US 2867214 A
Description (OCR text may contain errors)
Jan. 6, 1959 J. w. WILSON 2,867,214
SKIN TREATING APPARATUS Filed Feb. 14, 1956 4 Sheets-Sheet 1 IN VENTOR 6 ATTOEIEY Jan. 6, 1959 J. w. WILSON sxm TREATING APPARATUS 4 Sheets-Sheet 2 Filed Feb. 14, 1956 INVENTOR Jan. 6, 1959 J. w. WILSON SKIN TREATING APPARATUS Sheets-Sheet :5
Filed Feb. 14, 1956 J. w. WILSON SKIN TREATING APPARATUS Jan. 6, 1959 4 Sheets-Sheet 4 Filed Feb. 14, 1956 illlllllllllll' INVENTOR United States Patent SKIN TREATING APPARATUS John Walter Wilson, Los Angeles, Calif., assignor of onethird to Ralph Luikart II, Santa Barbara, and one-third to Samuel Ayres III, Los Angeles, Calif.
Application February 14, 1956, Serial No. 565,325
12 Claims. (Cl. 128-355) My invention relates broadly to surgery and more particularly to surgery at the surface of the skin.
One of the objects of my invention is to provide a surgery device capable of removing growth and other imperfections at the surface of the skin with minimum irritation to the patient where the imperfections are removed by abrasion after treatment of the patient to deaden the effects of the operation.
Another object of my invention is to provide an abrasion tool for treatment of the skin, including a rotatably driven abrading device operating within a guard and in the path of a spray mechanism for treating the skin preceding the abrasion operation.
Other and further objects of my invention reside in the construction of a readily portable surgical tool for performing skin operations as set forth more fully in the specification hereinafter following by reference to the accompanying drawings, in which:
Figure l is a perspective view showing one application of the device of my invention in the facialtreatment of a patient;
Fig. 2 is an elevational view of the complete surgical tool of my invention showing the relationship of the abrading device to the spray mechanism and the guard;
Fig. 3 is an enlarged side elevational view showing the operating end of the surgical tool of my invention;
Fig. 4 is a top plan view of the tool shown in Fig. 3;
Fig. 5 is a transverse sectional view taken on line 55 of Fig. 3;
Fig. 6 is a transverse sectional view taken on line 66 of Fig. 3;
Fig. 7 is a longitudinal sectional view taken through the end of the tool substantially on line 7-7 of Fig. 4;
Fig. 8 is a transverse sectional view taken on line 88 of Fig. 7;
Fig. 9 is a horizontal sectional view taken on line 99 of Fig. 8;
Fig. 10 is an enlarged transverse vertical sectional view taken on line Ill-10 of Fig. 7;-
Fig. 11 is a vertical sectional view taken substantially on line 1111 of Fig. 10;
Fig. 12 is a horizontal sectional view taken substantially on line 1212 of Fig. 10;
Fig. 13 is a horizontal sectional view taken on line 1313 of Fig. 10;
Fig. 14 is a fragmentary side elevational view showing the end structure of a modified form of tool embodying the principles of my invention;
Fig. 15 is a fragmentary top plan View of the modified form of my invention shown in Fig. 14;
Fig. 16 is a fragmentary vertical sectional view taken substantially on line 1616 of Fig. 14;
Fig. 17 shows a side elevational view of a modified form of the device of my invention, employing a single brush as an abrasive device;
Fig. 18 is a view similar to the view shown in Fig.
1 7, but shown partially in longitudinal vertical section;
Fig. 19 is a top plan view of the form of my invention shown in Figs. 17 and 18;
Fig. 20 is a transverse vertical sectional view taken on line 20-20 of Fig. 17;
Fig. 21 is a side elevational view of the single brush used in the form of my invention shown in Figs. 17-20;
Fig. 22 is an end view of the single brush used in the form of my invention illustrated in Figs, 17-21; and
Fig. 23 is a fragmentary vertical sectional view through the convolutions of the spring wound flexible tube which houses the drive shaft in the several forms of my invention.
My invention is directed to the construction and arrangement of a mechanical instrument assembly used In surgical planing for acne scars and other cutaneous defects. Surgical planing (dermal abrasion) is a surgical procedure for the treatment of scarring due to acne, chickenpox, smallpox and trauma; multiple senile keratoses (sailors or farmers skin); fine wrinkling; and traumic tattoos.
The planing, which is' performed in the ofiice, is preceded by Demerol and the application of ice cold packs to the operative site. Next the areas are scrubbed with alcohol. The area to be planed (about 3 inches in diameter) is then sprayed with a freezing agent, dichlorotetrafiuoro-ethane (Freon 114 Frigiderm which renders the skin temporarily rigid and locally anesthetized. The skin is then abraded or planed with a motor driven, rotating, stainless steel wire brush, the speed of which is controlled by a foot rheostat. The movement of the operators hand is at right angles to the plane of the brush. The entire face, if indicated, is usually treated at one session. A nonadherent dressing is applied which the patient removes the'next day. A crust forms quickly and then separates in about one week. The initial erythema fades gradually to match the adjacent skin. The average case of moderately severe acne scarring requires two planings. Some require only a single planing, while severe cases may need three or more. The-procedure may be repeated any time after four to six Weeks. In most cases the results are good to excellent, and nearly all cases where planing is indicated can be helped.
Microscopic studies show that the scarred epidermis and upper dermis are removed by the procedure. The epidermis regrows in about a week from themyriads of pilosebaceous units left behind.
Contraindications are the absence of the pilosebaceous units, as in radiation damage and severe burn scars, and insufiicient scarring to warrant the procedure (the overenthusiastic patient).
Complications include bacterial infection, which is rare and is easily dealt with; milia, which are not'uncommen, but are easily removed; relatively persistent erythema (rare); transient hyperpigmentation (the newly regrown epidermis should be protected from the sun); transient depigmentation; and hypertrophic scars (rareapparently the result of excessively deep planing).
Surgical planing has several advantages over abrasion with sandpaper. For example, with surgical planing hospitalization and a general anesthetic are not required; the small wire brush follows intricate facial contours; and there is no danger of silica granulomas. Finally, the results of surgical planing speak for themselves.
The refrigerant-anesthetic, dichloro-tetrafluoroethane, which the instrument of my invention employs in surgical planing, has several distinct advantages over the ethyl chloride which has been widely used for this procedure. In contrast to ethyl chloride, it is nontoxic,'has no general anesthetic properties, in noninfiammable, and nonexplosive. In short, it does thework of ethyl chloride without the. danger of. ethyl chloride.
Surgical planing, in the hands of an experienced operator, is a safe and highly effective procedure for treating a number of cutaneous ..defects, most notably pitted acnelscars, a condition :forwhichthere has :not heretofore been a really eifectiveetreatment. I
.Referring .to the drawings "in .more detail, reference character 1 designates a cylindrical :handle that houses a driven shaft-2 and a. refrigerant supply pipe-45 and clutch parts 4am 5 with whic hthereisassociated the flexible tube 3' thathouses the .power driven shaft 6. The flexible tube .3 is readily .manipulatible to disengage the clutch fparts normally "biased .to engaged position for transmitting adriving iforce frornp'ower driven shaft 6 to driven shaft The flexible tube 3 .is formed by a spiral wrapping of a wire having a flat offset -inner flanged surface overlapping the adjoining convolutions so that the convolutions form a flexible housing, .as s'hown'in Fig/23, which may be bent to various angles to enable the surgeon toreadily move the tool to various positions during an operation.
'The structureo'f the spiral wrapping forming the tube 3 is suchithat-even when the tube -is ,bent sharply the flanges of the wire are wide enough to cover the space between convolutions so that nothingcan reach the rotating .wire flexshaft'inside the tube. Theclutch parts 4'and 5 are housed within the handle 1.
Driven 'sha'ft'2 is disposed concentrically within handle 'land'is connected with an extension shaft 15 through a coupling 16 exteriorly of the handle '1, by means of 'a diiferential gear .assembly consisting of idler bevel gears 8,9, '10 and 11 journaled on stub shafts radially extending from the interior of the cylindrical handle 1, where bevel gear"7 carried by shaft 2 meshes with the idler gears and where .the idler gears drive bevel gear '12 connected with tubular shaft 14. The .tubular shaft biased into seated relation with the gaskets 30 and 31 by the valve springs 36 a'nd'37. "The valve stems'32 and 33 are guided in operation in sockets formed in socket members 38 and 39 screw threaded into the lower edge of the header 21. The upper edge of the header is pr vided with screw threaded sleeves 40 and 41 for guiding the screw threaded assemblies into position within the passageways 26 and 27 so that depressible actuators 42 and 43 are aligned with the ends of the valve stems 32 and 33. The coil springs 36 and 37 operating against the disc valves 34 and 35 exertatbias against thealigned ends of the depressible actuators 42 and 43 normally urging the depressible actuators to projected positions with the passage ways through the gaskets '30 and 31 and associated valve seats .28 and .29closed against the passage of refrigerant. However, upon depressing one or both of the depressible actuators 42 and 43 the associated disc .valves .34.and 35 are moved away .from their associated gaskets ,30 .and 31 and seats .28 and29 allowing refrigerant .to flow from the lower sections of .passageways 2.6.and .27 to the upper sections thereof.
Refrigerant issupplied through tube 44 and-45 tothe 3 connection 46 in header 21 and to the transverse passage 14 surrounds the shaft 2 within the handle 1 and is journaled in the header '21 that extends in a plane normal to the axis of the concentric shafts '2 and 14. The header 21 is of suflicient thickness'to house passage ways shown at 26 and 27 for the distribtion of refrigerant through nozzles 49 and 50 as will be described in more detailhereinafter.
The end of extension shaft 15 carries brush 17 as shown. The brush 17 is substantially fiat or disc-like and is formed by stiff radially disposed wire bristles that constitute 'abrading'means for planing the skin of the patient. To increase the efficiency of 'thetool for removing the layer of skin, I'provi'de a secondbrush '20 -operating in a plane immediately adjacent the planeof the brush 17, but operating .in the reverse direction. Brush 20is similar "to "brush '17 'and effects skin planing without tearingthettissue. Thebrush 20 is mounted on tubular "sleeve "18 that couples to tubular shaft 14 through coupling 19. Both couplings 1'6 and '19 are '-formed'by screw threaded connections where the threads 'extend in the direction opposite the direction of rotation of the shafts.
The header 21 has a'hub :forme'd'thereon as shown at 22 which facilitates the connection of the handle 1 to the header '21. 'The 'header 21 provides a'support for the rod' 23 which is clamped in the header by a set screw :2Sin a position aligned with the plane -of-the axis of the concentric shafts 2 and 14. The rod 23 extends over and beyond the two brushes 20 and 17 and carries thereon the shield or guard 24 that encircles a part of the brushes 20 and "17 and catches the particles of skin that are-removed by planing and prevents them from flying about.
flhe passageways for regrigerant-s'hownat 26'and 27 which'distribute refrigerant to the nozzles 49-and50: each include iannular shoulders 26a and 27a which receive valve seats 28 :and 29having valve gaskets 30 and 31 thereon and which are centrally apertured for the passageofzthe valve stems 32 and 33 'as shown. The valve .ing gaskets 51 and 52 which insure a tight seal between the nozzles and the header and yet allows the nozzles 49 and 50 tobe adjusted-in position for directing refrigerant over the area to be treated and immediately below the brushes 17 and20. s
In Figs. .14, 15 and 16 I have shown .a modified form of my invention in which a barrel shaped brush 54.is journaledin a frame. 53 attached to header 21 and driven with respect thereto. The barrel shaped brush 54 is journaled on ,a shaft transverse .to the end of frame 53 and carries a bevel gear.55 adjacentlone endthereof. The bevel gear .55 meshes witha driving bevel gear.56 carried by driving shaft 57 whichzis driven from a connection leading ,to driving shaft.2 ,.and power shaft 6. The barrel shaped brush 54 has the advantage of being able to reach curved contours of the face more readilythan the fiat disc-like brushe 17 and 20 and for'certain operations is to be preferred. Also the fact'that'the barrel shapedbrush 54 rotates atright anglesto the axis of the handle 1 theskindebrisisthrownofithe brush in -a direction which does not obscure the visionof the operator and surgeon who has full view of the .skin areain front of the'brush. The torque'of the brush'in this modified arrangement, tends to pull .the .cutting tool directly away from the operators handinstead of sideways.
In the operation of the device of my invention the flexible tube 44 connects to the refrigerant supply such as Freon and the gas therefrom is directed over the area of the skin on which the planing operation is to be performed immediatelyadjacent the brushes '17, 20, .or 54. A variety of "freezing agents maybe used, such .as l-Freon or similar non-toxic and non-explosive gas which when sprayed on theskin rapidl-yevaporates and freezes the skin. .skin to resemble leather. )1 minute fihn of skin .con-
This freezing reduces flexibility (and causes ,the
have described=my=invention'iin certain "of its prefered embodiments I realize that -modifications may -be made and 'I=desire that itbe understood thatno limitations upon stems 32 and 33 :carry disc valvesfi34-and 3 5-that are :my invention are intended-otherthan'may be-imposed'by the scope of the appended claims. For example,,in lieu of the oppositely driven brushes 17 and 2.0 where brush 17 is driven directly from driven shaft 2 and extension shaft while brush is driven through bevel gear 7 and the differential gear assembly 8, 9, 10 and 11 through bevel gear 12 attached to tubular shaft 14 which connects to tubular sleeve 18 carrying brush 20 which operates in a direction opposite to the direction of rotation of brush 17, I may employ a single disc-like brush, as shown in Figs. 17-22, operated in the area of the gaseous spray from the nozzles. Also, while I have shown an arrangement of two nozzles with separate valve controls I may employ a single nozzle and a single refrigerant spray. My reason for disclosing and explaining the dual arrangement of nozzles and the two separate controls is for the purpose of safety in operation. Should one nozzle spray fail during an operation the patient may still be protected by the operator inasmuch as the second nozzle and spray control is adequate to take over the duty of the dual spray system. Other modifications will occur to those skilled in the art and it is my intent to embrace all such modifications within the scope of my invention. For example, in Figs. 17-22 I have shown a single abrasive brush-type of tool in which the handle 1 is secured to a modified form of header which supports a yieldable bracket 61 on the top thereof having arearwardly extending depressible lever portion 62 which is readily manipulatable by the finger of the surgeon to press the stems 63 and 64 of the two refrigerant control valves designated at 65 and 66. By depressing valve stem 63 and 64 refrigerant supply through tube 45 and flexible tube 44 passes through the transverse passage 67 and is released through the nozzles 68 and 6S? and directed onto the area being treated by the single abrasive brush 70 driven from shaft 71. The shaft 71 is carried in the end of a chuck 72 located within a tapered tube 73 which is held in position in the spray header 60 by set screw 74. The tapered tube 73 is connected to clutch part 5 at 75. The clutch parts 4 and 5 are controlled by pulling or pushing on the spring convolutions of the flexible tube 3 shown more clearly in Fig. 23. The abrasive wheel shaft 71, which is approximately 7 3 in diameter is locked or gripped by the clutch parts by pulling on the convolutions of the spring 3 and released by pushing on the convolutions of spring 3.
The guard or shield in the form of my invention shown in Figs. 17-22 supports the brush 70 against the skin so that the depth of cut may be controlled by the angle at which the handle is held. A single wire member 76 is mounted in the header 60 and is looped upon itself at the end, as shown at 77, partially encircling the brush 70 in a substantially semi-circular frame. A shield 78 of substantially semi-circular contour is mounted within the looped portion 77 of the wire member 76 and serves to catch fragments or particles scraped by the rotating brush 70. The horizontal or transverse portion of the loop 77 serves as a supporting means for steadying the tool against the skin of the patient. The transverse portion of the loop 77 forms a bar about which the tool may be fulcrumed with respect to the skin being treated.
What I claim as new and desire to secure by Letters Patent of the United States is as follows:
1. An abrasive device comprising a rotary driven shaft, a handle for manipulating said shaft, a rotary brush mounted on the end of said shaft and operative over an area to be abraded, a shield device encircling a portion of said brush and supported from said handle, and means controlled from said handle for distributing a spray over the area abraded by said rotary brush consisting of a pair of selectively operated valves connected with a pair of spray nozzles directed toward the area to be treated, said valves being independently controllable for releasing the spray through one or the other of said pair of spray nozzles.
2. An abrasive device comprising a rotary driven shaft, a handle for manipulating said shaft, a rotary brush mounted on the end of said shaft and operative over an area to be abraded, a shield device encircling a portion of said brush and supported from said handle, and means controlled from said handle for distributing a spray over the area abraded by said rotary brush, in which said handle terminates in a substantially flat header disposed in a plane substantially normal to the axis of said handle,
of said brush and supported from said handle,and means controlled from said handle for distributing a spray over the area abraded by said rotary brush, in which said handle terminates in a substantially flat header disposed in 'a plane substantially normal to the axis of said handle,
said shaft extending centrally through said header and wherein said header supports an angularly disposed nozzle adjacent one side of said shaft for distributing the spray,
said nozzle being orientatable to a selected angular posi-.
tion for directing the spray to a predetermined position in the area being abraded, and a spring-actuated valve mounted in said header and connected in the path of said nozzle and operative from one edge of said header for turning the spray on or off.
4. An abrasive device comprising a rotary driven shaft, a refrigerant-carrying conduit, a handle device enveloping said shaft and conduit, said handle device terminating in a header extending in a plane substantially normal to the axis of said shaft, an angularly disposed nozzle mounted in said header, and connected with said conduit and a valve mounted in said header intermediate said nozzle and said conduit for controlling a refrigerant spray from said nozzle and a rotary abrading brush operated by said rotary driven shaft in a position within the area of the spray from said nozzle.
5. An abrasive device comprising a handle member, a
pair of concentrically arranged shafts extending longitudinally of the handle member, means for driving said shafts in opposite directions, brush members located in adjacent planes individual to said shafts and a shield supported from said handle member and enveloping a portion of both of said brush members.
6. An abrasive device comprising a handle member, a pair of concentrically arranged shafts extending longitudinally of the handle member, means for driving said shafts in opposite directions, brush members located in adjacent planes individual to said shafts, a header mounted on said handle member and surrounding said shafts, a conduit for feeding fluid through said handle member terminating in a transverse passage in said header, said header including passages for fluid extending therethrough and connected with said transverse passage, spray nozzles carried by said header and directed toward the area abraded by said brush members and valves controlled from a position exteriorly of said header for interconnecting said nozzles with said passages for distributing a fluid spray from said nozzles.
7. An abrading device as set forth in claim 6 in which said spray nozzles are located in symmetrical positions on opposite sides of said shafts.
8. An abrading device as set forth in claim 6 in which said spray nozzles are each angularly disposed with respect to the axis of said handle member, and means for effecting a fluid-tight connection between said nozzles and said header for any selected setting of said nozzles.
9. An abrading device as set forth in claim 6 in which said valves includevalve stems that are spring biased to closed position and each include a valve actuator slidable predetermined position toward-and away from the-associated spring biased 'valve 1 stem} each valve-' actuator being depressible from a :pro jected positionexteriorly of the -hea'der to a position 'adjacent fone'edgeof said header? 7 -10. An abrading device comprising a rotary driven shaft, a handle formanipulzitingsaid shaft, a rotary brush mounted on-the end of said shaft andoperative over an area' j to be-abr'adedga shield device encircling a portion of said brush and supportedfrom said handle, and means controlled from said handle for-distributin g -a sprayover thearea abraded by- -said-rotarybrush, in which said meanscontrolled 'from said handle fordistributing a spray over the area abradedby 'said rotary brush cornprises'a pair of valve members disposed in a refrigerant distribution path leading to a pair-of. nozzles supported through saidhandle-and means for simultaneously controlling said: valve -members =from a position adjacent said handle.
11. An abrading-device comprising a rotary driven shaft, a handle for.- manipulating :said shaft, a rotary brush mounted onthe' end of said shaft and operative over: an area tobe abraded, a shield device encircling aportion of said brush and supported from-said handle,
andmeans controlled from saidhandle for distributing avspray overthe area abraded by said rotary brush, in which said'shield device consists of a wire member looped upon itself andformingaguard-extendingtransversely 7 oi the front of said rotary =brush.
'semi-circular frame encircling a portion of saidrotary brush and extending in a transverse path across the front of said rotary brush andforming a bearing surface for stabilizing said handleand a semi-circular shield mounted interiorly of said semi-circular frame and around the periphery of said rotary brush.
References Cited in the 'file of this patent UNITED STATES PATENTS 727,736 Basford May 12, 1903 2,012,886 Lowry Aug. 27, 1935 r 2,442,033 Brantly et al. May 25, 1948 2,492,966 I Ckola Jan. 3, 1950 2,532,480 Cannon Dec, 5, 1950 2,712,823 Kurtin July 12, 1955