Medical compression therapy is a non-invasive approach used to manage venous and lymphatic diseases. This article explores the benefits and risks associated with stomach compression, achieved through devices like abdominal binders and compression garments. These tools are employed in various scenarios, from post-surgical recovery to managing specific medical conditions.
Introduction
Compression therapy utilizes medical compression (MC) devices like medical compression stockings (MCS), compression bandages (CB), adjustable compression wraps (ACW), and thromboprophylactic stockings (TPS) as basic management options for the non-invasive treatment of venous and lymphatic diseases. While offering numerous advantages, it's crucial to understand potential adverse events and contraindications associated with their use. These are based mostly on case reports and consensus documents, but some are based solely on theoretical concerns. This article aims to provide a comprehensive overview, drawing upon available literature and expert recommendations.
What are Abdominal Binders?
Abdominal binders are wide compression belts that wrap around the abdomen. They are a type of compression garment specifically designed to provide support to the abdomen. Their main purpose is to improve musculoskeletal function, aid respiratory function, especially after a spinal cord injury, and support systolic blood pressure. Abdominal binders come in many sizes and widths. Most are made from elastic and have Velcro or hook and loop closures. Some abdominal binders offer secondary lumbar support. Others have straps that hold surgical drainage tubes in place.
What are Compression Garments?
Compression garments are specialised clothing items designed to apply consistent and controlled pressure to specific parts of the body. Made from elastic fabrics, such as spandex or lycra, these garments are widely used in various medical and athletic settings. Compression garments are specific clothing items that apply consistent pressure to the surgical area. They play a vital role in the healing process by reducing swelling, increasing circulation, and providing the necessary support to the surgical site. Wearing these garments as part of the recovery regimen can significantly affect the results of the surgery.
Benefits of Stomach Compression
Post-Surgical Support and Healing
Compression garments are meticulously designed to facilitate recovery after an abdominoplasty by incorporating several features that address the needs of post-operative patients. These garments play a vital role in the healing process by reducing swelling, increasing circulation, and providing the necessary support to the surgical site. Wearing these garments as part of the recovery regimen can significantly affect the results of the surgery.
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Abdominal binders may be used to speed up the recovery process after abdominal surgery. After surgery, an abdominal binder is thought to support your surgical incision, relieve pain, get you moving more, and reduce swelling. A carefully-positioned abdominal binder may be used in people with spinal cord injury to help support the abdomen, maintain abdominal pressure, and improve respiratory function. Using an abdominal binder after a hysterectomy may help hold your abdominal muscles together to relieve pain, increase circulation at your surgical site to promote healing and decrease swelling, make physical activity more comfortable, and strengthen abdominal muscles.
- Reduced Swelling: The primary function of these garments is to apply controlled, consistent pressure to the surgical area. This pressure helps in reducing post-operative swelling by preventing the accumulation of fluids in the tissues, a common issue following surgery.
- Increased Blood Circulation: Increased blood circulation is essential for the healing process. Compression garments help promote better blood flow to the surgical site, making sure oxygen and essential nutrients are efficiently delivered to the tissues. Improving blood flow to a surgical site can speed the healing process and enhance tissue regeneration.
- Muscle and Skin Support: After a tummy tuck - abdominoplasty, the abdominal muscles and skin need adequate support to heal properly. Compression garments provide the necessary support to the abdominal area, helping to keep the muscles and skin in place as they heal.
- Scar Management: Compression garments play a significant role in managing scars by applying pressure to the incision sites. This pressure helps in keeping the scars flat and less noticeable over time.
- Increased Comfort: Wearing a compression garment can increase a patient’s comfort levels during the recovery phase. The garments are designed to be breathable and flexible, allowing for a degree of mobility while still providing necessary support.
Musculoskeletal Benefits
Musculoskeletal Benefits encompass improvements in bone strength, muscle mass, joint flexibility, and overall physical function, leading to increased mobility, reduced pain, and a decreased risk of injuries and age-related conditions like osteoporosis and arthritis.
Respiratory Support
Abdominal binders can provide respiratory support, especially after a spinal cord injury. A carefully-positioned abdominal binder may be used in people with spinal cord injury to help support the abdomen, maintain abdominal pressure, and improve respiratory function. They also may promote deep breathing.
Blood Pressure Regulation
According to a 2010 study, an abdominal binder should be the first line of defense for people who experience a severe drop in blood pressure upon standing. This is a symptom known as orthostatic intolerance (OI). Research showed that applying compression to the abdomens of people with OI helped prevent blood pooling. Wearing an abdominal binder also increased standing systolic blood pressure by 11 mmHG and diastolic blood pressure by 6 mmHG.
Postpartum Recovery
Postpartum belly wraps are usually used after you have your baby by C-section. Studies show that wraps or binders might help with pain and healing after a C-section (cesarean section). They might also help support your organs and muscles as they move back into place after having a baby. There are benefits to using an after-birth belly wrap. These include: helps relieve pain, helps you get moving, helps increase blood flow, helps muscles and incisions heal, lowers swelling from surgery, helps with posture, supporting your pelvic floor.
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The gentle compression on the abs may help the uterus return to its normal size quicker, so new moms may get rid of their still-pregnant-looking-belly quicker, Moore says. Another belly wrap bonus: “You may feel more comfortable and may feel like moving more, and the more you move and exercise, the quicker you get your figure back,” Moore says. He says women can put it on after delivery ends and wear it for 4 to 6 weeks after delivery to reap the maximum benefits.
- Supporting the Pelvic Floor: Your organs move and change during pregnancy to make room for a growing baby. During pregnancy, hormones also make your pelvic floor muscles relax. This can cause you to leak urine after having a baby. Using a postpartum belly wrap can offer some compression to gently hold your muscles in place as your body heals.
- Addressing Diastasis Recti: During pregnancy, the two large muscles that run down either side of your stomach area split apart as your uterus expands and pushes against them. This is called diastasis recti. Usually, your separated stomach muscles will go back into place on their own by 8 weeks after giving birth. Using a wrap can compress and support your muscles as they move back into place.
Risks and Contraindications
Medical compression therapy-associated adverse events and contraindications have been reported, although some contraindications are theoretically based.
General Risks
Compression around a surgical site may cause some discomfort. You may also find breathing to be uncomfortable. These garments may cause skin irritation. Wearing an abdominal binder is generally well-tolerated. Some people find it uncomfortable and hot. Although it’s meant to ease pain, compression around a surgical site may actually increase pain. It may also make breathing uncomfortable, although there’s no evidence that using an abdominal binder causes or worsens breathing problems. Compression garments may cause an allergic reaction, itching, rash, and other skin irritations. To reduce your risk, use an abdominal binder that fits properly and is made of hypoallergenic fabric.
Skin Irritation and Allergic Reactions
Low-severity skin problems, including itching, feeling cold or warm and dry skin, are frequently associated with compression therapy. Skin irritation may be mistaken for allergic reactions, but usually they are self-limiting, can be controlled without interruption of the compression treatment and may be prevented through adequate skin care. True allergic skin reactions to compression materials are rare, as allergenic components are usually avoided in actual MC products, but have been noted following the use of rubber-based products.
Discomfort and Compliance
The feeling that a compression device, MCS, TPS or CB, is ‘too tight’ is often reported by the patient on first application and may influence compliance. It may take several days before patients get used to wearing compression. Compression discomfort is experienced usually around the ankle or foot.
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Potential for Infection
In many conditions treated with compression devices, such as venous ulcers and lymphoedema, concomitant bacterial and fungal colonisation or infection may be present. Current evidence is lacking for the occurrence of infectious complications of previously uninfected skin after MCS use. There is no evidence that compression principally increases the risk of infection.
Tissue Damage and Necrosis
A reduced ankle-brachial pressure index (ABPI) is contributory to the risk of tissue damage by compression although it does not measure skin perfusion directly. Failure to maintain appropriate position on the leg with TPS, MCS or CB, which may lead to strangulation or inappropriate high local pressure values or continuous high pressure values, has been reported in association with tissue damage, and may also lead to arterial compression and necrosis.
Nerve Damage
In most cases, poorly fitted MCS or TPS and inadequate compression techniques with strangulation resulted in persistent, high focal pressure to a superficial nerve. Insufficient protection of a superficial nerve by padding below the compression in regions at risk was also reported.
Peripheral Artery Occlusive Disease (PAOD)
PAOD with low ankle pressure and low ABPI may interfere with compression treatment and increase the risk of soft tissue damage and necrosis due to insufficient arterial nutrition underneath the compression area. In severe PAOD, sustained compression is contraindicated if the systolic ankle pressure is <60 mmHg or the toe pressure is <30 mmHg. This is a clear contraindication against compression therapy with MCS.
Superficial Venous Thrombosis (SVT)
MCS and TPS may cause superficial venous thrombosis (SVT) in patients with varicose veins, primarily in regions where they could exert a tourniquet effect. Because of a tourniquet effect, improper compression can cause local SVT, especially in combination with prolonged sitting (long-haul flights).
Cardiac Insufficiency
The results of studies on the redistribution of regional blood volumes by applying compression to the legs of patients in supine position with the help of inflatable rubber boots indicated a reduction in blood volume in the legs and an increased blood volume in the organs of the thorax, abdomen and the liver. We recommend against applying compression in severe cases of cardiac insufficiency (NYHA IV). We also suggest against routine application of MCS in NYHA III cases.
Deep Vein Thrombosis (DVT)
There’s some debate about whether or not abdominal binders increase the risk of deep vein thrombosis (DVT). DVT occurs when a blood clot develops in at least one of the deep veins in your body. One 2007 study showed that abdominal binders increase intra-abdominal pressure. This may be associated with the development of DVT. Because abdominal surgery alone increases DVT risk, this leads some to question if using an abdominal binder after abdominal surgery is a good idea.
Recommendations for Safe Use
- Screening and Assessment: We recommend that every patient receiving compression therapy should be screened for conditions that increase the risk of complications, and every compression device should be checked for appropriate fit and application. Checking the arterial circulation status before any kind of compression therapy is initiated is critical.
- Infection Management: In patients with bacterial or fungal infection beneath the compression device, we recommend considering treatment with topical antiseptics or topical anti-microbiological medication. In patients with systemic symptoms (fever, chills), erysipelas or cellulitis, we recommend that systemic treatment should be given.
- Avoiding Excessive Pressure: We suggest preventing high or continuous local pressure in regions with a risk of nerve compression as well as correct sizing and application of compression. Patients at higher risk for nerve damage (e.g.
- Proper Fit and Application: When choosing an abdominal binder, it’s important to get the right size. To determine your size, measure the widest part of your body the binder will cover. For women, the widest part is usually the hips. For men, it’s usually the waist. Wrap the abdominal binder around your abdomen, under your clothes, with the closures in the front. Make sure the binder is snug, but not too tight. You should be able to breathe comfortably.
- Gradual Weaning Process: Dr. Watts advises a gradual weaning process when it comes to discontinuing the use of compression garments. Instead of stopping abruptly, he recommends gradually reducing the time spent wearing the garment over several weeks.
- Hygiene: Proper maintenance of your compression garment is essential for hygiene and effectiveness. Avoid using bleach or fabric softeners, as these can damage the elastic fibres. Keep the abdominal binder clean and dry. If it gets wet or dirty, it may irritate your skin or increase your risk of infection. Most abdominal binders may be spot-cleaned and air dried. Follow the manufacturer’s cleaning instructions.
Abdominal Binders vs. Traditional Compression Garments
While both abdominal binders and traditional compression garments serve to compress, their specific benefits and areas of focus vary. Abdominal binders specifically target the abdominal area, aiding in recovery and support.
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