Use of botulinum toxin in surgical preparation for complex incisional hernias

Abstract

Abdominal wall defects with incisional hernias after surgery represent a great challenge for surgeons due to their technical complexity for treatment, largely attributed to the retraction of the lateral muscles of the abdominal wall. Reconstruction of the abdominal wall is understood to re-functionalize it with the approximation of the rectus abdominis muscles through its midline. The use of botulinum toxin serotype A (TBA) has shown that its use produces a temporary flaccid paralysis in the abdominal muscles, favoring midline closure, caused by muscle flaccidity and greater complacency caused by the toxin. Abdominal hernias result in increased morbidity due to lung restriction, aerophagia, abdominal pain, constipation, and urinary alterations), with a consequent decrease in quality of life. The objective of this study is describe our initial experience with chemical separation of components using the TBA in Brazil.