Reducing Discomfort After Cesarean Birth Using Abdominal Binders

Abstract

Purpose: The purpose of this study was to evaluate potential benefits of use of an abdominal binder after cesarean birth. Study Design and Methods: A randomized controlled trial was conducted at a Magnet-designated, academic medical center in the southwest United States. English- and Spanish-speaking adult women scheduled for an elective cesarean birth were randomized to the intervention or control group. Outcomes were measured for the first 48 hours postoperatively, including pain, medication use, and self-reported symptom distress. Results: Randomization resulted in balanced groups. Women who used the abdominal binder after cesarean birth reported a decrease in pain after ambulation, whereas women in the control group reported an increase in pain after ambulation (p < .001). Women in the binder group reported less distress on the Breathe and Cough items of the Symptom Distress Scale than those in the control group. On postoperative day 2, women in the binder group used more ibuprofen (p = .002) and acetaminophen (p = .027) than the control group. Clinical Implications: Use of an abdominal binder by women after cesarean birth can decrease pain, potentially enhancing speed of postoperative recovery. As a nursing intervention, abdominal binders may offer women a safe nonpharmacologic option to provide postoperative comfort.

The effectiveness of the abdominal binder in relieving pain after cesarean delivery: A systematic review and meta‐analysis of randomized controlled trials

“…Four included studies 10,18,19,27 were performed in women having elective or planned cesarean deliveries, whether primary or repeat cesarean deliveries, while in the study by Gillier et al, 14 women with elective or emergency cesarean deliveries with low transverse skin incisions, whether primary or repeat cesarean deliveries, were included. Moreover, in the study by Saeed et al, 20 all patients having abdominal surgery, including elective and emergency abdominal surgery and cesarean deliveries, were included.…”

“…In the study by Tussey et al, 27 for participants in the intervention group, an abdominal binder was applied by a nurse the first time they ambulated. The nurse provided education to the patient on the proper use of the binder and applied the binder using the manufacturer's recommendations and the woman's level of comfort.…”

“…Tussey et al 27 stated that using an abdominal binder after cesarean delivery could decrease postoperative pain, thereby potentially enhancing the speed of postoperative recovery. Moreover, abdominal binders may offer women a safe, non‐pharmacologic option for providing postoperative comfort, as stated by Tussey et al 27 …”

“…Five studies 10,14,18,19,27 reported the use of pain medications, mostly non‐steroidal anti‐inflammatory drugs (NSAIDs), during the postoperative period in both the abdominal binder group and the control group. It is believed that the usage of additional analgesia did not affect the evaluation of pain and distress scores because the use of additional analgesics was balanced between both the abdominal binder group and the control group 10,14,18,19,27 …”

“…The references of included studies were searched manually, but no further records were added. Finally, six RCTs with 702 women 10,14,[18][19][20]27 were included (369 in the abdominal binder group and 333 in the control group) (Figure 1). The mean age, BMI, gravidity, and parity, in addition to the mean number of previous vaginal and cesarean deliveries, are summarized in Tables 1 and 2.…”