European Journal of Plastic Surgery

, Volume 38, Issue 5, pp 347–354 | Cite as

Effect of botulinum toxin type A in the contraction of lesions treated with full-thickness grafts

  • Gustavo de Azambuja Pereira Filho
  • Gustavo Alfredo Ochs de Muñoz
  • Pedro Bins Ely
  • Cláudio Galleano Zettler
Experimental Study
First Online:
Received:
Accepted:

Abstract

Background

The treatment of traumatic injuries and burns presenting tissue loss—which are called full-thickness wounds—is primarily accomplished with skin grafts. This, however, remains an ongoing challenge because grafts have a number of limitations, perhaps being the secondary contraction determining movement restriction due to graft contracture, the main one. In this context, the currently available treatments are—in many cases—insufficient, and thus, the search for new alternatives is necessary. The objective was to evaluate the effect of botulinum toxin type A (in different doses) in the contraction of full-thickness wounds treated with full-thickness grafts.

Methods

Eighteen male Wistar rats were used, with an average weight of 350 g, divided into three groups. In group 1, two full-thickness wounds were produced on their back. The first wound was subjected to graft + 1 Ui/cm2 and the second one was subjected only to skin graft. The same routine was done in group 2, except with a dose of 2 Ui/cm2. In group 3, aiming at a 14-day histological analysis, three full-thickness wounds were produced. On the first wound, a graft + toxin 1 Ui/cm2 was used, on the second one, a graft + toxin 2 Ui/cm2, and on the third, only the graft was done. The areas of injury were analyzed by both digital photography—at 7, 14, and 28 days—and histology—at 14 and 28 days.

Results

Decreased contractions of the graft (at 28 days) in the lesions treated with toxin 1 Ui/cm2 (p < 0.05) and 2 Ui/cm2 (p < 0.01) were observed. The epithelialization and neovascularization were not altered by the toxin, either at 14 or 28 days (p > 0.05). The degree of inflammation was reduced after 14 days in toxin-treated groups (p < 0.05), equaling up to controls after 28 days. The density of fibroblasts (p < 0.05) and collagen (p < 0.05) was reduced after 28 days in both treated groups.

Conclusions

According to the data obtained, botulinum toxin seems to reduce secondary contraction of the graft, thus reducing local inflammation, as well as the density of fibroblasts and collagen deposition.

Level of Evidence: Not ratable.

Keywords

Skin graft Botulinum toxin Contraction Full-thickness wound 
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Notes

Funding

The research received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).

Ethical standards

All experiments were performed following the principles of research ethics, according to Raymundo and Goldim [30] and by the Institutional animal ethics committee rules. The experiment was approved by the Institutional animal ethics committee under the protocol number 12098.

Conflict of interest

Gustavo de Azambuja Pereira Filho, Gustavo Alfredo Ochs de Muñoz, Pedro Bins Ely, Cláudio GalleanoZettler declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gustavo de Azambuja Pereira Filho
    • 1
  • Gustavo Alfredo Ochs de Muñoz
    • 2
  • Pedro Bins Ely
    • 1
  • Cláudio Galleano Zettler
    • 3
  1. 1.Department of Plastic SurgerySanta Casa de Porto Alegre Hospital ComplexPorto AlegreBrazil
  2. 2.Department of BiomedicineHospital de Clinicas de Porto AlegrePorto AlegreBrazil
  3. 3.Department of PathologySanta Casa de Porto Alegre Hospital ComplexPorto AlegreBrazil

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