US 2574873 A
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Description (OCR text may contain errors)
Nov. 13, 1951 c JoBsT SURGICAL STOCKING Filed May 25, 1949 2 SHEETS-SHEET l FIG.2.
CONRAD JOBST ATTORNEYS NOV. 13, 195] c JOBST 2,574,873
7 SURGICAL STOCKING Filed May 23, 1949 2 SHEETS-SHEET 2 FIGB.
CONRAD JOBST ATT O RN EYS Patented Nov. 13, 1951 UNITED STATES PATENT OFFICE SURGICAL STOCKING Conrad J obst, Toledo, Ohio Application Ma 23, 1949, Serial No. 94,831
3 Claims. i
The invention relates to surgical stockings such as are used to assist in the return circulation of blood.
It is the object of the invention to obtain a construction which eliminates certain detr'lmental characteristics of surgical stockings as heretofore used and which also increases efliciency in assisting return circulation.
More particularly, it is an object to obtain a construction for use of patients suffering from varicose veins.
The invention therefore consists in the construction of surgical stocking and method of forming the same as hereinafter set forth.
In the drawings:
Figure 1 is a diagrammatic side elevation of the leg of a patient illustrating the method of measuring the same preliminary to the forming of an individual surgical stocking for use thereon;
Figure 2 is a plan view of a blank cut from elastic fabric and from which the stocking is to be formed;
Figure 3 is an elevation similar to Figure 1 illustrating in dotted lines the relative dimensions of the stocking which has been longitudinally stretched but not circumferentially expanded;
Figures l and 5 are cross sections respectively on lines 3-4 and 5'5, Figure 3;
Figures 6 and '7 are diagrams showing fabric from which the stocking is formed respectively before and after stretching of the same;
Figure 8 illustrates a method of forming a template from which the surgical stocking can be accurately formed;
Figure 9 is a plan view of said template; and
Figure 10 is a longitudinal section through a modified form of stocking.
Surgical stockings as heretofore used are formed indifferent sizes from which selection is made for use Of individual patients. Inasmuch, however, as the contours of the legs of different patients are never precisely the same, it is difficult or impossible to obtain the same functioning in all cases. As a consequence, the pressure applied by the stocking to one portion of the leg may be less than that required for greatest help to the circulation, while the pressure in another portion may be too great so as to cause strangulation. With my improved construction it is essential to adapt the stocking to the individual for whom it is prepared so as to avoid on the one hand any danger of strangulation, and on the other hand to secure the proper degree of resilient pressure in all portions for greatest assistance to circulation. I have therefore devised a 2 method for forming individual surgical stockings as follows: a
As illustrated in Figure 1, the leg A of the patient is measured circumferentially at verti cally spaced points indicated by the lines al b, 0, etc. A blank B is then cut from a sheet of elastic fabric B which is capable of stretching in transverse directions to increase the tension on the strands thereof. Such fabric is diagrammatically illustrated in Figures 6 and '7, respectively, be fore and after stretching. In cutting the blank B, the width i nsuccessive lines a, b and c" is in predetermined ratio to the circumferential lengths a, b, 0 plus the material required for forming the seam. However, as the fabric is in its natural unstretched'condition, the lines a, b, c are more closely spaced than the lines a, b, c to compensate for the longitudinal stretching of the fabric when the stocking is drawn onto the leg. As it is the purpose of the stocking to pro duce radial pressure, the lengths a, b, c are less than the circumferential lengths a, b, 0, so that the fabric must be circumferentially stretched when placed on the leg.
An important feature of my invention is the variation in radial pressure at different points in the length of the stocking so as to secure just the required amount for assisting circulation without danger of strangulation. If the patient were constantly lying in a horizontal position such variation would not be necessary, but as he is frequently standing or walking the blood in the veins of the leg is more or less subject to varying hydrostatic pressure. The highest pressure will be in the foot or lower portion of the leg and from there upward the hydrostatic pressure sufficient to compensate for increase in hydro static pressure of the blood in the veins. In other words, the stretching of the fabric circumferentially will place the same under tension which will result in producing radial inward pressure against the leg. The more the fabric is stretched the greater its tension and by proper calculation the proper width of the blank at each point in its vertical length can be determined to produce the required pressure. As illustrated in Figures 3 and 4, the full line contours CC and DD (corresponding to those of the leg Figure 1) are non-parallel to the dotted line contours C'--C and D-D, which latter correspond to the stocking when longitudinally stretched but not ciriiiiiferntially expanded. It will be iioted that the full and dotted lines diverge from each other in a downward direction and, as illustrated in Figures 4 and 5, the ratio of the relative diameters of the full and dotted circles is greater in Figure than in Figure 4. To relieve pressure over the heel the stocking E may be formed with a gore E and the foot portion E. is preferably formed to exert a radial pressure at least as great as exerted along the line 5-5.
While I have described my improved surgical stocking as being formed from a flat sheet of elastic fabric, it is evident that it might be produced by knitting or weaving if the same relative dimensions were preserved in the difierent portions of the structure. The important feature is that the stocking when applied to the leg must be progressively increased in tension from its upper to its lower portion to produce radial pressures proportional to the hydrostatic pressures in a vertical column of blood of the same length. Also instead of a stocking formed of a single layer of fabric, it may be formed as shown in Figure of a plurality of super-posed lightweight layers F and F. flexibility.
Stated in the language of the surgeon or anatomist, the stocking made as above described will result in an equally controlled tension to all parts of the extremity both longitudinally and circumferentially while the part is at rest or in use. This tension accurately graduated to decrease from the distal end to the proximal portion of the extremity would assist or increase the flow of venous blood. There would be less opportunity for stasis in the lower portion of the leg when the patient is in the upright position. The normal function of the muscles contracting and relaxing in assisting venous circulation would be enhanced by such a stocking.
To facilitate the proper forming of the stocking for an individual patient or user, I have devised a template for obtaining accurate measurement of the portion of the anatomy to which it is to be applied. This consists of a paper or fabric sheet G cut to form a comparatively narrow, longitudinally extending central portion G, and a series of narrow strip portions (1 extending transversely and oppositely from the portion G and slightly spaced from each other. The strips G on one side of the portion G have adhesive G3 applied to one face thereof. Thus the patient can extend the portion G longitudinally along the back of his leg, around the heel, and along the sole of the foot. The strips G may then be bent circumferentially around the leg and the foot and secured to each other by the adhesive. Shears, or some other cutter, may then be used to sever the overlapped portions of the strip centrally and at the front of the leg and over the foot. This will produce a template giving the This will produce greater action and exact circumferential lengths of successive vrti= cally spaced portions of the leg. From this template the stocking can be accurately fashioned to produce the proper tensions in differeiit poi" tions thereof. The proper time for forming this template is after the patient has been lying in bed for a number of hours so that the leg will not be swollen.
While I have specifically described the application of my improved surgical stocking only to the leg of the patient, it is obvious that it might be useful in some cases for application to an arm. With either limb its functioning will be the same, viz., a progressive increase in radial pressure from the proximal portion to the distal end of the extremity.
What I claim as my invention is:
1. A stocking formed of an elastic fabric having the circumferential length of longitudinally spaced portions thereof progressively decreased from the upper end to the lower portion in greater ratio than that of the limb for which the stocking is designed.
2. An individual surgical stocking formed of elastic fabric, the circumferential measurements of vertically spaced portions of the stocking being less than those of the corresponding portions of the limb on which the stocking is to be placed, the difference between the circumferential measurements of the portions of the stocking and those of the limb increasing progressively from the proximal to the distal portions thereof.
3. A method of forming individual surgical stockings comprising measuring at vertically spaced intervals the circumferential lengths of the portion of the limb of the individual on which the stocking is to be worn, cutting an elastic fabric sheet to a pattern for fitting about said limb but with transverse dimensions at longitudinal intervals proportionately spaced to said vertically spaced intervals less than the circumferential lengths at the corresponding points with a progressively increasing differential, and seaming together the opposite edges of said out sheet.
CONRAD J OBST.
REFERENCES CITED The following references are of record in the file of this patent:
UNITED STATES PATENTS Number Name Date 967,585 Teufel Aug. 16, 1910 1,629,108 Lake May 17, 1927 2,169,203 Hinchliff Aug. 8, 1939 2,280,025 Bollinger Apr. 14, 1942 FOREIGN PATENTS Number Country Date 143,221 Austria Oct. 25, 1935