U.S. patent number 3,826,249 [Application Number 05/328,133] was granted by the patent office on 1974-07-30 for leg constricting apparatus.
Invention is credited to Arthur L. Lee, Milton M. Michaels.
United States Patent |
3,826,249 |
Lee , et al. |
July 30, 1974 |
LEG CONSTRICTING APPARATUS
Abstract
Leg constricting apparatus includes an air pressure control
system for supplying air under pressure to inflatable sacs within a
plurality of elastically extensible wrappings interlocked around
the lower extremity of an immobilized patient to aid in the venous
return of blood to the heart and to prevent thrombus formation.
Each of the plurality of elastically extensible wrappings are
hooked to adjacent wrappings in overlapping arrangement around the
extremity for a suitable length therealong and surrounds an elastic
stocking fitted firmly over the extremity. An air inflatable sac is
sewn onto the outside end of each of the plurality of extensible
wrappings which envelop the sacs in folds around the extremity.
Compressed air supplied from an air pressure control system is fed
by conduits to a cam actuated air valve for sequentially delivering
compressed air at preselected timed intervals to inflate the sacs.
The sequential intermittent supply of compressed air to each of the
wrappings inflates and deflates the sacs therein exerting pressure
against the elastically extensible wrappings to thereby exert
rhythmic pressure upon the extremity and to constrict the muscles
thereof. The rhythmic constriction of the extremity muscles
squeezes the blood in the veins to aid the venous return of blood
to the heart.
Inventors: |
Lee; Arthur L. (Columbus,
OH), Michaels; Milton M. (Pittsburgh, PA) |
Family
ID: |
23279666 |
Appl.
No.: |
05/328,133 |
Filed: |
January 30, 1973 |
Current U.S.
Class: |
601/152;
128/DIG.20 |
Current CPC
Class: |
A61B
17/135 (20130101); A61F 13/085 (20130101); A61H
9/0078 (20130101); Y10S 128/20 (20130101) |
Current International
Class: |
A61B
17/135 (20060101); A61B 17/12 (20060101); A61F
13/06 (20060101); A61F 13/08 (20060101); A61H
23/04 (20060101); A61h 001/00 () |
Field of
Search: |
;128/24R,64,DIG.20,327 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Attorney, Agent or Firm: Price, Jr.; Stanley J.
Claims
We claim:
1. A leg constricting apparatus comprising,
an elastic stocking adapted to be fitted on the extremity of a
patient,
a plurality of segments having a rectangular configuration with the
longitudinal dimension greater than the transverse dimension, said
plurality of segments longitudinally encircling the extremity in
overlying relation with said elastic stocking,
interlocking means for fastening together said plurality of
segments in lapping arrangement for a suitable length along the
extremity,
a plurality of inflatable chambers secured respectively within said
plurality of segments adjacent said elastic stocking,
fluid control means for sequentially supplying fluid under pressure
to each of said plurality of inflatable chambers at preselected
timed intervals, and
said chambers intermittently expandable upon the sequential
delivery of fluid thereto so that pressure forces are continuously
exerted upon the extremity to aid the venous return of blood from
the veins of the extremity to the heart of the patient.
2. A leg constricting apparatus as set forth in claim 1 which
includes,
each of said segments being fabricated of an elastically extensible
woven cloth material providing for longitudinal extension thereof,
and
said inflatable chambers being laterally spaced in parallel
relation on said segments along the extremity of the patient.
3. A leg constricting apparatus as set forth in claim 1 which
includes,
each of said chambers positioned transversely on said segments.
4. A leg constricting apparatus as set forth in claim 3 in which
each of said inflatable chambers includes,
an opening extending through said chamber, and
an elbow tube protruding through said chamber opening and arranged
in fluid communication with said chamber,
said elbow tube extending transversely relative to said
segment.
5. A leg constricting apparatus as set forth in claim 1 in which
each of said segments include,
an intermediate section,
terminal end sections at opposite ends of each of said
segments,
a buckle having a slidable cylindrical catch therein secured to
said intermediate section,
said inflatable chamber secured to said segment adjacent a terminal
end section thereof,
said segment applied to the extremity of a patient in folds around
the extremity so that said chamber is enveloped between the
overlapping folds of said segment, and
one of said terminal end sections being held in frictional
engagement between said buckle and said catch to retain said
segment firmly around the extremity.
6. A leg constricting apparatus as set forth in claim 1 in which
said interlocking means for fastening together each of said
plurality of segments includes,
a plurality of hooks positioned transversely at opposite edges of
each of said segments,
said hooks on one segment arranged to securely engage the hooks of
an adjacent segment so that portions of adjacent segments overlap
to form an extensible wrapping around the extremity for a suitable
length therealong.
7. A leg constricting apparatus as set forth in claim 1 wherin said
fluid control means includes,
a fluid compressor,
a prime mover drivingly connected to said compressor so that fluid
supplied to said compressor is compressed to a predetermined
pressure therein,
a fluid receiver,
a check valve operable to maintain said predetermined fluid
pressure being supplied to said air receiver,
first conduit means for connecting in series said receiver with
said compressor and said check valve interposed therebetween so
that fluid under pressure is fed from said compressor to said
receiver,
a valve means for supplying fluid under pressure therethrough at
preselected timed intervals, and
second conduit means for connecting said fluid receiver to said
valve means so that fluid under pressure is conveyed from said
fluid receiver to said valve means.
8. A leg constricting apparatus as set forth in claim 7 in which
said valve means includes,
a plurality of conduits arranged to provide fluid communication
between said valve means and said chambers of said segments,
and
said valve means operable to sequentially feed fluid under pressure
to said chambers through said plurality of conduits at preselected
timed intervals so that said chambers intermittently inflate and
deflate to thereby exert in timed sequence continuous pressure upon
the extremity.
9. A leg constricting apparatus as set forth in claim 1 which
includes,
said plurality of elastically extensible segments arranged to
rhythmically constrict the muscles of the extremity upon delivery
of fluid to said chambers at preselected timed intervals to thereby
aid the venous return of blood to the heart through the veins of
the extremity.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to a leg constricting apparatus and more
particularly to a leg constricting apparatus having a plurality of
elastically extensible wrappings applied to the extremity of an
immobilized patient for constricting the muscles thereof to aid in
the venous return of blood when supplied with compressed air from a
source.
2. Description of the Prior Art
A constant danger to a bedfast patient is the tendency to develop
thrombophlebitis with formation of intravascular thrombi which may
detach and flow towards the heart and lungs resulting in a
pulmonary embolus which may prove fatal. With immobility, the flow
of blood in the venous side of the circulatory system is reduced to
a point favoring venous stasis and subsequent localized clot
formation. Proximal to the adherent clot, the blood in the vein is
less adherent to the vessel wall. It is usually this portion of the
clot which detaches itself and acts as an embolus to the heart and
lungs.
There are many situations in a hospital population where the above
pertains, such as the patient who has recently suffered a heart
attack, the patient in coma, the patient with a fracture, the
post-operative patient who cannot be ambulated, and the burn
patient. A potential danger is also during prolonged surgical
procedures with the patient completely anesthetized. At present,
the only methods to prevent thrombophlebitis with resultant
thrombus formation are early ambulation, application of elastic
hose and anticoagulant therapy (Heparin, Coumadin, Warfarin sodium,
and Phenindione). Early ambulation is contraindicated in such
patients who have suffered an acute myocardial infarction or
fractured hip. Anticoagulants may produce bleeding especially in an
early post-operative patient. The elastic hose merely constricts
the musculature of the lower extremity but does not mimic the
pulsatile milking action of leg muscles upon the veins which
enhance venous blood flow back to the heart. It has been the
practice in extreme cases, in order to increase blood supply to a
local area blocked by an obstruction, to surgically remove the
lesion from the artery. When there is severely diminished blood
flow through the extremity, ulceration or gangrene may develop and
lead to amputation.
In those cases where it is not feasible to administer anticoagulant
treatment and surgery is not required, other therapy has been
pursued for the purpose of increasing blood circulation through the
lower extremities. In the treatment of middle-aged and elderly
bedfast patients, it is a well known practice to increase the rate
of blood circulation through the lower extremities by constricting
the extremities through the use of elastic stockings to prevent
thrombus formation. Correctly applied elastic bandages may be used
in place of elastic stockings by removing and re-applying them
every eight hours, checking the legs for redness, swelling and
tenderness.
When there has been destruction of the valves of the deep veins
within the lower extremity, a pneumatic legging of the type
manufactured by Surgical Research Corporation, Rochester, New York
may be prescribed. The legging is zippered on the patient's leg and
has a cloth cover and a rubber bladder inside into which air is
pumped to a pressure of 30 mm. Hg. A rhythmic increase in pressure
in the veins results as the patient walks. The device is intended
for use in cases where the person is fully ambulatory and edema or
swelling of the lower extremities is to be prevented. If the
patient is unable to walk and is immobilized, no increase in
pressure in the veins will occur as the extremity muscles are not
stimulated. There is need for a pressure control device to be
fitted on the extremity of an immobilized patient to aid in the
venous return of blood to the heart for the prevention of thrombus
formation. Accordingly, there is need to provide a sequential
application of compressed air to inflatable sacs within extensible
wrappings applied to the lower extremity for squeezing or
constricting the muscles thereof to prevent stasis of blood with
resultant thrombus formation in the leg veins and pulmonary emboli
associated therewith.
SUMMARY OF THE INVENTION
In accordance with the present invention, there is described and
illustrated a leg constricting apparatus for aiding the venous
return of blood to the heart from the veins of the extremity of an
immobilized patient to prevent thrombus formation therein. The leg
constricting apparatus includes an elastically extensible wrapping
constructed of woven fabric that folds around the extremity in
overlying relationship with an elastic stocking fitted thereon. The
elastically extensible wrapping includes a plurality of
interlocking segments having a longitudinal configuration. A fluid
inflatable chamber is suitably secured to each of the segments
adjacent a terminal end thereof. Each of the expandable chambers is
enveloped within the folds of the segment applied to the extremity
by interlocking means. The chamber is arranged to inflate when
fluid under pressure is introduced therein to thereby expand the
elastic segment and exert a constricting force upon the veins of
the extremity. The segments are positioned around the extremity of
a person in an arrangement in which each chamber overlaps in spaced
parallel relation an adjacent chamber of another segment to form a
staggered pattern of chambers and a continuous wrapping along the
length of the extremity.
A valve means sequentially delivers fluid under pressure to each
segment through a plurality of conduits which connect the air valve
means with the inflatable chambers in each of the segments. A fluid
control means for sequentially supplying fluid to each of the
chambers includes a valve means for delivering fluid under pressure
through the conduits to the chambers. The sequential delivery of
fluid under pressure to each of the segments inflates and deflates
the chambers to thereby exert a continous pressure upon the
elastically extensible segments and effect constriction of the
muscles of the veins within the extremity.
Accordingly, the principal object of this invention is to provide a
pressure exerting apparatus applied to the extremity of an
immobilized patient for constricting the muscles thereof to squeeze
the veins and thereby aid the venous return of blood to the heart
for prevention of blood stasis and thrombus formation in the
veins.
Another object of this invention is to provide a plurality of
elastically extensible segments which are easily applied to the
extremity by the interlocking of adjacent segments for a suitable
length along the extremity.
These and other objects of this invention will be more completely
disclosed and described in the following specification,
accompanying drawings and the appended claims.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a view in side elevation of the leg constricting
apparatus illustrating diagrammatically the plurality of
interlocking wrappings applied around the lower extremity of a
patient.
FIG. 2 is a top plan view of the leg constricting apparatus
illustrating the deflated sac enveloped between the folds of the
wrapping which encircle in overlying relationship the elastic
stocking.
FIG. 3 is another top plan view of the leg constricting apparatus
illustrating the inflated sac enveloped between the folds of the
wrapping.
FIG. 4 is a cross sectional view taken along the line IV--IV of
FIG. 2 illustrating the air tube leading to the inflatable sac
according to the invention.
FIG. 5 is a schematic illustration of the air pressure control
system for the leg constricting apparatus.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring to the Figures and particularly FIG. 1, there is
illustrated a leg constricting apparatus, generally designated by
the numeral 10 having a plurality of interlocking, longitudinal
wrappings 11, 12, 13 and 14 that encircle the lower extremity 15 of
a patient. Each of the wrappings 11, 12, 13 and 14, having a
suitable width, is constructed of an elastically extensible woven
fabric, such as nylon, to permit lengthwise extension of the
wrappings and like numerals refer to like parts of each of the
wrappings. The flexible wrappings 11, 12, 13 and 14 interlock with
adjacent wrappings by hooks 16 in overlapping relationship.
Accordingly, any number of wrappings may be interlocked for a
desired length along the lower extremity.
In the illustrated embodiment as shown in FIG. 1, the wrappings are
positioned between the ankle and the knee of the lower extremity
but a like arrangement may be positioned thereabove or on the upper
extremity. Each of the plurality of wrappings 11, 12, 13 and 14
encircle in overlying relationship an elastic stocking 18, as
illustrated in FIGS. 2 and 3, that fits closely over the lower
extremity 15. The elastic stocking 18 is constructed of a closely
meshed cloth material that permits passage of air therethrough and
around the lower extremity 15.
Each of the plurality of wrappings 11, 12, 13 and 14 having a
length which is substantially greater than the width envelopes the
extremity 15 in folds and is firmly applied thereon by passing the
terminal end 20 through a buckle 22 positioned intermediate of the
respective wrapping. The terminal end 20 is tightly secured in
buckle 22 by the frictional engagement of cylindrical catch 24 with
the terminal end 20. Adjacent wrappings encircle the extremity 15
in overlapping arrangement so that the hooks 16 of one wrapping
catch in the hooks 16 of an adjacent wrapping to form a continuous
connection that is easily detachable. In addition, the wrappings
11, 12, 13 and 14 may be joined together by using a conventional
Velcro closure as described in U.S. Pat. No. 3,054,400 and U.S.
Pat. No. 3,376,865.
In the preferred practice of this invention, the wrappings 11, 12,
13 and 14 are applied progressively to the lower extremity 15 of a
patient with the first wrapping positioned adjacent the ankle of
the lower extremity 15 and each successive wrapping 12, 13 and 14
hooked to the prior wrapping in a direction toward the knee of the
lower extremity 15. The wrapping 11 is applied to the lower
extremity 15 adjacent the ankle by placing the terminal end of the
wrapping 11 which is adjacent the sac 26 on the lower extremity 15
and folding the wrapping 11 therearound to envelop the sac 26
within the folds of the wrapping 11. The terminal end 20 of the
wrapping 11, as illustrated in FIG. 2, is passed through the buckle
22 beneath the cylindrical catch 24 to thereby urge the cylindrical
catch 24 into frictional engagement with the terminal end 20. The
engagement of the terminal end 20 with the buckle 22 and
cylindrical catch 24 generates tension within the elastic fiber of
wrapping 11 along the entire length thereof to firmly bind the
lower extremity 15. To aid in the passage of fresh air in and
around the enclosed lower extremity 15 each of the wrappings 11,
12, 13 and 14 has a plurality of ventilation slots (not shown)
spaced in parallel relationship across the width and running
longitudinally of the wrapping.
Each of the plurality of wrappings 11, 12, 13 and 14 includes an
inflatable sac 26 sewn thereon adjacent a terminal end of the
wrapping. The sacs 26 within the plurality of wrappings communicate
with an air pressure control system 28, hereinafter described, for
the sequential delivery of compressed air supplied through conduits
leading to each of the inflatable sacs 26.
Referring to FIG. 4, the deflated sac 26 is illustrated within the
wrapping and connected to an air tube 30. The plurality of air
tubes 30 lead from a compressed air source within the air pressure
control system 28 to a flexible elbow tube 32. The wrappings 11,
12, 13 and 14 are arranged on the lower extremity in such a manner
that the elbow tubes 32 protrude outwardly from the sacs 26 in a
longitudinal direction along the lower extremity with the enlarged
diameter end section 34 projecting toward the knee of the lower
extremity. The flexible elbow tube 32 joins the air tube enlarged
diameter end section 34 to an opening 36 within the sac 26.
The wrapping 12 is positioned on the lower extremity 15 adjacent
the wrapping 11 by engaging the hooks 16 of wrapping 12 with
adjacent hooks 16 of the wrapping 11 to form a continuous
connection between wrappings 11 and 12. Wrapping 12 is firmly held
to the lower extremity by frictionally engaging the terminal end 20
with the buckle 22 and the cylindrical catch 24. The wrapping 12 is
arranged in overlapping relationship to wrapping 11 in such a
manner that the sac of wrapping 12 is laterally spaced in parallel
relation to the sac of wrapping 11, as illustrated in FIG. 2. In a
similar manner, as described hereinabove, wrapping 13 is applied to
the lower extremity 15 to engage in overlying relationship the
wrapping 12. The sac of wrapping 13 is laterally spaced in parallel
relation to the sac of wrapping 12 and aligned on a line passing
through the sac of the wrapping 11. The wrapping 14 is applied to
the lower extremity 15 engaging in overlapping relationship the
wrapping 13. The wrapping 14, as illustrated in FIG. 4, is
positioned in the lower extremity adjacent the knee thereof;
however, the plurality of wrappings may continue progressively
upwardly on the lower extremity. The number of wrappings
illustrated herein is limited only for the purpose of description
and is not intended to restrict the scope of practice of this
invention.
Compressed air is supplied to the inflatable sacs 26 enveloped
between the folds of each of the plurality of wrappings 11, 12, 13
and 14 by the air pressure control system 28 schematically
illustrated in FIG. 5. The air pressure control system 28 includes
an air filter 38 connected by conduit 40 to air compressor 42. Air
compressor 42 is drivingly connected to a prime mover 44, such as
an electric motor, by crank shaft 46. Conduit 48 connects air
compressor 42 with the air receiver 50, and interposed therebetween
is a check valve 52 through which passes conduit 48. Air receiver
50 communicates with a cam actuated air valve 54 by way of conduit
56.
The cam actuated air valve is powered by the prime mover 44 and
connected thereto by the output shaft 58 leading to the planetary
gear reduction system 60 which is drivingly engaged to the cam
actuated air valve 54. The planetary gear reduction system 60
includes a sun gear in meshing relation with surrounding planet
gears which, in turn, revolve about a ring gear (all not shown).
The ring gear rotates at a lower angular velocity than the sun
gear, thus providing speed reduction between the input shaft 58 and
the cam shaft (not shown) of the air valve 54 for the operation
thereof. An air tube assembly 62 connects the inflatable sacs 26
within each of the plurality of wrappings 11, 12, 13 and 14 to the
air chamber (not shown) within the air valve 54. An exhaust outlet
64 is provided for the expulsion of air from valve 54 when the sacs
26 are deflated by operation of valve 54.
With this arrangement air is drawn from the atmosphere into filter
38 where particulate contaminates, such as dust particles, are
filtered from the air. The filtered air passes through the conduit
40 to the air compressor 42. The prime mover 44 imparts rotation to
crank shaft 46 which is linked to a connecting rod (not shown)
within the air compressor 42. The connecting rod transforms the
rotary motion of the crank shaft 46 to reciprocal motion for
reciprocating the piston in the cylinders (not shown) of the air
compressor 42. The air compressed by the reciprocating motion of
the piston in the cylinder within the compressor 42 is fed
therefrom through conduit 48 to the air receiver 50. The air
flowing through conduit 48 and supplied to the air receiver 50 is
maintained at a constant pressure therein by the operation of the
check valve 52. The check valve 52 operably prevents pressure loss
within the air receiver 50 and blocks backward flow of compressed
air through conduit 48 to air compressor 42.
The air receiver 50 operably supplies air at a preselected pressure
to the cam actuated air valve 54 through conduit 56. The cam
actuated air valve 54 is powered by the prime mover 44 through the
input shaft 58 and the planetary gear reduction system 60 to
sequentially supply compressed air at suitable, periodic intervals
to the plurality of tubes 30 comprising the air tube assembly 62.
The housing of air valve 54 is adapted to receive any number of air
tubes 30 for supplying compressed air from the air chamber of valve
54 to the inflatable sacs 26.
The cam actuated air valve 54 operably supplies air at a suitable
pressure to the sac 26 within the wrapping 11 through the air tube
30. The compressed air inflates the sac 26 to form the chamber 27
therein and to exert pressure against the wrapping 11 which, in
turn, constricts the muscles of the lower extremity 15. After
supplying pressure to wrapping 11 for a suitable time interval, the
air valve 54 delivers compressed air to the wrapping 12 to inflate
the sac 26 therein. As the chamber 27 of wrapping 12 inflates, also
constricting the extremity muscle, the air vale 54 operably
deflates sac 26 of wrapping 11 to release the pressure exerted on
the extremity muscle. In a like manner, compressed air is
sequentially delivered from the air valve 54 through the air tubes
30 to the wrappings 13 and 14 so that the vessels of the extremity
muscle are rhythmically constricted from the wrapping 11 adjacent
the ankle upwardly to the wrapping 14 adjacent the knee.
At any given instant during operation of the leg constricting
apparatus 10 the pressure exerted against each of the wrappings 11,
12, 13 and 14 differs from the pressure exerted against the other
wrappings, and the pressure exerted against the wrappings is either
progressively increasing or progressively decreasing along the
length of the extremity. The sequential delivery of compressed air
to each of the wrappings effects constriction of the muscles of the
lower extremity having a massaging effect on the veins thereof. The
muscle activity stimulated by the externally applied pressure aids
in the venous return of blood through the veins of the extremity to
the heart. By maintaining adequate venous return, stasis of blood
in the extremity with resultant thrombus formation which could
ultimately result in pulmonary emboli is thwarted.
According to the provisions of the patent statutes, we have
explained the principle, preferred construction, and mode of
operation of our invention and have illustrated and described what
we consider to represent its best embodiments. However, we desire
to have it understood that, within the scope of the appended
claims, the invention may be practiced otherwise than as
specifically illustrated and described.
* * * * *