The true purpose of the use of abdominal binders after incisional hernia repair: to reduce the stress forces along the suture line, to increase compression around the mesh, or to maintain the trunk circumference – a comprehensive literature review

Le résumé fourni par la source

Introduction: One common element of postoperative care for ventral hernia patients is the use of abdominal binders. Surgeons believe that abdominal binders provide external support and compression to the abdominal wall, potentially improving patient outcomes, promoting faster recovery, reducing postoperative pain, increasing comfort, and minimizing the risk of complications. However, the lack of scientific evidence has led to large discrepancies between the available data and common clinical practice. Aim: The aim of this study was to review the current literature regarding the use of abdominal binders after hernia repair, as there are currently no clear guidelines. Results: Surgeons are afraid of muscle thinning and weakening of muscle function due to the use of abdominal binders. Data show that the use of binders increases mobility and leads to greater activity, so it is not surprising that after orthoses are used, muscle thickness and strength may even increase. Although no available study has mentioned adjusting the binder size to the belly circumference, it cannot be ruled out that the use of binders has a beneficial effect on reducing tension in the abdominal line, as it would help maintain a constant abdominal circumference. In hernia surgery, highly extensible products are still commonly used, the structure and behavior of which resemble those of elastic bandages, which may explain why their effect on generated pressure and maintaining abdominal circumference may be insufficient. Unfortunately, we have not observed any compression stratification for abdominal binders used in the treatment and prevention of abdominal hernias. This may be the reason why the positive effect of abdominal garments has not yet been demonstrated. Future studies should analyze whether commonly used elastic and stretchable abdominal binders are able to reduce hernias and improve the quality of life of patients. Conclusions: The evidence from current studies on abdominal binders concerns a variety of significantly different products available on the market. Surgeons commonly use different protocols when prescribing abdominal binders to their patients, leading to heterogeneity in the analyzed groups. Surgeons assess the effects of abdominal binders on specific postoperative complications, but the mechanisms of action of these garments have not been thoroughly analyzed. The binders do not seem to harm patients and are safe, despite generating high intra-abdominal pressure.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.