The use of Botulinum Toxin in digital reconstruction of patients affected by Raynaud’s phenomenon: a case report

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.