U.S. patent number 3,721,232 [Application Number 04/731,864] was granted by the patent office on 1973-03-20 for surgical pad method for decubitus ulcer management.
This patent grant is currently assigned to Margaret R. Trenchard. Invention is credited to Sidney C. Trenchard.
United States Patent |
3,721,232 |
Trenchard |
March 20, 1973 |
SURGICAL PAD METHOD FOR DECUBITUS ULCER MANAGEMENT
Abstract
Method and surgical system for decubitus ulcer management, in
which the surgical devices in the system each comprise a flexible,
fluid-impervious bladder containing a gel or jelly formed as a
colloidal system from water and a water-soluble resin which is a
carboxy vinyl polymer of extremely high molecular weight and
capable of displacement or flow within the bladder distributing the
weight of the body of the user supported thereon. The mucilage or
jelly has some form of elasticity and has yield value, both of
which are controllable and variable and is capable of distributing
pressure over an entire portion of the body resting on the bladder
and avoids excessive pressure points thereon.
Inventors: |
Trenchard; Sidney C. (Westmont,
NJ) |
Assignee: |
Trenchard; Margaret R.
(Westmont, NJ)
|
Family
ID: |
24941253 |
Appl.
No.: |
04/731,864 |
Filed: |
May 24, 1968 |
Current U.S.
Class: |
5/644; 5/654;
5/909; 5/655.5 |
Current CPC
Class: |
A61G
7/05738 (20130101); Y10S 5/909 (20130101) |
Current International
Class: |
A61G
7/057 (20060101); A61h 001/00 () |
Field of
Search: |
;128/24,68,149,400,153,132,594 ;5/348,361 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Claims
What I claim and desire to be secured by Letters Patent is:
1. A surgical device for supporting at least a part of the body of
a user comprising, a liquid-impervious flexible bladder having a
selected configuration, a mucilage or jelly of selectively
adjustable viscosity contained in and at least partially filling
said bladder, said mucilage having a viscosity greater than water
and being capable of viscous flow displacement within said bladder
to thereby enable the latter to conform to and support the part of
the body of the user supported on said bladder and being effective
to cause pressure distribution over the entire portion of the body
of the user resting on said bladder, whereby excessive pressure
points on the supported portion of the body are avoided.
2. Surgical device for supporting at least a part of the body of
the user according to claim 1, in which said jelly has a viscosity
in the range between about 18,000 centipoise and 58,000
centipoise.
3. Surgical device for supporting at least a part of the body of
the user according to claim 1, in which said mucilage comprises a
carboxy vinyl polymer of extremely high molecular weight.
4. Surgical device for supporting at least a part of the body of
the user according to claim 1, in which said mucilage comprises
water and a water-soluble dry resin.
5. Surgical device for supporting at least a part of the body of
the user according to claim 4, in which said resin comprises a
carboxy vinyl polymer of extremely high molecular weight.
6. A surgical device according to claim 1 wherein said mucilage
comprises a solid constituent dispersed in and physically bonded to
a liquid constituent, the physical bond being breakable by applied
shear stress to permit plastic flow and being then
re-established.
7. A surgical device according to claim 6 wherein the viscosity of
said mucilage is variable as desired and precisely controllable by
controlling the ratio of the solid to the liquid constituent.
8. A method of supporting a human body comprising, mixing water and
a polymer of extremely high molecular weight in a confined volume
to form a deformable colloidal system characterized by plastic flow
having a viscosity greater than the viscosity of water and having
form elasticity and a selected yield value, and continuing
confinement of said colloidal system while supporting a human body
on said confined volume, whereby pressure is distributed over an
entire portion of the human body resting thereon and excessive
pressure points on said portion of the body are avoided.
9. A surgical device for supporting at least a part of the body of
a user comprising, a liquid-impervious flexible bladder having a
selected configuration, a predetermined quantity of a dry resin
contained in said bladder, said resin when having a liquid added
thereto forming a mucilage or jelly of selectively adjustable
viscosity which at least partially fills said bladder, said
mucilage when formed having a viscosity greater than water and
being capable of viscous flow displacement within said bladder to
thereby enable the latter to conform to and support the part of the
body of the user supported on said bladder and being effective to
cause pressure distribution over the entire portion of the body of
the user resting on said bladder, whereby excessive pressure points
on the supported portion of the body are avoided.
Description
This invention relates generally to the prevention and treatment of
decubitus ulcers and more particularly to a surgical pad, pillow
and mattress for bed-ridden patients to preclude decubitus ulcers
from forming and for their treatment.
It is known that decubitus ulcers form when the body weight is
supported chiefly by bony protuberances such as at the heels, hips,
base of the spine and shoulders. Circulation at these points is
compromised so that the surrounding tissue is not properly
nourished by blood and local necrosis occurs. Patients confined to
a conventional bed are subject to the formation of such ulcers. On
conventional mattresses steps taken to relieve pressure on
decubitus ulcer sites will only transfer pressure to other sites
where additional decubitus ulcers could and will form. The patients
are moved and massaged to attempt to relieve the formation of such
ulcers.
Decubitus ulcer management has presented a considerable problem and
attempts have been made to preclude the formation of such ulcers.
Thus, patients have been made to "float" on water-filled bladders
which will make some patients seasick. The bladder will tend to
mold, within substantially very restricted limits, to the patient's
body thereby making more body surface available for weight-bearing.
Use has been made of pads made of self-contained, stable,
chemically inert "gel" covered with a thin elastic membrane which
acts to protect the gel but does not constrict or inhibit the
properties of the gel which itself has restricted deformation
capabilities. Because of their compression limitations, i.e., water
is not compressible and the self-contained gel has limited internal
displacement, these known devices are not as effective as they
might be. They are often too small for large persons and too
expensive.
It is a principal object of the present invention to provide a
novel method and system for supporting the human body for prolonged
periods of time without excessive external pressure on localized
areas of tissue over rigid bony structures of the body.
In accordance with the invention a flexible, jelly-containing
bladder either in the form of a pad, for a seat, a pillow or a
mattress is provided. A weight-bearing colloidal solution, such as
a weight-bearing jelly, is contained in the bladder and has a
controllable viscosity, greater than that of water. The jelly has
some form elasticity and is capable of accurately conforming to a
surface of the body supported thereon effectively distributing the
weight of the body of the user so that pressure is distributed over
the entire surface of the portion of the body resting on the
bladder to avoid excessive pressure points.
A feature of the surgical devices in accordance with the invention
is that the jelly fill of the bladder will displace internally and
has flow characteristics such that nurses can readily place their
hands under the body of a patient on a mattress according to the
invention for rotating or moving him.
Other features and advantages of the surgical pad, pillow and
mattress and apparatus and system in accordance with the present
invention will be better understood as described in the following
specification and appended claims, in conjunction with the
following drawings in which:
FIG. 1, is a perspective view of a surgical pad made according to
the principles of the invention;
FIG. 2, is a perspective view of the pad in FIG. 1 in a filled
condition;
FIG. 3, is an elevation view of a patient on a wheelchair
illustrating the use of the pad in FIGS. 1 and 2;
FIG. 4, is a perspective view of a hospital bed provided with a
mattress made according to the invention.
A surgical pad made according to the invention is illustrated in
FIGS. 1-3 inclusive and comprises a bladder 11 made of a fluid
impervious material, for example a virgin polyvinyl chloride so
that it has a skin-like texture. The bladder has its peripheral
edges heat-sealed so that it can act as a fluid-tight jelly-filled
container for supporting a patient thereon as hereinafter
described. The bladder 11 is constructed with a water-soluble bag
13 disposed therein containing a chemical compound in powder form,
for forming a deformable colloidal solution within the bladder 11
by the addition of water through a closable plug 14. The body of
the bladder is provided with an air valve 15 for venting of the
bladder when filling with water in making the colloidal system and
to allow testing of the bladder by application of air pressure and
submersion in water, with the plug 14 in place, before filling
thereof.
When the pad 11 is to be used a volume of water, suitable to the
volume of chemical compound in the bag 13 is applied through the
plug 14 and the colloidal system will be formed and expand or swell
the bladder 11 to form a jelly-filled pad as illustrated in FIG. 2.
The bladder is provided with ties 17, 18 heat-sealed along the
edges of the bladder for tieing the pad to a back 20 of a
wheelchair 21 so that a patient can comfortably sit thereon as
illustrated in FIG. 3.
For purposes of illustrating the invention, the bladder 111 is
assumed to be a 22 inch .times. 22 inch square in which is
contained the bag 13 containing three ounces of the powdered
chemical compound "Carbopol 960" which is the ammonium salt of
"Carbopol 934" -- or "carboxypolymethylene." The chemical compound
is a water-soluble resin. The resin is a carboxy vinyl polymer of
extremely high molecular weight made by B. F. Goodrich Company and
described in the company's Service Bulletin GC-36 Revised and
Bulletin GC-42. When water is added to the bladder 11, the bag 13
is dissolved and the water and chemical create a homogeneous jelly.
As an example, it has been found that gel contents with a viscosity
of approximately 58,000 cps, (Brookfield at 20 rpm) can be formed
in bladder 13 by the three ounces of the chemical compound and the
application of 11/2 gallons of water. This jelly or paste has a
controllable form elasticity and yield value so that the surface of
the portion of the body of a patient resting on the pad has the
pressure distributed over its entire area and excessive pressure
points thereon are avoided, thereby avoiding the major cause of
pressure sores. The jelly distributes the weight of the body of the
patient to effect the pressure distribution so that the patient is
without possibility of formation of pressure sores or decubitus
ulcers on his buttocks because of the pattern of weight
distribution over the patient's buttocks.
The invention is equally applicable to the construction of a head
pillow 27 and a mattress 29 constructed in the manner above
described as to the seat pad. The mattress is constructed with four
corner ties 30 for securing the four corners thereof to posts 32 of
a bed 34 as illustrated in FIG. 4. The jelly-filled pillow and/or
mattress and the pad heretofore described may have the viscosity of
the jelly uniform or varied by controlling the amount of water
applied to the powdered chemical or by addition of water in local
areas as described hereinafter. The bladders from which the various
devices are made can have the jelly within different portions or
volumes of the bladder vary. Thus, some of the contents can be
withdrawn or added and more water added to lower the viscosity in
certain portions of the device or some of the resin can be added to
increase viscosity, and the devices, for example the mattress, can
be compartmented so that the compartments thereof can have the
different viscosities of the jelly therein. The change in viscosity
will change the form elasticity and yield value. Yield value is
defined as an initial resistance to flow under applied stress. The
jelly offers low resistance to manipulation. A practical
significance of yield value is that it prevents phase separation,
i.e. breaking of solids settling from the dispersion.
In one mattress constructed having beneficial results in the
treatment of decubitus ulcers it was found that an average
viscosity of 18,000 cps was recommendable. In that case the
mattress was made as 40 inches .times. 40 inches square pads in
which 81/2 ounces of the chemical powder were contained in a
plastic water soluble bag and about 17 gallons of water were added
thereto to obtain the desired viscosity. With such constructions,
two pads can be used as a mattress or one pad used on the upper or
lower part of the body of the patent.
Moreover, the mattresses can be made with ribs sealed every six
inches across the mattress top half with separate filling plugs,
not shown, between each rib and thus, the bed may be raised without
a corresponding shift of contents to the lower part of the
mattress.
It has been found that paraplegics and their physicians usually
prefer a low viscosity jelly in the surgical devices used by them
so that greater movement is transmitted throughout the contents.
Thus, when the patients arms are moved it creates internal movement
through the contents of the mattress and this applies a massaging
effect on the patient which also tends to cut down on the need for
regular turning. Furthermore, the low viscosity makes it possible
for a nurse to insert her hands under the patient's body to move
him or roll him over without bruising the patient's skin.
The use of the pads and mattresses containing the gelatinous
contents has indicated alleviation of decubitus ulcers and curing
thereof due to the avoidance of pressure spots. If the surgical
devices are used from the beginning of confinement in bed or in a
wheelchair decubitus ulcers will not be formed. Furthermore, it has
been found that the surgical devices are easily washed and cleaned
with a detergent, alcohol or suitable antiseptic so that they can
readily be kept sanitary.
It is known that in Newtonian systems flow is directly proportional
to applied stress. Pseudoplastic solutions flow more readily as
shear stress is increased. The water-soluble resin solution is of
this type. Solutions exhibiting plastic flow do not flow until the
applied shear stress exceeds a certain minimum value. This minimum
is known as yield value. The chemical powder, heretofore described,
forms a plastic flow solution with a yield value determined by the
measure of viscosity of the solution with a Brookfield RVT
Viscosimeter (Brookfield; 20 rpm). Thus, the "thickness" of the
formulation is variable and controllable. The jelly is non-toxic,
essentially inert in contact with the body and stable to bacterial
attack.
The chemical heretofore described is preferred for making the
gelatinous contents because it is a salt and does not require
neutralizing. Moreover, if lumps are formed when water is applied,
the lumps of soluble ammonium salt will solvate and swell. After
the lumps have swollen a slight working of the material as the
mattresses is readied for use on a chair or bed will produce a
smooth homogeneous gel.
The makers of Carbopol water-soluble resin make other usable
water-soluble resins such as "Carbopol resin 961" which is the
ammonium salt of "Carbopol resin 941." Water-soluble acid "Carbopol
resins 934, 940, 941" have the same properties of Carbopol resins
960 and 961 when neutralized to the identical pH, of the salt
resins, with ammonium hydroxide. Viscosity and neutralization data
of Carbopol water-soluble resins formulations made with water is
provided by the service bulletins of the manufacturer heretofore
mentioned so that the recipe for the desired thickness of the
formulation can be readily determined.
While preferred embodiments of the invention have been shown and
described it would be understood that many modifications and
changes can be made within the true spirit and scope of the
invention.
* * * * *