DE102020005821A1 - Anal prosthesis with integrated rinsing device for long-term use in fecal incontinence - Google Patents

Abstract

An anal prosthesis with and without an integrated rinsing device for long-term use in the case of fecal incontinence, particularly suitable for elderly people in need of care, which is preferably made of soft, elastic, tissue-friendly silicone elastomer and can be inserted and replaced with simple measures with the help of an insertion device and safely with the excreted feces It is gently and hygienically collected in easy-to-change special incontinence pads and can be disposed of particularly easily, quickly and hygienically. A wide variety of connectable containers, diapers, hoses, etc.

Description

introduction

1. 1. die sichere mechanische Fixierung über mehrere Tage bis Wochen bei einer hohen Gewebsverträglichkeit für Haut und Schleimhaut.
2. 2. Ein verhältnismäßig einfaches Anlegen und Entfernen der Analprothese bei geringster Traumatisierung von Haut und Schleimhaut.
3. 3. Einfache Durchführung hygienischer Maßnahmen und lokaler Haut-Kontrollen.
4. 4. Eine möglichst geringe Beschränkung körperlicher Aktivitäten des Betreuten
5. 5. Vereinfachung und Erleichterung der Versorgung der Pflegebedürftigen und vor allem die körperliche Entlastung der Pflegenden, häufig erst die Voraussetzung einer Realisierung der allgemein überwiegend gewünschten Pflege zuhause, in der gewohnter Umgebung durch die Angehörigen, evtl. noch unterstützt durch einen ambulanten Pflegedienst.
6. 6. Eine finanzielle Entlastung der Pflege-und Krankenkassen und ein verminderter Materialverbrauch.

Fecal incontinence is unfortunately a widespread ailment, especially among elderly women and men who are in need of care, and makes it difficult or often makes the desirable care in their familiar and beloved environment by the family members impossible due to excessive physical and temporal demands, especially when maintaining the Daily physical cleanliness (e.g. showering, bathing, changing duvet covers, jiaut care to avoid soreness and much more) and this often despite the supportive use of disposable diapers. These difficulties also make up a large part of the workload of the nursing staff in care facilities, so that for the individual Since there is very little time left for such important personal care with the staff shortage that is foreseeable nowadays, it would therefore be very desirable to make the uncontrollable excretion of stool, which is uncontrollable by old or damaged people, controllable again so that there might be a renewed mobilization not only at the Hettlägcigen. The invention described below enables controlled stool management with not only considerable physical relief for the caregiver, but also for those in need of care, and in addition a very large saving in working time and care aids. However, the following requirements should be met by an anal prosthesis

1. 1. the safe mechanical fixation over several days to weeks with a high tissue tolerance for skin and mucous membrane.
2. 2. Relatively simple application and removal of the anal prosthesis with minimal trauma to the skin and mucous membrane.
3. 3. Simple implementation of hygienic measures and local skin checks.
4. 4. The least possible restriction of the person's physical activities
5. 5. Simplification and facilitation of the care of those in need of care and, above all, the physical relief of the caregivers, often only the prerequisite for the realization of the generally desired care at home, in the familiar environment by the relatives, possibly supported by an outpatient care service.
6. 6. Financial relief for the care and health insurance companies and reduced material consumption.

The following describes the invention of an anal prosthesis for long-term use in fecal incontinence, especially for elderly people in need of care, which can largely meet the desirable requirements listed.

Figure list

• 1 shows the above-mentioned anal prosthesis in perspective from the front, top right. It consists of 3 rubber-elastic parts A, B, C which are firmly connected to each other. The wide, front, elastic, collar-shaped ring 1 , Part A shows the 4 retaining wings connected to it 2 those with a curved surface 3 are provided. This elastic part A is formed by an internal, wide, rigid cylindrical ring 4th (Support ring) stabilized and with part B a cylindrical elastic tube 5 connected, which in turn at its lower end 6th with the thin-walled, elastic, curved, the rima on the matching adapter piece 7th , Part C is connected. The longer part, the pubic end 8th of the adapter piece 7th has a hole 9 on for implementation and attachment of a pull rope (not shown here) that is attached to the support ring 4th is attached. The shorter narrower part of 7 is the tailbone end 10 .
• 2 shows in perspective from above, on the right the underside of the anal prosthesis. You can see clearly on the inwardly curved underside of the adapter piece 7th Part C, the end of the pubic bone on the right 8th and on the left the tailbone end 10 and in the middle a circular opening 11 with reinforced edge 12th and a feed-through opening 13th for the pull rope 14th (attached to the support ring 4th ). This opening 11 continues in the connected piece of pipe 5 , Part B and its inside 15th . On this elastic piece of pipe 5 applied you can see each in excerpts 16 the collar-shaped ring 1 , Part A and the cloverleaf-shaped retaining wings, each with a slightly concave underside 17th exhibit.
• 3 shows part A, ring 1 with the retaining wings and connected part B in detail, in perspective, from above. The part at the back in the picture above is the coccyx side 18th with the two small rudimentary retaining wings 19th and 20th . On the below, in front drawn ... pubic side 21 is on the right, just the lower half of the large retaining wing 22nd , folded down a little in the direction of the arrow 23 It is, like all lower halves of the retaining wings, an integral part of part A, the elastic ring 1 . As can be clearly seen, this ring shows a rectangular perforation 24 , one of the total of 4 passage openings for the one in the upper part all retaining wings each have integrated support ribs. The outer diameter of the ring 1 with its curved surface 25th decreases in the direction of its opening. In this you can see the lying support ring 4th , drawn transparently and resting on it, visible, the rectangular supporting ribs 26th , 27 , integrated part of the upper parts of the retaining wings 19th and 20th . Front, lower left is the second large retaining wing with its lower part 28 , drawn in dashed lines and separated from it for clarity, its arched upper part lying on it 29 with the integrated, rectangular support rib 30th which penetrates its passage opening. Both parts 28 , 29 but are inseparable, fluidly connected with each other.
• 4th shows the insertion device for the anal prosthesis. It consists of a rigid cylindrical rod, the base part 31 the one with two longitudinal grooves 32 and 33 as guide elements for the actuating rods 34 and 35 , each with a pressure plate 36 and 37 at one end and at the other a pivot lever 38 and 39 are provided. As shown, the lever is pivoted 38 outwards to a pivoting of the pressure plate 36 inward and reversed a swing of the lever 39 inwards to swivel the associated pressure plate outwards, in order to enable these movements, connect two spacer rods 4th 0 and 41 the base part 31 with the short, cylindrical anal introducer body, flattened on both sides 42 .
• 5 shows the anal prosthesis in perspective, ready for insertion into the anus. The insertion device is inserted into the prosthesis and protrudes with its anal insertion body 42 via the visible retaining wings 20th , 23 out. Both swivel levers 38 , 39 are in the inward position and accordingly the associated pressure plates 36 , 37 in outward position, part B bulging locally and tightly in close contact with the collar of the support ring 4th and the elastic ring 1 Part A on the necessary and effective exertion of pressure when inserting and positioning the prosthesis in the anus. If it is correctly positioned in the anus, it will show the end 8th and 10 of the adapter piece 7th Part C towards the pubic bone or tailbone.
• 6th shows a further embodiment of the anal prosthesis with integrated rinsing device, here part A of it in perspective, from and above the elastic ring 1 A with the support ring lying inside 55 , are on the pubic side 8th , right and left, two large retaining wings, shown retaining wings 46 with arched top 54 in which a right-angled, springy hook made of stainless steel wire 58 , 60 is embedded and on the right the retaining wing 50 (without upper part) folded down in the direction of arrow 51 (anal insertion position), also with a similar, resilient hook 59 . You can see that the lower part of the retaining wing 50 an elastic joint 52 with part A 1 forms, to return the retaining wing from the folded down to the horizontal rest position The upper part 53 of the retaining wing 50 , hatched and drawn the free end of the resilient hook 59 can be done by resting on the support ring 55 prevent the retaining wing from being folded up above the horizontal rest position. Subsequent to part A 1 are the very small retaining wings 47 and 49 arranged and as a conclusion of the upwardly and outwardly standing, soft wings 48 with its winding size 56 and supply line 57 , which comes to lie in the rectum of the Danns when the anal prosthesis is inserted.
• 7th Shows a perspective, simplified representation of the anal prosthesis in connection with an incontinence pad with an integrated stool collection container. The anal prosthesis is shown in simplified form in the picture above with its parts A, B, C.

These include the special incontinence pad D. This consists of the gas-permeable top layer film 61 and the bell firmly attached to it 62 Made of soft, flexible foam, which in turn firmly fitted a very thin-walled, rigid, cylindrical tube 63 having. Bell jar 62 and pipe 63 can fit precisely into the lumen of C and B in the direction of the arrow 64 be pushed in up to the support ring 55 . Top layer fofie 61 and gas- and watertight, tear-resistant floor film 65 are firmly connected to each other at the edges. The cavity formed between the foils is covered with cushioning, absorbent material 66 filled in, leaving a larger space free as a stool collection container 67 .

When the special incontinence pad is inserted, stool emptied by the patient passes directly from the intestine into the thin-walled tube 63 , via a wide channel in the elastic foam bell 62 into the container 67 with the help of the textile fabric strip 68 (wrapped around D, shown in dashed lines) the lying special incontinence pad D with its tube 63 in the area B uC of the anal prosthesis and the stool that is then located can be removed without soiling the anal prosthesis.

Function of the anal prosthesis with rinsing device for long-term use in fecal incontinence

In the case of fecal incontinence, the above-mentioned anal prosthesis is intended to create the possibility for seniors who are in need of care, as is often desired, to be cared for by their relatives at home in their familiar surroundings using an outpatient care service.

First, a doctor will examine the possibility of using an anal prosthesis. He will also at least take care of the initial care and give the necessary instructions for care.

1. 1. Der Enddann wird zuerst durch eine Darmspülung (Einlauf oder Klistier) gereinigt.
2. 2. In die individuell passende Analprothese wird die Applikationsvorrichtung 4, so eingeführt,wie in 5 abgebildet Wie erkennbar liegt der Basiskörper 31 im rohrförmigen Teil B beide Schwenkhebel 38, 39 sind nach innen geschwenkt und damit beide zugehörigen Druckteller 36, 37, nicht sichtbar, nach außen gedreht und dem Kragen des Stützrings 4 dicht anliegend (zur Verdeutlichung gestrichelt gezeichnet). Damit kann Druck auf den elastischen Ring 1 Teil A mit den Halteflügeln 17 (s. 1) ausgeübt werden. Als Varianten von 5 ,Teil B, kann der grob gestrichelt gezeichnete Teil 43, entweder sehr dünnwandig und damit sehr längselastisch, oder sehr flexibel als Rollmembran, oder als Faltenbalg ausgebildet sein und damit auch eine individuelle, anatomisch optimale Anpassung ermöglichen Die nun weiter unter stetigem manuellem Druck vorgeschobene Analprothese gleitet jetzt unter spürbarem Widerstand zuerst mit ihrem Analteil 42 der Einführvorrichtung und anschließend dem elastischen Ring 1 Teil A, mit herutergeklappten Halteflügeln, durch den äußeren Schließmuskelring und nachfolgend den inneren Schließmuskelring . Ist der innere Schließmuskelring passiert, dann verringert sich plötzlich der Einschiebewiderstand der Prothese. Die Halteflügel. 17 können nun in ihre waagerechte Ruhestellung ausklappen. Beim Versuch die Prothese herauszuziehen zeigt sich nun ein sehr deutlicher, hoher Widerstand. Die korrekte Lage der Prothese ist damit überprüft und die EinfUhrvorrichtung kann entfernt werden. Hierzu werden die Schwenkhebel 38 und 39 nach außen gedreht und dabei die Druckscheiben (36, 37) nach innen. Die Analpmthese-Einfuhrvorrichtung läßt sich nun mühelos herausziehen..Soll auch die Analprothese z.B. nach langer Liegedauer ausgewechselt werden, dann kann man durch Ziehen an dem nach außen geführten Zugseil das am Stützring 4 befestigt ist, diesen herunterziehen in Richtung Teil B, C. Es folgt damit ein Verlust seiner Stützfunktion für die Halteflügel, die nun leicht hochklappen können und damit ein einfaches manuelles Herausziehen der Analprothese ohne größeren Widerstand ermöglichen.

The application of an anal prosthesis is carried out as follows.

1. 1. The end then is first cleaned by an intestinal irrigation (enema or enema).
2. 2. The application device is inserted into the individually fitting anal prosthesis 4th , introduced as in 5 shown As you can see, the base is located 31 in the tubular part B both swivel levers 38 , 39 are swiveled inwards and thus both associated pressure plates 36 , 37 , not visible, turned outwards and the collar of the support ring 4th close fitting (shown in dashed lines for clarity). This can put pressure on the elastic ring 1 Part A with the retaining wings 17th (see 1 ) are exercised. As a variant of 5, part B, the roughly dashed part 43 , either very thin-walled and therefore very longitudinally elastic, or very flexible as a rolling membrane, or as a bellows and thus also enable an individual, anatomically optimal adjustment.The anal prosthesis, which is now pushed forward under constant manual pressure, now first glides with its anal part under noticeable resistance 42 the introducer and then the elastic ring 1 Part A, with the retaining wings folded down, through the outer sphincter ring and then the inner sphincter ring. Once the inner ring of the sphincter has passed, the insertion resistance of the prosthesis suddenly decreases. The retaining wings. 17 can now fold out into their horizontal rest position. When trying to pull out the prosthesis, there is now a very clear, high resistance. The correct position of the prosthesis is thus checked and the insertion device can be removed. The swivel levers are used for this 38 and 39 turned outwards and the pressure washers ( 36 , 37 ) inside. The anal prosthesis insertion device can now be pulled out effortlessly. If the anal prosthesis is also to be replaced, for example after a long period of inactivity, then the support ring can be pulled by pulling on the pulling cable that is led outwards 4th is attached, pull it down in the direction of part B, C. This results in a loss of its support function for the retaining wings, which can now easily be folded up and thus enable the anal prosthesis to be easily pulled out manually without great resistance.

Advantages of the anal prosthesis with rinsing device for long-term use in fecal incontinence

1. 1. No additional stress on the skin, which is already mechanically damaged and insufficiently supplied with blood, especially in the anal and coccyx area, through macerating stool and subsequently required cleaning actions with additional mechanical and chemical stress on the skin.
2. 2. Physical relief for the person in need of care through a possible reduction in hygienic and nursing measures, which are often perceived as painful by them.
3. 3. Decisive physical and temporal relief for the caregivers and / or a nursing service and a significant reduction in hard physical work for the patient (lifting, repositioning, turning, e.g. when changing contaminated bed linen, showering, washing up, applying lotion to the skin, etc.)
4. 4. Reduced consumption of laundry, cellulose, lower environmental pollution, odor nuisance, saving of care material by collecting the excrement in connected, easily disposable containers.
5. 5. Easier mobilization of the patient due to the possibility of using small or large-volume, anatomically well-fitting and easily exchangeable stool collection containers.
6. 6. Possibility of simple implementation of intestinal regulating measures e.g. B. Emptying through enemas, enemas, etc.

Claims (8)

Anal prosthesis with integrated rinsing device for long-term use in fecal incontinence with an insertion device, characterized in that it consists of three rubber-elastic parts A, B and C which are firmly connected to one another and uses an insertion device that can be disinfected / sterilized several times, and part A is a rubber-elastic, The wide, cylindrical ring is provided with a movably fitted, rigid support ring (4) and is provided with 2 large, cloverleaf-shaped, arched wings with integrated, right-angled, hook-shaped, resilient retaining elements and either with 2 on both sides very small, longitudinally oval, leaf-shaped wings adjoining each other in the round or without the like and at the end, a small, soft, cup-shaped wing that points backwards and upwards at about 30 - 60 degrees and with a flushing hose opening is or can be provided on the inner wing surface and with part B, which is designed as an elastic, thin-walled hose and integrated in the wall, has or can have a channel for a flushing hose and a pull rope and its transition piece to part C either is designed as a thin-walled or highly longitudinally elastic tube piece as a folded tube or as a roll membrane and with the elastic-soft anal adapter piece part C, which is either anatomically oval-funnel-shaped, as a 60-90 degree angle piece with a terminal edge bead and or supplemented with a closure piece with snap-on groove, Thread, bayonet or magnetic ring is or can be formed or an anatomically oval-funnel-shaped anal adapter piece C in combination with special, padded incontinence pads with integrated stool reservoir and provided with a thin-walled, rigid anal tube for precisely fitting into the lumen of the anal prosthesis and used that an insertion device for multiple use is used for insertion into the anus, which consists of a round, base rod made of solid, rigid material, with a smaller inner diameter than that of part B of the anal prosthesis, with 2 opposing guide grooves for 2 round rods terminal, swing-out pressure plates or swivel blades and has a round, conical anal inserter, flattened on both sides, fastened at a small distance with bolts. Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that the retaining wings are elastically connected with their roots to the elastic ring 1, A and can be easily folded down and have a curved surface and slightly concave underside, thus minimizing and rounding the diameter of the anal prosthesis for easy insertion in the anal canal. Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that the large retaining wings, which are flexibly hinged to part A by the support rib (s) incorporated in their upper part, with the possibility of supporting the support ring 4 movably fitted in part B, cannot or can only be folded up with difficulty. Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that the large retaining wings, which are elastically and articulated with part A, each have a resilient retaining element incorporated between the upper part and the lower part, the free, hook-shaped part of which is supported when the retaining wing is in a horizontal position of rest on the movably fitted support ring 4 and a prevents unwanted upward folding of the retaining wing and thus z. B. slipping out of the anal prosthesis Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that a pulling eye protruding into the lumen or an outwardly guided pull rope is attached to the support ring 4 with which the support ring 4 can be pulled down in part B with the loss of its function. It enables the retaining wings to be folded up with a significant reduction in the diameter of the anal prosthesis, which is important for effortless removal of the same. Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that the inside of part B of the anal prosthesis is coated with a material to reduce surface adhesion and improve lubricity. Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that the insertion device for the anal prosthesis consists of a round rod, which is attached to its end via 2 spacer bolts and carries a short, round, conical anal introducer body flattened on both sides and which has guide grooves on 2 sides for the 2 actuating rods which are eccentrically attached at one end , carry a pressure plate and its other end a pivot lever. Anal prosthesis with integrated rinsing device for long-term use in case of fecal incontinence Claim 1 characterized in that the special incontinence pad is made up of 2 foils which are firmly connected to one another at their edges. The upper gas-permeable film with attached, firmly connected, bell-shaped, soft, elastic foam body with an internal channel and with a very thin-walled, rigid pipe section (preferably made of Teflon, PA, PPPVC) that fits exactly into the lumen of part C and Part B of the anal prosthesis fits, forms a cavity with the lower, strong, tear-resistant, liquid- and gas-tight film, which is filled with a soft, cushioning, absorbent material, leaving out a free space as a collecting container for stool, which is directly connected via a wide channel in the foam body with the pipe section.

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