U.S. patent application number 11/422825 was filed with the patent office on 2006-12-07 for surgical tray.
Invention is credited to Robert A. Davlin, Lawrence M. Lubbers.
Application Number | 20060272979 11/422825 |
Document ID | / |
Family ID | 37493080 |
Filed Date | 2006-12-07 |
United States Patent
Application |
20060272979 |
Kind Code |
A1 |
Lubbers; Lawrence M. ; et
al. |
December 7, 2006 |
Surgical Tray
Abstract
A surgical tray for operations on a patient's limb or extremity
generally comprises a surgical site board adapted to support a
portion of the patient's body. The site board includes a plurality
of apertures. A retention device or retraction device is removably
securable in at least one of the apertures and configured to retain
a portion of the extremity being operated upon or retract tissue
from the intended surgical site.
Inventors: |
Lubbers; Lawrence M.;
(Columbus, OH) ; Davlin; Robert A.; (Hilliard,
OH) |
Correspondence
Address: |
WOOD, HERRON & EVANS, LLP
2700 CAREW TOWER
441 VINE STREET
CINCINNATI
OH
45202
US
|
Family ID: |
37493080 |
Appl. No.: |
11/422825 |
Filed: |
June 7, 2006 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60688036 |
Jun 7, 2005 |
|
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|
Current U.S.
Class: |
206/557 |
Current CPC
Class: |
A61B 50/20 20160201;
A61B 17/02 20130101 |
Class at
Publication: |
206/557 |
International
Class: |
B65D 1/34 20060101
B65D001/34 |
Claims
1. A surgical tray, comprising: a surgical site board adapted to
support a portion of a patient's body, the site board having a
plurality of apertures therein; and a retention device removably
securable in at least one of the apertures and configured to
overlap and retain a portion of the patient's body.
2. The surgical tray of claim 1, wherein the retention device is
moldable to a desired shape.
3. The surgical tray of claim 2, wherein the retention device
includes a body portion formed from a malleable sheet of material
and an anchor configured to be inserted into one of the
apertures.
4. The surgical tray of claim 2, wherein the retention device
comprises a wire.
5. The surgical tray of claim 4, wherein the retention device
further comprises a cushioning layer surrounding at least a portion
of the wire.
6. The surgical tray of claim 1, further comprising: a housing
configured to support the surgical site board.
7. The surgical tray of claim 6, wherein the housing defines a
bottom surface, the site board being inclined relative to the
bottom surface.
8. The surgical tray of claim 6, further comprising: a flange
coupled to at least one of the housing and the site board and
having a plurality of spaced apart notches formed therein.
9. The surgical tray of claim 8, wherein the flange is pivotally
coupled to at least one of the housing and the site board, the at
least one flange being moveable between a closed position in which
the flange is generally planar with the site board and an open
position in which the flange is angled relative to the site
board.
10. The surgical tray of claim 6, wherein the housing includes one
or more storage compartments.
11. The surgical tray of claim 6, further comprising: a foam pad
received in the housing.
12. The surgical tray of claim 6, wherein the housing defines a
basin positioned below the site board and configured to collect
fluids, the plurality of apertures communicating with the basin so
that fluids can drain into the basin during a surgical
operation.
13. The surgical tray of claim 12, wherein the housing further
defines a drainage slot adjacent the site board, the drainage slot
communicating with the basin.
14. The surgical tray of claim 13, further comprising: a drape
adapted to be secured to a portion of the housing and wrapped
around a portion of the patient's body, the drape further adapted
to direct fluids into at least one of the drainage slot and
apertures.
15. The surgical tray of claim 6, wherein the housing includes a
reservoir configured to receive irrigation fluid for a surgical
operation.
16. The surgical tray of claim 6, wherein the tray is used during a
surgical operation that requires surgical instruments, the housing
or the site board further including a plurality of pre-formed slots
for receiving the surgical instruments.
17. The surgical tray of claim 16, further comprising: a needle
cover; wherein at least one of the plurality of pre-formed slots is
configured to removably secure the needle cover.
18. The surgical tray of claim 6, further comprising a removable
sharps pad supported by the housing and having a suture count
printed thereon.
19. A surgical tray, comprising: a surgical site board adapted to
support a portion of a patient's body, the site board having a
plurality of apertures therein; and a retraction device removably
securable in at least one of the apertures and configured to
retract a portion of the patient's body during a surgical
operation.
20. The surgical tray of claim 19, wherein the retraction device
comprises a post member configured to be retained in one of the
apertures and a surgical stay configured to be secured to the post
member.
21. The surgical tray of claim 20, wherein the post member includes
a body having edges and a plurality of notches spaced along the
edges, the notches being configured to retain a portion of the
surgical stay during a surgical operation.
22. The surgical tray of claim 20, wherein the post member is
moldable to a desired position.
23. The surgical tray of claim 19, further comprising: a housing
configured to support the surgical site board.
24. The surgical tray of claim 23, wherein the housing defines a
bottom surface, the site board being inclined relative to the
bottom surface.
25. The surgical tray of claim 23, further comprising: a flange
coupled to at least one of the housing and the site board and
having a plurality of spaced apart notches formed therein.
26. The surgical tray of claim 25, wherein the flange is pivotally
coupled to at least one of the housing and the site board, the
flange being moveable between a closed position in which the flange
is generally planar with the site board and an open position in
which the flange is angled relative to the site board.
27. The surgical tray of claim 23, wherein the housing includes one
or more storage compartments.
28. The surgical tray of claim 23, further comprising: a foam pad
received in the housing.
29. The surgical tray of claim 23, wherein the housing defines a
basin positioned below the site board and configured to collect
fluids, the plurality of apertures communicating with the basin so
that fluids can drain into the basin during a surgical
operation.
30. The surgical tray of claim 29, wherein the housing further
defines a drainage slot adjacent the site board, the drainage slot
communicating with the basin.
31. The surgical tray of claim 30, further comprising: a drape
adapted to be secured to a portion of the housing and wrapped
around a portion of the patient's body, the drape further adapted
to direct fluids into at least one of the drainage slot and
apertures.
32. The surgical tray of claim 23, wherein the housing includes a
reservoir configured to receive irrigation fluid for a surgical
operation.
33. The surgical tray of claim 23, wherein the tray is used during
a surgical operation that requires surgical instruments, the
housing or the site board further including a plurality of
pre-formed slots for receiving the surgical instruments.
34. The surgical tray of claim 33, further comprising: a needle
cover; wherein at least one of the plurality of pre-formed slots is
configured to removably secure the needle cover.
35. The surgical tray of claim 23, further comprising a removable
sharps pad supported by the housing and having a suture count
printed thereon.
36. A surgical tray, comprising: a housing; a surgical site board
supported by the housing and adapted to support a portion of a
patient's body, the site board having a plurality of apertures
therein; a retention device removably securable in at least one of
the apertures and configured to overlap and retain a portion of the
patient's body; and a retraction device removably securable in at
least one of the apertures and configured to retract a portion of
the patient's body during a surgical operation.
Description
[0001] The present application claims the filing benefit of U.S.
Provisional Application Ser. No. 60/688,036, filed Jun. 7, 2005,
the disclosure of which is hereby incorporated herein by reference
in its entirety.
FIELD OF THE INVENTION
[0002] The present invention relates generally to medical
equipment, and more particularly, to a surgical tray for operations
on a patient's limb or extremity.
BACKGROUND OF THE INVENTION
[0003] Many emergency room and other surgical operations require a
doctor to operate on a patient's limb or extremity. Hands are some
of the most commonly operated upon extremities because they are
required to complete many tasks and activities and are thus highly
at risk to injury. For example, approximately 10 percent or more of
typical emergency room operations involve some form of acute hand
surgery. Operating on a hand requires a great deal of care because
tendons, nerves, and blood vessels must all be meticulously
rejoined to assure proper alignment of any lacerated tissues.
Additionally, microsurgical techniques are generally required
because the tissues that make the functions of the hand possible
are small by nature. Control of the position of a patient's hand
and fingers during surgery is therefore an important aspect of a
successful operation.
[0004] Current techniques for performing hand surgery in the
emergency room and elsewhere are inefficient and frustrating. For
example, when a patient is rushed into the emergency room with deep
laceration or similar hand injury, a surgeon must arrange the
patient in the proper position for surgery and gather the necessary
materials. Typically this requires positioning the hand on an arm
table adjacent to a hospital bed and arranging it in a manner that
provides the surgeon with easy access to the intended surgical
site. Maintaining the hand in a desired position can be a difficult
task when qualified assistants are not readily available, which is
often the case during late-night, weekend, or very busy emergency
room situations.
[0005] Additionally, gathering the necessary supplies from various
areas in the emergency room prior to operation can be a burdensome
task. Due to a lack of centralized storage, the surgeon may find
himself or herself walking back and forth between the patient and
various areas of the room to gather surgical tools, sutures,
needles, gauze, and other items required to complete the surgery.
The surgeon may experience additional frustration if supply amounts
have not been maintained or if items have changed locations.
[0006] As a result of the manner by which items are gathered for
surgery, the surgical operation itself becomes more difficult. For
example, the various items are typically contained in individual
packages and are not designed to be collectively organized in any
particular manner. After all of the packages are opened and the
items are placed together on a separate instrument table or the
like, the surgeon may have to sort through any resulting clutter on
the table to find the instrument he or she is looking for. The
clutter typically increases throughout the operation as surgeon
uses different tools and instruments and places them back on the
table. Any increased operating time resulting from the lack of
instrument management increases the overall cost of the surgery and
can compromise the quality of the operation. Additionally, the lack
of instrument management increases the potential of accidental
injury from exposed scalpel blades and the like.
[0007] Use of the tools themselves can also be a challenging task.
In particular, areas of tissue on the hand typically obstruct
access to the surgical site being operated upon. As a result,
surgical stays and retractors are used to pull the tissue back.
Because assistants are not always available to hold the stays
during an operation, many surgeons place some sort of retractor
frame around the surgical site. The frames typically include
notches that are spaced about a peripheral edge and adapted to
secure a portion of the surgical stays, as shown in U.S. Pat. No.
4,274,398. Although such frames may slightly facilitate the
surgical operation, they are better suited for (and were originally
developed for) areas of the body other than limbs and merely
represent an improvised solution for hand surgeries. The ability to
use a stay to retract tissue in a desired three-dimensional
direction is limited by the spacing of the notches and their
position relative to the tissue.
[0008] During the course of the operation, the surgeon must take
measures to maintain a sterile surgical site. This typically
involves disinfecting and irrigating the surgical site and draining
any resulting fluids. Oftentimes the drainage is done in an ad-hoc
manner by merely placing a plastic bin or basin under the patient's
hand. Such a technique, however, may not sufficiently capture the
fluids due to splashing while the fluids are being applied.
Moreover, the bin or basin may not be large enough to cover the
entire area where drainage is likely to occur and can create a mess
when attempting to dispose of its contents. As a result, the
surgeon has a more difficult time maintaining a sterile surgical
site and reducing his or her own exposure to potentially
contaminated and biohazardous fluids.
[0009] Although several attempts have been made to facilitate
surgical operations on a patient's extremities, these attempts
merely focus on one or few of the challenges associated with the
operations and do not adequately ease the burden on surgeons. For
example, many surgeons use a sheet of metal (typically aluminum or
lead) cut into the shape of a hand to help stabilize and position a
patient's extremities. After using straps or the like to attach the
patient's hand to the metal sheet, the sheet can be bent into
desired positions by applying sufficient force. Variations of this
type of hand device are shown in U.S. Pat. Nos. 4,798,195,
5,560,375, and 5,855,209. Despite the improvements in stability,
however, such devices do not adequately address the challenges
associated with tissue retraction, instrument management, and fluid
management. Indeed, assistants are still typically required to keep
an incision open or to hold nerves, blood vessels, and tendons or
the like during surgery.
[0010] The same can be said with respect to various surgical tables
or trays that have been developed facilitate surgery on a patient's
extremities. In particular, although most of the tables provide
some means for securing a hand or the like during surgery, the
tables still limit the manner by which surgical stays may be used
to retract tissue. As shown in U.S. Pat. Nos. 3,779,211, 4,082,257,
4,807,864, and 6,077,221, the tables typically include notches
around a peripheral edge to secure a portion of the surgical stays.
This row of notches, or "Scott fencing," suffers from the same
drawbacks as the notched framing discussed above--the desired
direction of retraction is limited by the spacing of the notches
and their position in 3 dimensions relative to the tissue. If blood
vessels need to be held in a particular manner or if tissue needs
to be retracted in a direction away from the plane formed by the
fencing and surgical table, one or more assistants will be needed
to manually complete these tasks.
[0011] As can be appreciated, there is a need for a surgical tray
that helps reduce the frustration surgeons currently experience
when attempting to operate on a patient's limb or extremity. A
surgical tray is needed to address the issues of hand positioning,
tissue retraction, instrument and sharps management, and
irrigation/waste fluids management without significantly
compromising the comfort and wellbeing of the patient.
SUMMARY OF THE INVENTION
[0012] The present invention overcomes the foregoing and other
shortcomings and drawbacks of surgical trays heretofore known.
While the invention will be described in connection with certain
embodiments, it will be understood that the invention is not
limited to these embodiments. On the contrary, the invention
includes all alternatives, modifications and equivalents as may be
included within the spirit and scope of the present invention.
[0013] The present invention provides a surgical tray that
facilitates surgical operations on a patient's limb or extremity.
In particular, the surgical tray is configured to retain a
patient's limb and retract tissue or the like to reduce the
surgeon's reliance upon medical assistants to complete a surgical
operation. The surgical tray is also configured to provide an
organized, sterile field for an operation by incorporating integral
irrigation/waste fluids management, instrument management, and
sharps management.
[0014] To this end, a surgical tray according to the invention
generally comprises a surgical site board adapted to support a
portion of a patient's body, such as a hand. The site board also
includes a plurality of apertures. A retention device or retraction
device is removably securable in at least one of the apertures to
retain or retract a portion of the patient's body. More
specifically, a retention device is configured to overlap and
retain a portion of the patient's body, such as the patient's
fingers. The retention device may therefore be a rigid component
shaped for this purpose or a component moldable to a desired shape.
For example, the retention device may include an anchor configured
to be inserted into one of the apertures and a body portion formed
from a malleable sheet of material. Alternatively, the retention
device may comprise a pliable wire configured to be at least
partially inserted into one of the apertures and a cushioning layer
surrounding at least a portion of the wire.
[0015] The retraction device, on the other hand, is configured to
retract tissue or the like to provide the surgeon with increased
access to the intended surgical site on the patient's extremity. In
general, the retraction device comprises a post member configured
to be retained in one of the apertures and a surgical stay
configured to be secured to the post member. Similar to the
retention device, the post member may be a rigid component or a
component moldable to a desired shape. For example, in one
embodiment, the post member includes a body having edges and a
plurality of notches spaced along the edges. The notches are
configured to retain a portion of the surgical stay during a
surgical operation. Thus, the surgical stay may be secured to the
appropriate notch depending upon the desired angle of retraction in
each of the x, y, and z planes.
[0016] In another aspect of the invention, the surgical tray
further includes a housing configured to support the surgical site
board. The housing defines a basin positioned below the site board
for collecting any fluids that may drain through the plurality of
apertures during a surgical operation. For example, irrigation
fluid applied to the surgical site, or bodily fluids, may drain
through the apertures into the basin. Gutters and run-off guides
may be provided around the site board to direct drainage fluids
into the basin as well. The basin may be drained manually after an
operation, using an integrated pour spout or aperture, or
continuously during the operation by attaching a vacuum hose or
drain to a port communicating with the basin. Thus, in addition to
helping prevent the spillage of blood, disinfectants, and washes,
the integrated fluid management system of the surgical tray may
retain waste liquids and other fluids for convenient disposal.
[0017] The housing may also include one or more storage
compartments positioned proximate to the site board. The storage
compartments may contain all of the medications and instruments
commonly needed for surgery on a patient's extremity, including
sutures, disinfectants, dressing materials, anesthetics, and the
retention and retraction devices discussed above. Thus, the
surgical tray reduces the need for a surgeon to walk back and forth
between various areas in an operating room to gather the necessary
materials for a surgical procedure. If desired, the storage
compartments may be sterilized and sealed when the surgical tray is
produced so that the surgeon need only open the compartments to
make sterile surgical instruments readily available for use.
[0018] During an operation, the surgical instruments and suture
needles may be inserted into one or more foam pads received by the
housing. For example, one or more foam islands may be received by
the housing adjacent to the site board. Scalpels, scissors,
forceps, and other surgical instruments are supported by the foam
when inserted therein so that they are readily available for use or
reuse during an operation. Alternatively, the foam islands, other
areas of the housing, or the site board itself may include a
plurality of pre-formed holes or slots for receiving the surgical
instruments.
[0019] By virtue of the foregoing, there is thus provided a
surgical tray that reduces the time and frustration occasionally
experienced by surgeons when preparing for and performing a
surgical operation on a patient's limb or extremity. The retention
and retraction devices cooperate with the apertures in the site
board to secure the extremity and provide the surgeon with visual
access to the intended surgical site without relying upon
additional personnel. Integrated fluid management improves overall
cleanliness during operations and facilitates disposal of
contaminated waste liquids, while integrated sharps and instrument
management helps increase overall efficiency and prevents
misplacement of items. In addition, safety is promoted by providing
containment of biohazardous liquids and protection from exposure to
needles, scalpels, and other sharps.
[0020] These and other objects and advantages of the present
invention will be made apparent from the accompanying drawings and
the description thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] The accompanying drawings, which are incorporated in and
constitute a part of this specification, illustrate embodiments of
the invention and, together with a general description of the
invention given above, and the detailed description given below,
serve to explain the principles of the invention.
[0022] FIG. 1 is a perspective view of a surgical tray according to
one embodiment of the invention;
[0023] FIG. 2 is an enlarged perspective view of a portion of the
surgical tray in FIG. 1 showing a removable sharps pad and
integrated needle covers;
[0024] FIG. 3 is a perspective view showing one embodiment of a
retention device according to the invention;
[0025] FIG. 4 is a perspective view showing another embodiment of a
retention device according to the invention;
[0026] FIG. 5 is a perspective view showing another embodiment of a
retention device according to the invention;
[0027] FIG. 6 is a perspective view showing another embodiment of a
retention device according to the invention;
[0028] FIG. 7 is a perspective view showing one embodiment of a
retraction device according to the invention;
[0029] FIG. 8 is a perspective view showing another embodiment of a
retraction device according to the invention;
[0030] FIG. 9 is a perspective view similar to FIG. 1 showing
various aspects of fluid management;
[0031] FIG. 10 is a cross-sectional perspective view taken along
line 10-10 in FIG. 9; and
[0032] FIGS. 11 and 12 are perspective views illustrating a
disposal bag included in the tray of FIG. 1.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0033] With reference to FIG. 1, a surgical tray 10 according to
one embodiment of the invention is shown. The surgical tray 10
generally comprises a surgical site board 12 adapted to support a
portion of a patient's body and a housing 14 configured to support
the site board 12. Although FIG. 1 illustrates the site board 12
being used to support a patient's hand 16, those skilled in the art
will appreciate that the tray 10 may also be used during surgical
operations on other areas of the patient's body or on small
animals. Additionally, although the surgical tray 10 may be
particularly advantageous for emergency-room situations, the tray
10 may also be utilized for small outpatient operative areas,
treatment rooms, minor surgical procedure rooms, clinics, military
field hospitals, and anywhere extremity surgery can be done. In
such environments the tray 10 may be secured to an operating table
18 by one or more straps 22 connected to the housing 14. The straps
22 may be secured by locking devices 19, velcro, knots, a pin and
belt holes, or any other suitable method.
[0034] Both the site board 12 and housing 14 may be constructed
from plastic, although other materials are possible as well. For
example, the site board 12 or housing 14 may alternatively be
constructed from foam or a similar material. In one embodiment, the
housing 14 is adapted to receive one or more foam pads or islands
20 for the management of sharps and other surgical instruments. The
foam islands 20 may be a polyurethane, polyethylene, or similar
foam having a density sufficient to support the instruments at the
angles with which they are inserted therein. For example, FIG. 1
shows scissors 24 and a surgical knife 26 inserted into the foam
islands 20 at various angles. Because the instruments are inserted
at angles with their respective grip portions 28, 30 elevated off
the site board 12 and housing 14, a surgeon can quickly and easily
grab the instruments when they are needed during an operation. The
foam islands 20 may be coupled to the housing 14 or may be
removable components inserted into corresponding pockets (not
shown) formed in the housing 14. The foam islands 20 may also have
different configurations and be located in various areas on the
housing 14. Thus, although FIG. 1 shows first and second foam
islands 20 on opposite sides of the site board 12, a foam island
may alternatively extend substantially around the periphery of the
site board 12 to form a "racetrack" (not shown) or may be
positioned in a localized area of the tray 10, such as in a base
area 32 of the housing 14.
[0035] To further facilitate instrument management during surgical
operations, the housing 14 may also include a plurality of
pre-formed slots or holes 36 adapted to receive scissors 38 and
other surgical instruments. The slots 36 may be provided in a
predetermined matrix array and at desired angles in the housing 14.
Preferably the slots 36 are formed in a compressible material such
as foam and define openings sized to provide a close fit for the
common instruments provided with the tray 10 or commonly used
during surgery. Although FIG. 1 only shows the housing 14 and foam
islands 20 incorporating the pre-formed slots 36, similar slots or
holes may also be provided in the site board 12.
[0036] In one embodiment, a special type of foam island and slot
array is provided in the housing 14 to manage sharps (including
suture needles, scalpel blades, and other sharp objects) during a
surgical operation. More specifically and with reference to FIG. 2,
the housing 14 may receive a removable sharps pad 40 and include
one or more needle covers or protective shields 42 molded, pressed,
or otherwise secured in specially designated slots 36. The sharps
pad 40 is preferably formed from foam, but may alternatively be
constructed from other materials pierceable by suture needles 43,
such as elastomeric sheets, penetrable films, felts, and the like.
A suture count is printed on the sharps pad 40 to identify the type
and number of sutures used during the surgical procedure. Upon
completing an operation, the sharps pad 40 may be removed intact
for disposal in a designated sharps container (not shown) provided
by the hospital or clinic. FIG. 2 also illustrates how a syringe 46
may be docked in one of the integrated needle covers 42 to protect
the associated needle 44 during an operation.
[0037] Referring back to FIG. 1, the housing 14 may also include
one or more storage compartments 48 for storing various surgical
tools and accessories. For example, in a manner not shown herein,
the compartments 48 may store surgical gloves, syringes, needles,
gauze, irrigation splash guards, and other items often used in
surgical operations. The compartments 48 may also store specific
modules or packages containing the various items needed to complete
a particular step of the surgical operation, such as a pre-prep
module (not shown) containing an alcohol-prewetted swab, a
pre-filled anesthetic syringe, and other materials. To prevent
contamination prior to use, the compartments 48 may be sealed by a
removable cover (not shown), such as a removable sheet of sterile
material, that may be peeled off of the housing 14 to expose the
contents of the associated compartment 48.
[0038] As shown in FIG. 1, the surgical site board 12 includes a
plurality of apertures 34 for the selective placement and
positioning of various retention devices 50, 52, 54 and/or
retraction devices 56, 58, 60. The retention and retraction devices
are each removably securable in at least one the apertures 34 and
configured to retain a portion of the patient's body or retract
tissue or the like during a surgical operation, as will be
described in greater detail below. A wrist restraint 62 and one or
more positioning blocks 64 (FIG. 9) may also be secured into the
apertures 34 to further immobilize and position the patient's hand
16 during an operation. The positioning blocks 64 may have
different shapes, sizes, and contours to provide the surgeon with
many options. Additionally, the positioning blocks 64 may
alternatively rest upon the site board 12 without being secured to
the apertures 34. In such an embodiment the positioning block may
be designed with one or more textured surfaces adapted to create
friction between the block 64 and the site board 12, thereby
preventing the positioning block 64 from sliding relative to the
site board 12.
[0039] Still referring to FIG. 1, one or more flanges 66 having
spaced apart notches or fencing 68 may be provided on the housing
14 or site board 12 to secure surgical stays 70, which also retract
tissue during an operation. Similar flanges 74 and 76 may be
pivotally coupled to the housing 14 or site board 12 so as to be
movable between a closed position in which the flange is generally
planar with the site board 12 and an open position in which the
flange is angled relative to the site board 12. FIG. 1 illustrates
flange 74 in the closed position and flange 76 in the open
position.
[0040] Now referring to FIGS. 3-8, the retention devices and
retraction devices are shown in further detail. The retention
devices 50, 52, 54 are configured to overlap and retain a portion
of the patient's body, such as the patient's fingers 80 (FIG. 1).
Accordingly, the retention devices may be shaped for this purpose
or may be moldable to a desired shape. FIGS. 3 and 4 illustrate
exemplary embodiments of the latter, where the retention device 50
comprises an L-shaped post 86 (FIG. 3) or a J-shaped post 88 (FIG.
4). A collar 90 may be integrally formed with or provided on the
posts 86, 88 to ensure that the retraction devices 50 do not extend
past a certain depth in the apertures 34.
[0041] Meanwhile, FIGS. 5 and 6 illustrate exemplary embodiments of
moldable retention devices. The retention device 52 (FIG. 5)
comprises a wire 96 having a portion 98 configured to be inserted
into one of the apertures 34 and a foam or other cushioning layer
100 surrounding at least a portion of the wire 96. The wire may be
bent to a desired position upon the application of force, but has
sufficient rigidity to hold the shape while retaining fingers 80 or
other body parts during a surgical operation. In one embodiment,
the gauge of the wire 96 is sized to provide a slight interference
fit with the apertures 34 in the site board 12. Also, if desired, a
collar 90 may be provided on the wire 96 much like the retention
device 50. And finally, in another embodiment, the wire 96 may be
pre-formed in plastic or metal to fit around the finger.
[0042] The retention device 54 (FIG. 6) includes a body portion 106
formed from a malleable sheet of material and an anchor 108
configured to be inserted into one of the apertures 34. For
example, the body portion 106 may be formed from a bendable sheet
of metal such as aluminum or lead, or from a cold-forming plastic.
To provide additional comfort for the patient, the retention device
54 may also include a foam or other cushioning layer 110 on one or
both sides of the formable sheet. Alternatively, the device may be
pre-formed of plastic or metal to fit over the finger.
[0043] FIGS. 7 and 8 illustrate the retraction devices 56, 58 in
further detail. As shown in FIG. 7, the retraction device 56
comprises a post member 116 configured to be retained in one of the
apertures 34 and a surgical stay 118 secured to the post member.
Like the retention device 50, a collar 90 may be integrally formed
with or provided on the post member 116 to ensure that the
retraction device 56 does not extend past a certain depth in the
apertures 34. Additionally, post members of various heights and
shapes may be provided with the tray 10 so that the surgeon can
select the retraction device 56 and secure it into the appropriate
aperture 34 according to the desired 3-dimensional angle and
position of retraction.
[0044] The retraction device 58 of FIG. 8 includes a body 126
having edges 128 and plurality of notches 130 spaced along the
edges. The notches 130 are configured to retain a portion of a
surgical stay 132, much like the notches 68 in the flanges 66, 74,
and 76. If desired, the body 126 may be formed from a malleable
sheet of material so that the retention device 58 is moldable to a
desired shape. Accordingly, the retraction device 58 may further
include a foam or cushioning layer 127 on one or both sides of the
body 126 and therefore be constructed in substantially the same
manner as the retention device 54, with the addition of the notches
130 for securing the surgical stay 132.
[0045] Although specific embodiments of retention and retraction
devices according to the invention are described above, those
skilled in the art will appreciate that a wide variety of shapes
and configurations are possible for such devices. For example, the
retraction device 60 (FIG. 1) may be constructed substantially the
same as the retraction device 58 but have a semi-circular
configuration. The variety of retention and retraction devices and
various locations to which they can be secured to the site board 12
helps enable the surgeon to retain the hand 16 in a particular
manner or retract tissue in a particular direction without relying
upon medical assistants. Also note that the retention and
retraction devices, along with the other components of the surgical
tray 10, may be made radiolucent so that x-rays may be taken after
the patient's hand 16 is positioned or any time during or after the
surgical operation. Such an embodiment provides a "hands-free"
radiologic positioner that allows x-rays in various
planes--anterior, posterior, lateral, or obliques--while providing
safety to the operator.
[0046] FIGS. 9 and 10 illustrate various fluid management aspects
incorporated into the tray 10. In particular, FIG. 9 illustrates
how one of the storage compartments 48 may be used as an instrument
cleaning station. Thus, during an operation, the compartment 48 may
be filled with cleaning solution 140 and include a foam pad or
abrasive material 142 on which to wipe surgical instruments. FIG. 9
also illustrates an irrigation squirt gun 144 configured to draw
irrigation fluid 146 from a reservoir 148 within the housing 14.
The reservoir 14 in such an embodiment is a closed storage
compartment formed in the housing 14 and may be filled with
irrigation fluid prior to use by opening a lid, door, or port (not
shown) on the a surface 150 of the housing 14 and subsequently
pouring the fluid in. In other embodiments, the reservoir 148 may
be an open storage compartment and the squirt gun may be configured
to manually draw fluid from the reservoir 148. Such a squirt gun
may require additional manipulation to dispense the fluid 146 and
thus operate much like a syringe. Traditional techniques for
irrigating a surgical site may also be used with the invention.
[0047] No matter which manner of irrigating the surgical site is
employed, however, the irrigation fluid 146 and bodily fluids may
drain through the apertures 34 into a basin 160 (FIG. 10) defined
by the housing 14. The basin 160 is positioned below the site board
12 and may include one or more ports (not shown) at a bottom end
162 communicating with a portion 164 of a vacuum or drainage hose
165. The hose 165 is connected to a collection system 167 so that
collected fluids are drawn away from the tray 10 for safe and
convenient disposal. Alternatively, the hose 165 may rely upon the
force of gravity to direct fluids to a container or area below the
operating table 18. To further facilitate drainage into the basin
160 and towards the bottom end 162, the site board 12 may be
inclined relative to a bottom surface 166 defined by the housing
14. Additionally, a drape 168 (FIG. 1) may be provided with the
tray to wrap around the patient's arm 170 and direct fluids to a
drainage slot 172 or absorbent material (not shown) positioned at a
lower end of the site board 12.
[0048] FIGS. 11 and 12 illustrate a further aspect to assist
cleanup of the tray 10 and waste fluids after an operation. As
shown in the figure, the tray 10 may include a biohazard waste bag
180 attached to the bottom or side of the housing 14. Thus, when a
surgical operation has been completed, the bag 180 may be pulled
out from the tray 10 and turned inside out while being pulled back
over the exterior of the tray 10. A sealing surface or strip 184
may be provided on the bag 180, along with appropriate biohazard
markings 186.
[0049] While the invention has been illustrated by the description
of one or more embodiments thereof, and while the embodiments have
been described in considerable detail, they are not intended to
restrict or in any way limit the scope of the appended claims to
such detail. Additional advantages and modifications will readily
appear to those skilled in the art. The invention in its broader
aspects is therefore not limited to the specific details,
representative apparatus and methods and illustrative examples
shown and described. Accordingly, departures may be made from such
details without departing from the scope or spirit of Applicants'
general inventive concept.
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