US2698270A

US2698270A - Method of incorporating a thread in wavy formin a gauze surgical dressing

Info

Publication number: US2698270A
Application number: US299043A
Authority: US
Inventors: Mesek Fred Karl
Original assignee: Johnson and Johnson
Current assignee: Johnson and Johnson
Priority date: 1952-07-15
Filing date: 1952-07-15
Publication date: 1954-12-28
Anticipated expiration: 1971-12-28

Description

Dec. 28, 1954 IN V EN TOR. A2 50 A5424 M5516.

United States Patent METI-IGD OF'INCORPORATIN G -A THREAD IN WA-VY FORM IN A GAUZE SURGICAL DRESSING Application July 315, 1952 Serial No. 299,043 9 Claims. {(1154-93) "This invention is directed to improvements in surgical sponges or the like.

*In'certain'classes of surgical operations, and particularly in abdominal surgery, it is common practice to-pack the wound cavity with absorbent pads or sponges.

In the course of an operation many such pads are used, antlzit-is difficult, if not impossible, to keep track of the exact number of sponges employed, inasmuch as such a check as maybe made is not altogether accurate, and as frequently happens, the operating surgeon remalns 1n doubt as to whether all such pads used were finally removed. It is not infrequent that due to the surgeons undivided attention focused on the delicate problems before him, he must ,depend to a great extent on the fsponge count, as performed by ,the other members of the operating team. "In an emergency operation where a time factor is involved and in which case all surgical procedure must cease .and the incision be closed, it is of paramount importance that asponge count, and a check of all surg cal paraphernalia be made, prior to, and after all such surgical operations.

However, the possibility of the humanerror must always be considered, and as previously mentioned, the surgeon ,mayremain in ,doubt and resort must be made to X-ray. or equivalent inan effort to determine the presence of aforeignbody remaining within the patient.

Hence, the principal object ,of the present invention is to provide a method for preparing a telltale absorbent pad orsponge which, if inadvertently lost in the wound, would, due to combining a sinuous radio opaque material with an ordinary surgical pad or sponge, be accurately localized by the X-ray machine. It would be quite a simple matter in many cases to take an X-ray film if there is ques tion of doubt during the temporary closing-of the incision, usually held closed by surgical clamps. Such a check would disclose the sponge, thus rendering it an easy matter to reopen the 1ncision and remove .the pad with the least possible risk to the patient. However, if the foreign matter is .not radlo opaque, as :is the :case in ordinary gauze pads or sponges, it will be necessary .during postoperative diagnosis to determine by physical signs and symptoms of the patient whether a sponge may have been lost, and just where in the wound an attempt should be made torecover it.

Another object of this invention is to provide an improved method for preparing a telltale absorbent pad or sponge with a tracer having means responsive to X-ray or an equivalent, which may be placed within the pad, or on itsexterior or-integrated with the pad in such a way as not to impair the necessary softness of the pad and in no way interfere with its swabbing or sponging properties, and which on exposure would cast a distinctive shadow or pattern easily discernible from the organs in the body.

Various other objects, invention will be apparent from the following description and from inspection of the accompanying drawings, in which-- Fig. 1 shows a face view of a section of gauze, having adhesively attached thereto a tracer of radio opaque material which when folded forms a completed surgical pad or sponge;

'Fig. 2 shows in tially folded;

Fig. .3 is a perspective view of a completed pad;

Fig. 4 is a perspective view similar to Fig. 3 but showingythe reverseside thereof;

perspective the elements of Fig. 1 parpresence and position of a lost pad or features and advantages of the- Fig. 5 is a diagrammatic view showing .the invention method of applyingzthe opaque material to thegauze strip.

Referring to Figs. .1, 2, 3, 4 and 5 of .thedrawings, the pad or sponge 10, which otherwise may be as usual, is provided with anzelement or elements, which whenin pad formas illustratedin Figs. 3 and 4, and inadvertently-left ina .Woundof the patient, will be responsive to .X-ray, and will :always appearon the X-ray plate in an unmistakable criss-crossof ripple wave patterns covering a wide area on ithe X-ray plate regardless of the angle from which the picture is taken. As shown :bestin Fig. l, a sinuous thread, preferably a monofilament 121's employed, suitably the same length as the unfolded-gauze section 14 and symmetrical thereto along a centerfold line 18.

The sinuous thread ormonofilament 12 described more fully below, as employed in this invention, comprises an elastomer loaded with an X-ray opaque material. The elastomer is'any natural or synthetic plastic which has, or maybe compounded to have, flexible'or elastic rubber-like properties, including freedom from tack at normal temperatures. The monofilament is preferably anchored vby adhesion to the surgical material, such as cotton gauze, by sealing thereto with heat, or other suitable means, use of heat being preferred.

The method of the present invention which affords easily controlled operation, consistent results, and a ripple wave pattern of thread, preferably monofilament, having substantially uniform sinuous configuration is illustrated in Fig. 5. A'continuous monofilament 30 withdrawn from a supply notshown is passed over guide roll 32 and on to the lower peripheral portion of rotating roll 42, which rotates in a counter-clockwise direction. The portion .of n1ono'filament'30 between

rolls

32 and 42 is preferably in an untensioned, substantially relaxed condition. A continuous strip of surgical gauze 34 is drawn from spool 36 andthence on to the bottom peripheral portion of roll 42 .monofilament 3.0. Gauze supply roll form and controllable tension on gauze strip 3421s itcontacts and passes around roll 42. .Superjacent roll/ll) is heated. Rolls 40 and 42, which rotate ,at the same speed, may be mechanically driven or may be driven by the gauze pulled through them. The tensioned gauze strip 34 passes around roll 42, holding monofilament 30 lightly against roll 42 but with sufiicient force to uniformly restrict substantially but yieldingly sidewise or longitudinal movement of the vmonofilament. The zone between the point where gauze 34 and thread 30 first contact roll 42, and the beginning of nip 41 is designated as the preliminary zone since it ,is here that the thread is so placed with relation to the gauze and roll 42 as to be receptive to acquirrig the wavy form from subsequent treatment in mp At the point where gauze and monofilament start to warp .around roll 42, the tension of the gauze around the roll holds the monofilament against the roll, causing the monofilament and the gauze to feed into the nip 41 at the same ratemeasured tangentially at the nip of the roll, the heat .and pressure cause the gauze and monofilament to combine. The region where the gauze and thread are squeezed in the nip between

rolls

40 and 42 is termed a pressuring zone. However, the monofilament elongates as ,it is forced between the rolls, higher temperatures tending to produce more elongation of filament. The excess length of monofilament caused by this elongation produces backing up of the monofilament. However, the confining action of gauze web 34 as it presses against roll 42 restricts movement of the monofilament and thereby produces a wave-like pattern of sinuous configuration therein.

The monofilament is sealed to the gauze in the form of this wavy pattern. The amplitude and frequency of the wavy pattern formed is determined by the amount of elongation and the tightness of the gauze wrapped around roll 42. When the gauze is extremely tight, this excess monofilament can work its way back a relatively short distance, and a wave of small amplitude butof high frequency is formed. As the tension of the gauze around roll 42 is relaxed, the excess monofilament can work its way further back around the periphery of the roll forming a wave with greater amplitude but with less 3 frequency. Higher elongations tend to produce a wave of higher amplitude. Experience has shown that with a tension of less than 2 lbs. per inch width on the gauze, the monofilament will not generally be fed around the roll at the same peripheral speed as the gauze. Hence, the excess monofilament may work its way completely around the roll, and periodic straight lines may appear in the filament. The tension on the gauze may be increased with the resultant decrease in amplitude and increase in frequency of the wave pattern up to the point where the gauze will break because of too high tension. In actual practice it was found that tensions up to about lbs. per inch are acceptable from the point of view of avoiding gauze breakage and obtaining a wavy pattern having satisfactorily high amplitude. A tension of approximately 3 to 8 lbs. provides a particularly desirable pattern and hence is preferred.

By controlling the tension in gauze 34 and the temperature of roll 40, the amplitude and frequency of the wave pattern may be controlled as desired. An important aspect of the invention is controlling conditions to produce a wave of uniform characteristics. In passage from nip 41 to the top peripheral portion of roll 40, the sealing of monofilament 30 to gauze 34 is completed. Bottom roll 42 is preferably unheated.

From

rolls

40 and 42 the gauze strip 34 containing the wave-form monofilament 30 is fed into a cut-off knife 46. Not shown is a device for folding the gauze strip section 14 containing the monofilament, as best seen in Fig. 1, into surgical pads or sponges, usually into squares.

In producing a wave-like monofilament in which the waves have uniform amplitude, there is notable advantage in employing a monofilament having a substantially circular cross-section. Accordingly, a preferred embodiment of the invention includes the use of a round monofilament. However, the invention is not limited to a round monofilament. The use of oval or flat monofilaments according to the present invention affords a method having important advantages over other methods. A filament of from 17 to 20 mils is utilized; carbon black present in said filament is to color the filament for visual detection. The X-ray opaque material may be any of a number of such materials as barium, strontium, thorium, lead, tungsten, etc., or compounds thereof, so long as they are not toxic; but barium sulphate has been found to be particularly advantageous. This material is in a finely divided or powdered state when incorporated into filament 12.

Considering further the cut section of gauze having the sinuous filament sealed thereto, and with particular reference to Fig. 1, it will be seen that by folding the end portions of the gauze section 14 along fold lines 16 towards the center and again folding the gauze from left to right or right to left along the center fold line 18, we are now ready for the final folding operation along fold line 20 (see Fig. 2) in the transverse direction from the previous lines of fold. This forms a pad containing a multiplicity of cotton gauze layers, in this particular embodiment eight (8) layers of cotton gauze, in which the elastomeric sinuous monofilament is located in four adjacent layers, comprising half the pad thickness while the remaining gauze layers are free from the sinuous or ripple wave monofilaments 12. To insure pad 10 from the tendency of fraying edges, the edges of the gauze section 14 as seen in Fig. 1, may be turned inwardly as along lines of fold 22.

Referring more specifically to Fig. 4, illustrating that side of the surgical pad or sponge 10, in which the monofilament 12 is most visible, it will be observed that the entire length of the ripple wave monofilament 12 is visible through the surgical gauze, crossing and recrossing upon itself in successive layers, to set up as previously mentioned, an unmistakable sinuous criss-cross pattern, covering a wide area on the X-ray plate when exposed, thereby making it an easy matter to localize its exact position in the patient.

Other commercially available sponges of similar construction have used straight line filaments, but the tendency for the lines to remain in substantially parallel relationship, or superimposed upon one another always exists, making it less discernible, and more likely to be confused with muscle structure and other internal organs. The sinuous monofilament is adapted to overcome such difli' culties in the manner previously stated.

The pad or sponge in the position illustrated in Fig. 4 may be packed to advantage, one upon another in a carton or package, so that as each successive pad is removed for use, the topmost pad will be always visually distinguishable from ordinary pads or sponges.

In the most usual application of this invention the X-ray opaque elastomeric sinuous monofilament 12 is combined with a gauze pad in the form of from 8 to 16 layers of cotton gauze. The gauze section may be so folded as to have the sinuous monofilament in alternate layers, but it is preferable to present the elastomer in the outer layers, such as to make it visually distinguishable from ordinary sponges as previously stated. The gauze is customarily sterilized before use.

The completed sponge 10 as has been fully described meets the requirements of such material as used in surgery, including X-ray opacity, sterilizability, non-absorbability in body fluids, reasonable cost, visually detectable color, firm anchorage, freedom from abrasion and irritation, non-fraying, and lack of toxicity.

While the invention has been described with particular reference to specific embodiments, it is to be understood that it is not to be limited thereto, but is to be construed broadly and restricted solely by the scope of the appended claims.

The claims are:

1. The method of incorporating into a dimensionally web in said pressuring zone and elongating said thread from said pressuring zone into said preliminary zone, whereby said thread is pressed against and sealed onto said web in said pressuring zone, and said thread is induced to assume a wavy configuration in said preliminary 2. The method of incorporating into a dimensionally stable web a flexible thread which is non-tacky at ordinary temperatures but tacky at elevated temperatures in per-' manently wave-like form which comprises feeding said web and said thread adjacent each other at the same linear speed through a preliminary unheated zone and toward a pressuring zone heated to temperature at which said thread is tacky, yieldingly uniformly restricting movement of said thread relative to said web in said preliminary zone, passing said web and said thread from said preliminary zone directly into said pressuring zone, pressing said thread against said Web in said pressuring zone and elongating said thread from said pressuring zone into said preliminary zone, whereby said thread is pressed against and sealed onto said web in said prestures in permanently wave-like form which comprises; feeding said web and said monofilament adjacent each other at the same linear speed through a preliminary unheated zone and toward a pressuring zone heated to temperature at which said monofilament is tacky, yieldingly uniformly restricting movement of said monofilament relative to said web in said preliminary zone, passing said Web and said monofilament from said preliminary zone directly into said pressuring zone, pressing saidmonofilament against web in said pressuring zone an elongating said monofilament from said pressuring zone into said preliminary zone, whereby said monofilament is pressed against and sealed onto said web in said pressuring zone, and said monofilament is induced to assume a wavy configuration in said preliminary zone.

4. The method of incorporating into a gauze web a flexible round monofilament which is non-tacky at normal temperatures but tacky at elevated temperatures in uniform permanently wave-like configuration which com prises feeding said gauze and said round monofilament adjacent each other at the same linear speed through a preliminary unheated zone and toward a pressuring zone heated at temperature at which said monofilament is tacky, yieldingly uniformly restricting movement of said monofilament relative to said gauze in said preliminary zone, passing said gauze and said monofilament from.

said preliminary zone directly into said pressuring zone,

pressing said monofilament against said gauze in said pressuring zone and elongating said monofilament from said pressuring zone into said preliminary zone, whereby said monofilament is pressed against and sealed onto said gauze in said pressuring zone, and said monofilament is induced to assume a uniform wavy configuration in said preliminary zone.

5. The method of incorporating into a gauze web a flexible monofilament which is non-tacky at normal temperatures but tacky at elevated temperatures in permanently wave-like configuration which comprises feeding said gauze and said monofilament adjacent each other at the same linear speed through a preliminary unheated zone and toward a rotating roll heated to temperature at which said monofilament is tacky, yieldingly uniformly restricting movement of said monofilament relative to said gauze in said preliminary zone, passing said gauze and said monofilament from said preliminary zone directly between said roll, and a cooperating pressure member, pressing said monofilament against said gauze in said pressuring zone and elongating said monofilament from said pressuring zone into said preliminary zone, whereby said monofilament is pressed against and sealed onto said gauze in said pressuring zone, and said monofilament is induced to assume a wavy configuration in said preliminary zone.

6. A method of producing a gauze surgical dressing comprising an X-ray opaque thread including an elastomer, said thread being afiixed to said dressing in permanent wave-like configuration, comprising feeding a web of said gauze and said thread at substantially the same linear speed to a preliminary roll-contacting zone on the periphery of a rotating roll, said thread being disposed between the surface of said roll and said gauze, controlling the tension on said gauze to produce substantial and uniform pressure thereof against the surface of said roll in said preliminary roll-contacting zone and thereby uniformly restrict substantially but yieldingly sidewise and longitudinal movement of said thread relative to said gauze in said preliminary roll-contacting zone, continuing rotational movement of said thread and said gauze about said first roll through said preliminary roll-contacting zone and directly into the nip between said first roll and a second heated roll, pressing said thread and said gauze in said nip to seal said thread to said gauze and induce backward elongation of said thread relative to said gauze in said preliminary roll-contacting zone whereby thread in said preliminary zone is induced to assume a wavy configuration and removing said threadsupporting gauze from said nip.

7. A method of producing a gauze surgical dressing comprising an X-ray opaque monofilament including an elastomer, said monofilament being affixed to said dressing in permanent wave-like configuration, comprising feeding a web of said gauze and said monofilament at substantially the same linear speed to a preliminary rollcontacting zone on the periphery of a rotating roll, said monofilament being disposed between the surface of said roll and said gauze, controlling the tension on said gauze to produce substantial and uniform pressure thereof against the surface of said roll in said preliminary rollcontacting zone and thereby uniformly restrict substantially but yieldingly sidewise and longitudinal movement of said monofilament relative to said gauze in said preliminary roll-contacting zone, continuing rotational movement of said monofilament and said gauze about said first roll through said preliminary roll-contacting zone and directly into the nip between said first roll and a second heated roll, pressing said monofilament and said gauze in said nip to seal said monofilament to said gauze and induce backward elongation of said monofilament relative to said gauze into said preliminary roll-contacting zone whereby monofilament in said preliminary zone is induced to assume a wavy configuration and removing said monofilament-supporting gauze from said nip.

8. A method of producing a gauze surgical dressing comprising an X-ray opaque monofilament including an elastomer, said monofilament being affixed to said dressing in uniform permanent wave-like configuration, comprising feeding a web of said gauze and a round X-ray opaque monofilament at substantially the same linear speed to a preliminary roll-contacting zone on the periphery of a rotating roll, said monofilament being disposed between the surface of said roll and said gauze, controlling the tension on said gauze to produce substantial and uniform pressure thereof against the surface of said roll in said preliminary roll-contacting zone and thereby uniformly restrict substantially but yieldingly sidewise and longitudinal movement of said monofilament relative to said gauze in said preliminary roll-contacting zone, continuing rotational movement of said monofilament and said gauze about said first roll through said preliminary roll-contacting zone and directly into the nip between said first roll and a second heated roll, pressing said monofilament and said gauze in said nip to seal said monofilament to said gauze and induce backward elongation of said monofilament relative to said gauze in said preliminary roll-contacting zone whereby monofilament in said preliminary zone is induced to assume a uniform wavy configuration, removing said monofilament-supporting gauze from said nip on the periphery of said second roll with rotating movement of the roll, and removing said monofilament-supporting gauze from the periphery of said second roll.

9. A method of producing a gauze surgical dressing comprising an X-ray opaque monofilament including an elastomer and non-tacky at normal temperatures but tacky at elevated temperatures, said monofilament being afiixed to said dressing in permanent wavelike configuration, comprising feeding a web of said gauze and said monofilament at substantially the same linear speed to a preliminary roll-contacting zone on the periphery of a rotating unheated roll, said monofilament being disposed between the surface of said roll and said gauze, controlling the tension on said gauze to produce sub stantial and uniform pressure thereof against the surface of said roll in said preliminary roll-contacting zone and thereby uniformly restrict substantially but yieldingly sidewise and longitudinal movement of said monofilament relative to said gauze in said preliminary rollcontacting zone, continuing rotational movement of said monofilament and said gauze about said first roll through said preliminary roll-contacting zone and directly into the nip between said first roll and a second roll heated to temperature at which said monofilament is tacky, pressing said monofilament and said gauze in said nip to seal said monofilament to said gauze and induce backward elongation of said monofilament relative to said gauze in said preliminary roll-contacting zone whereby monofilament in said preliminary zone is induced to assume a wavy configuration and removing said monofilament-supporting gauze from said nip.

References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 1,424,020 Hopkinson July 25, 1922 2,190,431 Lewison Feb. 13, 1940 2,321,512 Protz June 8, 1943 2,539,690 Boorn Jan. 30, 1951

Claims

1. THE METHOD OF INCORPORATING INTO A DIMENSIONALLY STABLE WEB A FLEXIBLE THREAD IN PERMANENTLY WAVE-LIKE FORM WHICH COMPRISES FEEDING SAID WEB AND SAID THREAD ADJACENT EACH OTHER AT THE SAME LINEAR SPEED THROUGH A PRELIMINARY ZONE AND TOWARD A PRESSURING ZONE, YIELDINGLY UNIFORMLY RESTRICTING MOVEMENT OF SAID THREAD RELATIVE TO SAID WEB IN SAID PRELIMINARY ZONE DIRECTLY INTO AND SAID WEB IN SAID PRELIMINARY ZONE, PASSING SAID WEB SAID PRESSURING ZONE, PRESSING SAID THREAD AGAINST SAID WEB IN SAID PRESSURING ZONE AND ELONGATING SAID THREAD FROM SAID PRESSURING ZONE INTO SAID PRELIMINARY ZONE WHEREBY SAID THREAD IS PRESSED AGAINST SAID SEALED ONTO SAID WEB IN SAID PRESSURING ZONE, AND SAID THREAD IS IN-