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Koyuncu F, Iyigun E. The effect of mobilization protocol on mobilization start time and patient care outcomes in patients undergoing abdominal surgery. J Clin Nurs 2021; 31:1298-1308. [PMID: 34346134 DOI: 10.1111/jocn.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/07/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the effect of mobilization protocol on mobilization start time, maintenance of mobilization and patient care outcomes in patients who underwent major abdominal open surgery. BACKGROUND Early mobilization in the first 24 hours postoperatively is recommended. Early mobilization is one of the evidence-based, effective nursing interventions that improve patient care outcomes. DESIGN A quasi-experimental non-randomised design was used in the study. METHODS In the study, the groups were followed sequentially and the data of the control group (n = 21) were collected before the intervention group (n = 21). The patients in the control group were mobilised postoperatively by the nurses according to the decision of the nurse and physician in the intensive care unit (ICU) on the day of the operation. There was no standard protocol for mobilization in the ICU. Mobilization training was given to the patients in the intervention group by the researcher nurse the evening before the operation, and a mobilization protocol was applied on the 0th postoperative day. Data on patient care outcomes were collected until the day when the patient was discharged from the hospital. The TREND checklist was followed. RESULTS According to the postoperative comparison of the patients in the intervention group to those in the control group, patients in the intervention group started mobilization earlier after admission in intensive care unit (6.22 ± 1.95 hours versus 12.21 ± 3.76 hours), had higher postoperative 0th -day total mobilization time (128 minutes versus 34 minutes), had a shorter passage of flatus time and length of intensive care unit and hospital stay and had higher sleep quality and satisfaction scores. CONCLUSIONS The structured mobilization protocol is effective in the management of early mobilization and improvement of patient care outcomes. RELEVANCE TO CLINICAL PRACTICE mobilization protocols ensure that the mobilization process is maintained effectively.
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Affiliation(s)
- Fadime Koyuncu
- Gülhane Faculty of Nursing, Department of Surgical Nursing, University of Health Sciences, Ankara, Turkey
| | - Emine Iyigun
- Gülhane Faculty of Nursing, Department of Surgical Nursing, University of Health Sciences, Ankara, Turkey
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Ossola P, Mascioli F, Coletta D, Pizzato M, Bononi M. Evidence on postoperative abdominal binding: A systematic review with meta-analysis of randomized controlled trials. Surgeon 2021; 19:244-251. [DOI: 10.1016/j.surge.2020.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/27/2022]
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Di Mascio D, Caruso G, Prata G, Saccone G, Terrin G, Giancotti A, Brunelli R, Muzii L, Benedetti Panici P, Di Donato V. The efficacy of abdominal binders in reducing postoperative pain and distress after cesarean delivery: A meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2021; 262:73-79. [PMID: 33993065 DOI: 10.1016/j.ejogrb.2021.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the efficacy of abdominal binders in reducing postoperative pain, patient distress and surgical postoperative sequelae after cesarean delivery (CD). METHODS A comprehensive search in electronic databases (MEDLINE, EMBASE, and Cochrane Central) was performed up to February 2021. Selection criteria included randomized clinical trials investigating the application or not of abdominal binder after CD. The primary outcome was postoperative pain, measured using the visual analog scale (VAS) pain score. Secondary outcomes were divided into short- and long-term postoperative outcomes, including patient distress, need for additional pain medications, time to mobilization, return to normal daily activities, surgical site infection, fascial dehiscence or incisional hernia, and rectus abdominis diastasis. The summary measures were reported as mean difference with 95 % confidence intervals (CI) using the random effects model of DerSimonian and Laird. An I2 (Higgins I2) value of greater than 0% was used to identify heterogeneity. RESULTS Four RCTs involving 601 women were included for meta-analysis: 310 (51.6 %) were randomized to the abdominal binder and 291 (48.4 %) to no abdominal binder group. There was no statistically significant difference between the two groups for VAS score either at 24 h (MD -0.97, 95 % CI -2.23 to 0.30; p = 0.13) and at 48 h (MD -0.30, 95 % CI -0.71 to 0.11; p = 0.15). Conversely, there was a significant reduction in postoperative distress (SDS) both at 24 h (MD -2.23, 95 % CI -3.77 to -0.70; p = 0.004) and 48 h (MD -2.37, 95 % CI -3.86 to -0.87; p = 0.002). CONCLUSION The present meta-analysis shows that the use of abdominal binders after CD significantly reduces patient distress.
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Affiliation(s)
- Daniele Di Mascio
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giuseppe Caruso
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
| | - Giovanni Prata
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Gianluca Terrin
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Antonella Giancotti
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Roberto Brunelli
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Pierluigi Benedetti Panici
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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Ammar AS, Naqi SA, Khattak S, Noumani AR. Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure. Pak J Med Sci 2021; 37:1118-1121. [PMID: 34290793 PMCID: PMC8281147 DOI: 10.12669/pjms.37.4.3671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/12/2020] [Accepted: 03/20/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure. Methods It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1st January 2018 to 31st December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared. Results Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063). Conclusion Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn't help in healing of wound and reclosure of the dehisced abdominal wound is needed.
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Affiliation(s)
- Ahmed Siddique Ammar
- Dr. Ahmed Siddique Ammar, MBBS, MS General Surgery Senior Registrar, EAST Surgical Ward, Mayo Hospital, Lahore, Pakistan
| | - Syed Asghar Naqi
- Prof. Dr. Syed Asghar Naqi, MBBS, FCPS, FRCS, MCPS-HPE Professor and Head of Surgical Department, EAST Surgical Ward, MAYO Hospital, Lahore, Pakistan. EAST Surgical Ward, Mayo Hospital, Lahore, Pakistan
| | - Shehrbano Khattak
- Dr. Shehrbano Khattak, MBBS, M-Phill Biochemistry Lecturer, Department of Biochemistry, King Edward Medical University, Lahore, Pakistan
| | - Ahmed Raza Noumani
- Dr. Ahmed Raza Noumani, MBBS, MS General Surgery Senior Registrar, EAST Surgical Ward, Mayo Hospital, Lahore, Pakistan
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Sun X, Wei Q, Fu C, Zhang Q, Liang Z, Peng L, Chen L, He C, Wei Q. Effects of abdominal binders on postoperative pain and functional recovery: a systematic review and meta-analysis. PAIN MEDICINE 2021; 22:2174-2184. [PMID: 33713136 DOI: 10.1093/pm/pnab099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE This study aimed to assess the effectiveness of abdominal binders (ABs) on postoperative pain and functional recovery in patients receiving abdominal surgery. METHODS The Pubmed, Embase, Cochrane Library, and PEDro databases were searched for clinical trials published up to November 30, 2019. Randomized controlled trials that compared the effects of wearing an AB to not wearing an AB in participants after abdominal surgery were included. The primary outcomes were pain, pulmonary function, and physical function, as assessed by the visual analog scale (VAS) score, a spirometry device, and the 6-min walk test (6MWT), respectively. The registration number of this review in PROSPERO is CRD42020165303. RESULTS Fourteen trials involving 1317 participants were included. Pooled estimates for the VAS score and the 6MWT showed significant differences between the AB group and the control group, especially on the fourth day following surgery (Mean Difference (MD) = -2.82, 95% Confidence Interval (CI) -3.41 to -2.22, P < 0.00001; MD = 50.97 m, 95% CI 39.99 to 61.95 m, P < 0.00001). However, no significant differences were found in pulmonary function (forced vital capacity (FVC): MD = 0.01, 95% CI -0.29 to -0.32, P = 0.94; forced expiratory volume during 1 s (FEV1): MD = -0.05; 95% CI -0.24 to 0.14; p = 0.63; FEV1/FVC: MD = 3.14, 95% CI -2.78 to 9.06, P = 0.30). CONCLUSION ABs probably improve postoperative pain and physical function, especially on the fourth day or more following abdominal surgery, but they have no effects on pulmonary function.
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Affiliation(s)
- Xin Sun
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Qingchuan Wei
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Chenying Fu
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qing Zhang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Zejun Liang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Lihong Peng
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Li Chen
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Chengqi He
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Quan Wei
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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Abd-ElGawad M, Said Ali A, Abdelmonem M, Elshamy NH, Abdeltawab AK, Abd El-Shafea M, Rund NMA, Fadlalmola HA, Ashour ASA, Almohamady M. The effectiveness of the abdominal binder in relieving pain after cesarean delivery: A systematic review and meta-analysis of randomized controlled trials. Int J Gynaecol Obstet 2021; 154:7-16. [PMID: 33471362 DOI: 10.1002/ijgo.13607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 10/19/2020] [Accepted: 01/18/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Abdominal binder is a non-pharmacological method of relieving pain after surgical procedures. OBJECTIVES To evaluate the effectiveness of the abdominal binder in relieving pain and distress scores after cesarean delivery (CD). SEARCH STRATEGY The following terms were searched: cesarean section, cesarean, caesarean, abdominal deliveries, C-section, abdominal delivery, abdominal binding, binder, and abdominal binder. SELECTION CRITERIA Randomized controlled trials (RCTs) with patients undergoing CD receiving an abdominal binder compared with non-users of the abdominal binder. DATA COLLECTION AND ANALYSIS Five electronic databases were searched until November 2019. Records were screened for eligibility. Data were extracted independently and analyzed. The main outcomes were pain and distress scores. RESULTS The final analysis included six RCTs. Overall effect estimate favored the abdominal binder group over the control group in the following outcomes: VAS pain scores after 24 h (mean difference [MD] -1.76; 95% confidence interval [CI] -3.14 to -0.39; P = 0.01), VAS scores after 48 h (MD -1.21; 95% CI -1.51 to -0.90; P < 0.001), distress score after 24 h (MD -1.87; 95% CI -3.01 to -0.73; P = 0.001), and distress score after 48 h (MD -1.87; 95% CI -3.07 to -0.67; P = 0.002). CONCLUSION The abdominal binder could be an effective, simple, non-pharmacological option of relieving pain and distress after CD.
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Affiliation(s)
| | | | | | | | | | | | - Nancy M A Rund
- Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Ahmed S A Ashour
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maged Almohamady
- Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Jiang N, Hao B, Huang R, Rao F, Wu P, Li Z, Song C, Liu Z, Guo T. The Clinical Effects of Abdominal Binder on Abdominal Surgery: A Meta-analysis. Surg Innov 2020; 28:94-102. [PMID: 33236689 DOI: 10.1177/1553350620974825] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. We conducted a meta-analysis to quantitatively evaluate the effects of abdominal binder in abdominal surgeries. Methods. Through literature retrieval in globally recognized databases (MEDLINE, EMBASE, and Cochrane Central), trials investigating the application of abdominal binder in abdominal surgeries were systematically reviewed. The main outcomes, namely, 6-minute walk test (6MWT), visual analog scale (VAS) pain score, and symptom distress scale (SDS) score, were pooled to make an overall estimation. I2 index was calculated to identify heterogeneity, and sensitivity analysis was performed to validate the stability of main results and explore the source of heterogeneity. A funnel plot and Egger's test were applied to assess publication bias. Results. Ten randomized controlled trials consisting of 968 subjects were ultimately included for the pooled estimation. Abdominal binder significantly increased the distance of 6MWT with standard mean difference (SMD) of .555 (P < .001) and decreased the scores of VAS and SDS with SMD of -.979 (P < .001) and -.716 (P < .001), respectively. Despite of the significant heterogeneity indicated by I2 index statistic, the results of sensitivity analysis revealed the reliability of the main conclusions. While we identified no obvious publication bias regarding 6MWT (Egger's test P = .321), it seemed that significant publication biases existed with respect to the estimation of VAS (P < .001) and SDS (P = .006). Conclusion. The current meta-analysis verified that abdominal binder efficiently promoted recovery after abdominal surgeries in terms of facilitating mobilization, alleviating pain, and reducing postoperative distress. More rigorously designed clinical trials with large sample size are expected to further elaborate its clinical value.
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Affiliation(s)
- Nanhui Jiang
- Department of Intensive Care Unit, Wuhan University Zhongnan Hospital, China
| | - Bihai Hao
- School of Nursing, Huanggang Polytechnic College, China
| | - Rong Huang
- Department of Intensive Care Unit, Wuhan University Zhongnan Hospital, China
| | - Fengying Rao
- School of Nursing, Huanggang Polytechnic College, China
| | - Ping Wu
- Department of Pediatric Surgery, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, China
| | - Zhen Li
- Department of Hepatobiliary and Pancreatic Surgery, Wuhan University Zhongnan Hospital, China
| | - Chunxue Song
- School of Nursing, Huanggang Polytechnic College, China
| | - Zhisu Liu
- Department of Hepatobiliary and Pancreatic Surgery, Wuhan University Zhongnan Hospital, China
| | - Tao Guo
- School of Basic Medical Sciences, 372527Weifang Medical University, China
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Saeed S, Rage KA, Memon AS, Kazi S, Samo KA, Shahid S, Ali A. Use of Abdominal Binders after a Major Abdominal Surgery: A Randomized Controlled Trial. Cureus 2019; 11:e5832. [PMID: 31754567 PMCID: PMC6827701 DOI: 10.7759/cureus.5832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective To compare the effect of abdominal binder versus no binder after major abdominal surgery and cesarean section on various post-operative recovery parameters. Materials and methods This is a randomized controlled trial conducted at the Department of General Surgery and Obstetrics, Civil Hospital, Karachi, Pakistan. All those patients aged ≥18 years having abdominal surgery including elective and emergency abdominal surgery and cesarean sections with American Society of Anesthesiologists Class I-III were included in the study. Randomization was done using the sealed envelope method by the principal investigator. The intervention group wore an abdominal binder postoperatively while the control group did not use it. Mobilization and the pain status of both groups were evaluated on the first, fourth, and seventh days after surgery. Results Primary outcome variables were mobility, assessed via 6-minute walk test (6MWT) and postoperative pain, evaluated via visual analogue scale. There was no statistically significant difference in the 6MWT distance before (p = 0.278) and on postoperative day one of the surgery (p = 0.0762). However, the difference was significant on fourth (p < 0.001) and seventh day (p value < 0.001). With regards to the pain status, patients in the binder group reported significantly less postoperative pain on first, fourth, and seventh (p value < 0.001) day compared to the non-binder group. Conclusion The use of abdominal binder postoperatively significantly reduced pain and improved mobility in both obstetric and surgery patients.
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Affiliation(s)
| | | | | | - Sarah Kazi
- Obstetrics and Gynecology, Civil Hospital, Karachi, PAK
| | | | | | - Aun Ali
- Surgery, Fazaia Ruth Pfau Medical College (FRPMC), Karachi, PAK
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