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A patient undergoing laparotomy at Kamuzu Central Hospital. Radiographs in the background 
show the diagnosis--sigmoid volvulus.

Postoperative complications after abdominal surgery often relate to impaired pulmonary function. The current standard of care at Kamuzu Central Hospital does not involve any active incentive spirometry, which is thought to be useful in preventing atelectasis and pneumonia, and common practice in the United States.

We hypothesize that the addition of modified incentive spirometry to standard postoperative chest physiotherapy would be associated with faster return to baseline and predicted pulmonary function, and fewer postoperative pulmonary complications in patients following laparotomy. We are currently conducting a prospective randomized trial evaluating the use of an inexpensive disposable incentive spirometry system.