KMID : 1195620090020010020
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Clinical and Experimental Otorhinolaryngology 2009 Volume.2 No. 1 p.20 ~ p.27
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Effect of Botulinum Toxin Type A on a Rat Surgical Wound Model
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Lee Byung-Joo
Jeong Jae-Hwi Wang Soo-Geun Lee Jin-Choon Goh Eui-Kyung Kim Hwal-Woong
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Abstract
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Objectives: The tension on a wound is one of the important factors that determine the degree of fibrosis and scar formation. We hypothesized that local botulinum toxin type A (Botox) induced paralysis of the musculature subjacent to a surgical wound with a skin defect would minimize the repetitive tensile forces on the surgical wound¡¯s edges, and this will result in a decreased fibroplastic response and fibrosis of the wound.
Methods: This is a prospective randomized experimental study. Two distinct surgical wounds were made to the dorsum of 15 adult rats, respectively. One of the 2 wounds was injected with Botox, and the other wound was used as a control, and this was done for all the rats¡¯ wounds. We evaluated the wound size, the degree of fibrosis and inflammation, the blood vessel proliferation, the thickness of the wound and the expression of transforming growth factor (TGF)-¥â1 in the wounds.
Results: There were significant differences of wound size at the 3rd and 4th week between the Botox and control groups (P<0.05). The Botox group showed less infiltration of inflammatory cells than the control group at the 2nd week (P<0.05). The Botox group showed a smaller number of fibroblasts and less fibrosis than the control group at the 4th week (P<0.05). The Botox group showed much strong collagen density than the control group at the 8th week (P<0.05). For the immunohistochemical staining, there was a lower transforming growth factor (TGF)-¥â1 expression in the Botox group than that of the control group at the 4th week (P<0.05).
Conclusion: The wounds of the Botox-treated group showed a larger wound size, less infiltration of inflammatory cells and less fibrosis, a much greater amount of collagen and a lower expression of TGF-¥â1 than did the control group. Botox might be used to decrease the fibrosis of a surgical wound without damaging the epithelial growth in situations for which decreased fibrosis is necessary, such as for treating laryngeal, tracheal and nasal stenosis.
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KEYWORD
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Botulinum toxin type A, Wound healing, Fibrosis
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