title: Botulinum toxin to improve results in cleft lip repair.
abstract: BACKGROUND
  Upper lip wounds that lie perpendicular to the relaxed skin tension lines are subjected to repetitive dynamic tension caused by the orbicularis oris muscle and are susceptible to unsatisfactory scarring.
  
  
  METHODS
  In this double-blind, randomized, vehicle-controlled, prospective trial, 60 consecutive patients with unilateral cleft lip undergoing primary cheiloplasties between August of 2011 and June of 2012 were randomized to receive botulinum toxin type A or vehicle injections into the subjacent orbicularis oris muscle immediately after wound closure. Scars were assessed after 6 months using the Vancouver Scar Scale, photographic visual analogue scale, and photographic scar width measurements.
  
  
  RESULTS
  Fifty-nine patients completed the trial. Measurements of scar widths at two defined points revealed significantly better visual analogue scale scores and narrower scars in the experimental group. However, Vancouver Scar Scale assessments were similar between groups.
  
  
  CONCLUSIONS
  Botulinum toxin injections into the subjacent orbicularis oris muscle produced better appearing and narrower cheiloplasty scars, but provided no additional benefits in terms of scar pigmentation, vascularity, pliability, or height.
  
  
  METHODS
  Therapeutic, II.
authors.affiliation: Taoyuan, Taiwan From the Graduate Institute of Biochemical and Biomedical Engineering, College of Engineering, and the Graduate Institute of Clinical Medical Sciences, School of Medicine, Chang Gung University; and the Craniofacial Research Center, Department of Medical Research, Department of Plastic Surgery, Chang Gung Memorial Hospital.
authors.forename: Chun-Shin
authors.initials: CS
authors.lastname: Chang
authors.forename: Christopher Glenn
authors.initials: CG
authors.lastname: Wallace
authors.forename: Yen-Chang
authors.initials: YC
authors.lastname: Hsiao
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Philip Kuo-Ting
authors.initials: PK
authors.lastname: Chen
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002921:Cicatrix / Q000209:etiology / Q000517:prevention & control*; D002971:Cleft Lip / Q000601:surgery*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005152:Facial Muscles; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008046:Lip / Q000601:surgery; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D015588:Observer Variation; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A