Abdominal binders after ventral hernia repair: Do we need to measure its influence on intraabdominal pressure?

Kryspin Mitura, PhD1, Slawomir Koziel, PhD2. 1Siedlce Municipal Hospital, 2Beskid Oncology Center

Ventral hernia repairs creates an increase in intra-abdominal pressure. In order to prevent hernia recurrence synthetic mesh is used. The optimal solution is the closure of fascial defect with or without component separation technique. However, after surgery there is concern that high intra-abdominal pressure, both at rest and during intense physical activity can cause stress on the suture line and at the fixing points of the mesh. This, in turn, can lead to mesh dislocation with respect to the abdominal wall and cause a relapse.

In order to induce intraabdominal pressure and therefore reduce stress forces on the suture line, patients receive a recommendation to use abdominal binder for a few weeks or months after the surgery. But there is no standard that describes the type of support belt, which should be used. Patients have a choice of elastic binders, stretch, rigid and short-stretch. But still we do not know the impact of these belts on the intraabdominal pressure.

In this paper we present the results of the analysis of intra-abdominal pressure in 40 patients with the use of various products available on the market. We measured essential parameters during and after the surgery under general anaesthesia, then at rest and during various forms of physical activity. We registered intrapulmonary pressure, inter-surface pressures between the binder and the abdominal wall and in the abdominal cavity.

The analysis results show that some of the products does not increase intra-abdominal pressure and thus have no impact on tension in suture line. Recommended type of supporting device should be standardized, based on the physical parameters.

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