Gastro Unit, Surgical Section, Hvidovre Hospital, University of Copenhagen, Kettegaard Alle 30, 2650, Hvidovre, Denmark,
Hernia. 2015 Feb;19(1):147-53. doi: 10.1007/s10029-014-1289-6. Epub 2014 Sep 9.
Application of an abdominal binder is often part of a standard postoperative regimen after ventral hernia repair to reduce pain and seroma formation. However, there is lack of evidence of the clinical effects. The aim of the present study was to investigate the pain- and seroma-reducing effect of an abdominal binder in patients undergoing laparoscopic umbilical or epigastric hernia repair.
Based on power analysis, a minimum of 54 patients undergoing laparoscopic umbilical and epigastric hernia repair were to be included. Patients were randomized to abdominal binders vs. no abdominal binders during the first postoperative week. Standardized surgical technique, anaesthesia, and analgesic regimens were used and study observers were blinded towards the intervention. Postoperative pain (visual analogue score) on day 1 was the primary outcome. In addition, ultrasonographic evaluation of seroma formation and several subjective patient-related parameters were registered. Furthermore, patients in the abdominal binder group were asked to rate benefits or discomforts of wearing the binder.
Data from 56 patients (abdominal binder, n = 28; no binder, n = 28) were available for analysis. No significant intergroup differences in postoperative pain or any of the other surgical outcomes, including seroma formation, were found. However, the abdominal binder group reported subjective beneficial effect of wearing the binder in 24 of the 28 patients (86%). No adverse effects of the abdominal binder were found.
There were no effects of an abdominal binder on pain, movement limitation, fatigue, seroma formation, general well-being, or quality of life. However, most patients claimed a subjective beneficial effect of using their abdominal binder.
腹部束带的应用通常是腹疝修补术后标准治疗方案的一部分,以减轻疼痛和血清肿形成。然而,缺乏临床效果的证据。本研究旨在探讨腹带在腹腔镜脐疝或上腹部疝修补术中减轻疼痛和血清肿的效果。
根据功效分析,至少纳入 54 例接受腹腔镜脐疝和上腹部疝修补术的患者。患者在术后第一周内随机分为使用腹部束带和不使用腹部束带两组。使用标准化的手术技术、麻醉和镇痛方案,研究观察者对干预措施保持盲态。术后第 1 天的疼痛(视觉模拟评分)是主要结局。此外,还记录了血清肿形成的超声评估和一些与患者相关的主观参数。此外,要求使用腹部束带的患者组对佩戴束带的益处或不适进行评分。
56 例患者(腹部束带组,n=28;无束带组,n=28)的数据可用于分析。两组患者在术后疼痛或任何其他手术结果(包括血清肿形成)方面无显著差异。然而,腹部束带组 28 名患者中有 24 名(86%)报告佩戴束带具有主观益处。未发现腹部束带的不良反应。
腹部束带对疼痛、活动受限、疲劳、血清肿形成、整体健康状况或生活质量没有影响。然而,大多数患者声称使用腹部束带具有主观益处。