A Meta-Analysis of the Efficacy and Safety of Botulinum Toxin Type A for the Management of Scars After Facial Surgery.

BACKGROUND

Postoperative scarring of the face can cause a serious psychological burden on people. Botulinum toxin type A has shown potential effectiveness in preventing scarring after facial surgery. The study aims to evaluate the role of botulinum toxin type A in postoperative scar management.

METHODS

We searched PubMed, Embase, MEDLINE, the Cochrane Library (CENTRAL), and Web of Science for all randomized controlled trials (RCTs) on the use of botulinum toxin type A in the treatment of postoperative facial scars, including all English articles published up to April 15, 2024.

RESULTS

Twelve randomized controlled trials involving 351 patients undergoing facial surgery were included. Quantitative analysis, STATA 17.0 software was used for meta-analysis, and fixed-effect and random-effects models were selected according to the size of heterogeneity, and the results were expressed as SMD and 95% CI for continuous data and OR and 95% CI for dichotomous data. Subgroup analyses were performed according to the different control groups. The OR and 95% CI of adverse effects were 1.74 (0.41-7.43). The p value of adverse reactions and PSAS results was greater than 0.05.

CONCLUSION

Due to the small heterogeneity of scar width, OSAS, and PSAS, SMD and 95% CI were -1.00 (-1.20 to 0.80), -0.61 (-1.0 to 0.13), and -0.08 (-0.56 to 0.39), respectively, using a fixed-effect model. Due to large heterogeneity, VAS and VSS scores were scored using a random-effects model, with SMDs and 95% CIs of 1.00 (0.47-1.53) and -0.41 (-0.73 to 0.1), respectively.

TRIAL REGISTRATION: PROSPERO number: CRD42024538070.