US 3416532 A
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Dec. 17, 1968 A; R. GROSSMAN DRAINAGE TUBE WITH MEANS FOR SCRAPING AWAY DEBRIS THEREWITHIN Fild July 24, 1964 INVEN TOR. ALA/V RICHARD GROSS/MAN ATTORNEY 3,416,532 DRAINAGE TUBE WITH MEANS FOR SCRAPING AWAY DEBRIS THEREWITHIN Alan Richard Grossman, 9201 Sunset Blvd., Los Angeles, Calif. 90069 Filed July 24, 1964, Ser. No. 384,918 3 Claims. (Cl. 128350) ABSTRACT OF THE DISCLOSURE A drainage tube is described made of bendable material, such as plastic, so that the whole tube is flexible. The tube is formed of two sections, an outer section with a distal end which is closed and with perforations adjacent this end. The outer tube is sufiiciently long so that its proximate end extends outside of a patients body when the tube is inserted for drainage. This end is open to the atmosphere. An inner tube of smaller diameter fits into the outer tube and forms therewith an annulus. The distal end of the inner tube, which can extend near to the distal end of the outer tube, is open and is cut ofi so that there are relatively sharp edges. If desired, it may be cut beveled to increase the sharpness of one of the edges. The length of the inner tube from distal end to proximate end is greater than that of the outer tube, and at its proximate end it is attached to a suction fitting so that a partial vacuum can be applied. The small inner tube can be removed and it or a replacement reinserted without touching the tissues of the patient; and if there is any plugging of the perforations near the distal end of the outer tube, the inner tube may be moved up and down and its relatively sharp edges at its distal end serve to scrape out debris or other material plugging the perforations in the outer tube. As the annulus between inner and outer tubes is open to the atmosphere, there is no vacuum applied to the tissues of the patient through the perforations and there is, therefore, no risk of sucking tissue in through the perforations, with resulting pain and clogging.
Background of the inventionv In the past drainage tubes have been used very extensively both to drain out such exudates as pus in abscesses and the like and drainage from surgical operations. It is normal to leave drainage tubes in the body cavities after surgical intervention or to introduce drainage tubes into such things as abscesses and the like. The distal end of the tube has perforations and theoretically the pressure of muscles, as the patient moves somewhat, is supposed to cause the exudate from the wound, or other site to be drained, to flow out. This has proven to be of limited value in cases where there is not sufiicient movement of the patient and it is easy for an ordinary drainage tube to clog up.
An improvement has been developed and used for many years in which the drainage tube is double walled with perforations in the outer wall of the tube which has a closed distal end, and an inner tube which extends out of the drainage tube into a connection to a source of suction. The suction permits removal continuously of the fluids which are to be drained, and has proven more satisfactory. However, it still has certain drawbacks. Thus it is still possible for the distal end of the inner tube to be clogged either by coagulation of fluids such as blood or pieces of tissue becoming lodged. When this occurs the tube has to be removed, which is almost always quite a painful procedure requiring the intervention of the surgeon, and a new drainage tube is inserted which is also painful; in effect the procedure might be considered as a minor operation. Not only is there pain and addi- United States Patent tional surgical intervention but in many cases it is undesirable to create the possibility of further irritation and introduction of infection.
Summary of the invention Essentially in the present invention there is a closed end outer tube with perforations adjacent its distal end just as in the ordinary suction drainage tube but the central tube is removable and the other end of the outer tube is open. This results in two important advantages. One, air can be drawn in between the outer tube and the inner tube which tends to discourage clogging of the perforations and if nevertheless clogging does occur, the inner tube can be removed without any pain to the patient, and by moving it up and down its end tends to scrape off clots, pieces of tissues and the like and then a new tube can be reinserted. All of this is effected without irritation and pain to the patient and does not require surgical intervention as it can be performed by any reasonably technically skilled person such as a nurse.
It is also possible to use quite a small inner tube because if its open distal end clogs it can be withdrawn, whereas in the one piece drainage tube formerly used the inner tube must be large enough so that its distal end will not be likely to clog and this in turn requires a larger outer tube which means that there is alarger opening remaining in the patient. This is particularly undesirable if the tube has to be inserted, for example into an abscess without surgically opening up the patient. It is not as important in the case of a drainage tube from an operation as in the latter case the tube is inserted before the opening is sewed up. Nevertheless the smaller the tube which will reliably operate, the better, and so the possibility of a much smaller size is of value even if the tube is used for drainage after a surgical operation.
Not only does the drainage tube of the present invention provide for improved reliability and elimination of unnecessary painful removal from the patient, but it is actually cheaper for the sealing in of the inner tube, which was necessary before it can be dispensed with and the inner tube can be of ordinary tubing which is made in great lengths and simply cut off at the length desired. Similarly the perforated outer tubing which is sealed at the distal end may also be made in various lengths and the excess length cut oif where not needed. Thus a single size permits use in various situations where the length of the drainage tube may vary.
When the inner tube is cut off initially or subsequently in long lengths, the distal end has relatively sharp edges even if the tube is cut straight across. It should be understood that the edges are only relatively sharp and are not sharp in the sense of a knife or other surgical instrument. If desired, and this is a preferred embodiment, the distal end of the inner tube may be beveled so that at its beveled end there is an even sharper edge. These relatively sharp edges tend to scrape otf debris which may have clogged the perforations near the distal end of the outer tube, and the debris may be sucked out through the inner tube or if it should be large enough to clog the distal end of the inner tube, the latter can be removed and reinserted. The cutting or scraping off of debris is effected without the moving inner tube contacting the tissues of the patient and is, therefore, substantially painless, and debris, such as clots and cells, which may plug the perforations should not be confused with the sucking in of tissue which actually occurred in the past when the drainage tubes were subjected to vacuum, which tended to pull tissues into perforations at the distal end of the drainage tube. This can be quite painful.
FIG. 1 illustrates, in a somewhat diagrammatic manner, a drainage tube installed in a patient, and
FIG. 2 shows part of the tubes in section.
Description 07 the preferred embodiments The patients skin surface is shown at 1 with the outer tube 2 penetrating into the patient, sealed at its distal end 3 and provided with perforations 4. An inner tube 5 with a. slant-cut distal end 6 and a proximate end which extends into a plastic adaptor 7 which can be attached to a source of suction shown on the drawing as rubber tubing 8. The inner tube is shown extending down to the distal end of the outer tube but of course it may have its distal end somewhat above the closed distal end of the perforated tube and this is often desirable. When suction is applied air flows in around the inner tube through the annulus between the tube and the proximate end of the outer tube and blood or other exudate which penetrates the perforations 4 is sucked up through the central tube 5. This is shown in the drawings with appropriate arrows.
If clogging of the perforations takes place the inner tube is moved in and out and the slanted edge of its distal end tends to scrape off clots or other clogging of the perforations. This operation can be carried out by the nurse and does not pain the patient because the movement of the inner tube is inside the outer tube and there is no movement in contact with the sensitive tissues of the patient. If the inner tube clogs, it is completely removed and a new one substituted. This also requires no surgical intervention, does not produce pain in the patient and can be carried out by hospital personnel such as nurses. Needless to say the proper aseptic environment must be maintained.
The simple inner tube shown in the drawings, which will normally be of suitable plastic, is ordinarily satisfactory for most drainage operations. Where, however, very severe clogging is anticipated and particularly where it is highly undesirable to irritate the patient by removing the outer tube, it is possible to provide the distal end of the inner tube with a hardened projection such as metal so that it will scrape off clots from the perforations when withdrawn. Ordinarily this is not necessary because the distal end of the ordinary inner tube is cut with relatively sharp edges which are suflicient for removing debris in most cases but such special inner tubes are not excluded from the present invention.
1. A flexible drainage tube made of readily bendable material for draining fluids and suitable for placement in a body cavity, said drainage tube having a flexible outer tube with a closed distal end provided with perforations adjacent thereto, the tube being of sufficient length so that its proximate end extends beyond the body cavity into the atmosphere, and an inner tube extending into the outer tube and removable therefrom, said inner tube being of bendable material and having an open ended tip at its distal end with relatively sharp edges at the open end of the tip and length sufficiently longer than the outer tube to extend substantially beyond the proximate end of the outer tube, said inner tube being of sufficiently smaller external diameter than the internal diameter of the outer tube so that an annular passageway is formed between the two tubes and this annular passageway communicates with the atmosphere at the proximate end of the outer tube, which protrudes from the body cavity, whereby moving the inner tube within the outer tube causes the relatively sharp edges of its distal end to scrape off debris accumulating in the perforations of the distal end of the outer tube.
2. A drainage tube according to claim 1 in which the open ended tip at the distal end of the inner tube is provided with a beveled cutting edge for scraping oif the debris from the perforations of the outer tube when the inner tube is moved therein.
3. A drainage tube according to claim 1 in which the proximate end of the inner tube outside of the outer tube is provided with a detachable fitting.
References Cited UNITED STATES PATENTS 985,865 3/1911 Turner 128--278 X 2,525,329 10/1950 Wyzenbeek 12s 347 2,614,563 10/1952 Devine' 128276 2,642,873 6/1953 Rice 128-347 DALTON L. TRULUCK, Primary Examiner.
US. Cl. X.R. l28276