Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol
Abstract Background Post-omphalocele ventral hernias (POVH) are common after giant omphaloceles. Abdominal wall botulinum toxin injections (BTI) are useful to treat complex incisional hernias (CIH) in adults, which may also apply to POVH. We review BTI data in the treatment of CIH and POVH and propo...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-12-01
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| Series: | Annals of Pediatric Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43159-020-00058-4 |
| _version_ | 1818643334536626176 |
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| author | Lisieux Eyer de Jesus Thais Cardoso Leve Celine Fulgencio Samuel Dekermacher |
| author_facet | Lisieux Eyer de Jesus Thais Cardoso Leve Celine Fulgencio Samuel Dekermacher |
| author_sort | Lisieux Eyer de Jesus |
| collection | DOAJ |
| description | Abstract Background Post-omphalocele ventral hernias (POVH) are common after giant omphaloceles. Abdominal wall botulinum toxin injections (BTI) are useful to treat complex incisional hernias (CIH) in adults, which may also apply to POVH. We review BTI data in the treatment of CIH and POVH and propose an algorithm applicable to POVH. Results Sixteen papers which described the treatment of CIH on the treatment of POVH in adults (n = 15) and children (n = 1) were reviewed. BTI elongates the lateral abdominal wall and reduces the hernia defect, with a lower incidence of compartment syndrome and respiratory complications. Doses and injection volumes vary. Effects start after 3 days, peak after 10–15 days, stabilize for 2–3 months, and decline after 4–6 months, disappearing after 6–9 months. Patients should be operated on 3–4 weeks after injection. Post-operative complications are uncommon. BTI may be associated with pre-operative pneumoperitoneum (PPP). Children presenting POVH differ from adults presenting CIH. Associated congenital cardiac malformations, genetically determined syndromes, pulmonary hypoplasia, abdominal wall hypoplasia, and thoracic dysmorphism, are common; children need sedation for any procedures; non-absorbable reinforcing meshes are not indicated; and POVH limits are frequently near to the costal margin. Conclusion BTI to induce preoperative muscular relaxation in preparation of CIH repair in adults is effective and safe. Experience with the method in children with POVH is limited, but the proposal is logical and probably safe. POVH differs from CIH in some aspects, especially abdominal wall hypoplasia, proximity to the rib cage, and diaphragmatic biomechanics. |
| first_indexed | 2024-12-16T23:57:18Z |
| format | Article |
| id | doaj.art-e8d3fd84f4c34587a6681fcfc75eed28 |
| institution | Directory Open Access Journal |
| issn | 2090-5394 |
| language | English |
| last_indexed | 2024-12-16T23:57:18Z |
| publishDate | 2020-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Pediatric Surgery |
| spelling | doaj.art-e8d3fd84f4c34587a6681fcfc75eed282022-12-21T22:11:10ZengSpringerOpenAnnals of Pediatric Surgery2090-53942020-12-011611810.1186/s43159-020-00058-4Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocolLisieux Eyer de Jesus0Thais Cardoso Leve1Celine Fulgencio2Samuel Dekermacher3Antônio Pedro University Hospital/School of Medicine, Federal Fluminense UniversityServidores do Estado Federal Hospital/Health MinistryServidores do Estado Federal Hospital/Health MinistryServidores do Estado Federal Hospital/Health MinistryAbstract Background Post-omphalocele ventral hernias (POVH) are common after giant omphaloceles. Abdominal wall botulinum toxin injections (BTI) are useful to treat complex incisional hernias (CIH) in adults, which may also apply to POVH. We review BTI data in the treatment of CIH and POVH and propose an algorithm applicable to POVH. Results Sixteen papers which described the treatment of CIH on the treatment of POVH in adults (n = 15) and children (n = 1) were reviewed. BTI elongates the lateral abdominal wall and reduces the hernia defect, with a lower incidence of compartment syndrome and respiratory complications. Doses and injection volumes vary. Effects start after 3 days, peak after 10–15 days, stabilize for 2–3 months, and decline after 4–6 months, disappearing after 6–9 months. Patients should be operated on 3–4 weeks after injection. Post-operative complications are uncommon. BTI may be associated with pre-operative pneumoperitoneum (PPP). Children presenting POVH differ from adults presenting CIH. Associated congenital cardiac malformations, genetically determined syndromes, pulmonary hypoplasia, abdominal wall hypoplasia, and thoracic dysmorphism, are common; children need sedation for any procedures; non-absorbable reinforcing meshes are not indicated; and POVH limits are frequently near to the costal margin. Conclusion BTI to induce preoperative muscular relaxation in preparation of CIH repair in adults is effective and safe. Experience with the method in children with POVH is limited, but the proposal is logical and probably safe. POVH differs from CIH in some aspects, especially abdominal wall hypoplasia, proximity to the rib cage, and diaphragmatic biomechanics.https://doi.org/10.1186/s43159-020-00058-4Giant omphaloceleVentral herniaIncisional herniaBotulinum toxin |
| spellingShingle | Lisieux Eyer de Jesus Thais Cardoso Leve Celine Fulgencio Samuel Dekermacher Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol Annals of Pediatric Surgery Giant omphalocele Ventral hernia Incisional hernia Botulinum toxin |
| title | Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol |
| title_full | Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol |
| title_fullStr | Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol |
| title_full_unstemmed | Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol |
| title_short | Botulinum toxin abdominal wall injection and post-omphalocele ventral hernia repair: database and proposal of a protocol |
| title_sort | botulinum toxin abdominal wall injection and post omphalocele ventral hernia repair database and proposal of a protocol |
| topic | Giant omphalocele Ventral hernia Incisional hernia Botulinum toxin |
| url | https://doi.org/10.1186/s43159-020-00058-4 |
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