Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
In Vivo. 2021 Jul-Aug;35(4):1913-1920. doi: 10.21873/invivo.12457.
BACKGROUND/AIM: Abdominal wall hernias represent a common problem in surgical practice. A significant proportion of them entails large defects, often difficult to primarily close without advanced techniques. Injection of botulinum toxin preoperatively at specific points targeting lateral abdominal wall musculature has been recently introduced as an adjunct in achieving primary fascia closure rates.
A literature search was conducted investigating the role of botulinum toxin in abdominal wall reconstruction focusing on anatomic repair of hernia defects.
Injecting botulinum toxin preoperatively achieved chemical short-term paralysis of the lateral abdominal wall muscles, enabling a tension-free closure of the midline, which according to anatomic and clinical studies should be the goal of hernia repair. No significant complications from botulinum injections for complex hernias were reported.
Botulinum is a significant adjunct to complex abdominal wall reconstruction. Further studies are needed to standardize protocols and create more evidence.
背景/目的：腹壁疝是外科实践中的常见问题。其中相当一部分涉及大的缺陷，往往难以在没有先进技术的情况下直接关闭。最近，在特定部位向侧腹壁肌肉注射肉毒毒素已被引入作为辅助手段，以提高初次筋膜关闭率。
进行了文献检索，调查了肉毒毒素在腹壁重建中的作用，重点是疝缺陷的解剖修复。
术前注射肉毒毒素可使侧腹壁肌肉产生化学性短期瘫痪，实现中线无张力闭合，根据解剖学和临床研究，这应该是疝修复的目标。对于复杂疝，肉毒毒素注射没有明显的并发症。
肉毒毒素是复杂腹壁重建的重要辅助手段。需要进一步的研究来标准化方案并提供更多的证据。
