US 3881477 A
A hollow tubular member of endless configuration in plan, defines an access opening or window and is supported at a level above a suitable supporting surface for the body of a patient. Conduits are provided for delivering into the hollow member, a constant flow of fluid at super atmospheric pressure, the fluid being at a controlled temperature and humidity and fully sterilized and, if desired, having a suitable medicament entrained therein. The member is formed with a first series of substantially contiguous fluid discharge ports, surrounding the access opening and discharging the fluid as a continuous, upwardly directed, convergent fluid shield over and around the access opening and is formed with a second series of substantially contiguous, downwardly directed fluid discharge ports, discharging the fluid as a downwardly directed fluid shield, also completely surrounding the access opening.
Description (OCR text may contain errors)
United States Patent [1 1 Von Otto May 6,1975
[ FLUID DISCHARGE APPLIANCE FOR MAINTAINING A STERILE ENCLOSURE  Inventor: Robert E. Von Otto, Washington,
 Assignee: Henry E. Nichols, Washington, DC.
 Filed: Aug. 7, 1973  Appl. No.: 386,350
 U.S. Cl. 128/132  Int. Cl. A61! 13/00  Field of Search 128/132, 66, 1, 191 A;
Primary ExaminerRichard A. Gaudet Assistant Examiner-J. C. McGowan Attorney, Agent, or FlrmWatson, Cole, Grindle & Watson  ABSTRACT A hollow tubular member of endless configuration in plan, defines an access opening or window and is supported at a level above a suitable supporting surface for the body of a patient. Conduits are provided for delivering into the hollow member, a constant flow of fluid at super atmospheric pressure, the fluid being at a controlled temperature and humidity and fully sterilized and, if desired, having a suitable medicament entrained therein. The member is fonned with a first series of substantially contiguous fluid discharge ports, surrounding the access opening and discharging the fluid as a continuous, upwardly directed, convergent fluid shield over and around the access opening and is formed with a second series of substantially contiguous, downwardly directed fluid discharge ports, discharging the fluid as a downwardly directed fluid shield, also completely surrounding the access openmg.
8 Claims, 6 Drawing Figures PMENTEDHAY BIBYS SHEET 10F 3 Fig. 2
PATENTEDHAY Ems SHEU 3 OF 3 l FLUID DISCHARGE APPLIANCE FOR MAINTAINING A STERILE ENCLOSURE This invention relates to improvements in a surgical appliance of the type disclosed in my prior US. Pat, No, 3,692,024 for application to a living body to maintain a surgical operating field or a burn or other area of the body, completely isolated from the surrounding atmosphere by means of a fluid shield.
In accordance with the disclosure of my said prior US. Pat. No. 3,692,024, the said appliance was conformingly supported on and adhesively secured to the patients body in fluid tight engagement therewith to prevent access of atmospheric air and airborne particles to the surgical field, between the appliance and the said body. This necessarily prevented access to the surgical field between the appliance and the patients body and to some extent, delayed rapid removal of the appliance in the case this were desirable to facilitate prompt recovery of surgical instruments, swabs, clamps or the like, inadvertently dropped into the incision. Also, the physical contact of the appliance with the patients body detracted from the utility of the appliance for protecting burned areas of the body.
In accordance with the present invention, an appliance of the same general nature, as that disclosed in the said patent, has been improved so as to avoid the necessity for contact thereof with the patients body. Further, it may be supported in spaced relation above the patients body to permit rapid access to an incision or burned area, either through an access opening in the appliance or through the space between the body and appliance, while still maintaining a sterile enclosure which completely isolates the said area from outside air and airborne foreign particles.
It is further an object of the invention to provide in such an appliance, an improved arrangement of fluid discharge ports, for directing jets of fluid in a manner to form a protective shield or shields which leave no openings, particularly at the base or roots of said jets through which external air might be permitted to enter or induced to flow into the shielded enclosure.
SUMMARY OF THE INVENTION With the foregoing considerations in mind, the appliance of the present invention comprises a hollow tubular member of endless configuration in plan surrounding an access opening which is defined by the said member, together with means for delivering into the member a constant flow of sterile fluid at super atmospheric pressure. The member is formed with a first series of substantially contiguous, upwardly and inwardly directed fluid discharge ports, completely surrounding the access opening and discharging the fluid as a continuous convergent fluid shield over and around such opening. A second series of substantially contiguous, downwardly directed discharge ports are formed in the member for discharging fluid as a continuous, downwardly directed fluid shield, completely around the access opening, thereby to define a completely enclosed space around such opening, between said member and either the patients body or a surface such as a hospital bed or operating table on which the body is supported.
It will be understood that during use of such a memher, the same may be supported in any suitable manner or by any suitable means at a predetermined level in spaced relation above the supporting surface and the living body to which it is applied.
An additional feature of the invention as employed in the preferred embodiment consists in forming each series of the fluid discharge ports by inner and outer rows of slots, opening outwardly from the hollow interior of the member to the atmosphere, wherein the slots of the outer row are closely adjacent and in staggered or overlapping relation with the respective slots of the inner row.
DETAILED DESCRIPTION OF THE INVENTION To promote an understanding of the invention, reference will now be made to the preferred embodiment thereof, illustrated in the accompanying drawings, and specific language will be used to describe the same. It will nevertheless be appreciated that no limitation of the scope of the invention is thereby intended, such further modifications and alterations being contemplated as would normally occur to one skilled in the art to which the invention relates.
IN THE ACCOMPANYING DRAWINGS FIG. 1 is a perspective view of a surgical appliance, per se in accordance with the preferred embodiment of the invention, the air or fluid supply conduits being shown fragmentarily and the direction of flow of the fluid streams or jets defining the respective fluid shields or curtains, being indicated diagrammatically by arrows.
FIG. 2 is a section on the line 2-2 of FIG. 1.
FIG. 3 is an enlarged detailed section, generally similar to FIG. 2, but with parts broken away.
FIG. 4 is a side elevation of the appliance and its supporting means as actually used in connection with the body of a surgical patient supported on a conventional operating table, the said patients body being illustrated in broken lines.
FIG. 5 is a plan view of the construction shown in FIG. 4; and,
FIG. 6 is a general perspective view of a modified embodiment of the invention.
Referring now in detail to the accompanying drawings, and first considering FIGS. 3 and 4, the reference numeral 10, designates in its entirety the surgical appliance of the invention in the form of a hollow tubular member, of endless or closed configuration in plan, defining and surrounding an access opening 12 and supported by a suitable bracket or frame 14 (FIGS. 4 and 5), at a predetermined level in spaced relation above the body of the patient which in turn, is supported on a generally horizontal supporting surface 15, exemplified by a conventional operating table. It will be noted that the member is supported in a generally horizontal plane, spaced somewhat above both the surface I5 and the patients body, with its central access opening 12, located above and in substantial registry with the particular area of the body which constitutes or includes the surgical field or the burned or damaged area to be shielded and protected by the appliance.
Any suitable means may be employed for thus supporting the member 10, though for purposes of illustration, the said means comprises a rigid rectangular frame 14, supported in a horizontal plane by a rigid supporting arm 16, adjustable horizontally through the sleeve 18 of a T-fitting, the perpendicular tubular sleeve 20 of which is supported on the upper end of a suitable vertical standard 22, having a supporting base 24.
By means of set screws 26 and 28, threaded through the respective sleeves 18 and 20, horizontal and vertical adjustment of the supporting bracket 14 are attainable and also it will be apparent that rotation of the frame to the desired angular position may be attained by loosening the set screw 28 and swinging the bracket 14 to the desired angular position about the vertical axis defined by the standard 22, then retightening the set screw. Such a frame 14 and its associated supporting and positioning means, merely exemplifies any of a number of suitable means for thus supporting the appliance of the present invention in any of various desired operative positions.
Turning now to a more detailed consideration of the member 10, in the preferred embodiment, the same is illustrated as constituting a rectangular and preferably rigid frame, which may conveniently be formed of a transparent plastic material to permit an optimum view of the surgical field.
Means in the form of flexible conduits 30 are provided for delivering into the hollow interior of the member 10, a constant flow of a selected sterile fluid, at super atmospheric pressure. It will be understood that the conduits 30, all communicate with any suitable source of such fluid, as for example filtered and sterilized air which is preferably maintained at a preselected temperature and humidity and which normally constitutes the only fluid which is permitted to contact the operating field or other area which is to be shielded and protected by the appliance of the invention. It is desirable that there be such a plurality of fluid supply conduits communicating with the member at relatively spaced locations, to thus achieve a substantial equalization of the flow rates and volumes of the various discharged jets of fluid.
A portion of the fluid which is thus delivered into the hollow tubular member 14 is discharged through a first series of substantially contiguous, inwardly directed discharge ports 32, completely surrounding the access opening or window 12 and arranged to discharge the fluid at a multiplicity of rapidly flowing streams or jets A, issuing from the respective ports and immediately merging to define a contiguous, upwardly directed and convergent fluid shield over and around the access opening 12.
A second series of substantially contiguous, downwardly directed discharge ports 34 is directed downwardly from the member for discharging the fluid from the hollow interior of the member in the form of a series of contiguous streams or jets B which merge immediately following their issuance from the respective ports to define a further fluid shield extending completely around the access opening. By virtue of the yieldability or deformability of the shield thus defined, it will be manifest that the same, when directed in a manner to impinge against the patients body and/or the supporting surface 15 there around will conform completely to the configuration thereof and will establish and maintain a complete unbroken shield or barrier between the member 10 and the body and/or surrounding surface 15 to prevent entrance of outside air and airborne particles to the area enclosed by this shield.
Although the size of the appliance or member 10 as herein illustrated is comparatively small, so that the downwardly directed air curtain, jointly defined by the airjets B issuing through the ports 34 and diagrammatically indicated by the arrows B in FIGS. 1 to 4 inclusive, will normally impinge against the patients body, it will be apparent that by substantially increasing the size of the member 10, the resulting downwardly directed air curtain or fluid shield B may be caused to impinge against any supporting surface on which the patients body B rests, as for instance the surface of the operating table 15 or a hospital bed, in a manner to surround the body without impinging thereon. In such event, it will be readily apparent that the downwardly directed fluid shield B, together with the upwardly directed fluid shield A and the tubular member 10 will jointly cooperate, either with the patients body and/or with the surface on which said body is supported, to define a completely enclosed volume which is protected and shielded from the external air and any airborne solid or liquid particles which might otherwise enter the operative field or the burned area on the body.
For enhancing the protective action of the two fluid shields defined by fluid jets A and B, it is desirable, though not essential, to provide the member 10 with a further or third series of substantially contiguous, upwardly and outwardly directed fluid discharge ports 36, externally of and surrounding the series of ports 32 and directed so that the jets of fluid merging therefrom will be contiguous and will merge to define a continuous fluid shield or barrier, as depicted by the arrows C in FIGS. 1 through 4, inclusive. This outer fluid shield or barrier C tends to supplement the shielding action of the conical inner shield or barrier A.
It has been found that where the fluid discharge ports, such as 32 of a particular series, comprised but a single row of such ports, no matter how closely spaced, the upwardly convergent jet streams A issuing through these ports may tend to induce a slight flow of air from the outside, inwardly to the protected area through the spaces between adjoining slots, at the roots of the respective fluid jets A, before these jets have had a chance to fully merge, thus contaminating the surgical field. In order to prevent such ingress of exterior air, it has been found desirable, therefore, to form each of the series 32, 34 and 36 of ports, in the manner best illustrated in FIG. 3, as a double row, or in other words as inner and outer parallel rows of slots in which the slots of one row are closely adjacent and in staggered relation with the respective slots of the other row. With this arrangement such induced inflow of exterior air is positively prevented.
Although the member 10 in the present exemplification has been illustrated as of polygonal configuration, specifically being in the form of a rectangle, and adapted to define an upwardly convergent fluid shield of generally pyramidal form, it may obviously be of any suitable closed or endless configuration, having ports arranged to define a suitable conical or pyramidal canopy over the access window or opening 12, as well as a conformingly shaped fluid shield there beneath.
in the present instance, the second downwardly directed fluid shield, defined by the ports 34, preferably diverges outwardly away from the center of the surgical field, and is thus particularly adapted to divert dust on other particles away from the surgical field.
in the use of the appliance of the invention, the member 10 will normally be supported by the vertical and laterally adjustable supporting bracket or frame 14 in somewhat spaced relation above the body of the pa tient on the bed or operating table 15, with the access window or opening 12 of the member in substantial vertical registry with the portion of the patients body which constitutes the surgical field or burned area to be shielded and treated by the appliance.
The member 10 is then supplied through the conduits 30 with filtered sterilized air or other fluid at the desired temperature, humidity and pressure, from any suitable conventional supply source, (not shown). It is desirable that the fluid which passes through the member 10 is humified to prevent dehydration of the incision, burn or wound within the surgical field and further, if desired, any suitable medication may be entrained within the said fluid. Manifestly, such medication will be deposited onto and around the surgical field by the discharged air stream or jets A and B.
It will be apparent that the surgeons hands may readily pass through the fluid barriers or shields defined by fluid jets A and B and thence through the window or access opening 12 within the member 10 to the operating field. During passage through the fluid shields, the surgeons hands and any instruments or objects will be washed and cleansed by the sterilized fluid from which the shields are formed. Moreover, because of the complete isolation of the operating field by the air shields or curtains, it is made possible for the surgeon to dispense with the usual face mask, without endangering the patient. The breath of the surgeon and the various attendants as well as foreign particles, resulting from talking, sneezing, coughing, etc., as well as airborne dust particles, will be barred and diverted from the operating field in the first instance by the outer shield or barrier C and any particles which might penetrate said barrier are still completely isolated from the operating shield by the pyramidal fluid shield A.
It is important to note that because of the complete disengagement or lack of contact with the patients body of the appliance or member 10, the same is particularly adapted for use in protecting burned areas on the patients body, as well as for maintaining the same under ideal, sterile conditions, with a controlled degree of humidity to promote rapid healing. Also, by virtue of the invention, medicines may be delivered directly onto the burned area by entrainment in the fluid supply, without the necessity for manual application in usual manner.
Moreover, where the member or appliance 10 is supported in spaced relation above the patients body as in the present invention, there is provided an increased freedom or access to the burned area or incision by virtue of the fact that the doctors or surgeons hands may be inserted between the patients body and the appliance. This is particularly desirable in the event it should become necessary, rapidly to retrieve a surgical tool, clamp or the like which may inadvertently have dropped into an incision during the course of an operation.
Also, the fact that the appliance need not be adhesively secured to the patients body facilitates both its application to and removal from the body and in particular, facilitates its rapid removal, if for any reason this should be necessary.
In the modified embodiment of the invention, as illustrated generally in FIG. 6, the supporting surface 15', of rectangular configuration, is provided by a conventional bed, and the member 10' is of similar configuration, proportioned so that its side and end portions overlie the corresponding edge or peripheral portions of the surface 15'. As thus arranged, the member 10' will normally surround or enclose a burned patient's body, supported on the surface 15' of the bed, and will 5 provide a protective fluid shield or curtain completely around and over the body, it being understood that the fluid discharge ports (not shown) in the member 10' will be arranged and will function in substantially the same manner disclosed in the preferred embodiment.
The words over, above, upwardly and horizontal are employed in the foregoing detailed description, not in an absolute or technical sense, but merely to indicate relative geographical orientation of the respective components, it being realized that under appropriate circumstances, the surface on which the patient's body is supported and therefore the appliance itself may be vertically inclined or in fact more nearly vertical than horizontal, in which event it should be understood that the terms upwardly and above indicate simply the relationships of the components to the supporting surface as a reference plane.
Having thus described my invention, 1 claim:
1. A surgical appliance for application to a living body to maintain a protective fluid shield for isolating an area of said body from the surrounding atmosphere, comprising: means defining a supporting surface for said body; a hollow tubular member of endless configuration in plan surrounding an access opening and supported at a level above said surface; means communicating with said member for delivering into said member a constant flow of fluid at super atmospheric pressure; said member being formed with a first series of substantially contiguous upwardly and inwardly directed fluid discharge ports, completely surrounding said access opening and discharging said fluid as a continuous, upwardly directed and convergent fluid shield over and completely around said access opening; said member being formed with a second series of substantially contiguous, downwardly directed discharge ports for discharging said fluid as a continuous, downwardly directed fluid shield completely around said access opening.
2. A surgical appliance as defined in claim 1, wherein said member is formed with a third series of substantially contiguous upwardly and outwardly directed fluid discharge ports, surrounding said first series of fluid discharge ports and discharging said fluid as a continuous, upwardly directed, supplemental fluid shield around said opening.
3. A surgical appliance as defined in claim 1 in which said supporting surface is of rectangular configuration, and said member is of similar configuration, above and in substantial registry with the periphery of said surface.
4. A surgical appliance as defined in claim 2, wherein each said series of discharge ports is defined by inner and outer adjoining rows of slots, establishing communication between the interior of said member and the atmosphere, the ports of said respective rows being closely adjacent and in staggered relation with each other.
5. A surgical appliance as defined in claim 1, wherein said member is of rigid construction.
6. A surgical appliance as defined in claim 5, wherein said member is of transparent material.
7. A surgical appliance as defined in claim 1, wherein the means for delivering into said member a constant flow of fluid, at super atmospheric pressure, comprises a plurality of fluid supply conduits, communicating with the interior of said hollow member at relatively spaced locations, whereby to substantially equalize the rate of discharge of fluid through the respective slots.
8. A surgical appliance as defined in claim 1, wherein said member is of rigid construction and of polygonal