US 2223006 A
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Description (OCR text may contain errors)
Nov. 26, 1940.
S. V. LAUB HERNIA APPLIANCE OR THE LIKE Filed Nov. 20, 1939 2 Sheets-Sheet l INVENTOR ATTORNEY Nov. 26, 1940. s. v. LAUB HERNIA APPLIANCE OR THE LIKE Filed Nov. 20, 1939 2 Sheets-Sheet 2 INVENTO R k 14a b: Sianle y l' 2 9&2
A TTORNE Ki Patented Nov. 26, 1940 HERNIA APPLIANCE on THE LIKE. 7
Stanley V. Laub, Detroit, Mich. I I Application November 20, 1939,:SerialNo.305,284 3 Claims. (01. 1289335) r The invention relates generally to medical or surgical appliances and it has particular relation to appliances for treating umbilical hernias that occur in infants and for closing incisions. v
The occurrence of umbilical hernias in infants is frequent, and careful treatment is required over alsubstantial period of time. In the treatment of hernias of this character, it is necessary to bring the separated parts together and hold them together until strong adhesion of the parts takes place. In so far as known prior to the present invention, no convenient appliance has been available particularly adapted for this treatment, and generally the practitioner has employed ordinary adhesive tape applied across the hernia.
A particular disadvantage of this practice is that it is impossible to observe the conditionof the hernia after the tape is applied, andu itis 20 very difficult to apply adhesive tape across the hernia so as to be certain after the tape covers. the hernia that the parts are inthe most desirable relation. Moreover, after the tape is across the hernia, it must be allowed to remain 25 in position for a substantial period of time if knitting and permanent adhesion is to occur, and during this time the practitioner usually must rely on the parts being held in proper -relation. While hernias have been corrected and treated in this general manner for an indefinitev time, it will be realized that this past practice has not been without disadvantages from the practitioners point of View. v
In connection with another form of the invention, it may be mentioned that the ordinary practice in closing incisions in the outer skin has usually comprised the use of stitches and in many instances patients prefer to avoid hav-. ing the stitch scars that invariabl result. While it has been advancedprior tothisinvention to avoid stitch scars, one form of the present invention provides a practical appliance forthis purpose. I
45 One object of this present invention is to provide an appliance .for treating and correcting umbilical hernias which will enable the prac titioner to observe how the hernia is closed, and to observe the condition of the hernia at any time without danger of the parts again separat- Another object of the invention is to provide an appliance for treating umbilical hernias which may be quickly applied by the practitioner in 55 order to save considerable time particularly on the part ofpractitioners specializing in the treatmento'f infants and children. V
' Another object of the invention is to provide an appliance for treating 'umbilical hernia, such as mentioned, 'whichis of such character that j the parts'are more positively held in proper relation so that the practitioner may have greater reliance on the condition of the herniabeing maintained throughout the period of time usually required. I A g,
Another object f the invention is to provide an appliance for treating umbilical hernias which 'may be manufactured so inexpensively that use of the appliance is possible in any case.
Another object of the invention is to provide an improved medical appliance forclosing outer skin incisions for the purpose of avoiding'stit'c'h' scars.
Another object of the invention is'to provide a medical appliance of the last mentioned char- 1' acter which'will enable the practitioner to observe the condition or; the incision at any time and" which will prevent undesirable bulging of the edges of the skin that are brought together.
Other objects of the invention will become ap parent from the renewing specificatiomffrom the 'drawings, and 'fromi'the claims hereinafter setforth.
For a better understanding o f the invention;
reference may be had to the drawingsiwherein:
Figure'l a 'planview illustrating an appliance' constructed according to the invention for treating umbilical hernia; I v
Fig. 2 is across-sectional view taken substantially along the 1ine-22 of Fig. 1; Fig. 3 illustrates an appliance in certain respects adapted "for closing an incision;
Fig. 4 is a cross-sectional view taken Substan tially along the line 4-4 of Fig. 3;'
Fig. '5 is a view on'the order of 3, illustr'atin another form of the invention particularly' adapted for-closing incisions; I Fig. 6 is'a' cross-sectional view taken substantiallyalong the line -45 of Fig. 5
Fig. 7 is a cross-sectional viewtaken substantially along the line l of Fig. 6;
Fig. 8 is a cross-sectional view taken substantially along the line 8-8 of Fig. 6;
Fig. 9; is a detail view illustrating the adhesive covered plate employed in thestructure shown .5
byFigs.5and 6; I
Fig. 10 is a detail view illustrating a transparent channel-shaped strip adapted to cover the incision;
Fig. 11 is a view on the order of Fig. 5, illustrating the employment of two of the appliances in joined relation;
Fig. 12 is a cross-sectional view taken substantially along the line I2I2 of Fig. 11.
Referring to Figs. 1 and 2, the appliance illustrated comprises plates I and II, each of which preferably is sufiiciently flexible that it will conform to body curvature in the region of the umbilical hernia to which the appliance is applicable. A cellulose derivative such as Celluloid of sufiicient thickness so that it wont be too flexible may be used and the material may be colored or it may be transparent, as desired. Each plate has slots I2 and I3 adjacent its ends respectively, and a strip of adhesive I4 is applied to the underside of each plate with the adhesive surface exposed downwardly. The ends of the adhesive tape project, upwardly through the slots I2 and I3, as indicated at I5 and I6, and by pressing such ends against the upper side of the plate adjacent the slots, it will be seen that the adhesive will adhere to the upper side of the plate and thus the strip will be maintained positively in position. Crinoline I! on the adhesive side 'of the tape is pulled away at the ends, as indicated at I8, and I9, so that the practitioner may quickly remove the crinoline by gripping either of the ends. When the crinoline is removed, the adhesive is exposed and the plate may be applied to the skin surface. The two plates thus provided with adhesive are adapted to be placed respectively at opposite sides of the hernia indicated at 20 inFig. 1 and may be pressed against the skin so as to positively adhere thereto.
With the two plates applied to the skin in this manner, the plates are drawn towards each other so as to properly close the hernia and then the plates are adjustably locked together by means of a connecting strip 25 having openings 26 for engaging over projections 21 on the upper side of the plates. These projections have reduced neck portions so that the strip normally will be locked against removal since opposing pulls on the plate will hold the edges of the openings in engagement with the neck portions. Thus, with the plates drawn properly to close the hernia, the strip 25 may be applied so as to hold the plates in position.
Each plate additionally has a slot 30 at its end opposite the hernia, and one; of these slots is secured to one end of a strip of flannel 3| by stitching 32, while the other end of the strip is adapted to be passed through the other slot 30 and to be adjustably connected to the plate I I by any suitable means such as by passing a safety pin 33 through the flannel-above the plate.
It will be apparent from this description that with the plates Ill and II applied -to the skin at opposite sides of the hernia the pulling of the plates toward each other will close the hernia in proper manner and the practitioner may observe this procedure since the space between the ends of the plates'is open. When the hernia is properly closed thestrip 25 may be applied so as to lock the plates in position and. it may be mentioned in this connection that the strip 25 preferably is constructed of transparent material such as heavy'Celluloid so that it will not interfere with viewingthe hernia. With the hernia properly closed, the flannel strip 3| is trained about the back of the infant and passed through the slot 30 in plate I I and then is tightened so as to press both plates against the skin. With the strip in position it is apparent, of course, that the plates will not be pulled any further apart by tightening the flannel strip 3I and that the result of tightening will be that the plates will not only be pressed against the skin, but also that they will be so locked together that accidental separation is practically impossible.
An appliance of this character can be constructed most inexpensively as will be apparent and it may be applied very simply and without requiring much time on the part of the practitioner. It may be further stated that the appliance minimizes employment of tape and, accordingly, the condition of the infant is more comfortable and there is less disturbance in its removal or application.
Again, the adjustability of the appliance enables bringing the adhesive carrying plates closer together from time to time in the event any slippage of the adhesive on the skin occurs. Thus, the practitioner not only may always observe the hernia and keep it clean but he may by adjusting the parts if necessary, always maintain the hernia in proper drawn together condition. It will be understood that the adjustable bar or strip 25 may be so constructed and arranged relative to the plates I0 and I I that desirably small degrees of adjustment may be eifected.
The structure shown by Figs. 3 and 4 is adapted particularly for closing incisions, such as indicated at 40. In this case, plates 4| and 42 are employed which are like the plates I0 and II with the exception that the slots 30 are eliminated and excepting also for the provision of suture openings and a different adjusting means. In this case, strips 44 and 45, which may be constructed of spring-like metal or the like, are suitably fastened to the plate 40 as indicated at 46 and opposite. ends of the strips have downwardly turned ends 41 adapted selectively to fit notches 48 in the plate 4|. The strips are so arranged that the incision 40 may be observed between them and if desired, such strips may be constructed of transparent material to provide visibility through them.
When the two plates are applied at opposite sides of the incision 40 and are pulled together to close the incision, undesirable outward bulging of the edges of the skin at the incision should be prevented, and to accomplish this result, a channel-shaped strip 50 is placed over the incision. The channel portion is directly over the incision and when the plates are moved toward each other, even though the edges of the skin tend to become bulged outwardly in their pressure against each other, the strip 50 will limit this and hold the edges in desired relation. This strip 50 may be secured to the skin at each end by means of small pieces of tape 5| and openings 52 may be provided in the strip to allow ventilation. It will be understood in this case also that the appliance will be generally covered by bandage material to prevent infection and to prevent dirt from getting to the incision.
Openings 55 may be provided in both plates to allow for reinforcing sutures that may be passed through the skin, skin tissues and muscles at some distance from the incision. It will be understood in this connection that ordinarily the inner tissues and muscles inwardly of the outer layer of skin are separately stitched before the incision in the outer skin is closed, and the appliance shown is merely to close the incision in the outer layer of skin so as to avoid stitch scars. The suture openings 55 allow inserting one or more reinforcing sutures through all layers and it will be understood that each suture will go through an opening in one plate, then under the incision, then through an opening in the other plate, and then outwardly of the plates.
The construction shown by Figures and 6 is for the same purpose as that shown by Figures 3 and 4 excepting that it is preferably made of metal and allows for application of the article to varying lengths of incisions. In this case, plates 60 and 61 provided with adhesive strips on the order of those described previously are employed, and these strips, respectively, are adapted to be inserted in guideways 63 and 64 of a pair of metal elements 65 and 66. Each of the elements 65 and 66 has one edge folded to provide the guideway 64, then extends laterally, as indicated at 61, then folded downwardly to provide a channel 68 substantially in alignment with the guideway 64!, then extends laterally, as indicated at ID, generally in the plane of the portion 61, then is folded downwardly to provide a second channel ll like the channel 68, then extends similarly to the portion 61, as indicated at 12, and then merges with the guideway 63. The channels 68 and H act as supports for the strips Bil and 6|, so that when the elements are pressed against the skin, the guideways 63 and 54 and the channels 68 and H, firmly will press the adhesive against the skin.
As shown in Figure 5, a strip 15 is riveted as indicated at 16 to the element 65 and this strip has a downwardly projecting end 11 adapted selectively to fit in notches 18 in the element 66. A similar member 80 is fastened to the member 66 and is adapted selectively to fit in notches 18 in the strip 65. Both strips may be sprung into and out of engagement with the notches.
In connection with Figures '7 and 8, it will be noted that tabs 86 and 85 are provided, respec- 40 tively; on the end of the guideways 63 and 64 and on the end of the channels 68 and H. The bent over tabs 86 serve as a stop when the plates 60 and BI are inserted. The purpose of the tabs 85 at the ends of the channels 68 and H will be 45 mentioned presently.
In the event a longer incision is present and it is desired to apply a longer appliance, two of the appliances shown by Fig. 5 may be placed in adjustable end to end ,relation with the tabs 85 on one appliance at the top and the tabs 85 on the other appliance at the bottom. Preferably, the tabs 86 will be omitted from the lower elements as seen in Fig. 5, so that with the elements in end to end relation, adhesive carrying plates 60 and 6| of desired length may be inserted at the lower end of the guideways 63 and 64 in the lower elements and then moved along such guideways in both upper and lower elements. Such plates 60 and 6| may be cut to variable lengths and the size of the appliance may be varied by moving the lower and upper elements respectively farther apart. Metal strips 90 and SI that are adapted to slidably fit in the channels 68 and H serve to properly and adjustably hold the elements in joined relation and such strips are prevented from sliding out of the channels by the tabs 85. After the appliance is on the skin, bandage material is applied in covering relation thereto, as indicated heretofore.
It may be mentioned that the adhesive may be supplied in different widths and cut to length as desired and that adhesive carrying plates of diiferent widths may also be provided so that the practitioner may apply the tape as needed without requiring new plates for each application. Also, it maybe stated that the incision covering strip 58 may be supplied in long lengths and then out to provide the lengths desired. From this it follows that the practitioner is equipped to use the appliance on incisions of varying lengths.
In particular, the invention provides an improved means for treating and correcting umbilical hernias, which enables the practitioner to properly close the hernia in less time and with less effort, while allowing observation of I the hernia during and after the procedure. Such observation may be made at any time without disturbing the condition of the hernia and thus the practitioner may observe it from time to time very easily. The appliance is of such character that it is very inexpensive and it follows that itmay be employed in any case without involving what is in certain cases a prohibitive cost. The ease of application and observation, and the adaptability of the appliance to observation of the hernia are of considerable importance to practicing physicians and especially those specializing in the treatment of infants and children.
The invention also provides an improved means for closing incisions so that stitches normally employed may be eliminated, from which it follows that stitch scars may be avoided. In this case also, the appliance allows observation during and after its application and moreover, a minimum of. time and effort is required in its application.
Although more than one form of the invention is illustrated and described in detail, it will be apparent to those skilled in the art that various modifications may be made without departing from the scope of the appended claims.
What is claimed is:
l. A medical appliance, comprising a pair of plates each having slots at opposite ends and a strip of adhesive tape on one side of each plate with the adhesive side outermost and with the ends of the tape extending through the slots respectively and adhered to the other side of the plate, and means linking the plates-together.
2. A medical appliance comprising a plate having slots at opposite ends respectively, an adhesive tape on one side of the plate with the adhesive side outermost and with the ends of the tape extending through the slots respectively and adhered to the other side of the plate, and means adapting said plate for operative connection to an associated part of said appliance.
3. A medical appliance comprising a pair of plates having adhesive surfaces, a pair of elements each having guideways for receiving the opposed edges of one of the plates, and means adjustably connecting the elements sothat the plates may be adhered to the skin and then pulled towards each other and fastened in adjusted positions by moving the elements and then locking them in adjusted positions.
STANLEY V. LAUB.