The Effect of Abdominal Binders on Postoperative Pulmonary Function

Abstract

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.

Ventral hernia and patient experience of an elastic girdle

“…No negative side effects on pulmonary function have been observed when using a girdle following laparotomy . Significant pain relief was seen in a recent randomized trial.…”

“…Reasons for using a post‐operative girdle are pain relief, prevention of seroma formation and improved in‐growth of the synthetic mesh . The hypothesis that abdominal binders increase the risk for pulmonary insufficiency has been disproved, forced vital capacity and expiratory volume being independent of whether patients use a post‐operative girdle or not.…”

Randomized controlled trial of abdominal binders for postoperative pain, distress, and blood loss after cesarean delivery

“…However, the studies included in the review did not specify any time intervals for measuring pain; consequently, the results are controversial. Of the studies included in the review, Larson et al . evaluated pain using a VAS after laparotomy, and Daniel et al .…”

“…Previous studies have assessed the effect of abdominal binders on post‐operative pain control, improvements in mobility, the prevention of incisional hernia, breathing in patients with spinal cord injuries, hemorrhage, and distress . Abdominal binders have been reported to exert their effects through the compression of the abdomen, limiting the movement of abdominal wall muscles …”

Perspectives on Incentive Spirometry Utility and Patient Protocols

“…1 IS is ordered for patients at risk for postoperative pulmonary complications to reduce that risk. [2][3][4] According to the American Association for Respiratory Care (AARC), 5 IS is indicated for patients with atelectasis and for those with the following risk factors for atelectasis: thoracic or abdominal surgery, 2 coronary artery bypass graft surgery, 67 patients wearing binders on the thorax or abdomen, prolonged bed rest, COPD, poor pain control, 8 neuromuscular lung disease, inspiratory capacity Ͻ 2.5 L, 9 spinal cord injuries, and sickle cell patients with acute chest syndrome. 8,10 There are no IS guidelines from the American Thoracic Society.…”