Use of abdominal binders in the prevention of hernias after liver transplantation: A randomised control study

Incisional hernia is frequent after liver transplantation (LT). A 3-band abdominal binder is often used after LT to prevent incisional hernias, although the efficacy of this is unclear. The aim of this paper is to evaluate whether not using abdominal binder is associated with an increased incidence of incisional hernias after LT. Methods: A single-center, randomised controlled trial was conducted. Intervention group was randomized to not using abdominal binder. Results: One-hundred-thirty-six patients were included, and 31% of them developed post-incisional hernias, without differences between groups (difference 0.06, 95% -0.24 to 0.09, p=0.373). The only factor independently linked to hernia development was age (HR 1.057, 95% CI 1.009-1.061, p=0.020). For hernias occurring more than six months post-LT, both age and increase of body mass index were associated with higher risk. Patient adherence to binder use decreased over time due to discomfort. Conclusion: Abdominal binders do not effectively prevent incisional hernias after LT and are often uncomfortable. Age and weight gain in the first six months post-transplant were significant risk factors for hernia development.