Effect of Abdominal Binder on Clinical Outcomes after Cesarean Section: A Randomized Controlled Trial

Abstract

Abstract : Background and Objective: Cesarean section is one of the most common surgeries in the world which is along with some clinical outcomes, including bleeding, pain and infection. In spite of technological advances in care after surgery, methods of reducing side effects are still inadequate; hence the need for intervention and alternative therapies is felt. An abdominal binder is a complementary therapy that has been used several centuries ago, but there is limited evidence about the effect of abdominal binders. The aim of this study was to determine the effect of using an abdominal binder on clinical outcomes after cesarean section Methods: This randomized controlled trial study was conducted in 2015 on 178 primiparous and biparous who underwent non-emergency CS in the hospitals in Gonbad-e Kavus, Golestan (Iran). The eligible women using random block method were allocated into the intervention group; abdominal binder with routine care and control group (only routine care). The binder was used for two hours and for two days after CS, with 5% reducing abdominal circumference (The binder was open from 10pm to 8am). After fasting abdominal binder the abdomen circumference were measured every 4 hrs for 2 days by the researcher to observe 5% drop in size. Data were collected by demographic and obstetric questionnaires, pain visual analogue scale, hemoglobin and hematocrit, analgesics, perceived distress, patient satisfaction, adverse events checklists, and recovery scale “REEDA”. Data were analyzed using independent T-test, Man Whitney U, Friedman, Wilcoxon, Chi square, Chi square for trend, and Fisher's exact test. Results: There was no significant difference between control and intervention groups in terms of socio-demographic characteristics except ethnicity and wanted or unwanted pregnancy. The mean pain score (p= 0.242) and distress (p=0.739) in the two groups showed no significant difference before intervention. Pain intensity at 6, 12, 18, 24, 36, 42, 48 hours and five days after the intervention in intervention and control groups had a statistically significant difference (p=0.001). The mean of perceived distress scores 24hrs and 48hrs after CS were respectively in the intervention group (1.9)15.1, (1)14.2 and in the control group (2.6)18.2, and (2.9)16.8. The mean of volume of blood lost 36 hours after the intervention in intervention group was (201.8) 166.9 ml and in the control group was (630.5) 651.1 ml. 36 hours after the intervention, the volume of blood loss was significantly lower in the intervention group than the control group (P<0.001). CS scare recovery score did not show statistically significant differences between the two groups (p=0.724). The amount of received suppository after 6 hours and injection analgesics 6, 24 and 48 hours after the intervention showed no significant difference between the two groups, while there were significant differences in other time periods (P<0.001). The satisfaction of participants in the two groups showed no statistically significant difference (p=0.325). One of the participants in intervention group had serious bleeding and one person reported abdominal binder intolerance. Conclusions: Abdominal binders were effective in reducing post-CS pain, SDS, volume of blood loss, and medication consumption at some intervals. However, it had no healing effect on CS scars.