Decreased utilization of component separation techniques over time in complex abdominal wall reconstruction following introduction of preoperative botulinum toxin A - 10/04/26
Abstract |
Introduction |
Component separation technique (CST) facilitates anterior fascial closure but can increase wound morbidity and alter abdominal wall anatomy. Preoperative Botulinum toxin A (BTA) relaxes the oblique musculature, potentially reducing CST. This study evaluated trends in CST utilization following the adoption of BTA.
Methods |
A prospectively maintained database was reviewed for patients who underwent open AWR (2016-2024). Primary outcome was proportion of CST use over time; secondary analysis compared early (2016-2017) versus late (2023-2024) cohorts.
Results |
Among 1484 patients (mean age 58.8 ± 12.3 years; BMI 31.0 ± 5.8 kg/m 2 ; defect size 211.5 ± 165.6 cm 2 ), fascial closure was achieved in 99.5%. CST decreased from 48.0% to 19.9% (OR: 0.88,95% CI: 0.813,0.946; p < 0.001). BTA increased (2.9% to 11.0%), though annual change was not significant (OR: 0.98,95% CI: 0.898,1.071; p = 0.670). Between early and late cohorts (n = 384 vs. 356), defect size was similar (219.1 ± 160.6 vs. 213.8 ± 181.3 cm 2 ; p = 0.367). There was a reduction in wound breakdown (6.5% vs. 0.8%) and recurrence (2.9% vs. 0.6%)( p < 0.05).
Conclusion |
Following the introduction of BTA, utilization of CST decreased and was accompanied by a reduction in wound morbidity.
Le texte complet de cet article est disponible en PDF.Highlights |
• | A principal goal of abdominal wall reconstruction is closure of the anterior fascia. |
• | Preoperative Botulinum Toxin A (BTA) injection aids in fascial medialization. |
• | Component separation (CST) declined over time with the introduction of BTA use. |
• | There was no difference in hernia defect size with the decline in CST. |
• | Wound morbidity was reduced over the same timeframe. |
Keywords : Hernia, Abdominal wall reconstruction, Ventral hernia, Loss of domain, Component separation, Botulinum toxin
Plan
Vol 256
Article 116919- juin 2026 Retour au numéro
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