American journal of surgery · 2026
Decreased utilization of component separation techniques over time in complex abdominal wall reconstruction following introduction of preoperative botulinum toxin A.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kerr Samantha W, Lorenz William R, Walker Victoria L, Lopez Robert R, Raible Robert J, Hinton Lucy, Holland Alexis M, Scarola Gregory T, Kercher Kent W, Augenstein Vedra A, Heniford B Todd, Ayuso Sullivan A
Аннотация
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/m2; defect size 211.5 ± 165.6 cm2), 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 cm2;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.
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/m2; defect size 211.5 ± 165.6 cm2), 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 cm2;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.