CA1155020A - Compression device with dressing - Google Patents

Abstract

COMPRESSION DEVICE WITH DRESSING

ABSTRACT OF THE DISCLOSURE

A device for applying compressive pressures against a patient's limb comprising, a sleeve having a pair of flexible sheets of fluid impervious material, with the sheets connected together along lines to define at least one inflatable chamber between the sheets. The device has an absorbent dressing extend-ing laterally across at least a portion of the sleeve, with the dressing being attached to an inner surface of the sleeve.

Description

~55~20 BACKGROUND OF THE INVENTION
The present invention relates to therapeutic and pro-phylactic devices, and more particularly to devices for applying compressive pressures against a patient's limb.
It is known that the velocity of blood flow in a patient's extremities, particularly the legs, markedly decreases during confinement of the patient. Such pooling or stasis of blood is particularly pronounced during surgery, immediately after surgery, and when the patient has been confined to bed for extended periods of time. It is also known that stasis of blood is a significant cause leading to the formation of thrombi in the patient's extremities, which may have a severe deleterious effect on the patient, iAcluding death. Additionally, in certain patients it is desirable to move fluid out of interstitial spaces in extramity tissues, in order to reduce swelling associated with edema in the extremities.
Devices have been disclosed in U.S. patents 4,013,069 and 4,030,488 which develop and apply the desired compressive pressures against the patient's limbs. Such devices comprise a pair of sleeves which envelop the patient's limbs, and a con-troller for supplying fluid pressure to the sleeves through con-duits which are connected in fluid communication with chambers in the sleeve. However, in certain patients it is necessary to place the sleeve over an open wound of the patient, and the sleeve is inadequate for covering such a limb on the patient.

SUMM~RY OF THE INVENTION
.
A principal feature of the present invention is the provision of a device for applying compressive pressures against a patient's limb with an open wound.

~lSS020 The device of the present invention comprises, a sleeve comprising a pair of flexible sheets of fluid impervious material, and means for connecting the sheets together along lines defining inflatable chamber means between the sheets.
A feature of the present invention is the provision of an absorbent dressing for the sleeve which extends laterally across at least a portion of the sleeve.
Another feature of the invention is that the dressing is releasably attached to an inner surface of the sleeve.
Still another feature of the invention is that the dressing may be readily attached to the inner surface of the sleeve.
Yet another feature of the invention is that the dress-ing may be located on the sleeve to contact the patient's wound.
Further features will become more fully apparent in the following description of the embodiments of this invention and from the appended claims.

DESCRIPT ION OF THE DRAWINGS
In the drawings:
Fig. l is a fragmentary perspective view of a compres-sion device of the present invention;
Fig. 2 is a front plan view, partly broken away, of a compression sleeve for the device of Fig. l;
Fig. 3 is a back plan view, partly broken away, of the sleeve of Fig. 2;
Fig. 4 is a front plan view on page 2 of the drawings of fluid impervious sheets defining chambers in the sleeve of Fig. 2;
Fig. 5 is a back plan view of the fluid impervious sheets of Fig. 4;

--;2--~155Q20 Fig. 6 is a fragmentary sectional view taken substanti-ally as indicated along the line 6-6 of Fig. 4;
Fig. 7 is a fragmentary sectional view taken substanti-ally as indicated along the line 7-7 of Fig. 4;
Fig. 8 is a fragmentary sectional view on page 1 of the drawings taken substantially as indicated along the line 8-8 of Fig. 4;
Fig. 9 is a perspective view on page 3 of the drawings illustrating the sleeve during placement on a patient's leg;
Fig. 10 is an outer plan view of a dressing for the sleeve; and Fig. 11 is a sectional view taken substantially as indicated along the line 11-11 of Fig. 10.

DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to Fig. 1, there is shown an intermit-tent compression device generally designated 20 having a con-troller 22, and a pair of elongated compression sleeves 26 for enclosing a length of the patient's extremities, such as the legs as shown. The controller 22 is connected through a tube 28 to a source S of pressurized gas, and to an exhaust tube 30.
Also, the controller 22 is connected to the separate sleeves 26 through separate sets of conduits 34 and 35. The controller may be of any suitable type, such as the controllers described in U.S. patents 4,013,069 and 4,030,488.
With reference to Figs. 2 and 3, the sleeve 26 has an outer cover sheet 36 covering the entire outer surface of an outer fluid impervious barrier sheet 38. Also, the sleeve 26 has an inner cover sheet 40 covering an inner surface of an inner fluid impervious barrier sheet 42. The outer cover sheet 36 may comprise a relatively inelastic fabric with a brushed matte or l~SSQ20 napped finish of nylon or polyester, such as a fabric sold under the trademark Flannel/Flannel II, No. 11630, by Guilford Mills, Greensboro, North Carolina, which provides an attractive outer surface for the sleeve, and also defines brushed or napped fibers across the entire outer surface of the sleeve for a purpose which will be described below. In suitable form, the fabric of the sheet 36 may be warp knit from polyester yarns on a tricot machine, after which the fabric is dyed to a suitable color, and the fabric is brushed or napped on a suitable machine to raise loops from the fabric. The inner cover sheet 40 may comprise a suitable nonwoven material which provides a comfortable inner surface of the sleeve for the patient. The barrier sheets may be formed from a suitable flexible plastic material, such as polyvinylchloride. If desired, a segment of the brushed nylon fabric may be formed into a tube 44 to cover the conduits which extend from the sleeve to the controller. As shown, the conduits and covering tube 44 may extend through an opening 46 in the inner cover sheet 40.
The sleeve 26 may have a pair of side edges 48a and 48b, and a pair of end edges 50a and 50b connecting the side edges 48a and b, with the side edges 48a and b being tapered toward a lower end of the sleeve. The sleeve 26 may also have an elongated opening 52 extending through a knee region 53 of the sleeve, and defined by peripheral edges 54 extending around the opening 52. In addition, the sleeve 26 has an elongated opening or cut-out 56 in the knee region 53 extending from the side edge 48a toward a lateral central portion of the sleeve, with the opening 56 being defined by peripheral edges 58 extend-ing from the side edge 48a around the opening 56. As shown, the inner end of the opening 56 is spaced from the opening 54, and ~5S(~ZO

the opening 56 defines an upper flap 60 and a lower flap 62 of the sleeve which are separated by the openlng 56. Further, the sleeve 26 may have a pair of lower fastening strips 61, such as a hook material sold under the trademark Velcro, secured to the inner cover sheet 40 along the side edge 48b.
With reference to Figs. 4-8, the inner and outer fluid impervious barrier sheets 38 and 42 have a plurality of later-ally extending lines 64, such as lines of sealing, connecting the barrier sheets 38 and 42 together, and longitudinally extend-ing lines 66, such as lines of sealing, connecting the sheets 38and 42 together and connecting ends of the lateral lines 64, as shown. The connecting lines 64 and 66 define a plurality of longitudinally disposed chambers 68a, 68b, 68c, 68d, 68e, and 68f, which for convenience will be termed contiguous. As shown, the chambers 48 extend laterally in the sheets 38 and 42, and are disposed in the longitudinal arrangement between the end edges 50a and 50b. When the sleeve is placed on the patient's leg, the lowermost chamber 68a is located on a lower part of the leg adjacent the patient's ankle, while the uppermost chamber 68f is located on an upper part of the leg adjacent the midthigh.
As shown, the longitudinal line 66 nearest the side edge 48b is separated intermediate the chambers 68b and c, 68c and d, and the chambers 68e and f. The lateral lines 64 define ventilation channels 70a, 70b, and 70c extending laterally in the sleeve from the longitudinal line 66 adjacent the side edge 48a toward the longitudinal lines 66 adjacent the side edge 48b, with the ventilation channels 70 being positioned at spaced loca-tions longitudinally along the sleeve intermediate different pairs of adjoining chambers. Thus, the ventilation channel 70a is located intermediate the chambers 68b and 68c, the ventila-~S~3ZO

tion channel 70b is located intermediate the chambers 68c and68d, and the ventilation channel 70c is located intermediate the chambers 68e and 68f. Moreover, the ventilation channels 70 have a width substantially less than the width of the chambers 68 such that the channels 70 do not detract from the size and volume required for the compression chambers 68. The inner and outer barrier sheets 38 and 42 also have a longitudinally extend-ing line 72 which defines a connecting channel 74 intermediate the line 72 and the adjacent longitudinal line 66. As shown, the connecting channel 74 extends along the sides of the cham-bers 68c, 68d, and 68e, and communicates with the ventilation channels 70a, b, and c, such that the channel 74 connects the spaced ventilation channels 70. Further, the inner barrier sheet 42 has a plurality of openings or apertures 76 which communicate lS with the channels 70. Thus, when the sleeve 26 is placed on the patient's leg, the openings 76 face toward the leg.
With reference to Figs. 4-7, the longitudinal lines 66 and 72 adjacent the side edge 48b define a pair of flaps 78a and 78b of the barrier sheets 38 and 42 which extend between the respective lines and the side edge 48b. As shown, the sheets 38 and 42 have a longitudinally extending line 79 which defines a directing channel 80 intermediate the lines 79 and 72, with the opposed longitudinal ends of the channel 80 being open. The sleeve 26 has a first connecter 82a which is commonly connected in fluid communication to the two lowermost chambers 68a and 68b, and which is connected to a conduit 34a in the illustrated con-duit set 34. As shown, the conduit 34~ passes through an opening 84a in the upper barrier sheet flap 78a which retains the conduit 34a at the desired position in the sleeve 26. The sleeve 26 also has a second connecter 82b which is commonly connected in fluid 1~55~)ZO

communication to the second pair of adjoining chambers 68c and 68d, and which is connected to a second conduit 34b in the con-duit set 34. The conduit 34b passes through an opening 84b in the upper flap 78a which retains the conduit 34b at the desired position. The sleeve 26 has a third connecter 82c which is com-monly connected in fluid communication to the uppermost chambers 68e and 68f, and which is connected to a third conduit 34c in the conduit set 34. As shown, the conduit 34c passes through an opening 84c in the upper flap 78a, with the conduit 34c extend-ing through the directing channel 80 in order to retain the thirdconduit 34c at the desired position in the sleeve. The sleeve 26 also has a fourth connecter 82d which is connected in fluid communication to the connecting channel 74 in order to permit passage of air to the ventilation channels 70. As shown, the connecter 82d is connected to a fourth conduit 34d in the conduit set 34, with the conduit 34d passing through an opening 84d in the upper barrier flap 78a. Thus, the conduits 34a, 34b, and 34c are separately connected to pairs of adjoining chambers, while the conduit 34d is connected to the connecting channel 74.
Of course, the other sleeve associated with the conduits 35 may be constructed in a similar manner. It will be apparent that the barrier flaps 78a and 78b, the directing channel 80, and the openings 84 cooperate to retain the conduits at the desired posi-tion within the sleeve. Further, the sleeve 26 has suitable securing means 86, such as regions of heat sealing or adhesive, bonding the flaps 78a and 78b to opposed sides of the conduits 34 adjacent the opening 46. Thus, in the event that forces are applied to the conduits 34 exterior the sleeve 26, the forces are transmitted to the flaps 78a and b rather than the connec-ters 82a, b, and c, in order to relieve possible strain from the ~ss~o connecters and prevent severance of the connecters from the sleeve.
In use, the sleeve 26 may be placed below the patient's leg preparatory to securement about the limb, as illustrated in Fig. 9. Next, the upper flap 60 and lower flap 62 may be inde-pendently passed around the patient's leg at locations above and below the knee, respectively. Thus, the opening 56 separates the flap portions of the sleeve in the region of the knee to per-mit independent wrapping of the upper and lower portions of the sleeve about the leg and simplify placement of the sleeve, as well as provide an improved fit. After both the upper and lower flaps 60 and 62 have been suitably wrapped about the patient's limb, the remaining part of the sleeve adjacent the side edge 48b may be wrapped over the flaps 60 and 62, and the fastening strips 61 may be pressed against the outer cover sheet 36. Thus, the hook fastening strips 61 engage with the brushed fibers of the outer cover sheet 36, such that the strips 61 and sheet 36 interengage and retain the sleeve in the wrapped configuration.
Since the sheet 36 extends entirely across the outer surface of the sleeve 26, the sleeve may be readily adjusted as necessary for the desired fit according to the size of the patient's leg.
Thus, the sleeve 26 may be placed in a simplified manner while accomplishing an improved fit on patients having varying leg sizes. In addition, the openings 52 and 56 greatly reduce the a~ount of material and bulk for the sleeve in the region of the patient's knee. Accordingly, the sleeve provides flexibility in the knee region in order to prevent binding and permit flexation of the knee during the extended periods of time while the sleeve is secured about the leg.
After placement of the sleeves on the patient's limbs, ~55~ZO

the controller 22 may be initiated in order to supply air to the sleeves 26. The controller 22 intermittently inflates the cham-bers 68 during periodic compression cycles, and intermittently deflates the chambers 68 through the exhaust tube 30 during periodic decompression cycles intermediate the compression cycles. The inelastic cover sheet 36 of the placed sleeve restricts the size of the inflated chambers, and greatly enhances the compressive action of the chambers to permit lower fluid vol-umes during the compression cycles. Further, the controller 22 supplies air through the conduits to the connecting channels 74 in the two sleeves. The air then passes from the common connect-ing channels 74 to the spaced ventilation channels 70 and through the openings 76 onto the patient's legs. In this manner, the device 20 ventilates a substantial portion of the patient's legs to prevent heat buildup and provide comfort for the patient dur-ing extended periods of time while the sleeves are retained in a wrapped condition about the patient's limbs. In a preferred form, the controller 22 supplies air to the ventilation channels 70 during the periodic decompression cycles. Also, the con-troller 22 may have suitable means, such as a switch, to selec-tively permit passage of air to the ventilation channels 70 or prevent passage of air to the ventilation channels 70, as desired. In addition, the switch may be utilized to control the quantity of air which ventilates the patient's limbs for maximum patient comfort.
At certain times it is necessary to place the sleeves 26 over the open wound on a patient's limb. With reference to Figs. 3, 10, and 11, the device 20 of the present invention has a dressing generally designated 90 comprising a sheet of absorb-ent material having a pair of tapered side edges 92a and g2b, ~5S~ZO

and a pair of spaced end edges 94a and 94b connecting the sideedges 92a and b. The dressing 90 has an inner surface 96 for contacting the patient's wound, and an opposed outer surface 98 which faces away from the patient's limb when the dressing is placed against the limb. The dressing 90 may be constructed from any suitable material, such as a washed gauze sponge dis-closed in U.S. Patent 3,190,289.
As best shown in Fig. 10, the dressing 90 has a pair of hook fastening strips lOOa and lOOb extending along the side edges 92a and b of the dressing 90, and a pair of hook fastening strips 102a and 102b extending along the end edges 94a and b of the dressing 90. As shown in Fig. 3, the inner cover sheet 40 has a plurality of loop fastening strips 104a and 104b extending along the length of the side edges 48a and b of the sleeve 26.
The sleeve 26 also has a plurality of spaced rows 106a, 106b, 106c, 106d, and 106e of loop fastening strips extending later-ally across the cover sheet 40 between the fastening strips 104a and b at longitudinally spaced locations on the sleeve. As shown, the rows 106a and 106e of loop fastening strips are located adjacent the end edges 50a and b, respectively, while the rows 106b and 106c of fastening strips are located on opposed sides of the opening 52 and cut-out 56 in the knee region, and the row 106d of fastening strips is located intermediate the rows 106c and e.
The dressings 90 are made of suitable width and length such that the hook fastening strips lOOa and b and 102a and b may be releasably attached to a portion of the loop fastening strips on the inner cover sheet 40. Thus, with reference to Fig.
3, a dressing 90 is illustrated as partially attached to the '" --10 -l~S5(~;æ

sleeve 26, with the hook fastening strips 100a and b being attached to a longitudinal portion of the loop fastening strips 104a and b, and with the hook fastening strips 102a and b being attached to the laterally extending loop strips 106c and 106d.
Of course, the dressing may be made of suitable length such that the end hook strips 102a and b of the dressing may be attached to the loop strips 106d and 106e, or the dressing hook strips 102a and b may be attached to the laterally extending loop strips 106a and 106b. Thus, in this manner, a dressing of suit-able length may be attached at different longitudinal positionson the inner surface of the sleeve 26. Alternatively, a dress-ing of suitable width and length may have the hook end strips 102a and b attached to the laterally extending loop strips 106c and 106e, such that the dressing extends substantially across the lower longitudinal portion of the sleeve 26.
It will be apparent that hook and loop fastening strips on the dressing 90 and sleeve 26 permit easy attachment of the dressing to the inner surface of the sleeve 26. Once attached, the sleeve and dressing may be wrapped around the patient's limb, as shown in Fig. 9, such that the dressing covers the open wound on the patient's limb, after which the compression device may be initiated to sequentially inflate and deflate the sleeve 26 with the dressing 90 in place. The sleeve 26 may be unwrapped at intervals in order to replace the dressing 90 with a new dress-ing, if desired, after which the sleeve may be wrapped about thelimb once again to sequentially inflate and deflate the chambers in the sleeve.
The foregoing detailed description is given for clear-ness of understanding only, and no unnecessary limitations should be understood therefrom, as modifications will be obvious to those skilled in the art.

Claims (11)

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. A device for applying compressive pressures against a patient's limb, comprising:
a sleeve comprising sheet means of fluid impervi-ous material defining inflatable chamber means;
an absorbent dressing comprising a multi-ply sheet of absorbent material having a length extending laterally across at least a portion of the sleeve, said dressing having a width substantially less than the length of the sleeve; and means for releasably attaching the dressing to an inner surface of the sleeve.

2. The device of claim 1 wherein the attaching means comprises means for releasably securing the dressing to the inner surface of the sleeve.

3. The device of claim 2 wherein the securing means comprises hook and loop fastening strips on the dressing and inner surface of the sleeve.

4. The device of claim 3 wherein the hook strips are located on an outer surface of the dressing, and in which the loop strips are located on the inner surface of the sleeve.

5. The device of claim 2 wherein the securing means extends along sides and ends of the dressing.

6. The device of claim 2 wherein the securing means extends laterally across the sleeve at longitudinally spaced locations, and in which the securing means extends longitudin-ally along sides of the sleeve between the laterally extending portions of the securing means.

7. The device of claim 6 wherein the sleeve contains a plurality of laterally and longitudinally extending portions of the securing means at different longitudinal locations of the sleeve for securing a dressing at different longitudinal loca-tions on the sleeve.

8. The device of claim 2 wherein the securing means extends longitudinally along opposed sides of the sleeve, and in which the securing means extends laterally across the sleeve between the longitudinally extending portions at longitudinally spaced locations such that the dressing may be secured on the sleeve at a plurality of longitudinal locations.

9. The device of claim 1 wherein the dressing com-prises a washed gauze sponge.

10. The device of claim 1 including means for inter-mittently inflating and deflating the chamber means.

11. The device of claim 1 wherein the chamber means comprises a plurality of chambers extending laterally across the sleeve at longitudinally spaced locations.