Postoperative use of a neoprene abdominal-pelvic binder significantly increases ambulatory events in the first 24 hours after surgery and may be of benefit particularly in a high-risk gynecological oncology surgical population, according to a study presented the American Congress of Obstetricians and Gynecologists’ Annual Clinical Meeting. Increasing ambulation and lowering morphine use can potentially decrease postoperative pneumonia, prevent venous thromboembolic events, and decrease instances of postoperative ileus.
In the study, 36 of 75 patients undergoing abdominal gynecologic surgery were randomly assigned a novel neoprene abdominal-pelvic binder in the first 24 hours after abdominal surgery. Standard morphine sulfate PCA pain control protocol was followed.
Before surgery, the two groups were demographically similar. Clinical variables included binder status, age, weight, comorbidities, prior surgeries, surgical indication, surgical complexity, and incision type and length. Morphine use, VAS linear-analog pain score at 24 hours, time to first ambulation and number of ambulatory events in the first 24 hours after surgery were evaluated outcomes.
“Our hypothesis was that an abdominal pelvic binder… [would result] in decreased abdominal pain and splinting, which aids in compliance with early ambulation and decreased use of IV pain medications,” said lead author Brian Szender, MD, of the University of Texas Health Science Center in San Antonio, Texas.
Spearman rank correlation was used to determine relationships between clinical and outcome variables. ANOVA was used for hypothesis testing; a p-value of < 0.05 was considered significant.
“The initial analysis identified a group that was high risk for decreased postoperative ambulation, specifically, those greater than age 50, those with gynecologic cancer [and complex surgeries] and those with vertical skin incisions,” Szender said. Use of the binder increased the number of ambulatory events in the first 24 hours after surgery by 250%, 174% and 300%, respectively.
The binder was well liked, well tolerated, and patient compliance was 100%. “The use of the binder increased ambulatory events across all of these high-risk patient groups and although we did not find a significant decrease in the amount of morphine that was used, the abdominal pubic binder did significantly increase the amount of times a patient got up and walked around postoperatively in that initial high risk-portion of the post op period where some of these complications can arise.” While there was a trend in decreased morphine use by patients, the change was not statistically significant.
Because the neoprene abdominal-pelvic binder increases ambulatory events and may result in decreased morphine use, routine use may help decrease postoperative complications like pneumonia and venous thromboembolic events, and lessen postoperative ileus.
“The abdominal pubic binder did significantly increase the amount of times a patient got up and walked around postoperatively in that initial high risk portion of the post op period where some of these complications can arise,” Szender said.