U.S. patent number 3,926,185 [Application Number 05/532,282] was granted by the patent office on 1975-12-16 for surgical drape.
This patent grant is currently assigned to Johnson & Johnson. Invention is credited to Henrietta K. Krzewinski.
United States Patent |
3,926,185 |
Krzewinski |
December 16, 1975 |
Surgical drape
Abstract
A fenestrated surgical drape for use in orthopedic and related
surgery comprising a flexible and unitary sheet having a main
portion and two adjacent wing portions whose inner edges,
preferably spaced a small distance from each other, define
therebetween an elongated slit or gap. The slit merges into a
fenestration which is located generally inwardly of the perimeter
of the drape. One of the two wing portions has a flap-like sheet
which, after the drape has been applied to a patient, covers at
least a portion of the length of the slit and lies beneath the
other of the wing portions. An extremity, e.g., a leg, extends
through the fenestration during surgery. The drape is preferably
reinforced in the areas adjacent the fenestration and the slit and
carries means for holding surgical tubing or electrical wires. The
drape also is provided with clipping tabs for securing the drape in
its desired position during surgery. The drape is readily foldable
into a compact unit which permits it to be easily and quickly
unfolded and applied to a patient prior to surgery.
Inventors: |
Krzewinski; Henrietta K. (Old
Bridge, NJ) |
Assignee: |
Johnson & Johnson (New
Brunswick, NJ)
|
Family
ID: |
24121122 |
Appl.
No.: |
05/532,282 |
Filed: |
December 12, 1974 |
Current U.S.
Class: |
128/854;
128/DIG.26 |
Current CPC
Class: |
A61B
46/00 (20160201); A61B 2046/201 (20160201); A61B
2046/205 (20160201); Y10S 128/26 (20130101) |
Current International
Class: |
A61B
19/08 (20060101); A61B 19/00 (20060101); A61F
013/00 () |
Field of
Search: |
;128/132D,292,132R |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Trapp; Lawrence W.
Claims
What is claimed is:
1. A surgical drape comprising a sheet of flexible drapable
material, said sheet having a main portion at one end thereof, and
a pair of spaced wings at the other end thereof, said wings
extending outwardly from a central region of said sheet and
defining a slit in said sheet; said slit merging into a widened
fenestration located generally inwardly of the perimeter of the
drape; a flap secured to one of said wings, said flap being
transversely extendible from said wing so as to cover at least a
portion of the length of said slit and to be in contacting
relationship with at least part of the other of said pair of wings
when the drape is in use; and means on said drape for preventing
said wings from moving with respect to each other when the drape is
in use.
2. A surgical drape according to claim 1 wherein a reinforcing
panel is attached to the upper surface of the drape.
3. A surgical drape according to claim 1 wherein said means for
preventing said wings from moving with respect to each other when
the drape is in use comprise two flexible tabs which may be brought
into mutual contact and held together.
4. A surgical drape according to claim 3 wherein a flexible tab is
attached to each wing portion at the inner edge thereof relatively
near the point where said slit merges into said fenestration.
5. A surgical drape according to claim 3 wherein one of said two
tabs is attached to said flap near the inner side edge of the wing
to which said flap is attached and the other of said two tabs is
attached to the remaining one of said two wings near the inner side
edge thereof.
6. A surgical drape according to claim 1 wherein said means for
preventing said wings from moving with respect to each other when
the drape is in use comprise a tab of flexible material and a
cooperating strip of pressure sensitive adhesive.
7. A surgical drape according to claim 6 wherein said pressure
sensitive adhesive is protected prior to use of the drape by a
release covering.
8. The surgical drape of claim 1 further comprising at least one
tubing holder on the upper surface of the drape, said tubing holder
having a flexible portion free from the rest of the drape, said
flexible portion having at least one opening therein through which
flexible members may be threaded and secured thereto.
9. A surgical drape according to claim 1 wherein said fenestration
is lined with an elastomeric film, said film lying in the major
plane of the drape.
10. A surgical drape according to claim 1 wherein each of the wing
portions is extended transversely to provide a generally T-shaped
surgical drape, said transverse extensions comprising armboard
covers for covering the laterally extending armboards of an
operating table.
11. A surgical drape according to claim 10 wherein an armboard flap
is attached to each of said armboard covers.
12. A surgical drape comprising a sheet of flexible, drapable
material, said sheet having a main portion at one end thereof and a
pair of spaced wings at the other end thereof, said wings extending
outwardly from a central region of said sheet and defining a gap in
said sheet; and a flap attached to at least one of said wings, said
flap being transversely extendible from said one wing so as to
cover at least a portion of said gap and to lie in contacting
relationship with at least part of the other of said pair of wings;
said flap on said one wing being folded to overlie said one wing;
said one wing with its said overlying flap and the other of said
two spaced wings each being folded longitudinally a plurality of
times in a sequence of folds toward the center of the drape, the
first fold in said sequence being a reverse fold and the last fold
in said sequence being a forward fold whereby, when said folding
sequence is completed, each folded wing portion overlies a central
portion of said sheet; a part of said main portion being folded
longitudinally a plurality of times in a sequence of folds toward
the center of the drape, the first fold in said sequence being a
reverse fold and the last fold in said sequence being a forward
fold whereby, when said folding sequence is completed, the folded
part of said main portion comprises a stack of folds overlying said
central portion of said sheet.
13. A surgical drape according to claim 12 wherein the folded wing
portions lie between said folded part of said main portion and said
central portion of the sheet.
14. A surgical drape according to claim 12 wherein each of said
wings is folded four times, the first and third folds being reverse
folds, and the second and fourth folds being forward folds.
15. A surgical drape according to claim 14 wherein said part of
said main portion is folded four times, the first and third folds
being reverse folds, and the second and fourth folds being forward
folds.
16. A surgical drape according to claim 15 wherein the folded wing
portions lie between said folded part of said main portion and said
central portion of the sheet.
17. A surgical drape according to claim 16 transversely folded into
a compact unit.
18. A surgical drape according to claim 17 treated to render it
sterile and packaged in said sterial condition.
19. A generally T-shaped surgical drape for use on an operating
table having laterally extending armboards for supporting a
patient's arm, said drape comprising a sheet of flexible drapable
material, said sheet having an upper portion, a lower portion and a
pair of side edges; said upper portion having armboard covers
comprising a flexible drapable material extending transversely
therefrom for covering the arms of a patient and said armboards,
each of said armboard covers having an upper surface, a side edge,
and a lower edge; each of said armboard covers having attached
thereto an armboard flap comprising a flexible, drapable material;
each of said armboard flap being folded to overlie the upper
surface of the armboard cover to which it is attached; each of said
armboard covers with its respective overlying armboard flap being
folded to overlie at least part of said upper portion; the upper
portion of the drape being folded longitudinally a plurality of
times in a sequence of folds toward the center of the drape, the
first and last folds in said sequence being forward folds whereby,
when said folding sequence is completed, the folded upper portion
comprises a stack of folds overlying a central portion of said
sheet; a part of said lower portion being folded longitudinally a
plurality of times in a sequence of folds toward the center of the
drape, the last fold in said sequence being a forward fold whereby,
when said folding sequence is completed, the folded part of said
lower portion comprises a stack of folds overlying said central
portion of said sheet.
20. A surgical drape according to claim 19 wherein each armboard
flap is folded twice, the first fold being a reverse fold and the
second fold being a forward fold; and each of said armboard covers
with its respective overlying armboard flap is forward folded to
provide a substantially rectangular partially folded drape.
21. A surgical drape according to claim 20 wherein said upper
portion is folded five times, the second fold being a reverse fold,
the third fold being a forward fold, and the fourth fold being a
reverse fold.
22. A surgical drape according to claim 21 wherein said part of
said lower portion is folded four times, said first fold being a
reverse fold, said second fold being a forward fold, and said third
fold being a reverse fold.
23. A surgical drape according to claim 22 transversely folded into
a compact unit.
24. A surgical drape according to claim 23 treated to render it
sterile and packaged in said sterile condition.
25. A generally T-shaped surgical drape for use on an operating
table having laterally extending armboards for supporting a
patient's arms, said drape comprising a sheet of flexible, drapable
material, said sheet having a main portion at one end thereof and a
pair of spaced wings at the other end thereof, said wings extending
outwardly from a central region of said sheet and defining a gap in
said sheet; a flap attached to at least one of said wings, said
flap being transversely extendible from said one wing so as to
cover at least a portion of said gap and to lie in contacting
relationship with at least part of the other of said pair of wings;
each of said wings having armboard covers comprising a flexible
drapable material extending transversely therefrom for covering the
arms of a patient and said armboards; each of said armboard covers
having an upper surface, a side edge and a lower edge; each of said
armboard covers having attached thereto an armboard flap comprising
a flexible drapable material; said flap on said one wing being
folded to overlie said one wing; each of said armboard flaps being
folded to overlie the upper surface of the armboard cover to which
it is attached; each of said armboard covers with its respective
overlying armboard flap being folded to overlie at least part of
the wing from which said armboard cover transversely extends; each
wing of the drape then being folded longitudinally a plurality of
times in a sequence of folds toward the center of the drape, the
first and last folds in said sequence being forward folds whereby,
when said folding sequence is completed, the folded wings comprise
a stack of folds overlying a central portion of said sheet; a part
of said lower portion being folded a plurality of times in a
sequence of folds toward the center of the drape whereby when said
folding sequence is completed, the folded part of said lower
portion comprises a stack of folds overlying said central portion
of said sheet.
26. A surgical drape according to claim 25 wherein each armboard
flap is folded twice, the first fold being a reverse fold and the
second fold being a forward fold; and each of said armboard covers
with its respective overlying armboard flap is forward folded to
provide a substantially rectangular partially folded drape.
27. A surgical drape according to claim 26 wherein said upper
portion is folded five times, the second fold being a reverse fold,
the third fold being a forward fold, and the fourth fold being a
reverse fold.
28. A surgical drape according to claim 27 wherein said part of
said lower portion is folded four times, said first fold being a
reverse fold, said second fold being a forward fold, and said third
fold being a reverse fold.
29. A surgical drape according to claim 28 transversely folded into
a compact unit.
30. A surgical drape according to claim 29 treated to render it
sterile and packaged in said sterile condition.
Description
FIELD OF THE INVENTION
The present invention relates broadly to surgical cover means. In
particular, the invention relates to new and improved surgical
drapes of the type which comprise a flexible sheet having a main
portion and wing portions whose inner edges define a slit or gap
which extends inwardly from an outer edge of the drape. Such drapes
are especially useful in orthopedic surgery and similar surgical
procedures.
In preparing for orthopedic and related surgery it is common
practice to cover the patient and operating table with a sterile
drape, or drapes, in such a way that only the limb (or portions of
the limb) on which surgery is to be performed is presented to the
surgeon and his assistants.
DESCRIPTION OF THE PRIOR ART
One drape that has been provided for orthopedic and similar surgery
comprises a sterile sheet having a main portion and an elongated
gap extending outwardly from a central region thereof to an outer
edge to provide two spaced wing portions. Such drapes are
frequently referred to as "split sheet" drapes.
One draping procedure for using these drapes involves raising the
patient's limb and putting it through the gap in the sheet in such
a way that, when the draping is completed, the limb on which the
operation is to be performed extends through the gap and lies on
the upper surface of the main portion of the drape. The wing
portions of the drape are then disposed to overlie parts of the
patient's body at a region adjacent the operative site.
It is necessary, of course, to insure that a sterile surgical field
be provided at the outset of the surgical procedure and that the
integrity of the sterile field be maintained until the surgical
procedure is completed. In order to establish the sterile field and
to prevent the contamination thereof in the event the wing portions
of the split sheet should slip or be accidentally moved during
surgery, it has been found necessary, prior to placement of the
split sheet, to cover the patient with an auxiliary surgical drape.
The auxiliary drape is placed over that portion of the patient's
body which will underlie the gap in the split sheet when the latter
has been positioned.
In commonly assigned patent application entitled "Surgical Drape",
filed on even date herewith, which patent application is hereby
incorporated by reference, there is disclosed a surgical drape of
the split sheet type in which a flap-like sheet is attached to at
least one of the wing portions of the drape. During surgery, this
flap-like sheet covers the slit or gap in the drape and eliminates
the need for the use of auxiliary drapes, thus reducing the number
of drapes that need to be handled by the operating room staff.
However, such a drape, i.e., a split sheet drape with a flap-like
sheet attached to one of its wing portions, still presents some
difficulties. For example, the wing portions may accidentally slip
relative to one another during surgery; such slipping causes the
drape to undesirably "bunch up" upon itself and indeed, in an
extreme case, the wings could be separated to such an extent that
the patient's body and/or other drapes or the like could be exposed
to contamination. Another difficulty with the drape disclosed in
the aforesaid commonly assigned patent application is that no means
are provided for securing surgical tubing, electrical wires and the
like to the surface of the drape in a position where they would be
prevented from interfering with the surgical procedure at hand, yet
be readily accessible when needed during surgery.
It is therefore an object of the present invention to eliminate
bunching or accidental movement of the wing portions of a split
sheet drape by providing means for securing the wing portions in a
closed, substantially flat position during surgery.
It is another object of the present invention to provide means for
securing items such as surgical tubing and the electrical wires of
monitoring devices to the surface of the drape in a position where
they will be conveniently accessible when needed and yet will not
unduly interfere with the surgical procedure.
SUMMARY OF THE INVENTION
In accordance with the present invention there is provided an
improved surgical drape for use in orthopedic and similar surgery
which eliminates the aforementioned difficulties. The drape of the
present invention simplifies the draping procedure, saves valuable
time, reduces costs, eliminates bunching of the wing portions, and
provides means for securing auxiliary tubing and electrical lines
to the surface of the drape.
The improved drape of the invention comprises a flexible unitary
sheet, suitably of a plastic film or a woven or nonwoven fabric,
having a main portion and two wing portions. The inner edges of the
wing portions define an elongated gap or slit which extends
inwardly of the drape from an outer edge thereof and joins a
fenestration located generally inwardly of the perimeter of the
drape. Attached to one of the wing portions, preferably at the
inner edge thereof adjacent the slit, is a flap-like sheet of
woven, nonwoven, plastic or similar material which, when the drape
is in use, covers a substantial portion of the length of the slit,
and lies beneath the second of the two wing portions.
Means (referred to as clipping means) are provided on the drape for
securing the wings of drape in their desired flat, wrinkle-free
position during surgery. The clipping means, as will be seen
hereinafter, may comprise relatively small tabs of material affixed
in hinge-like fashion to the upper surface of the drape. Prior to
use, the clipping tabs lie flat in a position generally overlying
the upper surface of the drape. During use the tabs are extended
upwardly from the surface of the drape. Adjacent, upwardly
extending tabs are brought into contact with each other and secured
together by any convenient means. Thus secured, the clipping tabs
prevent bunching and/or accidental lateral movement of the wing
portion of the drape.
The surgical drape of the present invention also comprises at least
one tubing holder affixed at a suitable location on the upper
surface of the drape. A tubing holder, as will be seen, is a
relatively small piece of material made from e.g., a nonwoven
fabric or a piece of plastic. The tubing holder must have at least
one opening therein. Surgical tubing, electrical wires or like
materials may be threaded through the tubing holder which then
holds the tubing in its desired position on the surface of the
drape.
BRIEF DESCRIPTION OF THE DRAWINGS
The aforementioned and other advantages of the present invention
will become apparent upon reading the following detailed
description and upon reference to the drawings in which:
FIG. 1 is a top plan view, with portions cut away, of one
embodiment of the surgical drape of the present invention, wherein
the flap-like sheet attached to one wing portion is shown in a
position underlying the second wing portion, and the clipping means
are shown in their flat position overlying the upper surface of the
drape;
FIG. 2 is a cross-sectional view taken along lines 2--2 of FIG.
1;
FIG. 3 is a perspective view of the surgical drape of FIG. 1
showing the flap-like sheet in a folded position overlying the wing
portion to which it is attached;
FIG. 4 is a cross-sectional view taken along line 4--4 of FIG.
3;
FIG. 5 is a perspective view of the surgical drape of FIG. 1
showing the flap-like sheet attached to one wing portion in an
extended position and with the other wing portion turned back to
expose its under surface;
FIG. 6 is a detailed view in perspective of a portion of the drape
of FIG. 1 showing the clipping means in their upwardly extended
position;
FIG. 6a is a cross-sectional view taken along line 6a--6a of FIG.
6;
FIG. 7 is a view similar to FIG. 6 showing the tabs comprising the
clipping means in an off-set position with respect to each
other;
FIG. 7a is a plan view of the tabs in their offset position;
FIG. 7b is an enlarged fragmentary view showing an alternative
placement of one of the tabs comprising the clipping means;
FIG. 7c is an enlarged fragmentary view wherein the clipping means
comprise an elongated tab attached to one of the wings and a
cooperating strip of pressure sensitive adhesive, protected by a
release sheet, attached to the other wing;
FIG. 8 is a top plan view of another embodiment of the surgical
drape of the present invention wherein the fenestration is lined
with a soft elastomeric lining material;
FIG. 8a is a cross-sectional view taken along line 8a--8a of FIG.
8;
FIG. 9 is a top plan view of the surgical drape of FIG. 1 with its
flap-like sheet shown in a folded position on the upper surface of
the drape and showing in broken lines the fold lines for the
longitudinal folding of the drape;
FIG. 10 is an enlarged cross-sectional view taken along line 10--10
of FIG. 9;
FIG. 11 is a perspective view showing the drape of FIG. 9 after the
wing portions have been folded longitudinally;
FIG. 12 is a perspective view showing the drape of FIG. 9 after the
longitudinal folding thereof has been completed;
FIG. 13-17 are perspective views showing the sequence of steps in
draping a patient for leg surgery with the drape of FIGS. 9-11;
FIG. 18 is a plan view, with parts in perspective and with portions
cut away, of another embodiment of the drape of the present
invention wherein the wing portions are extended transversely to
form a T-shaped drape having covers for the armboards of an
operating table;
FIG. 19 is a plan view of the drape of FIG. 18 with the flap-like
sheet folded and overlying the wing portion to which it is attached
and showing one of the armboard flaps in a folded position
overlying the armboard cover to which it is attached;
FIG. 20 is a cross-sectional view taken along line 20--20 of FIG.
19;
FIG. 21 is a plan view of the drape of FIG. 18 with its flap-like
sheet, armboard covers, and armboard flaps in a folded position and
showing the fold lines for completion of the longitudinal folding
of the drape; and
FIG. 22 is an enlarged fragmentary view, with portions cut away, of
the upper left hand portion of the drape of FIG. 18.
DETAILED DESCRIPTION OF THE INVENTION
While the invention will be described in connection with its
preferred embodiments, it will be understood that it is not
intended to limit the invention to those embodiments. On the
contrary, it is intended to cover all alternatives, modifications
and equivalents as may be included within the spirit and scope of
the invention as defined by the appended claims.
Referring more particularly to FIGS. 1-5, which show one embodiment
of the present invention, surgical drape 10 comprises a flexible
sheet 11 made from a single piece of a suitable drapable material
such as a woven or nonwoven fabric or a plastic film. Preferably,
the material is a drapable nonwoven fabric, such as a scrim
reinforced tissue or a wet-formed nonwoven containing long fibers.
Even more preferably, sheet 11 comprises a nonwoven fabric that has
been treated according to known methods to render it liquid
repellent. Flexible sheet 11 comprises a main portion 12 at the
lower end thereof, and a pair of spaced wings 20 and 30 at the
upper end thereof. The perimeter of the drape comprises opposed
side edges 16 and 17 and lower edge 15.
Wing portions 20 and 30 are integral with, and extend outwardly
from, main portion 12. Wing portion 20 has an inner side edge 24
and an upper edge 26. Correspondingly, wing portion 30 has an inner
side edge 34 and an upper edge 36. The upper edges of the wing
portions define the upper edge of the drape.
Drape 10 has a slit 45 which is defined by the adjacent inner edges
of the wing portions and which extends from the upper edge of the
drape inwardly to a generally central portion thereof. The slit has
a first, or open end, which communicates with the outer edge of the
drape. The other end of the slit merges into an enlarged or widened
fenestration 50 which, in the illustrated embodiment, is shaped in
the form of a tear-drop. It will be understood that the precise
configuration of the fenestration is not critical and may be varied
if so desired. The fenestration is located generally inwardly of
the perimeter of the drape but its precise location is not
critical. It is preferred that the fenestration be centered from
sides 16, 17 of the main sheet. The position of the fenestration
with relation to the top and bottom ends of the drape is not
critical. In one commercial embodiment of the drape of FIGS. 1-5,
the main sheet is about 114 inches long, this length being
sufficient, when the drape is in use, to cover both an adult
patient and the anesthesia screen. In this embodiment, fenestration
50 is about 15 inches long, with point 50' on the curved portion
thereof being about five feet from bottom edge 15 of the main
sheet. It will be understood that the above mentioned dimensions
are for purposes of illustration only; these dimensions may be
changed, for example, to provide a drape which is adapted for a
particular kind of surgery or which is tailored to fit a child
about to undergo surgery.
Inner side edge 34 of wing portion 30 carries a flap 40 of drapable
material, which, as illustrated in FIGS. 1 and 2 may be folded
across slit 45 to lie beneath wing portion 20.
Flap 40 has a lower edge 41, an upper edge 42, and side edges 43
and 44. The lower and upper edges of flap 40 are substantially
equal in length and are sufficiently long so that, when the flap is
extended crosswise of the drape to cover slit 45 and lie beneath
wing 20, edge 43 of the flap lies slightly beyond edge 17 of the
main sheet. It will be understood the length of the flap along its
upper and lower edges may vary considerably from the dimensions
shown in FIG. 1. The objects of the present invention are achieved
if flap 40 is long enough along its upper and lower edges to cover
slit 45 and lie beneath at least part of wing 20. Referring
especially to FIG. 1, it is seen that the length of the flap along
side edges 43, 44 is somewhat less than the length of slit 45. Flap
40 extends along inner edge 34 from a point inward of upper edge 36
of wing 30 to a point near where slit 45 merges into fenestration
50.
The particular part of wing 30 to which flap 40 is attached is not
critical, provided, of course, that the flap can be arranged, when
in use, to lie beneath wing 20. Preferably, however, flap-like
sheet 40 is attached to wing 30 at or near its inner side edge 34,
since a minimum amount of material is thus required and unnecessary
bulkiness in the folded drape is eliminated. As illustrated in FIG.
2, flap 40 is fastened, along a narrow line adjacent its side edge
44, to the lower surface of wing 30 a slight distance from its
inner side edge 34. This is conveniently accomplished by stitching
(not shown in the drawings), but other fastening means, such as an
adhesive, may be employed if so desired. Other acceptable ways of
affixing flap 40 to wing 30 are illustrated in the aforementioned
U.S. patent application.
Drape 10 has a reinforcing panel 60 secured to the upper surface of
the main street. In the preferred embodiment, the reinforcing panel
is positioned inwardly of the perimeter of the drape and extend
inwardly to the edges of fenestration 50 and to the edges of a
portion of slit 45. The reinforcing panel may comprise one or more
layers of the same material used for the main sheet. Preferably,
however, the reinforcing panel has an absorbent upper surface 61
and an impervious plastic film 62 between the absorbent surface and
the main sheet of the drape. The reinforcing panel can be secured
to the upper surface of the main sheet by any suitable securing
means well known to those skilled in the art, an adhesive being
preferred, however, over stitching for this purpose. It will be
recognized that the reinforcing panel, which provides increased
abrasion resistance and an absorbent surface in the areas
surrounding the fenestration, need not be used if such qualitites
are not required.
Means (hereinafter referred to as clipping means) are provided on
the upper surface of the drape so that, during actual use, the
wings thereof are maintained in a flat, wrinkle free position and
are prevented from moving laterally with respect to each other. The
clipping means as illustrated in FIGS. 1-5 comprise cooperating,
generally rectangular, flexible tab-like structures 65 that can be
easily fabricated from the same material used for flexible sheet 11
or from any other suitable woven, nonwoven or plastic sheet
material. As best seen in FIG. 2, each tab is secured to the drape
in hinge-like fashion by gluing a part of it between sheet 11 and
impervious layer 62 comprising the reinforcing panel. The remaining
portion of each tab then lies (prior to use of the drape) in a
position overlying absorbent surface 61 of the reinforcing
panel.
Where there is no reinforcing panel, or where the tabs are
positioned beyond the region where slit 45 is bordered by the
reinforcing panel, the tabs would be attached directly to the wing
portions of the drape. As seen in FIGS. 1 and 2, a tab is attached
to each wing portion at the inner edge thereof.
Prior to use, the clipping tabs lie flat on the upper surface of
the drape (See FIG. 1). During use the clipping tabs are extended
upwardly and joined together (see FIGS. 6 and 6a), for example,
with surgical clamps, whereby the wing portions are securely held
in position. It will be recognized that when the clipping tabs are
in their upwardly extended positions, a portion of one tab must be
able to come into contact with at least a portion of the other
clipping tab. In other words, one tab may be offset with respect to
the other (see FIGS. 7 and 7a), but not to such an extent that the
tabs will be unable to come into mutual contact with each
other.
Furthermore, it will be understood that the wing portions of the
drape can be effectively secured during use by placing the
cooperating clipping tabs at any of several positions on the upper
surface of the drape. Preferably, as shown in FIG. 1, the clipping
tabs are attached, one on either side of slit 45, relatively near
the point where slit 45 merges into fenestration 50. This
arrangement is quite advantageous because the clipping means then
serve not only to secure the wings during use but also to draw the
edges of fenestration 50 snugly around a limb protruding through
the fenestration. Thus, the limb is "surrounded" by drape material
and the portion of the limb to be incised is effectively isolated.
Additional sets of cooperating clipping means may be used on the
drape if desired.
Other ways of positioning the clipping tabs to achieve the
aforementioned desirable results will be apparent to those skilled
in the art. For example, one of the tabs 65 may be secured to
flap-like sheet 40 near the inner side edge 34 of wing 30 and the
other tab may be secured to wing 20 near its inner side edge 24
(See FIG. 7b). Similarly, the shape of the exposed portions of the
tabs may be varied, e.g., semi-circular tabs may be used if
desired.
Referring to FIG. 7c, there is illustrated another form of clipping
means that may be used to secure the wings in place during use of
the drape. The clipping means comprise an elongated tab 66 of
flexible material attached to the drape near inner side edge 34 of
wing 30 and a cooperating strip of pressure sensitive adhesive 67
adhered to wing 20 adjacent its inner side edge 24. The pressure
sensitive adhesive is protected prior to use of the drape by a
suitable release sheet 67'. After the wings of the drape have been
positioned on the patient, release sheet 67' is removed, thus
exposing pressure sensitive adhesive 67. Tab 66 may then be folded
across slit 45 and pressed into sealing engagement with the
pressure sensitive adhesive. Thus the wings may be quickly and
conveniently secured in abutting relationship and the edges of the
fenestration can be drawn snugly around the limb protruding
therethrough.
The drape is provided with at least one, and preferably two, tubing
holders 70. The tubing holders are rectangular pieces of a woven or
nonwoven fabric or plastic sheet material, and are typically about
2-6 inches long and 1-3 inches wide. Each tubing holder has a
flexible portion which is free of the rest of the drape and which
has at least one opening therein for securing flexible members such
as surgical tubing, electrical lead wires and the like in position
on the upper surface of the drape (see FIG. 8). In the preferred
embodiment, the tubing holders are attached to the wing portions
adjacent the upper edge of the reinforcing panel and each tubing
holder has two circular openings 71 therein.
FIG. 8 illustrates a modification in which the perimeter of
fenestration 50 is lined with a soft elastomeric film. Film 75 lies
substantially in the major plane of the drape and allows adjustment
and conformation of the fenestration to the limb surrounded by the
drape. The film lining the fenestration can be made from an
elastomeric material such as, for example, synthetic or natural
rubber. As seen in FIG. 8a, film 70 is preferably attached in the
regions adjacent the edges of the fenestration by gluing it in
place between sheet 11 and reinforcing panel 60. It will be
understood that the film lining the fenestration must not interfere
in any way with the continuity of slit 45. As seen in FIG. 8,
opposed edge portions 76 and 77 of film 70 actually define what
might be described as an extended portion of slit 45. Typically,
the film would extend about an inch or two inwardly from the edges
of the fenestration.
FOLDING OF THE DRAPE
Drapes of the present invention may be folded into a compact unit
which facilitates handling during packaging and storage and which
permits the drape to be easily and quickly applied to the patient
prior to surgery.
As used herein a "forward fold" is a fold in which the upper
surface is turned toward the upper surface of the drape around a
fold line. A "reverse fold" is a fold in which the upper surface of
the drape is turned toward the bottom surface of the drape around a
fold line. In the drawings, the letter R indicates a reverse fold
and the letter F indicates a forward fold. The numbers preceding
the letters F and R refer to the order in which the folding is
done.
The preferred method for folding drape 10 from end to end is
illustrated in FIGS. 9-12. As seen in FIGS. 9 and 10, flap 40 is
initially fan-folded to form a stack of folds overlying wing 30.
The folds may be any convenient size and number, but, as
illustrated, the folds are preferably arranged so that edge 43 of
flap 40 lies between the sides of the stack of folds formed by the
flap.
The wings (with flap 40 in folded position overlying flap 30 as
explained above) are folded next.
A part of wing 30 adjacent upper edge 36 thereof is reverse folded
around fold line 1R. Thereafter wing 30 is forward folded around
fold line 2F, reverse folded around fold line 3R, and forward
folded around fold line 4F. It will be observed that fold line 3R
intersects the drape substantially at the point where slit 45
merges into fenestration 50 and that fenestration 50 lies generally
between fold line 3R and fold line 4F. This folding of wing 30
(including its associated flap 40) provides a stack A of folds
which overlies a generally central portion 59 of the drape lying
between fold line 4F and fold line 8F. Wing 20 is then folded in
the manner just described for wing 30 to provide a stack B of folds
which also overlies central portion 59. FIG. 11 shows drape 10
after it has been folded in accordance with the above described
folding procedure. It will be noticed that slit 45 is exposed to
view at the upper central portion of the partially folded
drape.
Main portion 12 of the drape is folded next. Bottom portion 58 is
reverse folded around fold line 5R. The main portion is then
forward folded around fold line 6F, reverse folded around fold line
7R, and forward folded around fold line 8F. This folding sequence
provides a stack C of folds overlying stacks A and B of folds and
results in the elongated, longitudinally folded unit illustrated in
FIG. 14.
Each end of the drape in the elongated, partly folded form shown in
FIG. 14 may then be folded, toward the center, to give a final
compactly folded drape. Although an ordinary fan-fold is suitable
for this purpose, it is preferred that a modified fan fold be used.
The term fan-folded refers to a folding sequence in which the
material being folded has alternate forward and reverse folds. The
term modified fan-fold refers to a folding sequence which is
similar to a fan-fold but in which the first two folds thereof are
of the same type. An example of a modified fan fold sequence is
forward, forward, reverse, forward . . . , etc.
Thus, the transverse folding of the drape as shown in FIG. 14 is
begun from side edge 16 with a forward fold. The second fold is
likewise a forward fold while the third fold is a reverse fold. The
forward and reverse fold sequence may subsequently be repeated
until the desired degree of compactness is obtained. The transverse
folding of the drape from side edge 17 toward the center is
accomplished in the same manner.
In the drape of FIG. 11, the distances between fold lines 1R and
2F, between fold lines 2F and 3R, and between fold lines 3R and 4F
are substantially the same. The distance between the fold lines,
and the resulting number of fabric layers in the folded drape, is
not particularly critical and may be varied according to the degree
of compactness required or desired in the folded drape. In any
event, the distance between fold lines 4F and 8F should be slightly
greater than the distance between any two consecutive fold lines
above fold line 4F or any two fold lines below fold line 8F. This
is so because all the other folds in the drape as finally folded
will lie above that portion of the drape lying between fold lines
8F and 4F.
APPLICATION OF THE DRAPE TO THE PATIENT
Referring now to FIGS. 13-17, there is illustrated in stepwise
fashion a method of applying the drape of FIG. 1, folded as just
described, to a patient about to undergo surgery on the left knee.
FIG. 13 shows drape 10, unfolded from side to side, placed across
the right leg and under the left leg, in the general area of the
patient's knees. The patient's left leg is lifted upwardly and
stack C of folds is unfolded toward the foot of the operating
table. The patient's left leg is then lowered to overlie body
portion 12 of main sheet 11. By virtue of the above step, stacks A
and B of folds are exposed (see FIG. 14).
Wing portion 30 having the flap-like sheet 40 attached thereto
(stack A of folds in the illustration) is then unfolded toward the
top of the operating table. This step exposes flap 40 in its folded
position overlying wing 30 (see FIG. 15). Flap 40 is then unfolded
(as indicated by the arrow in FIG. 15) across the operating table
to overlie the upper portions of the patient's body. Stack B of
folds comprising wing portion 20 is then unfolded, as indicated by
the arrow in FIG. 16, toward the top of the operating table.
Referring to FIG. 17, the entire lower portion of the patient's
body (i.e., the region from the upper chest area to the toes),
except for the left knee and lower portion of the left leg, is
covered by the drape. The lower part of the left leg extends
through fenestration 50 and clipping tabs 65, 65 and tubing holders
70, 70 are exposed on the upper surface of the drape.
The clipping tabs are extended upwardly to a vertical position and
are brought into contact with one another. The clipping tabs are
then held together by any convenient means, such as a surgical
clamp, illustrated in FIG. 6a. The securing of the clipping tabs in
this fashion has two beneficial effects. First, fenestration 50 now
surrounds the patient's leg at a point just above the knee on which
surgery is to be performed. At the same time the wing portions are
prevented from slipping or sliding laterally. The upper surface of
the drape is free from any undesirable wrinkling or bunching and
the tubing holders are available, at the upper portion of the
drape, where they will not interfere with surgery and yet will be
readily accessible when needed. Reinforcing panel 60 is positioned
in the general area where surgery is to be performed and where
increased exposure to abrasion is normally encountered.
Another embodiment of the drape of the present invention is shown
in FIGS. 18-22. Drape 100 is generally T-shaped in construction and
is intended for use with an operating room table having armboards
extending laterally therefrom.
Drape 100 is identical in many of its features to drape 10 and
includes a flexible sheet 11 comprising a main portion 12 and wing
portions 20 and 30. The drape has a flap-like sheet 40 attached to
wing 30; a slit 45 merging into a tear-shaped fenestration 50, a
reinforcing panel 60, clipping means 65, and tubing holders 70.
The upper portions of wing 20 and 30 are extended transversely of
the drape, i.e., beyond side edges 16, 17 of flexible sheet 11 to
provide armboard covers 110, 110'. The armboard covers have side
edges 112, 112' and lower edges 114, 114', respectively. Referring
especially to FIG. 22, transverse cuts 116, 116' are provided in
sheet 11 just below lower edges 110, 110' of the armboard covers.
This construction allows side portions 16a, 17a of flexible sheet
11 in the areas of the drape below cuts 116', 116, respectively, to
fall over the sides of the operating table where they will be in a
generally vertical plane on either side of the table when the drape
is positioned on the patient.
Armboard covers 110, 110' have armboard flaps 120, 120'. The
armboard flaps are pieces of flexible drapable material attached,
preferably with an adhesive, to the armboard covers and wings along
a line, extending inwardly of the drape, which lies just above the
lower edge of the armboard cover and the upper edge of the cut at
the side of the drape. FIG. 22 shows the structural relationship
between armboard cover 110' and its associated armboard flap 120'.
The outer edges 124, 124' of the armboard flaps are generally
coextensive with the outer side edges of the armboard covers, while
the inner side edges 126, 126' thereof extend somewhat inwardly of
the innermost ends of cuts 116, 116', respectively. As a result of
this structural arrangement, the armboard flaps may hang over the
sides of the armboards of the operating table and extend generally
vertically downward when the drape is in place. The various
possible structural relationships of the armboard covers to the
armboard flaps and of the armboard covers and armboard flaps are
discussed and illustrated in commonly assigned U.S. patent
application Ser. No. 384,842, filed Aug. 2, 1973, which patent
application is specifically incorporated herein by reference.
The armboard covers, inasmuch as they are extensions of the wing
portions of the drape, and armboard flaps, are suitably made from
the same material as that used for flexible sheet 11.
FOLDING OF THE DRAPE HAVING EXTENDED WING PORTIONS
FIG. 18 shows a plan view of drape 100, with flap 40 thereof
already in its folded position overlying wing 30. The dot and dash
lines indicate the fold lines for the folding of the drape. As
before, the letter R indicates a reverse fold, the letter F a
forward fold, and the numbers indicate the steps in the folding
sequence. In the figures, the lower surfaces of the drape are
indicated by stippling, and the upper surfaces are left plain.
Flap-like sheet 40 is folded in the manner explained earlier for
the folding flap 40 of drape 10.
The longitudinal foldng of the armboard flaps and armboard covers
is the next step in the folding sequence. The folding of armboard
flap 120' and armboard cover 110' will be taken as illustrative.
Referring to FIG. 18 a portion 128' of armboard flap 120' adjacent
its lower edge is preferably reverse folded around fold line 1R' .
If desired, portion 128 could be forward folded, rather than
reverse folded, around this fold line. The last fold in the
longitudinal folding of the armboard flap must be a forward fold
around fold line 2F'. Fold line 2F' extends inwardly of the drape
from outer side edge 124' of armboard flap 120' and coincides with
lower edge 114' of the armboard cover and the upper edge of
transverse cut 116'. Although usually not necessary, additional
folds may be made in the armboard flap between the above described
first and last folds. It will be apparent that the number and size
of any such intervening folds will depend on the size of the
armboard flap and the degree of compactness required in the finally
folded drape. Too many folds, of course, will undesirably add to
the bulk of the folding portions. Regardless of the number of
intervening folds, if there be any, the last fold given the
armboard flap must be a forward fold so that the armboard flap when
folded, overlies the upper surface of armboard cover 110'. When
this part of the folding sequence is completed, the armboard flap
lies in its folded position on the upper surface of armboard cover
110 in the relationship shown in FIG. 20.
The next step in the folding sequence is to fold armboard cover
110', with its now overlying armboard flap 120', transversely of
the drape. This may be accomplished with any number of folds
starting from outer edge 112' but the last fold must be a forward
fold so that armboard cover 120', when folded, overlies the upper
surface of wing 30. Preferably, armboard cover 110' is forward
folded, without any other folds, around fold line 3F' which
coincides vertically with side edge 16 of sheet 11. When this step
is completed, the armboard flap and armboard cover are in a folded
position overlying the upper surface of wing 30 as may be seen in
the left hand portion of FIG. 21.
Armboard flap 120 and armboard cover 110 are then folded, in the
same fashion as just described for armboard flap 120' and armboard
cover 110', to overlie the upper surface of wing 20. At this
particular stage in the folding sequence, the drape will have
assumed the configuration illustrated in FIG. 21.
The longitudinal folding of drape 100, in the configuration shown
in FIG. 21, is continued by folding each wing a plurality of times
toward the center of the drape.
A portion 130 of wing 20 (with armboard cover 110 and armboard flap
120 folded thereover) adjacent the upper edge of the drape is
forward folded around fold line 4F. The wing is then reverse folded
around fold line 5R, forward folded around fold line 6F, and
reverse folded around fold line 7R. The first fold in folding wing
20, i.e., the folding of portion 130 around fold line 4F, must be a
forward fold, and the last fold in folding the wing, that is, the
fold around fold line 8F, must be a forward fold. Thus, when
folded, wing 20 lies on the upper surface of a generally central
portion 135 of the drape. Although three folds, a reverse fold
(5R), a forward fold (6F) and a reverse fold (7R) are illustrated
in FIG. 21, it will be understood that the number of folds given
wing 20 intermediate the first and last fold may vary, if the size
of the drape, for example, should so require.
Wing 30, with its armboard cover 110' and armboard flap 120' in
their aforementioned folded position, is subsequently folded in the
same way just described for wing 20 with its overlying armboard and
armboard cover.
The wings, when their folding has been completed, overlie the upper
surface of a generally central portion 135 of the drape lying
between fold lines 8F and 12F. Also it will be noticed that the
enlarged fenestration 50 preferably lies entirely within portion
134 of the drape. As seen in FIG. 21, the fenestration lies between
that central portion of the drape between the last fold line (i.e.,
fold line 8F) and the next to the last fold line (i.e., fold line
7R) used in folding the wing portions of the drape. The wing
portions may be folded along a line that runs transversely through
fenestration 50, but this is disadvantageous to the extent that the
material at either side of the fenestration will be creased.
The longitudinal folding of the drape is completed by folding part
of main portion 12 a plurality of times toward the center of the
drape. A portion 139 adjacent the bottom edge of main portion 12 of
the drape is reverse folded around fold line 9R; the main portion
is then forward folded around fold line 10F, reverse folded around
fold line 11R, and forward folded around fold line 12F. The number
of folds used for the main portion may vary, but the last fold must
be a forward fold so that the folded part of the main portion
overlies the same central portion 135 as do the folded wings. Drape
100, when thus folded, assumes the general configuration shown for
drape 10 in FIG. 12. In the preferred folding sequence, the folded
part of the main portion of the drape overlies the folded wing
portions and central portion 135 of the drape.
The size of the various longitudinal portions 130-139 of the drape
will vary according to the length of the drape and according to the
number of folds that are made. In the preferred embodiment under
discussion, portion 135 (that portion of the drape on top of which
the folded wings and the folded main portion will lie) has the
longest length (i.e., vertical dimension in FIG. 21). The lengths
of portions 131, 132, 133, 134, 136, 137 and 138 are roughly
equivalent to each other and are somewhat, e.g., a half inch, less
than the length of portion 135. Portions 130 and 139 at either end
of the drape are about 1/4 the length of portion 131-134 and
136-138.
After T-shaped drape 100 has been folded longitudinally in the
manner just described, it may be folded transversely, from each
side toward the center, using the modified fan folding described
earlier herein for drape 10. This provides a compactly folded drape
which can be conveniently packaged e.g., in a paper bag. The
packaged drape may be sterilized according to well known
techniques.
In applying drape 100 to a patient about to undergo knee surgery,
the procedure described herein for the application of drape 10
(illustrated in FIGS. 13-17) is used. After main portion 12, wing
30, flap-like sheet 40, and wing 20 have been unfolded and secured
in place in the manner already described for drape 10, armboard
covers 110 and 110' are unfolded outwardly to cover the armboards
on the operating table. Thereafter armboard flaps 120 and 120' are
unfolded to lie in their vertically downward position. Side
portions 16a and 17a are then free to fall over the sides of the
operating table in their vertically downward position.
It will be understood and recognized by those skilled in the art
that the folding sequence described above for drape 100 need not be
limited to that specific drape, but can be used for various kinds
of generally T-shaped drapes. Thus, for example, surgical drapes of
the kind described in the aforementioned U.S. patent application
Ser. No. 384,842 may be advantageously folded using the procedure
described herein for drape 100.
* * * * *