Effect of an elastic girdle on lung function, intra-abdominal pressure, and pain after midline laparotomy: a randomized controlled trial.
OBJECTIVE
Girdles and abdominal binders may reduce pain and stabilize the abdominal wall after laparotomy, but a risk for increased intra-abdominal pressure and decreased lung function is also hypothesized. The aim of this study was to investigate the effect of an abdominal girdle after midline laparotomy in a randomized controlled trial.


METHODS
Twenty-three patients undergoing laparotomy were randomized to wear an elastic girdle postoperatively and 25 were randomized to no girdle. Pulmonary function was evaluated with; forced vital capacity (FVC), forced expiratory volume during one second (FEV1), peak expiratory flow (PEF), and cough PEF. Pain was recorded using a visual analog scale (VAS). All patients completed the ventral hernia pain questionnaire (VHPQ) before surgery and at the end of the study. Intra-abdominal pressure was measured via an indwelling urinary catheter. Wound healing was assessed from photographs.


RESULTS
FVC, FEV1, PEF, and cough PEF were reduced by about 30 % after surgery, but there were no differences between patients with or without a girdle (ANOVA). Intra-abdominal pressure and wound healing were the same in both groups. Pain was significantly lower on day 5 in the girdle group (p = 0.004).


CONCLUSIONS
An individually fitted elastic girdle used after midline laparotomy was found to be safe, as this did not affect lung function, coughing, intra-abdominal pressure, or wound healing. The immediate decline in lung function after surgery is restrictive and due to anesthesia and the surgical procedure. Pain was significantly decreased in the girdle group. The study is registered at ClinicalTrials.gov, number NCT01517217.
Division of Surgery, Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
L
L
Clay
U
U
Gunnarsson
K A
KA
Franklin
K
K
Strigård
D000005:Abdomen / Q000502:physiology*; D000700:Analgesics / Q000627:therapeutic use; D003020:Clothing; D003108:Colonic Diseases / Q000601:surgery; D003371:Cough / Q000503:physiopathology; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects*; D008168:Lung / Q000502:physiology*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010366:Peak Expiratory Flow Rate; D011182:Postoperative Care / Q000379:methods*; D011312:Pressure; D012002:Rectal Diseases / Q000601:surgery; D014945:Wound Healing / Q000502:physiology
D000700:Analgesics