Content area
Full Text
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.
ABDOMINAL BINDERS ARE ordered by some surgeons postoperatively for patient comfort and the possibility that they may aid in the prevention of wound compUcations. However, there are surgeons who believe that abdominal binders make no difference overall in patient outcomes and even can be detrimental to postoperative pulmonary function in that they have a restrictive effect on deep breathing and secretion clearance. Many of these same surgeons, both binder users and nonbinder users, admit mat their treatment strategies come not from objective data, but ramer from subjective, anecdotal evidence and from the experience of "how I was trained." For these reasons, we developed a study to help clarify those varying positions.
In the literature, mere is evidence for the effect of abdominal binders on intra-abdominal pressure and the effect on breathing1-4; however, there are minimal data on the specific relationship between abdominal binders and pulmonary function. For example, the only available reference we were able to identify...