{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T05:49:16Z","timestamp":1776491356068,"version":"3.51.2"},"reference-count":16,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"abstract":"<jats:p>ABSTRACT  Introduction:  the botulinum toxin A (BTA) has been used to achieve a chemical component separation, and it has been used with favorable outcomes for the repair of complex ventral hernia (CVH) with and without loss of domain (LD). The aim of this study is to describe our early experience with the chemical component separation in the United Sates.  Methods:  a retrospective observational study of all patients who underwent ventral hernia repair for CVH with or without LD between July 2018 and June 2020. Preoperative BTA was injected in all patients via sonographic guidance bilaterally, between the lateral muscles to achieve chemical denervation before the operation. Patient demographics, anatomical location of the hernia, perioperative data and postoperative data are described.  Results:  36 patients underwent this technique before their hernia repair between July 2018 to June 2020. Median age was 62 years (range 30-87). Median preoperative defect size was 12cm (range 6-25) and median intraoperative defect size was 13cm (range 5-27). Median preoperative hernia sac volume (HSV) was 1338cc (128-14040), median preoperative abdominal cavity volume (ACV) was 8784cc (5197-18289) and median volume ration (HSV\/ACV) was 14%. The median OR time for BTA administration was 45 minutes (range 28-495). Seroma was the most common postoperative complication in 8 of the patients (22%). Median follow up was 43 days (range 0-580).  Conclusion:  preoperative chemical component separation with BTA is a safe and effective adjunct to hernia repair in CVH repairs where a challenging midline fascial approximation is anticipated.<\/jats:p>","DOI":"10.1590\/0100-6991e-20213152","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T22:12:31Z","timestamp":1646172751000},"source":"Crossref","is-referenced-by-count":8,"title":["Preoperative botulinum A toxin as an adjunct for abdominal wall reconstruction: a single-center early experience at an Academic Center in New York"],"prefix":"10.1590","volume":"49","author":[{"given":"COSMAN CAMILO","family":"MANDUJANO","sequence":"first","affiliation":[{"name":"Montefiore Medical Center,  United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7383-1284","authenticated-orcid":false,"given":"DIEGO LAURENTINO","family":"LIMA","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center,  United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ANALENA","family":"ALCABES","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center,  United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"PATRICIA","family":"FRIEDMANN","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center,  United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"XAVIER","family":"PEREIRA","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center,  United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FLAVIO","family":"MALCHER","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center,  United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2022]]},"reference":[{"key":"ref1","first-page":"17","article-title":"Complex Ventral Hernias A Review of Past to Present","volume":"22","author":"Trujillo CN","year":"2017","journal-title":"Perm J"},{"issue":"2","key":"ref2","first-page":"67","article-title":"Content of Botulinum Neurotoxin in Botox(r)\/Vistabel(r), Dysport(r)\/Azzalure(r), and Xeomin(r)\/Bocouture(r) Drugs","volume":"10","author":"Frevert J","year":"2010","journal-title":"R D"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"535","DOI":"10.3390\/toxins10120535","article-title":"AbobotulinumtoxinA (Dysport(r)), OnabotulinumtoxinA (Botox(r)), and IncobotulinumtoxinA (Xeomin(r)) Neurotoxin Content and Potential Implications for Duration of Response in Patients","volume":"10","author":"Field M","year":"2018","journal-title":"Toxins (Basel)"},{"issue":"1-2","key":"ref4","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/ans.13258","article-title":"Preoperative abdominal muscle elongation with botulinum toxin A for complex incisional ventral hernia repair","volume":"86","author":"Farooque F","year":"2016","journal-title":"ANZ J Surg"},{"issue":"2","key":"ref5","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s00464-017-5750-3","article-title":"Preoperative Botulinum toxin A enabling defect closure and laparoscopic repair of complex ventral hernia","volume":"32","author":"Rodriguez-Acevedo O","year":"2018","journal-title":"Surg Endosc"},{"issue":"12","key":"ref6","doi-asserted-by":"crossref","first-page":"2830","DOI":"10.1007\/s00268-013-2211-6","article-title":"Outcomes of Chemical Component Paralysis Using Botulinum Toxin for Incisional Hernia Repairs","volume":"37","author":"Zendejas B","year":"2013","journal-title":"World J Surg"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.1007\/s00268-009-0203-3","article-title":"Use of Botulinum Toxin Type A Before Abdominal Wall Hernia Reconstruction","volume":"33","author":"Ibarra-Hurtado TR","year":"2009","journal-title":"World J Surg"},{"issue":"8","key":"ref8","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1007\/s00464-018-6089-0","article-title":"Preoperative combination of progressive pneumoperitoneum and botulinum toxin type A in patients with loss of domain hernia","volume":"32","author":"Bueno-Lled\u00f3 J","year":"2018","journal-title":"Surg Endosc"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s10029-017-1582-2","article-title":"Preoperative progressive pneumoperitoneum and botulinum toxin type A in patients with large incisional hernia","volume":"21","author":"Bueno-Lled\u00f3 J","year":"2017","journal-title":"Hernia"},{"issue":"1","key":"ref10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s10029-013-1168-6","article-title":"Criteria for definition of a complex abdominal wall hernia","volume":"18","author":"Slater NJ","year":"2014","journal-title":"Hernia"},{"key":"ref11","year":"2020"},{"issue":"4","key":"ref12","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1007\/s00268-019-05317-z","article-title":"Definitions for Loss of Domain An International Delphi Consensus of Expert Surgeons","volume":"44","author":"Parker SG","year":"2020","journal-title":"World J Surg"},{"issue":"1","key":"ref13","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10029-009-0560-8","article-title":"A computerized tomography scan method for calculating the hernia sac and abdominal cavity volume in complex large incisional hernia with loss of domain","volume":"14","author":"Tanaka EY","year":"2010","journal-title":"Hernia"},{"issue":"5","key":"ref14","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s10029-014-1280-2","article-title":"Effect of botulinum toxin type A in lateral abdominal wall muscles thickness and length of patients with midline incisional hernia secondary to open abdomen management","volume":"18","author":"Ibarra-Hurtado TR","year":"2014","journal-title":"Hernia"},{"issue":"3 Suppl","key":"ref15","doi-asserted-by":"crossref","first-page":"58S","DOI":"10.1097\/PRS.0000000000004856","article-title":"Chemical Components Separation Concepts, Evidence, and Outcomes","volume":"142","author":"Motz BM","year":"2018","journal-title":"Plast Reconstr Surg"},{"issue":"2","key":"ref16","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1007\/s00464-016-5030-7","article-title":"Preoperative chemical component relaxation using Botulinum toxin A enabling laparoscopic repair of complex ventral hernia","volume":"31","author":"Elstner KE","year":"2017","journal-title":"Surg Endosc"}],"container-title":["Revista do Col\u00e9gio Brasileiro de 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