US 3347227 A
Description (OCR text may contain errors)
Oct. 17, 1967 H. w. HARROWER 3,347,227
WOUND EDGE PROTECTOR Filed Dec. 11, 1964 VEN TOR. HAROLD HARROWER ATTORNEY United States Patent Oflice 3,347,2217 Patented Oct. 17, 1967 3,347,227 WOUND EDGE PROTECTOR Harold W. Harrower, 35 Maple Crest Drive, Smithfield, R.I. Filed Dec. 11, 1964, Ser. No. 417,560 9 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 asurgical wound cavity so as to cover the entire peripheral surface as well as adjacent inner and outer surface portions thereof.
I 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 where in 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.
Various other objects and advantages will become apparentfrom the detailed description to follow.
In the drawings:
FIGURE'l is a plan view of a wound edge protector according to the present invention;
FIGURE 2 is a side elevational view thereof;
FIGURE 3 is a side elevational view thereof in a compressed form;
FIGURE 4 is an end elevational view of the protector shown in FIGURE 1;
FIGURE 5 is a detail sectional view taken substantially along the plane of line 5-5 in FIGURE 4;
FIGURE 6 is a perspective view showing the protector in place in use, with part in section;
FIGURE 7 shows the protector in a folded over form.
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 number of siz s for use in incisions of similar variations in size.
The protector 10 is comprised of a pair of flexible rings 12, 14 joined by a thin sheet 16 of flexible material formed to tubular shape. The rings can be preformed to endless shape or formed by lengths of stock arcuated and joined at their ends, as by clips, not shown. In any event the stock should have sufllcient preforming to give a generally oval shape, 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 and Teflon, by way of example, as being highly suited to the 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, unafliected by autoclaving or sterilization i 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 tubular form of the sheet 16 can be effected by preforming stock to that shape or, preferably, by forming a flat sheet of predetermined width to cylindrical form and sealingly overlapping the ends as at 18, in FIGURE 2. The longitudinal side edges then, respectively, can be folded about the rings and sealed as at 20, in FIGURE 5, to thus provide a unitary structure ready for sterilization and packaging.
For the purpose of packaging, the protector can be compressed with one ring 12 against the other ring 14 as shown in FIGURE 3.
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, subcutaneous 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 soiledwhenever 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. t
The protector of the present invention has been found idea ly suited to the needs of Wounds such as here described.
The wound protector, after the incision is made, 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 its normal form 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 40 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. Thus the upper or outer ring is inverted and positioned within the wound and the plastic sheet is stretched acrOS the center of the wound. FIGURE 7 shows the protector when so folded. 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 de- 3 scribed. 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 cavity and edge'protector comprising a pair of flexible and resilient rings preshaped to arcuate form, a sheet, of flexible material impervious to body liquids and solids and having a thinness such that it will conform closely to the wound surface and being of openended sleeve-like shape having a size such that its end edges can be joined respectively with said rings each end edge of said sheet being joined with a respective one of said rings to provide an endless wall therebetween, one of said rings being compressible and initially insertable into a wound cavity of slightly smaller size than the ring and allowed to expand substantially to its normal form at the base of the cavity, the other of said rings retainable exteriorly of and in a self-retaining manner to overlap the skin edge surface ofthe wound, with the flexible wall protectively covering the entire wound surface.
2. A wound edge protectoras defined in claim 1 With said sheet having a width selected so as to provide a predetermined area between said rings.
3. A wound edge protector as defined in claim 1 wherein the sheet material consists of a transparent, polyvinyl material with each edge of said sheet being folded back upon the sheet and about a respective one of said rings and bonded to the sheet so as to form a unitary structure with the rings.
4. A wound edge protector as defined in claim 1 wherein the thin sheet is a pliable polyvinyl material with each edge of said sheet being folded about a respective one of said rings and bonded to the sheet portion adjacent the respective ring, said tubular form being of pre-selected length and with the sheet having a width selected so as to provide a predetermined area between said rings to facilitate fabrication in a predetermined range of sizes.
5. A surgical wound edge protector as defined in claim 1, wherein the flexible rings, are of endless resilient form,
and the flexible sheet is a transparent polyvinyl material, each edge of said sheet being folded about a respective one of said rings and bonded to the sheet portion adjacent the respective ring, said sheet having a width selected so as to provide a predetermined area between said rings, said sheet Width and material being such that either ring can be inverted in relation to the other ring.
6. A wound edge protector as defined in claim 1 wherein therings are preshaped to a generally oval configuration.
7. A surgical method comprising:
(a) making an incision wound of predetermined size in the body of a patient to produce a surgical cavity,
(b) utilizing an aseptic surgical wound edge protector which embodies a pairof spaced apart, resilient endless ring members interconnecting a flexible walled body having an open tubular form and fabricated of transparent pliable sheet material impervious to body fluids and solids, and of a size slightly larger in circumference than the open incision,
(c) compressing one resilient endless ring member to conform to the general longitudinal dimension of the cavity, (d) inserting the said endless ring member into the base of the cavity, (e) allowing the said ring member to expand substantially to its normal form within the base of the cavity, (f) initially retaining the other endless ring member exteriorly of the surgical cavity, with the flexible open tubular wall portion protectively covering the entire peripheral wound surface in a self-sustaining manner and aiding to hold the cavity open during surgery. 8. A surgical method as defined in claim 7 subsequently including inverting the exteriorly disposed ring member in relation to the first-mentioned ring member while simultaneously compressing and inserting it into the base of the cavity adjacent to the first-mentioned ring member whereby the walls of the protector are disposed contiguously over and serve to hold down the body organs within the cavity thereby facilitating more expeditious suturing of the wound after surgery.
9. A surgical method as defined in claim 8, further including extracting the wound protector from the wound just prior to final suturing.
References Cited 1 UNITED STATES, PATENTS 2,170,060 8/1939 Meyer 229-35 2,335,293 11/ 1943 Meyer 206-4534 2,778,362 1/1957 Pallock et a1 128-283 3,076,458 2/ 1963 Mason 1284-283 3,111,943 11/1963 Orndorlf 128132 ADELE M. EAGER, Primary Examiner.