Francesco  Segreto,Giovanni F  Marangi,Mario Alessandri-Bonetti,Paolo  Persichetti,Vincenzo Cerbone,
The use of Botulinum Toxin in digital reconstruction of patients affected by Raynaud?s phenomenon
Surgical Case Reports
2018
2613-5965
http://dx.doi.org/10.31487/j.SCR.2018.03.023
https://www.sciencerepository.org/the-use-of-botulinum-toxin-in-digital-reconstruction-of-patients-affected-by-raynauds-phenomenon_SCR-3-123 
Abstract: Background: Surgical reconstruction in patients affected by Raynaud’s phenomenon is a challenging
procedure due to the vascular impairment, which prevents flap survival and secondary healing. Botulinum
Neurotoxin-A showed vasodilatatory and angiogenic properties in animal studies, increasing blood flow in
flap surgery.
Case presentation: We report an off-label application of Botulinum Neurotoxin-A used for digital
reconstruction in a patient affected by Reynaud’s phenomenon, in order to enhance flap survival and avoid
digital amputation. Complete flap survival and symptomatic relief were achieved.
Conclusions: This new approach may be extremely valuable when performing flap reconstruction in
patients affected by RP, allowing for increased vascular safety as well as symptomatic improvement.Keywords: Amputation, botulinum toxin, raynaud phenomenon, raynaud disease, surgical flap