Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
dc.contributor.authorTomazini Martins, Rodrigo-
dc.contributor.otherElstner, K.E.-
dc.contributor.otherRead, J.W.-
dc.contributor.otherSaunders, J.-
dc.contributor.otherCosman, P.H.-
dc.contributor.otherRodriguez-Acevedo, O.-
dc.contributor.otherJacombs, A.S.W.-
dc.contributor.otherIbrahim, N.-
dc.description.abstractINTRODUCTION: Repair of complex ventral hernia presents a significant challenge plagued by high morbidity and recurrence. Recent studies have demonstrated significant benefits achievable with preoperative Botulinum Toxin A (BTA) chemical component paralysis to the abdominal wall muscles, facilitating primary closure of complex ventral hernia defects. However, transversus abdominis is known to play an integral role in truncal stability, and its paralysis can result in unwanted physiological changes. This is the first study to report on selective administration of preoperative BTA to internal and external oblique muscles only, thus sparing transversus abdominis from paralysis. METHODS: This is a prospective observational study of 46 patients who underwent either selective two-layer or standard three-layer abdominal wall muscle BTA injection prior to elective laparoscopic ventral hernia repair. Serial abdominal CT imaging was performed to compare defect size and length of the lateral abdominal musculature. RESULTS: 46 patients received preoperative BTA injections (23 in each group). A comparison of gains achieved from chemical component paralysis demonstrated no statistically significant difference between the two groups. Fascial closure was achieved in all cases, with no post-operative sequelae of abdominal hypertension. There are no hernia recurrences to date. CONCLUSION: Preoperative selective muscle chemical component paralysis is an effective technique to counteract the chronic muscle retraction observed in large ventral hernias. Transversus abdominis plays a significant role in truncal and spinal stability, and sparing it from paralysis preserves an important component of abdominal wall physiology and does not detract from the ability to primarily close complex defects.en
dc.subjectDrug Therapyen
dc.titleSelective muscle botulinum toxin A component paralysis in complex ventral hernia repairen
dc.typeJournal Articleen
dc.description.affiliatesCentral Coast Local Health Districten
dc.description.affiliatesGosford Hospitalen
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
Appears in Collections:Health Service Research
Show simple item record

Page view(s)

checked on Mar 28, 2023

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.