{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:04:14Z","timestamp":1772690654202,"version":"3.50.1"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Hernia"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To explore how intramuscular injection of botulinum toxin A (BTA) affects the lateral abdominal wall (LAW) musculature, abdominal- and hernia dimensions, and muscle structure on computed tomography (CT) in patients scheduled for complex abdominal wall reconstruction (CAWR).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Retrospective analysis of prospectively registered patients who received bilateral intramuscular BTA injections into all three muscles of the LAW. Only patients for which a CT was available before and 3\u20136\u00a0weeks after BTA treatment prior to surgery were analyzed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-two patients were analyzed. Median hernia width in all patients decreased with 0.4\u00a0cm (IQR \u2212\u00a02.1;0.6) (<jats:italic>p<\/jats:italic>\u2009=\u20090.023). Median intra-abdominal transverse diameter increased with 0.9\u00a0cm (IQR \u2212\u00a00.2;3.3) (<jats:italic>p<\/jats:italic>\u2009=\u20090.001) and the intra-abdominal anterior\u2013posterior diameter decreased with 0.5\u00a0cm (IQR \u2212\u00a01.3;0.5) (<jats:italic>p<\/jats:italic>\u2009=\u20090.017), making the abdomen more oval. Median LAW muscle length increased with 0.9\u00a0cm (IQR 0.0;2.4) per side (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), muscle thickness decreased with 0.5\u00a0cm (IQR \u2212\u00a00.8;\u2212\u00a00.2) (\u2212\u00a025.0%) per side (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and muscle mass decreased with 3.9\u00a0cm<jats:sup>2<\/jats:sup> (IQR \u2212\u00a06.4;-1.5) (\u2212\u00a015.8%) per side (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Median HU of the psoas muscles (density) increased with 4.8 HU (IQR 0.4;9.7) (10.3%) per side (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Effects of BTA were more pronounced in patients with a loss of domain (LoD)\u2009\u2265\u200920%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The main effect of BTA injections is elongation and thinning of the LAW muscles, more than a decrease in hernia width. Concomitantly, the abdomen becomes more oval. An increase of psoas muscles density is seen, associated with offloading of the LAW muscles. Patients with large LoD have a proportionally higher effect of BTA.\n<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10029-022-02692-w","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T10:02:56Z","timestamp":1665741776000},"page":"281-291","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A computed tomography study investigating the effects of botulinum toxin injections prior to complex abdominal wall reconstruction"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5061-7752","authenticated-orcid":false,"given":"J. J. M.","family":"Claessen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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M. Claessen, Allard S. Timmer, Robert Hemke, Jasper J. Atema, R. Hompes, and Martin V. H. Rutten declare that there is no conflict of interest. Marja A. Boermeester reported receiving institutional grants from J and J\/Ethicon, KCI\/3\u00a0M, and New Compliance; and being a speaker, advisor, and\/or instructor for KCI\/3\u00a0M, J and J\/Ethicon, BD Bard, Gore, GD Medical, Medtronic, TELABio, Molnlycke, and Smith and Nephew. No other disclosures were reported.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the Institutional Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"No rights were violated.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"All patients gave consent for the use of their data.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}