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Journal of Toxicology
Volume 2012, Article ID 159726, 9 pages
Review Article

Kinetic and Reaction Pathway Analysis in the Application of Botulinum Toxin A for Wound Healing

1Integrated Toxicology Division, US Army Medical Research Institute of Infectious Diseases (USAMRIID), 1425 Porter Street, Fort Detrick, MD 21702, USA
2USAMRMC, Combat Casualty Care Research Program, ATTN: MCMR-RTC, 504 Scott Street, Fort Detrick, MD 21702-5011, USA
3Division of Medicine, USAMRIID, 1425 Porter Street, Fort Detrick, MD 21702-5011, USA
4Neurobehavioral Toxicology Branch, Analytical Toxicology Division, US Army Medical Research Institute of Chemical Defense, Aberdeen Proving Ground, Edgewood Area, MD 21010, USA

Received 24 May 2011; Accepted 5 September 2011

Academic Editor: Martha L. Hale

Copyright © 2012 Frank J. Lebeda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A relatively new approach in the treatment of specific wounds in animal models and in patients with type A botulinum toxin is the focus of this paper. The indications or conditions include traumatic wounds (experimental and clinical), surgical (incision) wounds, and wounds such as fissures and ulcers that are signs/symptoms of disease or other processes. An objective was to conduct systematic literature searches and take note of the reactions involved in the healing process and identify corresponding pharmacokinetic data. From several case reports, we developed a qualitative model of how botulinum toxin disrupts the vicious cycle of muscle spasm, pain, inflammation, decreased blood flow, and ischemia. We transformed this model into a minimal kinetic scheme for healing chronic wounds. The model helped us to estimate the rate of decline of this toxin's therapeutic effect by calculating the rate of recurrence of clinical symptoms after a wound-healing treatment with this neurotoxin.