Patient study: Significantly reduced pain with NordiCare’s postoperative binder
Study shows that NordiCare’s postoperative binder reduces pain after laparotomy.
The study “Effect of an elastic girdle on lung function, intra-abdominal pressure, and pain after midline laparotomy: a randomized controlled trial” demonstrates positive effects of using a post-operative abdominal binder. According to the study, patients undergoing laparotomy who use an individually fitted, prefabricated abdominal binder post-operatively experience significantly less pain than patients who do not use a binder. The study was conducted by L. Clay, U. Gunnarsson, K. A. Franklin and K. Strigård.
The study used LyftPlus from NordiCare.
The use of an abdominal binder may therefore be considered a cost-saving measure due to lower morphine doses and faster mobilisation. The study is registered at ClinicalTrials.gov, registration number NCT01517217. It was approved in January 2014 and published in the International Journal of Colorectal Disease (Springer Berlin Heidelberg).
Study summary
Objective
For patients, laparotomy can cause pain at the surgical site, weakness of the abdominal muscles, reduced lung function and pain when coughing. The benefits of using an abdominal binder to support coughing after abdominal surgery have been debated, and the scientific evidence has been limited and contradictory.
The hypothesis of this recently published randomised study is that using a prefabricated abdominal binder after laparotomy provides comfortable support when coughing without adversely affecting respiratory function, reduces pain and is easy to use. No previous study has investigated the effects of prefabricated abdominal binders.
Methods
A total of 48 patients were included and randomised into two groups: one group used a prefabricated abdominal binder post-operatively (23 patients), while the other group did not (25 patients). Patients were over 18 years of age and scheduled to undergo a midline incision longer than 12 cm in the umbilical region. Both benign and malignant diagnoses were accepted. Patients with dementia or requiring long-term oxygen therapy were excluded. The prefabricated abdominal binder was Lyft Plus, supplied by NordiCare. It was selected because it is easy to apply, has a wide hook-and-loop fastening and has no uncomfortable seams, which is important for comfort. If necessary, an opening can easily be cut for a stoma without compromising the support provided. The product is available in five sizes and was fitted by an experienced nurse to ensure optimal support without affecting breathing.
Lung function was measured the day before surgery using peak expiratory flow (PEF) and cough peak expiratory flow (cough PEF), and then post-operatively on days 1–5. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were also measured alongside PEF. Pain was assessed using a visual analogue scale (VAS) the day before surgery and twice daily on post-operative days 1–5. The Ventral Hernia Pain Questionnaire (VHPQ) was also completed the day before surgery and on post-operative day 5. Intra-abdominal pressure was measured via a urinary bladder catheter in patients who had received epidural anaesthesia. Wound healing was assessed using photographs.
Results
Both groups showed a significant decline in respiratory function after surgery. No significant differences in respiratory function were found between the groups in terms of PEF, cough PEF, FVC or FEV1. The results suggest that the decline in respiratory and coughing function after surgery is attributable to factors other than the abdominal binder, such as anaesthesia and/or surgery. No significant differences were found in intra-abdominal pressure or wound healing either. However, regarding pain, the study showed that the group wearing an abdominal binder experienced significantly less pain on post-operative day 5. Patients in the binder group who required morphine also received significantly lower doses than those in the group without a binder.
Patients undergoing laparotomy who use an individually fitted, prefabricated abdominal binder post-operatively experience significantly less pain. The use of an abdominal binder may therefore be considered a cost-saving measure due to lower morphine doses and faster mobilisation.
The full study is available in English here. See also www.clinicaltrials.gov, registration number NCT01517217.
