Botox in the Healing of Surgical Wounds of the Neck
Recruitment status was Not yet recruiting
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Purpose
The investigators hypothesize that Botox A will reduce scarring and improve healing of surgical neck wounds.
| Condition | Intervention | Phase |
|---|---|---|
|
Scar |
Drug: Botulinum Toxin Type A Drug: Normal Saline |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Botulinum Toxin A in the Healing of Surgical Wounds of the Neck: a Randomized, Prospective, Placebo-controlled Trial |
- Vancouver Scar Scale [ Time Frame: 6 months ] [ Designated as safety issue: No ]The surgeon will assess the healing of the surgical incision at 6 months and fill out the Vancouver Scar Scale following the operation.
- Patient and Observer Scar Assessment Scale [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]The surgeon and the patient will be asked to fill out the survey at 4 weeks following the operation.
- Patient and Observer Scar Assessment Scale [ Time Frame: 6 months ] [ Designated as safety issue: No ]The surgeon and the patient will be asked to fill out the survey at 6 months following the operation.
- Vancouver Scar Scale [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]The surgeon will assess the healing of the surgical incision and fill out the Vancouver Scar Scale at 4 weeks following the operation.
| Estimated Enrollment: | 100 |
| Study Start Date: | August 2010 |
| Estimated Study Completion Date: | February 2012 |
| Estimated Primary Completion Date: | August 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Botulinum Toxin A injection
A vial of Botulinum Toxin A containing 100U of Botox will be reconstituted with 2mL of normal saline for a concentration of 50U/mL. 5 Units (0.1 mL) of Botulinum Toxin A will be injected at three sites along the incision (midline and 1.5 cm lateral to midline) following a thyroidectomy or parathyroidectomy. |
Drug: Botulinum Toxin Type A
A vial of Botulinum Toxin A containing 100U of Botox will be reconstituted with 2mL of normal saline for a concentration of 50U/mL. 5 units (0.1mL) of Botulinum Toxin a will be injected at midline and 1.5cm lateral to midline, bidirectionally, following a thyroidectomy or parathyroidectomy. Other Names:
|
|
Placebo Comparator: Saline
0.1 mL of normal saline in a placebo vial containing 2 mL of normal saline will be injected along the incision (midline and 1.5 cm lateral to midline) following a thyroidectomy or parathyroidectomy.
|
Drug: Normal Saline
0.1mL of normal saline in a placebo vial containing 2mL of normal saline will be injected along three sites (midline and 1.5cm lateral from midline) following a thyroidectomy or parathyroidectomy.
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Detailed Description:
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.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- all patients referred to the ENT clinic for a thyroidectomy or parathyroidectomy
Exclusion Criteria:
- patients with missing information, including demographic information
- patients lost to follow up or have been followed for less than 6 months
- patients with known allergy to lidocaine
- patients in whom botox would be contraindicated in:
- known history of neuromuscular disorders (myasthenia gravis, amyotrophic lateral sclerosis, Eaton-Lambert syndrome)
- pregnant women
- known allergy to botox, albumin
Contacts and Locations| Contact: Elaine W Fung, BSc, MD | 1-902-412-1240 | elaine.fung@dal.ca |
| Canada, Nova Scotia | |
| Queen Elizabeth II Hospital | Not yet recruiting |
| Halifax, Nova Scotia, Canada, B3H 1V7 | |
| Contact: Elaine W Fung, MD, BSc 1-902-412-1240 elaine.fung@dal.ca | |
| Principal Investigator: Mark Taylor, FRCS | |
| Principal Investigator: | Mark Taylor, FRCS | Capital District Health Authority Nova Scotia |
More Information
Publications:
| Responsible Party: | Dr. Mark Taylor, CDHA, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery |
| ClinicalTrials.gov Identifier: | NCT01177358 History of Changes |
| Other Study ID Numbers: | BTX-001 |
| Study First Received: | July 8, 2010 |
| Last Updated: | August 6, 2010 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Capital District Health Authority, Canada:
|
Scar Botox |
Additional relevant MeSH terms:
|
Cicatrix Fibrosis Pathologic Processes Botulinum Toxins, Type A Botulinum Toxins Neuromuscular Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Anti-Dyskinesia Agents Central Nervous System Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 21, 2013