Use of botulinum toxin type A in the prehabilitation of abdominal wall musculature for hernia repair: a consensus proposal

Abstract

The prehabilitation of the abdominal wall through the infiltration of botulinum toxin type A, which induces temporary chemical denervation ("chemical component separation") in the lateral abdominal musculature, is a common practice in units specialized in abdominal wall surgery. However, its use for this indication is currently off-label. The main objective of this article is to describe a consensus proposal regarding indications, contraindications, dosages employed, potential side effects, administration method, and measurement of possible outcomes. Additionally, a proposal for an informed consent document endorsed by the Abdominal Wall Section of the Spanish Association of Surgeons is attached.

Keywords: Botulinum toxin; Complex ventral hernia repair; Hernia con pérdida de domicilio; Hernia incisional; Hernia ventral; Incisional hernia; Loss of domain hernia; Prehabilitación; Prehabilitation; Reparación de hernia ventral compleja; Toxina botulínica; Ventral hernia.