Effect of abdominal binders on pulmonary mechanics with implications for the military surgical population

Abstract

Objective: After percutaneous endoscopic gastrostomy (PEG) tube placement, many surgeons will place an abdominal binder to protect the tube. Analysis of the literature shows mixed data as to the safety of abdominal binders with respect to pulmonary function. In this study, pulmonary function tests (PFTs) were used to assess changes in pulmonary status with and without an abdominal binder in volunteer active-duty personnel.

Design: Patient's forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow (FEF), peak expiratory flow (PEF) maximal inspiratory (P(i) max) and expiratory pressures (P(e) max), total lung capacity (TLC), vital capacity (VC), functional reserve capacity (FRC), expiratory reserve volume (ERV), and residual volume (RV) were measured with and without an elastic abdominal binder in prone, 30 degree and 60 degree positions in 5 male and 5 female active-duty personnel.

Setting: 81st Medical Group Clinical Research Laboratory at Keesler AFB, MS.

Participants: Five male and five female active-duty personnel of multiple ethnicities weighing between 125 and 240 lb.

Results: There were multiple statistically significant differences in the effect on lung function in the combined data between males and females, including maximum inspiratory pressure (Pi Max) at 60 degree head-of-bed elevation and RV and TLC in the supine position (p < 0.05). There was no statistically significant effect on expiratory pressures at any head-of-bed position.

Conclusions: In otherwise healthy active-duty members, abdominal binder placement has a small but statistically significant effect on some lung function but not on parameters that would impede airway protection. For the purpose of protecting wounds, specifically PEG tubes, we conclude that abdominal binders cause no significant safety risk.