The efficacy of abdominal binder in women undergoing cesarean delivery: A meta-analysis of randomized controlled trials

Background: Abdominal binders are a prominent non-pharmacological intervention aimed at mitigating adverse outcomes following Cesarean delivery (CD), including pain and distress.

Aim: We conducted a meta-analysis to quantitatively evaluate the effects of abdominal binders on women undergoing CD.

Methods: A systematic search was conducted using terms such as "abdominal binder," "clinical trials," and variations of "cesarean" across multiple electronic databases, including PubMed, Google Scholar, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Chinese National Knowledge Infrastructure (CNKI), and Wan-Fang database, up to November 2024. Study quality was assessed using the Cochrane Risk of Bias Tool 2.0. Statistical analysis was performed using Review Manager 5.4 and Comprehensive Meta-Analysis 4.0. Randomized controlled trials (RCTs) evaluating the use of abdominal binders compared to no binder usage following CD were included. The outcomes analyzed were postoperative pain, symptom distress, ambulatory function, and the occurrence of adverse effects.

Results: Thirteen RCTs were included. Abdominal binders demonstrated a strong safety profile with no significant differences in postoperative complications between groups. Significant pain reductions were observed at 6, 12, 24, and 48 h postoperatively (weighted mean differences [WMD]: -1.13, 95 % confidence interval [CI]: -2.15 to -0.10, p = 0.03; WMD: -1.48, 95 % CI: -2.90 to -0.06, p = 0.04;WMD: -0.95, 95 % CI: -1.49 to -0.41, p = 0.0005; and WMD: -0.70, 95 % CI: -1.17 to -0.22, p = 0.004, respectively). Pain interference with breastfeeding was significantly lower in the binder group (WMD: -1.30, 95 % CI: -2.24 to -0.36, p = 0.006). Symptom Distress Scale scores were significantly reduced at 24 and 48 h (WMD: -1.22, 95 % CI: -2.05 to -0.39, p = 0.004; WMD: -1.63, 95 % CI: -2.67 to -0.60, p = 0.002). Improved ambulatory function was also observed at 8, 12, and 24 h (WMD: 20.57, 95 % CI: 16.91 to 24.23, p < 0.00001; WMD: 11.97, 95 % CI: 7.67 to 16.27, p < 0.00001; WMD: 10.14, 95 % CI: 1.89 to 18.40, p = 0.02, respectively).

Conclusions: This study uniquely demonstrates the temporal effects of abdominal binder use, with significant pain reductions noted at 6, 12, 24, and 48 h post-CD. These results provide actionable guidance for the timing of abdominal binder application, emphasizing their importance as an early intervention to optimize postoperative recovery. As a secure, cost-effective, and non-pharmacological solution, abdominal binders are strongly recommended as part of routine postpartum care for women following CD.