GB2303554A - Surgical swab management system - Google Patents

Abstract

The management system 10 comprises an array of five pockets 11 formed on a backing sheet 17 with each pocket containing a clean surgical swab 12, the pockets being so arranged that each swab is readily visible. In use, sterile swabs may be removed as required and soiled swabs 22 replaced in the pockets, the front panels of which are transparent or semi-transparent so that the presence in each pocket of a clean swab or soiled swab, or the absence of a swab, can be readily ascertained. Thus, all swabs can be accounted for at the end of surgery. The backing sheet may be coloured to improve swab visibility or, if a transparent sheet is used, the system may be suspended in front of a suitably coloured background material.

Description

SURGICAL SWAB MANAGEMENT SYSTEM This invention relates to a management system for surgical swabs.

Absorbent swabs of cotton gauze material are almost universally used in surgical procedures to absorb body fluids, especially blood at the site of surgical entry into the body. It is still customary for used swabs to be passed by the surgeon to a member of the theatre nursing staff, and for those used swabs to be counted to ensure that no swab has been inadvertently left within the patient's body. Such a procedure, however, has many inherent dangers and disadvantages. The major danger from the patient's viewpoint is that the counting process is laborious and prone to human error, particularly when major surgical procedures may last for several hours and use many dozens of swabs and may include the closing of several different tissue layers within the patient with each closing involving a separate swab count.

The danger to the surgical theatre staff is that blood-soaked swabs carry with them the risk of infection from blood-borne pathogens, for example the AIDS and hepatitis viruses.

Recently, proposals have been made for the safer disposal of used surgical swabs, for example as described in US Patent Nos. 4,234,086 to Dorton, 4,361,231 to Patience, 4,713,136 to Li, 4,887,715 to Spahn et al. and 5,048,683 to Westlake, and in published International Patent Application No.

W089/02726 to Norman. The disposal systems disclosed in those documents involve a plurality of pocket-like receptacles formed of transparent plastics sheeting into which the soiled swabs may be placed for disposal, the pockets enabling blood to be safely contained and their transparent character enabling the soiled swabs to be readily visible for being counted.

In the system described by Dorton, the individual pockets may receive one large soiled swab or two small soiled swabs and include heat-sealed connections between the front and rear of each pocket to prevent the pockets from gaping. The system described by Li includes also flaps to cover the pocket openings. The Patience patent discloses a system in which each pocket may accommodate one large used swab or two small used swabs and the Westlake patent (which is commonly assigned) discloses a similar system in which the absorbed blood may drain through an opening into the lower part of the pocket to reduce the risk of spillage and contamination during disposal.Spahn et al. describe a system in which the pockets containing the discarded swabs can be folded within a containment pocket, and Norman discloses a system which can be folded and sealed to enclose the soiled swabs within their respective pockets.

Finally, published European Patent Application No. 0401744 assigned to Rauscher & Co discloses a system which involves a rigid array of swab receptacles into which soiled swabs may be disposed.

The present applicant is unaware of any of the systems disclosed in the above-referenced documents having been manufactured or used and can envisage clear disadvantages in them which predicate against such use. For example, all of the proposals although laudable in their objectives and excellent in their proposed functions are of varying complexity to manufacture, are cumbersome to manipulate under at best the busy conditions prevailing in an operating theatre and at worst the frantic atmosphere of an emergency theatre, and are of varying utility in fulfilling the promises they make for thorough containment of blood and safe disposal of soiled swabs. They all rely also upon the nursing staff handling the system actually counting the used swabs to ensure correlation with sterile swabs.

The present invention seeks to provide a management and disposal system for surgical swabs which not only is both simple to use and straightforward to manufacture but also provides the necessary safeguards against swab loss without the need to count individual swabs, and against swab contamination.

In accordance with the invention, there is provided a swab management system comprising an array of pockets formed on a backing member, each pocket containing a clean surgical swab, and the pockets being so arranged on the backing member that each swab is readily visible.

Preferably, the pockets (which may be five in number in accordance with current practice for bundling surgical swabs in groups of five) are arranged in a single column. The system is suitably supplied in a fully sterile state within a doublelayer outer wrapping, as is conventional for known surgical swabs.

The present invention is described below in greater detail by way of example only with reference to the accompanying drawings in which Fig. 1 is a schematic representation of a swab management system according to the invention; and Fig. 2 is a schematic representation of the same swab management system during use.

Referring to the drawings, there is shown in Fig.

1 a swab management system indicated generally at 10 comprising an array of five pockets 11 each containing a surgical swab 12. The pockets are arranged in a column with their openings 13 along their upper edges 14 and the whole system may be suspended from a pair of support pegs (not shown) arranged to extend through perforations 15 adjacent the upper edge of a top flap 23 of the system 10.

The front panels 16 of the pockets 11 are of a transparent or semi-transparent plastics film (for example unpigmented polyethylene or polyethylene terephthalate), so that the presence in each pocket 11 of a clean surgical swab 12 or a soiled surgical swab 22 (Fig. 2) or the absence of a swab (as in the case of the top pocket 11 in the system shown in Fig. 2) can be readily ascertained. The backing sheet 17, however, is suitably of an opaque plastics film (such as pigmented polyethylene or polyethylene terephthalate) with which the material of the front panels 16 of the pockets 11 is readily heat-sealable.

The backing sheet 17 is suitably of a colour against which the presence of a clean or soiled swab or the absence of a swab can be immediately ascertained (and a suitable colour in this respect is a medium blue).

Alternatively, the backing sheet 17 may be of a transparent or semi-transparent material and the system may then be suspended immediately in front of a suitably coloured, for example blue, background material (not shown).

The precise identities of the materials for the front panels and backing sheet are, however, unimportant provided that they are compatible for heat-sealing purposes when the system is manufactured using heat sealing techniques, and that they are capable of being sterilized to surgical standards, using heat, radiation or ethylene oxide.

The swab management system 10 according to the invention may be manufactured in a straightforward and inexpensive manner simply by heat-sealing the material of the front panel 16 of each pocket 11 along its two side edges 18,18' and its lower edge 19 to the backing sheet 17. If necessary or desired, the upper end 20,20' of each of the two side edge seams 18,18' may be reinforced, for example with an enlarged heatsealed region, to resist tearing of the side seams 18,18' when the opening 13 at the top edge 14 of the front panel 16 is pulled upon to insert a swab. If desired, the top edge 14 of the front panel 16 of each pocket 11 may be held closed by a heat-sealed spotweld, although in the embodiment shown in Figure 1 the swabs 12 extend above the upper edges 14 of the front panels 16 of the pockets 11 and no such spot weld is required. Alternatively, there may be used an adhesive patch (not shown) for closing the pocket 11 which may be reused to close the pocket 11 once a soiled swab 22 has been returned to the pocket 11 to prevent the soiled swab 22 becoming accidentally displaced from the pocket 11.

The backing sheet 17 must of course be capable of bearing the weight of a full complement of soiled swabs 22 which may all be saturated with blood, and the repeated forces exerted on it as the respective pockets 11 are pulled open first to extract the clean swabs 12 and then to insert the soiled swabs 22. For this reason, the backing sheet 17 is preferably of a relatively thick gauge film, for example up to 5 mils (125 im) thick. In contrast, the front panels 16 of the pockets 11 have to support only the weight of a single clean swab 12 or soiled swab 22 and to withstand the forces of only single extraction and insertion actions, and they may be of a thinner gauge material, for example up to 2 mils (50 Sm) thick.

As can be seen in the drawings, the backing sheet 17 has an upstanding top flap 23 which as mentioned above has perforations 15 adjacent its upper edge.

These perforations 15 may be used to suspend the system from a pair of support pegs (not shown). Those pegs themselves may be mounted on a free-standing frame (not shown) which may be positioned at a suitable location ' in the operating theatre.

Alternatively, the frame or stand may include one or more spring-loaded clips or mechanical clamps, for example, for gripping the top flap of the management system. If desired, the frame or stand may incorporate also a weighing device by means of which the weight of absorbed blood and hence the patient's blood loss may be continually monitored, and a disposal receptacle into which the swab management system 10 may be placed once the pockets 11 contain a full complement of soiled swabs 22.

After positioning of the disposable receptacle on the stand and zeroing the weight monitor, sterile swabs 12 may be removed as required and soiled swabs 22 replaced in the pockets 11 after use. As each column of pockets 11 is filled with soiled swabs 22, the system 10 may be disengaged from the pegs (or clips or clamps) and dropped into the disposal receptacle. In this way, a further system 10 including a fresh column of pockets 11 containing sterile swabs 12 is revealed and the soiled swabs 22 are immediately removed from the vicinity of sterile swabs.

The swab management system 10 shown in the embodiment herein contains just five pockets 11 in a column. Five has been selected as the number for the collection of surgical swabs because it aligns with current practice, but it is equally possible from a practical aspect to have a system with a lesser or greater number of pockets and swabs. Similarly, it is not inconceivable that it will be equally acceptable to operating theatre staff to include in a single swab management system two or more columns of pockets arranged side-by-side, each column containing, say, five pockets, or to arrange five pockets on both sides, i.e. obverse and reverse, of a single backing sheet. Still further, it is entirely practical to arrange the pockets in a side-by-side relationship, i.e. in a horizontal row.

The swab management system of the invention has one clear and very significant advantage over the swab disposal systems disclosed in the prior art documents identified above, and that is that its use eliminates totally the need for the number of swabs used during the course of any surgical procedure to be counted.

This is because all swabs are initially contained within pockets in the system, and all that is required of the nursing staff is to ensure that all pockets contain either a used or unused swab at the end of the surgical procedure. This does of course presuppose that every pocket does indeed contain a sterile swab at the outset, but modern manufacturing techniques incorporating, for example, product weight monitoring, are able to guarantee such a feature.

Claims (8)

CLAIMS:

1. A swab management system, comprising an array of pockets formed on a backing member, each pocket containing a clean surgical swab, and the pockets being so arranged that each swab is readily visible.

2. A swab management system according to claim 1, wherein the pockets are arranged on the backing member in a single column.

3. A swab management system according to claim 2, wherein the column consists of 5 pockets.

4. A swab management system according to any one of claims 1 to 3, wherein each pocket is open along its upper edge.

5. A swab management system according to any one of claims 1 to 4, wherein the front panel of each pocket is formed of a transparent material.

6. A swab management system according to claim 5, wherein the backing member is coloured.

7. A swab management system according to any one of claims 1 to 6, which is surgically sterile.

8. A swab management system according to claim 1, substantially as described herein with reference to and as shown in Fig. 1 of the accompanying drawings.