GB2589314A

GB2589314A - A medical garment

Info

Publication number: GB2589314A
Application number: GB1916661.0A
Authority: GB
Inventors: Tooke Stephen
Original assignee: Tookie Ltd
Current assignee: Tookie Ltd
Priority date: 2019-11-15
Filing date: 2019-11-15
Publication date: 2021-06-02
Also published as: GB201916661D0

Abstract

A garment 10 comprises a front panel 12, a back panel 14 and an abdominal aperture (24, fig.2) in the front panel of the garment. The abdominal aperture is provided with a covering 28 that is at least partially detachable and may comprise a plurality of overlapping flaps. The flaps may be made of a stiffer material than the rest of the garment. Tube holding strips (32, fig.3) may be provided. A further garment may comprise a front panel with an internal section (34, fig.7) which is at least partially detachable, wherein apertures are provided to receive a medical tube between the front panel and the internal section. A third embodiment describes a lower body garment having a pocket (50, fig 11a) with internal closure elements (58, fig. 11a) provided to vary the internal volume. The aperture may allow access to a stoma, and the pockets may be used to hold a stoma bag.

Description

A Medical Garment

Field of the Invention

The invention relates to a medical garment, particularly for use in enteral nutrition, stomas and/or with central venous catheters.

Background to the Invention

In medical environments, patients that are fitted with a central venous catheter (central line) or a stoma have a need to keep those devices in place and clean. Should they become dirty, there is a risk of infection and should they become dislodged or removed they will require reinstalling or re-siting. Similarly, should those elements be inadvertently pulled or caught, they may also be damaged. There is considerable cost associated with re-siting medical devices as they can be time-consuming to fit back in place and they require a medical professional to undertake the procedure. Thus, there is a need to protect the stoma and/or central line from damage or soiling.

An ostomy pouch, also called a stoma bag, is normally connected to a stoma to receive waste from the patient. The ostomy pouch is sized according to the patient's needs and those needs may vary according to the activity undertaken, for example, larger pouches are often used overnight because of the larger capacity reducing the risk of leaking overnight, whist smaller pouches might be used during the daytime to minimize the appearance of the bag under clothing The ostomy pouch is often adhered to the patient's skin or held against the user's abdomen using a belt; however, both systems of keeping the pouch in place are problematic. In patients with skin conditions, the adhesion of the pouch to the skin can cause further complications and the plastics material of the pouch against the skin can cause sweating and irritation. Additionally, in smaller patients, such as children, there is often insufficient space to adhere the pouch to the skin. The use of belts is known to cause complications because the belts often compress the pouch and reduce its capacity.

Another option is to hang the pouch via a medical tube, but that puts strain on the stoma and may cause it to become detached. Shorts and undergarments have previously been proposed that incorporate a pocket for holding the stoma pouch.

Summary of the Invention

Accordingly, the present invention is directed to a garment comprising a front panel and a back panel connected thereto, wherein the garment further comprises an abdominal aperture in the front panel of the garment, the abdominal aperture being provided with a covering that is at least partially detachable.

The present invention thus provides a garment that can be worn by a patient that has a stoma fitted, wherein the garment provides access to the stoma without the need for the garment to be removed. The aperture is sufficiently large to provide access to the stoma, for example, greater than 50mm in either length and width or diameter, the aperture may be larger than this, for example being made larger by lmm increments. Thus, the aperture may be 80mm or 100mm is length, width or diameter, depending upon the patient size; however, the aperture should be at least 50% of the covering size, and preferably 75% or more, in order to provide good access to the stoma site. This allows the aperture to be covered completely by the covering, whilst allowing the periphery of the covering to be attached to the garment.

Preferably, the abdominal aperture covering comprises a stiffer material than the rest of the garment. A stiffer section, which may be made stiffer by use of a different type of material or a thicker material reduces the risk of the stoma being removed from the patient because it becomes more difficult for a user to grip the stoma. This reduces the risk of the stoma becoming dislodged to removed, thus reducing the need to re-positioning. In one arrangement, it may be useful to have a plurality of layers of material, for example, a top layer of cotton, a middle layer of rubber, and a bottom layer of cotton. The rubber may be synthetic nibber, for example polychloroprene.

It is advantageous that the abdominal covering comprises a plurality of flaps. By employing a plurality of flaps or coverings, part, for example, one side of the aperture, can be exposed whilst the other part or side remains covered This allows access to the whole aperture area should it be needed, but part of the aperture can remain covered to reduce heat loss of the patient through the exposed area. In a further advantageous arrangement, the flaps are arranged laterally, rather than longitudinally on the garment, although the latter is envisaged as being useful in some arrangements. The present invention allows a patient to be reviewed and treated without removing the garment and allowing sufficient access to the stoma site.

Where a plurality of flaps is employed, it is preferable that they overlap one another when covering the abdominal aperture. Providing an overlap between the flaps or coverings allows for a readily sealed arrangement, thereby allowing access to the abdominal region whilst providing a quick closure mechanism. The left-hand side flap may overlap the right-hand side flap at the external side of the garment, or vice versa.

In a preferred arrangement, the, or each, aperture covering is completely detachable from the garment. Such an arrangement allows for the covering(s) to be removed from the garment for washing or replacement should they become soiled or damaged.

Advantageously, a tube holding device, which may be in the form of a tube holding strip, is provided at a position adjacent the abdominal aperture, the strip comprising a holding mechanism to releasably retain a medical tube on the garment. The tube holding strip, although it will be appreciated that other shapes may be employed, provides a mechanism for securely holding the tube in place, thereby reducing the risk of the tube being strained.

Additionally, it may be preferable to employ a mechanism that allows the tube to be held in an "S" or "IV' shape to provide some resilience against strain on the tube. This may be in the form of a clip, holder or a channel in which the tubing can be received and in which the curved sections contain some slack, redundancy or some excess tubing to allow part of the tube to be 'pulled' through the holding mechanism without the other end of the tube being moved. The tube holding strip is particularly advantageous in respect of delivering treatment to a patient through the stoma, especially children. Treatments, particularly feeding the patient via an enteral tube, can take a considerable time to deliver to the patient and it is often the case that the patient gets uncomfortable laying in one position for the whole time. Thus, the tube holding strip can be employed to reduce relative movement between the tube and the stoma, thereby reducing the risk of the tube being removed during treatment.

In one arrangement, the tube holding strip comprises a first part and a second part, each of the parts comprising respective parts of a two-part connection mechanism, which may be in the form of hook-and-eye materials. Having a first part of the connection mechanism on the garment and a removable strip attaching thereto allows for a readily releasable holding mechanism, which, preferably, is sufficiently sized to allow the tube to be received in a manner in which it is un-curved or in which it is curved to allow some redundancy in the length to reduce the risk of the tube pulling on the stoma. The use of this type of strip allows for various diameter or bore of tubing to be held securely.

The present invention extends to an upper body garment comprising a front panel, wherein the front panel is provided with an internal section that is at least partially detachable from the front panel and wherein, when fixed onto the front panel, two apertures are provided in the internal section to receive a medical tube at a position between the front panel and the internal section.

The medical tube, which is likely to be part of a central line, is sandwiched between the internal face of the front of the garment and the internal section. It may be desirable to locate tube holders upon one or both surfaces to retain the tubing in a predetermined position and orientation. The retaining means may be in the form of hook-and-eye fasteners, foam members with a recess into which the tubing can be received, clips or other retaining mechanisms. This arrangement keeps the central line held in a secure and known manner and may assist in stabilising the central line. It may be desirable to retain the medical tube in a substantially linear manner across the garment to avoid fatigue in the tube material that may cause damage or failure of the tube. Alternatively, it may be desirable to coil or curl the tube or to provide an "S" or "N" shaped curve in the tube to reduce the risk of strain on the central line site. Such curving of the tubing may involve a tube holding device to retain it in the desired shape.

The present invention further extends to a lower body garment comprising at least one pocket, wherein the pocket has an opening therein and the pocket is provided with at least one internal closure element to vary the accessible internal volume of the pocket Thus, the pocket has an opening and the operable depth of that pocket is adjustable by the fixing and/or releasing of the closure elements. Therefore, the pocket can be adapted to receive different sized stoma pouches, whilst providing support to the pouch without compressing them because the pouch can rest on the lowest closed closure elements or the base of the pocket In a preferred arrangement, the pocket is provided with a plurality of internal closure elements and, more preferably, the closure elements run substantially laterally across the pocket. Using a plurality of internal closure elements allows for various sized bags to be accepted and supported within the pocket, thereby making the pocket more appropriate for different sized pouches. Furthermore, whilst the closure elements may be on an angle, it is preferable that they extend laterally across the pocket. The closure elements may extend across the whole pocket or may extend only partially across the pocket. Furthermore, they may be continuous or comprise a plurality of elements that, together, comprise the closure elements, for example poppers within the pocket or sections of hookand-eye fasteners that extend across the pocket.

It is envisaged that the garment may be provided with a plurality of pockets on a single garment. This provides flexibility to the user so that the stoma pouches can be positioned as required for a particular task or for a particular appearance For example, the pocket(s) may be located on the front, side and/or rear of the garment and may be of varying height on the garment to allow for a pocket nearer the hip or knee.

Whilst the volume variable pocket may be integrally formed with the garment, it will be appreciated that the pocket may be a separate element that can be attached to a garment, for example, by the use of hook-and-eye fastenings, poppers or other appropriate fastenings. This allows the user more flexibility in where the pocket should be located on the garment.

Brief Description of the Drawings

An embodiment of the invention will now be described, by way of example only, and with reference to the accompanying drawings, in which.

Figure 1 shows an infant garment in accordance with the present invention; Figure 2 shows a further view of the garment of Figure 1; Figure 3 shows another view of the garment of Figure 1; Figure 4 shows the garment of Figure 1 when worn by a user; Figure 5 shows a further view of the garment of Figure 4, Figure 6 shows a view of the garment of Figure 4; Figure 7 shows another view of the garment of Figure 6; Figure 8 shows a garment in accordance with the present invention; Figure 9 shows a further view of the garment of Figure 8; Figure 10a and 10b show a further views of the garment of Figure 8 and Figure 11a to 11c show a further view of the garment of Figure 8.

Detailed Description of Exemplary Embodiments

Figures 1 to 7 show a paediatric garment 10, in the form of a vest or baby-grow, that is intended for babies and/or infants. The garment 10 comprises a front panel 12 and a back panel 14 that are connected to one another by shoulder straps 16. The shoulder straps 16 are releasable via a shoulder connection mechanism 18, and the position between the shoulder straps 16 constitutes a head aperture 20. The garment 10 is provided with a crotch element 22, as is standard in this type of garment.

The garment 10 is provided with a central abdominal aperture 24 in the front panel 12. A line of one part of a hook-and-eye fastening material 26 surrounds the periphery of the abdominal aperture 24, although it will be appreciated that this could be discrete portions of fastening material rather than a continuous line thereof Two abdominal aperture coverings 28 are provided in the form of flaps or doors that are sized to each cover approximately half of the abdominal aperture 24, although the ratio of the coverings may be adjusted. The coverings 28 have an external surface and an internal surface, the latter of which is provided with a line fastening material 30 adjacent the periphery of the covering 28, the line of fastening material 30 being the second part of the fastening material, which is adapted to cooperate with the corresponding line of fastening material 26 on the front panel 12. The coverings comprise a top layer of cotton material, a middle layer of 3mm polychloroprene and a bottom layer of cotton material, although it will be appreciated that the thickness of the middle layer may be varied by up to 3mm and other materials may be employed.

Situated adjacent the lower edge of the abdominal aperture 24 is a tube holding strip 32. The tube holding strip 32 has an external surface and an internal surface, the latter of which is provided with one part of a connection mechanism and a corresponding part is provided on the front panel 12. The tube holding strip 32 is at least partially detachable from the front panel 12 to allow a medical tube to be positioned between the tube holding strip 32 and the front panel 12. The medical tube 33 may then be held in place whilst treatment is delivered, thereby reducing the risk of inadvertent 'pulling' on the tube during treatment.

As shown in Figure 4, one of the coverings 28 can be opened to administer treatment to a patient, with the other covering 28 being kept closed to reduce heat loss.

The lower half of the garment 10 shown in Figures 1 to 7 can be opened to provide access to the whole abdominal region whilst keeping the top of the garment 10 in place. The lower part of the garment flares open to allow sufficient access to the abdominal area and top of the legs. Additionally, this allows removal of the garment whilst the patient is being treated or fed via the stoma.

Figures 6 and 7 shown the shoulder strap 16 being disconnected and the upper part of the front panel 12 being folded away from the patient. An internal section 34 is provided on the internal surface of the front panel 12. The internal section 34 is fixedly connected along the edge distal from the top seam of the front panel 12, although this edge may be releasable connected to allow the internal section 34 to be removed completely. The opposing edge of the internal section, that is to say the edge proximal to the top seam of the front panel 12, is releasably connected to the internal surface of the front panel 12 by way of a releasable connection mechanism. The respective sides of the internal section and not connected to the front panel 12, thereby creating apertures and forming a conduit or tunnel between the internal section 34 and the internal surface of the front panel 12.

Thus, the top part of the internal section can be folded down to allow access to the conduit between the internal section 34 and the internal surface of the front panel 12. This is further discussed in relation to Figures 10a and 10b.

Figures 8 to 10a show an adolescent and adult garment, which might be considered a vest, romper suit or playsuit, that incorporates the abdominal aperture 24 and the coverings 28 therefor. Additionally, as shown in Figure 10b, the garment incorporates an internal section 34, which is shown in the substantially closes position in Figure 10a, wherein a medical tube 36 is shown in position. The storage of the medical tube 36 in the conduit formed between the internal section 34 and the front panel 12 allows for the safe storage of a central line 36. The respective parts of the internal connection mechanism 40 are shown in Figure 10b, Figures 10a and 11 a to 11c further show a garment having a pocket 50 for receiving a stoma pouch 52. The garment may be integral with an upper body garment as shown in Figure 10, or it may be a separate lower body-only garment, such as shorts or underpants, as shown in Figures lla to 11c. The garment may be provided with a gusset opening all allow its removal during treatment whilst the stoma or other tubing is connected to the patient and to a medical device providing treatment.

The pocket 50 has an opening 54 at the top end, adjacent the waist of the garment, and three compartments 56a, 56b, 56c that extend longitudinally down the garment. The compartments 56 are separated by closure elements 58 that comprise hook-and-eye fastenings. As shown in Figures lla to 11c, the releasing of the closure elements 58 increases the effective volume or capacity of the pocket 50, thereby allowing larger stoma pouches 52 to be inserted when required, without requiring a separate garment. Additionally, the next closure element 58 in the pocket 50 forms a base on which the pouch 52 is supported, although it will be appreciated that when all of the closure elements 58 are released, or opened, the pouch 52 can rest on, and be supported by, the base 60 of the pocket 50. The depth of the pocket 50 is increased to accommodate larger pouches 52, thereby providing flexibility to a user to change the size of the pouch 52 without having to change garment.

Whilst the coverings may be completely removable from the garment, it is envisaged that they may, alternatively, be fixedly connected thereto along one edge, which may to prevent them being removed and lost Additionally, other shapes beyond rectangular coverings may be employed and, in such shapes, more than one edge may be fixedly connected.

All connection mechanism, such as poppers and hook-and-eye elements comprise non-metallic parts, such as plastics materials, in order to be compatible with x-ray and magnetic resonance imaging, and so minimize any obscuring of the biological elements shown in images obtained therefrom. Similarly, where hook-and-eye material has been described, that may be replaced with another appropriate connection mechanism, such as poppers or other elements. Additionally, where such are described as a line or a strip, they may be continuous or a line of discrete elements constituting a line.

The openings to the internal conduit between the internal section and the front panel could be positioned at other locations around the internal section, for example at least one opening might be arranged at the end of, or along, the 'fixed' edge.

Claims

-1 0 -Claims A garment comprising a front panel and a back panel connected thereto, wherein the garment further comprises an abdominal aperture in the front panel of the garment, the abdominal aperture being provided with a covering that is at least partially detachable A garment according to Claim 1, wherein the abdominal aperture covering comprises a stiffer material than the rest of the garment.A garment according to Claim 1 or Claim 2, wherein the abdominal covering comprises a plurality of flaps.4. A garment according to Claim 3, wherein the respective flaps overlap when covering the abdominal aperture.A garment according to Claim 3 or Claim 4, wherein the, or each, aperture covering is completely detachable from the garment 6. A garment according to any preceding claim, wherein a tube holding strip is provided at a position adjacent the abdominal aperture, the strip comprising a holding mechanism to releasably retain a medical tube on the garment.7. A garment according to Claim 6, wherein the tube holding strip comprises a first part and a second part, each of the parts comprising respective parts of a two-part connection mechanism.8. An upper body garment comprising a front panel, wherein the front panel is provided with an internal section that is at least partially detachable from the front panel and wherein, when fixed onto the front panel, two apertures are provided in the internal section to receive a medical tube at a position between the front panel and the internal section. 10.II. A 12.A lower body garment comprising at least one pocket, wherein the pocket is provided with an opening therein and the pocket is provided with at least one internal closure elements to vary the accessible internal volume of the pouch.A lower body garment according to Claim 9, wherein the pocket is provided with a plurality of closure elements garment according to Claims 9 or Claim 10, wherein the, or each, closure element run substantially laterally across the pocket.A garment according to any one of claims 9 to 11, wherein the closure elements comprise hook-and-eye elements.A garment according to any one of Claims 9 to 12, wherein a plurality of pockets is provided on a single garment.Claims 2.o 15 3. C\I a) 6.A garment comprising a front panel and a back panel connected thereto, wherein the garment further comprises a central abdominal aperture in the front panel of the garment, the abdominal aperture being provided with a covering that comprises a plurality of flaps that overlap when covering the abdominal aperture to cover the abdominal aperture; and wherein each flap is completely detachable from the garment.A garment according to Claim 1, wherein the abdominal aperture covering comprises a stiffer material than the rest of the garment.A garment according to claim 1 of claim 2, wherein a tube holding strip is provided at a position adjacent the abdominal aperture, the strip comprising a holding mechanism to releasably retain a medical tube on the garment.A garment according to Claim 3, wherein the tube holding strip comprises a first part and a second part, each of the parts comprising respective parts of a two-part connection mechanism.A lower body garment comprising at least one pocket, wherein the pocket is provided with an opening therein and the pocket is provided with at least one internal closure elements to vary the accessible internal volume of the pouch.A lower body garment according to Claim 5, wherein the pocket is provided with a plurality of closure elements A garment according to Claims 5 or Claim 6, wherein the, or each, closure element run substantially laterally across the pocket.A garment according to any one of claims 5 to 7, wherein the closure elements comprise hook-and-eye elements.A garment according to any one of Claims 5 to 8, wherein a plurality of pockets is provided on a single garment.