U.S. patent number 3,753,439 [Application Number 05/174,466] was granted by the patent office on 1973-08-21 for general purpose surgical drain.
This patent grant is currently assigned to Elias & Brugarolas. Invention is credited to Antonio Brugarolas, Elias G. Elias.
United States Patent |
3,753,439 |
Brugarolas , et al. |
August 21, 1973 |
GENERAL PURPOSE SURGICAL DRAIN
Abstract
A surgical drain for operative and post operative usage
providing a core comprising a pliant drainage conduit having
through wall passages throughout its lenth from its distal end to a
point inset from its proximal end and a co-extensive pliant
irrigation conduit open at its ends, a padding layer of soft,
non-friable absorbent material surrounding said core from its
distal end to a point opposite the proximal end passages of the
drainage conduit, a soft rubber or like sheathing surrounding the
padding layer from end-to-end and having through wall passages
throughout its length from its distal end to a point opposite the
proximal end passages of the drainage conduit, and a securing
suture extending through the proximal ends of the padding layer and
sheath and encircling the core to retain the parts assembled.
Fittings are provided at the proximal ends of the respective
conduits adapting them respectively for connection to a suction
line and to an irrigation line and the fitting of the irrigation
conduit includes a normally closed plug valve selectively opened to
provide irrigation when needed.
Inventors: |
Brugarolas; Antonio (Buffalo,
NY), Elias; Elias G. (Buffalo, NY) |
Assignee: |
Elias & Brugarolas
(Buffalo, NY)
|
Family
ID: |
22636249 |
Appl.
No.: |
05/174,466 |
Filed: |
August 24, 1971 |
Current U.S.
Class: |
604/43 |
Current CPC
Class: |
A61M
27/00 (20130101); A61M 1/85 (20210501) |
Current International
Class: |
A61M
27/00 (20060101); A61M 1/00 (20060101); A61m
027/00 () |
Field of
Search: |
;128/35R,35V |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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|
|
|
|
|
|
358,933 |
|
Jan 1906 |
|
FR |
|
358,937 |
|
Jan 1906 |
|
FR |
|
Primary Examiner: Laudenslager; Lucie H.
Claims
What is claimed and desired to be secured by Letters Patent is:
1. A general purpose disposable surgical drain for placement in a
surgical wound or body cavity during operative and post operative
surgical procedures comprising a drain core including an elongated
open ended drainage conduit having through wall passages therein
angularly staggered throughout its length from its distal end to at
least a point a predetermined distance inwardly from its proximal
end and a second conduit of a length substantially equal to the
length of said drainage conduit having respective openings at its
distal and afferent ends, said second conduit having at least its
distal end fixedly connected to the distal end of said drainage
conduit and its afferent end freely related to the proximal end of
said drainage conduit; a soft pliable tube sheathing said core in
radial spaced relation from a point inset from the distal end of
said core to a point beyond the proximal end passage of said
drainage conduit, said sheathing tube having through passages
therein angularly staggered throughout its length from its distal
end to the proximal end passage of said drainage conduit; and
adsorbent padding of non-friable material interposed between said
core and said sheathing tube and fixedly secured to said core and
said sheath, said padding maintaining said sheath expanded and
forming an air and fluid passage chamber surrounding said core.
2. The surgical drain of claim 1 wherein said padding comprises a
fluffy, mesh-like material loosely enclosing said core and said
sheathing tube and padding are secured to said core outwardly of
the proximal end passage by a suture encircling said core.
3. The surgical drain of claim 1 wherein the proximal end of said
drainage conduit includes means adapting said drainage conduit for
connection to a suction line adapting the drain for use as a sump
drain and wherein said padding permits air to enter the proximal
end of said sheath and pass through the padding into the drainage
tube through its wall passages thereby aspirating the tissue
drainage from the wound or cavity and in normal usage reduces the
suction force applied to the sheath and body tissues forming the
walls of the wound or body cavity sufficiently to prevent
collapsing of the padding and sheathing tube around the drainage
conduit and entry of the body wall tissues into the drainage
passages under influence of the applied suction.
4. The surgical drain of claim 1 wherein the afferent end of said
second conduit is provided with means adapting said second conduit
for selective use as an irrigation conduit should irrigation be
required.
5. The surgical drain of claim 4 wherein said means comprises a
plug member carried by a tie cord fixedly secured at one end to the
second conduit wall near its proximal end.
6. The surgical drain of claim 3 wherein said means adapting said
drainage conduit for connection to a suction line comprises a
tubular plug fitting secured to the proximal end of said drainage
conduit.
Description
BACKGROUND OF THE INVENTION
In performing many surgical procedures, it is necessary to insert
surgical drains to dispose of the fluids which accumulate in the
operative wound (the incision made to perform the required surgery)
during the operation and, oftentimes, to provide for post operative
drainage of the operative wound. Prior to this invention, it has
been the general practice to provide drainage devices of varying
construction for use during the operation and for post operative
drainage. These drainage devices customarily take the form of
devices known as "drain catheters" typified by United States
Letters Pat. No. 3,524,427 issued Sept. 15, 1970 to David G.
Sheridan or surgical wound drains typified by United States Letters
Pat. No. 3,384,089 issued May 21, 1968 to Walter Shriner. Some of
these types of drainage devices, due to the semi-rigid nature of
the material from which they are made, may produce pressure
necrosis of the surrounding tissues. Other drains, although made of
soft material utilised as sump drains may collapse or cause
complete collapse of the body tissues over the drainage device and
therefore fail to maintain their patency for the desired period of
time.
SUMMARY OF THE INVENTION
The present invention overcomes the aforementioned disadvantages of
prior art drainage devices by providing a padded, multi-purpose
drainage device which may be applied to more efficiently remove the
accumulating fluids while at the same time preventing complete
collapse of the body tissues over the drainage device maintaining
its patency and eliminating much of the patient discomfort
attendent upon use of a surgical drainage device.
It, accordingly, is a primary object of the present invention to
provide a surgical drain having a soft rubber tubular envelope or
outer tube which may be sutured to the skin at a selected point
adjacent the operative wound to fix the drain in a desired position
in the operative wound and a non-friable spacer layer of adsorbent
material disposed between the outer tube and the portion of a
semi-rigid two way catheter to form an air and fluid permeable
chamber around the portion of the catheter positioned in the
operative wound, which avoids pressure necrosis of the tissues.
A further important object of the present invention is to construct
the soft rubber tubular envelope or outer tube and spacer layer of
a length such that their distal ends are inset inwardly from the
distal end of the two way catheter and their proximal ends extend
beyond the proximal end drainage passage of the catheter to provide
said air chamber and fixedly connecting the proximal ends of the
outer tube and spacer layer to the catheter at a point beyond the
proximal end drainage passage by a suture which encircles the
catheter.
Another object of the present invention resides in providing the
catheter of the primary object in the form of a one piece dual
passage tubing member the distal end of which is separated
longitudinally throughout a portion of its length to provide
respectively a drainage passage terminal connection and an
irrigation passage afferent end connection.
A further object of the present invention resides in providing the
side walls of the tubing member of the preceding object defining
the drainage passage with radially directed through passages
leading to the air chamber and angularly staggered throughout its
length from its distal end to a point a predetermined distance
inwardly from the drainage passage terminal connection serving
suction or drainage to the whole depth or length of the wound, in
providing the distal end of the irrigation passage with a discharge
opening, and in providing the afferent end connection of the
irrigation passage with a normally closed, valve to be selectively
opened when the need for irrigation arises, adding the advantage of
asyptic irrigation system.
BRIEF DESCRIPTION OF THE DRAWINGS
Still further objects will appear from the following description
and appended claims when read in conjunction with the accompanying
drawings wherein:
FIG. 1 is a perspective view of the surgical drain of this
invention;
FIG. 2 is a top plan view of the surgical drain of FIG. 1;
FIG. 3 is a transverse sectional view of the surgical drain of FIG.
1 when taken substantially on line 3--3 of FIG. 1; and
FIG. 4 is a perspective view illustrating the surgical drain in use
to drain a body cavity or abscess cavity.
DESCRIPTION OF PREFERRED EMBODIMENT
With continued reference to the drawings wherein the same reference
numerals are used throughout the several views to indicate the same
parts, the numeral 10 indicates generally a padded surgical drain
made in accord with the present invention. Surgical drain 10 is
made up of three principal elements, namely, a two way catheter 11
surrounded by a soft padding layer of non-friable material, for
example, surgical gauze or similar wide mesh adsorbent material 12
and an outer tube sheath 13 of soft, non-absorbent material, for
example, soft rubber or synthetic material.
The two way catheter 11 is formed of pliable rubber or a suitable
pliable synthetic material, preferably with radio-opaque lines 9
scattered throughout to enable the drain to be located by x-ray to
determine its position when employed as a post operative drain,
formed to provide a first conduit 14 and a second conduit 15. The
conduit 14, as best seen in FIG. 4, is in the form of an open ended
tube the side wall of which is provided with a multiplicity of
through passage 16 haphazardly located in angularly, and
logarithmically axially spaced relation throughout a portion of its
length beginning at a substantial distance inwardly from its
proximal end 18 and terminating at its distal end 17. The conduit
15, as best seen in FIG. 4, is in the form of a smaller diameter,
imperforate open ended tube the open distal end 19 (FIG. 4) of
which is preferably inserted through one of the distal end passages
16 of tube 14 to dispose the open distal end 19 in fluid
communication with the open distal end 17 of tube 14. While tubes
14 and 15 could be separate tubes suitably fixedly secured together
from a point inwardly from their extreme distal ends to a point
slightly beyond the priximal end passage 16 of tube 14, it is
preferred that they be integrally formed as best seen in FIG. 3.
When such an integrally formed tube is employed, the line of
connection 21 (FIGS. 1 and 3), preferably, will be longitudinally
slit inwardly from the distal end sufficiently to free the distal
end of tube 15 so it may be bent and inserted through a selected
distal end passage 16 of tube 14 and the proximal end, will be
longitudinally slit to separate the tubes 14 and 15 at their
proximal ends. This separation at the proximal end is effected to
render the respective tubes more readily adaptable for connecting
the proximal end 18 of tube 14 to the suction intake of a suction
pump (not shown) through tubular fitting 22 and to fit the afferent
end 23 of tube 15 with a normally closed plug fitting 24 or a one
way valve provided for connecting an irrigation syringe or the like
(not shown) to provide for irrigation of the operative wound when
necessary. Since the application of suction to tube 14 and the use
of tube 15 as an irrigation conduit is conventional practice in the
use of two way catheters, a detailed description of pump and
irrigation means or the means of connecting them is not deemed
necessary here.
The padding layer 12 of surgical gauze or similar fluffy wide mesh
adsorbent material 12 is preferably loosely wound or packed around
the perforated length of the two way catheter 11 to a desired
radial thickness and is then enclosed within the outer soft rubber
sheath 13 with the distal and proximal ends protruding slightly
beyond the ends of sheath 13 by entering catheter 11 encased in the
padding layer 12 endwise into sheath 13. Sheath 13 is provided with
through passages 26 distributed randomly throughout its length from
its distal end to a point inwardly from its proximal end opposite
the proximal end passages 16 of tube 14. The catheter 11, padding
layer 12, and sheath 13 are secured against relative axial movement
by a silk suture 27 passed inwardly and outwardly through the
preferably turned down proximal end 28 of sheath 13 and the
proximal end of padding layer 12 and around catheter 11 several
times. In this connection, it has been determined that a very soft,
thin, highly flexible rubber sheath 13 and light, fluffy padding
material 12 should be employed to assure that the catheter is
softly cushioned on all sides throughout the portion entered into
the operative wound by the enclosing padded sheathing. By
constructing the drain in this manner, the patient's comfort is
materially increased since the weight of the catheter will be
widely distributed through the padding and sheath when the drain is
employed as a regular wound drain, a cigarette drain or as a sump
drain. In all such usages, the soft, pliable sheath and padding
will be interposed between the catheter and the body tissues of the
operative wound or body cavity to serve as a readily deformable
sheathing which will conform to the contour of the walls of the
wound or body cavity. As a consequence, localized pressure points
are avoided.
Additionally, the padded drain of the present invention, as will be
clear from an inspection of FIG. 4, permits the drain to be
reasonably positively fixed in place in an operative wound or body
cavity to minimize, if not eliminating, discomfort due to shifting
movement. Referring for the moment to FIG. 4 where the drain is
shown applied to drain a body cavity or abscess cavity 31, the
drain 10 is entered endwise into the cavity 31 distal end first
through the entrance opening 32. It passes first through the skin
layer 33, then successively, in the case of an incision made to
remove a tumor or puss cells of an abscess, through the
subcutaneous tissues 34 and deep structure 35, to position the
slightly protruding distal end of catheter 11 in suitably spaced
relation to the cavity end wall and the proximal end passages 26
and 16 within the cavity. A holding suture 36 is then loosely run
through the sheath 13 at the skin level and the skin layer 33
immediately adjacent thereto to secure drain 10 against axial
bodily movement relative to the incision opening 32. As a
consequence of this sutured connection and the deformable and
inherent nature of sheathing 13 to cling to the opening defining
skin layer of the incision and cavity, sheath 13 and padding layer
12 of drain 10 are effectively fixed against movement relative to
the incision and body cavity 31 with catheter 11 axially suspended
by suture 27 in generally centered relation within the padding
layer.
Bearing in mind that operative wounds necessitate incision of
widely different length, depth and even axial curvature, the
present invention contemplates that drain 10 (1) be readily
bendable to maintain a longitudinal curvature to conform to the
varying axial curvature of the incisions, (2) be produced in
varying lengths from, for example, the dimensions of a cigarette to
a length of 11 inches or more measured from the distal end to the
proximal end of sheath 13, (3) be adaptable for use with or without
suction and/or irrigation facilities; and (4) sterily prepared and
packaged, and disposable after being used once. The surgical tubing
employed in conventional catheters and pliability of the packing
and sheathing heretofore described assures attainment of the first
two objectives while the tubular fitting 22 and plug fitting 24
assures attainment of the third objective. In this latter
connection, when drain 10 is used with or without suction, drain 10
is placed within the wound so that the imperforate proximal ends of
catheter 11, sheath 13 and the padding layer 12 protrude outwardly
from the wound or a conventionally located stab wound adjacently
related to the operative incision. In either case, the skin layer
defining the opening 32 through which the drain protrudes is
loosely sutured to sheath 13. When used without suction, the plug
38, preferably fixedly joined to fitting 24 by a tie cord 39, is
removed from fitting 24 as shown in FIGS. 1 and 2. With the plug 38
removed as there illustrated, drain 10 may be immediately employed
to irrigate the operative wound merely by fitting a syringe or
other irrigation means to fitting 24 at the afferent end 18 of tube
15.
When drain 10 is to be used with suction, plug 38 is inserted into
fitting 24 to shut off tube 15 at its extreme afferent end and a
conventional suction device is plugged into tubular fitting 22. The
suction applied to tube 14 effectively increases the drainage flow
through tube 14 and is maintained, so long as the drainage fluid
entering through the distal end and/or passages 26 of sheath 13
enters the free spaces provided by the fluffy padded layer 12, to
aspirate the fluid into tube 14 through passages 16. To assure
proper drainage under suction or when drain 10 is used without
suction, it is essential that the drain be properly positioned to
dispose all passages 26 and passages 16 within the operative wound
and that ambient air have free access into the padding layer 12
that protrudes through the proximal end of sheath 13.
In addition to providing a primary air flow path when drain 10 of
this invention is used as a suction drain, the padding layer 12
acts by adsorption and capillary action to convey the drainage
fluid from the wound or body cavity to catheter passages 16 where
the inrushing air passing through padding layer 12 and passages 16
picks up the drainage fluid constantly and carries it into and
through drainage tube 14 keeping the wound dry and hastening the
healing processes. Removal of drain 10, when the physician feels
the drain is no longer needed, is readily effected by merely
removing the holding suture 36 and grasping the protruding proximal
ends of the drain 10 (including sheath 13, padding 12 and catheter
11) and pulling the drain 10 as a unit out through opening 32.
From the preceding description, it will be appreciated that the
padded surgical drain of the present invention provides a surgical
drain which, in addition to providing a drain which stays in proper
placement and is maintainable fully functional longer than the
surgical drains heretofore provided, also provides a surgical drain
which (1) reduces patient discomfort, and (2) can be used as an all
purpose drain, i.e., as a regular wound drain, a cigarette drain, a
sump drain, and an irrigation drain.
The invention may be embodied in other specific forms without
departing from the spirit or essential characteristics thereof. The
present embodiment is, therefore, to be considered in all respects
as illustrative and not restrictive, the scope of the invention
being indicated by the appended claims rather than by the foregoing
description, and all changes which come within the meaning and
range of equivalency of the claims are therefore intended to be
embraced therein.
* * * * *