WO2005097022A1

WO2005097022A1 - Head dressing

Info

Publication number: WO2005097022A1
Application number: PCT/GB2005/001315
Authority: WO
Inventors: Jake Timothy
Original assignee: Jake Timothy
Priority date: 2004-04-05
Filing date: 2005-04-05
Publication date: 2005-10-20
Also published as: GB0407669D0

Abstract

A post-operative head dressing (10) comprises a rigid cap (22) adapted to fit over the head (20) of a patient, and a liner (12) The liner is a network of tubes (14) of resilient material connected to a single opening (18) through which gas may be introduced to pressurise the liner network. The liner expands against the cap to squeeze the head. The network, when inflated, covers less about 20% of the area covered by the lining (12). The tubes have a diameter of about 5 mm. Different caps are provided to enable more accurate fitting of the cap to a patient's head.

Description

HEAD DRESSING

This invention relates to a method of, and apparatus for, reducing the occurrence of post-operative swelling in patient's undergoing surgery on the head, and in particular to a head dressing for such patients.

Post-operative swelling is always an issue that is sought to be minimised. It hinders recovery. On the other hand, it cannot be eliminated altogether because the operation wound needs a blood supply to enable healing, and that inevitably results in some leakage, and hence swelling. Bandages are usually employed but, for head injuries, bandages are bulky and cumbersome. Indeed, most of the bandage employed does not come into contact with the wound but rather is around the head merely holding a small part of the bandage against the wound. Moreover, wounds need to be checked periodically, to ensure that there is not excessive leakage of fluid from the wound. Generally, bandages are disposed of when a wound is checked and this is wasteful .

US-A-6592535 discloses apparatus for arresting scalp bleeding, and comprises a skull cap including a plurality of inflatable bladders each inflatable to press different parts of the head and effect haemostasis. Presumably, the device is intended for emergency situations in which stemming of bleeding from^' an open wound . at an accident/incident site is desired. This is thus a temporary measure while the victim is awaiting proper medical attention. In this circumstance, the ability to inflate perhaps a single bladder that applies pressure only on the wound site is a satisfactory arrangement.

However, in a post operative _. situation, where a permanent dressing is needed, this single-site application of pressure would not be satisfactory.

Thus it is an object of the present invention to provide a post-operative dressing that stems swelling and bleeding of a patient that has undergone surgery on their head.

In accordance with the present invention there is provided a post-operative head dressing comprising an expansion resistant cap adapted to fit over the head of a patient and a liner therefor, which liner comprises a network of tubes of resilient material connected to a single opening through which gas may be introduced to pressurise the liner network so that the liner expands against the cap to be urged inwardly, reducing its circumference about a periphery of the cap. When the cap is worn by a human patient and the liner is inflated, pressure is applied to the patient's scalp, at least around a periphery of the skull. This stems blood flow in the capillaries of the scalp and reduces inflammation therein.

The single opening enables the entire network to be filled at the same time, equalising pressures. Also, any leakage from the network is evident in a general loss of applied pressure.

Said network is preferably an open network which, when inflated, covers less than 30% of the area covered by the lining, and preferably less than 20%, and preferably more than 10%. This ensures that most of the patients/ scalp is not covered with the network tubes, and therefore enables air to circulate over the wound permitting it to dry and heal. Preferably the tubes have a diameter of between 3 and 10 mm, preferably between 4 and 7 mm, about 5 mm.

The tubes are preferably moulded from a latex or other biologically inert elastomeric material .

In use, wounds will be covered with a gauze dressing, to prevent direct contact between the tubes and a patients' skin.

Different caps may be provided to enable more accurate fitting of the cap to people's (differently-shaped) heads. This ensures, as far as practicable, that there are not regions of a patients' skull that are too far from the inside of the cap for the tubular network to reach. If it is too far, the tubes will fail to- apply pressure to the scalp in that region.

Be that as it may, the primary role of the cap and network is to apply pressure about a circumference of the patients' head. Therefore, blood flowing over the scalp, in the network of arteries and veins that cover the human scalp, cannot,' under normal arterial and venal pressures, reach the wound site, at least not in great quantity.

Indeed the pressure applied by the network needs to be controlled so that it does not cut-off all blood flow. Accordingly, a pressure gauge is preferably provided with the dressing to permit control of inflation pressure.

Preferably, the dressing further comprises a chin-strap to hold the cap on the patient's head when the liner is inflated. An alternative embodiment of the invention provides not a network of tubes joining each other in different places forming rings of pressurisable tubes, but a liner formed from a flat blank comprising inner and outer layers with joins between them to form an interconnected chambered network, the chambers of the network being linked to each other in a three-dimensional arrangement to form a cap- shape. Preferably, said linking is by resilient material completing the cap-shape of the liner.

Preferably, said chambers comprise a frontal chamber, two bulbous temple lobes and two cranial limbs, wherein said frontal chamber is adapted to cover the forehead of a patient, the temple lobes to cover the side of the head and ears, and the cranial limbs to extend over the crown of the head. Preferably, said cranial limbs and temple lobes are each connected to said frontal chamber, one of said cranial limbs being provided with an access port at its end remote from said frontal chamber by which the liner is inflated.

Preferably, said linking is between said cranial limbs and temple lobes . Preferably a drawstring is provided between said temple lobes in the region of said remote ends of the cranial limbs to reduce the overall circumference of the liner. Preferably, the inner and outer layers of said temple lobes are sealed together in the region of the patient's ears and provided with through holes to allow sound and ventilation access to the ears.

In that respect, the liner material is preferably of heat weldable material, said network being formed by simple welding of two shaped sheets of said material about its periphery and subsequently joining said periphery together along said cranial limbs, preferably with intervening strips of said resilient material. Said cranial limbs may be directly connected to each other.

The invention also provides method of reducing postoperative swelling of the head of a human or animal patient, comprising the steps of: a) applying a cap liner to the head of the patient, which liner comprises ^■ a cap-shaped network of hollow resilient material connected to a single opening through which gas may be introduced to pressurise the liner network; b) applying an expansion resistant cap. over said liner, which cap is shaped to fit the head of the patient; and, c) pressurising the liner by introduction of gas through said opening so that the liner expands against the cap to be urged inwardly, reducing its circumference about a periphery of the cap and pressing against the head of the patient.

Preferably, said cap and liner employed in said method is the cap and liner of a dressing as defined above.

Embodiments of the invention are further described hereinafter, by way of example, with reference to the accompanying drawings, in which: - Figure 1 is a perspective view of a patient's head on which a liner for a dressing in accordance . with a first embodiment of the present invention is fitted; Figure 2 is a perspective of a patient having the entire dressing positioned on the head; Figures 3a and b are respectively a front-side perspective view and a rear view of a liner according to a second embodiment of the invention; and Figure 4 is a plan view of a blank for the liner of Figures 3a and b.

In Figure 1, a head dressing .10 comprises a liner 12 consisting of a network of tubes 14 which are interconnected together in the form of a hemispherical dome, having a rim 16. At the back of the rim 16 is a single port 18 through which air can be introduced to, and evacuated from, the network 14.

In use, a patient 20 has undergone surgery of one description- or another on their head. At the end of surgery, the wound (not shown) is closed in the normal way, and covered with breathable gauze (not shown) . Then, the liner 12 is placed over the head 20, enclosing the wound and its gauze covering. The liner 12 is a loose fit over the skull of the patient. Different sizes are made available for patients with differently sized heads .

Next, a rigid cap 22 is placed over the liner 12. Again, the cap 22 is sized to fit the patient, differently sized and shaped caps being available to suit particular circumstances. Nevertheless, the cap is preferably moulded from rigid plastics material, such as polypropylene, which, despite being relatively rigid, nevertheless can be deflected relatively easy. That is to say, if the cap should be round, but the skull of a given patient should be oval, then deflection of the cap to fit the skull will not be such as to place great pressure on the skull where it is deformed to fit the skull. Indeed, the fundamental principle of the cap is that it should resist expansion of its surface area. That is, its material should not be stretchable to any significant extent, although it may be flexible. In any event, the liner 12 is then inflated, employing the port 18, so that the network of tubes 14 expand and press against the inside of the cap 22. The reaction against the cap is provided by the scalp 21 of the patient 20.

The network of tubes 14 is comprised mostly of spaces 15 between them. The purpose of this is to permit the scalp 21 underneath the network 14 to breathe. For this purpose, the inside of the cap 22 maybe roughened or ridged, so that air passages are always available between adjacent spaces 15 and, indeed the outside environment. That is to say, the tubes 14 do not seal against the underside of the cap 22. Thus wounds have the opportunity to be ventilated. Nevertheless, the liner 12 presses against the patient's scalp, restricting the flow of blood into the scalp. The constriction is primarily around the entire periphery of the patient's crown. Even if other regions of the network 14 do not press against the scalp (by virtue of a mismatch of shape of the scalp 21 and cap 22) , blood supply is still restricted to such space. This is because the blood supply to and from the scalp is via a network of veins and arteries that cover the scalp. Ultimately, the veins and arteries enter or leave the scalp across a line essentially corresponding with the rim 16 of the network 14 of the liner 12.

The spaces 15 occupy about 80% of the area covered by the network 14. Because of the ventilation, the dressing 10 constituted by the liner 12 and cap 22 can be worn for extended periods of time, and at least until it would normally be necessary to change dressings.

By virtue of the restriction of blood supply, swelling associated with the trauma of surgery can be limited. Indeed, leakage from the wound can also be minimised. In fact, the arrangement could be used purely for the purpose of stemming blood flow from a scalp wound.

In Figures 3a and b and 4, a different embodiment is shown, although like parts are given the same reference numerals, but with a prime' . Here, the liner 10' comprises a shaped fitting for the head in flexible material. Prior to assembly, it has the flat shape 10a shown in Figure 4. The liner consists of inner and outer layers 30,32 welded to each other around a periphery 34 to enclose a linked chamber 36. An inflation port 18' is at the end of one of two cranial limbs 36,38, the other ends of the limbs joining a frontal chamber 40. Two side temple lobes 42,44 extend ^' from the ends of the frontal chamber 40.

Lycra^® or like resilient material strips 48,50 join the temple lobes 42,44 to the cranial limbs 38,36 to give a three-dimensional cap-shape to the liner 10'. Cranial limbs 36,38 are joined to each other along a centre line 52. Welded periphery 34 is extended at ear portions 42a, 44a. Holes 54 are formed through the ear portions, so that sound and ventilation can gain access to a wearer's ears (not shown) .

When first fitted to a wearer's head, draw string 56 is tightened between tabs 58 connected at the back of each temple lobe 42,44 to fit the liner closely. Then, a cap 22, as described above with reference to Figure 2, is fitted over the liner 10' and, when snug, the liner is inflated using the port 18' .

Because the liner is a single chamber 36, the pressure inside must be the same throughout. Consequently, the pressure exerted by the liner on the wearer's skull is necessarily uniform. In addition, because the liner is flat against the curved surface of the wearer's skull prior to inflation, but when inflated takes on a third dimension away from the wearer's skull when inflated, the Lycra^® strips 48,50 are stretched imparting a similar pressure to that exerted by the liner on the wearer's skull. The net effect is a relatively uniform pressure on the wearer's skull which, accordingly, does not need to be high in order to stem blood flow around the wearer's scalp. It is to be noticed that, around the periphery of the wearer's skull above their ears, the inflatable part of the liner is almost complete, with the exception of two gaps 60 between the ends of the cranial strips and adjoining lobes 42,44. Consequently, even if there is some variation in pressure applied to the scalp above said periphery, flow of blood to any low pressure region is stemmed, in any event, by the uniform pressure of the peripheral region of the liner 10' .

Finally, Velcro^® or like material patches 62 are provided at the base of ear portions 42a, 44a so that a chin strap is attachable.

Claims

1. A post-operative head dressing comprising an expansion-resistant cap adapted to fit over the head of a patient and a liner therefor, which liner comprises a network of tubes of resilient material connected to a single opening through which gas may be introduced to pressurise the liner network so that the liner expands against the cap to be urged inwardly, reducing its circumference about a periphery of the cap.

2. A dressing as claimed in claim 1, in which said network is an open network which, when inflated, covers less than 30% of the area covered by the lining.

3. A dressing as claimed in claim 1, in which said network is an open network which, when inflated, covers less than 20% of the area covered by the lining, but more than 10%.

4. A dressing as claimed in claim 1, 2 or 3 , in which the tubes have a diameter of between 3 and 10 mm.

5. A dressing as claimed in claim 1, 2 or 3 , in which the tubes have a diameter of between 4 and 7 mm.

6. A dressing as claimed in any preceding claim, in which the tubes are moulded from a latex or other biologically inert elastomeric material .

7. A dressing as claimed in any preceding claim, in which different caps are provided to enable more accurate fitting of the cap to a patient's head.

8. A dressing as claimed in any preceding claim, in which a pressure gauge is provided to permit control of inflation pressure.

9. A dressing as claimed in any preceding claim, further comprising a chin-strap to hold the cap on the patient's head when the liner is inflated.

10. A dressing as claimed in claim 1, wherein said network of tubes comprises a liner formed from a flat blank comprising inner and outer layers with joins between them to form an interconnected chambered network, the chambers of the network being linked to each other in a three-dimensional arrangement to form a cap-shape.

11. A dressing as claimed in claim 10, wherein said linking is by resilient material completing the cap-shape of the liner.

12. A dressing as claimed in claim 10 or 11, wherein said chambers comprise a frontal chamber, two bulbous temple lobes and two cranial limbs, wherein said frontal chamber is adapted to cover the forehead of a patient, the temple lobes to cover the side of the head and ears, and the cranial limbs to extend over the crown of the head.

13. A dressing as claimed in claim 12, wherein said cranial limbs and temple lobes are each connected to said frontal chamber, one of said cranial limbs being provided with an access port at its end remote from said frontal chamber by which the liner is inflated.

14. A dressing as claimed in claim 12 or 13, wherein said linking is between said cranial limbs and temple lobes.

15. A dressing as claimed in claim 12, 13 or 14, wherein a drawstring is provided between said temple lobes in the region of said remote ends of the cranial limbs to reduce the overall circumference of the liner.

16. A dressing as claimed in claim 1, wherein said inner and outer layers of said temple lobes are sealed together in the region of the patient's ears and provided with through holes to allow sound and ventilation access to the ears .

17. A dressing as claimed in any of claims 12 to 16, wherein said the liner material is of heat weldable material, said network being formed by simple welding of the edges of two shaped sheets of said material about its periphery and subsequently joining said periphery together.

18. A method of reducing post-operative swelling of the head of a human or animal patient, comprising the steps of: a) applying a cap liner to the head of the patient, which liner comprises a cap-shaped network of tubes of resilient material connected to a single opening through which gas may be introduced to pressurise the liner network; b) applying an expansion resistant cap over said liner, which cap is shaped to fit the head of the patient; and, c) pressurising the liner by introduction of gas through said opening so that the liner expands against the cap to be urged inwardly, reducing its circumference about a periphery of the cap and pressing against the head of the patient .

19. A method as claimed in claim 18, in which said cap and liner is the cap and liner of a dressing as claimed in any of claims 2 to 17.

20. A method as claimed in claim 19 when dependent on claim 9, further comprising the step of: d) before step c) , applying said chin strap and tightening same.

21. A post-operative head dressing, substantially as hereinbefore described with reference to the accompany drawings .