부산대학교 도서관

BACKGROUND:: Botulinum toxin A (BTxA) injection is effective for surgical scar prevention. Although some studies have aimed to confirm the efficacy of BTxA injection at different time points, none have been conducted to determine the most appropriate timing of injection for scar management. We predicted that the injection of BTxA at different times during the wound healing process would cause different scar quality improvement and clarify unknown molecular mechanisms. METHODS:: The study included adults who underwent thyroidectomy. All patients received paralesional BTxA injections on the day of the surgery on either the right or left side of the operation site. The same dose was injected on the non-injected side via the same method after 2 weeks. At 2, 4, 12, and 24 postoperative weeks, the modified Stony Brook Scar Evaluation Scale, visual analog scale, and erythema index were used for objective, subjective, and quantitative evaluations of the scar. At 24 postoperative weeks, a quantitative scar assessment was performed with respect to the erythema index, skin elasticity, melanin index, and friction. RESULTS:: On objective evaluation of the scar and patient satisfaction at 24 postoperative weeks, the operation-day injection side showed better outcomes than the 2-week-postoperative injection side. These differences were significant from 4 postoperative weeks. In the final quantitative scar assessment at 24 postoperative weeks, significant improvements were observed in the erythema index and skin elasticity. CONCLUSION:: These results suggest that immediate postoperative BTxA injection is more effective for thyroidectomy scar management in terms of erythema, skin elasticity, and patient satisfaction.