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World Journal of Surgery

, Volume 33, Issue 12, pp 2553–2556 | Cite as

Use of Botulinum Toxin Type A Before Abdominal Wall Hernia Reconstruction

  • Tomas R. Ibarra-HurtadoEmail author
  • Carlos M. Nuño-Guzmán
  • Jorge E. Echeagaray-Herrera
  • Everardo Robles-Vélez
  • José de Jesús González-Jaime
Article

Abstract

Background

Abdominal wall hernia repair after open abdomen management represents a surgical challenge, particularly due to muscle tension and lateral retraction. This study was designed to propose the use of Botulinum Toxin Type A (BTA) before abdominal wall hernia repair.

Methods

A prospective study of patients with abdominal wall hernia after open abdomen management was undertaken between September 2007 and January 2009. Bilateral BTA application was performed under electromyographic guidance at the abdominal wall. Transverse abdominal wall defect measurement was practiced at weekly intervals: clinically, in the first two patients, and with CT scan in the following 10 patients. Surgical closure was scheduled if no further hernia defect reduction was noted. Patients were followed at monthly hospital visits.

Results

In the first two patients, a hernia defect reduction of 50 and 47.2%, respectively, was documented by the third week after BTA application, with no further reduction. In the 10 patients under CT scan hernia defect measurement, when comparing the initial mean transverse defect measure and at 4 weeks after BTA application (13.85 ± 1.49 cm vs. 8.6 ± 2.07 cm), an overall mean reduction of 5.25 ± 2.32 cm was observed (p < 0.001; 95% confidence interval, 3.59–6.91). Hernia repair was performed, with no recurrences at a mean follow-up of 9.08 months.

Conclusions

BTA application before abdominal wall hernia repair seems to be useful. The lateral muscles paralysis achieved and transverse hernia defect reduction allows a minimal tension closure. To our knowledge, this is the first report of BTA application before abdominal wall hernia reconstruction.

Keywords

Abdominal Wall Defect Hernia Defect Abdominal Wall Hernia Dysport Abdominal Wall Reconstruction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

There was no external financial support for the achievement of this study. There is no conflict of interest to report by the authors.

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Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Tomas R. Ibarra-Hurtado
    • 1
    Email author
  • Carlos M. Nuño-Guzmán
    • 1
  • Jorge E. Echeagaray-Herrera
    • 1
  • Everardo Robles-Vélez
    • 2
  • José de Jesús González-Jaime
    • 3
  1. 1.Department of General SurgeryAntiguo Hospital Civil de GuadalajaraGuadalajaraMéxico
  2. 2.Department of Plastic and Reconstructive SurgeryAntiguo Hospital Civil de GuadalajaraGuadalajaraMéxico
  3. 3.Department of Rehabilitation MedicineAntiguo Hospital Civil de GuadalajaraGuadalajaraMéxico

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