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Publication numberUS3926185 A
Publication typeGrant
Publication dateDec 16, 1975
Filing dateDec 12, 1974
Priority dateDec 12, 1974
Also published asCA1061211A, CA1061211A1, DE2542856A1
Publication numberUS 3926185 A, US 3926185A, US-A-3926185, US3926185 A, US3926185A
InventorsHenrietta K Krzewinski
Original AssigneeJohnson & Johnson
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Surgical drape
US 3926185 A
Abstract
A fenestrated surgical drape for use in orthopedic and related surgery comprising a flexible and unitary sheet having a main portion and two adjacent wing portions whose inner edges, preferably spaced a small distance from each other, define therebetween an elongated slit or gap. The slit merges into a fenestration which is located generally inwardly of the perimeter of the drape. One of the two wing portions has a flap-like sheet which, after the drape has been applied to a patient, covers at least a portion of the length of the slit and lies beneath the other of the wing portions. An extremity, e.g., a leg, extends through the fenestration during surgery.
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Description  (OCR text may contain errors)

United States Patent 11 1 Krzewinski 1 Dec. 16, 1975 1 1 SURGICAL DRAPE [75] Inventor: Henrietta K. Krzewinski, Old Bridge, NJ.

[73] Assignee: Johnson & Johnson, New

Brunswick, NJ.

22 Filed: Dec. 12, 1974 211 App]. No.: 532,282

Primary Examiner-Lawrence W. Trapp [57] ABSTRACT A fenestrated surgical drape for use in orthopedic and related surgery comprising a flexible and unitary sheet having a main portion and two adjacent wing portions whose inner edges, preferably spaced a small distance from each other, define therebetween an elongated slit or gap. The slit merges into a fenestration which is located generally inwardly of the perimeter of the drape. One of the two wing portions has a flap-like sheet which, after the drape has been applied to a patient, covers at least a portion of the length of the slit and lies beneath the other of the wing portions. An extremity, e.g., a leg, extends through the fenestration during surgery.

The drape is preferably reinforced in the areas adjacent the fenestration and the slit and carries means for holding surgical tubing or electrical wires. The drape also is provided with clipping tabs for securing the drape in its desired position during surgery. The drape is readily foldable into acompact unit which permits it to be easily and quickly unfolded and applied to a patient prior to surgery.

30 Claims, 27 Drawing Figures Sheet 2 0f 4 US. Patent Dec. 16, 1975 U.S. Patent Dec .16,19 75 sheet om 3,926,185

U.S. Patent Dec.16,1975 Sheet40f4 3,926,185

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K //Z/ fF SURGICAL DRAPE FIELD OF THE INVENTION The present invention relates broadly to surgical cover means. In particular, the invention relates to new and improved surgical drapes of the type which comprise a flexible sheet having a main portion and wing portions whose inner edges define a slit or gap which extends inwardly from an outer edge of the drape. Such drapes are especially useful in orthopedic surgery and similar surgical procedures.

In preparing for orthopedic and related surgery it is common practice to cover the patient and operating table with a sterile drape, or drapes, in such a way that only the limb (or portions of the limb) on which surgery is to be performed is presented to the surgeon and his assistants.

DESCRIPTION OF THE PRIOR ART One drape that has been provided for orthopedic and similar surgery comprises a sterile sheet having a main portion and an elongated gap extending outwardly from a central region thereof to an outer edge to provide two spaced wing portions. Such drapes are fre quently referred to as split sheet drapes.

One draping procedure for using these drapes involves raising the patients limb and putting it through the gap in the sheet in such a way that, when the draping is completed, the limb on which the operation is to be performed extends through the gap and lies on the upper surface of the main portion of the drape. The wing portions of the drape are then disposed to overlie parts of the patients body at a region adjacent the operative site.

It is necessary, of course, to insure that a sterile surgical field be provided at the outset of the surgical procedure and that the integrity of the sterile field be maintained until the surgical procedure is completed. In order to establish the sterile field and to prevent the contamination thereof in the event the wing portions of the split sheet should slip or be accidentally moved during surgery, it has been found necessary, prior to placement of the split sheet, to cover the patient with an auxiliary surgical drape. The auxiliary drape is placed over that portion of the patients body which will underlie the gap in the split sheet when the latter has been positioned.

In commonly assigned patent application entitled Surgical Drape filed on even date herewith, which patent application is hereby incorporated by reference, there is disclosed a surgical drape of the split sheet type in which a flap-like sheet is attached to at least one of the wing portions of the drape. During surgery, this flap-like sheet covers the slit or gap in the drape and eliminates the need for the use of auxiliary drapes, thus reducing the number of drapes that need to be handled by the operating room staff. However, such a drape, i.e., a split sheet drape with a flap-like sheet attached to one of its wing portions, still presents some difficulties. For example, the wing portions may accidentally slip relative to one another during surgery; such slipping causes the drape to undesirably bunch up upon itself and indeed, in an extreme case, the wings could be separated to such an extent that the patients body and/or other drapes or the like could be exposed to contamination. Another difficulty with the drape disclosed in the aforesaid commonly assigned patent application is that no means are provided for securing surgical tubing, electrical wires and the like to the sur' face of the drape in a position where they would be prevented from interfering with the surgical procedure at hand, yet be readily accessible when needed during surgery.

It is therefore an object of the present invention to eliminate bunching or accidental movement of the wing portions of a split sheet drape by providing means for securing the wing portions in a closed, substantially fiat position during surgery.

It is another object of the present invention to provide means for securing items such as surgical tubing and the electrical wires of monitoring devices to the surface of the drape in a position where they will be conveniently accessible when needed and yet will not unduly interfere with the surgical procedure.

SUMMARY OF THE INVENTION In accordance with the present invention there is provided an improved surgical drape for use in orthopedic and similar surgery which eliminates the aforementioned difficulties. The drape of the present invention simplifies the draping procedure, saves valuable time, reduces costs, eliminates bunching of the wing portions, and provides means for securing auxiliary tubing and electrical lines to the surface of the drape.

The improved drape of the invention comprises a flexible unitary sheet, suitably of a plastic film or a woven or nonwoven fabric, having a main portion and two wing portions. The inner edges of the wing portions define an elongated gap or slit which extends inwardly of the drape from an outer edge thereof and joins a fenestration located generally inwardly of the perimeter of the drape. Attached to one of the wing portions, preferably at the inner edgethereof adjacent the slit, is a flap-like sheet of woven, nonwoven, plastic or similar material which, when the drape is in use, covers a substantial portion of the length of the slit, and lies beneath the second of the two wing portions.

Means (referred to as clipping means) are provided on the drape for securing the wings of drape in their desired flat, wrinkle-free position during surgery. The clipping means, as will be seen hereinafter, may comprise relatively small tabs of material affixed in hingelike fashion to the upper surface of the drape. Prior to use, the clipping tabs lie flat in a position generally overlying the upper surface of the drape. During use the tabs are extended upwardly from the surface of the drape. Adjacent, upwardly extending tabs are brought into contact with each other and secured together by any convenient means. Thus secured, the clipping tabs prevent bunching and/or accidental lateral movement of the wing portion of the drape.

The surgical drape of the present invention also comprises at least one tubing holder affixed at a suitable location on the upper surface of the drape. A tubing holder, as will be seen, is a relatively small piece of material made from e.g., a nonwoven fabric or a piece of plastic. The tubing holder must have at least one opening therein. Surgical tubing, electrical wires or like materials may be threaded through the tubing holder which then holds the tubing in its desired position on the surface of the drape.

BRIEF DESCRIPTION OF THE DRAWINGS The aforementioned and other advantages of the present invention will become apparent upon reading 3 the following detailed description and upon reference to the drawings in which:

FIG. 1 is a top plan view, with portions cut away, of one embodiment of the surgical drape of the present invention, wherein the flaplike sheet attached to one wing portion is shown in a position underlying the second wing portion, and the clipping means are shown in their flat position overlying the upper surface of the drape;

FIG. 2 is a cross-sectional view taken along lines 2-2 of FIG. 1;

FIG. 3 is a perspective view of the surgical drape of FIG. 1 showing the flap-like sheet in a folded position overlying the wing portion to which it is attached;

FIG. 4 is a cross-sectional view taken along line 44 of FIG. 3;

FIG. 5 is a perspective view of the surgical drape of FIG. 1 showing the flap-like sheet attached to one wing portion in an extended position and with the other wing portion turned back to expose its under surface;

FIG. 6 is a detailed view in perspective of a portion of the drape of FIG. 1 showing the clipping means in their upwardly extended position;

FIG. 6a is a cross-sectional view taken along line 6a-6d of FIG. 6;

FIG. 7 is a View similar to FIG. 6 showing the tabs comprising the clipping means in an off-set position with respect to each other;

FIG. 7a is a plan view of the tabs in their offset position;

FIG. 7b is an enlarged fragmentary view showing an alternative placement of one of the tabs comprising the clipping means;

FIG. 70 is an enlarged fragmentary view wherein the clipping means comprise an elongated tab attached to one of the wings and a cooperating strip of pressure sensitive adhesive, protected by a release sheet, attached to the other wing;

FIG. 8 is a top plan view ,of another embodiment of the surgical drape of the present invention wherein the fenestration is lined with a soft elastomeric lining material;

FIG. 8a is a cross-sectional view taken along line 8a8a of FIG. 8;

FIG. 9 is a top plan view of the surgical drape of FIG. 1 with its flap-like sheet shown in a folded position on the upper surface of the drape and showing in broken lines the fold lines for the longitudinal folding of the drape;

FIG. 10 is an enlarged cross-sectional view taken along line 10-40 of FIG. 9;

FIG. 11 is a perspective view showing the drape of FIG. 9 after the wing portions have been folded longitudinally;

FIG. 12 is a perspective view showing the drape of FIG. 9 after the longitudinal folding thereof has been completed;

FIG. 13-17 are perspective views showing the sequence of steps in draping a patient for leg surgery with the drape of FIGS. 9-11;

FIG. 18 is a plan view, with parts in perspective and with portions cut away, of another embodiment of the drape of the present invention wherein the wing portions are extended transversely to form a T-shaped drape having covers for the armboards of an operating table;

FIG. 19 is a plan view of the drape of FIG. 18 with the flap-like sheet folded and overlying the wing portion to which it is attached and showing one of the armboard flaps in a folded position overlying the armboard cover to which it is attached;

FIG. 20 is a cross-sectional view taken along lin 2020 of FIG. 19;

FIG. 21 is a plan view of the drape of FIG. 18 with its flap-like sheet, armboard covers, and armboard flaps in a folded position and showing the fold lines for completion of the longitudinal folding of the drape; and

FIG. 22 is an enlarged fragmentary view, with portions cut away, of the upper left hand portion of the drape of FIG. 18.

DETAILED DESCRIPTION OF THE INVENTION While the invention will be described in connection with its preferred embodiments, it will be understood that it is not intended to limit the invention to those embodiments. On the contrary, it is intended to cover all alternatives, modifications and equivalents as may be included within the spirit and scope of the invention as defined by the appended claims.

Referring more particularly to FIGS. 1-5, which show one embodiment of the present invention, surgical drape 10 comprises a flexible sheet 11 made from a single piece of a suitable drapable material such as a woven or nonwoven fabric or a plastic film. Preferably, the material is a drapable nonwoven fabric, such as a scrim reinforced tissue or a wet-formed nonwoven containing long fibers. Even more preferably, sheet 11 comprises a nonwoven fabric that has been treated according to known methods to render it liquid repellent. Flexible sheet 11 comprises a main portion 12 at the lower end thereof, and a pair of spaced wings 20 and 30 at the upper end thereof. The perimeter of the drape comprises opposed sideedges 16 and 17 and lower edge 15.

Wing portions 20 and 30 are integral with, and extend outwardly from, main portion 12. Wing portion 20 has an inner side edge 24 and an upper edge 26. Correspondingly, wing portion 30 has an inner side edge 34 and an upper edge 36. The upper edges of the wing portions define the upper edge of the drape.

Drape 10 has a slit 45 which is defined by the adjacent inner edges of the wing portions and which extends from the upper edge of the drape inwardly to a generally central portion thereof. The slit has a first, or open end, which communicates with the outer edge of the drape. The other end of the slit merges into an enlarged or widened fenestration 50 which, in the illus trated embodiment, is shaped in the form of a teardrop. It will be understood that the precise configuration of the fenestration is not critical and may be varied if so desired. The fenestration is located generally inwardly of the perimeter of the drape but its precise location is not critical. It is preferred that the fenestration be centered from sides 16, 17 of the main sheet. The position of the fenestration with relation to the top and bottom ends of the drape is not critical. In one commercial embodiment of the drape of FIGS. l-S, the main sheet is about 114 inches long, this length being sufficient, when the drape is in use, to cover both an adult patient and the anesthesia screen. In this embodiment, fenestration 50 is about 15 inches long, with point 50 on the curved portion thereof being about five feet from bottom edge 15 of the main sheet. It will be understood that the above mentioned dimensions are for purposes of illustration only; these dimensions may be changed, for example, to provide a drape which is adapted for a particular kind of surgery or which is tailored to fit a child about to undergo surgery.

Inner side edge 34 of wing portion carries a flap of drapable material, which, as illustrated in FIGS. 1 and 2 may be folded across slit to lie beneath wing portion 20.

Flap 40 has a lower edge 41, an upper edge 42, and side edges 43 and 44. The lower and upper edges of flap 40 are substantially equal in length and are sufficiently long so that, when the flap is extended crosswise of the drape to cover slit 45 and lie beneath wing 20, edge 43 of the flap lies slightly beyond edge 17 of the main sheet. It will be understood the length of the flap along its upper and lower edges may vary considerably from the dimensions shown in FIG. 1. The objects of the present invention are achieved if flap 40 is long enough along its upper and lower edges to cover slit 45 and lie beneath at least part of wing 20. Referring especially to FIG. 1, it is seen that the length of the flap along side edges 43, 44 is somewhat less than the length of slit 45. Flap 40 extends along inner edge 34 from a point inward of upper edge 36 of wing 30 to a point near where slit 45 merges into fenestration 50.

The particular part of wing 30 to which flap 40 is attached is not critical, provided, of course, that the flap can be arranged, when in use, to lie beneath wing 20. Preferably, however, flap-like sheet 40 is attached to wing 30 at or near its inner side edge 34, since a minimum amount of material is thus required and unnecessary bulkiness in the folded drape is eliminated. As illustrated in FIG. 2, flap 40 is fastened, along a narrow line adjacent its side edge 44, to the lower surface of wing 30 a slight distance from its inner side edge 34. This is conveniently accomplished by stitching (not shown in the drawings), but other fastening means, such as an adhesive, may be employed if so desired. Other acceptable ways of affixing flap 40 to wing 30 are illustrated in the aforementioned US. patent application.

Drape 10 has a reinforcing panel 60 secured to the upper surface of the main street. In the preferred embodiment, the reinforcing panel is positioned inwardly of the perimeter of the drape and extend inwardly to the edges of fenestration and to the edges of a por tion of slit 45. The reinforcing panel may comprise one or more layers of the same material used for the main sheet. Preferably, however, the reinforcing panel has an absorbent upper surface 61 and an impervious plastic film 62 between the absorbent surface and the main sheet of the drape. The reinforcing panel can be se cured to the upper surface of the main sheet by any suitable securing means well known to those skilled in the art, an adhesive being preferred, however, over stitching for this purpose. It will be recognized that the reinforcing panel, which provides increased abrasion resistance and an absorbent surface in the areas surrounding the fenestration, need not be used if such qualitites are not required.

Means (hereinafter referred to as clipping means) are provided on the upper surface of the drape so that,

during actual use, the wings thereof are maintained in a flat, wrinkle free position and are prevented from mov ing laterally with respect to each other. The clipping means as illustrated in FIGS. 1-5 comprise cooperating, generally rectangular, flexible tab-like structures 65 that can be easily fabricated from the same material used for flexible sheet 11 or from any other suitable woven, nonwoven or plastic sheet material. As best seen in FIG. 2, each tab is secured to the drape in hinge-like fashion by gluing a part of it between sheet 11 and impervious layer 62 comprising the reinforcing panel. The remaining portion of each tab then lies (prior to use of the drape) in a position overlying absorbent surface 61 of the reinforcing panel.

Where there is no reinforcing panel, or where the tabs are positioned beyond the region where slit 45 is bordered by the reinforcing panel, the tabs would be attached directly to the wing portions of the drape. As seen in FIGS. 1 and 2, a tab is attached to each wing portion at the inner edge thereof.

Prior to use, the clipping tabs lie flat on the upper surface of the drape (See FIG. 1). During use the clipping tabs are extended upwardly and joined together (see FIGS. 6 and 6a), for example, with surgical clamps, whereby the wing portions are securely held in position. It will be recognized that when the clipping tabs are in their upwardly extended positions, a portion of one tab must be able to come into contact with at least a portion of the other clipping tab. In other words, one tab may be offset with respect to the other (see FIGS. 7 and 711), but not to such an extent that the tabs will be unable to come into mutual contact with each other.

Furthermore, it will be understood that the wing portions of the drape can be effectively secured during use by placing the cooperating clipping tabs at any of several positions on the upper surface of the drape. Preferably, as shown in FIG. 1, the clipping tabs are attached, one on either side of slit 45, relatively near the point where slit 45 merges into fenestration 50. This arrangement is quite advantageous because the clipping means then serve not only to secure the wings during use but also to draw the edges of fenestration 50 snugly around a limb protruding through the fenestration. Thus, the limb is surrounded by drape material and the portion of the limb to be incised is effectively isolated. Additional sets of cooperating clipping means may be used on the drape if desired.

Other ways of positioning the clipping tabs to achieve the aforementioned desirable results will be apparent to those skilled in the art. For example, one of the tabs 65 may be secured to flap-like sheet 40 near the inner side edge 34 of wing 30 and the other tab may be secured to wing 20 near its inner side edge 24 (See FIG. 7b). Similarly, the shape of the exposed portions of the tabs may be varied, e.g., semi-circular tabs may be used if desired.

Referring to FIG. 7c, there is illustrated another form of clipping means that may be used to secure the wings in place during use of the drape. The clipping means comprise an elongated tab 66 of flexible material attached to the drape near inner side edge 34 of wing 30 and a cooperating strip of pressure sensitive adhesive 67 adhered to wing 20 adjacent its inner side edge 24. The pressure sensitive adhesive is protected prior to use of the drape by a suitable release sheet 67'. After the wings of the drape have been positioned on the patient, release sheet 67 is removed, thus exposing pressure sensitive adhesive 67. Tab 66 may then be folded across slit 45 and pressed into sealing engagement with the pressure sensitive adhesive. Thus the wings may be quickly and conveniently secured in abutting relationship and the edges of the fenestration can be drawn snugly around the limb protruding therethrough.

The drape is provided with at least one, and preferably two, tubing holders 70. The tubing holders are rectangular pieces of a woven or nonwoven fabric or plastic sheet material, and are typically about 2-6 inches long and l-3 inches wide. Each tubing holder has a flexible portion which is free of the rest of the drape and which has at least one opening therein for securing flexible members such as surgical tubing, elec trical lead wires and the like in position on the upper surface of the drape (see FIG. 8). In the preferred embodiment, the tubing holders are attached to the wing portions adjacent the upper edge of the reinforcing panel and each tubing holder has two circular openings 71 therein.

FIG. 8 illustrates a modification in which the perimeter of fenestration 50 is lined with a soft elastomeric film. Film 75 lies substantially in the major plane of the drape and allows adjustment and conformation of the fenestration to the limb surrounded by the drape. The film lining the fenestration can be made from an elastomen'c material such as, for example, synthetic or natural rubber. As seen in FIG. 8a, film 70 is preferably attached in the regions adjacent the edges of the fenestration by gluing it in place between sheet 11 and reinforcing panel 60. It will be understood that the film lining the fenestration must not interfere in any way with the continuity of slit 45. As seen in FIG. 8, opposed edge portions 76 and 77 of film 70 actually define what might be described as an extended portion of slit 45. Typically, the film would extend about an inch or two inwardly from the edges of the fenestration.

FOLDING OF THE DRAPE Drapes of the present invention may be folded into a compact unit which facilitates handling during packaging and storage and which permits the drape to be easily and quickly applied to the patient prior to surgery.

As used herein a forward fold is a fold in which the upper surface is turned toward the upper surface of the drape around a fold line. A reverse fold is a fold in which the upper surface of the drape is turned toward the bottom surface of the drape around a fold line. In the drawings, the letter R indicates a reverse fold and the letter F indicates a forward fold. The numbers preceding the letters F and R refer to the order in which the folding is done.

The preferred method for folding drape from end to end is illustrated in FIGS. 9-12. As seen in FIGS. 9 and 10, flap 40 is initially fan-folded to form a stack of folds overlying wing 30. The folds may be any convenient size and number, but, as illustrated, the folds are preferably arranged so that edge 43 of flap 40 lies between the sides of the stack of folds formed by the flap.

The wings (with flap 40 in folded position overlying flap 30 as explained above) are folded next.

A part of wing 30 adjacent upper edge 36 thereof is reverse folded around fold line 1R. Thereafter wing 30 is forward folded around fold line 2F, reverse folded around fold line 3R, and forward folded around fold line 4F. It will be observed that fold line 3R intersects the drape substantially at the point where slit 45 merges into fenestration 50 and that fenestration 50 lies generally between fold line 3R and fold line 4F. This folding of wing 30 (including its associated flap 40) provides a stack A of folds which overlies a generally central portion 59 of the drape lying between fold line 4F and fold line 8F. Wing is then folded in the manner just de- 8 scribed for wing 30 to provide a stack B of folds which also overlies central portion 59. FIG. 11 shows drape 10 after it has been folded in accordance with the above described folding procedure. It will be noticed that slit 45 is exposed to view at the upper central portion of the partially folded drape.

Main portion 12 of the drape is folded next. Bottom portion 58 is reverse folded around fold line 5R. The main portion is then forward folded around fold line 6F, reverse folded around fold line 7R, and forward folded around fold line 8F. This folding sequence provides a stack C of folds overlying stacks A and B of folds and results in the elongated, longitudinally folded unit illustrated in FIG. 14.

Each end of the drape in the elongated, partly folded form shown in FIG. 14 may then be folded, toward the center, to give a final compactly folded drape. Although an ordinary fan-fold is suitable for this purpose, it is preferred that a modified fan fold be used. The term fan-folded refers to a folding sequence in which the material being folded has alternate forward and reverse folds. The term modified fan-fold refers to a folding sequence which is similar to a fan-fold but in which the first two folds thereof are of the same type. An example of a modified fan fold sequence is forward, forward, reverse, forward etc.

Thus, the transverse folding of the drape as shown in FIG. 14 is begun from side edge 16 with a forward fold. The second fold is likewise a forward fold while the third fold is a reverse fold. The forward and reverse fold sequence may subsequently be repeated until the desired degree of compactness is obtained. The transverse folding of the drape from side edge 17 toward the center is accomplished in the same manner.

In the drape of FIG. 11, the distances between fold lines IR and 2F, between fold lines 2F and BR, and between fold lines 3R and 4F are substantially the same. The distance between the fold lines, and the resulting number of fabric layers in the folded drape, is not particularly critical and may be varied according to the degree of compactness required or desired in the folded drape. In any event, the distance between fold lines 4F and SF should be slightly greater than the distance between any two consecutive fold lines above fold line 4F or any two fold lines below fold line 8F. This is so because all the other folds in the drape as finally folded will lie above that portion of the drape lying between fold lines 8F and 4F.

APPLICATION OF THE DRAPE TO THE PATIENT Referring now to FIGS. 13-17, there is illustrated in stepwise fashion a method of applying the drape of FIG. 1, folded as just described, to a patient about to undergo surgery on the left knee. FIG. 13 shows drape l0, unfolded from side to side, placed across the right leg and under the left leg, in the general area of the patients knees. The patients left leg is lifted upwardly and stack C of folds is unfolded toward the foot of the operating table. The patients left leg is then lowered to overlie body portion 12 of main sheet 11. By virtue of the above step, stacks A and B of folds are exposed (see FIG. 14).

Wing portion 30 having the flap-like sheet 40 attached thereto (stack A of folds in the illustration) is then unfolded toward the top of the operating table. This step exposes flap 40 in its folded position overlying wing 30 (see FIG. 15). Flap 40 is then unfolded (as indicated by the arrow in FIG. 15) across the operating table to overlie the upper portions of the patients body. Stack B of folds comprising wing portion 20 is then unfolded, as indicated by the arrow in FIG. 16, toward the top of the operating table.

Referring to FIG. 17, the entire lower portion of the patients body (i.e., the region from the upper chest area to the toes), except for the left knee and lower portion of the left leg, is covered by the drape. The lower part of the left leg extends through fenestration 50 and clipping tabs 65, 65 and tubing holders 70, 70 are exposed on the upper surface of the drape.

The clipping tabs are extended upwardly to a vertical position and are brought into contact with one another. The clipping tabs are then held together by any convenient means, such as a surgical clamp, illustrated in FIG. 6a. The securing of the clipping tabs in this fashion has two beneficial effects. First, fenestration 50 now surrounds the patients leg at a point just above the knee on which surgery is to be performed. At the same time the wing portions are prevented from slipping or sliding laterally. The upper surface of the drape is free from any undesirable wrinkling or bunching and the tubing holders are available, at the upper portion of the drape, where they will not interfere with surgery and yet will be readily accessible when needed. Reinforcing panel 60 is positioned in the general area where surgery is to be performed and where increased exposure to abrasion is normally encountered.

Another embodiment of the drape of the present invention is shown in FIGS. 18-22. Drape 100 is generally T-shaped in construction and is intended for use with an operating room table having armboards extending laterally therefrom.

Drape 100 is identical in many of its features to drape 10 and includes a flexible sheet 11 comprising a main portion 12 and wing portions and 30. The drape has a flap-like sheet 40 attached to wing a slit 45 merging into a tear-shaped fenestration 50, a reinforcing panel 60, clipping means 65, and tubing holders 70.

The upper portions of wing 20 and 30 are extended transversely of the drape, i.e., beyond side edges 16, 17 of flexible sheet 11 to provide armboard covers 110, 110'. The armboard covers have side edges 112, 112' and lower edges 114, 114', respectively. Referring especially to FIG. 22, transverse cuts 116, 116' are provided in sheet 11 just below lower edges 110, 110' of the armboard covers. This construction allows side portions 16a, 17a of flexible sheet 1 1 in the areas of the drape below cuts 116, 116, respectively, to fall over the sides of the operating table where they will be in a generally vertical plane on either side of the table when the drape is positioned on the patient.

Armboard covers 110, 110 have armboard flaps 120, 120. The armboard flaps are pieces of flexible drapable material attached, preferably with an adhesive, to the armboard covers and wings along a line, extending inwardly of the drape, which lies just above the lower edge of the armboard cover and the upper edge of the cut at the side of the drape. FIG. 22 shows the structural relationship between armboard cover 110' and its associated armboard flap 120. The outer edges 124, 124' of the armboard flaps are generally coextensive with the outer side edges of the armboard covers, while the inner side edges 126, 126 thereof extend somewhat inwardly of the innennost ends of cuts 116, 116, respectively. As a result of this structural arrangement, the armboard flaps may hang over the sides of the armboards of the operating table and extend generally vertically downward when the drape is in place. The various possible structural relationships of the armboard covers to the armboard flaps and of the armboard covers and armboard flaps are discussed and illustrated in commonly assigned US. patent application Ser. No. 384,842, filed Aug. 2, 1973, which patent application is specifically incorporated herein by reference.

The armboard covers, inasmuch as they are extensions of the wing portions of the drape, and armboard flaps, are suitably made from the same material as that used for flexible sheet 11.

FOLDING OF THE DRAPE HAVING EXTENDED WING PORTIONS FIG. 18 shows a plan view of drape 100, with flap 40 thereof already in its folded position overlying wing 30. The dot and dash lines indicate the fold lines for the folding of the drape. As before, the letter R indicates a reverse fold, the letter F a forward fold, and the numbers indicate the steps in the folding sequence. In the figures, the lower surfaces of the drape are indicated by stippling, and the upper surfaces are left plain.

Flap-like sheet 40 is folded in the manner explained earlier for the folding flap 40 of drape 10.

The longitudinal foldng of the armboard flaps and armboard covers is the next step in the folding sequence. The folding of armboard flap 120 and armboard cover will be taken as illustrative. Referring to FIG. 18 a portion 128 of armboard flap adjacent its lower edge is preferably reverse folded around fold line 1R. If desired, portion 128 could be forward folded, rather than reverse folded, around this fold line. The last fold in the longitudinal folding of the armboard flap must be a forward fold around fold line 2F. Fold line 2F extends inwardly of the drape from outer side edge 124 of armboard flap 120 and coincides with lower edge 114 of the armboard cover and the upper edge of transverse cut 116. Although usually not necessary, additional folds may be made in the armboard flap between the above described first and last folds. It will be apparent that the number and size of any such intervening folds will depend on the size of the armboard flap and the degree of compactness required in the finally folded drape. Too many folds, of course, will undesirably add to the bulk of the folding portions. Regardless of the number of intervening folds, if there be any, the last fold given the armboard flap must be a forward fold so that the armboard flap when folded, overlies the upper surface of armboard cover 110'. When this part of the folding sequence is completed, the armboard flap lies in its folded position on the upper surface of armboard cover 110 in the relationship shown in FIG. 20.

The next step in the folding sequence is to fold armboard cover 110', with its now overlying armboard flap 120', transversely of the drape This may be accomplished with any number of folds starting from outer edge 112' but the last fold must be a forward fold so that armboard cover 120, when folded, overlies the upper surface of wing 30. Preferably, armboard cover 110 is forward folded, without any other folds, around fold line 3F which coincides vertically with side edge 16 of sheet 11. When this step is completed, the armboard flap and armboard cover are in a folded position overlying the upper surface of wing 30 as may be seen in the left hand portion of FIG. 21.

Armboard flap 120 and armboard cover 110 are then folded, in the same fashion as just described for armboard flap 120 and armboard cover 110, to overlie the upper surface of wing 20. At this particular stage in the folding sequence, the drape will have assumed the configuration illustrated in FIG. 21.

The longitudinal folding of drape 100, in the configuration shown in FIG. 21, is continued by folding each wing a plurality of times toward the center of the drape.

A portion 130 of wing 20 (with armboard cover 110 and armboard flap 120 folded thereover) adjacent the upper edge of the drape is forward folded around fold line 4F. The wing is then reverse folded around fold line 5R, forward folded around fold line 6F, and reverse folded around fold line 7R. The first fold in folding wing 20, i.e., the folding of portion 1130 around fold line 4F, must be a forward fold, and the last fold in folding the wing, that is, the fold around fold line 8F, must be a forward fold. Thus, when folded, wing 20 lies on the upper surface of a generally central portion 135 of the drape. Although three folds, a reverse fold (5R), a forward fold (6F) and a reverse fold (7R) are illustrated in FIG. 21, it will be understood that the number of folds given wing 20 intermediate the first and last fold may vary, if the size of the drape, for example, should so require.

Wing 30, with its armboard cover 110 and armboard flap 120 in their aforementioned folded position, is subsequently folded in the same way just described for wing 20 with its overlying armboard and armboard cover.

The wings, when their folding has been completed, overlie the upper surface of a generally central portion 135 of the drape lying between fold lines 8F and 12F. Also it will be noticed that the enlarged fenestration 50 preferably lies entirely within portion 134 of the drape. As seen in FIG. 21, the fenestration lies between that central portion of the drape between the last fold line (i.e., fold line 8F) and the next to the last fold line (i.e., fold line 7R) used in folding the wing portions of the drape. The wing portions may be folded along a line that runs transversely through fenestration 50, but this is disadvantageous to the extent that the material at either side of the fenestration will be creased.

The longitudinal folding of the drape is completed by folding part of main portion 12 a plurality of times toward the center of the drape. A portion 139 adjacent the bottom edge of main portion 12 of the drape is reverse folded around fold line 9R; the main portion is then forward folded around fold line 10F, reverse folded around fold line 11R, and forward folded around fold line 12F. The number of folds used for the main portion may vary, but the last fold must be a forward'fold so that the folded part of the main portion overlies the same central portion 135 as do the folded wings. Drape 100, when thus folded, assumes the general configuration shown for drape 10 in FIG. 12. In the preferred folding sequence, the folded part of the main portion of the drape overlies the folded wing portions and central portion 135 of the drape.

The size of the various longitudinal portions 130-139 of the drape will vary according to the length of the drape and according to the number of folds that are made. In the preferred embodiment under discussion, portion 135 (that portion of the drape on top of which the folded wings and the folded main portion will lie) has the longest length (i.e., vertical dimension in FIG. 21). The lengths of portions 131, 132, 133, 134, 136,

12 137 and 138 are roughly equivalent to each other and are somewhat, e.g., a half inch, less than the length of portion 135. Portions 130 and 139 at either end of the drape are about A the length of portion 131-134 and 136-138.

After T-shaped drape has been folded longitudinally in the manner just described, it may be folded transversely, from each side toward the center, using the modified fan folding described earlier herein for drape 10. This provides a compactly folded drape which can be conveniently packaged e.g., in a paper bag. The packaged drape may be sterilized according to well known techniques.

In applying drape 100 to a patient about to undergo knee surgery, the procedure described herein for the application of drape 10 (illustrated in FIGS. 1317) is used. After main portion 12, wing 30, flap-like sheet 40, and wing 20 have been unfolded and secured in place in the manner already described for drape l0, armboard covers and 110 are unfolded outwardly to cover the armboards on the operating table. Thereafter armboard flaps and 120 are unfolded to lie in their vertically downward position. Side portions 16a and 17a are then free to fall over the sides of the operating table in their vertically downward position.

It will be understood and recognized by those skilled in the art that the folding sequence described above for drape 100 need not be limited to that specific drape, but can be used for various kinds of generally T-shaped drapes. Thus, for example, surgical drapes of the kind described in the aforementioned US. patent application Ser. No. 384,842 may be advantageously folded using the procedure described herein for drape 100.

What is claimed is:

1. A surgical drape comprising a sheet of flexible drapable material, said sheet having a main portion at one end thereof, and a pair of spaced wings at the other end thereof, said wings extending outwardly from a central region of said sheet and defining a slit in said sheet; said slit merging into a widened fenestration located generally inwardly of the perimeter of the drape; a flap secured to one of said wings, said flap being transversely extendible from said wing so as to cover at least a portion of the length of said slit and to be in contacting relationship with at least part of the other of said pair of wings when the drape is in use; and means on said drape for preventing said wings from moving with respect to each other when the drape is in use.

2. A surgical drape according to claim 1 wherein a reinforcing panel is attached to the upper surface of the drape.

3. A surgical drape according to claim 1 wherein said means for preventing said wings from moving with respect to each other when the drape is in use comprise two flexible tabs which may be brought into mutual contact and held together.

4. A surgical drape according to claim 3 wherein a flexible tab is attached to each wing portion at the inner edge thereof relatively near the point where said slit merges into said fenestration.

5. A surgical drape according to claim 3 wherein one of said two tabs is attached to said flap near the inner side edge of the wing to which said flap is attached and the other of said two tabs is attached to the remaining one of said two wings near the inner side edge thereof.

6. A surgical drape according to claim 1 wherein said means for preventing said wings from moving with 13 respect to each other when the drape is in use comprise a tab of flexible material and a cooperating strip of pressure sensitive adhesive.

7. A surgical drape according to claim 6 wherein said pressure sensitive adhesive is protected prior to use of the drape by a release covering.

8. The surgical drape of claim 1 further comprising at least one tubing holder on the upper surface of the drape, said tubing holder having a flexible portion free from the rest of the drape, said flexible portion having at least one opening therein through which flexible members may be threaded and secured thereto.

9. A surgical drape according to claim 1 wherein said fenestration is lined with an elastomeric film, said film lying in the major plane of the .drape.

10. A surgical drape according to claim 1 wherein each of the wing portions is extended transversely to provide a generally T-shaped surgical drape, said trans verse extensions comprising armboard covers for covering the laterally extending armboards of an operating table.

11. A surgical drape according to claim 10 wherein an armboard flap is attached to each of said armboard covers.

12. A surgical drape comprising a sheet of flexible, drapable material, said sheet having a main portion at one end thereof and a pair of spaced wings at the other end thereof, said wings extending outwardly from a central region of said sheet and defining a gap in said sheet; and a flap attached to at least one of said wings, said flap being transversely extendible from said one wing so as to cover at least a portion of said gap and to lie in contacting relationship with at least part of the other of said pair of wings; said flap on said one wing being folded to overlie said one wing; said one wing with, its said overlying flap and the other of said two spaced wings each being folded longitudinally a plurality of times in a sequence of folds toward the center of the drape, the first fold in said sequence being a reverse fold and the last fold in said sequence being a forward fold whereby, when said folding sequence is completed, each folded wing portion overlies a central portion of said sheet; a part of said main portion being folded longitudinally a plurality of times in a sequence of folds toward the center of the drape, the first fold in said sequence beinga reverse fold and the last fold in said sequence being a forward fold whereby, when said folding sequence is completed, the folded part of said main portion comprises a stack of folds overlying said central portion of said sheet.

13. A surgical drape according to claim 12 wherein the folded wing portions lie between said folded part of said main portion and said central portion of the sheet.

14. A surgical drape accordingto claim 12 wherein each of said wings is folded four times, the first and third folds being reverse folds, and the second and fourth folds being forward folds.

15. A surgical drape according to claim 14 wherein said part of said main portion is folded four times, the first and third folds being reverse folds, and the second and fourth folds being forward folds.

16. A surgical drape according to claim 15 wherein the folded wing portions lie between said folded part of said main portion and said central portion of the sheet.

17. A surgical drape according to claim 16 transversely folded into a compact unit.

18. A surgical drape according to claim 17 treated to render it sterile and packaged in said sterial condition.

19. A generally T-shaped surgical drape for use on an operating table having laterally extending armboards for supporting a patients arm, said drape comprising a sheet of flexible drapable material, said sheet having an upper portion, a lower portion and a pair of side edges; said upper portion having armboard covers comprising a flexible drapable material extending transversely therefrom for covering the arms of a patient and said armboards, each of said armboard covers having an upper surface, a side edge, and a lower edge; each of said armboard covers having attached thereto an armboard flap comprising a flexible, drapable material; each of said armboard flap being folded to overlie the upper surface of the armboard cover to which it is attached; each of said armboard covers with its respective overlying armboard flap being folded to overlie at least part of said upper portion; the upper portion of the drape being folded longitudinally a plurality of times in a sequence of folds toward the center of the drape, the first and last folds in said sequence being forward folds whereby, when said folding sequence is completed, the folded upper portion comprises a stack of folds overlying a central portion of said sheet; a part of said lower portion being folded longitudinally a plurality of times in a sequence of folds toward the center of the drape, the last fold in said sequence being a forward fold whereby, when said folding sequence is completed, the folded part of said lower portion comprises a stack of folds overlying said central portion of said sheet.

20. A surgical drape according to claim 19 wherein each armboard flap is folded twice, the first fold being a reverse fold and the second fold being a forward fold; and each of said armboard covers with its respective overlying armboard flap is forward folded to provide a substantially rectangular partially folded drape.

21. A surgical drape according to claim 20 wherein said upper portion is folded five times, the second fold being a reverse fold, the third fold being a forward fold, and the fourth fold being a reverse fold.

22. A surgical drape according to claim 21 wherein said part of said lower portion is folded four times, said first fold being a reverse fold, said second fold being a forward fold, and said third fold being a reverse fold.

23. A surgical drape according to claim 22 transversely folded into a compact unit.

24. A surgical drape according to claim 23 treated to render it sterile and packaged in said sterile condition.

25. A generally T-shaped surgical drape for use on an operating table having laterally extending armboards for supporting a patients arms, said drape comprising a sheet of flexible, drapable material, said sheet having a main portion at one end thereof and a pair of spaced wings at the other end thereof, said wings extending outwardly from a central region of said sheet and defining a gap in said sheet; a flap attached to at least one of said wings, said flap being transversely extendible from said one wing so as to cover at least a portion of said gap and to lie.in contacting relationship with at least part of the other of said pair of wings; each of said wings having armboard covers comprising a flexible drapable material extending transversely therefrom for covering the arms of a patient and said armboards; each of said armboard covers having an upper surface, a side edge and a lower edge; each of said armboard covers having attached thereto an armboard flap comprising a flexible drapable material; said flap on said one wing being folded to overlie said one wing; each of said armboard flaps being folded to overlie the upper surface of the armboard cover to which it is attached; each of said armboard covers with its respective overlying armboard flap being folded to overlie at least part of the wing from which said armboard cover transversely extends; each wing of the drape then being folded longitudinally a plurality of times in a sequence of folds toward the center of the drape, the first and last folds in said sequence being forward folds whereby, when said folding sequence is completed, the folded wings comprise a stack of folds overlying a central portion of said sheet; a part of said lower portion being folded a plurality of times in a sequence of folds toward the center of the drape whereby when said folding sequence is completed, the folded part of said lower portion comprises a stack of folds overlying said central portion of said sheet.

26. A surgical drape according to claim 25 wherein each armboard flap is folded twice, the first fold being a reverse fold and the second fold being a forward fold; and each of said armboard covers with its respective overlying armboard flap is forward folded to provide a substantially rectangular partially folded drape.

27. A surgical drape according to claim 26 wherein said upper portion is folded five times, the second fold being a reverse fold, the third fold being a forward fold, and the fourth fold being a reverse fold.

28. A surgical drape according to claim 27 wherein said part of said lower portion is folded four times, said first fold being a reverse fold, said second fold being a forward fold, and said third fold being a reverse fold.

29. A surgical drape according to claim 28 transversely folded into a compact unit.

30. A surgical drape according to claim 29 treated to render it sterile and packaged in said sterile condition.

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Classifications
U.S. Classification128/854, 128/DIG.260
International ClassificationA61B19/08
Cooperative ClassificationA61B2019/085, A61B19/08, A61B2019/086, Y10S128/26
European ClassificationA61B19/08