Sock or Stocking for Therapeutic Use.
The invention is a sock or stocking for therapeutic use, more specifically as defined in the introduction to claim 1.
It is known that corns, bunions and related pressure sore problems on the feet can be treated with pressure-relieving dressings consisting of a soft elastomeric pad which is held in position over the affected point on the foot with the aid of an elastic bandage or a plaster. The exposed and often highly pressure-sensitive part of the foot is thus protected against direct external pressure and against the irritation which, for example, can be caused by friction against the shoe, or, in the case of a pressure sore on the inner side of a toe, by rubbing against the neighbouring toe. The elastomeric insert or pad is usually made of a soft, almost viscous plastic. This plastic, which, for example, can consist of a silicone-based gel or another appropriate elastomer, is characterised by being extremely soft and workable, and ensures an optimal relief of pressure via this property and alleviation at the point of tenderness. The insert is usually shaped (prefabricated) as a flat circular piece which is placed over the tender point and fixed with the aid of the bandage as specified above. The insert or pad is referred to below as a pad.
The known technique is usable for the treatment of a single bunion or a single pressure sore of limited physical extent, but in practice it is a problem that the bandage used to fix the pad is often very bulky, as a result of which the dressing itself can be a source of irritation and can, at worst, cause new pressure sores. The known treatments for relief of pressure are unsuitable for the prophylactic treatment of patients who are known to have a substantial risk of developing pressure sores on the feet, such as patients with diabetes, heart patients and patients with paralysis, because prophylactic use of the known forms of treatment will of its very nature assume a large number of individual dressings and pads on the foot at the same time, and this is of course not possible in practice without major inconvenience for the patient.
U.S. patent no. 5,823,195 describes a therapeutic stocking with two ankle inserts. The two ankle inserts protect the ankle and the area around it down to the heel against the formation of sores. The elastic stocking ensures an even pressure distribution over the relevant part of the foot. The ankle inserts are made of a siiicone elastomer and are hydrophobic. For obvious reasons the therapeutic stocking is unsuitable for use in prophylactic treatment to prevent pressure sores between the toes. The ankle inserts are placed in the therapeutic stocking as loose inserts. In practice this is done by the patient first putting on the stockings, after which the inserts are placed in them. The procedure is laborious and means that many patients, for example those with restricted ability to move or with paralysis, will have difficulty completing the task without assistance.
The object of the invention was to devise an improved form of pressure-relieving bandage or dressing which, based on known forms of treatment using point-wise relief of pressure on particularly exposed areas of the foot, would enable simultaneous relief of pressure at a number
of points or areas of the foot An attempt was also made to find a solution which can be used in everyday life as normal preventive treatment for the patients at special risk discussed above, so that these patients' problems with pressure sores on the feet and between the toes can be prevented simply and effectively The invention's pressure-relieving bandage must be easy to put on and take off, the bandage must be able to be worn discreetly under the clothing (under stockings or similar), and the bandage may not cause discomfort or other forms of inconvenience to patients These and other benefits are achieved in the invention by equipping the dressing as specified in the characterising part of claim 1
The new element in the invention is that a number of elastomeric, pad-like inserts are fastened, opposite the area(s) of the foot on which pressure is to be relieved, on the inner side of the foot- shaped sock or stocking, which is appropriately made of thin flexible and mainly also elastic material (textile of natural or artificial material) With a single bandage, the patient can thus gain pressure relief in a single action at all points on the foot which are liable to the formation of sores (pressure sore problems) or which are tender or exposed to pressure for other reasons The bandage is simple for the patient to apply, thanks to the textile material's elasticity and the bandage's foot-shaped form The elastomeric inserts attached to the inner side of the bandage will immediately sit "correctly" in relation to the areas of the foot which are exposed to pressure when the bandage is pulled on, and in particular the pads which are to protect the inner sides of the toes and the outer sides of the joints are positioned correctly solely because of the bandage's "foot shape" During use, the bandage ensures that the pads are held in their correct relative positions and that the pads do not shift unintentionally relative to their various pressure points The bandage's main use will be for prophylactic purposes
The invention's elastomeric inserts are suitably made of a soft, almost viscous plastic, for example a known silicone-based gel-like type Alternatively, the insert can be made of foamed plastic, foam rubber, natural rubber or another appropriate material The elastomeric inserts are fastened to the inner side of the bandage by thermal welding, sewing, adhesion or other appropriate method The sock or stocking itself is made of NYLON or an equivalent thin and elastic textile, mainly of a type with a suitable permeability to water vapour and which takes as little space and causes as little inconvenience as possible so that the bandage can be worn under ordinary footwear (socks, stockings, shoes etc ) without inconveniencing the patient
In one preferred embodiment of the invention, the bandage is equipped with separate cavities for the individual toes, that is, cavities analogous to the "fingers" in a glove The inner sides of these toe cavities carry elastomeric inserts dimensioned for therapeutic pressure relief on the inner sides of the toes, that is, in the spaces between the toes Experience has shown that these areas of the feet are highly susceptible to the formation of pressure sores The bandage makes it possible to relieve the pressure on the exposed areas in a very gentle and yet effective
manner, without making the bandage bulky and uncomfortable to wear. The toe cavities are appropriately open at the ends, so that the bandage terminates at the toe's outer joint. In popular terms, the toe ends of the bandage are cut off. From the toes, the bandage extends backwards to about the middle of the forefoot. The bandage is thus shaped like a half-sock. In this embodiment the bandage is extremely comfortable for the patient to wear, and the price of manufacture for the bandage is the lowest possible.
Examples of preferred embodiments of the bandage according to the invention are given in claims 5-8. The bandage itself can be shaped like a full sock, a half sock or a knee-high stocking as required, and the elastomeric inserts can be freely placed in the bandage according to where there is a need for pressure relief. Claim 8 concerns an embodiment equipped with full foot lamina, that is, where the elastomeric insert almost forms an internal sole in the bandage. This form of therapeutic stocking is used with advantage by patients with fallen arches.
To increase the therapeutic effect of the bandage, the invention makes it possible to supplement the pressure-relieving effect with some form of medication. This requires the measures specified in claims 9 and 10, which consist of the elastomeric inserts containing a drug which is released successively to the patient during the treatment, either by diffusion, evaporation or otherwise dissolving. Under the invention the drug can be a hormone, an antibiotic e.g. for the healing of sores, a morphine preparation to treat pain in combination with the soothing effect of the pad, or other appropriate medication.
A more detailed description of the invention is now given in association with the drawings, of which
Fig. 1 shows a forefoot bandage according to the invention with pressure pads inserted between the toes, viewed obliquely from the front, in use on a patient. Fig. 2 The same separately, viewed obliquely from above. Fig. 3 The forefoot bandage viewed directly from the front. Fig. 4 A magnified section which shows a toe section of the bandage with associated pressure pads. Fig. 5 The same in cross-section.
Fig. 6 The same in an embodiment with circular ring-shaped pressure pad which completely surrounds the toe. Fig. 7 A stocking-shaped, knee-length bandage according to the invention viewed obliquely from the side. Fig. 8 The underside of the same with the foot lamina insert marked.
In the embodiment shown in Figs. 1-5, the sock or stocking consists principally of an elastic bandage 1 in the shape of a "foot glove", designed to cover the forefoot from the outer joints of the toes to about the middle of the forefoot as shown. The bandage is called a forefoot sock. The bandage, which is made of an elastic textile material (NYLON or equivalent), has separate
"fingers" for the toes, that is, cavities 2 in which the toes fit when the stocking is put on. These "fingers" or cavities 2 are open at the ends 2a, so that the outer joints of the toes are not covered by the bandage. Experience shows that the outer joints seldom suffer pressure sores or similar problems.
The bandage is equipped on the inner side with elastomeric inserts 3 at the points where pressure on the foot and the toes is to be relieved. In the embodiment shown there are several separate inserts 3 in the actual toe cavities 2, designed to relieve the pressure of the inner sides of the toes against each other. The inserts are shaped as circular or rectangular pads which are fastened to the inner side of the bandage by sewing, thermal welding or adhesion. Alternatively, the inserts on the toe cavities 2 can be ring-shaped (insert shown in 4) to completely encircle the toe when the bandage is put on (Fig. 6). Inserts placed opposite bunions, i.e. on the outer sides of the big and the little toes, can also be used in the forefoot stocking in question (inserts 5 and 6).
Figs. 7 and 8 show the bandage in a knee-length embodiment 7, but still with separate cavities for the toes which are open at the ends 2. Apart from the toe inserts 3 already discussed, the knee-length stocking can be equipped with inserts 8 opposite the heel and opposite both ankle protuberances. In a special embodiment this knee-length stocking can also be equipped with a full foot lamina 9 of elastomeric material designed for therapeutic treatment of patients with fallen arches. In other embodiments not figured here, the bandage can be shaped like a short sock and fitted with inserts combined in various ways according to the patient's individual needs. The inserts can, as already discussed, contain a drug which is successively released during the treatment via the pad's direct contact with the skin.