CA1187363A - Cardiovascular surgical drape - Google Patents

Abstract

ABSTRACT

A folded surgical drape has a top surface and a bottom surface for contacting the patient. The drape has a fenestration and a split which connects the fenestration with an edge of the drape. There are pressure sensitive adhesive strips on the bottom surface of the drape bordering the fenestration and both sides of the split. Gaps separate the adhesive strips surrounding the fenestration from those along the sides of the split. The drape is folded so that a forward fold crosses the gaps between the fenestra-tion adhesive and the adhesive bordering the split.

Description

CARDIOVASCULAR ~URGICAL D~E

Don W. Oliver TECHNICAL FIELD
This invention relates to a drape for use in a surgical operation and, more specifically, to a folded surgical drape particularly adapted for use S in cardiovascular surgical operations.

- BACKGROUND ART
~ ~ . . ~, Disposable surgical drapes made of nonwoven fabrics are in common use. Such drapes are generally supplied by manufacturers in a prefolded, wrapped, sterilized condition. Xt is important that the drape be wrapped and folded in such a manner that it can easily be unwrapped and unfolded without contaminating the portions of the drape which are desired to remain sterile durlng the operation. Such disposable surgi-cal drapes often have a fenestration which providessuitable access to the surgical site. The drape should be folded such that the fenestration can easily be positioned properly on the patient.
For cardiovascular surgery where it is often necessary to expose one or both legs of the patient in addition to the chest area, -two fenestrated drapes are sometimes used, one covering the chest area of the patient and the other covering the patient's legs.
A single drape designed specifically for use in ~5 cardiovascular surgery is described in U.S. Patent 4,027,665 issued to George W. Scrivens on June 7, 1977.
Drapes known in the trade as "split sheetsl' have a slit which usually s-tarts in the middle of one edge of the drape and runs perpendicular to that edye to the interior of the drape where it may connect with a fenestration. Descriptions of such '73~

drapes can be found in U.S. Patents 3,926!185 issued to Henrie-tta ~. Krzewi.nski on December 16, 1975;
3,930,497 issued to Kay E. Krebs and Marion T. Arps on January 6, 1976; and 4,041,9~2 issued to Ramon C.
Dougan on August 16, 1977. Split sheets are generally designed for use in extremity surgery where the "tail portions" of the split sheet are wrapped around the base of the e~tremity to be operated on. Krebs & Arps describes the use of pressure sensitive adhesive adjacent the edges of the split so that the drape can be secured in position on the patient.
It is an object of this invention to provide a surgical drape which is particularly suitable for use in covering a patient undergoing a cardiovascular 1~ surgical operation.
It is a further object of this invention to ! provide such a drape folded in a manner such that it can be conveniently placed and secured on the patient prior to surgery.

SUMMARY OF_T~E DISCLOSURE
The present invention concexns a surgical drape having a top surface and a bottom sur~ace for contacting a patient, a fenestration, a split connect-ing the fenestratiorl with an edge of the drape, and tail portions on each side of the split. There are pressure sensitive a,dhesive strips on the bot-tom surface of the drape bordering the edges of the fenestration and the split. The ends of the adhesive strip bordering the fenestration are spaced in non-overlapping relationship from the adjacent corresponding ends of the adhesive strips borderiny the split to provide a pair of gaps therebetween which are free of adhesive. The gaps are aligned in a direction generally perpendicular to the split and these gaps are of sufficient size to allow the adhesive strip bordering the fenestration and the adhesive strip bordering the split to be used independently. The drape is folded such that a forward fold crosses both of the gaps and extends in their direc~ion of alignment, whereby the adhesive strip bordering the fenestration is located on one side of ~he forward fold and the adjacent corresponding ends of the adhesive strip bordering the split are exposed on ~he other side of the forward fold.

BRIEF DESCRIPTION OF ~HE DRAWINGS
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Figure 1 is a plan view of the top surface of a preferred embodiment of a drape of the present invention, before folding.
Figure 2 is a plan view of the drape of Figure 1 as partially folded with lateral folds.
Figure 3 is an enlarged cross-sectional view of the drape of Figures 1 and 2 as folded laterally into stacks of folds.
Figure 4 is a plan view of the top surface oE
a second preferred embodiment of a drape of the present invention, before folding.
Figure 5 is an enlarged cross-sectional view of the drape of Figure 4 as folded laterally into stacks of folds.
Figure 6 is a plan view of the laterally folded drape of Figure 3 before transverse folding~
Figures 7 and 8 are enlarged cross~sectional views of the drape of Figures 1-3 and 6 as partially folded transversely with the edge of the laterally folded drape shown as a single line.
Figure 9 is an enlarged cross-sectional view of the drape of Figures 1-~ and 6 8 as folded transversely with the edge of the laterally Eolded drape shown as a single line~
Figure 10 is a bottom view of the partially folded drape of Figure 8.

~a~ ;3 DBTAILED DESCRIPTION OF THE INVENTION
_ Referring to the drawings wherein like referenced characters are utilized to identify like parts throughout the several views, there is illustrated in ~igure 1 a rectangular surgical drape lOo In a preferred embodiment, the drape 10 is made of a nonwoven fabric base sheet 20 such as that described in U.S. Patent 4,113,911 issued to Larry L. LaFitte and James B. Camden on September 12, 1978. The drape preferably has a reinforcement patch 12 in the central portion of the drape; the reinforcement patch can be a fluid impervious material adhesively attached preferably to the top surface of the base sheet 20. A preferred reinforcement patch material is a 3-layer laminate, about 0.25 mm. in thickness, marketed by the 3M Company, St, Paul, Minnesota. The laminate is made by adhering a carded rayon staple fiber web to each side of a polyethylene film by means of a latex adhesive to which an antistatic agent has been added.
The drape lOt shown in Figure 1~ has a top surface

2~ 13 and a bottom surface 14, a pair of opposed longitudinal edges 15 and 16, and a pair of opposed lateral edges 17 and 18. The drape has a fenestration or opening 11 in a central area of the drape within the reinforcement patch 12 and a split 19 which runs from fenestration 11 to an edge of the drape~ preferably lateral edge 18. The por-tions of drape 10 separated by split 19 are tail portions 41 and 42. Reinforcement patch 12 preferably extends into tail portions 41 and 42 adjacent a substantial portion of split lg.
The drape of the present invention is especially adapted for use in cardiovascular surgical ~L~B~i93~i3 procedures. Although there is nothing critical aboutthe dimensions, a typical size for such a cardiovascu-lar drape is 333 cm. long and 218 cm. wide. Rein-forcement patch 12 is 178 cm. long and 76 cm. wide and is located centrally between longitudinal sides 15 and 16 of drape 10 and starts 63 cm. from lateral side 18.
Fenestration 11 is 30 cm. long and 18 cm. wide, is located midway between longitudinal ed~es 15 and 16, and its closed end 51 is 203 cm. from lateral side 18. The side of fenestration 11 opposite closed end ~1 tapers down into split 19 which is 10 cm. wide.
Split 19 is equidistant from longitudinal drape edges 15 and 16 and extends from fenestra-tion 11 to lateral edge 18.
There are located on bottom surface 14 of drape 10 and bordering the edges of fenestration 11 and split 19 strips of pressure sensitive adhesive.
There is preferably a continuous strip 50 of pressure sensitive adhesive bordering the closed end 51 and longitudinal sides 52 and 53 of fenestration 11. Also, there are strips 54 and 55 of pressure sensitive adhesive on the edges of tails 41 and 42, respectively, bordering split 19; adhesive strips 54 and 55 prefer-ably e~tend a substantial portion of the distance along split 19 from fenestration 11 to lateral edge 18. The ends of adhesive strips 54 and 55 and the adjacent corresponding ends of adhesive strip 50 are spaced in non-overlapping relationshlp. The adhesive strips 50, 54, and 55 are preferably about 2.5 cm.
wide. The spacing between adjacent ends of adhesive strip 50 and strips 54 and 55 provides gaps 56 and 57 which are free of pressure sensitive adhesive. These adhesive free gaps 56 and 57 allow the fenestration and split adhesive systems to be used independently, yet in a complementary manner. This will be explained 1:~87363 in detail below. The length of gaps 56 and 57 is preferably about 5 cm., and they occur on both sides of fenestration ll and split 19 about where fenestra-tion ll tapers into split l9 so that gaps 56 and 57 are aligned in a direction generally parallel to lateral edge 18. ~ach of the adhesive strips 50, 54, and 55 are separately covered by one or more pieces of release paper. The release papers adhere to and cover the adhesive strips. The release papers are made from a coated sheet that when pulled from adhesive strips 50, 54, and 55 comes off the adhesive cleanly leaving the adhesive applied to drape surface 14.
Folding of the Drape As used herein with reference to Figures l lS and 4, the term "forward fold" refers to a fold which brings portions of the top surface 13 of drape 10 together while the term "reverse fold" as used herein is a fold which results in bringing portions of the bottom surface 14 together. Similarly, with reference to Figures 6 and lO, "forward fold" re-fers to a - fold which brings the upper side surfaces pictured therein together and "reverse fold" refers to a fold which brings the unseen lower side surfaces of the item pictured therein together. The term "fan 2~ old" as used herein refers to a folding pattern which is the result of alternating forward and reverse folds. In Figures l, 4, 6 and 10 a forward fold line is indicated by a dashed line ~ade up of alternating long and short segments while a reverse fold line is indicated by a dashed line made up of segments of approximately equal length.
A preferred lateral folding pattern for d.rape j 10 is shown in Figures 2 and 3. Stacks 21a, ~lb, and l~ 22 of s~perposed laterally extendin~ drape panels are .. . . . . .. . .. ...

3~3 formed by fan folding the opposed lateral edges 17 and 18 inwardly toward the center of the drape. Stacks 21a and 21b are formed by fan folding lateral portion 23 of drape 10 which includes tail portions 41 and 42.
Stacks 21a and 21b are fan folded atop a portion of top surface 13 between fold lines 25a and 26a in which fenestration 11 is located. Stack 21a is folded tail portion 41, and stack 21b is folded tail portion 42.
The fan folding begins for each of tail portions 41 and 42 with a forward fold at fold line 25a which crosses gaps 56 and 57 and extends in their direction of alignment. The forward fold at fold line 25a is followed by alternate reverse and forward ~olds at parallel fold lines 25b, 25c, 25d, ..., 25s, and 25t.
The distance between fold lines 25a and 25b is greater than that between fold lines 25b and 25c, 25c and 25d, O~/ and 25s and 25t.
Figure 2 is a plan view of drape 10 with fan folded stacks 21a and 21b in place. The longer distance between fold lines 25a and 25b results in portions 43a and 43b of the bottom flaps of corre-sponding stacks 21a and 21b being exposed beyond the upper portions of stacks 21a and 21b, when viewed from above as in Figure 2. These exposed flap portions 43a and 43b are the part of bottom surEace 14 of drape 10 where the ends of adhesive strips 54 and 55 closest to fenestration 11 are located. The ends of the release papers covering adhesive strips 54 and 55 preferably extend a short distance beyond the adhesive so that they are easily accessible for grasping when drape 10 is thus positioned. By having fold line 25a cross, i.e. extend through, gaps 56 and 57, no part of adhesive strip 50 is exposed on flap portions 43a and 43b.

Lateral portion 24 of drape 10 on the side of fenestration 11 opposite split 19 is then fan folded into stack 22 atop stac~s 21a and 21b, as shown in Figure 3, by alternating forward and reverse folds at fold lines 26a, 26b, 26c, ... , and 26t. This completes a preferred lateral olding of drape 10.
An alternative preferred lateral Eolding pattern is shown for drape 70 in Figures 4 and 5.
Drape 70 has top surface 73, bottom surface 74, opposed longitudinal edges 75 and 76, opposed lateral ed~es 77 and 78, and reinforcement patch 72. Fenestra-tion 71 tapers into split 79 and has adhesive strip 90 bordering its three closed edges There are gaps 96 and 97 between adhesive strip 90 and adhesive strips 94 and 95 which are bordering the edges of split 79.
The lateral portion 83 of drape 70 which includes tail portions 91 and 92 is roll folded starting at drape edge 78 using a series of forward folds at fold lines 85a, 85b, ..., 85s and 85t, with fold line C 85t crossing gaps 96 and 97. Thus roll folded stack 81 is formed from tail portions 91 and 92 and is atop a portion of top surface 73 between fold lines 85t and 86a in which fenestration 71 is located. The portion 93 of drape 70 exposed atop stack 81 is the part of bottom surface 74 of drape 70 bet~een fold lines 85s and 8St which includes the ends of adhesive strips 94 and 95 closest to fenestration 71. Thus the ends of the release papers covering adhesive strips 94 and 95 are exposed for eas~ grasping when portion 93 is exposed; but since fold line 85t crosses gaps 96 and 97, none of adhesive strip 90 is exposed on portion 93. Lateral portion 84 of the drape on the opposite side of fenestration 71 from split 79 is then fan folded to form stack 82 atop stack 81, as shown in 3S Figure 5.

~8~3 g The la-terally folded drape 70 of Figure 5 or drape 10 o~ Figure 3 is then transversely folded, A
preferred mode of transverse folding is shown using drape 10 as an example in Figures 6 through 9.
Figure ~ is a plan view of laterally folded drape 10 with transverse fold lines shown. Forward folds at fold lines 27a and 2~a bring lateral edges 15 and 16 into juxtaposition at the center of laterally folded drape 10, as shown in Figure 7. Then forward folds at fold lines 27b and 28b bring fold lines 27a and 28a into juxtaposition, as shown in Figure 8. A forward fold at fold line 29 completes the preferred folding of drape 10, as shown in Figure 9.
To utilize folded drape 10, it is first opened flat by reversing the fold at fold line 29 so that drape 10 is as pictured in Figure 8. Figure 10 is a bottom view of folded drape 10 as shown in Figure 8 which depicts the exposed outer surface of drape 10 when folded in the manner described above.
This exposed surface is a portion of bottom surface 14 of drape 10 which includes fenestration 11.
Adhesive strip 50 bordering fenestration 11 is thus exposed and the release paper covering it is peeled off by surgical personnel. Drape 10 folded as shown in Figures 8 and 10 is placed with fenestration 11 on the chest of the patient such that adhesive strip 50 adheres the drape to the patient with the open end oE
fenestration 11 toward the legs of the patient. A
portion of drape 10 is exposed through fenestration 11 and may come in contact with the patient1s chest and be contaminated. A protective paper placed on fenes~
tration 11 prior to folding and incorporated in the folded drape can be used to preven-t such potential contamination.

3'736~

The drape is then unfolded transversely so that drape 10 is laterally folded as shown in Figures 3 and 6 with longitudinal edges 15 and 16 hanging over the sides of the operating table. Stack 22 of laterally folded drape 10 is then unfolded so that it covers ~he patient above the chest.
This exposes stacks 21a and 21b of folded tail portions 41 and 42, as shown in Figure 2. As previously described, the ends of adhesive strips 54 and 55 are exposed when drape 10 is unfolded to this point. The release papers covering adhesive strips 54 and 55 can be grasped and removed as tail portions 41 and 42 are separately unfolded toward the patient's feet. Tail portions 41 and42 can be adhered in place in any of a number of desired positions using the adhesive strips 54 and 55 so that parts of either or both of the legs can be exposed, or tail portions 41 and 42 can be overlapped so the legs are not exposed at all.
While particular embodiments of the present invention have been illustrated and described, it will be obv~ous to those skilled in the art that various changes and modifications can be made without departing from the spirit and scope of the invention. I-t is intended to cover, in the appended claims~ all such modifications that are within the scope of this invention.
What is claimed is:

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Claims (9)

Claims:

1. A folded surgical drape comprising:
(a) a top surface and a bottom surface for contacting a patient;
(b) a fenestration in a central area of said drape;
(c) a split connecting said fenestration with an edge of said drape;
(d) tail portions on each side of said split;
(e) pressure sensitive adhesive strip means on said bottom surface of said drape bordering the edges of said fenestration and of said split, the ends of said adhesive strip means bordering said fenestration being spaced in non-overlapping relationship from the adjacent corresponding ends of said adhesive strip means bordering said split to provide a pair of gaps therebetween which are free of adhesive, said gaps being aligned in a direction generally perpendicular to said split, said gaps being of sufficient size to allow said adhesive strip means bordering said fenestration and said adhesive strip means bordering said split to be used independently; and (f) a forward fold which crosses both of said gaps and extends in their direction of alignment, whereby said adhesive strip means bordering said fenestration is located on one side of said for-ward fold and said adjacent corresponding ends of said adhesive strip means bordering said split are exposed on the other side of said forward fold,

2. The surgical drape of Claim 1 wherein said tail portions are laterially fan folded atop a portion of said top surface of said drape that includes said fenestration such that ends of said adhesive strip means bordering said split that are closest to said fenestration are exposed prior to unfolding said fan folded tail portions.

3. The surgical drape of Claim 1 wherein said tail portions are roll folded atop a portion of said top surface of said drape that includes said fenestration such that the ends of said adhesive strip means bordering said split that are closest to said fenestration are exposed prior to unfolding said roll folded tail portions.

4. The surgical drape of Claim 2, wherein said drape is folded such that said adhesive strip means bordering said fenestration are exposed on an exterior surface of said folded drape.

5. The surgical drape of Claim 1, wherein there is a base sheet having a fluid-impervious reinforcement patch which is adhered to said base sheet such that said patch surrounds said fenestration and extends into said tail portions adjacent a substantial length of said split.

6. The surgical drape of Claim 4 wherein there is a base sheet having a fluid-impervious reinforcement patch which is adhered to said base sheet such that said patch surrounds said fenestration and extends into said tail portions adjacent a substantial length of said split.

7. The surgical drape of Claim 1 wherein said gaps are about 5 cm in length.

8. The surgical drape of Claim 2 wherein said gaps are about 5 cm in length.

9. The surgical drape of Claim 6 wherein said gaps are about 5 cm in length.