U.S. patent number 3,648,291 [Application Number 05/052,570] was granted by the patent office on 1972-03-14 for protective garment for bedridden people.
This patent grant is currently assigned to William A. Braddock. Invention is credited to Alva L. Pankers.
United States Patent |
3,648,291 |
Pankers |
March 14, 1972 |
PROTECTIVE GARMENT FOR BEDRIDDEN PEOPLE
Abstract
A garment for protecting an elbow or other protuberance of a
bedridden patient includes sleeve for encompassing such
protuberance. The sleeve is made from a cloth having a relatively
low coefficient of friction with respect to sheets and other
bedclothes and employing a nonabsorbent monofilament fiber such as
nylon. The sleeve has a stretchability at least in direction
transverse of the axis of the sleeve. A nonslip cushion constituted
as a sheet of foam rubber is adhered to the interior of the sleeve
to provide a protuberance-covering pressure-bearing portion
constituted as a laminate of foam rubber sheeting directly in
contact with the flesh and covered by the cloth layer, this portion
being devoid of any seams or other obstructions which can cause
localized pressure on the flesh at the pressure-bearing portions of
the protuberance. A casing in the end of each sleeve completely
covers an elastic cord. Together they tend to prevent the sleeve
from rolling up and they act to stabilize the garment to maintain
the cushion in contact with the pressure bearing portion of the
flesh adjacent the protected protuberance.
Inventors: |
Pankers; Alva L. (Bloomington,
MN) |
Assignee: |
Braddock; William A.
(Minneapolis, MN)
|
Family
ID: |
21978464 |
Appl.
No.: |
05/052,570 |
Filed: |
July 6, 1970 |
Current U.S.
Class: |
2/16; 128/892;
2/22; 602/63; D2/860; D2/896; D2/983 |
Current CPC
Class: |
A61F
13/069 (20130101); A61F 13/101 (20130101) |
Current International
Class: |
A61F
13/06 (20060101); A61F 13/10 (20060101); A41d
013/08 () |
Field of
Search: |
;2/16,22,24,240
;128/165,166,149,153 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Boler; James R.
Claims
The embodiment of the invention in which an exclusive property or
privilege is claimed are defined as follows:
1. A garment to protect the flesh adjacent a bony protuberance of a
limb of a bedridden patient, said garment including a hollow sleeve
of flexible, hard surface cloth having a relatively low coefficient
of friction with respect to bed clothes, a smooth resilient, flesh
contacting cushion sheet having a relatively high coefficient of
friction with respect to flesh, said sheet being adhered to an
interior surface of a portion of said sleeve to provide a laminate,
protuberance-covering, pressure-bearing garment portion devoid of
obstruction, at least one casing at an end portion of said sleeve,
and an elastic cord in said casing tensioning said casing to tend
to hold said end portion snugly in contact with portions of the
limb of such patient adjacent said protuberance when said cushion
is in contact with the flesh adjacent the protuberance.
2. The combination of claim 1 wherein said casing and cord make
substantially only a line of contact with the flesh around the
limb.
3. The combination of claim 2 wherein the elastic causes such
tensioning of the casing against the flesh that the casing will
tend to be easily displaced due to movement of the patient in bed,
and wherein the cushion will have a sufficiently high coefficient
of friction with respect to the flesh to tend to strongly resist
movement with respect thereto due to movement of the patient in
bed.
4. The combination of claim 1 wherein the cloth sleeve is further
characterized as having a tendency to cling to a limb around which
said sleeve is positioned.
5. The combination of claim 4 wherein said cushion is made of an
expanded foam material.
6. The combination of claim 5 wherein said cloth is made from a
monofilament nylon fiber.
7. The combination of claim 2 wherein the casing completely
encompasses the cord and wherein the cord is formed as a continuous
loop inside the casing.
8. The combination of claim 1 wherein the cloth of said sleeve is
made up of nonabsorbent material.
Description
BACKGROUND OF THE INVENTION
A continuing problem in the care of bedridden patients involves the
pain and discomfort and the breakdown of tissue which develops in
the pressure-bearing portions of flesh surrounding the various
protuberances of the body. Specifically, the flesh around the bony
protuberances of the elbows, knees, and the heels are subject to
this kind of damage. Causes include breakdown of tissue due to
constriction of capillary flow within the flesh, the pinching and
abrading of nerves in the same area, and the abrasion initially on
the skin and, as this wears away, on subcutaneous layers due to
movement over the sheets and other bedclothes.
For many years it has been known that some relief can be obtained
for the heels and the toes of the foot by providing a footboard
along the bottom of the bed and draping the bedclothes over that
footboard thus to keep the weight of the bedclothes off of the
feet, minimizing the direct pressure on the toes, for example,
while limiting the pressure which must be carried by the heel to
the weight of the foot.
Various garments and wrappings have been suggested for further
alleviating this problem, but each has been subject to one or more
objections. Specifically, U.S. Pat. No. 3,322,118 to Sotherlin
discloses a device for projecting the elbow or heel of a bedridden
patient, but discloses elastic cuffs of substantial longitudinal
dimension which are supposed to be for the purpose of preventing
the device from moving out of proper alignment with the part to be
protected. In order to get sufficient "nonslip" action, these cuffs
have a substantial width and are fairly tight on the arm. This wide
band of pressure causes many capillaries to be cut off. Thus the
flesh underneath these cuffs has been found to be subject to the
same kind of discomfort and pain, if not damage, which the device
is intended to alleviate. Furthermore, these cuffs have been found
to roll up along the edge, thus causing even more constriction to
the circulation clear around the limb, and thus more pain and
discomfort.
The prior art shows cushions positioned in cloth envelopes; but
this placement of cloth between the cushion and the arm prevents
the cushion from clinging to the flesh to deter relative movement
of the cushion and flesh. Thus the device of Sotherlin is subject
to the objection that this slides easily from its intended position
and off of the protuberance which is designed to protect.
Other devices in which a seam is situated in line with the area of
the protuberance subject to the damage are objectionable because
the localized pressure of such seams induces the discomfort and
pain and ultimately the damage the garment is designed to
eliminate.
SUMMARY OF THE INVENTION
Protective garments of the present invention have been designed to
overcome the difficulties in the prior art and to inhibit or
completely prevent tissue breakdown due to prolonged interruption
of circulation through the capillaries in the pressure-bearing
flesh between the protuberance and the bed on which the patient is
resting.
In a protective garment made according to the present invention as
shown, a cloth sleeve made from monofilament, hard-surface
nonabsorbent fiber is provided with a protuberance-covering,
pressure-bearing area which is completely devoid of seams or other
obstructions, and this area is covered with a cushioning sheeting
of expanded foam material or the like which, over the same area, is
also devoid of seams, folds or other obstructions. The expanded
foam material is adhered to the cloth material on the inside of the
sleeve so that the foam cushion comes in direct contact with the
flesh over the protuberance to be protected. The cushion has a high
coefficient of friction with respect to this flesh and thus will
lie in "nonskid" relationship to such flesh, to tend to prevent
relative movement there between.
The cloth sleeve is provided with a continuous casing around each
of outer end portions thereof, and an elastic cord is situated
inside of each such casing, the casing and cord being of dimension
to make a single line contact with the limb at positions on either
side of the protected protuberance and to be held smoothly and
snugly against the flesh of the patient at such positions. Because
of the nonskid relationship between the foam cushion and the flesh
over the protuberance, the tendency of the garment to slide with
respect to the protuberances is substantially lessened, but as the
joint is flexed, the line contact between the casing and elastic
cord and the flesh will tend to move, from time to time, thus
permitting circulation through capillaries immediately adjacent the
cord, to the end that the flesh does not tend to break down as is
the case when a wide band of elastic blocking circulation in many
capillaries was employed. Use of nylon or similar cloth which tends
to cling to the limb also help keep the garment in position.
The cloth of the garment is stretchable in direction transverse of
the longitudinal axis of the sleeve so that flexure of the joint
which is related to the protuberance will not in and of itself put
pressure of the garment on the flesh.
By positioning the soft cushion in nonslip relationship over the
protuberance, and by providing a hard surface cloth on the outside
thereof, the friction between the protuberance and the bedclothes
is reduced, and the friction-generating relative movement takes
place between this cloth and the bedclothes rather than between the
flesh over the protuberance and the garment or bedclothes.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a side-elevational view of the foot of a bedridden
patient resting with the heel on the bedclothes and showing a first
form of the invention in position on said foot;
FIG. 2 is a perspective view of the protective garment of FIG.
1;
FIG. 3 is a bottom plan view of the protective garment of FIGS. 1
and 2;
FIG. 4 is an enlarged sectional view of the garment of the first
three figures taken as on the line 4--4 in FIG. 3;
FIG. 5 is a perspective view of a protective garment of the
invention designed to go on an elbow or knee; and
FIG. 6 is an enlarged sectional view of the garment of FIG. 5 taken
as on the line 6--6 in that figure.
DESCRIPTION OF PREFERRED EMBODIMENTS
As seen in the first four figures, a protective garment 9 for
protecting the heel of a bedridden patient includes a continuous
hollow sleeve 10 made from a piece of nonabsorbent, hard surface
clot 11, made from a monofilament fiber such as nylon. Longitudinal
edges of this cloth have been sewn together at the longitudinal
seam 12 to form the sleeve 10, and darts 13 and 14 have been taken
in top portions of the sleeve in order to shape it to better fit
over the foot and ankle on either side of the heel. Castings 15, 15
are formed by turning under opposite end portions of the sleeve 10,
and each such casing encompasses an elastic cord 16 which will have
sufficient resiliency to snugly hold the casing in place adjacent
the heel as best seen in FIG. 1. It is to be noted that the contact
on the flesh of the foot and ankle is virtually a line contact. It
is to be understood that the force holding the casings 15, 15 and
hence the ends of the sleeve in place is light enough so that there
will be some shifting of this line contact as the patient moves in
bed, thus restricting circulation permanently to no portion of the
flesh.
The cushion employed is constituted as an expanded foam rubber of a
type which can be easily washed and sterilized. Many different
formulations will be satisfactory for this purpose. This foam
rubber sheeting 17 is shown stitched as at 18 to the interior
surface of the sleeve 10 in such a manner as to provide a
protuberance-covering, pressure-bearing garment portion 19 of
sufficient size and in position so that the weight of the heel on
the bedclothes will always fall within that portion. It is to be
noted that this portion is constituted as a laminate of the nylon
cloth 11 and the foam rubber sheeting 17 and that this entire area
is devoid of any seams or other obstructions which can cause
localized pressure on or around the flesh of the heel.
Referring now to FIGS. 5 and 6, a protective garment 29 for
protecting the elbow or knee of a bedridden patient will consist of
a continuous hollow sleeve 30 made from a hard surface cloth 31. A
longitudinal seam 32 joining longitudinal edges of the cloth 31
makes the sleeve continuous, and a pair of casings 35, 35 each
enclose an elastic cord 36. Foam rubber sheeting 37 is stitched as
at 38 to the inside of the hollow sleeve 30 to form a
protuberance-covering, pressure-bearing portion 39.
To put either of the garments in use, it will be slid over the end
of the limb to be protected and the flesh between the bony
protuberance of the heel, elbow or knee, will be situated in
contact with the foam rubber cushion. The properties of this
expanded foam sheeting material are such that there is a high
coefficient of friction between the flesh and the sheeting
material, thus virtually assuring that the garment will not become
displaced and thereby assuring that the cushioning effect of this
sheeting material on the flesh between the protuberance and the
bedclothes will not be disturbed. This positioning is aided by the
gentle but snug holding of the elastic cord and casing against
portions of the limb on either side of the protuberance, and by the
clinging qualities of the nylon cloth, for example. Since there is
only a line of contact at the casings, any capillary vessel which
might possibly be cut off by the pressure of the casing and its
elastic cord will only be cut off at one point, and the other
capillaries will sufficiently nourish the flesh in that general
vicinity so that breakdown of the flesh will not occur. Also, since
this line of contact does tend to move as the patient moves in bed
and as the casing moves correspondingly over the limb, the closed
off capillary will be allowed to open, and blood will flow therein
even though an adjacent capillary may then be closed off due to the
action of the casing and cord.
Although nylon cloth has been mentioned throughout the
specification to this point, it is to be understood that any cloth
which will tend to cling to the limb and/or which has a hard, low
friction surface can be employed to make garments of the invention.
While, for the purposes of shading, diagonal lines to represent
woven cloth have been used, it is to be understood that the cloth
will be sewed into the sleeve in such a manner that a substantial
ability to stretch will be afforded the garment in direction
transverse of the longitudinal axis of the sleeve as seen in FIGS.
4 and 6, for example.
Because pain and discomfort afforded bedridden patients arises from
the abrasion and/or pinching of nerves for an extended period on a
localized area and from the destruction of tissues due to lack of
circulation in localized areas, the provision for all of the
friction of movement to take place between the cloth and the
bedclothes (on the other side of the foam rubber sheeting from the
flesh) and the provision that there are no seams to cause localized
pressure to be put through the foam rubber sheeting onto the flesh
adjacent the protuberance effectively eliminates such pain,
discomfort and/or breakdown of tissue.
While the foam rubber sheeting is illustrated and described as
being stitched to the cloth, it is to be understood that there are
other effective ways of adhering the sheeting to the cloth and that
these will be satisfactory as long as the pressure-bearing portion
is maintained devoid of obstructions which can cause localized
pressure to be transmitted through the garment to the flesh
adjacent the protected protuberance.
* * * * *