US 2371978 A
Description (OCR text may contain errors)
March 20, 1945. R. G. PERHAM 2,371,978
: CLAMP FOR RETAINING THE EDGES OF A WOUND IN APPOSITION Filed Dec. 13, 1941 3 Sheets-Sheet 1 &\\\\\\\\\\\\\ INVENTOR. R0 Y PEKHA m ifl/ug PM ATTORNEYS R. s. PERHAM 2,371,978
CLAMP FOR RETAINING THE EDGES OF A WOUND IN APPOSITION M ch 20, 1945.
Filed Dec. 13, 1941. 3 Sheets-Sheet 2 INVENTOR. Y Pay 6. PERHAM ATTOR/YEYS R. G. PERHAM March 20, 1945.
CLAMP FOR RETAINING THE EDGES OF A WOUND IN APPOSITION Filed Dec. 13, 1941 3 SheetsSheet 3 I N V EN TOR. F0 y 6, Ff/PHHM Patented Mar. 20, 1945 CLAMP FOR RETAINING THE EDGES WOUND IN APPOSII ION Roy G. Pei-ham,- Hasbrouck Heights, N. J. Application December 13, 1941,;Serial No. 422.885 7 2 Claims. (01. 1284-335) This invention i for a means for drawing and retaining the opposite edges of the layers of the skin and subcutaneous tissue of a wound crincision in apposition 01' in impinging relation so as to effect a more rapid healing thereof and to relieve the lower muscle from strain or stress.
The general practice of employing sutures or skin piercing clamps for drawing the opposite sides of a wound or incision together ha been found objectionable. since the same draw the edges of the wound or incision together at spaced intervals onlyand permits the wound orincision to separate between the stitches or prongs of the clamp, while the puncturing of the skin renders it susceptible to local infection. Furthermore, the subcutaneous fatty tissue has a tendency to recede from the wound or incision due to the fact that such tissuefcannot be held together by surface sutures or clamps and no means other than bindings is provided for preventing strain or stress on sutured lower muscles which often results in rupture due to coughing or vomiting.
The present invention, therefore, provides an improved clamp or surgical appliance for drawing areas of the skin on opposite sides of a wound, or incision towards each other to form an upstanding ridge between said areas to thereby dispose the edges of the skin and subcutaneous tissue on opposite sides of the wound or incision in apposition continuously throughout the extent thereof and with the wound or incision disposed longitudinally oi the upstanding ridge and substantially at the center thereof and for drawin lateral areas of the skin on opposite sides of said first mentioned areas towards each other to form a relatively larger upstanding ridge or bulge between said lateral areas so as to dispose the first mentioned ridge longitudinally ofthe said larger ridge and substantially at the center thereof for preventing transmission of strains or stresses to the wound or incision and the lower sutured muscles. r
The invention is further directed to surgical appliances having spaced parallel bars joined tov gather by bowed bridge members and having adhesive strips carried by the bars for attaching the appliance in position with the bars disposed on opposite sides of a wound or incision so as to draw the opposite sides thereof outwardly into ridge formation with the edges of the woundor incision in continuous apposition. I
With the foregoing and other objects in view, reference is now madeto the following specification and accompanying drawings in which clamps employed in carrying out there is illustrated the preferred forms of the appliances for carrying out themethod. f
In the drawings: I v Fig. 1 is a perspective view of one of thesrnailer the invention; ig'. 2 is a similar view thereof strips applied thereto. M Fig. 3 is a' transverse sectional view of a large and small clamp illustrating the same in applied position with reference to a wound or incision.
Fig. 4 is a perspective view oi large and small clamps in applied position and illustrating a modi fied form of large clamp. f
Fig; 5 is a transverse'sectional view there'- through. H v
Figs. 6, 7, 8 and 9, are perspective views of modifled 'forms of smaller clamps with the adhesive tape omitted.
'Fig. 1015 a perspective view of the largeand small clamps illustrated in Figs. 4 and 5 of the drawings, the large clamp being Provided witha modified form of auxiliaryadhesive strip.
- Fig. 11 is a perspective view of the clamp 'il-' lustrated in Figs. 4, 5 and 10 with the adhesive strips removed. "Referring to the drawings by characters, of reference and more particularly to the form of the invention illustrated in Figs. 1 to 3 of the drawings, the clamp indicated generally by the reference character A is adapted to be adhesively' secured to areas B and C of the skin on opposite sides of a wound or incision D to. thereby form an upstanding ridge E between the areas B and C and to draw the opposite edges of the wound or incision together to dispose the same in continuous apposition.
"As illustrated in Fig. 3 of the drawings the edges of the outer layer F of the skin on opposite sides of the wound or incision D are compressed together continuously throughout the extent of the wound or incision so as to close the same. l'he 1 edge of the inner layer G of the skin on opposite sides of the wound or incision ar likewise com pressed to ether in continuous apposition and since this layer of the skin contains blood vessels, the sameg'row together more rapidly when firmly held together in continuous apposition.
A relatively large clamp H may also beemployed which is'adapted to be adhesively secured to areas J and K of the skinon ppposite sides of 'thew'ound or incision and laterally of the areas B and C. In applying the clamp H to the skin, the areas J and K are drawn towards each other so as to form a relatively larger upstand ing ridge or bulge L of the skin and subcutaneous with the. adhesive tissue between the areas J and K and within which ridge or bulg the wound or incision D is disposed longitudinally and substantially at the center thereof. The drawing of the spaced areas J and K inwardly toward each other into the upstanding ridge or bulge L produces a slackness on opposite sides of the wound or incision for preventing transmission of strains or stresses of the muscles to the wound or incision.
The clamps A and H are of substantially similar construction and each includes'longitudinally extending bars ID which are connected together in spaced parallel relation by bridge elements each consisting of an arcuate bight portion H minals of which are connected with the bars l preferably at theends thereof. "Theba-rs Ill each carries an adhesive strip l3 which embraces the,
The strips l3 may consist of either single or double faced adhesive material, the .outer adhesivefaces of whichare covered bystrips of gauze l4 and to maintain the same in an antiseptic condition until the same is to be used when the gauze strip I5 is removed to expose the fresh adhesive.
The .clamps are composed of deformable .material such as malleable .or untempered steel or iron, synthetic plastic compositions or any other equivalent material which possesses .thecharacter or quality of retaining afixed shape or formation against distortion under any usual strain or stress to which the clamp is subjected when in use, while permitting of .the manual bending of the bridge elementsor legs ltowards each other when adhesively secured in applied position. When the legs I2 of the smaller clamps are thus bent from outwardly divergent relation .as illustrated in Figs. .1 and 2 of the drawings to inwardly bowed formation, as illustrated in Fig. 3 thereof, the bars 10 are compressed against the opposite sides .of the ridge or bulge to retain the edges of the wound or incision in apposition. This inward bending of the legs may be periodically effected .during the healing of the wound or incision.
In use, theclampais first applied :by securing one of th adhesive-strips l3'thereof to the area of the skin B longitudinally and at one side of the woundor incision Dafter which the opposite strip of adhesive is applied to the area C on the oppositeside of the wound or incision D, while drawing the .areas B and C of the skin together into ridge formation. When in applied position, the legs l2 are pressed inwardly or towards each otherto thereby provide the desired compression on the opposite sides of the ridge E to dispose the edges of the skin .and subcutaneous tissue .on opposite sides of the wound or incision in continuous apposition throughout the extent thereof. The large clamp .H is .applied in a similar .manner in .straddling relation with th clamp A so as to provide the. upstanding ridge or bulge L .between the bars in thereof and with the wound or incision D disposed lqngitudinally of and substantially at thecenter thereon.
A .clampsuch as illustrated in Figs. 4 and 50f the drawings may .be employed for retaining in continuous pposition during healing the opposite edgeslof a wound or incision which is located in the walls of the abdomen or other parts of the body having fatty tissue between the skin and muscles: .As shown therein the clamp M maybe employed in addition to the clamp A which is secured to the areas B and C of the skin on opposite sides of the wound or incision D to form the upstanding ridge E as hereinbefore described.
The clamp M is disposed in straddling relation to the clamp A and is adhesively secured to areas N and O of the skin on opposite sides of the wound or incision D and laterally of the areas B and C. The clamp is thus applied to draw the areas N'and O of the skin towards eachother so as'to form the upstanding ridge or bulge P between the areas N and O and within which ridge or bulge P the clamp A and wound or incision D are located longitudinally and substantially at the .center .thereof. The ridge or bulge P is of a height that the fatty tissue and muscles located between the areas N and O are likewise bulged outwardly. The :slackness produced by the bulge P extends into the muscles Q to thereby relieve strains or stresses from the sutures so as to prevent rupture thereof which frequently happens due to coughing or vomiting. The fatty tissuelit on opposite sides of the wound or incision is also drawn together to thereby close the wound or incision between theskin and muscles and to .cover and protect the sutures in the muscles.
The clamp M consists of longitudinally extending .bars H which are connected together in tively at the ends thereof. The said bridge elements are connected together at the juncture of the medial portions 88 with the bowed end portions H? by longitudinallyextending parallel bars 20. The bars .11 each carries an adhesive strip which embraces the same and is doubled upon itself to provide a two ply thickness with the upper ply 2| secured upon the lower Iply .22 by any desired means, ,thelower ply 22 being adapted to be adhesively secured to the areas .N and Obi theskin as hereinbefore described.
The bars 20 may each be similarly provided an auxiliary adhesive strip .23 which embraces the said bars and is secured tothe lower ply as at 24 in any desired manner and which lower .ply is.
adapted to be secured to the skin at the areas S and T as illustrated in Figs. 4 and 5.
the body inorder-to assist the adhesive strips22 for maintaining the elampinposition.
In place .of the clamp A employed in -.carry.ing out the invention as illustrated intheforms hereinbefore described, the same maybe inthe form of theclamps U, V, Wand Xshown in Eigs. 6=to,9' inclusive of thefdrawings. .As illustrated in Rig 6, the longitudinally extending bars 25;,of the clamp 13 are iongitudinallycurved to provide longitudinally extending concave bottom edges 36.
adapted to bearrangedin. straddling relation with a wound .or incision in a :convex body.
formation, while in Fig. .8 the longitudinally extending bars 31 of the.clamp- W are curved .orlaterally offset intermediate their length in a ny;
These. strips .23 function to draw .the clamp M towards portion of the.
desired manner so as to coincide with the contour of wound-s or incisions of irregular shape.
The clamp X illustrated in Fig. 9 of the drawings, is of relatively shorter length having the opposite bars 33 parallel and provided with the upwardly projecting lugs 34 for facilitating the grasping thereof, it being understood that the said bars in the clamps illustrated in Figs. 6 1:09 inclusive are provided with adhesive strips similar to th strips l3 for securing the same in position with the areas of the skin B and C.
In treating certain wounds orincisions it is desirable to provide means for periodically increasing the lateral pressure at the opposite sides of the longitudinally extending ridge or bulge P formed by the large clamp M. This may be effected by providing the clamp M with auxiliary adhesive strips which are adjustable to shorten their overall length. I
As illustrated in Fig. 11, the clamp M is similar to the construction of the large clamp M shown in Figs; 4 and 5 of the drawings, and is provided with auxiliary strips 36 each consisting of sec tions 31 and 38, the formerbeing attached to a bar 20 of the clamp, while the latter is adapted to be adhesively secured to the skin as at S and T. The sections 31 and 38 are provided with tie strings 39 and 40 adapted to be tied together for exerting outward tension on the bars 20 at the opposite ends of the clamp to thereby efiect a drawing of the clamp towards the body and the inward tightening of the bars I! against the opposite sides of the ridge or bulge P. I
The clamps H and M may also be used independently of the small clamp A or the clamps U, V, W and X for gangrenous or sloughing wounds or incisions. When thus used, the opposite edges of the wound or incision are maintained in open relation so as to permit of drainage. The legs l2 of the clamp H and the bowed end portions IQ of, the clamp M being deformable, the same may be progressively advanced towards each other to increase the pressure from day to day thus forcing the opposite edges of the skin and subcutaneous tissue gradually together as the cleansing and granulations of the wounds or incisions progress.
What is claimed is:
1. A surgical clamp consisting of longitudinally extending bars, bridge elements connecting the same together and each including a transversely extending elevated medial portion and oppositely disposed confronting bowed end portions having their inwardly directed terminals connected with the bars respectively at the ends thereof, and longitudinally extending bars connecting the bridge elements at the juncture of said medial and bowed end portions and adhesive strips carried'by all of said bars to project laterally therefrom and adapted to be adhesively secured to the skin on opposite sides of an incision for producing an elevation of the skin and subcutaneous tissue on opposite sides of theincision;
2. A surgical clamp consisting of longitudinally extending bars, bridge elements connecting the same together at the opposite ends thereof, said bridge elements each including a transversely extending elevated medial portion, oppositely disposed confronting bowed end portions having their inwardly directed terminals connected with i ments of the clamp at the opposite ends thereof.
ROY G. PERI-1AM-