U.S. patent application number 10/113355 was filed with the patent office on 2003-10-02 for heel elevator support.
Invention is credited to DuDonis, Matt, Rowan, Leslie.
Application Number | 20030182727 10/113355 |
Document ID | / |
Family ID | 28453577 |
Filed Date | 2003-10-02 |
United States Patent
Application |
20030182727 |
Kind Code |
A1 |
DuDonis, Matt ; et
al. |
October 2, 2003 |
HEEL ELEVATOR SUPPORT
Abstract
A heel elevating foam cushion is used to relieve heel pressure
ulcers in patients confined to bed. The cushion elevates the lower
legs and thereby supports the feet without any contact with the
feet. Bolsters or palisades on either side of the cushion prevent
the legs from falling from the bed, while allowing normal movement
of the legs associated with cleaning of the patient, medical
treatment of the limbs, etc. The surface of the cushion is covered
by a waterproof covering. The cushion may be in a single use or
multiple use configuration. A compression process is used to reduce
the volume of the cushion by a factor of approximately eight,
thereby allowing the convenient storage of cushions without the
requirement for extensive storage facilities. The cushion finds
application in treating persons with heel or foot pressure ulcers,
in treatment of persons after orthopedic surgery, and in recovery
from venous surgery for insufficient circulation in the lower
limbs.
Inventors: |
DuDonis, Matt; (Columbia,
MD) ; Rowan, Leslie; (Washington, DC) |
Correspondence
Address: |
William S. Ramsey
5253 Even Star Place
Columbia
MD
21044
US
|
Family ID: |
28453577 |
Appl. No.: |
10/113355 |
Filed: |
April 1, 2002 |
Current U.S.
Class: |
5/648 |
Current CPC
Class: |
A61G 7/0755 20130101;
A47C 20/021 20130101 |
Class at
Publication: |
5/648 |
International
Class: |
A47G 009/00 |
Claims
We claim:
1. A heel elevator support for stimulating circulation in the lower
extremities and for preventing and managing heel pressure ulcers
comprising: a rectangular cushion having a front end and a back
end, a left and a right side, and a top and bottom surface, the
cushion having a width from the left side to the right side
approximating or less than the width of a bed, the cushion having a
length from the front end to the back end approximating the length
of a patient's leg from knee to Achilles tendon, the cushion having
from the top surface to the bottom surface a height adequate to
stimulate stimulate circulation in the lower extremities, two
ramparts integral with the cushion, a first rampart located at the
left side and parallel to the left side, a second rampart located
at the right side and parallel to the right side, each rampart
extending above the upper surface of the cushion, the support
comprised of a foam material, and the support having a cover
comprised of a water-resistant elastomer material.
2. The heel elevator support of claim 1 wherein the width of the
cushion is approximately 26 to 36 inches.
3. The heel elevator support of claim 1 wherein the length of the
cushion is approximately 12 to 25 inches.
4. The heel elevator support of claim 1 wherein the height of the
cushion is approximately 3 to 6 inches.
5. The heel elevator support of claim 1 wherein the rampart extends
above the upper surface of the cushion approximately 1 to 8
inches.
6. The heel elevator support of claim 1 wherein the ramparts are
bolsters.
7. The heel elevator support of claim 1 wherein the ramparts are
palisades.
8. The heel elevator support of claim 1 wherein the foam is
polyurethane foam or copolymer foam.
9. The heel elevator support of claim 1 wherein the foam is
polyurethane foam.
10. The heel elevator support of claim 1 wherein the foam is high
resiliency, high density, or viscoelastic foam.
11. The heel elevator support of claim 1 wherein the density of the
foam is from 1.2 to 2.4 pound per cubic foot.
12. The heel elevator support of claim 1 wherein the foam further
comprises an antimicrobial additive.
13. The heel elevator support of claim 12 wherein the antimicrobial
additive is vinyzine or biopruf.
14. The heel elevator support of claim 1 wherein the upper surface
of the cushion further comprises leg indentations, the leg
indentations parallel to the ramparts.
15. The heel elevator support of claim 1 wherein the cushion
further comprises a cushion inlay of foam of composition differing
from the composition of the cushion foam, the inlay located on the
upper surface of the cushion.
16. The heel elevator support of claim 15 wherein the upper surface
of the cushion inlay has leg indentations, the indentations
parallel to the ramparts.
17. The heel elevator support of claim 1 wherein the cover
comprises a clear elastomer film or a coated nylon fabric.
18. The heel elevator support of claim 1 wherein the cover is a
clear elastomer film.
19. The heel elevator support of claim 1 wherein the cover is a
coated nylon fabric.
20. The coated nylon fabric of claim 17 wherein the coating is
urethane or butyl rubber.
21. The heel elevator support of claim 1 further comprising holes
in the cover for the escape of air from the support.
22. The heel elevator support of claim 1 wherein the cover is
manufactured from strips of elastomer film welded together by radio
frequency welding.
23. The heel elevator support of claim 1 wherein the cover is
manufactured from strips of coated fabric sewn together and secured
about the support by zippers or hook and loop closures.
24. The heel elevator support of claim 1 wherein the cover is
retained on the cushion by a flange which extends from the sides of
the cover onto the bottom of the cushion.
25. A wedge shaped supplemental support for use in conjunction with
the heel elevator support of claim 1, the supplemental support
comprising a secondary cushion with a cover, the supplemental
support having a front end and a rear end, a left side and a right
side, an upper surface and a lower surface, the supplemental
support having the front end in contact with the rear end of the
heel elevator support, the height of upper surface at the front end
of the supplemental support approximating the height of the heel
elevator support, the height of the upper surface at the rear end
of the supplemental support declining to the level of the lower
surface of the supplemental support, the upper surface of the
supplemental support sloping from the front end to the rear end,
the width of the supplemental support approximating the width of
the heel elevator support, the supplemental cushion comprised of a
foam material, and the supplemental cushion covered by a cover
comprised of water-resistant elastomer material.
26. The heel elevator support of claim 1 further comprising a
supplemental support integral with the heel elevator support.
27. The supplemental support of claim 25 wherein the foam has the
composition of the foam of the heel elevator support cushion.
28. The supplemental support of claim 25 wherein the cover has the
composition of the heel elevator support.
29. A packaged heel elevator support comprising in combination, a
heel elevator support comprised of a foam cushion with ramparts,
the cushion covered by a water-resistant elastomer material, the
water-resistant elastomer material having holes for the passage of
air, the support compressed to not more than 15% of its freely
expanded volume, the compressed support rolled, and a elongated
flexible tubular casing or straps, the rolled compressed support
inserted into and enclosed by the elongated flexible tubular casing
or the straps.
30. A packaged heel elevator support comprising in combination, a
heel elevator support comprised of a foam cushion with ramparts,
the cushion covered by a water-resistant elastomer material, the
water-resistant elastomer material having holes for the passage of
air, the support compressed to not more than 15% of its freely
expanded volume, and a flexible, air-impermeable, wrap, the
compressed support enclosed by the flexible, air-impermeable
wrap.
31. The packaged heel elevator support of claim 29 further
comprising a supplemental support.
32. The packaged heel elevator support of claim 29 wherein the
supplemental support is integral with the heel elevator
support.
33. A packaged heel elevator support comprising in combination, a
heel elevator support comprised of a foam cushion with ramparts,
the support compressed to not more than 15% of its freely expanded
volume, the compressed support rolled, a elongated flexible tubular
casing or straps, the rolled compressed support inserted into and
enclosed by the elongated flexible tubular casing or the straps,
and a cover comprised of a water-resistant elastomer material, the
cover capable of enclosing a freely expanded heel elevator support
inserted into the cover, the cover retained on the fully expanded
heel elevator support by a flange.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] Not Applicable.
FEDERALLY SPONSORED RESEARCH
[0002] Not Applicable.
SEQUENCE LISTING OR PROGRAM
[0003] Not Applicable.
BACKGROUND OF THE INVENTION
[0004] 1. Field of Invention
[0005] This invention relates to supports which elevate the lower
legs of patients with circulatory insufficiency in the lower limbs
in order to prevent or relieve pressure ulcers on the heels or
feet.
[0006] 2. Description of Related Art
[0007] The incidence of pressure ulcers is sufficiently high as to
warrant concern among health care providers. High-risk groups
include elderly patients admitted to a hospital for femoral
fracture and critical care patients. The prevalence of pressure
ulcers in skilled care facilities and nursing homes is reported to
be as high as 23 percent.
[0008] Successful management of pressure ulcers involves three
components; nutritional assessment and support; management of
tissue loads; and managing bacterial colonization and
infection.
[0009] Management of tissue loads, i.e. pressure, friction, and
shear, through use of positioning techniques and support surfaces
is critical to the treatment of pressure ulcers. It is important
that individuals with pressure ulcers who are in bed not be
positioned on the pressure ulcers. Positioning devices should be
used to raise a heel ulcer off the support service and prevent
direct contact between bony prominences. Care should be taken to
assure that the patient has not "bottomed out" under a pressure
ulcer or part of the body at risk for ulcer formation, that is,
that there should be at least one inch of support material below
that portion of the body.
[0010] Because of the small surface area it is difficult to
redistribute pressure under the heels and new pressure ulcers often
develop on the heels of patients cared for on pressure-reducing
devices. Suspension of the heel has been suggested as the best
remedy, especially in individuals unable to reposition their lower
extremities. Ring cushions have been found to be more likely to
cause pressure ulcers than to prevent them. Treatment of Pressure
Ulcers, Clinical Guideline Number 15, AHCPR Publication No.
95-0625, December 1994.
[0011] The present invention deals with the prevention and
management of heel pressure ulcers primarily in two ways. 1. It
raises the lower legs with respect to the torso and thereby
promotes the circulation of blood through the legs and feet. 2. It
suspends the heels and feet above and out of contact with any
support surface, thereby preventing the development of pressure
ulcers and encouraging the healing of existing pressure ulcers. The
present invention also finds additional application in treating
post-operative orthopedic patients, and in pre- or post-operative
patients with venous insufficiency.
[0012] U.S. Pat. No. 2,709,435 discloses a leg rest which supports
a leg for the purpose of treating the leg with medical fluids and
for collecting the fluids which drain from the leg.
[0013] U.S. Pat. No. 3,333,286 discloses an adjustable sick-bed
bolster which is wedge shaped and capable of multiple
configurations. The bolster can be made of foam rubber or any
similar material.
[0014] U.S. Pat. No. 3,639,927 discloses a mattress for invalids in
which two wedge pieces support the shanks down to the region of the
ankles. The heels and feet do not contact the mattress.
[0015] U.S. Pat. No. 3,842,977 discloses a pillow-enclosing casing
in which a pillow, particularly a foam pillow, is rolled and
reduced in volume and then inserted into a tubular casing.
[0016] U.S. Pat. No. 4,045,204 discloses a compressed foam article
which is compressed and packaged by enclosure in a substantially
air-tight sack and a vacuum is drawn in the sack.
[0017] U.S. Pat. No. 4,711,067 discloses a method of packaging a
mattress to a small size, in which the mattress is squeezed by
compression means which drive the air from mattress and is then
placed in a closed container or case.
[0018] U.S. Pat. No. 5,134,739 discloses a protective device which
gives a set position to lower limbs. This involves a central block
with side supports for the legs which have a concave shape.
[0019] The heels and feet do not touch the device. This device does
include provisions for preventing the legs from falling off the
device.
[0020] U.S. Pat. No. 5,173,979 discloses an inflatable leg and foot
supporting cushion. The heels are supported by the cushion. The
cushion is covered by a fluid-impermeable material. The cushion may
include a lip or be covered with a diaper-like material to contend
with fluids from ulcers.
[0021] U.S. Pat. No. 5,289,828 discloses a pillow for orthopedic
support, especially for support after hip surgery.
[0022] U.S. Pat. No. 5,584,303 discloses a therapeutic leg elevator
which supports the leg from the ankle to at least the calf which
can be configured so that the heel does not contact the foot
portion of the support.
[0023] U.S. Pat. No. 5,666,682 discloses a foam mattress pad of
adjustable width which has a tear strip of foam material to reduce
the width of the mattress.
[0024] U.S. Pat. No. 5,745,939 discloses a leg rest for supporting
a patient on a bed during turning or otherwise managing the
patient. There are a pair of trough portions for receiving the
patient's legs and which prevent movement of the patient's
legs.
[0025] U.S. Pat. No. 5,878,551 discloses method of packaging a foam
pet industry product which involves placing the foam product inside
a plastic bag, reducing the pressure to remove fir from the bag,
and sealing the bag.
[0026] U.S. Pat. No. 5,944,683 discloses a resilient cushion to be
positioned on the skin adjacent a bony prominence having a recess
for the bony prominence.
[0027] U.S. Pat. No. 6,065,166 discloses an inflatable surgical
support cushion which includes a concavity formed by side bolster
structures.
[0028] U.S. Pat. No. 6,085,371 discloses a leg support apparatus
which supports a single leg and is made from cardboard, plastics,
or wire frames, and are stack able or foldable.
[0029] U.S. Pat. No. 6,135,560 discloses a travel headrest pillow
shaped to conform to the shape formed by the back of the user's
neck, head and shoulder.
[0030] U.S. Pat. No. 6,151,739 discloses a sleep support surface
including a mattress with inflatable bladders near the foot end
which lift the calves of the patient and reduce pressure on the
patient's heels.
[0031] U.S. Pat. No. 6,175,979 discloses an inflatable orthopedic
pillow with an area for isolating a patient's foot as well as
provisions for maintaining the foot in a particular position or
orientation.
[0032] U.S. Pat. No. 6,186,967 discloses a elevation support for a
limb which surrounds a limb and has a longitudinal aperture for
insertion at least a portion of the limb.
[0033] U.S. Pat. No. 6,256,804 discloses a pillow like protector
and support device with a central surface having cut-away air gaps
forming grooves for supporting various body parts.
[0034] U.S. Pat. No. 6,260,221 discloses a heel supporting
apparatus which substantially immobilizes the legs and includes a
heel pad which supports the heel and an inflatable bladder which
contacts the bottom of the feet.
[0035] U.S. Pat. No. D311,470 discloses a support cushion with
contours which supports a person's legs and feet.
[0036] None of the prior art devices have the characteristics of
the present invention, that of elevating and supporting a patients
heels and feet to prevent and manage pressure ulcers using an
inexpensive cushion which is inexpensive, easy to manufacture and
clean, and provides support for the legs while allowing reasonable
movement associated with patient treatment.
BRIEF SUMMARY OF THE INVENTION
[0037] This application discloses a heel elevator support for
stimulating circulation in the lower and upper extremities and for
preventing and managing heel pressure ulcers. The invention
comprises a rectangular cushion having a front end and a back end,
a left and a right side, and a top and bottom surface, the cushion
having a width from the left side to the right side approximating
the width of a bed, approximately 26 to 36 inches. The cushion
having a length from the front end to the back end approximating
the length of a patient's leg from knee to Achilles tendon,
approximately 12 to 25 inches. The cushion having from the top
surface to the bottom surface a height adequate to stimulate
circulation in the lower extremities, approximately 3-6 inches. Two
ramparts are integral with the cushion, a first rampart located at
the left side and parallel to the left side, and a second rampart
located at the right side and parallel to the right side. Each
rampart extends above the upper surface of the cushion
approximately 1 to 8 inches. Examples of ramparts which are
bolsters and palisades are disclosed. The support is comprised of a
foam material, and the support is covered by a water-resistant
elastomer material.
[0038] Pressure ulcers have become a multi million dollar largely
preventable problem for the healthcare industry. The incidence of
lawsuits due to patient injury has continued to increase
exponentially, with the average settlement rising from $250,000 to
$450,000 in the past two years. In areas that do not have caps for
settlements, this figure has been in the millions of dollars. This
is regarded as a sentinel injury.
[0039] Heel pressure ulcers in particular are a problem because,
due to decreased blood flow, they do not heal quickly. Heel ulcers
cause decreased mobility, considerable pain, and can lead to
amputation in patients with severe arterial disease.
[0040] Venous stasis disease, predisposing to heel pressure ulcers,
is a lifetime problem for some patients, necessitating continued
control of edema in order to prevent recurrent skin breakdown. Many
of these patients also have some degree of arterial insufficiency,
which makes leg elevation painful. Because of these factors,
noncompliance with prescribed treatment regimens to manage the
disease is very high.
[0041] Orthopedic patients, particularly patients with lower
extremity procedures such as hip surgery, and those with cases, are
at extreme risk because of the immobility needed in the immediate
post procedure period. Additional immobility sometimes occurs due
to pain while in rehab. These patients can experience only the
slightest degree of elevation, due to the need for proper joint
positioning, which leads to a very high degree of heel pressure and
risk of development of heel pressure ulcers. Any such heel injury
can cause delays in rehab because of inability to walk on the
injured foot or to put a shoe on the injured foot.
[0042] Any patient who requires extended periods (greater than 1-2
hours) of limb elevation would benefit from this invention, as it
does not require constant repositioning or reapplication. This
includes upper extremities, as may occur in patients with
lympodema, which often accompanies mastectomy patients. In these
cases maintaining proper blood flow to reduce swelling while
minimizing pain or joint injury are key in the post operation
period. The present invention provides minimum elevation under
stable conditions, due to the use of high density foam.
[0043] Even the use of pressure relief beds has been shown to
result in pressures as high as 25 mmHG on patient's heels. The
present invention eliminates any pressure on the heel.
[0044] Elevation of extremities, upper as well as lower, allows
increased venous flow without compromising arterial flow. This is
particularly beneficial in the treatment and prevention of
edema.
[0045] The present invention allows for proper positioning of
extremities, while allowing for leg and foot mobility, which
provides maximum comfort for any patient who must be in bed longer
than 2 hours.
[0046] The present invention can be used for patients with bed
immobility due to any disease process, venous stasis disease,
including patients with mixed arterial insufficiency, orthopedic
patients who require positioning and pressure ulcer prevention, and
in general, any patient whose disease process would benefit from
minimal extremity elevation.
[0047] The present invention does not require the use of boots.
Boots can injure the patient through improper fit, pressure due to
hook and loop straps, and the boot slipping into improper position.
These problems can cause sever injury to the patient through
decreased arterial flow and direct pressure on the skin. The use of
boots requires removal and inspection every 2 hours to avoid these
problems. The present invention avoids all of these
difficulties.
[0048] The present invention avoids patient injury due to waffle
type foam. Such foam can cause "indention" and pressure injury,
particularly in patients with sever edema. Waffle boots have the
additional disadvantage in that they cannot be adjusted to rotate
pressure points on the calf and foot areas. Furthermore, after
periods of time as little as 1 hour the foam in waffle boots can
compress so the heel is no longer relieved of pressure, and, in
fact, is in a pocket of increased pressure.
[0049] Because the present invention has minimal elevation and does
not restrain the movement of the patient, it is especially suitable
for use with patients having arterial disease. It avoids the pain
associated with slings and other means of limb elevation in such
patients. The present invention allows the patient to continue to
have minimal unconstricted movement of the extremity, which
provides increased comfort with no decrease in blood flow.
[0050] The use of high density foam in the present invention allows
positioning of the patient at the recommended elevation of
approximately 1 inch with support of the calf and knee. The average
hospital pillow is not made of high density foam and is not
suitable for this use. On the contrary, the average hospital pillow
compresses under extremity pressure and does not keep the heel or
upper extremity off the bed for extended periods of time.
[0051] The standard hospital wedge type pillow does not provide for
the proper positioning of the present invention. A wedge type
pillow is intended for upper torso elevation, and can constrict the
knee area, which decreases circulation to the foot and calf area,
causing discomfort and possible injury.
[0052] The object of this invention is to provide a support used to
prevent development of heel and foot pressure ulcers in patients
confined to bed.
[0053] Another objective is to provide a support with a waterproof
coating which resists infiltration by would exudate and allows easy
cleaning of the cushion.
[0054] Another objective is to provide a support which elevates the
legs with respect to the torso in order to improve circulation in
the legs and feet.
[0055] Another objective is to provide a support which suspends the
heels and feet without contact with a support surface to prevent
the development of pressure ulcers or facilitate the management of
existing pressure ulcers.
[0056] Another objective is to provide a support which prevents the
patient's legs from falling from the edges of the cushion while
allowing normal movement of the legs associated with patient
management.
[0057] Another objective is to provide a support with an inlay of
specialized support surface for patients at unusual risk of
development of pressure ulcers in the lower extremities.
[0058] Another objective is to provide a support with a scalloped
surface for accommodations of the lower extremities in patients
where it is desirable to suppress movement of the lower
extremities.
[0059] Another objective is to provide a support which can be
packaged in a reduced volume in order to relieve the storage
requirement for cushion inventory.
[0060] A final objective is to provide a support which is
inexpensive, easy to manufacture, and capable of manufacture and
use without adverse effect on the environment.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0061] FIG. 1 shows a perspective view of the first embodiment heel
elevator support and secondary heel elevator support.
[0062] FIG. 2 shows a side view of the first embodiment heel
elevator support and secondary heel elevator support in use.
[0063] FIG. 3 shows a side view of the first embodiment heel
elevator support in use.
[0064] FIG. 4 is a perspective view of the ninth embodiment heel
elevator support.
[0065] FIG. 5 is a perspective view of the tenth embodiment heel
elevator support.
[0066] FIG. 6 is a side view of the ninth and tenth embodiment heel
elevator support.
[0067] FIG. 7 shows a plan view of the first embodiment heel
elevator support.
[0068] FIG. 8 shows a bottom view of the first embodiment heel
elevator support.
[0069] FIG. 9 shows a end view of the first embodiment heel
elevator support.
[0070] FIG. 10 shows a cross section of the first embodiment heel
elevator support taken at 10-10 of FIG. 9.
[0071] FIG. 11 shows a cross section of the second embodiment heel
elevator support.
[0072] FIG. 12 shows a end view of the third embodiment heel
elevator support.
[0073] FIG. 13 shows a end view of the fourth embodiment heel
elevator support.
[0074] FIG. 14 shows a perspective view of the fifth embodiment
heel elevator support.
[0075] FIG. 15 shows an end view of the fifth embodiment heel
elevator support.
[0076] FIG. 16 shows an end view of the sixth embodiment heel
elevator support.
[0077] FIG. 17 shows an end view of the seventh embodiment heel
elevator support.
[0078] FIG. 18 shows an end view of the eighth embodiment heel
elevator support.
[0079] FIG. 19 shows a plan view of the supplemental heel elevator
support.
[0080] FIG. 20 shows bottom view of the supplemental heel elevator
support.
[0081] FIG. 21 shows cross section of the supplemental heel
elevator support taken at 21-21 of FIG. 19.
[0082] FIG. 22 shows a bottom side of the first embodiment heel
elevator support showing the first embodiment cover.
[0083] FIG. 23 shows a bottom side of the first embodiment heel
elevator support showing the second embodiment cover.
[0084] FIG. 24 shows a bottom side of the first embodiment heel
elevator support showing the third embodiment cover.
DETAILED DESCRIPTION OF THE INVENTION
[0085] FIG. 1 is a perspective view showing the relation between
the first embodiment heel elevator support 100 and the supplemental
support 200. The front end 210 of the supplemental support is
adjacent to or touching the rear end 120 of the heel elevator
support. The top surface 270 of the supplemental support is visible
in FIG. 1. Dotted lines are used to indicate the location of the
bottom surface, left side, and right side of the supplemental
support.
[0086] FIG. 2 is a side view of the heel elevator support 100 in
use by a patient 50. The patient and first embodiment heel elevator
support are lying the upper surface of a mattress 25. The patient's
legs below the knees 55 and above the Achilles tendon 60 are
elevated and supported by the heel elevator support. Note
especially that the heel 65 and foot 70 are suspended without
contact with any surface.
[0087] FIG. 3 is a side view of the first embodiment heel elevator
support 100 with the supplemental support 200 in use by a patient
50. FIG. 3 is identical to FIG. 2 except that the patient's legs
from the hips 52 to the knees 55 are supported by the supplemental
support 200.
[0088] FIG. 4 is a perspective view of the ninth embodiment of the
heel elevator support. The ninth embodiment is a heel elevator
support in which the ramparts are bolsters and the supplemental
support is integral with the heel elevator support. Visible in FIG.
4 is the rear end 620, the sloping upper surface 670, the upper
surface 670 of the heel elevator portion, the left bolster 650, the
right bolster 660, the end 694 of the left bolster, and the end 692
of the right bolster.
[0089] FIG. 5 is a perspective view of the tenth embodiment of the
heel elevator support. The tenth embodiment is a heel elevator
support in which the ramparts are palisades and the supplement
support is integral with the heel elevator support. The tenth
embodiment is identical to the ninth embodiment, and FIG. 5 is
identical with FIG. 4 except that a left palisade 658 and a right
palisade 668 is present instead of a left bolster and a right
bolster (650 and 660 in FIG. 4, respectively). Visible in FIG. 5 is
the concave surface 652 and end 696 of the left palisade 650 and
the concave surface 662 and end 698 of the right palisade 660.
[0090] FIG. 6 is a side view of the ninth and tenth embodiments of
the heel elevator support. In the ninth and tenth embodiments, the
supplemental support is integral with the heel elevator support.
Visible in FIG. 6 is the bottom 680 of the support, the front end
610, the rear end 620, the sloping upper surface 670, the right
side 640, the right rampart 690, the outer surface 664 of the right
rampart, and the end 692 of the right rampart.
[0091] FIG. 7 is a plan view of the first embodiment heel elevator
support 100. Depicted in FIG. 7 is the front end 110, the rear end
120, the left side 130 and the right side 140, and the top surface
170. The width of the support from the left side to the right side
approximates the width of a bed, and is approximately 26 to 36
inches. The length from the front end to the back end approximates
the length of a patient's lag from knee to Achilles tendon. In a
preferred embodiment the length ranges from 12 to 25 inches.
Ramparts elevated above the surface of the support run along the
left and right sides to prevent the patient's legs from falling
from the support. In the first embodiment the ramparts are bolsters
with the upper surface rounded. A left bolster 150 is integral with
the support at the left side 130 and is oriented parallel to the
left side. A right bolster 160 is integral with the support at the
right side 140 and is oriented parallel to the right side. The
bolsters extend above the top surface of the support approximately
1 to 8 inches. A cover 190 encloses the entire cushion 125.
[0092] FIG. 8 is a bottom view of the first embodiment heel
elevator support. Depicted in FIG. 8 is the front end 110, rear end
120, the left side 130, the right side 140, and the bottom surface
180. Dotted lines indicate the position of the left bolster 150 and
right bolster 160 which are not visible in FIG. 8. A cover 190
encloses the entire cushion 125. A left hole 192 in the support
cover 190 and right hole 194 in the support cover 190 are visible
in FIG. 8.
[0093] FIG. 9 is an end view of the first embodiment heel elevator
support from the rear end 120. Depicted in FIG. 9 is the upper
surface 170, the left bolster 150, left side 130, right bolster
160, right side 140 and bottom surface 180. A cover 190 encloses
the entire cushion 125.
[0094] FIG. 10 is a cross section of FIG. 7 taken at 10-10. The
features shown in FIG. 10 are the same as the features shown in
FIG. 7. Also shown in FIG. 10 is the cushion 125 and the cover
190.
[0095] FIG. 11 is a cross section of a second embodiment heel
support cushion. This embodiment is identical to the first
embodiment heel elevator support except for the inclusion on the
top surface 170 of the cushion 125 of two indentations which are
parallel with the bolsters, a left indentation 172 and a right
indentation 174. The indentations 172 and 174 have a depth of 1 to
3 inches and run from the front end to the rear end of the cushion
and run parallel to the bolsters. The other features shown in FIG.
11 are the same as the corresponding features in FIG. 10.
[0096] FIG. 12 is an end view of a third embodiment heel elevator
support. The third embodiment support is the same as the first
embodiment except that the distance between the upper surface 170
and the bottom is approximately 1 to 3 inches less in the third
embodiment than in the first embodiment. An insert 176 covers the
upper surface 170 of the third embodiment support. The insert has a
thickness of 1 to 3 inches. The insert 176 is rectangular and
covers the upper surface between the front end, the rear end 120,
the left bolster 150 and the right bolster 160. The bolsters 150
and 160 extend 1 to 8 inches above the insert 176. The insert 176
has a composition different from that of the cushion of the first
embodiment heel support (125 in FIG. 10). The other features shown
in FIG. 12 are the same as the corresponding features in FIG.
11.
[0097] FIG. 13 is an end view of a fourth embodiment heel elevator
support. The fourth embodiment is identical to the third embodiment
heel elevator support except for the inclusion on the top surface
177 of the insert of two indentations which are parallel to the
bolsters, a left indentation 173 and a right indentation 175. The
indentations have a depth of 1 to 3 inches and run parallel to the
bolsters from the front end to the rear end. The other features
shown in FIG. 13 are the same as the corresponding features in FIG.
12.
[0098] FIG. 14 is a perspective view of the fifth embodiment heel
elevator support 500. Depicted in FIG. 14 is the front end 510, the
rear end 520, the left side 530 and the right side 540, and the top
surface 570. The width of the fifth embodiment support from the
left side to the right side is less than the width of the first
embodiment and is approximately 22 to 32 inches. The length from
the front end to the back end approximates the length of a
patient's lag from knee to Achilles tendon. In a preferred
embodiment the length ranges from 12 to 25 inches. In the fifth
embodiment the ramparts are palisades 550 and 560 with a concave
surface 552 and 562, respectively, facing the center of the
support. A left palisade 550 is integral with the support at the
left side 530 and is oriented parallel to the left side. A right
palisade 560 is integral with the support at the right side 540 and
is oriented parallel to the right side. The left palisade 550 has a
concave side 552 which rises from the top surface 570 of the
support and a vertical side 554 which is an extension of the left
side 530 of the support. The right palisade 560 has a concave side
562 which rises from the top surface 570 of the support and a
vertical side 564 which is an extension of the right side 540 of
the support. The palisades extend above the top surface 570 of the
support approximately 1 to 4 inches. A cover 590 encloses the
entire cushion.
[0099] The bottom view of the fifth embodiment is the same as the
bottom view of the first embodiment in FIG. 8. The fifth embodiment
support differs from the first embodiment primarily in the
substitution of palisades for bolsters. In addition, the fifth
embodiment is narrower than the first embodiment. The fifth
embodiment may be more easily packaged than the first embodiment
and the fifth embodiment requires less material in manufacture.
[0100] FIG. 15 is an end view of the heel elevator support from the
rear end 520. Depicted in FIG. 15 is the upper surface 570, the
left palisade 550 comprised of the concave side 552 and vertical
side 554, left side 530, right palisade 560 comprised of the
concave side 562 and vertical side 564, right side 540 and bottom
surface 580. The tops 551 and 561 of the palisades are preferably
flat. A cover 590 encloses the entire cushion 525.
[0101] FIG. 16 is an end view of a sixth embodiment heel support
cushion. This embodiment is identical to the fifth embodiment heel
elevator support except for the inclusion on the top surface 570 of
the cushion 525 of two indentations which are parallel with the
palisades, a left indentation 572 and a right indentation 574. The
indentations 572 and 574 have a depth of 1 to 3 inches and run from
the front end to the rear end of the cushion and run parallel to
the palisades. The other features shown in FIG. 16 are the same as
the corresponding features in FIG. 15.
[0102] FIG. 17 is an end view of a seventh embodiment heel elevator
support. The seventh embodiment support is the same as the fifth
embodiment except that the distance between the upper surface 570
and the bottom 580 of the cushion is approximately 1 to 3 inches
less in the seventh embodiment than in the fifth embodiment. An
insert 576 covers the upper surface 570 of the fifth embodiment
support. The insert has a thickness of 1 to 3 inches. The insert
576 is rectangular and covers the upper surface between the front
end, the rear end 520, the left palisade 550 and the right palisade
160. The palisades 550 and 560 extend above the insert 576
approximately 1 to 4 inches. The insert 576 has a composition
different from that of the cushion of the fifth embodiment heel
support 525 in FIG. 16. The other features shown in FIG. 17 are the
same as the corresponding features in FIG. 16.
[0103] FIG. 18 is an end view of a eighth embodiment heel elevator
support. The eighth embodiment is identical to the seventh
embodiment heel elevator support except for the inclusion on the
top surface 577 of the insert of two indentations which are
parallel to the palisades, a left indentation 573 and a right
indentation 575. The indentations have a depth of 1 to 3 inches and
run parallel to the palisades from the front end to the rear end.
The other features shown in FIG. 18 are the same as the
corresponding features in FIG. 17.
[0104] FIG. 19 is a plan view of the supplemental support 200.
Depicted in FIG. 19 is the front end 210, the rear end 220, the
left side 230 and the right side 240 and the top surface 270. The
width of the support from the left side to the right side
approximates the width of a bed, and is approximately 26 to 36
inches. The length from the front end to the back end is
approximately 12-24 inches. A cover 290 covers the entire cushion
225.
[0105] FIG. 20 is a bottom view of the supplemental support.
Depicted in FIG. 20 is the front end 210, the rear end 220, the
left side 230, the right side 240, and the bottom surface 280. A
cover 290 encloses the entire cushion 225. A left hole 292 in the
support cover 290 and right hole 294 in the support cover 290 are
visible in FIG. 20.
[0106] FIG. 21 is a cross section of the supplemental support taken
at line 21-21. Features visible in FIG. 21 are identical to the
corresponding features shown in FIGS. 19 and 20. Also shown in FIG.
21 is the cushion 225 and the cover 290. Also visible are the right
hole 294 in the support cover 290.
[0107] FIG. 22 is a bottom view of the first embodiment heel
elevator support showing the first embodiment cover 390. The first
embodiment cover is intended for single use. The first embodiment
heel elevator support using the first embodiment cover is
disposable and is intended for single use. The first embodiment
cover is comprised of water-resistant elastomer material. A
preferred material is thermoplastic polyurethane film manufactured
by J. P. Stevens Elastomerics of Holyoke, Mass.
[0108] In FIG. 22 the first embodiment cover 390 is shown with the
bottom cover panel 391, left cover panel 393, and rear end panel
395. Also visible is the left cover hole 392 which ventilates the
bottom cover panel 391 and left side panel 393 and the right cover
hole 394 which ventilates the bottom cover panel 391 and the right
side panel (not visible in FIG. 22). The holes in the coating allow
the escape of air from the support when it is packaged, and allows
return of air when the shape of the support is reconstituted when
the package is opened. The holes may be covered with mesh
fabric.
[0109] The first embodiment cover panels are attached to each other
by radio frequency (RF) welding shown along the seams 396. The heel
elevator support is constructed by first shaping the cushion, then
applying cover panels, then welding the panels together by radio
frequency welding. Other suitable methods for attaching the panels
together, such as sewing, heat sealing, or gluing with permanent
adhesives, such as epoxy adhesives, may be used.
[0110] FIG. 23 is a bottom view of the first embodiment heel
elevator support showing the second embodiment cover 490. The
second embodiment cover is intended for multiple use. The first
embodiment heel elevator support using the second embodiment cover
is intended for multiple use. The second embodiment cover is
comprised of water-resistant coated fabric material. A preferred
material is 70 denier nylon taffeta manufactured by Stafford
Textiles of Toronto, Ontario, Canada. Other suitable fabric
materials may be used, such vinyl and rayon may be used.
[0111] The fabric material is coated with a suitable
water-resistant polymer such as polyurethane, butyl rubber, vinyl,
and thermoplastic urethane. A preferred coatings include polycast
coat laminate and Staph Chek medical grade vinyl. Staph Check is a
trademark owned by Herciulite Products of Emigisville, Pa.
[0112] In FIG. 23 the second embodiment cover 490 is shown with the
bottom cover panel 491, left cover panel 493, and rear end panel
495. Also visible is the left cover hole 492 which ventilates the
bottom cover panel 491 and left side panel and the right cover hole
494 which ventilates the bottom cover panel 491 and the right side
panel (not visible in FIG. 23). The holes in the coating allow the
escape of air from the support when it is packaged, and allows
return of air when the shape of the support is reconstituted when
the package is opened. The holes may be covered with a mesh
fabric.
[0113] The second embodiment cover panels are attached to each
other by sewing along the seams 496. A zipper 497 which runs along
three sides of the bottom cover panel 491 opens the cover so the
cushion can be inserted and removed. The heel elevator support is
constructed by first shaping the cushion, assembling the second
embodiment cover by sewing together the cover panels, inserting the
cushion into the cover through the opening 498 defined by the
zipper 497, and closing the opening using the zipper. Other
suitable methods for attaching the panels together, such as radio
frequency welding, heat sealing, or gluing with permanent
adhesives, such as epoxy adhesives, may be used. Other suitable
means for closing the hole 498 such as hook and fabric closures,
buttons, and snaps may be used.
[0114] The reusable water-resistant elastomer material is 70 denier
nylon taffeta manufactured by Stafford Textiles of Toronto,
Ontario, Canada. The nylon elastomer is coated with a polycast coat
laminate or with Staph Chek medical grade vinyl. Staph Check is a
trademark owned by Herculite Products of Emiigsville, Pa.
[0115] FIG. 24 is a bottom view of the first embodiment heel
elevator support showing the third embodiment cover 590. The third
embodiment cover is identical to the first embodiment cover (shown
in FIG. 22) except the central portion 592 of the bottom panel 391
has been removed leaving the bottom panel or flange 591 which
extends from and is attached to the front, rear, and side panels. A
large portion of the bottom of the cushion is not covered when the
third embodiment cover is used. The third embodiment cover 590 is
assembled as is the first embodiment cover except the third
embodiment cover is assembled without including a cushion. After
the third embodiment cover is assembled, the cushion is inserted
into the bottom of the cover and the cover pulled over the cushion.
The flange 591 serves to retain the cover on the cushion. The
elasticity of the flange retains the cover in place. Alternatively,
an elastic cord may be added to the open edge of the flange for
additional retention.
[0116] Although the first embodiment heel elevator support has been
described with three embodiments of covers, similar covers with
similar structures and compositions may be used with the
supplemental support and with all embodiments of the heel elevator
support.
[0117] The cushion material used in all embodiments of the heel
elevator support and supplemental support is any suitable foam
material, such as polyurethane foam, copolymer foam, latex foam. A
preferred foam is polyurethane foam. The preferred foam is
available in several variations, such a 1A high resiliency; HD high
density, VE viscoelastic, which has very high density. Latex foam
is less preferred because of the hazard of incurring allergic
reactions to the foam. In a preferred foam an antimicrobial
additive is included in the foam, Bio-Pruf. Bio-Pruf is a trademark
for a antimiciobial additive obtainable from Morton International
of Cincinnati, Ohio. The foam density range is from 1.2 to 4.6
pounds per cubic foot. The firmness of foam is measured by
indention force deflection (IFD). A preferred foam has an IFD of 15
to 50.
[0118] It is important that the heel elevator support and
supplemental support be capable of reduction in volume during
shipping, storage, and generally when not in use. The relatively
large supports place severe burdens on the storage facilities of
hospitals and nursing facilities when the supports are stored. This
burden is especially high with cushions using the first embodiment
cover, which are disposable and have high inventory
requirements.
[0119] The supply volume problem is alleviated by reducing the
volume of packaged supports. In this process, the support is first
compressed and reduced in volume to not more than 15% of freely
expanded volume and the compressed support is then packaged by
tightly wrapping with a suitably strong material, such as plastic
film or fabric straps. In an alternative process the compressed
support is placed into a cylindrical cover which is manufactured of
a suitable strong material such as plastic film or fabric. Removal
of the packing material or the cylindrical cover allows the
supports to resume a freely expanded volume and be ready for
use.
[0120] In a second method of packing supports, the cushion without
a cover is compressed and reduced in volume to not more than 15% of
freely expanded volume and the compressed support is then packaged
by tightly wrapping with a suitably strong material, such as
plastic film or fabric straps. In an alternative process the
compressed support is placed into a cylindrical cover which is
manufactured of a suitable strong material such as plastic film or
fabric. To prepare the support for use, the packing material or
cover is removed, the cushion is allowed to resume the freely
expanded volume, and a third embodiment cover is placed over the
cushion, thus providing a complete support.
[0121] It will be apparent to those skilled in the art that the
examples and embodiments described herein are by way of
illustration and not of limitation, and that other examples may be
used without departing from the spirit and scope of the present
invention, as set forth in the appended claims.
* * * * *