US 3347226 A
Description (OCR text may contain errors)
Oct. 17, 1967 H. w. HARROWER 3,347,226
ADJUSTABLE WOUND EDGE PROTECTOR Filed Dec. 11, 1964 HAROLD W. HARROWER ATTORNEY United States Patent Office 3,347,225 Patented Oct. 17, 1967 3,347,226 ADJUSTABLE WOUND EDGE PROTECTOR Harold W. Harrower, 35 Maple Crest Drive, Smithfield, RI. Filed Dec. 11, 1964, Ser. No. 417,559 4 Claims. (Cl. 128132) The present invention relates to improvements in surgical wound protection.
An object of the present invention is to provide an improved wound protector wherein an entire surgical wound surface is protectively covered.
Another object of the present invention is to provide an improved wound protector wherein it can be inserted easily into a surgical wound cavity so as to cover the entire peripheral surface as well as adjacent inner and outer surface portions thereof.
Still another object of the present invention is to provide an improved wound protector according to the previous object wherein the space occupied thereby is minimal and the protector is transparent so that the surgeon can see and work as though no protector were in use.
A further object of the present invention is to provide an improved wound protector in accordance with foregoing objects wherein the protector is self-retaining so as to obviate the need for any sutures or other holding devices.
A still further object of the present invention is to provide an improved wound protector which is:
(a) Impervious to moisture, body fluids, bacteria and cancer cells.
(b) Non-irritating to wound surfaces.
(c) Strong but pliable to conform to wound contour and to allow for purposeful distortion of the wound by retractors.
(d) Readily sterilized or is disposable.
(e) Capable of being inverted upon itself so as to cover the organs within the wound to facilitate closure of the wound.
Still another object of the present invention is to provide an improved wound protector which is adjustable to various size incisions.
Various other objects and advantages will become apparent from the detailed description to follow:
In the drawings:
FIGURE 1 is a plan view showing a wound protector according to the present invention;
FIGURE 2 is a side elevational view thereof;
FIGURE 3 is a vertical sectional view taken substantially on the plane of line 33 in FIGURE 1;
FIGURE 4 is a perspective view thereof, partially broken away, and showing the adjusting means;
FIGURE 5 is an exploded perspective view showing a modified form of adjusting means;
FIGURE 6 is a perspective view showing the protector in use, part being cut away;
FIGURE 7 is an enlarged detail longitudinal sectional view through certain of the telescoping adjusting means of FIGURES 1-4.
Referring more particularly to the drawings wherein like numerals apply to like parts throughout, it will be seen that I have provided an improved wound edge protector 10 which can be manufactured in a few different sizes each of which is adjustable for use in incisions of varied size.
The protector 10 is comprised of a pair of flexible rings 12, 14 joined by a thin sheet 16 of flexible material. The rings can be formed by lengths of stock preformed to arcuate shape to give a preselected shape, when ready for use, as viewed in FIGURE 1, yet be resilient and flexible so as to be easily flexed for insertion through a wound opening as will presently be described. There are a number of suitable plastics from which the rings can be made among which I have found nylon, by way of example, as being highly suited to the purpose.
Each of the rings 12, 14 is of a preselected length designed to accommodate a certain range of incision sizes. The ring 12 has its end formed with a reduced diameter section 44 which may be preformed with the stock for the ring or provided by inserting stock of smaller diameter into hollow stock which is used for the ring proper. The opposing end of the ring 12 is hollow to telescopically receive the section 44 therein for adjustment purposes, as shown in detail in FIGURE 7. Of course the ring. 14 is similarly formed for the same purpose.
The thin sheet is preferably made of a plastic which has certain physical and chemical characteristics. The plastic must be impermeable to fluids and bacteria, physiologically inert, unaffected by autoclaving or sterilization in ethylene oxide, free of electrostatic hazard, resistant to melting, non-flammable if touched by cautery, and somewhat elastic. Also, the material must be formable in thin, transparent, and flexible sheets. Polyvinyls are highly suitable plastics for this purpose and have been found in actual tests to fill the requirements set forth.
The sheet 16 can be formed by cutting a flat sheet of selected stock to predetermined width. The longitudinal side edges respectively, are folded about the rings and sealed as at 20, 21 in FIGURE 3, at least along a portion of its length, to thus provide a unitary structure ready for adjusted assembly.
The sheet 16 has a length generally comparable to the length of the rings but the end edge portions 23, 25 at one end are not sealingly wrapped around the rings 12, 14 but are free, as shown in FIGURE 4. Thus, the ends 44 can be telescoped into the cooperative opposing ends of the rings to give the desired size. The sheet transverse free end portion 27 can be overlapped about the opposing end portion and its side edge portions 23, 25 wrapped around the telescoping ring ends. If the size of protector is excessively large, of course the inside end portion 29, as viewed in FIGURE 4 can be transversely cut to eliminate the excess and thus give a higher degree of adjustability.
In a modified form of protector, the rings 12', 14' are non-telescopic. Each of the rings has one end provided with a pair of clips 31, 33 which is bonded or otherwise unitarily formed therewith. The clips 31, 33 have open sides 35, 37 to receive the opposing ends of the rings, as by snapping the same into the clips. The sheet 16' is joined to the rings in the same fashion as above described except the sheet stock does not envelop the clips 31, 33. Adjustment can be effected in an obvious fashion in view of the above description.
For the purpose of packaging, the protector can be compressed with one ring 12 against the other ring 14 as described and shown in my copending application.
In use, the wound protector 10 is especially useful in abdominal incisions. FIGURE 6 shows a portion of a patients abdomen at A with an incision having been made. The layers through which the incision is made include the skin 22, subcut tissue 24, anterior fascia 26, muscle 28 and peritoneum 30. At the incision these layers and the adjacent interior and exterior surfaces 32, 34, respectively, constitute the wound edge. The wound edge is subject to contamination by the hands, retractors or other instruments which must be introduced through the wound opening. The wound edge can be soiled whenever the biliary, intestinal, or genitourinary tracts are opened or a cyst or abcess drained.
In the past, a surgeon has customarily wrapped a laparotomy pad over each side of the wound but this has proved unsatisfactory because the pads become moist, slip out of position and are bulky. Prior alternatives of rubber dam or plastic sheeting have proved unsatisfactory unless sewed to the peritoneum, which takes time.
The protector of the present invention has been found ideally suited to the needs of wound such as here de scribed.
The wound protector, after the incision is made, is adjusted to the size of the incision and is squeezed together so that one of the rings 14 has its longitudinal side portion 36, 38 pressed together. The ring 14 can thus be inserted through the wound opening and allowed to expand to itsv normalform within the wound. The ring 14 will thus be positioned on the inside of the peritoneum 30 over the surface portion 32 as seen best in FIGURE 6. The outer ring 12 will naturally similarly overlap the skin edge surface at 34 and the sheet 16 will contact the entire wound surface and protectively cover the same and seal it from contamination and infection. Obviously, the protector utilizes substantially no space and aids in holding the wound open.
After the surgeon has completed his work in the wound, the wound protector serves an additional important function. The intestines at 46 must be held in when the surgeon closes the wound. To do this, the ring side portion 42 is folded over beneath the other ring side portion 44 to adjacent the ring side edge portion 38 and the portion 44 is folded back over to adjacent the ring side portion 36, as described and shown in my copending application. Thus the upper or outer ring is inverted and positioned within the wound and the plastic sheet is stretched across the center of the wound. The surgeon can then close the wound except for a small end opening through which the protector is extracted and then closing is completed.
By way of information, the thickness of the abdominal wall may vary from one to three inches. Thus the width of the sheet 16 between the rings must be related to this dimension and the ability to be folded over as here described. A width of about four (4) inches has proved satisfactory.
In view of the foregoing it is believed that I have provided a wound edge protector which fulfills the objects hereinbefore enumerated.
As this invention may be embodied in several forms without departing from the spirit or essential characteristics thereof, the present embodiment is therefore illustrative and not restrictive, since the scope of the invention is defined by the appended claims rather than by the description preceding them, and all changes that fall within the metes and bounds of the claims or that form their functional as well as conjointly cooperative equivalents, are therefore intended to be embraced by these claims.
1. A wound edge protector comprising a pair of flexible, resilient rod-like elements, each of said elements being bent to endless ring-like form with the free ends in juxtapOsitiOn, means for releasably joining the juxtaposed ends of each element, a thin sheet of transparent flexible plastic material of a preselected width and of a length generally equal to the length of said elements, said sheet having each of its side edges encircling one of said elements and secured to the sheet along portions of the lengths of said elements, said means including cooperative end formations on each of said elements, one of said end formations being telescopically receivable in the other of said formations of each rod-like element, said end formations of each element including a reduced diameter portion at one end and a tubular portion at the opposing end.
2. A wound edge protector comprising a pair of flexible, resilient rod-like elements adapted to be bent to ring-like form, means for releasably joiningthe ends of each element, a thinsheet of transparent flexible plastic material of a preselected width and of a length generally equal to the length of said elements, gsaid sheet having each of its side edges encircling one of said elements and secured to the sheet along portions of the lengths of said elements, said means including cooperative end formations on each of said elements, one of said end formations being telescopically receivable in the other of said formations of each rod-like element, said end formations of each element including a reduced diameter portion at one end and a tubular portion at the opposing end, said side edges of said sheet along the remaining portions of said rod-like elements being free to wrap around the opposing ends of the rod-like elements, said remaining portions being coextensive with said reduced diameter portions of said rod-.
3. A wound edge protector comprising a pair of flexible.
resilient rod-like elements, each of said elements being bent to endless ring-like form with their free ends in juxtaposition, means for releasably joining the juxtaposed tions of the lengths of said elements, said side edges of said sheet along the remaining portions of said rod-like elements being free to wrap around the opposing ends of the rod-like element, said means including cooperative end formations on each of said elements, one of said end formations being telescopically receivable in the other of said formations of each rod-like element, said end formations of each element including a reduced diameter porition'at one end and a tubular portion at the opposing en 4. A wound edge protector according to claim 3 wherein said means includes clips carried by said end portions of the elements attached to releasably grip the opposing end portions thereof. 0
References Cited UNITED STATES PATENTS 2,170,060 8/1939 Meyer 229-3.5 2,294,589 9/1942 Waterbury 128463 X 2,335,293 11/1943 Meyer 20663.2 2,446,437 10/1948 Schoebel 128-471 2,511,641 6/1950 Kuhn 128-463 2,558,414 6/1951 Blackman 2-49 2,778,362 1/1957 Pollack et 'al. 128-283 2,809,632 10/1957 Von S0sdy 128-136 3,076,458 2/1963 Mason 128283 3,111,943 11/1963 Orndorif 128132 ADELE M. EAGER, Primary Examiner.