The effect of abdominal compression device on patients after external hernia repair surgery: A systematic review and meta-analysis

Abstract

Background:

To evaluate the effectiveness of abdominal compression devices after external hernia repair.

Methods:

A search was conducted for randomized controlled trials on the application of abdominal compression devices after abdominal hernia repair surgery in databases such as Cochrane Library, PubMed, EMbase, CNKI, VIP, and Wanfang Data Knowledge Service Platform. The retrieval deadline was from the establishment of the database to November 2024. Two researchers independently assessed the risk of bias of the included studies and extracted relevant data using pre designed tables. RevMan 5.4 software was used for statistical analysis.

Results:

Ten articles were included, with a total of 1081 patients undergoing abdominal hernia repair surgery. The systematic review and meta-analysis results showed no statistically significant difference in the incidence of wound infection (relative risk [RR] = 0.41, P > .05), wound bleeding (RR = 0.56, P > .05), perineal hematoma (RR = 0.93, P > .05), or wound infection (RR = 0.40, P > .05). In terms of pain, subgroup analysis was performed to determine the incidence of wound infection (RR = 0.41), wound bleeding (RR = 0.56, P > .05), perineal hematoma (RR = 0.93, P > .05), and recurrence (RR = 0.70, P > .05) between the compression group and non-compression group. In terms of pain, subgroup analysis showed that the postoperative use of abdominal bands to compress the surgical area could reduce pain (mean difference [MD] = −1.17, P < .01), while the use of sandbags was not recommended, while the use of sandbags to compress the surgical area increased pain (MD = 1.09, P < .01).

Conclusion:

After abdominal hernia repair surgery, the use of abdominal compression devices had no significant effect on reducing the incidence of serum swelling, wound infection, and recurrence compared to the method of removing compression. After abdominal hernia repair surgery, the use of abdominal compression devices had no significant effect on reducing the incidence of serum swelling, wound infection, and recurrence compared to the method of removing compression. Abdominal band compression has a significant effect on reducing pain, whereas sandbag compression can increase pain.

1. Introduction

An extra-abdominal hernia is a condition in which an abdominal organ protrudes through an abnormal hole in the abdominal wall or cavity.^[1] In China, the incidence of extra-abdominal hernia is approximately 0.3% to 0.5%, and the incidence is more than 5% in people over 60 years of age.^[2] In China, the incidence of extra-abdominal hernia is approximately 0.3% to 0.5%, and the incidence in people over 60 years of age is more than 5%. Extra-abdominal hernia includes inguinal, femoral, umbilical, incisional, and other types, among which inguinal hernia is the most common, and surgery is the only effective treatment for extra-abdominal hernia.^[3] The Complications of ventral hernia repair include seroma, perineal hematoma, wound infection, intestinal injury, intestinal obstruction, early or late recurrence, and pain. Seroma formation is seroma formation.^[4] Doctors in Western countries often prescribe a lap-band after surgery to relieve postoperative pain caused by coughing, deep breathing, and activity, and to reduce tissue edema as well as the rate of wound dehiscence,^[5–9] while Chinese doctors often use sandbags to apply pressure to the surgical incision to stop bleeding.^[10–13] However, there is no conclusive evidence to show that abdominal compression devices can reduce the postoperative complications of extra-abdominal hernia, and the use of abdominal compression devices such as sandbags and lap-bands after extra-abdominal hernia surgery is still controversial. Studies^[4] have shown that abdominal compression devices can reduce psychological distress in patients after abdominal surgery, but their effect on seroma and other complications after abdominal hernia repair remains unclear. Therefore, domestic and international randomized controlled studies of abdominal compression devices after abdominal hernia surgery were selected for meta-analysis to provide an evidence-based basis for clinical practice.

2. Methods

No artificial intelligence (AI) tools were used for screening. This study adhered to the PRISMA for network meta-analyses (PRISMA-NMA) guidelines^[14] and followed the standard methodology recommended by the Cochrane Collaboration. The study protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO)^[15] under the code CRD42024601145.

2.1. Literature inclusion and exclusion criteria

2.1.1. Type of study

Randomized controlled trial or concurrent clinical controlled trial with or without blinding.

2.1.2. Study population

Patients with a clear diagnosis of extra-abdominal hernia who underwent abdominal hernia repair.

2.1.3. Interventions

The test group underwent compression interventions with common types of compression (e.g., sandbags and abdominal bands) and a detailed compression protocol; the control group received routine postoperative care without compression.

2.1.4. Outcome

Indicators mainly include pain; seroma formation, seroma is a type of confined exudate fluid mainly between the patch and the anterior abdominal wall for various reasons, named because its main component is similar to plasma; perineal hematoma formation incision infection rate recurrence rate.

2.1.5. Exclusion criteria

Conference papers, retrospective studies, uncontrolled studies, unreliable data, and non-Chinese and English literature were excluded.

2.2. Search strategy

A computerized search of the Cochrane Library, PubMed, EMbase, China Knowledge, Wipo, Wanfang, and Sinomed databases for randomized controlled trials of abdominal compression devices after abdominal hernia repair was conducted using subject + free words (keywords), with the time frame of the library being built until November 2024. The English search strategy was “Compression Bandages/Sandbag compression/pressure dressing/binder/exemption from compression,” “Herniorrhaphy/ Hernioplasty/Ventral hernia repair/hernia repair,” and the Chinese search strategy was “Herniorrhaphy/Hernia.” “compression/ sandbag/ lap band.” The English database is PubMed, for example, and the search formula is: ((Herniorrhaphy[MeSH Terms]) OR (Hernioplasty[Title/Abstract]) OR (Ventral hernia repair[Title/Abstract])OR (hernia repair[Title/Abstract])) AND ((Compression Bandages[MeSH Terms]) OR (Sandbag compression[Title/Abstract])) OR (pressure dressing[Title/Abstract]) OR (binder[Title/Abstract]) OR (exemption from compression[Title/Abstract]), Chinese databases to Zhi.com, for example, the search formula is TKA% = (“Hernia” + “Ventral hernia”) AND TKA%=(“compression” + “sandbag” + “lap band”). References included in the literature were manually searched.

2.3. Literature screening and data extraction

Data for inclusion in the literature were independently extracted by 2 researchers using a pre-designed form, which mainly included general information about the study, patient characteristics, characteristics of the intervention and control groups (form of compression, duration, and frequency of compression), and outcome indicators.

2.4. Literature quality evaluation

Risk of bias was assessed independently by 2 investigators for the included randomized controlled trials, according to the Cochrane Handbook for Systematic Evaluation 5.0.1. The evaluation included 7 aspects: the generation of randomized sequences, allocation concealment, blinding of study subjects or interviewees, data completeness, selective reporting of results, and other biases. The results of the evaluation are expressed as “high risk of bias,” “low risk of bias,” or “unclear.”

2.5. Data processing

Meta-analysis was performed using RevMan 5.4 software. Clinical heterogeneity (differences in participants, interventions, and outcomes) and methodological heterogeneity (differences in study design and risk of bias) were also assessed. Statistical heterogeneity was the result of clinical heterogeneity, methodological heterogeneity, or both. If statistical heterogeneity existed, subgroup analyses were performed for the mode and duration of compression. If there were at least 2 studies in a subgroup, the subgroups were considered based on factors affecting the outcome indicators. Statistical heterogeneity between the trials in each analysis was measured using I². If P > .1 and I² < 50%, the analysis was performed using a fixed-effects model due to the homogeneity of the studies; if P < .1 and I² ≥ 50%, a random-effects model was used. If P < .1 and the source of heterogeneity was unknown, descriptive analysis was used instead of a meta-analysis. The test level for meta-analysis α = 0.05, with P < .05, considered a statistically significant difference. For the outcome indicators of continuous variables, the standardized mean difference was chosen as the effect size indicator when the measurement methods or units of the outcome indicators were identical, and the weighted mean difference was chosen as the effect size indicator when the measurement methods or units of the outcome indicators were too different. For outcome indicators of dichotomous variables, the relative risk (RR) was chosen as the effect size indicator, and the 95% confidence interval (CI) was calculated.

Publication bias was determined by visual inspection of the degree of asymmetry in funnel plots. Sensitivity analyses were used to explore the sources of heterogeneity and robustness of the results.

3. Results

3.1. Results of the literature search and basic characteristics of the included literature

The initial search yielded 933 studies. A total of 690 articles remained after the removal of duplicate literature. After an initial reading of the titles and abstracts, 655 articles were excluded because they did not meet the inclusion criteria. The remaining 35 studies were included in the analysis. 24 articles were excluded after reading the literature; therefore, 10 articles were included in this systematic review the meta-analysis. The literature screening process is illustrated in Figure 1. The basic characteristics of the included studies are presented in Table 1.

Figure 1.

Flow chart of study identification and selection.

Table 1.

Studies included in the systematic review and meta-analysis.

Inclusion of studies	Published (yr)	Sample size (cases, compression group/no compression group)	Sex (cases, m/f)	Age (yr, x ± s), (pressure group/no-pressure group)	Hernia type	Surgical procedures	Compression group compression method	Duration of compression	Nursing care in the no-pressure group	Outcome indicator
Paasch et al[8]	2021	12/16	21/7	61.7 ± 12.0/56.2 ± 15.2	Incisional hernia	Laparoscopy	Abdominal belt	14 d	No compression device	abcdg
Merei et al[6]	2006	52/44	Undescribed	Median 40.5 months/41.5 months	Umbilical hernia	Currently unknown	Pressure dressing	7 d	Routine care	abc
Christoffersen et al[5]	2014	29/31	47/13	Median 56/51	Umbilical hernia, epigastric hernia	Laparoscopy	Abdominal belt	7 d	Routine care	bcdg, etc
Muhammad Akram Dogar, etc[9]	2018	30/30	28/32	42.36 ± 8.52/45.11 ± 10.2	Umbilical hernia, epigastric hernia, incisional hernia	Currently unknown	Abdominal belt	6 wk	No compression device	acdg, etc
Ortiz et al[7]	2023	21/19	22/18	63.4 ± 13.7/62.4 ± 13.8	Incisional hernia	Laparoscopy	Abdominal belt	14 d	No compression device	b
Yuexia et al[11]	2010	120/40	160/0	Average 59	Inguinal hernia	Currently unknown	500 g of sandbags	24 h	No compression device	ade, etc
Xiuju et al[12]	2017	60/60	93/27	47.46 ± 19.53, 46.85 ± 15.30	Inguinal hernia	Laparoscopy	1.5 kg sandbags	24 h	The poke holes were regularly observed for bleeding, swelling in the groin area and scrotum, and patient comfort.	defh etc
Qing et al[13]	2020	43/42	76/9	(43.05 ± 3.09)/42.61 ± 3. 18	Inguinal hernia	Laparoscopy	1.5 kg sandbags	12 h	Perform routine care and dispense with sandbag compression postoperatively	bcdefh etc
Haikun et al[16]	2021	44/44	not have	(41. 23 ± 5. 94)/(39. 51 ± 6. 28)	Inguinal hernia	Currently unknown	1.5 kg sandbags	24 h	Routine care	cdefh, etc
Dai et al[17]	2022	110/225	335/0	62.5 ± 15.6/62.2 ± 14.5	Inguinal hernia	Laparoscopy	Hernia belt + lap belt	1 wk	Postoperatively, no compression of the inguinal region on the affected side in group A.	c

Note: a: wound infection rate; b: recurrence rate; c: incidence of seroma; d: pain; e: incidence of perineal hematoma; f: postoperative hospitalization days; g: mobility restriction; h: bleeding rate; i: incidence of urinary retention; j: FEV1; k: number of nausea and vomiting episodes; l: wound healing time; m: comfort; n: satisfaction; o: wound dehiscence; p: health status; q: fatigue; r: quality of life.

3.2. Basic characteristics and quality assessment of the included studies

The general information of the 10 included studies is shown in Table 1. Of the 10 studies, 3 were^[7,8,16] were grouped using the randomized numeric table method; 1 study^[6] used date of birth for grouping by randomization, and 6 studies^{[5,9,11–13,17]} mentioned randomization but did not specify the exact grouping method; 1 study^[5] used envelopes for allocation concealment, 9 studies^{[6–9,11–17]} were not clear about allocation concealment; 1 study^[5] used blinding, 1 study^[7] did not use blinding, 8 studies^{[6,8,9,11–15]} did not mention whether blinding was used; ten studies had comparable baseline data for the 2 groups, all had complete data and reported all pre-designed indicators without measurement bias; however, it was unclear whether any other cheapness existed; the results are shown in Figures 1 and 2 according to the Cochrane quality assessment criteria.

Figure 2.

Risk of bias assessment using the Cochrane tool: (A) overall trials; (B) individual trials.

3.3. Meta-analysis results

3.3.1. Wound infection

There were 4 studies^[5,6,9,11] that compared wound infections between the 2 groups of patients, which were analyzed without statistical heterogeneity (P = .55, I² = 0%), so a fixed-effects model was used. The results showed that there was no significant difference in the incidence of wound infection between the patients in the compression and no-compression groups (Fig. 3).

Figure 3.

Effect of abdominal compression devices on wound infection in postoperative patients with extra-abdominal hernia.

3.3.2. Wound bleeding

Three studies^[12,13,16] compared wound bleeding between the 2 groups of patients, which were analyzed without statistical heterogeneity (P = .75, I² = 0%); therefore, a fixed-effect model was used. The results showed no statistically significant difference in the incidence of wound bleeding between the 2 groups (Fig. 4).

Figure 4.

Effect of abdominal compression devices on wound bleeding in patients after extra-abdominal hernia surgery.

3.3.3. Perineal hematoma

There were 4 studies^[11–13,16] compared the occurrence of perineal hematoma between the 2 groups of patients, which were analyzed without statistical heterogeneity (P = .93, I² = 0%) so a fixed effect model was used. The results showed no statistically significant difference in the incidence of perineal hematoma between the 2 groups (Fig. 5).

Figure 5.

Effect of abdominal compression devices on perineal hematoma in patients after extra-abdominal hernia surgery.

3.3.4. Recurrence

There were 5 studies that^[5–8,13] the recurrence of abdominal hernia between the 2 groups of patients, which were analyzed without statistical heterogeneity (P = .70, I² = 0%); thus, a fixed effect model was used. The results showed no statistically significant difference in the incidence of disease recurrence between the 2 groups (Fig. 6).

Figure 6.

Effect of abdominal compression device on recurrence in patients after extra-abdominal hernia surgery.

3.3.5. Pain

Six studies compared the pain of patients in the 2 groups^{[5,8,9,12,13,16]} compared the pain of patients in the 2 groups. Statistical heterogeneity between the 6 studies was examined (P < .001, I² = 95%), so the source of heterogeneity was analyzed and it was found that 3 of the studies^[12,13,16] used sandbags as the compression method, and the other 3 studies^[5,8,9] used lap belts, so the methods of compression were divided into the “sandbag group” and the “lap belt group.” The 3 studies in the “sandbag group” were statistically heterogeneous (P < .001, I² = 91%), so a sensitivity analysis was applied to the 3 studies in the “sandbag group,” and it was found that the data of the test group in 1 study were different from the data of the test group in the other 3 studies, and the data of the test group in the other 3 studies were different from the data of the lap-band group.^[12] Therefore, sensitivity analysis was applied to the 3 studies of the “sandbag group,” and 1 study was found to have a large discrepancy between the data of the experimental group and those of other studies, which was not in line with clinical practice, and was not involved in the effect combination. There was no statistical heterogeneity between the 2 studies included in the “sandbag group” (P = .53, I² = 0%), which were analyzed using a fixed-effects model, and the results showed that the pain level of the experimental group was heavier than that of the no-sandbag compression group after the application of the sandbag compression (MD = 1.09, 95% CI = 0.95–1.23, P < .001). There was no statistical heterogeneity among the 3 studies included in the “lap-band group” (P = .94, I² = 0%), and a fixed-effects model was used for the analysis, which showed that compression with the application of a lap-band was less painful than compression without a lap-band (MD = −0.88, 95% CI = −1.17 to −0.60], P < .001) (Figs. 7 and 8.

Figure 7.

Effect of sandbag subgroup of abdominal compression device on pain in postoperative.

Figure 8.

Effect of abdominal compression device lap-band subgroup on pain in postoperative patients with extra-abdominal hernia.

3.3.6. Seromas

The occurrence of seroma was compared between the 2 groups of patients, and statistical heterogeneity was examined between the 7 studies^{[5,6,8,9,13,16,17]} (P = .53, I² = 57%), so the source of heterogeneity was analyzed, and it was found that 4 of the studies^[5,6,8,9] used lap-band compression as the compression method, and the other 2 studies^[13,16] used sandbags as the compression method, and 1 study^[15] used special hernia belt as the compression method. Therefore, the methods of compression were divided into the “sandbag group” and the “lap-band + hernia belt group.” There was no statistical heterogeneity between the 2 studies included in the “sandbag group” (P = .68, I² = 0%), which were analyzed using a fixed-effects model. The results showed that there was no statistically significant difference in the incidence of seromas between the 2 groups of patients after the application of sandbag compression. The 5 studies included in the “lap-band + hernia belt group” showed no statistical heterogeneity (P = .10, I² = 48%) and were analyzed using the fixed-effect model. The difference in the incidence of seroma between the 2 groups was not statistically significant after application of the lap-band (Figs. 9 and 10).

Figure 9.

Effect of sandbag subgroup of abdominal compression device on seroma in postoperative patients with extra-abdominal hernia.

Figure 10.

Effect of abdominal compression device lap-band + hernia belt subgroup on seroma in postoperative patients with extra-abdominal hernias.

4. Discussions

A previous meta-analysis^[4] showed that lap-banding reduces psychological distress in patients after abdominal surgery, with a nonsignificant trend towards reduction of seroma formation and pain reduction, but did not include extra-abdominal hernia repair as a procedure. The effect on seroma formation after extra-abdominal hernia repair is unclear, although there are various compression modalities, and he did not perform subgroup analysis based on compression modalities, and did not describe infection, bleeding, perineal hematoma, or recurrence.

Evaluation of the effect of abdominal compression devices applied after abdominal hernia repair Post-abdominal hernia repair compression devices mainly include sandbags, salt bags, ice bags, hernia belts, abdominal belts, etc, which use the pressure generated by the compression device with a view to reducing tissue edema and lowering the rate of wound dehiscence; the effect of the use of clinical abdominal hernia surgery after the use of compression devices is still unclear, and the use of sandbags, abdominal belts, and other compression devices remains controversial.^[8] The use of compression devices such as sandbags and belts is still controversial. In this study, the effect of Meta-analysis showed that the application of abdominal belt, hernia belt and sandbag compression device for compression in patients after abdominal hernia repair would not reduce the incision infection rate, the incidence of seroma, nor would it reduce the incision bleeding rate, the incidence of perineal hematoma, and the recurrence rate, and as for the pain, the use of the abdominal belt and the hernia belt could reduce the pain, and the use of the sandbag would increase the pain.

Mixed effects of abdominal compression devices on postoperative pain after extra-abdominal hernia included studies.^{[5,8,9,12,13,16]} For all measures of pain, the VAS (Visual Analogue Scale) was used to measure pain, which made it easier to incorporate pain as an outcome indicator. The use of physical methods to reduce pain is critical to reduce the amount of opioids used and reduce opioid addiction. The results of the meta-analysis in this study showed that lap and hernia belts help reduce postoperative pain after extra-abdominal hernia, and that sandbags increase postoperative pain. The reason may be that the mechanism of action of the lap-band and hernia belt is mainly to press the abdominal tension inward to reduce the incision tension; after abdominal surgery, when the patient coughs and turns over, the pain will increase due to the increased incision tension; the protection of the lap-band reduces pain.^[18] In contrast, the mechanism of action of the sandbag is to compress the abdomen downward. The tension generated when the patient coughs and turns over cannot be gathered, and the lapband is well fixed and not easy to shift, whereas the sandbag is easy to shift and fall off, and the patient needs to care about the position of the sandbag all the time, which reduces the comfort level.^[16] The comfort level was reduced. It is important to note that despite the superiority of the lap-band in reducing pain, clinical practice should be reminded to use the lap-band appropriately and in a timely manner according to the patient’s specific situation.

Abdominal compression devices do not reduce the incidence of seromas. A postoperative seroma after an extra-abdominal hernia is a sterile mass of localized fatty, serous, and lymphatic fluid that collects in a closed tissue space. Seroma formation is a common complication of extra-abdominal hernia repair and occurs in almost all patients diagnosed using ultrasound. The risk of symptomatic seroma formation after open extra-abdominal hernia repair may range from 1% to −33%, whereas the risk of symptomatic seroma formation in laparoscopic hernia repair ranges from 2% to −36%.^[19,20] The meta-analysis of this study showed that the effect of abdominal compression on seroma formation in patients undergoing abdominal compression after extra-abdominal hernia repair was not statistically significant when compared with the no compression group (P > .05). However, Jin et al^[21] envisioned that the abdominal band creates a pressure gradient that pushes fluid across the patch, thereby reducing the seroma formation. The reason for this may be that the residual gas and serum in the operative area can be drained through the residual hernia sac or loose tissue space. If the sandbag and lap-band are compressed to the neck of the hernia sac, it may lead to poor drainage, which may exacerbate the occurrence of seroma.

Abdominal compression devices do not reduce the incidence of incision infection, incision bleeding This study showed that abdominal compression devices do not reduce the incision infection rate, incision bleeding rate. Merie et al’s study^[22] showed that exposing a clean wound immediately after wound closure without any dressing did not lead to an increase in the rate of wound infection, which is consistent with the results of this study. The reason for this may be that excessive pressure on the skin from the lap-band or sandbag may lead to skin breakdown and skin infection, and the risk of infection may be increased if the lap-band or sandbag is contaminated and does not change over time.

Tissue laxity in the inguinal region, where intraoperative bleeding is often easily overlooked, is a major cause of postoperative incisional bleeding.^[23] This is the main cause of postoperative bleeding from the incision. The most commonly used method of postoperative hemostasis is compression hemostasis, the principle of compression hemostasis is to apply a certain amount of pressure on the surgical incision, narrowing or even closing the vascular bevels, platelets, erythrocytes, and fibrin due to the slowing down of the blood flow and rapid formation of thrombus, so that the incision stops bleeding. This study shows that abdominal compression devices do not reduce the incidence of postoperative incisional bleeding after extra-abdominal hernia. The reason for this may be that the incision is small and the location is deep, and the abdominal band and sandbags cannot form an effective compression, and therefore are ineffective in stopping bleeding in the postoperative period.

Abdominal compression devices do not reduce the incidence of postoperative perineal hematoma this study showed that abdominal compression devices did not reduce the incidence of postoperative perineal hematoma. The reason for this is that perineal hematoma is mainly due to the low position of scrotal laxity, where exudates tend to accumulate.^[23] The reason for this is that perineal hematoma is mainly due to the low level of scrotal laxity and the tendency for fluid to accumulate there. The main preventive measure is to hold the scrotum up after surgery to promote venous and lymphatic return. The use of lap-bands or sandbags can easily squeeze blood vessels, affecting venous blood return and aggravating the formation of perineal hematoma.

Abdominal compression devices do not reduce postoperative recurrence rates In the era of patchless surgery, the recurrence rate of primary extra-abdominal hernia surgery is 10% to 30%, and the recurrence rate of recurrent extra-abdominal hernia surgery is 35%; the Shouldice extra-abdominal hernia repair procedure is the only surgical procedure that has a very low recurrence rate, with a recurrence rate of only 2.2%.^[24] The study found a recurrence rate of only 2.2%. We found that sex, concomitant diabetes mellitus, concomitant hypertension, concomitant cardiac disease, duration of surgery, type of patch, degree of adhesion to the hernia ring, preoperative recurrent hernia, type of hernia, experience of the surgeon, emergency surgery, incarcerated hernia, and body mass index were the main factors affecting the recurrence of extra-abdominal hernia.^[25] In this study, we found that abdominal compression devices do not reduce the rate of postoperative recurrence, which may be attributed to the inability of the lap band or sandbag to reduce the risk of postoperative infection and postoperative bleeding, making it difficult for the incision to heal and subsequently prone to recurrence.

5. Limitations of this study

Subjects of the 10 papers included were all patients after abdominal hernia repair, but the specific types of hernia varied, and there was a lack of large-eyed, high-quality, multicenter randomized controlled trials; the number of randomized controlled trials at home and abroad that conducted postoperative abdominal hernia repair compression devices vs exemptions from compression devices was limited, and only the papers that used sandbags, lap belts, and hernia belts as the type of compression were included, and for the abdominal compression devices, the domestic There is also the use of salt bags^[26] For abdominal compression devices, there are domestic studies using salt bags, ice packs, and other compression devices.^[27] There are also studies using salt bags, ice bags, and other compression devices in China, but there is a lack of blank controls that could be included in this meta-analysis. The measurement of pain in the included studies varied, and there was measurement bias. Lap-band compression showed good pain relief; however, only 1 study described the adverse effects of lap-banding in terms of lung capacity, which did not allow for the effects to be combined. Therefore, further studies using more scientific methods, larger sample sizes, and multicenter designs are required.

6. Conclusions and outlook

The analysis found that the application of abdominal compression devices for compression after abdominal hernia repair, abdominal band, and hernia belt compression is better than no compression device in terms of pain reduction, and sandbag compression increases pain compared to no compression device. The gap band, hernia belt, and sand belt did not significantly reduce the incision infection, seroma formation, recurrence, or incision bleeding rates. The use of the lap band and hernia belt is a key measure to reduce pain, reduce the use of opioid analgesic drugs, and reduce the addiction to analgesic drugs; however, its effect on lung capacity and respiratory infections still needs to be further studied. Therefore, in the future, further systematic evaluation of the use of lap belts and hernia belts should be carried out to improve the content and basis of the clinical practice of abdominal compression devices

Author contributions

Conceptualization: Binru Xiong.

Data curation: Binru Xiong, Shi Liu.

Formal analysis: Binru Xiong, Shi Liu.

Funding acquisition: Binru Xiong.

Investigation: Binru Xiong.

Methodology: Binru Xiong, Shi Liu.

Project administration: Binru Xiong.

Resources: Binru Xiong.

Software: Binru Xiong.

Supervision: Binru Xiong, Shi Liu.

Validation: Binru Xiong.

Visualization: Binru Xiong.

Writing – original draft: Binru Xiong.

Writing – review & editing: Shi Liu.