U.S. patent number 3,753,438 [Application Number 05/247,422] was granted by the patent office on 1973-08-21 for suture clip.
Invention is credited to Peter B. Samuels, Ernest C. Wood.
United States Patent |
3,753,438 |
Wood , et al. |
August 21, 1973 |
SUTURE CLIP
Abstract
In order to promote even healing and minimize scarring, this
application discloses a flat clip to be applied to each end of a
thread drawn by a needle through the edges of the wound until the
clip lies flat against the surface of the skin. The application
also discloses a tool carrying a cartridge holding a supply of
clips for securing the clips on the thread and severing it. In
addition, there is shown a tool for removing the clips from the
thread so that the sutures may be removed when the wound has
healed.
Inventors: |
Wood; Ernest C. (Los Angeles,
CA), Samuels; Peter B. (Encino, CA) |
Family
ID: |
22934869 |
Appl.
No.: |
05/247,422 |
Filed: |
April 25, 1972 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
Issue Date |
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817496 |
Apr 18, 1969 |
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Current U.S.
Class: |
606/232;
606/143 |
Current CPC
Class: |
A61B
17/0682 (20130101); A61B 17/0487 (20130101); A61B
2017/0488 (20130101); A61B 2017/049 (20130101); A61B
2017/0464 (20130101); A61B 2017/0454 (20130101) |
Current International
Class: |
A61B
17/04 (20060101); A61B 17/068 (20060101); A61b
017/04 () |
Field of
Search: |
;128/334R,335,337,326,346 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Truluck; Donald L.
Parent Case Text
This application is a continuation of our co-pending application,
Ser. No. 817,496 filed Apr. 18, 1969, now abandoned.
Claims
What we claim and desire to secure by Letters Patent of the United
States is:
1. A clip for holding thread in position on sutured wounds
comprising: a thin flat member having a first end; a second end
constituted by a pair of spaced apart legs forming a relatively
wide notch; the outer sides of each of said spaced apart legs
having a first surface extending from the outer ends of said legs
spaced from said first end to a point intermediate the length of
said legs, said first surfaces of each leg being substantially
parallel to each other whereby said clips may be aligned in an
elongated clip holder having straight parallel sides and having a
second surface continuing from the termination of said first
surface, said second surfaces converging toward each other to form
said first end, whereby said first end is relatively narrow with
respect to said second end so that the first end of one clip can be
positioned within a clip holder, the relatively wide notch of a
second clip for storage purposes; and a relatively narrow notch
formed in said first end to facilitate the bending toward each
other of said spaced apart legs.
2. A clip as set forth in claim 1 in which said spaced apart legs
are shaped at their outer ends to form a relatively narrow notch
when they are bent toward each other to provide a narrow notch at
each end of the clip for engagement by elements of a clip removing
tool.
Description
This invention relates to surgical devices. More specifically, it
relates to devices useful for the suturing of skin wounds.
The conventional method of closing skin wounds consists of sewing
the edges of the wound together with thread. Threads are placed and
tied separately along the wound and are termed "interrupted
sutures." Alternatively, wounds may be closed by a continuous
thread anchored by tying the thread at either end of the wound.
Very frequently wounds sutured in accordance with these techniques
tend to have the edges inverted so that when healed a noticeable
scar may remain. Also, it is not uncommon that the healing may be
uneven to such an extent as to delay complete healing and to
further aggravate the scarring situation.
It is an object of this invention to provide a novel apparatus for
suturing skin wounds which promote even healing.
It is still a further object of this invention to provide a novel
apparatus for suturing skin wounds which eliminates any encircling
thread over the wound, thus eliminating the possibility of a
cross-hatched scar.
These and other objects are achieved by novel clips secured to the
free end of a thread which is then drawn through the edges of the
wound until the clip contacts the surface of the skin at one edge,
permitting the edges of the wound to be drawn together, at which
time another clip may be applied to the thread to secure the thread
in the wound.
In an important aspect of the invention there is provided a novel
clip formed as a flat member out of a material with sufficient
resiliency and strength so that it can be clamped about a suturing
thread.
BRIEF DESCRIPTION OF THE DRAWINGS
These and other objects and advantages of this invention will
hereinafter appear and for purposes of illustration, but not of
limitation, an embodiment of the invention is shown in the
accompanying drawings in which:
FIG. 1 is a plan view of an applicator tool embodying the invention
and suitable for carrying out the inventive method;
FIG. 2 is a plan view of a cartridge holding a supply of clips in
accordance with the invention;
FIG. 3 is an end view of the cartridge of FIG. 2;
FIG. 4a is a plan view of a clip in accordance with the invention
shown prior to its assembly on a thread;
FIG. 4b is a view of a clip in accordance with the invention
showing the position assumed upon its assembly on a thread;
FIG. 5a is a diagrammatic illustration showing the use of a thread
on which a clip has been secured in suturing a wound;
FIG. 5b is a diagrammatic figure similar to FIG. 5a in which
several sutures have been completed using the method and apparatus
of the invention;
FIG. 6 is an illustration of a tool suitable for removing clips
from a thread in accordance with the invention.
DETAILED DESCRIPTION
This invention is practiced by applying a flat clip to the end of a
thread and passing the thread through the skin, using a surgical
needle, until the clip lies flat against the surface of the skin at
one edge of the wound. This is illustrated in FIG. 5a where a clip
2 has been clamped to a thread 4 and the thread, in turn, threaded
through a suitable surgical needle 6. The thread 4 has been drawn
through the surface of the skin at one edge 8 of a wound and the
clip 2 lies flat against that surface of the skin. The needle 6 is
then used to penetrate the surface of the other edge 10 of the
wound from the underside and emerge from the upper side of that
edge. At that point another clip 2 is applied to the thread 4 and
the thread is then severed. In order to facilitate the suturing, an
applicator tool is constructed to apply two clips simultaneously to
the thread and to sever the thread between the two clips. In this
manner, the emerging end of the thread is clipped and the suture
secured, and at the same time the thread is provided with a clip at
its free end to commence the next suturing operation. This sequence
of operations is repeated to the extent necessary to close the
wound, as may be seen in FIG. 5b wherein several sutures of the
interrupted variety have been applied, each suture consisting of a
pair of clips 2 and a thread 4. During each suturing operation the
thread is pulled sufficiently tight to bring the edges of the wound
together and to evert them slightly. If desired, a continuous
suture could be applied with a clip at each end.
It has been found that in addition to fixing the thread in place
the clips spread the pull exerted at the skin edge by the thread
over the entire surface of the clip and thus spread the pressure at
the point of engagement of the clip with the skin over the entire
clip, thus relieving the pressure from a restricted area. It has
also been found that the clips tend to assume a position parallel
to each other, thus contributing to the eversion of the skin edge.
By resisting the natural tendency of the skin edge to turn inward,
even healing is promoted and scarring is minimized. Another
advantage of this method results from the tendency of the clips to
immobilize the skin beneath them, that is, they, in effect, splint
the skin edge and prevent its movement. This "splinting effect"
also helps to minimize scarring of the wound by allowing healing to
proceed with the wound immobilized.
Since the practice of this method eliminates threads overlying the
wound, there is no cross-hatched scar as is seen in wounds sutured
by the prior art methods. In addition, the absence of a circular
suture relieves the wound of any circumferential compression.
In order to practice the invention, the clip applicator tool
illustrated in FIGS. 1 through 3 may be used. As seen in FIG. 1,
the clip applicator comprises a body portion 14 on which the
remaining elements of the applicator are mounted for use. These
elements comprise a pair of handle portions 16 and 18 pivoted at
points 20 and 22, respectively, on the forward end of the body
portion. Passing through the body portion is a channel guide 24
which is provided at its rearward end with a spring clip 26 which
is normally urged upward from the bottom of the channel guide 24 to
hold a cartridge 28 in the channel guide. The cartridge 28 extends
through the body portion and has a front end 30 which terminates in
a pair of V-shaped openings 32 adjacent the confronting ends 34 and
36 of a pair of jaws 38 and 40, respectively, which are pivoted on
the body portion at the points 42 and 44, respectively. A pair of
outwardly bowed leaf springs 43 and 45 urge the jaws 38 and 40
outwardly from the body portion 14. The handle 16 has secured to
its undersurface a leaf spring 46 which slides at its inner end on
the surface of the channel guide 24 to normally urge the handle 16
in an outward direction. A similar leaf spring 48 is secured to the
handle 18 for the same purpose. The handles 16 and 18 are provided
with enlarged portions 47 and 49, respectively, which bear on the
jaws 38 and 40 and function as camming surfaces to cause inward
movement of the jaws when the handles are forced inwardly. A pair
of stops 50 and 52 may be provided on the body portion, engaging
with the handles 16 and 18, respectively, to limit their outward
movement.
The cartridge 28 is illustrated in greater detail in FIGS. 2 and 3.
As illustrated, it takes the form of an elongated rectangular
member provided with a pair of slots 54 and 56 extending along its
length into which clips to be applied to a thread may be stored and
from which they may be fed for compression by the jaws 38 and 40 as
required. A means to force the clips forward in the slots 54 and 56
is constituted by a slide 58 having a handle portion 60 extending
through an elongated opening 62 extending over a major portion of
the length of the cartridge 28. A notch 64 is formed in the end of
the cartridge 28 to permit passage of a thread-severing means in a
manner to be described in greater detail hereinafter. Instead of
using a handle to urge the slide forward, a spring feed could be
provided.
The thread-severing means is constituted by an arm 66 pivoted
coaxially with the jaw 40 at 44 but capable of independent movement
and carrying at its free end a cutting edge 67 and a projection 68
which acts to maintain a thread in position to be cut. Extending
from the arm 66 through an opening in the jaw 40 is a projection 70
engageable with the pivoted handle 16.
The operation of the applicator tool 14 in conjunction with the
cartridge 28 is as follows. After the cartridge 28 is caused to be
filled with an appropriate number of clips in the slots 56 and 54,
the cartridge is inserted into the channel guide 24 until its
forward motion is stopped by virtue of its contact with the
confronting surfaces 34 and 36 of the jaws 38 and 40. It is
retained in this position by the engagement of the spring clip 26
with its rear end. In order to feed clips to a position to be
applied to a thread, the slide 58 is moved forward by applying
pressure to the handle 60 so as to feed clips forward to a position
between the jaws. As may be seen in FIG. 1, the forward movement of
the slide 58 is permitted by the provision of a slotted opening 66
in the body portion 14. The forward motion of the clips is limited
by their engagement in cut-out portions 71 formed in the
confronting surfaces 34 and 36 of the jaws 38 and 40.
Referring to FIGS. 3a and 3b, it may be seen that each clip 2 is
formed as a thin, flat member having notch 72 formed at its lower
end and a pair of spread-apart legs 74 and 76 forming a wider notch
78 at its upper end. When inserted into the slots 54 and 56, the
clips nest within each other, i.e., the narrow part of a clip with
the notch 72 rests within the wider notch 78 of each adjacent clip.
As may best be seen in FIGS. 2 and 4a, the outer surfaces 82 and 84
extending from the end of the wide notch are substantially parallel
to each other to engage and be aligned by the straight sides of the
slots 54 and 56 when the clips are placed in the cartridge 28.
Thus, when the clips are moved forward in the cartridge 28 by the
action of the slide 58, they are positioned in the cut-out portions
71 with the notch 78 exposed between the confronting portions 34
and 36 of the jaws 38 and 40. With the clips so positioned, a
thread is laid between the confronting portions in the notches 78
of the clips. The handles 16 and 18 are then squeezed together
about their pivots 20 and 22. By virtue of their engagement with
the forward ends of the jaws 38 and 40 these jaws are caused to
rotate inwardly about their pivots 42 and 44 moving the confronting
ends 34 and 36 together.
The pressure caused by the inward motion of the confronting ends 34
and 36 causes the legs 74 and 76 of the clips to be moved toward
each other securing or clamping the clip about the thread in what
was the notch 78. The dimensions are such that the legs 74 and 76
move into substantial contact with each other and are securely
fastened to the thread leaving a small notch 80 in the upper end of
the clip, as may be seen in FIG. 4b. Further compression of the
handles 16 and 18 causes the inner side of the handle 16 to bear
against the projection 70 on the arm 66 so that it continues to
move inwardly, whereby the severing edge 68 on the end of that arm
cuts the thread in between the two clips. When the thread has been
severed there results an arrangement where two clips have been
applied, one to each end of the severed thread. In practice, it has
been found desirable to dimension the clips and the applicator tool
14 so as to apply them to the thread approximately one centimeter
apart.
The clipped ends of the thread are now ready for use in the
practice of the method described above. The clipped thread which
has been severed from a longer piece may be discarded and the first
suturing operation begun using the clipped thread remaining. In the
execution of the suturing operation after the thread has been drawn
through both edges of the wound and the wound drawn together, the
applicator tool may again be used by first feeding forward another
pair of clips to a position between the confronting ends 34 and 36,
then using the applicator tool in the manner described above. This
results in a clip being applied to the emerging end of the thread,
such a clip being designated by reference numeral 12 in FIG. 5b,
and a clip has been secured to the free end of the thread so that
another suturing operation may be commenced.
After the wound has healed and it is desired to remove the sutures,
the invention provides a removing tool or opener illustrated in
FIG. 6. This is constituted by a pair of pivoted handles 86 and 88
which are provided at their free ends with a pair of pointed
projections 90 and 92, respectively. These projections may be
engaged in the notches 72 and 80 of a clip and the handles brought
together to force the projections into those notches and spread
apart or open the clip to remove it from the thread. When the clips
on each side of the wound are removed, the suturing thread may be
withdrawn in the usual manner.
It is to be understood that changes may be made in the details of
construction, arrangement, and operation without departing from the
spirit of the invention, especially as defined in the following
claims.
* * * * *