US 3000378 A
Description (OCR text may contain errors)
Sept. 19, 1961 s. A. ZIEMAN LIMB COMPRESSION SLEEVE Filed Nov. 26, 1957 IN VEN TOR 5TE HE/V HZ/E/I/H/V BY 6 ATTORNEY United States Patent 3,000,378 LIMB COMPRESSION SLEEVE Stephen A. Zieman, Mobile, Ala., assignor to S. H. Camp 8: Company, Jackson, Mich., a corporation of Michigan Filed Nov.26, 1957, Ser. No. 698,945 3 Claims. (Cl. 128165) The invention relates to surgical compression devices and particularly pertains to an elastic limb sleeve for control of swelling.
In many instances after radical mastectomy, lymphedema of the adjacent arm occurs because of the surgical trauma, ligation of various vessels, and the removal of lymph glands in the axilla. Stasis of the blood-vascular and lymph flow results in dilation of these vessels with accumulation of fluid in the tissue spaces. Swelling of the extremity and water-logging of the subcutaneous tissues result, and is proportionate to the accumulated fluid. This is known as lymphedema, and reversion to the normal state without therapy is not possible. It is imperative therefore in controlling lymphedema to establish new lymphatic drainage routes, bypassing the obstructed, damaged area. This is accomplished by means of implanting strands of nylon suture material subcutaneously, which create tissue channels through which the edema fluid may drain unimpeded. In order to facilitate the flow of the edema fluid into unobstructed channels of the patients body, the extremity is elevated. An elastic compression of the arm. throughout its length from hand to axilla facilitates the flow of lymph in the right direction, obliterates the dilated tissue pools and vessels, prevents as well as corrects the fibromatosis which lymphedema invariably causes in the extremity. Normally, the hand and arm would be elevated at'night, and retained under compression during the day when the limb is pendant and affected by the pull ofgravity. It is, thus, an object of the invention to provide a limb sleeve which will effectively compress the limb to control lymphedematous swelling during activity.
Another object of the invention is to provide an elastic arm sleeve which may be easily adjusted to enclose a wide variety of arm or leg sizes and which may be adjusted to regulate the compression of the sleeve irrespective of the limb size.
A further object of the invention is to provide an elastic arm sleeve which will remain in place during extensive movement of the arm, which will neither slide down from the upper shoulder portion, or work up from the wrist.
Yet another object of the invention is to provide a compression limb sleeve which is comfortable to wear, may be put on unassisted by the wearer, and which is provided with a detachable half mitten for controlling swelling of the hand or foot.
These and other objects of the invention will become apparent when viewed with regard to the following description and accompanying drawings wherein:
FIG. 1 is an elevational view of the sleeve of the invention as used on the left arm of a patient illustrating the inside of the arm and sleeve;
FIG. 2 is an elevational view showing the outside of the arm and sleeve;
FIG. 3 is a partial view illustrating the shoulder piece affixed to the upper portion of the sleeve.
FIG. 4 is directed to the wrist cuff detail, and
FIG. 5 is a view of the half mitten used with the sleeve.
The sleeves of the invention are made either for the right or left arm, and as the components and relationship of the arm, shoulder, and sleeve are the same for either arm, the following description of a sleeve for the left "ice arm would suflice for a right sleeve as well. It will be understood that although the illustrated embodiment of the invention is directed toward an arm sleeve, a similarly constructed sleeve may be made for the leg to control swelling, and it is intended that such a leg sleeve,
be Within the purview of the invention.
Basically, the sleeve '10 consists of a tubular portion extending the full length of the arm. The sleeve is preferably composed of Kiddie elastic cloth which will stretch in a transverse direction around the arm and is stitched with a dart 12 at the outside of the sleeve at the elbow, facilitating bending of the arm. As seen in FIG. 1, sleeve '10 is held together by a lacing 14 extending the entire length thereof, forming a part of the periphery. Reinforcing eyelet strips 16 aresewn to the elastic, and are provided with eyelets through which the lack-ing 14 is threaded. -A tongue or shield 18 is affixed to the underside of one of the eyelet strips 16 within the sleeve 10, note FIG. 4, to enclose the entire circumference of the arm, protecting the wearer from direct contact with the lacing. A zipper may be incorporated into the opposite side of the sleeve to facilitate unassisted application by the wearer.
A shoulder piece 20 is affixed to the upper portion of the sleeve 10 for the purpose of preventing the sleeve from working downward due to extensive movements of the arm. Shoulder piece 20 extends up over the wearers shoulder, FIG. 3, and is-he1d in place by an adjustable elastic band 22 extending transversely to the length of the sleeve circumscribing the upper chest of the wearer. 'Ihe, sleeve 10 is'thus firmly held in position at the upper portion of the arm Where swelling may be first to occur; Sleeve 10 is provided at the lower periphery with a wrist cuifreinforcing strip 24 in which arelocated button holes 26 for a purpose that will be apparent later.
As swelling of the hand often accompanies enlargement of. the arm after radical mastectomy, anelastic half mitten 28 is attached to the sleeve 10 providing compression of the palm and heel of the hand. As illustrated in FIG. 5, the mitten 28 is substantially cylindrical in its free form, composed of elastic cloth, and provided with a thumb hole 30 in the seam 32. The mitten is bound at the top and bottom edges to prevent unraveling and buttons 34, five in the illustrated embodiment, attached to the upper edge. The buttons 34 cooperate with holes 26 to aflix the mitten 28 to sleeve 10 whereby insertion of the arm within sleeve 10 will also draw the mitten 28 on the hand. Of course, the mitten may be attached to the sleeve by any conventional means such as a slide fastener, etc., buttons being shown only by way of illustration.
The sleeve is used in the following manner: the lacing 14 is unloosened and the elastic band 22 is unfastened. The arm is usually held in an elevated position and thrust into the shoulder end of the sleeve 10, care being taken to avoid excessive wrinkling or displacing of tongue 18. The arm is inserted into sleeve 10 until the wrist cufl? strip 24, contacts the wrist portion adjacent the hand, at such time the hand will be encased in the half mitten, 28, the thumb projecting through hole 30, and the fingers through the bottom of the mitten. The lacing 14 may now be drawn as tight as practical, placing the elastic under tension and compression the arm. The lacing is then tied to maintain the desired compression. It is recommended that the lacing 14 be threaded through eyelet strips 16 so that the knot or bow of the lacing be located at the top of the sleeve under the armpit, preventing the bow and excess lacing from interfering with the wearers hand. Where the zipper is employed, the lacings are no longer used except to tighten the sleeve as the arm decreases in size during the day. The shoulder piece 20 is then adjusted on the shoulder and the band The arm may now be lowhalf mitten 28 may be drawn on the hand after the sleeveis secured on the arm. In such case, the mitten is drawn on the hand separately and buttoned to the sleeve after the sleeve is positioned. This sequence of assembly is especially advantageous where difliculty is encounteredin placing the hand within the mitten. The half mitten 28 being on the hand, will naturally become soiled sooner than the main portion of sleeve 10, and by making the mitten detachable, laundering is easily accomplished.
When used to control lymphedema of the leg, a similarly constructed sleeve may be used, the difference in construction only being that necessary to accommodate the physical difierences between arms and legs, the lacing preferably being located at the rear of the leg; In place of the shoulder piece, means may be carried by the leg sleeve permitting vertical support by a garter belt and an elastic foot encompassing sleeve may be aflixed to the bottom of the leg sleeve to control swelling thereof in a manner similar to half mitten 28.
It is thus seen that the elastic limb sleeve of the invention will elfectively maintain an arm and hand or leg and foot in any desired compression to control lymphedematous swelling. The lacing permits a given model of sleeve to be used with a wide variety of sized limbs; may be put on by the wearer unassisted; and may be adjusted during the day as muscular exercise reduces the limb swelling throughout the day.
1. A compression sleeve to be worn following the Zieman Needle Lymphangioplasty for controlling lymphedema comprising an elongated arm encompassing portion adapted to enclose the entire length of the arm, said arm portion consisting of elastic cloth expandable transversely to the length of said arm portion, lacing extending the length of said arm portion constituting a portion of the periphery thereof whereby the circumference of 4 said arm portion may be varied along the length and a shoulder piece afiixed to one end of said arm portion having a shoulder overlying portion adapted to engage the shoulder of the wearer and a band affixed to said shoulder piece extending transversely to the longitudinal length of the sleeve for encompassing the upper chest region of the wearer thereby maintaining said end of said arm portion adjacent said shoulder.
2. A compression sleeve to be worn following the Zieman Needle Lymphangioplasty for controlling lymphedema comprising an elongated arm encompassing portion adapted to enclose the entire length of the arm,
said arm portion consisting of elastic cloth expandable transversely to the length of said arm portion, lacing extending the length of said arm portion constituting a portion of the periphery thereof whereby the circumference of said arm portion may be varied along the length, a shoulder portion affixed to one end of said arm portion adapted to overlie the shoulder of the wearer, a band alfixed to said shoulder portion extending transversely to the length of the sleeve for encompassing the upper chest region of the wearer, fastening means affixed to the other end of said arm portion and an elastic hand compression portion attached to said arm portion by said fastening means.
3. A compression sleeve to be worn following the Zieman Needle Lymphangioplasty for controlling lymphedema as in claim 2 wherein said hand compression portion comprises a tubular sleeve of elastic cloth formed with finger and thumb openings.
References Cited in the file of this patent UNITED STATES PATENTS 932,066 Smith Aug. 24, 1909 1,117,077 Mooney Nov. 10, 1914 1,287,870 Burk Dec. 17, 1918 1 1,488,379 Chaflee Mar. 25, 19% 2,280,025 Bollinger Apr. 14, 1942 2,904,792 Elliott Sept. 22, 1959