KR20150135921A - Medical Holding Apparatus for Drain - Google Patents

Abstract

Disclosed is a medical drain fixing apparatus which comprises: a plurality of clamps having a ring shape so as to perform clamping or unclamping action by covering an outer side of a drain which is installed while being inserted into a surgical area of a patient to remove blood from the surgical area of the patient to the outside the body, and further having first and second end parts which are detachable while being disconnected with each other; and a connection member connecting the clamps. In addition, a thread, which is tied up after stitching and supporting the skin of the patient, can be fixed by allowing the thread to pass thorough a space between the drain and the clamp, which are combined by clamping the drain.

Description

{Medical Holding Apparatus for Drain}

The present invention relates to a medical drain fixation device, and more particularly, to a method for securing a drain to a skin of a patient using a seal.

Drain is used to drain blood or body fluids that occur at the surgical site after surgery, in various areas such as surgery, obstetrics, neurosurgery, orthopedics, plastic surgery, otolaryngology, urology and the like. These drains are fixed so as not to be moved into the inserted state at the surgical site.

FIG. 1 is a basic structure of a general drain. One side has a plurality of micro-pores for facilitating aspiration of intraperitoneal secretions, and the other has a sharp stainless steel trocar needle penetrating the abdominal wall and positioned out of the body And then the metal bracing needle is removed and the suction bag is connected.

The drainage procedure of laparoscopic surgery and laparoscopic surgery is similar except for a few differences. Referring to FIG. 2, a drain (Drain) 1 is fixed by using a tread (20) which is sewn to the skin, and specifically, four knots are formed and fixed in a yarn . Here, the four knots consist of a skin suture knot for fixing the skin and the thread, two primary and secondary loop knots tangent to the thread and drain (1) fixed to the skin, and a loop connecting the primary and secondary loop knots It is divided into connecting knots.

Meanwhile, there are several differences in the drain installation process in the laparoscopic surgery and the laparoscopic surgery, and the drain insertion and fixation method in the open surgery will be described below with reference to FIGS. 3A and 3B.

First, the abdominal wound retractor is used to secure the intra-abdominal view to locate the drain. As shown in FIG. 3A, the drain is inserted into the abdominal wall including the skin from the inside of the abdominal cavity to the outside of the abdominal cavity, as shown in FIG. 3A, with the suction side of the drain at a position spaced apart from the open hack for surgery. So that the metal bushing needle is removed. Then, as shown in FIG. 3B, after the drain is determined, a stay suture is performed with a simple suture to fix the skin to the skin.

In the simple suturing method, the thread 20, which is connected to the needle at a position spaced apart from the drain, penetrates the skin once, and then ties three times to fix the thread and the skin, .

The drain 1 is placed at the center of both side seats of the knot made and the two seams are staggered and wrapped around a circle and then tie three times to complete the first loop knot fixing the thread 2 and the drain 1 do. Next, a second loop knot is performed for the purpose of stabilization. Three rings are tied at a distance from the first ring knot to complete the ring knot. Cover the finished part with a dressing, connect the suction bag to drain the secretions from the abdominal cavity at the drain end located outside the abdominal cavity, and finish by applying negative pressure.

The method of installing drains in laparoscopic surgery is almost similar to the method of the open surgery described above, but there are differences in the two steps, and will be described with reference to FIGS. 4A and 4B.

First, the method of positioning the intraperitoneal drain is different. In the case of laparoscopic surgery, the drain is pierced through the abdominal cavity using a metal bracing needle at a position spaced a distance from the open wound for surgery to create a new drain abdominal stab. On the other hand, in laparoscopic surgery, as shown in FIG. 4A, the suction side of the drain is inserted from the outside of the abdominal cavity through a side of the auxiliary 5 mm trocar inserted for laparoscopic surgery, instead of making a new abdominal balloon for drain insertion. Laparoscopic surgical forceps are then inserted into another 5 mm secondary trocar to hold the intraperitoneal drain and place it in position.

Second, there is a difference in the stay suture, which is the skin suturing method that fixes the skin and the thread.

A sharp, thin metal bracing needle is used to position the drain during open surgery to create a stab through the entire abdominal wall, including the skin, which does not create any leakage between the drain and abdominal wall. On the other hand, during laparoscopic surgery, 5 mm penetration of the abdominal cavity inserts a 5 mm straight incision into the skin and inserts the trocar, creating a hack, cut, and a leakage space on the drain and abdominal wall Occurs.

As a result, the drain wound site produces a small stab at the time of laparotomy, but in the laparoscopic surgery, it produces a wide penetrating wound (cut or cut) as shown in Figs. 4A and 4B.

Therefore, at the time of laparotomy, it is not necessary to make the stay suture directly on the piercer, but to measure the positive pressure in the abdominal cavity and the suction bag connected to the drain end outside the abdominal cavity Intraperitoneal secretions are drained by negative pressure. Drain is usually removed 2 to 4 days after surgery if there are no special problems, and the remaining penetrating staples will heal naturally without additional sutures.

However, during laparoscopic surgery, complications of intratumoral hernia have been reported on rare occasions or with a 5 mm trocar inserted wound, and wide wounds of straight incision are healed by multiple sutures. For this purpose, the stay suture for fixing the drain is not made at a position spaced a certain distance from the drain, but the drain is brought into close contact with one end of the through-cut wound (Hack, Cut) Vertical mattress sutures are used to seal the leaky space. After removal of the drain, the vertical cuts (vertucal mattrtrerss suture) performed on the hacking cut are maintained for 2 to 3 more days before the skin sheet is sutured.

However, the method of fixing the drain 1 as described above has the following problems.

First, it is impossible to calibrate the drain if the drainage (1) is fixed to the skin and the stay suture and primary and secondary loop knots are performed. There are several cases where the positional correction of the drain is necessary. The most common cases are as follows.

That is, the distal end of the suction side of the drain in the abdominal cavity stimulates or pushes the organs of the human body, causing pain temporarily or continuously. In addition, although the position of the drain is appropriate, the strength of the primary and secondary loop knots fixing the thread to be connected to the drain and the skin may not be appropriate. When the loop knot is fixed too tightly, the inner diameter of the drain becomes narrow. When the loop is too weak, the drain moves and a part of the microabsorption hole on the abdominal cavity suction side is exposed to the outside of the human body so that the negative pressure of the suction bag is not applied, . In both cases, it is technically difficult to loosen the first and second loop knots to correct the position of the grain, or to adjust the strength of the first and second loop knots. Therefore, there is a problem that the patient has to perform the procedure again from the stay stent to fix the drain to the skin by local anesthesia.

Second, there is a case where water leakage occurs between the abdominal wall penetration surface and the drain. Especially, it occurs well in drain installed in laparoscopic surgery. This is because the drain is installed at the place where the trocar is removed, so there is structurally leakage space. To prevent this, a drain is attached to one end of the penetrating wound, and the other is vertically mattressed suture. In this case, if the suture is not performed properly, it is necessary to repeat the stay suture to fix it thickly. If it is not severe, it is troublesome to perform frequent dressing with thick gauze. do.

Third, drain pulling can cause pain to the patient. The drain is fixed by a stay suture connected to the skin, so if the suture is improperly performed, or if the drain or inhalation bag is pulled by the patient due to carelessness, the skin is pulled by the thread, There is a problem that inconvenience is caused. In order to solve this inconvenience, the knot should be loosened by releasing the thread. If the drain is to be fixed again, local anesthesia must be performed again to seal the patient's skin.

Fourth, the installation and removal of the drain is troublesome and inconvenient. As mentioned above, according to the prior art, the drain (Drain) 10 is fixed through a total of four knots, and each knot is made by three ties. Not only is it a cumbersome task for the practitioner, but if the knot is not properly applied, the inner diameter of the drain becomes narrower or deviates from its position and can no longer function.

Further, in order to remove the drain 10, the two ring knot yarns 20 are cut with a scalpel, and then the drain is removed from the abdominal cavity. In this case, the ring knot thread is tightly connected to the drain, which sometimes causes the drain to be cut at the same time, and the remaining portion of the drain may enter the abdominal cavity, which is difficult to remove.

Various methods have been attempted in view of this point. One example of the method for fixing the drain without sealing the skin is a method in which, as described in the prior art (Korean Patent Registration No. 10-1133854) And a fixing portion formed with an insertion hole into which a drain penetrating the cover portion is inserted to fix the drain.

A major advantage of such a conventional medical drain fixation device is that it lessens the patient's inconvenience because it fixes the drain without sealing the skin. However, as mentioned above, when the drain is fixed in laparoscopic surgery, the widening wound of the straight cut is not only damaged by the multiple sutures but also does not cause leakage space between the drain and abdominal wall penetration. Therefore, it is not suitable for use in drain fixation in laparoscopic surgery. Recently, the laparoscopic surgery is performed in almost all diseases except for some cancers, so that the conventional medical drain fixation device has a limited use range.

In addition, according to the conventional medical drain fixation apparatus, since the width of the cover portion is required to be wide in order to stably fix the cover portion, and the fixing portion is formed so as to protrude from the cover portion, There is a problem that the patient is discomforted when installed on the skin of the patient and the manufacturing cost is increased.

Further, in order to fix the drain so as not to move with respect to the cover portion, it is necessary to fix the knot by using a thread or to use a separate fixing device (coupling portion), which makes it inconvenient to use and increases the number of parts, .

In order to allow the drain to pass through the cover portion and the fixing portion, the drain is preliminarily passed through the cover portion before insertion into the surgical site of the patient, or after the other end of the drain is separated from the medical suction device, There is an inconvenience that the user has to pass the same through the inhaler again.

Korean Patent No. 10-1133854

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and it is an object of the present invention to provide an improved medical drain fixture which can easily fix a drain using a seal and easily change a fixation position, The purpose of the device is to provide.

Another object of the present invention is to prevent water leakage phenomenon between the abdominal wall penetration surface and drain while reducing patient pain and inconvenience due to the drain fixing site and to determine the drain bore strength according to the loop knot strength, Which is influenced by experience and skill of the user.

In order to accomplish the above object, a medical drain fixation device according to the present invention is a medical drain fixation device that surrounds a drain inserted into a surgical site of a patient to remove blood from the surgical site, and clamps or unclamps A plurality of clamps having first and second ends that can be engaged and disengaged from each other in a disconnected state; And a connecting member for connecting the plurality of clamps, wherein a thread tied with a knot after supporting and sealing the skin of the patient can be passed between a clamp and a drain which are coupled by clamping the drain to be fixed.

The clamp includes: a clamp body having a ring shape for clamping the drain; A locking engagement portion for locking the disconnected first and second ends of the clamp body to each other; And a friction pad provided on the inner periphery of the clamp body.

Further, the clamp may further include a handle that is connected to the first and second ends so as to protrude outwardly.

It is preferable that the friction pad has at least one cutout section cut from the surface toward the inner circumferential surface of the clamp body, and the cutout is fixed in a state where the cutout passes through the cutout.

In addition, the connection member may include: a ring through which the drain can be inserted; And a connection cord for connecting the loop and the clamper.

The clamp may further include an extension part for the cover which is extended from the end of the clamp body and has an adhesive part which can be adhered to the skin of the patient on the inner side surface.

Further, the cover extension part is gradually expanded from the friction pad into a funnel shape and is deformed by an external force so that its inner surface can be brought into close contact with the skin of the patient.

1 is a photograph showing the structure of a general drain.
FIGS. 2 to 4B are photographs respectively showing an example of a conventional medical drain fixation device.
5 is a perspective view showing a medical drain fixation device according to an embodiment of the present invention connected to a drain.
6 is a perspective view of a medical drain fixture according to an embodiment of the present invention.
7 is a plan view of the medical drain fixation device shown in Fig.
FIG. 8 is a view showing a state in which the drain is fixedly installed after the open surgery using the medical drain fixation device shown in FIG. 4. FIG.
FIG. 9 is a perspective view showing a medical drain fixture according to another embodiment of the present invention connected to a drain. FIG.
10 is a sectional view taken along the line I-I in Fig.
11 is a view showing a state in which the drain is fixed after the open surgery using the medical drain fixation device of FIG.
12 is a plan view showing a state where a drain is inserted through a penetrating wound after laparoscopic surgery.
FIG. 13 is a plan view showing a state in which the drain is in close contact with one side of the through-hole in the state of FIG. 12, and a state in which a vertical matrix is sealed.
FIG. 14 is a schematic view showing a state in which a drain is fixed after laparoscopic surgery using a drain fixation device according to another embodiment of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a medical drain fixation device according to an embodiment of the present invention will be described in detail with reference to the accompanying drawings.

5 to 7, a medical drain fixation apparatus 10 according to an embodiment of the present invention includes a pair of clamps 20 having the same structure, a connection (not shown) for connecting a pair of clamps 20, And a member (30).

As shown in FIG. 5, the drain 1 has a plurality of micro-pores 1a inserted into the abdominal cavity at one end for suctioning intraperitoneal secretions, and at the other end, A stainless steel trocar needle (1b) is inserted through the abdominal wall to position it outside the body. The metal bracing needle 1b is removed by cutting the drain 1 in a state where it is positioned outside the human body in the abdominal cavity and the other end of the removed drain 1 is cut off from the abdominal cavity And is connected to the suction bag 3.

The medical drain fixation device 10 of the present invention is intended to prevent the position of the drain 1 installed on the human body from being fixed with respect to the human body by such a method as described above and to prevent the drain 1 from falling out of the human body.

The plurality of clamps 20 are clamped to the drain 1 to enclose the drains 1 located outside the human body and are fixed to the drains 1 at the time of fixation, So as to fix the seal 2 in a state that the seal 2 is passed.

The clamp 20 includes a clamp body 21 having a ring shape for wrapping and clamping the drain 1 and a clamping body 21 for clamping the disconnected first and second ends 22, A handle 25 connected to each of the first and second end portions 22 and 23 and a friction pad 27 provided on the inner periphery of the clamp body 21 .

The clamp body 21 is formed of a resin material such as plastic and has a circular ring shape and has first and second end portions 22 and 23 which are disconnected from each other. The first and second end portions 22 and 23 are brought into close contact with each other while the drain 1 is sandwiched therebetween and the locking engagement portion 24 So that the drain 1 can be clamped and clamped. At this time, since the clamping body 21 has elasticity, the first and second end portions 22 and 23 can be forcibly opened, and preferably, the central portion between the first and second end portions 22 and 23 It is preferable to form the folded portion 21a by cutting it to a certain depth. Therefore, when the first and second end portions 22, 23 are spread to both sides, the drain 1 can be easily inserted into the clamp body 21 by being opened based on the folded portion 21a.

The locking engagement portion 24 is for engaging the first and second end portions 22 and 23 so as to be held in close contact with each other. The locking engagement portion 24 includes a locking groove 24a formed by being drawn from the end surface of the first end portion 22, And a locking protrusion 24b having a shape corresponding to the end surface of the first end portion 22 and protruding from the second end portion 23 so as to be complementarily inserted into the locking groove 24a and locked. According to the locking engagement portion 24 having the above-described structure, the locking protrusions 24b are coupled to the locking recess 24a in a so-called one-touch manner so that the first and second end portions 22, have.

The handle 25 is installed to protrude outward from each of the first and second end portions 22 and 23, and is preferably integrally formed with the clamp body 21. [ Thus, by forming the handle 25 on each of the first and second end portions 22 and 23, when the user desires to separate the clamp 20 from the drain 1, the user holds the handle 25 with both hands The first end portion 22 is pushed and the handle 25 on the second end portion 23 is pulled to easily unlock and separate the locking state of the locking engagement portion 24. [ Therefore, when the length of the seal 2 sealed in the skin 3 of the patient's surgical site is to be adjusted, or the distance between the clamps 20 and the position of the drain 1 are to be changed, It is easy to use because it is easy to unclamp and clamp again.

The friction pad 27 is installed on the inner circumference of the clamp body 21 to a predetermined thickness. The friction pad 27 may be formed to have a width corresponding to the clamp body 21 and may be formed to have a sufficient inner diameter smaller than the outer diameter of the drain 1 when the clamp body 21 is clamped in a ring- . The friction pad 27 is preferably made of a material such as rubber, silicone, or the like, which is deformable and has a high frictional force.

More preferably, the friction pad 27 is formed with at least one cut-out portion 27a. The cutout portion 27a may be formed to extend from the surface of the friction pad 27 to the inner circumferential surface of the clamp body 21. [ When the drain 1 is inserted into the clamping body 21 and clamped and fixed in a state where the thread 2 is inserted into the cut portion 27a so that the thread 2 is passed through the thread 2, So that it can be pressed and fixed firmly to the cutout portion 27a of the pad 27. [ Therefore, even if the drain 1 is pulled or the thread 2 is pulled out while the thread 2 sealed with the skin is fixedly connected to the drain 1 by using the clamp 20 as shown in Fig. 8, 2 are firmly and doubly fixed to the pair of clamps 20 so that the drain 1 can be stably fixed and the thread 2 can be prevented from being pulled out of the clamp 20 do.

8, the thread 2 supported and sewn on the skin of the surgical site of the patient is tied with a knot only once, and then the bifurcated yarn connected from the knot portion is wound into a plurality (one pair) of clamps 20 The drain 1 is firmly fixed so as not to come off the patient's surgical site by clamping the clamps 20 by a simple operation of clamping the clamps 20 to the drain 1 with a predetermined distance therebetween, .

Further, the pair of clamps 20 are connected to each other by the connecting member 30 in a state of being fitted to the drain 1, so that the installation position (distance) between them can be appropriately adjusted. The connecting member 30 has a loop 31 and a connecting cord 33 for connecting the loop 31 to each clamp 20. The pair of clamps 20 can be connected by using the connecting member 30 to prevent loss and the pair of clamps 20 can be used in a single set. As shown in FIG. 5, the loop 31 is provided while being coupled with the drain 1, and the clamp 20 is provided separated from the drain 1. Only the loop 31 of the medical drain fixation device 10 of the present invention can be stored, packaged and provided in a state of being connected to the drain 1, so that the user can conveniently use it and there is no fear of loss.

It is also possible to omit the ring 31 and to connect the pair of clamps 20 using only the connection cord 33. [

9 to 11, a medical drain fixation apparatus 10 'according to another embodiment of the present invention includes a pair of clamps 20 and 20', a pair of writing lamps 20 and 20 And a connecting member 30 for connecting the connecting member 30 '. Here, the same components as those of the medical fixing apparatus 10 described above with reference to FIGS. 5 to 8 are denoted by the same reference numerals, and a detailed description thereof will be omitted.

In the case of the present embodiment, in the case of the clamp 20 'positioned close to the skin 4 of the patient out of the pair of clamps 20 and 20', the extension for the cover formed by extending from the end side of the clamp body 21 (26). ≪ / RTI > Preferably, the extension 26 is extended from one end of the friction pad 27 in a so-called funnel shape or hemispherical shape, and the inner side thereof is provided with an adhesive portion 28, As shown in Fig. The cover extension portion 26 is integrally formed of the same material as that of the friction pad 27. The cover extension portion 26 is provided with a cutout portion 26a that allows the cover body 21 to be opened when the clamping body 21 is opened. The adhesive portion 28 preferably includes a double-sided tape adhered to the inner surface of the extension portion 26.

According to the above configuration, as shown in Fig. 12, the human body is supported by a seal 2 for fixing the drain 1 in a state where the drain 1 is provided to the human body of the patient. 11A and 11B illustrate a drain installation process at the time of open surgery and the seal 2 is supported at a position spaced apart from the drain 1 and the clamps 20 ' Clamp the chambers 2 to the clamps 20 'and 20 and fix them.

11A, the cover extension portion 26 is deformed and the adhesive portion 28 is attached to the surface of the skin 20, as shown in FIG. 11A. At this time, when the extension portion 26 for cover of the clamp 20 ' And adhered and fixed to the surface. As described above, when the covering extension portion 26 is adhered and fixed to the surface of the skin using the adhering portion 28 while closely adhering to the skin, the position of the drain 1 can be more firmly fixed, The pain is not generated at the knot portion by the thread 2. [

11A and 11B, in order to install the drain 1 after the open surgery, a new drain abdominal stab is created on the skin using a metal bracing needle connected to the drain. In this case, Since there is no possibility of occurrence of leakage through the stab passing through the drain 1, the seal 2 is supported at a position spaced apart from the stab by a simple suture method, Can be fixedly connected to the drain 1 using the clamps 20 'and 20 as described above. Therefore, it is not necessary to make the first and second loop knots for connecting and fixing the drain 1 to the thread after the support suturing as in the prior art, and it becomes easy to fix the drain connection, The drain can be easily fixed and installed.

When the degree of pulling of the thread is to be adjusted after the drain 1 is installed, the position of the clamp 20 can be adjusted by loosening the clamp 20 without the knot being loosened or the thread being newly stitched, The tension can be adjusted and then fixed again, so that any problems that have arisen in the prior art can be solved.

12, in order to insert the auxiliary trocar for the laparoscopic surgery into the skin 4, a 5 mm trocar penetrating wound for inserting the trocar (6) is formed, and the penetrating wound 6 (6) ) Undergoes a 5 mm incision on the skin with a scalpel. Therefore, the drain 1 is inserted into the abdomen through the hack, cut 6, and a leakage space S is generated between the drain 1 and the abdominal wall penetration surface.

Therefore, the stay suture for fixing the drain during the open surgery is not performed at a position spaced apart from the drain 1 by a certain distance. Instead, as shown in Fig. 13, one of the through- The drain 1 is brought into close contact with the end and a vertical mattress suture is made with the seal 2 on the other side to block the leakage space.

With the vertical mattress suture as described above, the yarn 2 is connected to the drain 1 using the clamps 20 'and 20' as described above with reference to FIGS. 11A and 11B Can be fixed. 14, the vertical mattress suture portion and the penetrating wound portion (Hack) are bonded to the skin by adhering the extension portion 26 of the clamp 20 ' , Cut (6) can be covered without being exposed to the outside. Therefore, it is possible to effectively prevent leakage of water through the penetrating wounds (6) and to prevent foreign matter, contaminants, bacteria and the like from flowing into the penetrating wounds (6).

As described above, according to the present invention, it is possible to easily install the drain 1 regardless of the open surgery or the laparoscopic surgery, and to adjust the position of the installed drain 1 as well as to easily adjust the tension of the thread 2 It is possible to easily cope with the pain generated in the patient.

Further, it is not necessary to form the primary and secondary loop knots and the connection knot that are formed by winding the drain 1 using the yarn 2 in the conventional manner. Accordingly, the inner diameter of the drain 1, which is determined according to the knot strength of the first and second loop knots, can be uniformized uniformly regardless of the physician's experience and proficiency, and reliability can be ensured.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments. Those skilled in the art will readily appreciate that many modifications and variations of the present invention are possible without departing from the spirit and scope of the appended claims.

1 .. drain 2 .. thread
10,10 '.. Medical drain fixture 20,20' .. Clamp
30.

Claims (7)

A first and a second separator which have a ring shape for clamping or clamping the outer side of a drain inserted and installed in a surgical site of the patient to remove blood from the surgical site of the patient, A plurality of clamps having two ends;
And a connecting member connecting the plurality of clamps,
Wherein the thread of the knot is clamped to the skin of the patient, and the thread is then passed between the clamp and the drain to clamp the drain to be fixed. The clamp according to claim 1,
A clamp body having a ring shape so as to be able to clamp and clamp the drain;
A locking engagement portion for locking the disconnected first and second ends of the clamp body to each other; And
And a friction pad mounted on an inner circumference of the clamp body. The clamp according to claim 2,
Further comprising: a handle coupled to the first and second ends so as to protrude outwardly from the first and second ends. The method according to claim 2 or 3,
Wherein the friction pad has at least one cutout cut from the surface toward the inner circumferential surface of the clamping body,
And the seal is fixed in a state in which the seal passes through the cut portion. The connector according to claim 4,
A ring through which the drain can be inserted;
And a connecting strap connecting the loop and the clamp. The clamp according to claim 2 or 3,
Further comprising a cover extension portion formed on the inner side of the clamp body and having an adhesive portion adhered to the skin of the patient. The method according to claim 6,
Wherein the cover extension portion is gradually expanded from the friction pad into a funnel shape and is deformed by an external force so that an inner surface of the cover is in close contact with the skin of the patient.

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