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dc.contributor.authorLuton, O. W.
dc.contributor.authorMortimer, M.
dc.contributor.authorHopkins, L.
dc.contributor.authorRobinson, D.
dc.contributor.authorEgeler, C.
dc.contributor.authorSmart, N. J.
dc.contributor.authorHarries, R.
dc.identifier.citationAnn R Coll Surg Engl. 2022 Feb 17. doi: 10.1308/rcsann.2021.0284.
dc.description.abstractINTRODUCTION: Emergency laparotomy for either trauma or non-trauma indications is common and management is varied. Use of the open abdomen technique allowing for planned re-look is an option; however, performing delayed definitive fascial closure (DFC) following this can be a challenge. The use of botulinum toxin-A (BTX) infiltration into the lateral abdominal wall has been well documented within the elective setting; its use within the emergency setting is undecided. This systematic review assesses the efficacy and safety of BTX injection into the lateral abdominal wall muscles in the emergency setting. The primary outcome is DFC rate. METHODS: Systematic review was performed according to the PROSPERO registered protocol (CRD42020205130). Papers were dual screened for eligibility, and included if they met pre-stated criteria where the primary outcome was DFC. Articles reporting fewer than five cases were excluded. Bias was assessed using the Cochrane Risk of Bias and Joanna Brigg's appraisal tools. FINDINGS: Fourteen studies were screened for eligibility, twelve full texts were reviewed and two studies were included. Both studies showed evidence of bias due to confounding factors and lack of reporting. Both studies suggested significantly higher rates of DFC than reported in the literature against standard technique (90.7% vs 66%); however, these data are difficult to interpret due to strict study inclusion criteria or lack of a control population. CONCLUSION: The use of BTX is deemed safe and its effects in the emergency situation may have great potential. Unfortunately, to date, there is insufficient evidence to facilitate opinion.
dc.publisherRoyal College of Surgeons
dc.rights© 2022 The Royal College of Surgeons of England
dc.subjectEmergency laparotomy
dc.subjectOpen abdomen
dc.titleIs there a role for botulinum toxin A in the emergency setting for delayed abdominal wall closure in the management of the open abdomen? A systematic review
dc.typeJournal Article
dc.identifier.journalAnnals of the Royal College of Surgeons of England
dc.description.noteThe article is available via Open Access. Click on the 'Additional link' above to access the full-text.
dc.description.admin-noteNot permitted

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