GB2274823A

GB2274823A - Medical dressing aid pack

Info

Publication number: GB2274823A
Application number: GB9402405A
Authority: GB
Inventors: Joseph Eliaho Abboudi
Original assignee: SHERMOND SURGICAL SUPPLY LIMIT
Current assignee: SHERMOND SURGICAL SUPPLY LIMIT
Priority date: 1993-02-09
Filing date: 1994-02-08
Publication date: 1994-08-10
Anticipated expiration: 2014-02-08
Also published as: GB2274823B; GB9302540D0; GB9402405D0

Abstract

A medical dressing aid pack comprises an outer envelope containing at least a sterile sheet 11 and a sterile pair of gloves 13, in which the sheet is folded such that it encloses the gloves, and such that, when the outer envelope is removed, it may be unfolded to expose the gloves, the upper surface 12 of the unfolded sheet then providing a sterile field. The sheet is formed of a lightweight plastics material which is adapted to lie substantially flat under its own weight upon being unfolded thus reducing the risk of the sterile field that the sheet forms in use being breached during the opening of the dressing aid pack. The sheet is preferably impervious to liquids and manipulable when touching one surface only. It is preferably folded in a manner so as to minimise the number of unfolding steps. The pack may also contain a disposable waste bag 14 and other implements or may be provided as part of a kit with further packs containing such other implements (such as swabs, spatulae or a gallipot etc). <IMAGE>

Description

Medical Dressing Aid Pack The present invention relates to dressing aids such as those used in hospitals, nursing homes, doctors' surgeries, etc., when a dressing on a patient needs replacing. More particularly, the invention relates to a sterile pack which contains the dressing aid or aids.

When a patient's dressing is changed, a new, sterile dressing is brought into contact with the affected part of the patient. It is therefore necessary during this procedure to maintain the sterility of the dressing. Thus any implements used during the procedure must be kept sterile and not come into contact with nonsterile areas. In practice, this is achieved by establishing a sterile field within which any implements or dressings may be placed without becoming contaminated.

This sterile field comprises a sterilised area or region on a work surface.

The presently employed method by which a sterile field is created is to cover all or part of the work surface with a sterile paper sheet. Work may then be carried out on the sterile upper surface of this paper sheet.

It is usual to incorporate the paper sheet in the sterilised dressing aid pack which is used during the dressing procedure. A dressing aid pack therefore usually comprises an outer envelope which contains a paper sheet which is folded so as to enclose such items as a pair of gloves and a waste bag which are to be used when changing the dressing. The pack as a whole, once it has been sealed, is initially sterilised, for example by gamma irradiation, and thus the contents remain sterile until the pack is opened.

The paper sheet in the pack is folded in such a way that the surface facing inwards and in contact with the gloves and bag does not come into contact with the work surface as the paper sheet is unfolded, so that this surface forms the upper surface when it is completely unfolded onto a work surface. By carefully unfolding the paper sheet so as not to contaminate, as far as possible, this upper surface, the sterile field may be established.

Once the pack is opened and the paper sheet unfolded, the sterile contents of the dressing aid pack lie on the top surface of the paper sheet ready for use.

The sterile gloves may then be donned by the nurse who is then free to touch the sterile surface of the paper sheet without contaminating it. Similarly, her gloves will not be contaminated by this contact. Of course, the underside of the paper sheet is no longer sterile, as it is contaminated by the unfolding procedure.

The above method of establishing a sterile field is used extensively throughout the world.

We have however found that, with the known packs of this type, there is a tendency for the paper sheet to refold along the folds placed therein to enable it to be placed in the pack in the first place. The paper sheet will therefore not readily lie flat on the work surface as shown schematically in Figure 1.

We have discovered that, in practice, this characteristic of the paper sheet can result in difficulties for the nurse or doctor who is applying the dressing, as they do not have a flat surface on which to work and thus, for example, any items which they place on the sterile field may fall over, possibly resulting in contamination.

We have also found that there is, in practice, a temptation for the doctor or nurse to attempt to flatten the paper sheet by pressing it down with their hands and trying to smooth it out, not just once the. paper sheet is fully unfolded but also during the unfolding procedure itself. This action would, of course, contaminate the sterile upper surface of the sheet, as unless the doctor or nurse is wearing the gloves enclosed by the sheet, their hands are not normally sterile. Obviously this undermines the main objective which is to provide a completely sterile working area.

According to the present invention, there is provided a medical dressing aid pack comprising an outer envelope containing at least a sterile sheet and a sterile pair of gloves, in which the sheet is folded such that it encloses the gloves, and such that, when the outer envelope is removed, it may be unfolded to expose the gloves, the upper surface of the unfolded sheet then providing a sterile field, and in which the sheet is formed of a lightweight plastics material which is adapted to lie substantially flat under its own weight upon being unfolded.

As is traditional, it is preferred that the pack further comprises a waste bag which is also enclosed by the folded sheet.

The provision of the present invention of a sheet which, without the need for the user to smooth down the folds, lies substantially flat when unfolded eliminates problems associated with the prior art dressing aid packs and represents a very significant advance in practice.

The sheet of the dressing aid pack of the present invention preferably lies substantially flat under its own weight at every stage of the unfolding procedure, even where there are still several layers at a fold line, and not just once the sheet is completely unfolded.

Furthermore, it lies flat at each stage without the need for additional smoothing or pressing down operations by the nurse or doctor.

The sheet is most preferably impervious to liquids.

This solves a further problem of the paper sheet used in prior art dressing packs in that paper is pervious to liquids. Any liquids spilt on the paper may therefore pass through it to the work surface below and the sheet may become saturated. More importantly, any liquid on the work surface which comes into contact with the paper sheet will soak into it and contaminate it, thus rendering the sheet non-sterile.

It is desirable for a dressing aid pack to be as small and compact as possible. This reduces both the amount of storage space required and the waste involved.

The standard method of packing the contents in the dressing aid pack is therefore to arrange them such that the individual gloves and bag lie on top of one another when the pack is sealed, thereby reducing the area of the sealed pack.

It is also desirable to the user to have the contents of the pack displayed and placed conveniently once the sheet is completely unfolded. This means that the pack also has to be arranged and the sheet folded such that the individual gloves 3 lie side-by-side when the sheet is fully unfolded, with the waste bag 4 preferably either on top of or underneath one glove, as can be seen in Figure 1.

The gloves must also lie flat such that their turned-back cuffs 5 are easily accessible so that the gloves may be put on in a sterile manner.

Finally, it is desired for the sterile field to be as large as possible, so that working conditions are not restricted.

The above requirements, together with the need to avoid contamination of the upper surface of the sheet during the unfolding procedure, are all taken into account when folding the sheet to assemble the medical aid pack.

Furthermore, due to the relatively stiff nature of the paper sheet used in previous dressing aid packs, a number of additional limitations are placed on the folding procedure. Firstly, it is difficult to fold a double or greater thickness of the paper sheet and therefore the folding is arranged such that this is avoided wherever possible. Secondly, it is not possible, without great difficulty and the causing of substantial damage and creasing to the sheet, to manipulate the paper sheet without touching both surfaces of it, for example by trying to pinch one surface only.

The above requirements and limitations result in a folding sequence involving five steps, when using a paper sheet of the prior art package and a sterile field of restricted size. The fold lines 6a-6e in Figure 1 show the folding steps which must be undertaken.

Furthermore, it is necessary to provide flanges 7 on the paper sheet to enable the paper sheet to be gripped so that the final unfolding steps which expose the contents and upper surface of the sheet may be carried out. However, in taking hold of these flanges, the nurse or doctor must necessarily touch and contaminate the upper surface of the paper sheet, albeit in its edge region. The sterile field has therefore already been breached even before any medical operation has been carried out. This necessary breaching of the field may also have a psychological effect on the nurse or doctor, in that once the field has been breached, there is less reluctance to do so again. This is especially significant when the temptation to flatten the paper sheet is taken into account.

It is preferred in the present invention that the sheet be such that it is possible to manipulate it when touching one surface only. Thus the sheet is manipulated during unfolding by pinching it between finger and thumb from the side which is the underside when unfolded. This eliminates the initial contamination of the upper surface of the edge regions of the sheet which occurs in the prior art. The doctor or nurse therefore starts with a completely sterile field on which to work. This heightens the psychological reluctance to breach the sterile field.

In a first embodiment, the folding procedure during assembly of the pack begins with the sheet laid out fully opened and the gloves placed side-by-side, on its upper surface. One side of the sheet is then folded along a line close to the gloves, such that the flap formed thereby substantially covers the gloves, the fold line being substantially perpendicular to the line dividing the gloves. Next the opposite side of the sheet is folded towards the centre such that it overlaps the flap formed by the first folded side. Preferably, the opposite side of the sheet substantially covers the flap formed by the first folded side.

This initial folding sequence allows a substantially larger sheet than that in the prior art dressing aid packs to be used, as a number of layers of the sheet are stacked on top of each other when the sheet is subsequently folded.

The assembly of the pack is then completed by folding the sheet centrally along the line dividing the gloves, whereby after this fold the gloves are lying one on top of the other separated by at least one layer of the sheet. Finally, the remaining multi-layered flap is folded back over the gloves.

In the first folding arrangement, the sheet requires only four folding or unfolding steps. This reduction in the number of steps saves time, and more significantly, simplifies the sequence of steps which are involved, thus reducing the likelihood of errors which may result in contamination of the sterile upper surface sheet.

The unfolding sequence is essentially the reverse of this sequence and therefore similarly involves only four steps.

A second folding arrangement, although involving five folding steps, enables an increase in field size for a given size of folded pack.

The second folding procedure may involve the same initial two folding steps as the first procedure.

Alternatively, the initial two folds may be along lines parallel to the line dividing the gloves i.e. the other two sides of the sheet are initially folded over the gloves to substantially completely overlap one another.

The end portions of the partially folded sheet are then each in turn folded over the gloves along respective fold lines adjacent the gloves and perpendicular to the first fold lines to form a parcel enclosing the gloves which are still side by side at this stage. Finally, this parcel is folded centrally along the line dividing the gloves, whereby after this fold the gloves are lying one on top of the other separated by at least one layer of the sheet.

The above folding sequence ensures that there are no large areas of sheet extending beyond the area of the individual, stacked gloves. It is preferred in this second arrangement that the final area of the folded sheet is substantially similar to the area of an individual glove.

Both the preferred folding sequences-for assembling the pack ensure that the surface facing the nurse or doctor at any stage before the final unfolding step is the eventual lower surface of the sheet and therefore since it is possible to manipulate the sheet whilst touching only the undersurface of it, no contamination of the upper surface occurs during unfolding. Both the above folding procedures enable the use of a sheet which is considerably larger than prior art sheets. This stems from the ability to fold a greater number of thicknesses of the sheet material on top of one another and from the inherent lightness of the sheet material.

Suitable plastics for the sheet of the present invention include polymers such as polyester, polythene, polypropene, and polyvinyl chloride. The plastic sheet may be between 9 to 75 ym in thickness.

The relative flexibility and lack of stiffness of a polymer sheet of such thickness means that the sheet has virtually no resistance to unfolding, hence it lies flat on any surface on which it is placed. Furthermore, it is possible to manipulate easily the sheet touching one surface only, by pinching it, without producing any permanent distortion or deformation of the sheet.

By using a polymer sheet, the thickness of the sheet is substantially less than that of the paper sheet used previously and therefore the bulk and weight of the dressing aid pack may be reduced. Thus, the size of the sheet may be increased without increasing the bulk above that of a prior art pack, therefore allowing for a larger sterile field, and thus less restricted working conditions.

The dressing aid pack of the present invention can include further implements, if desired, such as swabs, spatulae or a gallipot, etc., as well as the gloves and waste bag. These further implements can either be enclosed by the sterile sheet if they are to be sterile once the pack is fully opened, or can simply be placed within the outer envelope, but outside the sterile sheet.

In a preferred alternative arrangement, the further implements are provided in a separate, sterile if necessary, pack in combination with the medical dressing aid pack of the present invention. This arrangement means that the further pack need not be opened and its contents have to be discarded, if all that is required is a sterile pair of gloves. We have found this to be a particularly cost effective system, as only those items essential to the medical procedure in question are used, thus reducing material wastage. Furthermore, we have found that the provision of separate packs encourages the doctor or nurse to assess initially the procedure to be carried out in order to decide which pack or packs to use. This avoids wastage due to incorrect selection of equipment, and avoids the performance of unnecessary procedures on the patient which has been found occur with packs containing equipment not essential to the required procedure, due to a desire to use equipment which would otherwise simply be discarded on the part of the doctor or nurse.

The present invention also extends to a method of assembling a medical dressing aid pack using the preferred folding sequences and having any or all of the features described above.

Preferred embodiments of the present invention will now be described, by way of example only, and with reference to the accompanying drawings, in which: Figure 1 shows a fully opened prior art dressing aid pack; Figure 2 shows a fully opened dressing aid pack according to the present invention; Figures 3, and 4 show the first two steps for folding the sheet of the dressing aid of the present invention; Figures 5 and 6 show the steps for completing the folding of the sheet of the dressing aid pack according to the first folding arrangement of the present invention; Figures 7, 8 and 9 show the steps for completing the folding of the sheet of the dressing aid pack according to the second folding arrangement of the present invention; Figure 10 shows the sealed dressing aid pack of the present invention;; Figures 11 to 15 show the unfolding of the dressing aid pack of the first folding arrangement of the present invention.

In Figure 2, at the commencement of the folding operation during assembly of the pack, the polymer sheet 11 is laid out flat on a work surface. As can be seen the sheet lies completely flat when unfolded. The upper surface 12 of the sheet will form the sterile field when the pack is used. Laid side-by-side on the upper surface are a pair of gloves 13, together with a disposable waste bag 14. These items are preferably placed centrally on the sheet.

In addition to the gloves and waste bag, further implements to be included in the pack may be placed on the sheet, for example a gallipot, swabs, spatulae, etc.

Alternatively, these additional items can be included in separate packs to be supplied with the dressing aid pack of the present invention.

The preferred polymer sheet is about 20 ym thick, although thicknesses of between 9 and 75 ym are acceptable provided that there is no substantial resistance to unfolding to the extend that the material lies flat under its own weight without being smoothed down.

If desired, the polymer sheet may be provided with a hole in it, such that it can then be placed over a wound so as to leave the wound exposed, whilst covering the surrounding area.

The first two steps of the folding sequence are illustrated in Figures 3 and 4. During the folding sequence both sides of the sheet may be touched, as sterilisation has not yet taken place. The first fold to be made, as shown in Figure 3, is along the line 15. One side of the sheet is folded along this line so that the sheet substantially covers the gloves 13. As can be seen, once this fold has been made the lower surface of the folded part of the sheet forming the flap 16 now faces the folder.

The next step is to fold the opposite side of the sheet such that it overlaps the flap 16 formed by the first folded side, thus leaving none of the upper surface 12 of the sheet exposed. The sheet after this fold is shown in Figure 4. It is preferred that the overlapping flap 17 is of a similar width to the first flap 16 so that the size of the sheet, within the constraints of the folding operation, is maximised. Both the flaps 16 and 17 are preferably approximately the length of a hand, for ergonomic reasons. In Figure 4, the positions of the gloves 13 and bag 14 within the folded sheet are shown in dotted outline.

The first folding procedure for completing assembly the pack of the present invention will now be described with reference to Figures 5 and 6.

The sheet is now folded centrally along the line 18 between the gloves, such that the gloves then lie one on top of the other, with two layers of the sheet lying between them. This is shown in Figure 5.

The final folding operation comprises folding the flap 19 back over the gloves, as shown in Figure 6. This figure shows the two gloves 13 lying one above the other.

It will be seen that this embodiment involves only four folding steps.

An alternative folding arrangement for completing assembly of the dressing aid pack is shown in Figures 7, 8 and 9. This involves five folding steps. Firstly, the two side flaps 22 and 23, shown in Figure 4, are folded over the gloves along fold lines 24 and 25 closely adjacent the gloves as shown in Figures 7 and 8, such that they overlap and the area of the folded sheet is substantially similar to the area of the gloves when laid side by side. Finally, the sheet is folded centrally along the line 18 between the gloves, such that the gloves then lie one on top of the other. As can be seen in Figure 9, the final area of the folded sheet is similar to that of an individual glove 13.

In the second folding arrangement, the folding of the side flaps 22 and 23 over the gloves, before folding the sheet so that the gloves are one on top of the other, means that the end portions 30 of the flaps 22, 23 are folded back on themselves during the final folding step so that there are no parts of the sheet left extending significantly beyond the gloves after the final fold has been made. In the first folding procedure, this does not happen and the consequence is that the width of the flap 19, and therefore of each of the flaps 22, 23, has to match the desired width of the final folded assembly, i.e. approximately a glove's width.In the illustrated embodiments, the preferred size of the sheet in the first embodiment is about 50" x 42" (the shorter dimension being perpendicular to the final fold line) whereas in the second embodiment it can be increased to 50" and 50" without increasing the size of the pack in its folded condition. This latter size matches the size of a typical medical trolley on which a sterile field is often required. However, 50" x 42" is still much larger than can be achieved with prior art systems, and the first embodiment is to be preferred in that only four unfolding steps are required.

Both of the above folding sequences result in the lower surface 21 of the sheet, which is in contact with the work surface when it is unfolded, facing the person unfolding the sheet at all times during the unfolding operation, until such time as the sheet is fully unfolded.

Figure 10 shows the folded sheet 11 placed inside the outer envelope 20, which encloses the contents of the dressing aid pack. The outer envelope is sealed and then the entire pack is sterilised prior to use, for example, by gamma irradiation. Once it has been sterilised, the pack remains sterile until it is opened, or in any other way contaminated. The outer envelope may be made of paper or any other suitable material.

Once the outer envelope has been removed, the sheet may be unfolded. The steps are essentially the reverse of the folding steps. This process is similar for both folding arrangements, and therefore only the sequence of unfolding steps for the first folding arrangement will be described herein. It is to be understood that everything stated in relation to this arrangement applies equally to the second folding arrangement.

Once the envelope 20 has been opened and removed, the sheet is unfolded in sequence, in the direction of the arrows as shown in Figures 11 to 15.

It can be seen from this unfolding sequence that at every stage, the doctor or nurse is able to manipulate the sheet by pinching its lower surface 21, the properties of the polymer film allowing this to be done, and therefore comes into contact with the lower surface of the sheet only. At no stage therefore does the upper surface 12 become contaminated.

As can also be seen, the sheet lies substantially flat at every stage of the unfolding sequence.

Once the sheet is fully unfolded, as in Figure 12, the doctor or nurse is able to remove the gloves by means of their folded-back cuffs, and put them on. The doctor or nurse's hands are then sterile and he or she may work within the sterile field without contaminating it.

Claims

1. A medical dressing aid pack comprising an outer envelope containing at least a sterile sheet and a sterile pair of gloves, in which the sheet is folded such that it encloses the gloves, and such that, when the outer envelope is removed, it may be unfolded to expose the gloves, the upper surface of the unfolded sheet then providing a sterile field, and in which the sheet is formed of a lightweight plastics material which is adapted to lie substantially flat under its own weight upon being unfolded.

2. A medial dressing aid pack as claimed in claim 1, further comprising a waste bag which is also enclosed by the folded sheet.

3. A medical dressing aid pack as claimed in claim 1 or 2, wherein said sheet lies substantially flat under its own weight at every stage of the unfolding procedure.

4. A medical dressing aid pack as claimed in claim 1, 2 or 3, wherein said sheet is impervious to liquids.

5. A medical dressing aid pack as claimed in claim 1, 2, 3 or 4, wherein said sheet can be manipulated when touching one of its surfaces only.

6. A medical dressing aid pack as claimed in any preceding claim, wherein said sheet is made of one of the following materials: polyester, polythene, polypropene or polyvinylchloride.

7. A medical dressing aid pack as claimed in any preceding claim, wherein said sheet is between 9 to 75#m in thickness.

8. A medical dressing aid pack as claimed in any preceding claim, wherein said sheet is folded so as to enclose the gloves by laying the sheet out fully opened with the gloves placed side-by-side on its upper surface, folding one side of the sheet along a line close to the gloves such that the flap formed thereby substantially covers the gloves, the fold line being substantially perpendicular to the line dividing the gloves, and then folding the opposite side of the sheet such that it overlaps the flap formed by the first folded side.

9. A medical dressing aid pack as claimed in claim 8, wherein the folding of said sheets further includes then folding the sheet centrally along the line dividing the gloves, whereby after this fold the gloves lie one on top of the other separated by at least one layer of the sheet, and then folding the remaining flap of sheet over the gloves.

10. A kit for aiding the dressing of wounds, comprising a medical dressing aid pack as claimed in any preceding claim, and a separate, sterile pack containing medical implements.

11. A kit as claimed in claim 10, wherein said further pack contains at least one of a swab, a spatula and a gallipot.

12. A kit as claimed in claim 10 or 11, wherein said medical dressing aid pack contains only a pair of gloves and a sheet.

13. A method of assembling a medical dressing aid pack, comprising the steps of: placing a pair of gloves side-by-side on the upper surface of a fully opened sheet of a lightweight plastics material which is adapted to lie substantially flat under its own weight upon being unfolded; folding one side of the sheet along a line close to the gloves which is substantially perpendicular to the line dividing the gloves, such that the flap formed thereby substantially covers the gloves; folding the opposite side of the sheet such that it overlaps the flap formed by the first folded side; placing the folded sheet within an outer envelope; sealing the envelope and sterilising the sealed pack.

14. A method as claimed in claim 13, further comprising the steps of: folding, after said two folding steps, the sheet centrally along the line dividing the gloves, whereby after this fold the gloves lie one on top of the other separated by at least one layer of the sheet; and folding the remaining flap of sheet over the gloves, before placing the folded sheet within the envelope.