GB2617807A

GB2617807A - Dressing for a medical tube

Info

Publication number: GB2617807A
Application number: GB2117367.9A
Authority: GB
Inventors: Cotton Stephen
Original assignee: Brightwake Ltd
Current assignee: Brightwake Ltd
Priority date: 2021-12-01
Filing date: 2021-12-01
Publication date: 2023-10-25
Also published as: GB202117367D0

Abstract

A dressing 1 for a medical tube comprises: an absorbent body 2 having an absorbent foam core 3 between a base layer 4 and a cover layer 5, formed with an opening (9, Fig.2) for accommodating a medical tube and a slit (11, Fig.2) extending from the opening to a periphery of the absorbent body; and a clip 8 for securing around a medical tube, the clip being attached to the upper surface layer of the cover layer and comprises an openable annual body defining an opening in correspondence with the opening 9 in the absorbent body. Also disclosed is a dressing as described above where the foam core 3 is a hydrophilic polyurethane foam, the base layer 4 comprises a layer of silicone gel carried on a melt-blown non-woven material, the base layer and cover layer 5 being approximately the same dimensions and form a boarder around the absorbent core, and the clip 8 is attached by means of an adhesive to the upper surface of the cover layer. The invention is intended to provide a dressing which can be easily and securely applied around a medical tube and reduce the risk of tracked and secondary infections.

Description

DRESSING FOR A MEDICAL TUBE

This invention relates to a dressing for a medical tube, and in particular to a dressing with an integral clip for securing around a medical tube.

BACKGROUND TO THE INVENTION

Medical tubes are used in a number of situations. For example, in a situation in which a person is unable to gain enough nutrition through eating, a feeding tube may be inserted through the skin and into the stomach and intestines, to deliver liquid nutrition, fluids and medication. In a situation in which a blockage prevents urine draining from the kidney and into the bladder via the ureter, a nephrostomy tube may be inserted into the kidney to permit the drainage of urine from the kidney into a collecting bag outside the body. Breast surgery often involves placement of a surgical drain for drainage of fluids that may build up post-surgery and delay healing. In chest surgery, a surgical drain may be inserted through the chest wall and into the pleural space to remove air, fluid or pus from the intra-thoracic space. The person skilled in the art will be aware of many other circumstances in which a medical tube may be applied, in addition to the examples above.

The sites at which medical tubes enter the body are particularly vulnerable to infection, as contaminants can track along the exterior surface of the drain. In addition, a medical tube may move in and out of the body ('piston') in response to movement of the patient if the tube is not properly secured, causing irritation at the entry site and further increasing the risk of contaminants entering the body.

Often, medical tubes (referred to herein as 'tube', 'tubes', 'medical tube', 'medical tubes', 'surgical drain' or 'surgical drains', meaning any type of medical tube that is inserted into a patient through a wound or surgical incision) are sealed and secured to the body using a combination of, for example, petroleum gauze, medical tape and polyurethane film, in a makeshift construction which can be bulky, prone to leaking, and an unreliable barrier to infection. Alternatively, the tube may be sutured directly to the skin, but this can be painful and can cause damage to the skin, thus creating a further potential site for infection.

Clamps for securing medical tubes inserted through the skin of a patient are known. One such clamp is disclosed in GB2556107, the contents of which are incorporated herein by reference. The clamp comprises a clamp body defining an opening for accommodating a medical tube, an outer portion and a sealing element that engages with a medical tube accommodated in the opening, forming a seal around the external surface of the tube.

Surgical drains may be used in combination with dressings adapted to accommodate the drain. WO 2015/173546 discloses a dressing for use with a surgical drain, the dressing comprising an absorbent body in which a superabsorbent material is contained within a compartment formed by a base of open-celled foam and cover member bonded thereto. The dressing has a radial slot that extends from the perimeter of the absorbent body to an opening within the absorbent body, for accommodating the surgical drain.

The present invention concerns a dressing for a medical tube, which dressing can be easily and securely applied around the tube, holds the tube in place, manages exudate from the wound site and is easily removed from around the tube. Reduced or no pistoning minimises the risk of tracked and secondary infections.

BRIEF SUMMARY OF THE INVENTION

According to the invention, there is provided a dressing for a medical tube, the dressing comprising: an absorbent body comprising an absorbent core between a base (skin-contact) layer and a cover layer, and a clip for securing around the tube, wherein: the absorbent body is formed with an opening adapted to accommodate the tube, and further with a slit extending from said opening to a periphery of the absorbent body; and the clip comprises an openable annular body defining an opening in correspondence with the opening in the absorbent body, which clip is attached to the upper surface of the cover layer of the dressing.

The medical tube is any tube that is inserted into a patient through a wound or surgical incision. Preferably, the absorbent core comprises an absorbent foam.

DETAILED DESCRIPTION OF THE INVENTION Absorbent Body The absorbent body comprises an absorbent core between a base layer and a cover layer and is formed with an opening adapted to accommodate a medical tube and a slit extending from said opening to a periphery of the absorbent body.

For the avoidance of doubt, any of features described in relation to the absorbent body may be combined with any other feature described in relation to the absorbent body, and with any feature described herein in relation to the clip.

The opening may be formed at any suitable position in the absorbent body. Preferably, the opening is formed in a substantially central position in the absorbent body. The slit extends from the opening to a periphery of the absorbent body. In order to accommodate tubes of differing diameters, the absorbent body may be provided with radial slits that extend outwardly from the opening.

The absorbent core comprises an absorbent material, most preferably an absorbent foam, such as an open-celled foam. The foam may be any suitable foam known in the art. Preferably, the foam is a hydrophilic foam. More preferably, the hydrophilic foam is a polyurethane foam. Most preferably, the foam is an open-celled hydrophilic polyurethane foam. The foam typically has a thickness (in a non-compressed state) of 0.5mm to lOmm, preferably from 1mm to 5mm, or from 1mm to 3mm. Most preferably, the foam has a thickness of about 1mm, about 2mm, or about 3mm.

An absorbent foam core has the advantage of being soft, flexible, and conformable, remaining so even after absorption of wound exudate. It is therefore comfortable for a patient and is advantageous for use in the dressing of the present invention. In addition, the use of foam facilitates the incorporation of antimicrobial and other agents into the absorbent core.

In preferred embodiments, the absorbent core is free from superabsorbent materials.

The foam may incorporate an antimicrobial agent. One antimicrobial agent that may be incorporated into the foam is silver. Despite metallic silver being relatively unreactive, ionic silver has been shown to have antimicrobial activity and has been previously used in wound dressings. In use, positively charged silver ions bind to negatively charged sites on proteins and nucleic acids in bacteria. This causes a number of effects, including alteration of the protein structure, rupture of the cell wall and/or cell death. It is believed that silver ions have multiple attack sites, interacting with a number of different functional groups in bacteria, including thiol groups, carboxylates, phosphates, indoles and amines. This makes the development of bacterial resistance to silver unusual.

The incorporation of silver into the absorbent core results in the sustained release of low concentrations of silver ions over time. Such a slow release has been shown to stimulate healing and inhibit the growth of micro-organisms. Any suitable method or form of silver known in the art may be used in the present invention. For example, the silver may be in nanocrystalline form, or in the form of silver sulphadiazine.

Other antimicrobial agents that may be incorporated into the foam include polyhexamethylene biguanide (PHMB) and chlorhexidine. PHMB is available as a 20% aqueous solution under the trade name COSMOCIUB CO from Arch Personal Care Products, 70 Tyler Place, South Plainfield, NJ 07080, USA.

A further antimicrobial agent that may be incorporated into the foam is honey. Honey has long been known to be effective in treating wounds, with records of such use dating from at least 2000 years ago. More recently, research has shown honey to have potent antimicrobial, antifungal and anti-inflammatory properties, and to be able to stimulate lymphocytic and phagocytic activity within the body.

Further, honey has been demonstrated to assist in the debridement of necrotic tissue, and to stimulate the growth of new tissue. In terms of its antibacterial activity, honey has been reported to have an antibacterial effect on more than sixty species of bacteria, including aerobes and anaerobes, and both Gram-positive and Gram-negative bacteria. In particular, honey has been shown to be effective against antibiotic resistant strains of bacteria including MRSA.

Honey is produced worldwide from many different floral sources, and its antibacterial activity varies with the source of the honey and the processing it has undergone. For example, lotus honey in India is reputed to be good for eye diseases, whereas manuka honey, a monofloral honey produced from the nectar of the manuka bush, is known for its antiseptic properties. The manuka plant is part of the genus Leptospermum, and honeys produced from plants of this genus, such as manuka or jellybush honey, are known for their particularly strong antibacterial properties. Preferably, the honey used in the present invention is produced from plants of the genus Leptospermum. More preferably, the honey is manuka honey or jellybush honey.

Multiple antimicrobial agents may be incorporated in the absorbent core. For example, a combination of chlorhexidine and honey may be used.

The base layer forms the skin-contact layer of the absorbent body. The skin contact layer is the part of the absorbent body that, in use, is applied to the patient's skin, and will generally comprise a skin-contact adhesive. This skin-contact adhesive is preferably non-adherent and permits the wound dressing to be removed relatively easily and without causing trauma to the drain site and surrounding skin. Thus, the skin-contact adhesive may be, for example, a hydrocolloid adhesive, a polyurethane adhesive, a hydrogel, an acrylic adhesive or a silicone adhesive such as a silicone gel.

Silicone gel adhesives may be referred to as soft skin adhesives, or soft silicone adhesives.

Soft silicone adhesives are particularly suited for use as skin contact layers in wound dressings. They are soft, tactile and conformable, and exhibit good adhesion to dry skin but low adherence to an underlying wound. Thus, the dressing can be applied to a wound and subsequently removed without causing trauma to the wound.

Soft silicone adhesives are generally supplied in solventless two-part systems, for example with a vinyl-substituted silicone component and a hydride-containing silicone component. The silicone gel is formed by a reaction between the two components, which are generally mixed immediately before application to a carrier layer and curing. Suitable two-part soft silicone adhesive systems are available for example from the Dow Chemical Company (Dow Corning S.A., rue Jules Bordet, Parc Industrie!, Zone C, B-7180 Seneffe Belgium). One specific example of a suitable system is the DOW CORNINGTM 7-9700 Soft Skin Adhesive Kit, available as above.

Silicone gels suitable for use as skin contact materials in the present invention may be carried on a suitable carrier. For example, they may be carried on a layer of melt-blown non-woven material, e.g., a sheet of melt-blown polyurethane (MBPU), as described in W02007/113597.

The MBPU or other carrier may be affixed to other components of the absorbent body using an adhesive. The adhesive may be any suitable adhesive, for example an acrylic adhesive and in particular an acrylic pressure sensitive adhesive, applied to the reverse side the MBPU. Suitable adhesives are well known.

The base layer may form a border around the absorbent core. That is, the base layer may extend beyond the absorbent core. In this manner, a greater contact area between the absorbent body and the skin is provided.

The skin-contact adhesive may be provided only on the parts of the base layer that form the border around the absorbent core. More commonly, however, the skin contact adhesive is present across the full extent of the base layer.

The base layer is preferably provided with perforations to increase breathability of the dressing, and so lessen the likelihood of maceration of the skin to which the dressing is applied. The perforations may also provide for greater ease of removal of the dressing, and improved flexibility and conformity.

The cover layer forms the upper (non-skin-contact) layer of the absorbent body and is the layer to which the clip for securing around a medical tube is attached.

The cover layer may comprise any suitable material. For example, the cover layer may comprise a polymeric film, such as a polyurethane film, particularly a breathable polyurethane film. The polymeric film or other material may be coated on its underside with a suitable adhesive, for example an acrylic adhesive such as an acrylic pressure sensitive adhesive, or a silicone pressure sensitive adhesive.

Suitable adhesives are well known.

The cover layer preferably has a moisture vapour transmission rate (MVTR) of at least 300 g/m2/24h at 37°C and 100% to 10% relative humidity difference.

Preferably, the cover layer is of approximately the same dimensions as the base layer and forms a border around the absorbent core. However, in some embodiments, the cover layer may be larger than the base layer, forming a border around the base layer.

The absorbent body may have any suitable shape and dimensions, depending on the nature of the tube about which the dressing is to be applied, the part of the body to which it is to be applied, etc. In preferred embodiments, the absorbent body is generally circular in shape. Clip

The clip is attached to the upper surface of the top layer of the dressing and defines an opening in correspondence with the opening in the absorbent body. By attached' is meant that the clip is permanently affixed to the top layer of the dressing. Thus, the clip is an integral part of the dressing. Preferably, attachment of the clip to the absorbent body is achieved with a double-sided adhesive that is provided between the underside of the clip and the upper surface of the cover layer of the absorbent body.

The adhesive may be any suitable adhesive and is preferably a double-sided adhesive tape, for example comprising pure acrylic adhesive on a carrier. The carrier may be, for example, a polymer film such as a polypropylene or polyethylene film. An example of a suitable adhesive is DuploCOLL® 20606 (Lohmann GmbH & Co. KG, Neuwied, Germany). DuploCOLL® 20606 is a double-sided adhesive tape with a propylene film carrier and pure acrylic adhesive.

The clip is aligned with the absorbent body such that opening of the clip widens the slit therein (for example, to allow fitting around the medical tube).

In some embodiments, the clip may comprise an openable annular body which is provided with a pair of operating members such as tabs that are moveable relative to each other, for opening and closing the clip. In some embodiments, the tabs are moveable relative to each other such that when pressed towards one another, the clip is opened, and when released, the clip is closed (for example, around a medical tube).

In a preferred embodiment, the clip comprises an openable annular body comprising a hinge, a pair of clip walls, and a fastening mechanism for securing the clip around a medical tube. Preferred features of this embodiment are described below. For the avoidance of doubt, any of the described features may be combined with any other described feature, and with any feature described herein in relation to the absorbent body.

The hinge joins the clip walls together in a rotatable manner and may comprise, for example, a post provided on one clip wall and a corresponding hook or opening, on the other clip wall. In some embodiments, one clip wall is provided with a post and the other clip wall is provided with a hook and opening in a stacked arrangement such that the post may be inserted first into the opening and then into the hook.

The clip extends around the opening in the absorbent body, with the fastening mechanism being positioned in correspondence with the slit in the absorbent body and the hinge being positioned at the point of the opening directly opposite said slit. The clip walls extend around the circumference of the opening in the absorbent body, between the hinge and the fastening mechanism.

The clip walls may be provided with protrusions on the outer surfaces thereof, to aid the user in gripping the clip. The protrusions may take the form of longitudinal ribs, or any other suitable form.

In preferred embodiments, the clip comprises a pair of flanges that extend radially outwards from the clip walls and are integral with the clip walls. The flanges provide a flat surface and facilitate attachment of the clip to the upper surface of the cover layer of the absorbent body.

The fastening mechanism is adapted to releasably clip together the pair of clip walls, such that in an open position, the dressing may be placed around a medical tube, and in a closed position, the dressing is secured around said medical tube.

The fastening mechanism may take any suitable form; for example, it may comprise interlocking components such as a detent in one of the clip walls and a protrusion on a projecting member that extends from the other clip wall, which protrusion fits into the detent when the clip is in the closed position and is released by pulling on the projecting member to open the clip.

The clip as described above may be formed from any suitable material, for example, from a thermoplastic material such as polycarbonate. It may be manufactured by any suitable process including 3D printing and injection moulding. Preferably, the clip is manufactured by injection moulding.

In preferred embodiments, the clip additionally comprises a sealing element adapted to engage with a medical tube accommodated within the opening in the dressing, such that a seal is formed around the external surface of the tube. Thus, the seal is provided on the inner surfaces of the clip walls. Preferably, the seal is formed around substantially the entire circumference of the tube.

The sealing element may be formed of a different material to the clip walls. In particular, the sealing element is preferably formed of a material having a high coefficient of friction in order to grip the tube with sufficient force to restrict movement of the tube relative to the clip whilst not deforming the tube.

Preferably, the sealing element is formed of a rubber-type material, for example a natural or synthetic rubber. A preferred material for the sealing element is silicone rubber or TPU (thermoplastic polyurethane).

The sealing element may be provided with deformable protrusions that project into the opening and, in use, are deformed around the medical tube, forming the seal. Preferably, the protrusions are resiliently deformable. The protrusions may be in any suitable form, for example in the form of a series of ribs or an array of bars or hemispherical bumps. Preferably the protrusions are a series of lateral ribs which run parallel to the top and base of the sealing element.

In an embodiment, the sealing element may comprise a base portion and first and second wall portions. One face of the first wall portion comprises the deformable protrusions that project into the opening, while the other face of the first wall portion sits adjacent to and in contact with the clip wall. The second wall portion is placed within the clip wall, which in this embodiment comprises an internal recess adapted to receive the second wall portion of the sealing element.

The dressing of the present invention will generally be supplied with a releasable liner on its underside. The releasable liner may cover the adhesive portions of the dressing prior to use and be removed from the dressing immediately before application of the dressing. This reduces the risk of contamination of the dressing and facilitates handling of the dressing.

Such releasable liners are commonly used on dressings known in the art, and suitable materials which can be employed in the present invention will be familiar to the skilled person. For example, the releasable liner may be of a suitable plastics sheet or a siliconised paper, or the like.

The releasable liner may be a single sheet which covers the underside of the dressing, or it may be formed of two or more sheets. The releasable liner may further comprise one or more tabs to enable the liner to be easily removed from the dressing before use. When the releasable liner is formed of two or more parts, the parts may either overlap or abut and extend outwards from the dressing, thus providing an easy method for removal of the releasable liner.

In a particular embodiment, a dressing in accordance with the present invention comprises an absorbent body comprising an absorbent core between a base (skin-contact) layer and a cover layer, the absorbent body being formed with an opening adapted to accommodate a medical tube, and further with a slit extending from said opening to a periphery of said absorbent body; wherein the absorbent core is a hydrophilic polyurethane foam; the base layer comprises a layer of silicone gel carried on a melt-blown non-woven material, e.g., a sheet of melt-blown polyurethane (MBPU); the cover layer comprises a polyurethane film coated on its underside with an adhesive; and the base layer and the cover layer are of approximately the same dimensions and form a border around the absorbent core; and a clip for securing around a medical tube, said clip being attached by means of an adhesive to the upper surface of the cover layer of the dressing and comprising an openable annular body defining an opening in correspondence with the opening in the absorbent body; preferred options being as described herein.

The dressing of the present invention may be used with any type of medical tube, including, but not limited to, a feeding tube, a nephrostomy tube, and a surgical drain.

BRIEF DESCRIPTION OF THE DRAWINGS

An embodiment of the invention will now be described in greater detail, by way of illustration only, with reference to the accompanying drawings, in which: Figure 1 is an expanded view of a cross-section of a dressing in accordance an embodiment of the present invention; Figure 2 is a plan view of the dressing of Figure 1, from the top side thereof; Figure 3 is a schematic plan view of the dressing of Figures 1 and 2, from the underside thereof; and Figures 4 and 5 illustrate a clip in accordance with an embodiment of the present invention.

All dimensions given are illustrative only.

DESCRIPTION OF PREFERRED EMBODIMENT

Referring to Figure 1, a dressing (1) in accordance with the present invention comprises an absorbent body (2) comprising an absorbent core (3) between a base layer (4) and a cover layer (5). The absorbent core is made from 3mm thick hydrophilic polyurethane foam. The base layer forms the wound-facing layer of the dressing and is made of a layer of silicone gel carried on a sheet of melt-blown polyurethane with a thickness of 2mm, which, prior to use, is covered by a three part release liner (6). The cover layer forms the non-wound-facing layer of the dressing and is made of a polyurethane film.

A double-sided acrylic adhesive (7) is provided to attach a hinged clip (8) to the upper surface of the cover layer (5).

As can be seen in Figures 2 and 3, the dressing (1) is generally circular in shape, with, in this embodiment, a diameter of approximately 135 mm. An opening (9) is provided in the absorbent body (2), at a generally central position of the dressing, and has a diameter of approximately 5 mm. A number of outwardly extending radial slits (10), each approximately 5 mm in length, are provided around the opening (9), and a slit (11) extends from the opening (9) to a periphery of the dressing. The absorbent core (3) extends around the opening (9) and has a diameter of approximately 80 mm. As can be seen best in Figure 3, the absorbent core (3) is cut away from either side of the slit (11) such that a generally rectangular cut (12) is formed in the absorbent core (3), allowing the base layer (4) and cover layer (5) to be bonded to each other at either side of the slit (11). In the illustrated dressing, the cut has a width of approximately 10 mm and is symmetrical about the slit (11).

Referring back to Figure 1, the base layer (4) and cover layer (5) of the dressing extend beyond the absorbent core (3). Thus, the base layer (4) and cover layer (5) of the dressing form a border around the absorbent core (3). As illustrated in Figure 2, the base layer is formed with a regular array of perforations.

Figure 4 is an exploded view of a clip (8) in accordance with the present invention.

The body of the clip (8) is provided in two semi-circular components, each of which comprises a clip wall (13a, 13b) and a flange (14a, 14b). A hinge (15) comprises a first hinge portion (15a) and a second hinge portion (15b). The first hinge portion (15a) extends from one clip wall (13a) and in includes a downwardly projecting post (not shown). The second hinge portion (15b) extends from the other clip wall (13b) and comprises upper and lower portions separated by an opening (16), the lower portion comprising a hook (17). The second hinge portion (15b) accommodates the first hinge portion (15a) such that when assembled the post slots into the hook (17) and the remainder of the first hinge portion (15a) is accommodated in the opening (16). A fastening mechanism comprises a projecting member (18) that extends from one clip wall, said projecting member (18) including a protrusion (19), and a detent (20) in the other clip wall. In use, the clip walls may be pressed together such that the protrusion (19) slots into the detent (20) to close the clip and separated by pulling on the projecting member (18) to release the protrusion from the detent. The outward facing surface of each clip wall (13a, 13b) is provided with a series of protrusions (21) which aid gripping the clip and also increase the structural integrity of the component. Sealing elements (22a, 22b) each comprise a base portion and first (23) and second (24) wall portions. The second wall portions (24) fit within internal channels or recesses in the clip walls (13a, 13b) while the first wall portions (23) sit adjacent with and in contact with the clip walls (13a, 13b). Deformable protrusions (not shown) are provided on the sealing elements, on the face intended for contact with the medical tube. The sealing elements are provided in different sizes for use with a universal clip body.

Figure 5 is a bottom view of the clip (8) of Figure 4, in a closed position.

Claims

CLAIMS1. A dressing for a medical tube, comprising: an absorbent body comprising an absorbent core between a base (skin-contact) layer and a cover layer, and a clip for securing around a medical tube, wherein: the absorbent body is formed with an opening adapted to accommodate a medical tube, and further with a slit extending from said opening to a periphery of said absorbent body; and wherein the absorbent core comprises an absorbent 10 foam; the clip comprises an openable annular body defining an opening in correspondence with the opening in the absorbent body, which clip is attached to the upper surface of the cover layer of the dressing.
2. A dressing as claimed in claim 1, wherein the absorbent core comprises a hydrophilic polyurethane foam.
3. A dressing as claimed in claim 1 or claim 2, wherein the absorbent core is free from superabsorbent materials.
4. A dressing as claimed in any preceding claim, wherein the absorbent foam core has a thickness in a non-compressed state of from 0.5mm to 10mm.
5. A dressing as claimed in any preceding claim, wherein the absorbent foam core comprises an antimicrobial agent.
6. A dressing as claimed in any preceding claim, wherein the base layer comprises a skin-contact adhesive layer.
A dressing as claimed in claim 6, wherein the skin-contact adhesive layer comprises a silicone gel.
8. A dressing as claimed in claim 7, wherein the silicone gel is carried on a sheet of melt-blown polyurethane or other melt-blown non-woven material.
9. A dressing as claimed in any one of the preceding claims, wherein the cover layer comprises a polymeric film coated on its underside with an adhesive.
10. A dressing as claimed in any one of the preceding claims, wherein the absorbent body is generally circular in shape.
11. A dressing as claimed in any one of the preceding claims, wherein the opening is formed in a substantially central position in the absorbent body.
12. A dressing as claimed in any one of the preceding claims, wherein the absorbent body is provided with radial slits that extend outwardly from the opening.
13. A dressing as claimed in any one of the preceding claims, wherein the base layer and the cover layer are of approximately the same dimensions and extend beyond the absorbent core, forming a border around said absorbent core.
14. A dressing as claimed in any one of the preceding claims, wherein a double-sided adhesive is provided between the underside of the clip and the upper surface of the cover layer of the absorbent body, adhering the clip to the absorbent body.
15. A dressing as claimed in any one of the preceding claims, wherein the clip comprises a hinge, a pair of clip walls, and a fastening mechanism for securing the clip around a medical tube.
16. A dressing as claimed in claim 15, wherein the fastening mechanism of the clip is positioned in correspondence with the slit in the absorbent body, the hinge of the clip is positioned directly opposite said slit, and the clip walls extend around the circumference of the opening in the absorbent body, between the hinge and the fastening mechanism.
17. A dressing as claimed in claim 15 or claim 16, wherein the clip comprises a sealing element adapted to engage with a medical tube accommodated within the opening in the dressing, such that a seal is formed around the external surface of the tube.
18. A dressing as claimed in claim 17, wherein the sealing element is provided with deformable protrusions that project into the opening and, in use, are deformed around the medical tube, forming the seal.
19. A dressing as claimed in any one of claims 15-18, wherein the clip walls are provided with protrusions on the outer surfaces thereof, to aid the user in gripping the clip.
20. A dressing as claimed in any one of claims 15-19, wherein the clip comprises a pair of flanges that extend radially outwards from the clip walls and are integral with the clip walls.
21. A dressing as claimed in any one of the preceding claims, further comprising a release liner covering the skin-contacting adhesive portions thereof.
22. A dressing for a medical tube, comprising: an absorbent body comprising an absorbent core between a base (skin-contact) layer and a cover layer, the absorbent body being formed with an opening adapted to accommodate a medical tube, and further with a slit extending from said opening to a periphery of said absorbent body; wherein the absorbent core is a hydrophilic polyurethane foam; the base layer comprises a layer of silicone gel carried on a melt-blown non-woven material, e.g., a sheet of melt-blown polyurethane (IVIBPU); the cover layer comprises a polyurethane film coated on its underside with an adhesive; and the base layer and the cover layer are of approximately the same dimensions and form a border around the absorbent core; and a clip for securing around a medical tube, said clip being attached by means of an adhesive to the upper surface of the cover layer of the dressing and comprising an openable annular body defining an opening in correspondence with the opening in the absorbent body.
23. A dressing as claimed in claim 22, further defined by any feature or combination of features of claims 2-21.