Document Type : Original Article
Authors
1 Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
2 Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz , Ahvaz, Iran.
3 Department of Pathobiology, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran.
Abstract
The aim of this study was to investigate the effects of Botulinum Toxin A (Botox) and lidocaine on the repair of abdominal muscle defects. This study was conducted on 40 rats in four groups. Animals during experimental abdominal wall defect creation and before closing the defect in the Botox group, 5 units of Botox, in the lidocaine group 1 ml of 1% lidocaine, in the Botox-lidocaine group 10 units of Botox with lidocaine with a final volume of 1 cc and in the control group received normal saline in a volume of 1 ml. Each group was divided into two subgroups. Each subgroup animal was sacrificed on days 6 and 12, respectively, after surgery, and after taking a sample, it was examined macroscopically and microscopically. In macroscopic evaluation on both days 6 and 12 after surgery, the highest muscle tension (stretching of the muscles in the nipple area and a significant reduction in abdominal volume) belonged to the normal saline group and the lowest to the Botox and Botox-lidocaine groups. In microscopy on day 6, in normal saline and lidocaine groups, a wider area of granulation tissue and a large number of inflammatory cells were observed, and in the Botox and Botox-lidocaine groups, a less limited amount of granulation tissue was observed. On day 12, in the control and lidocaine groups, a large level of granulation tissue and fibroblasts was observed, while in the Botox and Botox-lidocaine groups, a very small amount of connective tissue was seen at the incision site. Animals receiving normal saline had significantly more inflammation than the groups receiving Botox and Botox lidocaine. According to the results, it seems that topical administration of Botox-lidocaine combination can be a good solution to reduce suture tension and prevent rupture of abdominal sutures.
Keywords
Main Subjects
- Fitzgibbons RJ, Forse RA. Groin hernias in adults. New England Journal of Medicine. 2015; 372: 756-763.
- Fossum TW. Small Animal Surgery E-Book. Elsevier Health Sciences. 2018; 518-521.
- Santora TA, Roslyn JJ. Incisional hernia. Surgical Clinics of North America. 1993; 73: 557-570.
- Carlson MA, Condon RE. Polyglyconate (maxon (r)) versus nylon suture in midline abdominal incision closure: A prospective randomized trial. American Surgery. 1995; 61: 980-983.
- Guo S, DiPietro LA. Factors affecting wound healing. Journal of Dental Research. 2010; 89: 219-229.
- Kreszinger M, Delimar D, Kos J, Jovanov N, Vnuk D, Matičić D, Pirkić B, Stejskal M, Capak D. Wound strength after midline laparotomy: A comparison of four closure techniques in rats. Veterinary Arhiv 2007; 77: 397-408.
- Helm JM. The use of botulinum toxin in abdominal wall reconstruction: A case series. Undergraduate senior honors thesis, Honors College. 2017.
- Farazi-Chongouki C, Filippou D. Role of botulinum toxin a in the management of complex incisional hernias. World Journal of Surgical Procedures. 2019; 9: 1-6.
- Ibarra-Hurtado TR, Nuño-Guzmán CM, Echeagaray-Herrera JE, Robles-Vélez E, de Jesús González-Jaime J. Use of botulinum toxin type a before abdominal wall hernia reconstruction. World Journal of Surgery. 2009; 33: 2553-2556.
- Chen H, Pan W, Zhang J, Cheng H, Tan Q. The application of w-plasty combined botox-a injection in treating sunk scar on the face. Medicine. 2018; 97: 14-19.
- Farooque F, Jacombs AS, Roussos E, Read JW, Dardano AN, Edye M, Ibrahim N. Preoperative abdominal muscle elongation with botulinum toxin a for complex incisional ventral hernia repair. ANZ Journal of Surgery. 2016; 86: 79-83.
- Rodriguez-Acevedo O, Elstner KE, Jacombs AS, Read JW, Martins RT, Arduini F, Wehrhahm M, Craft C, Cosman PH, Dardano AN. Preoperative botulinum toxin a enabling defect closure and laparoscopic repair of complex ventral hernia. Surgical Endoscopy. 2018; 32: 831-839.
- Lien SC, Hu Y, Wollstein A, Franz MG, Patel SP, Kuzon WM, Urbanchek MG. Contraction of abdominal wall muscles influences size and omlurrence of incisional hernia. Surgery. 2015; 158: 278-288.
- Soltanizadeh S, Helgstrand F, Jorgensen LN. Botulinum toxin a as an adjunct to abdominal wall reconstruction for incisional hernia. Plastic and Reconstructive Surgery. 2017; 5: 6-10.
- Hijji T, AlShammari A, AlHammad A, AlKhalefah G, Hashem F, Almomen S, Aburahmah M. Incisional hernia repair with plication and utilization of Botox injections: First case report from Saudi Arabia for a 19‐year‐old female. Clinical Case Reports. 2019; 7: 311-315.
- Smoot D, Zielinski M, Jenkins D, Schiller H. Botox a injection for pain after laparoscopic ventral hernia: A case report. Pain Medicine. 2011; 12: 1121-1123.
- Kim A, Jung J, Pak A. Botulinum toxin type a reconstituted in lidocaine with epinephrine for facial rejuvenation: Results of a participant satisfaction survey. Cutis. 2013; 1: 13-18.
- Gassner HG, Sherris DA. Chemoimmobilization: improving predictability in the treatment of facial scars. Plastic and Reconstructive Surgery. 2003; 112: 1464-1466.
- Bittner R, Bain K, Bansal V, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz U, de Beaux A. Update of guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (international endohernia society (IEHS))—part A. Surgical Endoscopy. 2019; 33: 3069-3139.
- Deerenberg EB, Elhage SA, Raible RJ, Shao JM, Augenstein VA, Heniford BT, Lopez R. Image-guided botulinum toxin injection in the lateral abdominal wall prior to abdominal wall reconstruction surgery: Review of techniques and results. Skeletal Radiology. 2020; 1: 1-7.
- Capece SJ, Wallace SJ, Wojcik JR, Browne M. Botulinum toxin for giant omphalocele abdominal wall reconstruction. Journal of Pediatric Surgery Case Reports. 2020; 61: 101562.
- Çakmak M, Caglayan F, Somuncu S, Leventoglu A, Ulusoy S, Akman H, Kaya M. Effect of paralysis of the abdominal wall muscles by botulinum a toxin to intraabdominal pressure: An experimental study. Journal of Pediatric Surgery Case Reports. 2006; 41: 821-825.
- Blaha L, Chouliaras K, White A, McNatt S, Westcott C. Intraoperative botulinum toxin chemodenervation and analgesia in abdominal wall reconstruction. Surgical Innovation. 2020; 2: 1553350620975253.
- El Shaer WM, Ahmed AE, Sakr WM, Hawas EM, Fathi MZ. Effect of perivascular injection of botulinum toxin type a versus lidocaine in survival of random pattern flaps in a rat model. Plastic and Reconstructive Surgery. 2019; 143: 527-533.
- Lee BJ, Jeong JH, Wang SG, Lee JC, Goh EK, Kim HW. Effect of botulinum toxin type a on a rat surgical wound model. Clinical and Experimental Otorhinolaryngology. 2009; 2: 20-25.
- Kucukkaya D, Irkoren S, Ozkan S, Sivrioglu N. The effects of botulinum toxin a on the wound and skin graft contraction. Journal of Craniofacial Surgery. 2014; 25: 1908-1911.
- Jalalipour H, Jahromi AR, Naeini AT, Aghaei S, Sepaskhah M. Botox immobilization effects on equine wound healing. 4th International Symposium of Veterinary Surgery, 2013; 1: 32-41.