paralyse the underlying muscles may reduce the tensile force on the overlying
skin, and thus reduce scar formation and promote healing. Botox has also been shown to
affect the cell cycle distribution of fibroblasts derived from hypertrophic scars.
The objective of this study is to determine the effects of BTX-A in wound healing and the
reduction of scar formation.
Patients undergoing a thyroidectomy or parathyroidectomy will be randomized to receive
either BTX-A injections along the surgical site or placebo immediately following closure.
All incisions will be sutured in a similar fashion. BTX-A or normal saline will then be
injected along the platysma muscle. The patient and the surgeon will be blinded to the
treatment arm. Photographs will be taken of the surgical site at 4 weeks and 6 months. The
patient and two otolaryngologists will independently score the healing of the wound using a
standardized scoring method. The scores be compared between the two surgeons to determine
correspondence and interobserver reliability.
The scores of the two treatment arms will be compared to reveal the effect of BTX-A on wound
healing.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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