Deerenberg EB, Shao JM, Elhage SA, et al. - Improvement in recurrence and wound infection rates has been observed in correlation with fascial closure during complex abdominal wall reconstruction (AWR). Considering that preoperative botulinum toxin A (BTA) injection can facilitate fascial closure in massive ventral hernias, researchers conducted 2:1 propensity-score matching of patients undergoing AWR with and without BTA based on BMI, defect width, and loss of domain using CT-volumetric analysis. They identified 145 patients without BTA and 75 with BTA as comparable on hernia size and hernia volume. Outcomes suggest that preoperative BTA-injection results in improvement in fascial closure rates during AWR in patients with massive ventral hernias and severe loss of domain.