Abdominal binder device and procedure designed to prevent abdominal wound dehiscence post-operatively.

Introduction: The Integrated Binder Wrap System (IBWS, patent pending) was developed in a surgical practice based on observed patient needs.  All surgeries require mechanical closure of incisions by means of sutures, staples, glue, etc.  We identified that post-surgical patient manipulation was a major factor in the risk of wound dehiscence and other complications, particularly for trunk surgeries as; (tummy tucks, C-sections, and hernia repairs, etc.).  We developed a surgical strategy and device to minimize patient manipulation prior to physical securement of the wound site with the device. Methods:Current practice for abdominal binder placement is to roll the patient manually from side to side to clean the patient and to remove dirty surgical drapes.  Then the patient is lifted or sat up to slide a binder under the patient.  The IBWS is a device, and also an innovation in procedure, because it is pre-positioned before surgery.  The IBWS features tear-away surgical draping that can be removed from under the patient with minimal manipulation prior to securement of the IBWS.Results:The IBWS design evolved in a surgical setting based on practitioner observations, and has not yet gone into independent controlled studies.  Using IBWS prototypes and techniques we observe fewer issues of wound dehiscence with each applicable  procedure.   We estimate the incidence of dehiscence to be about  2% compared to 5-6% reported from comparable practices and methods, and further note that severity of observed wound issues is minimized.Discussion: Surgical wound closures are most vulnerable immediately after surgery, so the strategy of providing optimal secondary securement with minimal patient manipulation is an obvious advantage for the patient and caregiver.  We have designed the IBWS system to allow easy placement before surgery begins.  Evolutions of IBWS add features, i.e. a pubic attachment to stabilize post-surgical Jackson Pratt abdominal drains, and use of antimicrobial fabrics with moisture wicking capabilities.  Adjustments are provided to optimize compression to  allow venous outflow and arterial in-flow while keeping the wound stable.  During development of IBWS in our practice we have noted decreases in wound complications and better wound healing, which has increased our patients’ satisfaction with their surgical experience.References: