Post-operative Use of Abdominal Binders: Bound to Tradition?

Abstract

Introduction: An abdominal binder is an elastic or non-elastic belt applied to the abdomen in post-operative patients with abdominal surgery. These provide support and splintage to the operative wound, reducing incision site pain. The present work aims to investigate the institutional practices regarding the use of abdominal binders, gain insight into the expected benefits that these practices are targeted to achieve, and determine if current practices are in accordance with the available evidence.

Materials and methods: It is a survey-based questionnaire study conducted at the Department of Surgical Oncology at Shaukat Khanum Memorial Cancer Hospital and Research Centre. Respondents were inquired about designation, frequency of binder usage, reasons for prescribing/not prescribing binders, duration of the prescription, clinical factors that influence the decision to use binders and the estimated cost of the device.

Results: The questionnaire was emailed to 85 surgeons working in the department of surgical oncology. Out of these, 34 responded, resulting in an overall response rate of 40%. Twenty-two (64.7%) of the respondents used abdominal binders regularly in post-operative patients. Eight (22.5%) reported using it occasionally, while 4 (11.7%) did not use abdominal binders in their clinical practice. About 67.8% and 50% of the respondents believed that it helped early mobilisation and better pain control, respectively. About 60.7% of the respondents believed that binders prevent incisional hernia formation, while 46.4% were of the view that these prevented wound dehiscence. Up to 60% of the respondents reported using an abdominal binder for 1 week-1 month after discharge, whereas 23.3% preferred using it only till discharge.

Conclusion: This survey demonstrates a gap between the evidence and actual practice. These gaps are often overlooked because of busy clinical practice. Equally important is the issue of surgical conservatism and the intrinsic desire to resist change by continuing old practices.