US 3385299 A
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May 28, 1 968 P. L. LE ROY 3,385,299
WOUND CLIP Filed Oct. 1965 United States Patent Olfice 3,385,299 Patented May 28, 1$68 3,385,299 WQUND CLIP Pierre L. Le Roy, Wilmington, Deh, assigrlor to New Research and Development Laboratories, Inc, Wilmington, Del., a corporation of Delaware Filed Oct. 23, 1965, Ser. No. 563,039 2 Ciaims. (Cl. 128337) ABSTRACT OF THE DISCLOSURE A wound clip includes a hollow housing which is open at one end for receiving a slidable ratchet therein. The housing and the ratchet include tines which are adapted to be inserted into the skin on opposite sides of the wound. The housing also includes a pair of slots for receiving a spring which has a pair of free ends to engage in the ratchet and thus hold the ratchet in place. The spring is in the form of a loop which may be compressed to spread the ends and release the ratchet while still being held in the housing slots.
T his invention relates to a clip for use on wound flaps, particularly to such clips which may be used in place of sutures.
One of the most important considerations during surgery is the element of time. With conventional procedures, for example, much time is spent in suturing wound flaps or in closing the flaps with non-adjustable metal clips. This time expenditure contributes to causing surgeon fatigue. This is particularly important when considering for example that an hour may be spent in closing a scalp wound. The element of time is even more important during drastic surgery and in emergency cases as may be encountered during wartime in battlefields.
There is accordingly a definite need for easy operable wound clips which are readily adjustable and may be easily applied and removed whereby the clip can replace sutures and other conventional clips. The search for such an ideal wound clip has been carried out extensively for many years. U.S. Patent No. 268,632 which issued in 1882 is an example of one such attempt at providing the ideal wound clip. That patent relates to a clamp which includes a slidable ratchet member controlled by a single leaf spring or spring-pawl. For various reasons, however, this clamp did not meet acceptance in the art. Other attempts followed the eiforts of Patent No. 268,632, but none of these previous clips were able to completely fulfill the above indicated needs.
An object of this invention is to provide an easily operable wound clip which satisfies the above indicated needs.
A further object of this invention is to provide such a wound clip which is simple enough in structure so as to be disposable, without adverse aifect to its reliability of operation.
In accordance with this invention the wound clip is in the form of a main body and a sliding member. Both the body and the sliding member have opposed tines which may be easily inserted into the wound area. The clip also includes a control element which engages the sides of the sliding member to accurately regulate the distance between the tines on the body and on the sliding member. This control element may be a spring having a pair of free ends engaging ratchet teeth on the sliding member so that the sliding member may be moved in only one direction. The intermediate portion of the spring may advantageously be a loop which is normally wider than the body, so that opposed portions of the loop can be squeezed together to release its ends from the ratchet. The body may advantageously be wedge shaped with its sides converging toward the tines to facilitate the placement of a plurality of these clips in juxtaposition to each other.
Novel features and advantages of the present invention will become apparent to one skilled in the art from a reading of the following description in conjunction with the accompanying drawings wherein similar reference characters refer to similar parts and in which:
FIG. 1 is an assembly view of one embodiment of this invention;
FIG. 2 is a perspective view of the embodiment of the invention shown in FIG. 1 in its assembled condition;
FIGS. 3 and 4 are a top plan view and an end view, respectively, of the embodiment of this invention shown in FIG. 2;
FIG. 5 is an end view of another embodiment of this invention; and
FIG. 6 is a plan view of a plurality of the clips shown in FIG. 5.
As shown in FIG. 1 wound clip 10 includes a hollow fiat body .12, a sliding member 14, and an increment control spring 16. The outer member or body 12 is rectangular in cross section for receiving inner ratchet member 14. Additionally, body 12 includes a pair of spring registry slots 18 and its lower surface has a pair of tines 26 (only one of which is shown in the drawings).
Sliding member 14 has teeth 22. As best shown in FIG. 3 teeth 22 have a and a 45 angle cut so as to permit the teeth to slide past the free ends 24 of spring 16 when member 14 is slid into body 12, but to prevent withdrawal of member 14 from the body.
In operation, tines 2% on body 12 and tines 26 on sliding member 14 are introduced for example approximately one-half to three-quarters of an inch from the wound edge with the clip 1i detached in two parts. For secure attachment the tines 20 and 26 are inclined toward each other. Once firm anchoring of the soft tissue has been accomplished ratchet 14 is introduced into body 12 and the clamp or clip 10 is closed gently. This makes for an extremely rapid and flexible application and quickly results in closed wound area, of for example, one square inch.
Advantageously, spring 16 includes a loop which is wider than body 12. Accordingly, withdrawal of sliding member 14 from body 12 may be easily accomplished by simply compressing or squeezing opposed portions of the spring loop together to release the legs 24 in registry slots 18 from the teeth 22 of ratchet 14. This reduces the tension on the ratchet 14, and ratchet 14 and body 12 may be then gently manually removed.
The ease of application of clip 10 is a particularly notable feature. Even with the handling of parts which are Wet with serous or hemorrhagic fluids in and around a fresh wound, the parts can be handled precisely and a rapid, firm application can be done quite easily without prior training,
Adjustability for closure is an extremely important feature since elasticity of tissue is unique to each operating problem. The ratchet feature provides gentle or firm approximation as the surgeon desires. Additionally, the disposition of spring ends 24 on opposed sides of sliding member 14 assures that the sliding member will remain in its desired location in contrast for example to an arrangement in which a locking member or spring engages a sliding member at only one location.
Another important consideration is that following the insertion of the wound clamp, the wound is covered with bulky dressings. The flatness or curved contour of clip 10 against the skin, has made for patient comfort even while lying with body pressure directly on clips 10. All of these desired results are accomplished with cosmeti- 3 cally acceptible closures, even in cases where the clip 10 has been reused.
The ease of application of clip 10 is also such that medical personnel under civilian or military conditions would be able to close the skin and subcutaneous sections of wounds without special training, thus freeing the surgeon for the more technical problems of the operation itself.
The simplicity of clip 10 makes it particularly adaptable to be disposable. In this instance the clip can thus be made of any clinically acceptable disposable material such as any of the available plastics. Even spring 10 may be made of a disposable plastic material. When it is desired to reuse the clip it may be made of, for example, stainless steel. Of course, the body 12 and sliding member 14 may additionally be molded of nylon, Delrin, Lucite, polyethylene, polypropylene or any other clinically acceptable plastic in which the tines 20, 26 can be anchored in the molded members by any conventional means.
The particular dimensions for the various elements of clip 10 would of course be determined by the particular desired use. One such example of acceptable dimensions is in forming the body member A by /2 by A3 inch, with sliding member 14 being 1% by by A inches and with inch tines set at an angle of 30 inclined toward the clip body. Care should be taken to allow ample clearance between inner member 14 and body 12 to prevent jamming with clotted blood and tissue debris. Advantageously, tines 20, 26 may be constructed of 16 gauge piano wire and silver soldered to the appropriate member.
FIGS. -6 show a particularly advantageous embodiment of this invention. As indicated in FIG. 5 the cross section of body 12a and sliding member 14a is wedge shaped or trapezoidal with its sides converging toward the tines 26a. This wedge shape of clips a permits a plurality of these clips to be disposed in juxtaposition to each other along an arc, as shown in FIG. 6. This close arrangement of clips 10a is facilitated because the tines and lower corners of each clip are disposed a further distance from the tines and lower corners of the adjacent clip whereby the clips do not interfere with each other despite their close proximity.
Obviously, many modifications and variations of the present invention are possible in the light of the above teachings. It is, therefore, to be understood that within the scope of the appended claims the invention may be practiced otherwise than as specifically described.
What is claimed is:
1. A Wound clip comprising a hollow housing open at one end, a sliding member inserted in said housing, said member having teeth on opposite sides thereof to form a pair of ratchets, a spring member, said spring member being in a form of a loop having a pair of free ends inverted downwardly from said loop, a pair of slots in said housing, said free ends of said spring being inserted in said slots and engageable with said ratchets to prevent said sliding member from sliding in said housing, opposed tines on said housing and said sliding member for engaging on opposite sides of a wound, and said slots being of such a width with respect to said ratchet and said free ends of said spring whereby said loop may be compressed to spread said free ends and free said member for slidable movement in said housing while still maintaining said free ends of said spring in said slots.
2. A wound clip as set forth in claim 1 wherein said housing and said sliding member are wedge shaped each having a wider top surface than its respective bottom surface.
References Cited UNITED STATES PATENTS 215,956 5/ 1879 Miller 24-206 268,632 12/ 1882 Danforth 128-337 3,068,869 12/ 1962 Sheldon et a1 128-337 FOREIGN PATENTS 26,624 1904- Great Britain.
717,256 10/ 1954 Great Britain.
DALTON L. TRULUCK, Primary Examiner.