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265. maffulli n, boie-linardi l, el mouigat a, aziz-saada d, fleurent f, fanti e, de marchi f, accalchia e, dauvois a. a controlled, double-blind pilot trial of the positioning of elastic binder on laparotomy wounds and the prevention of postoperative pain and swelling. eur surg res. 2019;51(6):964-71. doi.org/10.1016/j.eurosrv.2019.08.011. pmid: 30811793

the authors performed a small, prospective rct to assess if application of an abdominal binder after a non-complicated implantation of a cardiac pacemaker would improve pain and decrease postoperative complications, particularly incisional pain and seroma. forty patients were randomized to receive binder or no binder. their conclusion was that after implantation of a cardiac pacemaker, application of an abdominal binder may reduce postoperative pain and improve wound healing. further, it did not interfere with the procedure or require any additional equipment [35].

an expert panel in a systematic review of literature addressed six clinical questions about the use of abdominal binders following laparotomy, one for each day post-operative until discharge. the answers to the six questions included: (1) routine use of abdominal binders is recommended after abdominal surgery, including colorectal surgery; (2) routine use of binders is not recommended after laparoscopic procedures; (3) routine use of binders after elective abdominal surgery is recommended to reduce pain, decrease postoperative complications, and optimize patient recovery [36].

the authors evaluated the long-term effect of an abdominal binder in a prospective, randomized, single-blinded study, including 104 patients who underwent a laparotomy procedure. the binder or no binder groups were comparable in terms of age, sex, and weight. patients in the binder group received a binder for the first 5 postoperative days. postoperatively, pain and wound healing were comparable between groups, however, adverse effects were more common in patients who used the binder. the authors concluded that the use of abdominal binders after laparotomy is associated with an increased incidence of wound-related complications. they suggested that it could be associated with an increase in the intensity of pain. therefore, they suggest a delay in binder use after laparotomy until the patient is fully ambulatory [37].

abdominoplasty (tummy tuck) is one of the most common operations performed. if used correctly, it can have some very positive outcomes in the form of a well-proportioned body, reduction of excess skin, and improvement in skin quality. however, abdominoplasty can also lead to complications such as hernia, abdominal contour irregularities, seroma, long-term volume loss, possibly reducing ability to gain weight, and ileus [ 8, 10 ]. this includes a higher risk of hernia in women, more abdominal scars, and a higher rate of contour irregularities compared to men [ 5 ]. contour irregularities can be corrected through a combination of abdominoplasty, preoperative intramuscular or intradermal injections, liposuction, and perioperative care [ 7 ]. other factors such as body weight and bmi have also been described as risk factors for hernia occurrence, even if patients are evaluated for hernia risk preoperatively [ 3 ].
in a different type of study that aimed to determine the effect of elastic compression stockings on iap in parturients, iap was measured by bladder palpation before and after placement of compression stockings and after delivery. they concluded that compression stockings significantly decreased the iap and that this might be a reasonable prevention strategy in high-risk parturients [49].
another study using bladder percussion to measure iap was conducted in a facility where a new postoperative abdominal binder was introduced. initial readings were taken in the recovery area before binder use. after the patient was ready to leave the facility, they were weighed on a scale and then brought into the postoperative care unit (pcu) for iap measurement. the measurement was taken in the pcu before and after the patient had dressed with the new binder. these authors concluded that it is a simple and quick method for measurement of iap without any special equipment and that compression stockings could decrease iap in postoperative parturients. furthermore, accurate measurement of iap by palpation is not very accurate (4 cm h2o variation in iap reading compared to 0.3 cm h2o measured by bladder percussion).
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