Surgical Suction Pump Assembly

Abstract

A surgical suction assembly for use in closed wound surgical techniques comprising a bellows of inherently resilient material, a drainage tube for insertion in a wound, and a plug assembly for connecting the drainage tube to the bellows which incorporates a one-way valve arranged to open in response to resilient expansion of the bellows and to close in response to compression of the bellows in order to prevent accidental return to the wound of fluids which have been drained therefrom.

Parent Case Text

RELATED APPLICATIONS

This application is a continuation-in-part of our application Ser. No. 633,316, filed Feb. 23, 1967 now abandoned, which was in turn a continuation-in-part of our application Ser. No. 327,392, filed Dec. 2, 1963 and now abandoned.

Description

BACKGROUND OF THE INVENTION

The surgical technique known as "closed wound suction" involves the insertion of one end of a drainage tube in the interior of a closed wound and the connection of the other end of the tube to a source of suction and a receptacle for the fluids thus drawn from the wounds. Use of this technique has increased considerably over the past 15 to 20 years, especially with the aid of portable suction-collector devices such as pre-evacuated bottles and syringe-type units, a typical example of the latter being shown in our above applications, and springactuated collapsible units such as are shown in McElvenny et al. U.S. Pat. No. 3,115,138.

All of these prior art devices have some practical disadvantages. In the case of pre-evacuated bottles, it has been customary to utilize a bottle having a volume of about 500 cc which is pre-evacuated to a negative pressure in the range of 70-75 cm of mercury. This suction is greater than is required for closed wound suction techniques, but it is needed initially in the bottle because as the bottle fills with fluids from the wound, the suction correspondingly decreases. Further, such bottles are relatively bulky as well as breakable, a supply of them in pre-evacuated condition is necessary, and their storage and use is correspondingly inconvenient.

The device of the McElvenny et al. patent is mechanically relatively complex and correspondingly expensive, comprising as it does a multiplicity of component parts including a set of springs for imparting the desired resilient expansion after the unit has initially been compressed. Even more important, that device has an open, unvalved connection between its interior and the drainage tube from the wound, and if the patient should roll sufficient to compress the unit with his or her body, the result will be to apply positive pressure through the tube to the interior of the wound and even to pump the contents of the unit back into the wound. The device of our first above noted application is subject to the same disadvantage in use, although it otherwise offers significant advantages over the device of the McElvenny et al. patent from the standpoint of simplicity and economy of manufacture.

SUMMARY OF THE INVENTION

The present invention provides a self-actuated closed wound suction device which is of simpler construction than the closed wound suction devices of the prior art and which overcomes their operations and disadvantages. In particular, the device of the invention provides assurance against accidental reversal of the pressure condition in the wound and accidental return to the wound of fluids which had been drained therefrom.

More particularly, the device of the invention in its preferred form comprises a bellows structure molded of a plastic material which possesses inherent flexible and resilient properties such that a bellows molded therefrom with convoluted sides will possess sufficient inherent resilience and plastic memory to expand to its original form after it has been manually compressed. Preferably, the device is produced of such size or configuration that after it has been compressed, it is readily folded back on itself and held in compressed condition by one hand of the operator, leaving the other hand free for the additional necessary operations. A novel configuration has been found especially useful from this standpoint, although a circular or other configuration could be used.

In its simplest form, the bellows unit of the invention is provided with a single opening in its top wall of a bottle-neck configuration to receive a complementarily shaped plug which forms a removable sealed connection between the bellows and the drainage tube from the wound. This plug also incorporates a one-way or check valve which is arranged to open in response to negative pressure within the bellows in order to permit flow therepast of fluids from the wound, but to close in response to positive pressure in the bellows and thereby to block the possibility of return flow of fluid to the wound. Then when sufficient fluid has been collected to warrant emptying of the bellows, this plug is removed, the bellows is emptied and recompressed, the plug is replaced, and the suction operation resumes.

It is a primary object of the present invention to provide a close wound suction device which offers all of the advantages outlined above, including especially safety, and also simplicity of use and economy of construction. Additional objects and advantages will be apparent from the following description, the accompanying drawings and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective exploded view of all of the components utilized in the practice of the invention;

FIG. 2 is a side elevation illustrating somewhat diagrammatically the bellows of FIG. 1 in partially collapsed and folded condition prior to connection to the drainage tube from the wound;

FIG. 3 is a fragmentary view partly in elevation and partly in section showing the plug assembly of FIG. 1 attached to the bellows;

FIG. 4 is a detail elevational view of the plug of FIG. 3 and taken at right angles to FIG. 3;

FIG. 5 is a bottom view of the plug assembly of FIG. 4;

FIG. 6 is a fragmentary section showing the assembled and connected position of the bellows and a plug assembly of a different construction;

FIGS. 7 and 8 are sections on the lines 7--7 and 8--8 of FIG. 6, respectively; and

FIG. 9 is an exploded view of the plug assembly of FIGS. 6-8.

DESCRIPTION OF THE PREFERRED EMBODIMENT

The device of the invention is ordinarily supplied to the surgeon or operating room with its several main components disassembled and separately packaged in sterilized containers. These components are the suction-collector unit 10, the plug assembly 11, the drainage tube 13, which is preferably provided with perforations 12 near its suction end 14, and the surgical needle 15, which has a point 16 and a dull end 17 preferably barbed, threaded or otherwise roughened for firm attachment within the drainage end 18 of tube 13 opposite its suction end 14.

The suction-collector unit 10 is a bellows comprising a top wall 20 and bottom wall 21 connected by a convoluted side wall 22. This entire unit is readily produced by blow molding from a suitable plastic, such as polyethylene or polypropylene, having sufficient resilient plastic memory characteristics to recover its normal shape after being compressed and to develop a desired degree of suction during such recovery, namely suction in the range of 75-125 mm of mercury. It has been found convenient to dimension the unit 10 to provide a volume of 600 cc, which can be done in a unit about 2 inches deep and about 6 inches by 4.5 inches overall in the preferred oval configuration shown in the drawings.

A short neck portion 25 forms a port in the top wall 20 of the bellows 10, and may be cylindrical or slightly tapered to diverge outwardly from wall 20. The neck 25 is preferably located in approximately the center of one of the two areas into which the wall 20 is divided by its shorter diametral dimension along the line 26, for reasons explained in detail hereinafter.

The plug assembly 11 includes a tubular plug body 30 proportioned for removable sealing engagement within the neck 25. Its outer surface 31 is therefore preferably tapered, and it is also provided with tabs 32 which serve as handles facilitating its removal from neck 25. The bore 33 in the larger end of body 30 is sized to receive one end of the tube 13 firmly therein.

At the opposite end of plug body 30 from bore 33 is a one-way valve 35 comprising a cylindrical portion 36 and a tapered portion terminating in a pair of flexible lips 37. The valve 35 should be formed of a soft and rubbery material, such as suitably plasticized polyvinyl chloride so that in the unstressed condition of lips 37, they tend to engage each other as shown in FIG. 5 and thus to block entry to the inner end of bore 33. Conversely, they tend to separate and thus to open the inner end of bore 33 in response to the flow of fluid toward them from bore 33 which is induced by suction within the bellows 10.

In the use of this device for closed wound suction, the surgeon will normally insert the perforated end of tube 13 in the wound before the wound is closed. This is preferably done by passing the needle 15 from the interior of the wound through healthy tissue to a location spaced from the wound opening. The tube 13 is drawn through the resulting stab hole to the desired length but with its suction end 14 and perforated portion remaining within the wound. The needle is then separated from the tube, as by cutting off the connecting end portion of the tube, and the resulting free discharge end 18 of the tube is inserted firmly in the bore 33 in plug body 30.

After the wound is completely closed, the bellows unit 10 is collapsed to empty it of air. As illustrated in FIG. 2, the oval shape of the unit facilitates this operation by enabling the operator to bend the unit back on itself about its diametral dimension 26 and to hold it in this collapsed condition in one hand. While the bellows unit is thus collapsed, the plug body 30 is inserted in the neck 25, and the unit is then released. Since it will immediately seek to recover its normal condition by resilient expansion, suction will thereby be applied to the plug assembly, causing lips 37 to open and thereby making the suction effective within the wound cavity to draw fluids therefrom through the tube 13 and into the interior of the bellows.

This suction effect will continue until the bellows unit has completely recovered its normal condition, at which time it will be substantially full of fluid. Commonly, however, a nurse or other attendant will empty and replace the bellows unit before it is completely full. This is done by removing the plug body 30 from the neck 25, pouring out the contents of the bellows, and then collapsing it and replacing the plug body 30 to cause the suction drainage process to resume. Obviously the full bellows could be replaced by a sterile unit, but commonly a single bellows is used for one patient and then destroyed.

The valve lips 37 will remain open to permit the flow of fluid therepast as long as the pressure within the bellows unit remains negative. If this negative pressure condition should terminate or reverse, either because the bellows recovers its normal condition or because of pressure thereon from the exterior, for example if the patient should inadvertently roll, lean or sit on it, the resulting pressure reversal will cause the valve lips 37 to close and thereby to block the escape of fluid from the unit. Thus in addition to the simplicity of its construction and the manner of its use, the device of the invention offers positive assurance against the accidental return to the wound of any of the fluids which have been drained therefrom.

FIGS. 6-9 illustrate another construction of plug assembly in accordance with the invention. It similarly comprises a tubular plug body 40 proportioned at one end 41 for removable sealing engagement within the neck 25, and provided at its other end with handle tabs 42. The bore 43 of plug 40 is cylindrical, and its inner end is partially closed by a perforate web 44 sized to retain the valve ball 45 within bore 43.

The valve body 50 is a tubular member having a bore 51 in its outer end sized to receive and retain one end of a tube 52 having an inner diameter which will similarly receive and retain one end of the discharge end of the drainage tube 13. The other end portion 53 of valve body 50 is sized to fit firmly within the bore 43, and its free end acts as a seat for the ball 45. Preferably this end of the portion 53 includes a diaphragm-like radial skirt 55 having a center hole 56 smaller than the diameter of ball 45 which seals against the ball in its seated position. The annular shoulder 57 at the junction at the larger and smaller portions of the valve body 50 limits insertion of the portion 53 into the bore 43 to provide adequate space between the web 44 and the skirt 55 for free movement of the ball.

The plug assembly shown in FIGS. 6-9 is used in the same manner as already described in connection with the plug body 30. After the drainage tube 13 has been drawn through from the wound and the needle cut off, the free end of this tube is inserted into the free end of the tube 52. The bellows unit is then collapsed as already described, and the plug body 40 is seated in the neck portion 25. Thereafter the unit applies suction within the wound through the tubes 13 and 52, and so long as there is negative pressure within the bellows, the ball 45 will remain spaced from the valve body 50 to allow drainage therethrough to and through the perforate web 44.

If during use of the device, the patient should accidentally recompress the bellows, the resulting reversal of pressure will cause the ball 45 to move into sealing engagement with the skirt 55, thereby preventing forced return flow of fluid to the wound. This safety action of the ball 45 is enhanced if the ball is made of a light material and preferably one which will float in water. Satisfactory results from all of these standpoints have been obtained with the ball 45 molded from polyethylene.

The invention may be practiced in a variety of additional modifications. For example, the valve body 50 may be made with its bore 51 sized to receive the drainage tube 13, and conversely the bore 33 in the valve body 30 may be sized to receive a tube of the dimensions of the tube 52. When the larger tube 52 is used, a plurality of drainage tubes may be coupled therewith by a Y-connector as shown in the McElvenny et al. patent. It will also be apparent that either of the plug assemblies described above may be used with a suction-collector unit of the type shown in McElvenny et al. patent or our prior application wherein there is a pair of openings, one of which is equipped with a removable sealing plug. For such use, the sealing plug would ordinarily be retained in sealing position so that the unit will effectively have only a single port as in the unit 10. Charging of the unit would then be carried out in the same way as already described, but the alternate procedure could be used as described in the McElvenny et al. patent, with the sealing plug being temporarily removed and then replaced after the empty unit has been compressed.

While the form of apparatus herein described constitutes a preferred embodiment of the invention, it is to be understood that the invention is not limited to this precise form of apparatus, and that changes may be made therein without departing from the scope of the invention which is defined in the appended claims.

Claims

What is claimed is:

1. A surgical suction assembly for withdrawing fluids from within a closed wound, comprising a tube having an intake end adapted for insertion within a closed wound and a discharge end, a resiliently compressible and expansible suction-collector unit having a port in one wall thereof for both entry and discharge of fluids in response to expansion and compression of said unit, means including a plug body removably connecting said discharge end of said tube to said port, said plug body having its outer surface adjacent one end thereof in sealing engagement within said port, said plug body having a central bore of substantially cylindrical section, perforate web means partially closing said bore at said one end of said plug body, tubular connector means at one end inserted firmly into the other end of said bore, shoulder means limiting the extent of insertion of said tubular connector means into said bore to provide a space between said web means and the opposed one end of said tubular connecting means, a ball received in said space and of smaller diameter than said bore and the axial dimension of said space to provide for free movement of said ball in said space, said tubular connector means having an inner diameter smaller than said ball diameter to form an annular seat for said ball, and means connecting the other end of said tubular connector means to said discharge end of said tube, whereby with said bore constituting the sole passagway into and out of said collector unit, said ball will move away from said seat in response to negative pressure within said collector unit to provide for application of suction to said tube and drainage therefrom of fluid through said perforate web means into said collector unit, and said ball will move into seated engagement with said seat in response to positive pressure within said collector unit and thereby block the flow of fluid outwardly from said collector unit.

2. The assembly as defined in claim 1 wherein said ball is composed of a material having a lower specific gravity than water.

3. The assembly as defined in claim 1 wherein said suction-collector unit is a bellows formed of inherently resilient material of sufficient plastic memory to return to a normal expanded position after compression thereof, said bellows being further characterized by oval shape and by comprising substantially flat top and bottom walls connected by a convoluted side wall providing for compression of said bellows to a condition of substantially minimum volumn by collapsing of said side wall and bending of said side and bottom walls about the shorter diametral dimension thereof.