NZ628101B - Tube support - Google Patents

Abstract

Disclosed is a support (100) in the form of a harness for supporting a portion of a feeding tube. The disclosure notes that typically adhesive tape is used to secure a free end of a feeding tube which is surgically embedded in patient. Adhesive tape can cause tearing and irritation to a patients skin. The support (100) includes a torso embracing portion (10) and two or more tube holding portions. The torso embracing portion (10) embraces a torso of the patient. The two or more tube holding portions hold the tube and are fixable to, or part of, the torso embracing portion (10). The two or more tube holding portions are positioned to be spaced across the patient’s chest to embrace the tube at differing locations to accommodate variation in the location and the orientation at which the tube is at least partly embedded. n. The support (100) includes a torso embracing portion (10) and two or more tube holding portions. The torso embracing portion (10) embraces a torso of the patient. The two or more tube holding portions hold the tube and are fixable to, or part of, the torso embracing portion (10). The two or more tube holding portions are positioned to be spaced across the patient’s chest to embrace the tube at differing locations to accommodate variation in the location and the orientation at which the tube is at least partly embedded.

Description

P1199NZ01 TUBE SUPPORT FIELD The invention relates to supporting a portion, external to a patient, of a tube partly embedded in the patient.

BACKGROUND Clinicians install tubes into the upper body of people requiring various medical procedures, such as percutaneous endoscopic gastrostomy (P EG) feeding tubes and other feeding tubes, catheters and wound drainage tubes, etc. Tubes are surgically installed into the patients body and the free end of the tube is supported.

PEG feeding tubes are surgically installed into the stomach through the abdomen wall just below the rib cage and are typically oriented so that the portion of the tube external the patient projects upwardly to overlie the patients chest.

Typically the tube portion external to the patient is a free end. Conventionally the free end of the tube is supported by adhesive tape attaching it to the skin of the chest of the recipient. When the tube is used or cleaned, the free end of the tube is removed from its location by removing the adhesive tape from the skin of the patient. Once the tube has been accessed, it is resecured using more adhesive tape.

Post-surgery complications occur from time to time. The present inventors have recognised that some of these complications are associated with the conventional approach to supporting the external portion of the tube. For example, adhesive tape is thought to cause tearing of the skin (w hich tearing can result in infection) and allergic reaction. Adhesive tape also pulls on the skin, causing discomfort to the recipient.

P1199NZ01 The inventors have recognised that cancer patients are at higher risk of such complications because some medication required to treat such patients can cause the skin to be sensitive and easily damaged.

Occasionally an external portion of an embedded tube is accidently snagged and the tube pulled out, resulting in a medical emergency which may have dire consequences.

With the foregoing in mind, the present invention aims to provide improvements in and for supporting tubes, or at least to provide an alternative for those concerned with supporting tubes.

It is not admitted that any of the information in this patent specification is common general knowledge, or that the person skilled in the art could be reasonably expected to ascertain or understand it, regard it as relevant or combine it in any way at the priority date.

SUMMARY One aspect of the invention provides a support for supporting a portion, external to a patient, of a tube partly embedded in the patient; the support including a torso embracing portion, e.g. a strap, for embracing a torso of the patient; and one or more tube holding portions for holding the tube; the tube holding portion(s ) being fixable to, or part of, the torso embracing portion.

Preferably the support includes a releasable fastening mechanism by which two ends of the straps are releasably fastenable to close the strap. The releasable fastening mechanism is preferably positioned to overlie the patients chest.

P1199NZ01 The support preferably includes a mechanism by which a circumference of the torso embracing portion is adjustable to suit torsos of varying size. The torso embracing portion may include elastic material whereby the torso embracing portion is configured to elastically embrace the torso.

The support preferably further includes a shoulder strap, which strap preferably connects to the torso embracing portion in the vicinity of the patients spine.

The support may include a connection arrangement by which the shoulder strap is attached or attachable to the torso embracing portion; which is laterally relocatable across the patients back.

A releasable fastening mechanism may be positioned to releasably fasten the shoulder strap to the torso embracing portion whilst overlying the patients chest.

The support is preferably configured to embrace the tube at differing locations spaced across the patients chest to accommodate variation in the location and the orientation at which the tube is at least partly embedded. By way of example, the support may be so configured by the inclusion of two or more of the tube holding portions positioned to be spaced across the patients chest.

Preferably the torso embracing portion includes two layers of material mutually fastened at points of fastening; and the points of fastening are positioned to be spaced across the patients chest such that each of the tube embracing portion(s ) is defined between a respective adjacent two of the points of fastening.

P1199NZ01 Another aspect of the invention provides the use of the support to support the tube, including arranging the torso embracing portion and the tube holding portion such that the torso embracing portion embraces the patients torso; and the tube holding portion holds the tube.

Another aspect of the invention provides a support, for supporting a PEG feeding tube, formed from two 20mm plastic side release buckles; two 20mm plastic tri-slides; and 2.95m of 19mm soft elastic; and to make a chest strap, cutting 1.7m of the elastic and sliding a female side of one of the buckles 250mm in from an end of the 1.7m of elastic to define a 250mm end portion of the elastic; folding the 250mm end portion back along the elastic and bar tacking the end of the 250mm end portion; bar tacking every 50mm back towards the buckle, to make pockets for the PEG, leaving the last bar tack; cutting 50mm of the elastic; P1199NZ01 threading the 50mm of elastic through the female side of another of the buckles; sewing the 50mm of elastic, via bar tack, at right angles to and next to the first buckle to give an attachment point for a shoulder strap; sliding the other end of the 1.7m of elastic through one of the tri-slides and the male side of one of the buckles and back through the one of the tri-slides; folding and bar tacking the other end of the 1.7m of elastic to stop it fraying; to make the shoulder strap, cutting 1.2m of the elastic; sewing an end of the shoulder strap to the chest strap 600mm from the first buckle and on the same side of the chest strap; and sliding the other end of the shoulder strap through the other of the tri-slides and the male side of the other of the buckles and back through the other of the tri- slides.

Another aspect of the invention provides a support, for supporting a PEG feeding tube, formed from two 20mm plastic side release buckles; three 20mm plastic tri-slides; and 2.31m of 19mm soft elastic; and P1199NZ01 to make a chest strap, cutting 1.5m of the elastic and sliding the female side of one of the buckles, 250mm in from an end of the 1.5m of elastic to define a 250mm end portion of the elastic; folding the 250mm end portion back along the elastic and bar tacking the end of the 250mm end portion; bar tacking every 25mm back towards the buckle, to make pockets for the PEG, leaving the last bar tack; to make a shoulder strap, cutting 700mm of the elastic and sewing a 25mm loop in one end of the 700mm of the elastic; cutting 110mm of the elastic; threading the 110mm of the elastic through the female side of the other buckle to form a loop and bar tacking to form a 20mm loop; sliding the other end of the 1.5m of elastic through the 20mm loop, then one side of one of the tri-slides, then the 25mm loop of the shoulder strap, then the other side of the one of the tri-slides; fitting another of the tri-slides to the 1.5m of the elastic; then sliding the other end of the 1.5m of elastic P1199NZ01 through the male side of one of the buckles from the underside and back through from above, then back through the other of the tri-slides; and fitting a further of the tri-slides to the 700mm of the elastic; then sliding the other end of the 700mm of elastic through the male side of one of the buckles from the underside and back through from above, then back through the further of the tri-slides.

BRIEF DESCRIPTION OF DRAWINGS An embodiment of the apparatus will now be described by way of example only with reference to the accompanying drawings in which: Figure 1 is a plan view of an embodiment of the invention laid flat; Figure 2 is a plan view of a portion of the embodiment of Figure 1; Figure 3 is a plan view of the embodiment of Figure 1 partially disassembled; Figure 4 is a front view of a patient wearing the embodiment of Figure 1; Figure 5 is a rear view of a patient wearing the embodiment of Figure 1; Figure 6 is a plan view of a tri-slide; Figure 7 is a plan view of a male portion of a buckle; P1199NZ01 Figure 8 is a plan view of a female portion of a buckle; Figure 9 is a cross-section view of an end portion of a torso embracing portion; Figure 10 is cross-section view of the relocatable connection mechanism; and Figure 11 is another cross-section view of the relocatable connection mechanism.

DESCRIPTION OF EMBODIMENTS Disclosed herein are apparatus and methods that can be used to comfortably and detachably secure the free end of a tube (e .g., a feeding tube, catheter, etc) to the body of a patient without using adhesive tape. At least preferred forms of these apparatus and methods comfortably support the tube and reduce the risk of infection.

The preferred form of the apparatus is a harness from which the free end of the tube is detachable when the harness is accidently snagged during normal activities, to reduce the risk of the tube being dislodged from its attachment in the patients body.

The disclosed support 100 takes the form of a harness consisting of a chest strap 10 and a shoulder strap 20. The chest strap 10 is an example of a torso embracing portion. The shoulder strap 20 is an example of a shoulder overlying portion.

The chest strap 10 includes: a length of elastic which is preferably slighter longer than is required to encircle the torso of a large patient and is preferably about 1 (2 5mm) wi de; a pair of tri-slides 30a, 30c; a buckle made up of a male portion 41a and a female portion 40a; and an extension 11 including the female buckle portion 40b.

P1199NZ01 Preferably each of the tri-slides and buckle portions is a respective integral plastic molding (se e Figures 6 to 8).

The tri-slide 30a includes a trio of spaced parallel bars 130a, 230a, 330a, the ends of which are connected by a pair of parallel rails.

The male buckle portion 41a includes a pair of spaced parallel bars 141a, 241a. A prong 341a and a pair of resilient barbs 441a extend perpendicularly away from the bars 141a, 241a. The prong 341a sits centrally between the barbs 441a.

The female buckle portion 40a is a hollow body having an open end 140a to receive the prong 341a and barbs 441a. The body further includes a pair of side openings 240a and a bar 340a.

The barbs 441a are: outwardly biased to engage the openings 240a to resist removal of the male portion 41a from the female portion 40a; and pressed inwardly via the openings 240a to disengage and allow the removal of the male portion 41a from the female portion 40a.

The buckle 40a, 41a is thus one example of a releasable fastening mechanism. Other possible examples include hook and loop fastening (su ch as Velcro ) , press studs, hooks and eyes, etc.

At one end of the strap 10, the elastic is wrapped around the bar 340a of the female buckle portion 40a and is stitched back on to itself to define a permanently closed loop capturing the female buckle portion 40a.

P1199NZ01 At the other end of the strap 10 (Fi gure 9), the elastic is laced through the tri-slide 30a, around the bar 241a then back through the tri-slide 30a, such that the second pass of the elastic through the tri-slide 30a sits between the bar 230a and the elastic of the first pass through the tri-slide. The buckle portion 41a is thus captured at the end of the elastic.

The layers of elastic through the tri-slide 30a frictionally engage each other sufficiently to resist inadvertent reversal. On the other hand, with careful hand manipulation, elastic can be fed through the tri-slide to adjust length of the strap 10. In use, the length of the strap 10 corresponds to the circumference of the patient s torso. Thus the arrangement of Figure 9 constitutes a mechanism for adjusting the circumference of the strap 10.

The shoulder strap 20 includes a length of elastic, one end of which is looped back on, and stitched to, itself to define a loop 21. The other end of the elastic is fitted with a tri-slide 30b and a male buckle portion 41b, whereby the shoulder strap is a length adjustable shoulder strap.

The tri-slide 30c is the major component of a connection arrangement by which the shoulder strap 20 is connected to the back of the chest strap 10 (se e Figures 10 and 11). To form this connection: prior to the fitment of components 30a, 41a, an end of the elastic of the strap 10 is passed through the gap defined by the bars 130c, 230c; the loop 21 at the end of the shoulder strap 20 is then passed over the tri-slide 30c; the end of the elastic of the strap 10 is passed through the gap defined by the bars 230c, 330c (o r more precisely by an edge of the loop 21 and the bar P1199NZ01 330c, since the loop 21 partly covers the gap defined by the bars 230c, 330c) to define a loop 14 in the elastic of the strap 10.

With careful hand manipulation, the elastic of the strap 10 can be fed through the tri- slide 30c so as to move the tri-slide 30c (a nd in turn the loop 21 and the end of the shoulder strap 20) along the strap 10. Thus Figures 10 and 11 describe one example of a relocatable connection arrangement by which an end of the shoulder strap can be relocated across the patients back 61.

The extension 11 including the female buckle portion 40b includes a short length of elastic. The short length of elastic encircles the bar of the buckle portion 40b and is stitched to the elastic of the strap 10 at a location adjacent the buckle portion 40a so that in use the buckle 40b opens upwardly to receive the buckle portion 41b of the shoulder strap 20.

The front run of the elastic of the strap 10 (i .e. the portion that sits on the patients chest 60) is formed as a double layer of elastic. These layers are stitched to each other at stitching points 13 spaced at a pitch of about 50mm along the elastic. Here, and elsewhere in the harness 100, the stitching preferably takes the form of bar tacks such as short zig-zag stitching.

Each pair of adjacent stitching points 13 defines a respective open ended pocket 13a though which a tube (e .g. a feeding tube or a catheter) may be passed. These pockets embrace the tube to hold it in place.

Stitching is but one means of mutually fastening the two layers. Alternatively, by way example, buttons or press studs could be used. Plastic welding is also contemplated.

In the illustrated example, the tube 50 is a Y tube having two branches 51. Each of the two branches 51 is respectively received in a respective one of the pockets 13a.

P1199NZ01 For the avoidance of doubt, e mbrace and h old and similar terms as used herein do not require compression or continuous conformal contact. That said, in the described support 100, the length of the strap 10 is preferably adjusted to gently compress the patients torso. When the support 100 is so adjusted, the tension in the strap gently compresses the tube by urging the pocket in which the tube is received to close in the fore-aft direction (i .e. normal to the patients chest).

In the described example, the tube holding pockets are formed as part of the strap 10.

In other variants, the tube holding portion could take the form of a clip carried by the tube and attachable to the strap 10 at a preferred location along the strap.

Alternatively, loops of fabric may be stitched to the front run of the elastic of the strap The support could be formed from a variety of materials. That said, it is preferably formed of soft elastic materials and plastic (e .g. nylon) fittings that are freely available and well known in the context of clothing and bags, etc. These materials are comfortable to the patient, suited to routine washing (t hus making the support conveniently and economically reusable) and suited to medical procedures such as Magnetic Resonance Imaging (M RI), radiation therapy and chemotherapy.

To fit the support 100: The support is obtained in (o r first assembled to) the condition illustrated in Figure 1 in which the buckles 40a, 41a and 40b, 41b are released.

The strap 10 is placed around and as high as possible on the patients chest.

The buckle portions 40a, 41a are mutually engaged.

P1199NZ01 The elastic of the strap 10 and the tri-slide 30a are manipulated to adjust the length of the strap 10 so that it gently compresses the patients chest to stay firmly in place.

The elastic of the strap 10 and the tri-slide 30c are manipulated to position tri- slide 30c substantially at the centre of the patients back.

The shoulder strap 20 is passed over the patients should er and the buckle portions 40b, 41b are mutually engaged.

The elastic of the shoulder strap and the tri-slide 30b are manipulated to adjust the length of the strap until the shoulder strap is firm.

Insert the tube to be supported into a suitably positioned one of the pockets 13a.

Trim each of the chest and shoulder straps at an angle of about 45° as required to leave about 100mm to about 150mm free elastic.

Trimming the straps at an oblique angle, such as 45°, reduces fraying.

Positioning the tri-side 30c at the centre of the patients back stably positions the support 100 on the patients body. It also comfortably locates the tri -side (a nd connection arrangement generally) in the hollow of the patients back.

In the illustrated example, the strap 20 is passed over the patients right shoulder.

Alternatively, it may be passed over the left shoulder.

Preferred forms of the support 100 do away with the need for adhesive tape to secure the free end of the tube, and with various of the problems associated with adhesive tape. These preferred forms are comfortable for patients. They also provide a degree P1199NZ01 of resilience, thus reducing the risk of the tube being pulled out when the tube is inadvertently snagged. They also allow the tube to separate from the support, thus reducing the risk of the tube being pulled out when the harness is inadvertently snagged.

One example of the disclosed support is a feeding tube support brace that is a cost effective and comfortable alternative to adhesive tape. This support brace is made using the following materials and in accordance with the following the instructions.

Materials: 2 x 20mm plastic side release buckles 2 x 20mm plastic tri-slides 2.95mtr 19mm soft elastic Instructions: 1. To make the chest strap, cut 1.7mtr elastic and slide the female side of one buckle, 250mm in from the end of the elastic 2. Fold the 250mm end back along the elastic and bar tack the end 3. Bar tack every 50mm back towards the buckle, to make pockets for the PEG, leaving the last bar tack 4. Cut 50mm length of elastic and thread it through the female side of the other buckle and sew it, via bar tack, at right angles to and next to the first buckle to give attachment of shoulder strap P1199NZ01 . Slide the free end of the chest strap through a tri-slide and the male side of the buckle and back through the tri-slide 6. Fold and bar tack the end of the elastic to stop it fraying 7. To make the shoulder strap, cut 1.2mtr elastic 8. Sew shoulder strap to chest strap 600mm from the shoulder strap buckle and on the same side 9. Install the tri-slide and the male side of the buckle using the same method as the chest strap To fit this support brace: A. Place the chest strap around the chest and insert the PEG through the pocket in the chest strap that is the most comfortable, adjust the strap via the side release buckle then take up the excess strap using the tri-slide B. Fasten the shoulder strap and adjust in the same way as the chest C. This item can be used as right hand or left hand Another example of the disclosed support is a feeding tube support brace that is a cost effective and comfortable alternative to adhesive tape. This support brace is made using the following materials and in accordance with the following the instructions.

Materials: 2 x 20mm plastic side release buckles P1199NZ01 3 x 20mm plastic tri-slides 2.31m of 19mm soft elastic Instructions: 1. To make the chest strap, cut 1.5m elastic and slide the female side of one buckle, 250mm in from the end of the elastic 2. Fold the 250mm end back along the elastic and bar tack the end 3. Bar tack every 25mm back towards the buckle, to make pockets for the PEG, leaving the last bar tack 4. To make the shoulder strap, cut 700mm elastic and sew 25mm loop in one end 5. Cut 110mm length of elastic and thread it through the female side of the other buckle to form a loop and bar tack to form a 20mm loop 6. Slide the free end of the chest strap through the 20mm loop in step 5 then through one side of a tri-slide and the 20mm loop of the shoulder strap then through the other side of the tri-slide 7. Fit a tri-slide to the chest strap then through the male side of the buckle from the underside and back through from above then back through the tri-slide 8. Install the tri-slide and the male side of the buckle using the same method as the chest strap P1199NZ01

Claims (12)

1. A support for supporting a portion, external to a patient, of a tube partly embedded in the patient; the support including a torso embracing portion for embracing a torso of the patient; and 5 two or more tube holding portions for holding the tube; the tube holding portions being fixed to, or part of, the torso embracing portion and positioned to be spaced across the patients chest to embrace the tube at differing locations to accommodate variation in the location and the orientation at which the tube is at least partly embedded. 10

2. The support of claim 1 wherein the torso embracing portion is a strap.

3. The support of claim 2 including a releasable fastening mechanism by which two ends of the strap are releasably fastenable to close the strap.

4. The support of claim 3 wherein the releasable fastening mechanism is positioned to overlie the patients chest. 15

5. The support of any one of claims 1 to 4 including a mechanism by which a circumference of the torso embracing portion is adjustable to suit torsos of varying size.

6. The support of any one of claims 1 to 5 wherein the torso embracing portion includes elastic material whereby the torso embracing portion is configured to 20 elastically embrace the torso.

7. The support of any one of claims 1 to 6 further including a shoulder strap. P1199NZ01

8. The support of claim 7 wherein the shoulder strap connects to the torso embracing portion in the vicinity of the patients spine.

9. The support of claim 7 or 8 including a connection arrangement by which the shoulder strap is attached or attachable to the torso embracing portion; 5 and which is laterally relocatable across the patients back.

10. The support of claim 7, 8 or 9 including a releasable fastening mechanism positioned to releasably fasten the shoulder strap to the torso embracing portion whilst overlying the patients chest. 10

11. The support of any one of claims 1 to 10 wherein the torso embracing portion includes two layers of material mutually fastened at points of fastening; the points of fastening being positioned to be spaced across the patients chest such that each of the tube holding portion(s ) is defined between a respective adjacent two of the points of fastening. 15

12. The use of the support of any one of claims 1 to 11 to support the tube, including arranging the torso embracing portion and the tube holding portion such that the torso embracing portion embraces the patients torso; and at least one of the tube holding portions holds the tube.