Abdominal binders are ordered by some surgeons postoperatively for patient comfort and to prevent wound complications. There has been some question as to the compressive effect that an abdominal binder has on pulmonary function. We prospectively randomized 54 patients undergoing a midline laparotomy incision to two groups: a “binder” group and a “no binder” group. Preoperative pulmonary function tests (vital capacity and incentive spirometry) were measured. Postoperatively, pulmonary function tests, pulse oximetry, oxygen requirement, pulmonary and wound complications, pain control, time to ambulation, and hospital length of stay were examined. Vital capacity as a per cent of preoperative values on postoperative Day 1 for the binder and nonbinder groups were 64.7 and 54.6 per cent, respectively, but this was not statistically significant. Average level of pain using the visual analog pain scale on postoperative Days 1 through 3 in the binder versus nonbinder groups was 4 versus 8, 3 vs 6, and 3 versus 7, respectively. Time to ambulation was 18.6 hours in the binder group and 16.7 hours in the nonbinder group. Hospital length of stay in the binder and nonbinder groups was 3.9 days and 3.7 days, respectively. We conclude that abdominal binders in our patients with midline abdominal incisions had no significant effect on postoperative pulmonary function, but seemed to help with pain control.

Currently, the rapid diagnosis of mesenteric ischemia is problematic because of the nonspecificity of most laboratory assays and the unreliability of physical examinations. The evaluation of the cobalt-albumin binding assay (CABA) as a diagnostic marker for short-term risk stratification of emergency department patients presenting with symptoms of intestinal ischemia is reported. This preliminary study includes patients scheduled for exploratory laparotomy with symptoms of ischemic bowel and/or bowel obstruction. Approximately 10 mL of blood was drawn from each patient 1 hour preoperatively into a serum separator gel tube. After 30 minutes of clotting time, serum was collected and frozen at -80 degrees C. The CABA test was performed on the samples by an investigator blinded to the patient's condition, and values were compared with the clinical and pathologic diagnosis of ischemic bowel postoperatively. CABA test values are reported as absorbance units (ABSU) at 470 nm. Of the 26 patients enrolled in the study, 12 were clinically diagnosed with intestinal ischemia. These patients had significantly higher CABA test values (0.52 ABSU +/- 0.04 SEM) than patients without intestinal ischemia (0.31 ABSU +/- 0.02 SEM, p = 0.00023). Only two false-positives and no false-negatives were recorded. This resulted in a sensitivity of 100% and a specificity of 85.7% for the CABA test for these particular samples. The CABA test could be a useful tool for clinicians in the risk stratification of intestinal ischemia.