IE41710B1 - Surgical drape - Google Patents

Abstract

1502957 Surgical drape sheets JOHNSONJOHNSON 22 Sept 1975 [12 Dec 1974] 38789/75 Heading A5R A surgical drape comprises a sheet of flexible material 11 having spaced wings 20, 30 at one end defining, between side edges 24, 34 thereof, a slit leading to a widened fenestration 50, a flap 40 being attached to wing 30, and tabs 65 attached to each wing 20, 30, whereby in use a limb extends through fenestration 50, flap 40 underlies wing 20 and the wings are prevented from relative movement by clipping tabs 65 together. A reinforcing panel 60 is provided around fenestration 50 and comprises a layer of liquid-impervious plastics superposed by an absorbent layer 61. Tubing holders 71 having openings 70 are provided at the edge of the reinforcing panel 60 adjacent the slit. One of the tabs may be attached to the flap or be replaced by a patch of pressure-sensitive adhesive for securement with the remaining tab. In an alternative embodiment, Figs. 18-22 (not shown), the drape may be provided with armboard covers and with armboard flaps for overlying a table provided with armboards. Prior to use the drapes are folded in a manner whereby in use the main portion 12 is unfolded over the patient prior to unfolding the wings and flap around a limb. The drape may be made of woven, non-woven or plastics film material.

Description

The present invention relates to new and improved surgical drapes of the type which comprise a flexible sheet having a main portion and wing portions whose Inner edges define a slit or gap which extends inwardly from an outer edge of the drape. Such drapes are especially useful in orthopedic surgery and similar surgical procedures.

In preparing for orthopedic and related surgery It is common practice to cover the patient and operating table with a sterile drape, or drapes, in such a way that only the limb (or portions of the limb) on which surgery is to be performed is presented to the surgeon and his assistants.

One drape that has been provided for orthopedic and similar surgery comprises a sterile sheet having a main portion and an elongated gap extending outwardly from a central region thereof to an outer edge to provide two spaced wing portions. ' Such drapes are frequently referred to as split sheet drapes.

One draping procedure for using these drapes involves raising the patient's limb and putting it through the gap in the sheet in such a way that, when the draping is completed, the limb on which the operation is to be performed extends through the gap and lies on the upper surface of the • main portion of the drape. The wing portions of the drape are then disposed to overlie parts of the patient's body at a region adjacent the operative site.

It is necessary, of course, to ensure that a sterile surgical field be provided at the outset of the surgical - 2 41710 procedure and that the integrity of the sterile field be maintained until the surgical procedure is completed. In order to establish the sterile field and to prevent the contamination thereof in the event the wing portions of the spilt sheet should slip or be accidentally moved during . t * surgery, It. has been found necessary, prior to placement of the split sheet, to cover the patient with an auxiliary surgical drape. The auxiliary drape Is placed over that portion of the patient's body which will underlie the gap in the split sheet when the latter has been positioned.

In Patent Specification No, there is disclosed a surgical drape of the split sheet type in which a flap-like sheet is attached to at least one of the wing portions of the drape. During surgery, this flap-like sheet covers the slit or gap ln the drape and eliminates the need for the use of auxiliary drapes, thus reducing the number of drapes that need to be handled by the operating room staff. However, such a drape, i.e., a split sheet drape with a flap-like sheet attached to one of its wing portions, still presents some difficulties. For example, the wing portions may accidentally slip relative to one another during surgery; such slipping causes the drape to undesirably bunch up upon itself and Indeed, in an extreme case, the wings could be separated to such an extent that the patient's body and/or other drapes or the like could be exposed to contamination. Another difficulty with the drape disclosed in the aforesaid commonly assigned patent application is that no means are provided for securing surgical tubing, electrical wires and the like to the surface of the drape in a position where they would be prevented from interfering with the surgical procedure - 3 41710 at hand, yet be readily accessible when needed during surgery.

It is therefore an object of the present invention to eliminate bunching or accidental movement of the wing portions of a split sheet drape by providing means for securing the wing portions in a closed, substantially flat position during surgery.

It is a preferred object of the present invention to provide means for securing items such as surgical tubing and the electrical wires of monitoring devices to the surface of the drape in a position where they will be conveniently accessible when needed and yet will not unduly interfere with the surgical procedure, The drape of the present invention simplifies the draping procedure, saves valuable time, reduces costs, eliminates bunching of the wing portions, and in preferred embodiments provides means for securing auxiliary tubing and electrical lines to the surface of the drape.

In accordance with the present invention there is provided a surgical drape comprising a sheet of flexible drapable material having a main portion at one end thereof, and a pair of spaced wings at the other end thereof extending outwardly from a central region of said sheet and defining a slit in said sheet; said slit merging into a widened fenestration located generally inwardly of the perimeter of the drape; a flap secured to one of said wings and transversely extendible from said wing so as to cover at least a portion of the length of said slit and to be in contact with at least part of the other wing when the drape is in use? and stabilising means on said drape for preventing the wings from moving with respect to each other when the drape is in use.

The flexible drapable material is suitably of a plastics film or a woven or nonwoven fabric, preferably the said flap is attached to one of the wing portions at the inner edge thereof adjacent the slit, and is a flap-like sheet of woven, nonwoven, plastics or similar material which, when the drape is in use, covers a substantial portion of the length of the slit, and lies beneath the second of the two wing portions Said stabilising means are preferably means (referred to as clipping means) provided on the drape for securing the wings of the drape in their desired flat, wrinkle-free position during surgery, and may comprise relatively small tabs of material affixed in hinge-like fashion to the upper surfaoe of the drape. Prior to use, the clipping tabs lie flat in a position generally overlying the upper surfaoe of the drape. During use the tabs are extended upwardly from the surface of the drape. Adjacent, upwardly extending tabs are brought into contact with each other and secured together by any convenient means. Thus secured, the clipping tabs prevent bunching and/or accidental lateral movement of the wing portion of the drape.

The surgical drape of the present invention also preferably comprises at least one tubing holder affixed at a suitable location on the upper surface of the drape. A tubing holder, as will be seen, is a relatively small piece of material made from e.g., a nonwoven fabric or a piece of plastics. The tubing holder must have at least one opening therein. Surgical tubing, electrical wires or like materials may be threaded through the tubing holder which then holds the tubing in its desired position on the surface of the drape. - 5 . 41710 The aforementioned and other advantages of the present Invention will become apparent upon reading the following detailed description and upon reference to the drawings in which: Fig. 1 la a top plan view, with portions cut away, of one embodiment of the surgical drape of the present invention, wherein the flap-like sheet attached to one wing portion la shown in a position underlying the second wing portion, and the clipping means are shown in their flat lo position overlying the upper surface of the drape; Fig< 2 1» a cross-sectional view taken along lines 2-2 of Fig. 1; Fig. 3 is a perspective view of the surgical drape of Fig. 1 showing the flap-like sheet in a folded position overlying the wing portion to which it is attached; Fig. 4 is a cross-sectional view taken along line 4-4 of Fig. 3i Fig. 5 i· a perspective view of the surgical drape of Fig. 1 showing the flap-like sheet attached to one wing 2o portion in an extended position and with the other wing portion turned back to expose its under surface; Fig. 6 is a detailed view in perspective of a portion of the drape of Fig. 1 showing the clipping means in their upwardly extended position; Fig. 6a Is a cross-sectional view taken along line 6&-6& of Fig. 6; Fig. 7 1· a view similar to Fig. 6 showing the tabs comprising the clipping means in an off-set position with respect to each other; - 6 41710 Bg. 7® Is «= ^lon of th® tabs in their offS@t position? Fig. 7b is m enlarged ffrageentary view showing an alternative pleeramt of one of tfe® tabs eesprising the clipping «asss Fig. ?e ig aa eialargad fragmentary view wherein the slipping ffitaao comprise an elongated tab attaehed to one of the wings and a separating etrip off pressure sensitive adhesive, protested by e release sheet, attaehed te the other wing; Fi®. © is ® tap plan view of another embodiment of the surgical feaps oS th® present invention wherein th® fenestration is lined with a soft elastomeric lining material; Kg. 8a ia & ersss»saeti©Ml view taken along line 3=::.-8½ sf Wgo S; Kg. 9 is a t@p plan view of tfca surgical drape of Fig. 1 with its flap-like sheet shown In a folded position ©n the upper eurfaea off th® drape and showing in broken lines the fold Usee for th® longitudinal folding of the drape; Kg. 10 is aa enlarg©! erosa-eestional view taken along line 10-10 off Pig. 9; Fig. 11 is a perspective vl®w showing the drape of Fig. 9 after tfea wing portions have been folded longitudinally; Fig. 12 is a perspective viw showing the drape of Fig. 9 after t&s longitudinal folding thereof has been completed; Figo. 13»lf ar® perageetiTO view showing the sesps&s® of BtojGG 1e draping a petiont for leg surgery with th© δ?®»© off Bg&rss 9>ll? Wig. IS is g, pl®n viwp with parte in perspective 30 s»S wits portions eat essay, off another embodiment off the drape of tha present invention wherein the wing portions are extended transversely t© fora a T»ahap®d drape having eovers for the ambocrds of ca oporatiag toblG; Pig. 19 lo 0 pica view of th® drapes of Fig. 18 with th® flop-lilto shoet folded and overlying th® wing portion to which it io attcehod cad showing one of the araboard flaps in a folded position overlying th® araboard cover to which it is attaehod; Pig. £0 io a @r©os»s®etlos»X view taken along line 20=20 of Pig. 19; Pig. 21 io a pica view of the drape of Fig. IS with 10 its flep-liho shoots arnsaerd e®vers, and anaboard flaps in a folded position end ohowiag the fold linos for eoapletion of th® longitudinal folding of ths drags; and Pig. §2 is on oalarged fragarantary view, with portions out kjl©-c of tho upper loft hand portion of the drape of Pig. IS.

While the invention will he described in connection with its preferred embodiments, it will be understood that it is not intended to limit the invention to those embodiments.

On the contrary, it is intended to cover all alternatives, modifications and equivalents as may be included within the scope of the invention as defined by the appended claims.

Referring more particularly to Figs. 1-5, which show one embodiment of the present Invention, surgical drape comprises a flexible sheet 11 made from a single piece of a suitable drapable material such as a woven or nonwoven fabric or a plastics film. Preferably, the material is a drapable nonwoven fabric, such as a scrim reinforced tissue or a wet-formed nonwoven containing long fibers. Even more preferably, sheet 11 comprises a nonwoven fabric that has been treated according to known methods to render it liquid repellent. Flexible sheet 11 comprises a main portion 12 at the bottom end thereof, and a pair of spaced wings 20 and 30 at the top end thereof. The perimeter of the drape comprises opposed side edges 16 and 17 and bottom edge 15.

Wing portions 20 and 30 are integral with, and extend outwardly from, main portion 12. Wing portion 20 has an inner side edge 24 and a top edge 26. Correspondingly, wing· portion 30 has an inner side edge 34 and a top edge 3§· The top edges of the wing portions define the top edge of the drape.

Drape 10 has a slit 45 which is defined by the adjacent inner edges of the wing portions and whieh extends from the top edge of the drape inwardly to a generally central portion thereof. The slit has a first, or open end, which communicates with the outer edge of the drape. The other end of the silt merges into an enlarged or widened fenestration 50 which, In the illustrated embodiment, is shaped in the form of a tear-drop. It will be understood that the precise configuration of the fenestration is not critical and may be varied if so desired. The fenestration is located generally inwardly of the perimeter of the drape but its precise location is not critical. It is preferred that the fenestration be centered from sides l6, 17 of the main sheet. The position of the fenestration with relation to the top and bottom ends of the drape is not critical. In one commercial embodiment of the drape of Figs. 1-5, the main sheet is about one hundred and fourteen inches long, this length being sufficient, when the drape is in use, to cover both an adult patient and the anesthesia screen. In this embodiment, fenestration 5θ is about fifteen inches long, point 50' on the curved portion thereof being about five feet from bottom edge 15 of the main sheet. It will be understood that the above mentioned dimensions are for purposes of illustration only; these dimensions may be changed, for example, to provide a drape which is adapted for a particular kind of surgery or which is tailored to fit a child about to undergo surgery.

Inner side edge 34 of wing portion 30 carries a flap 40 of drapable material, which, as illustrated in Figs. and 2 may be folded across slit 4-5 to lie beneath wing portion 20.

Flap 40 has a bottom edge 41, a top edge 42, and side edges 4-3 and 44. The bottom and top edges of flap 40 are substantially equal in length and are sufficiently long so that, when the flap is extended crosswise of the drape to cover slit 45 and lie beneath wing 20, edge 43 of the flap lies - 10 41710 slightly beyond edge 17 of the main sheet. It will be understood the length of the flap along its top and bottom edges may vary considerably from the dimensions shown in Fig. 1. Tlie flap 40 is long enough along its top and bottom edges to cover slit and lie beneath at least part of wing SO. Referring especially to Fig. 1, it is seen that the length of the flap along side edges #3, 44 is somewhat less than the length of slit 45. Flap 40 extends along inner edge 34 from a point inward of top edge 36 of wing 30 to a point near where slit 45 merges into fenestration 50.

The particular part of wing 30 to which flap 40 is attached is not critical, provided, of course, that the flap can be arranged, when In use, to lie beneath wing 20.

Preferably, however, flap-like sheet 40 is attached to wing 30 at or near its inner side edge 34, since a minimum amount of material is thus required and unnecessary bulkiness in the folded drape is eliminated. As illustrated in Fig. 2, flap 40 is fastened, along a narrow line adjacent Its side edge 44, to the lower surface of wing 30 a slight distance from its inner side edge 34. This is conveniently accomplished by stitching (not shown in the drawings), but other fastening means, such as an adhesive, may be employed if so desired.

Other acceptable ways of affixing flap 40 to wing 30 are illustrated in Patent Specification No. j IS.

Drape 10 has a reinforcing panel 60 secured to the upper surface of the main sheet. In the preferred embodiment, the reinforcing panel is positioned inwardly of the perimeter of the drape and extends inwardly to the edges of fenestration 50 and to the edges of a portion of slit 45. The reinforcing panel may comprise one or more layers of the same material used - 11 41710 for the main oheet. Preferably, however, the reinforcing panel has an absorbent upper surface 6l and an impervious plastic fils 62 between the absorbent surface and the main sheet of the drape. Eia reinforcing panel can ba secured to the upper surface of the main sheet by any suitable securing means well known to those skilled in the art, an adhesive being preferred, however, over stitching for this purpose.

Xt will be roeognisod that the reinforcing panel, which provides increased abrasion resistance and aa absorbent surface inift© areas surrounding the fenestration, need not be used if ough aualltlec are not required.

Keans (hereinafter referred to as clipping means) are provided on the uppor surface of the drepe eo that, during actual use, tho wings thereof are maintained in a flat, wrinkle free position and ar® prevented from moving laterally with roopoet to each otter. Tne clipping means as illustrated in Figo. 1=5 comprise cooperating, generally rectangular, floxiblo tab-like structures 65 that can be easily fabricated fren the some material used for flexible sheet 11 or frsn cay othor suitable woven, nonwoven or plastic sheet material. As best seen in Fig. 2, each tab is secured to the drape in hinge=like fashion fey gluing & part of it between sheet 11 and impervious layer 62 comprieing the reinforcing panel. She remaining portion of each tab then lies (prior to use of the drape) in a position overlying absorbent surface 6l of the reinforcing panel.

TJhore there io no reinforcing panel, or where the tabs are positioned beyond the region where slit 45 is bordered by the reinforcing panel, th© tabs would be attached directly to th© wing portions of tho drape. As seen in Figs. 1 and 2, a tab io attached to each wing portion at the inner efigo thereof. - 12 41710 Prior to use, th® clipping tabs lie flat on the upper surface of the drape (See Pig. 1). During use the clipping tab® are extended upwardly and Joined together (see Pigs. 6 and 6t$, for exaople with surgical clamps, Whereby the wing portions are securely held in position. It will be recognised that when the clipping tabs are in their upwardly extended positions, a portion of one tab suit be able to eoae into contact with at least a portion of the other clipping tab. In other words, one tab may be offset with respect to the other (see Pigs. 7 and 7a), but not to such an extent that the tabs will be unable to coae into mutual eontaet with each other.

Purtheraore, it will be understood that the wing portions of the drape ean be effectively secured during use by placing the cooperating clipping tabs at any of several positions on the upper surface of the drape. Preferably, ae shown in Pig. 1, the clipping tabs are attached, one on either side of slit 45» relatively near the point where slit 45 aerges into fenestration 50· This arrangement ls quite advantageous because the clipping aeans then serve not only to secure the wings during use but also to draw the edges of fenestration 50 snugly around a liab protruding through the fenestration. Thus, the liab is surrounded by drape aaterial and the portion of the liab to be incised is effectively isolated. Additional sets of cooperating clipping aeans may be used on the drape iff desired.

Other ways of positioning th® clipping tabs to maintain the wings flat and wrinkle-free and prevent them moving laterally with respect to one another and assist in fitting the drape, will be apparent to those skilled in the art. For example, one of the tabs 65 may be secured to flap-like sheet 40 near the inner side edge 34 of wing 30 and the'other tab may be secured to wing 20 near its inner side edge 24 (See Fig. 7fe). Similarly, the shape - 13 41710 eS tho olosed portions of the tabs coy he varied, e.g., soci-gireulor tabs cay be used If fiooirod.

Soforrirag t© Fig. 7e» there io illustrated another fom of elipping noaao that cay bo used to soeure the wings in plaeo during uoo of tho drapo. &o elipping means comprise an elongated tab SS ©f flosiblo catorial attested to tte firapo raear irnaor olds odgo 34 ©f tsing 3© end a cooperating atrip of pressure ooraoitivs adhesive fi? c,ama to wing 20 adjacent Ito iranor oido cage S4. Bao pressure sensitive 1Θ adtosivo io pretogtod prier t© aso of th® drape lay a suitable soIoqoo shoot 6?’ .· After tho wings of tho drape have been positioned ©ra tho patient, roloaoo shoot §7' is removed, thus creasing pressure soaoltivo adhosiva 67. Tab 66 may then bo folded asroso slit 45 and pressed irate sealing oagagccoat with tho pressure sensitive aflfeosiv®. Thue the wings cay bo '^®i@h3y and ©©raveraieratXy soeursd ia abutting relationship and tho edges of th® feraestratiora can be drawn snugly around tho Xidb pretrudisg therethrough. Ξ10 drapo io provided with at least one, and preferably to, tubing holdoro 70. a® tubing holders are rectangular pioees of a woven er raerawvora fabric or plastic shost catorial, and aro typically assEt 2-6 iraetas long and 1=3 iraehos wide. Each tubing holdor has a flexible portion whieh is frao of tho rest ©f tho drapo erad whieh has at least ®rao ©porairag thoroira for securing flexible members such as surgical tubing, oloetrieGl loGd wires arad tho like in position ©ra tte upper surface of tho drops (see Fig. 8).

The tubing holders are preferably attached to the wing psrtiorac adjasorat tho sopor odgo of tho reinforcing 3@ paraol and each tubing holder has to circular ©panings 71 therein.

Fig. 8 illuotratoo 0 codification in whieh tte = 14 41710 perimeter of fenestration 50 is lined with a soft elastomeric film. Film 75 lies substantially in the major plane of the drape and allows adjustment and conformation of the fenestration to the limb surrounded by the drape. The film lining the fenestration ean ba made from an elastomeric material such as, for example, synthetic or natural rubber. As seen in Wg. 8a, film 70 is preferably attached in the regions adjacent the edges of the fenestration by gluing it in place between sheet 11 and reinforcing panel 60. It will be under10 stood that the film lining the fenestration must not interfere in any way with the continuity of slit #5· As seen in Wg. 8, opposed edge portions 76 and 77 of file 70 actually define what might be described as an extended portion of slit 45. Typically, the film would extend about an inch or two inwardly from the edges of the fenestration. - 15 β ft 7 ft 0 Drapes of the present invention may be folded into a compact unit which facilitates handling during packaging and storage and which permits the drape to be easily and quickly applied to the patient prior to surgery.

As used herein a forward fold is a fold In which the upper surface of the drape Is turned towards itself around a fold line. A reverse fold is a fold in which the upper surface of the drape Is turned toward the lower surface of the drape around a fold line. In the drawings, the letter & Indicates a reverse fold and the letter F indicates a forward fold. The numbers preceding the letters F and R refer to the order in which the folding is done.

The preferred method for folding drape 10 from end to end is Illustrated In Figs. 9=12. As seen in Figs. 9 and 10, flap 40 is initially fan=folded to form a stack of folds overlying wing 30. The folds say be any convenient size and number, but, as illustrated, the folds are preferably arranged so that edge 43 of flap 40 lies between the sides of the stack of folds formed by the flap.

Th® wings (with flap 40 in folded position overlying flap 3° as a.splained above) are folded next.

A part of wing 30 adjacent top edge 36 thereof is reverse folded around fold line IR. Thereafter wing 30 is forward folded around fold line 2F, reverse folded around fold ' line 3R, and forward folded around fold line 4f. It will be observed that fold line 3R intersects the drape substantially ι at the point where slit 45 merges into fenestration 50 and » that fenestration 50 lies generally between fold line 3R and fold line 4f. This folding of wing 30 (Including its associated flap 40) provides a stack A of folds which overlies a generally central portion 59 of the drape lying between fold line 4F and fold line 8f. Wing 20 is then folded in the manner Just described for wing 30 to provide a stack B of folds which also overlies central portion 59· Fig. 11 shows drape 10 after it has been folded in accordance with the above described folding procedure. It will be noticed that slit 45 is exposed to view at the upper central portion of the partially folded drape.

Main portion 12 of the drape is folded next.

Bottom portion 58 is reverse folded around fold line 5R. The main portion is then forward folded around fold line 6F, reverse folded around fold line 7R, and forward folded around fold line 8f. This folding sequence provides a stack C of folds overlying stacks A and B of folds and results in the elongated, longitudinally folded unit illustrated in Fig. 12.

Each end of the drape in the elongated, partly folded form shown in Fig. 12 may then be folded, toward the center, to give a final compactly folded drape. Although an ordinary fan-fold is suitable for this purpose, lt is preferred that a modified fan fold be used. The term fan-folded refers to a folding sequence in which the material being folded has alternate forward and reverse folds. The term modified fanfold refers to a folding sequence which is similar to a fan25 fold but in which the first two folds thereof are of the same type. An example of a modified fan fold sequence is forward, forward, reverse, forward..., etc.

Thus, the transverse folding of the drape as shown in Fig. 12is begun from side edge l&.wlth a forward fold. The second fold is likewise a forward fold while the third fold is a reverse fold. The forward and reverse fold sequence may subsequently be repeated until the desired degree of compactness Is obtained. The transverse folding of the drape from side edge 17 toxvard the center is accomplished in the same manner.

In the drape of Fig. 11, the distance® between fold lines IR and 2F, between fold lines 2F and 3R, and between fold lines 3R and 4F are substantially the same. The distance between the fold lines, and the resulting number of fabric layers in the folded drape, is not particularly critical and may be varied according to the degree of compactness required or'desired in the folded drape. In any event, the distance between fold lines 4f and 8f should be slightly greater than the distance between any two consecutive fold lines above fold line 4? or any two fold lines below fold line ,8f. This is so because all the other folds in the drape as finally folded will lie above that portion of the drape lying between fold lines 8f and 4F.

Referring now te Figs. 13=17, there is illustrated in stepwise fashion a method of applying the drape of Fig. 1, folded as Just described, to a patient about to undergo surgery on the left knee. Fig. 13 shows drape 10, unfolded from side to side, placed across the right leg and under the left leg, in the general area of the patient’s knees. The patient's left leg is lifted upwardly and stack C of folds is unfolded toward the foot of the operating table. The patient's left leg is then lowered to overlie body portion 12 of main sheet 11. By virtue of the above step, stacks A and B of folds are eisposed (see Fig. 14).

Uing portion 30 having the flap-like sheet 40 attached thereto (stack Δ of folds in the illustrations) is then unfolded toward the top of the operating table. This 3Q step esspoaes flap 40 in its folded position overlying wing 30 o 2,@ <= (see Fig. 15). Flap 40 is then unfolded (as indicated by an arrow in Fig. 15) across the operating table to overlie the upper portions of the patient's body. Stack B of folds comprising wing portion 20 is then unfolded, as Indicated by the arrow in Fig. 16, toward the top of the operating table.

Referring to Fig. 17, the entire lower portion of the patient's body (i.e., the region from the upper chest area to the toes), except for the left knee and lower portion of the left leg, is covered by the drape. The lower part of the left leg extends through fenestration 50 and clipping tabs 65, 65 and tubing holders 70, 70 are exposed on the upper surface of the drape.

The clipping tabs are extended upwardly to a vertical position and are brought into contact with one another. The clipping tabs are then held together by any convenient means, such as a surgical clamp, illustrated in Fig. 6&. The securing of the clipping tabs in this fashion has two beneficial effects. First, fenestration 50 now surrounds the patient's leg at a point just above the knee on which surgery is to be performed. At the same time the wing portions are prevented from slipping or sliding laterally. The upper surface of the drape is free from any undesirable wrinkling or bunching and the tubing holders are available, at the upper portion of the drape, where they will not interfere with surgery and yet will be readily accessible When needed. Reinforcing panel 60 is positioned in the general area where surgery is to be performed and where increased exposure to abrasion is normally encountered.

Another embodiment of the drape of the present invention is shown in Figs. 18-22. Drape 100 is generally T-shaped in construction and is intended for use with an operating room table having armboards extending laterally thorofron. Σ&ορο ICO io idontieal in many of its features to drops 1Θ ond ineXudoo a flexible shoot XX comprising a main portion XS ond wisg portions 20 and 30. The drape has a flap5 like shoot 4© attested ts wing 3©; a slit 45 margins into a toar=ohapad fonootratien gQ, a roinfensing panel 60, clipping □oano 65, cad tubing toldoro 70» Tho uppor p©rti©ns of wing §0 and £0 are extended traaovorooly ©f tho drapo, i.o., beyond sido odgos Χβ, X? of X© flexible shoot 11 to prsvids arsboard eovors 110, 110'. The ambaard eoverc havo oido odgos 112, 112’ and bottom edges 114, 114’, roopoetivoly. Soferring ©specially ts Fig. 22, tranevoroo euto 116, 116’ aro provided in shoot 11 just below lower Odgas of the .arrribeard c.overs 110, 110'„ This ©©notruction allows sido portions ISq, 17a of flexible shoot 11 in the aroao ©f tho drapo bol@w euto 116', 116, roopoetivsly, to fall ©vor tho sidoo ©f tho ©porating tablo where they will be in a goaorolly vortieal piano ©a sitter oido ©f the table when the dropo io paoitienod ©n tho patient.

Armboard severs 110, 11©' hovo ermtoard flaps 120, 120'. Tho armboard flaps aro gioeaa ©f floxible drapable notorial attested, proforafely with an adhosivo, to the armboard covers and wings al@ng a lino, oxtonding inwardly of the drape, which Hod Just ofeavo tho bottom edge of the armboard cover and tho top edge of the cut at the side of the drape. Fig. 22 shews tho structural rolatienohip botwoon armboard cover 110' and ito aosssiatod armbserd flap 12©’. Tho ©utor edges 124, 124' of tho armbaard flaps aro gonorally eeoxtoneive with the outer oido odgos ©f tho ormbeard esvoro, whilo th© inner oido odgos 126, 126’ thoro©f oxfcond oecowhat inwardly of the innoraoot ends of euto 116, 1X6', roopoetivoly. As a result ©f this structural arraagomont, tho armbeard flaps my hang svor tho oidoo ©f tho ambsarda ©f tho ©porating table and - 20 41710 extend generally vertically downward when the drape ie in place. The varioue poesible structural relationships of the araboard covers to the araboard flaps and of the araboard covers and araboard flap* are discussed and Illustrated in British Patent Specification No. 1,476,258.

The araboard covers, inasmuch as they are extensions of the wing portions of the drape, and araboard flaps, are suitably made from the saae material as that used for flexible sheet ll.

Fig. 18 show* a plan view of drape 100, with flap thereof already ln its folded position overlying wing 30.

The dot and dash lines indicate the fold lines for th* folding of the drape. Ae before, the letter R indicates a reverse fold, the letter F a forward fold, and the numbers indicate the steps in the folding sequence. In the figures, the lower surfaces of the drape are indicated by stippling, and the upper surfaces are left plain.

Flap-like sheet 40 is folded ln the manner explained earlier for the folding flap 40 of drape 10.

The longitudinal folding of the araboard flaps and araboard covers is the next step in the folding sequence. The folding of araboard flap 120' and araboard cover 110’ will be taken as illustrative. Referring to Fig. 18 a portion 128' of araboard flap 120' adjacent its lower edge is preferably reverse folded around fold line IR'. If desired, portion 128 could be forward folded, rather than reverse folded, around this fold line. The last fold in the longitudinal folding of - 21 tho araboard flap eudv bo Q'forward fold areunfi fold line SP'. Fold lino 2P* ostonds inwardly of tha drape from outer oido odgo 124’ of araboard flap 120' and eoineides with bottom odge 114’ of tho araboard eovor aad the top edge of trans5 vorso out 116'. Although usually not neessoary, additional foldo coy bo caflo in the araboard flap betwoan the above described first end last folds. It will bo apparent that the nuabor and also of any oueh intervoning folds will depend on tho siso of tho araboard flop and tto dogreo of compactness roquirod in tho finally folded drape. Too ssny folds, of eouraos will undosirably add to tho hulk of the folding portions. ROgardloss of the number of intervening folds, if thoro bs any, tho last fold given th© araboard flap must he a forward fold o® that the araboard flap whon folded, overlies tho uppor osrfcso of araboard eovar 1101. Ttaa this part of tho folding ooquonoo io eoqploted, tto araboard flap lies in its foldod position on tto uppor curfaeo of araboard cover HQ in tto rolotionohip shows in Pig. 29.

Tho noct stop in tto folding sequence is to fold araboard eovor 110'„ with its now overlying araboard flap 120', tronovorooly of tho drops. This soy bo accomplished with any nuabor of folds starting fron outor afigs 112' but the last fold must bo a forward fold so that araboard eover 120.', when foldod, ©vorlioo tto uppor surfaeo of wing 30. Preferably, araboard eovor 110' is forward feldod, without any other folds, around fold lino 3E" whieh eoineidos vertically with side edge IS of shoot 11. Whan thia stop io eoEplotod, the araboard flap and araboard eovor aro in a folded position ©vorlying the upper surfaeo of wing 3© as cay bo soon in tto loft hand portion of 3© Pig. 21.

Araboard flap ISO and araboard eovor 110 are then folded, in tho oano fashion as Just dooeribod for araboard - 22 41710 flap 120' and armboard cover 110', to overlie the upper surface of wing 20. At this particular stage in the folding sequence, the drape will have assumed the configuration illustrated ln Fig. 21.

The longitudinal folding of drape 100, in the configuration shown in Fig. 21, is continued by folding each wing a plurality of times toward the center of the drape.

A portion 130 of wing 20 (with armboard cover 110 and armboard flap 120 folded thereover) adjacent the top edge of the drape is forward folded around fold line 4f. The wing is then reverse folded around fold line 5R, forward folded around fold line 6f, and reverse folded around fold line 7R.

The first fold in folding wing 20, i.e., the folding of portion 130 around fold line 4f, must be a forward fold, and the last fold ln folding the wing, that is, the fold around fold line 8f, must be a forward fold. Thus, when folded, wing 20 lies on the upper surface of a generally central portion 135 of the drape. Although three folds, a reverse fold (5R), a forward fold (6F) and a reverse fold (7R) are illustrated in Fig. 21, it will be understood that the number of folds given wing 20 intermediate the first and last fold may vary, if the else of the drape, for example, should so require.

Wing 30, with its armboard cover 110' and armboard flap 120' in their aforementioned folded position, ls subse25 quently folded in the same way just described for wing 20 with its overlying armboard and armboard cover.

The wings, when their folding has been completed, overlie the upper surface of a generally central portion 135 of the drape lying between fold lines 8F and 12F. Also it will be noticed that the enlarged fenestration 50 preferably lies entirely within portion 134 of the drape. As seen ln Fig. 21, the fenestration lies between that central portion of the drape between the laot fold line (i.e., fold line 8f) and the nest to the last fold line (I.©., fold line 7R) used in folding the X7ing portions of tho drapo. The wing portions may be folded along a line that runs transversely through fenestration 50, but this ia disadvantageouc to the extent that the material at either side of the fenestration will be creased.

The longitudinal folding of the drape io completed by folding part of main portion IS a plurality of times toward the center of tho drnpo. Δ portion 139 adjacent the bottom edge of main portion 12 of ths drape io revoroe folded around fold lino 9Sj the main portion io then forward folded around fold line 10P, reveroo folded around fold line IIB, and forward foldod around fold lino ISP. Tho number of folds used for the main portion nay vary, but the last fold must ba a forward fold so that the folded part of the main portion overlies the same central portion 135 oo do the foldod wisiga. Drape 100, when thus foldod, asouneo tho general configuration shown for drape 10 in Pig. IS. In tho proferrod folding aequoneo, the folded part of the main portion of tho drape overlies the folded wing portions and central portion 135 of tho drape.

Esq oiso of tho various longitudinal portions ISO139 of tha drape will vary according to th© length of the drape and according to the number of folds that are made. §5 In the preferred oabodinont under discussion, portion 135 (that portion of the drape on top of which the folded wings and the folded main portion will He) hao tho longost length (i.e., vortical diaenoioa In Kg. 21). She longhto of portions 131, 132, 133, 134, 13β, 137 and 138 aro roughly equivalent to each other and are somewhat, e.g., a half Inch, less than the length of portion 135· Portions 130 and 139 at either end of the drape are about 1/4 the length of portion 131-134 and 138-138. - 24 41710 After T-shaped drape 100 has been folded longitudinally in the Manner just described, it may be folded transversely, from each side toward the center, using the modified fan folding described earlier herein for drape 10. This provides a compactly folded drape which can be conveniently packaged e.g., ln a paper bag. The packaged drape may be sterilised according to well known techniques.

In applying drape 100 to a patient about to undergo knee surgery, the procedure described herein for the io application of drape 10 (illustrated ln Figs. 13-17) is used. After main portion 12, wing 30, flap-like sheet 40, and wing 20 have been unfolded and secured ln place in the manner already described for drape 10, araboard covers 110 and 110' > are unfolded outwardly to cover the araboards on the operating table. Thereafter araboard flaps 120 and 120' are unfolded to lie ln their vertically downward position. Side portions 16* and 17a ars then free to fall over the sides of the operating table ln their vertically downward position.

Apart from its application to the present invention the folding sequence described above for drape 100 can be used for various kinds of generally T-shaped drapes. Thus, for example, surgical drapes of the kind described in British Patent Specification No. 1,476,258 may be advantageously folded using the procedure described herein for drape 100.

Patent Specification No. 4/711 claims a surqical drape comprising when laid out flat: a unitary sheet of flexible, drapable material having a main portion at one end thereof and a pair of spaced wings at the other end thereof, said wings extending outwardly from a central region of the sheet and 2° defining in the sheet a gap extending inwardly from an outer edge of the sheet; and on at least one of the wings, a flap which extends transversely from the wing so as to cover at least a lengthwise portion of the gap and to lie over and in contact with at least part of the other wing.

Claims (21)

1. CLAIMS:1. A surgical drape comprising a sheet of flexible drapable material having a main portion at one end thereof, and a pair of spaced wings at the other end thereof extending outwardly 5 from a central region of said sheet and defining a slit in said sheet; said slit merging into a widened fenestration located generally inwardly of the perimeter of the drape; a flap secured to one of said wings and transversely extendible from said wing so as to cover at least a portion of the length 10 of said slit and to be in contact with at least part of the other wing when the drape is in use; and stabilising means on said drape for preventing the wings from moving with respect to each other when the drape is in use.

2. A drape according to Claim 1, wherein a reinforcing panel is 15 attached to the outer surface of the drape.

3. A drape according to Claim 1, wherein said stabilising means comprises two flexible tabs which may be brought into mutual contact and held together.

4. A drape according to Claim 3, wherein a flexible tab is 20 attached to each wing portion at the inner edge thereof in that half of the length of the slit nearer to said fenestration.

5. A drape according to Claim 3, wherein one of said two tabs is attached to the flap near the inner side edge of the wing to which said flap is attached and the other of said two tabs 25 is attached to the remaining wing near the inner side edge thereof.

6. A drape acoording to Claim 1 or 2, wherein said stabilising means comprises a tab of flexible material and a co-operating strip of pressure-sensitive adhesive.

7. A drape acoording to Claim 6, wherein said pressure-sensitive 30 adhesive is protected by a release covering prior to use of the drape.

8. The drape according to any preceding Claim, further comprising at least one tubing holder on the outer surface of 25 4l7i0 the drape, said tubing holder having a flexible portion free from the rest of the drape, said flexible portion having at least one opening therein through which flexible members may be threaded and secured thereto.

9. A drape according to any preceding Claim, wherein the fenestration is lined with an elastomeric film, said film lying in the major plane of the drape.

10. A drape according to any preceding Claim, wherein each wing portion extends transversely to provide a generally IEshaped surgical drape, the transverse extensions comprising armboard covers for covering the laterally extending armboards of an operating table.

11. A drape according to Claim 10, wherein an armboard flap of flexible drapable material is attached to each of said armboard covers.

12. A drape according to any of Claims 1 to 9, wherein said flap on said one wing ls folded to overlie said one wing; said one wing with its said overlying flap and the other of said two spaced wings are each folded longitudinally a plurality of times in a sequence of folds toward the centre of the drape, the first fold in said sequence being a reverse fold and the last fold in said sequence being a forward fold whereby, when said folding sequence is completed, each folded wing portion overlies a central portion of said sheet; and a part of said main portion is folded longitudinally a plurality of times in a sequence of folds toward the centre of the drape, the first fold in said sequence being a reverse fold and the last fold in said sequence being a forward fold; whereby, when said folding sequence is completed, the folded part of said main portion comprises a stack of folds overlying said central portion of said sheet.

13. A drape according to Claim 12, wherein the folded wing portions lie between said folded part of said main portion and said central portion of the sheet. - 27, 41710

14. A drape according to Claim 12 or 13, wherein eaoh of said wings is folded four times, the first and third folds being reverse folds, and the second and fourth folds being forward folds. 5 15. A drape according to Claim 11, wherein said flap on said one wing is folded to overlie said one wing; each of said armboard flaps is folded to overlie the upper surface of the armboard cover to which it is attached; each of said armboard covers with its respective overlying armboard flap is folded 10 to overlie at least part of the wing from which said armboard cover transversely extends; each wing of the drape is then folded longitudinally a plurality of times in a sequence of folds toward the centre of the drape, the first and last folds in said sequence being forward folds whereby, when said folding

15. Sequence is completed, the folded wings comprise a stack of folds overlying a central portion of said sheet; a part of the main portion of the sheet is folded a plurality of times in a sequence of folds toward the centre of the drape whereby when said folding sequence is completed, the folded part of 20 said main portion comprises a stack of folds overlying said central portion of said sheet.

16. A drape according to Claim 15, wherein each armboard flap is folded twice, the first fold being a reverse fold and the second fold being a forward fold; and each of said armboard 25 covers with its respective overlying armboard flap is forward folded to provide a substantially rectangular partially folded drape.

17. A drape according to Claim 16, wherein each said wing is folded five times, the second fold being a reverse fold, the 30 third fold being a forward fold, and the fourth fold being a reverse fold.

18. A drape according to Claim 14 or 17, wherein said part of said main portion is folded four times, said first fold being a reverse fold, said second fold being a forward fold, and said third fold being a reverse fold.

19. A drape according to Claim 18, transversely folded into a compact unit. 5

20. A surgical drape substantially as described herein with reference to the accompanying drawings.

21. A surgical drape according to any preceding Claim, treated to render it sterile and packaged in said sterile condition.