Surgery: splint – brace – or bandage – Bandage structure – Support covering
Reexamination Certificate
2000-06-23
2001-08-07
Yu, Mickey (Department: 3764)
Surgery: splint, brace, or bandage
Bandage structure
Support covering
C602S060000, C602S067000, C602S075000, C128S096100, C128S099100, C128S100100, C450S140000, C002S401000
Reexamination Certificate
active
06270469
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention is an improvement in medical support garments. More specifically the present invention is a postoperative support binder for patient use after abdominal surgery to control pain, edema and infection, whereby postoperative complications are reduced and recovery time and postoperative mobility of patients is improved.
2. Background of the Prior Art
Patients who have undergone aesthetic or reconstructive surgery of the abdomen, genitals or pelvis are likely candidates for some form of complications during the recovery period. Typical complications are atelectasis, hypostatic pneumonia, phlebitis and pulmonary complications. Clinical evidence indicates that 20 to 40 percent of patients will experience pulmonary complications (Bartlett, Robert H. et al., Respiratory Maneuvers to Prevent Post-Operative Pulmonary Complications, JAMA, Vol. 224, No. 7, (1973). Thus it is important that the rehabilitation program encourage and develop the return of respiratory efficiency.
Early ambulation is a key factor in helping the patient reestablish his normal physiology and preventing or minimizing postoperative complications. Ambulation hastens muscle redevelopment, wound healing (Brunner, Lillian Sholtis, et al., The Textbook of Medical Surgical Nursing (Second Edition, Lippincott, Philadelphia, 1978) p. 134.) and the return of vital lung capacity (Ali, J. and Khan, T. A., The Comparative Effects of Muscle Transection and Median Upper Abdominal Incision on Post Operative Pulmonary Function, Surgery, Gynecology & Obstetrics, Vol. 148, No. 6, (1979)).
The prior art teaches the use of binders or girdles that use the elastic properties of fiber to provide abdominal support, such as U.S. Pat. No. 5,571,039, issued to Ford in 1994. This abdominal support comprises a plurality of webs having therein elastic fibers, said web forming the girdle that fits around at least a portion of the abdomen, hips and buttocks of the patient. Another example is the waist support and hip girdle taught by U.S. Pat. No. 3,783,879 issued to Stalder in 1971, which teaches use of a knitted elastic fabric with an open mesh.
The best prior art known to the present inventor is the commercial postoperative binders sold by the Veronique Compression Wear company of San Leandro, Calif.; and the Dale® Abdominal Binder, sold by Dale Medical. All of the prior art known to the inventor depends primarily on the elastic properties of the material forming the binder to provide the compression. The use of such postoperative compression clothing is a well-established medical practice. Abdominal binders have been assigned Medicare/Medicaid reimbursement codes L0960 or A4465.
The prior art has a problem. The prior art uses the stretch of an elastic fiber to provide compression, the garments tend to roll, ‘rope’ or bunch up. Also elastic force is insufficient to control edema. They provide the least pressure where there is swelling, as elastic conforms to the body shape of the patient.
BRIEF DESCRIPTION OF THE INVENTION
The present invention is a postoperative binder made of relatively inelastic material that is cut to fit the patient and held in place by Velcro®. The present invention uses mechanical, rather than elastic, compression in this relatively inelastic material. Mechanical loads are carried near or on the hip joint, either by physically hooking the binder over the hips or attaching it to an elastic band that rides on or above the patient's hips. The present invention provides greater mechanical support to lower abdominal tissue, especially near genitals and in the area of the peritoneum, than is possible using prior art elastic binders. This solves the problem of fluid tissue water retention and long healing times that are not answered by existing designs.
The invention's special industrial utility comprises:
a. Obesity surgery: male or female
b. Postoperative wound care: especially for diabetic, immune compromised (AIDS) or vascular insufficiency.
c. Military wounds/trauma: especially crushing injury, blast injury, gun shot, blunt trauma (car wreck), military field stabilization to control bleeding in lower abdomen and/or upper portion of lower extremities.
d. Penile surgery: penile augmentation, penile amputation (cancer); penile reconstruction.
e. Vaginal delivery, caesarian section wounds.
f. General surgery: hernia repair, abdominal and/or rectal cancer resection, orthopedic surgery, total hip replacement (support for rotary abductor box); hip nailing.
g. Hyperbaric care: scrotal lymph edema, section wounds in obese patients or those who are immune or vascularly compromised; difficult wound healing.
h. Sex change surgery
For the state of the art please see:
1. Weiss, E. B., Dale Combo Abdominal Binders—A Study in a Post-Operative Setting, (Independent clinical study conducted at St. Vincent's Hospital, Worcester, Mass. Date available on request.)
2. Khan, T. A., Serrette, C., and Ali, J., The Effect of Abdominal Binders on Postoperative Pulmonary Function, Infections in Surgery, Vol. 2., No.1 L pp. 875-881, November 1983.
3. Finn, Kathleen, How's Your Post-Op Ambulation Technique? R.N., Vol. 42, page 9.
Abdominal Surgery in General
After open abdominal surgery, the patient may avoid the very activities that can help restore normal pulmonary function and muscle redevelopment. These activities are deep breathing, coughing, and ambulation. To the patient even the thought of sitting up or getting out of bed may seem forbidding and coughing can be a frightening experience. Under these circumstances, the patient needs instruction and direct physical assistance in splinting coughs, maneuvering in and out of bed, breathing, and walking erect.
Patients with abdominal incisions tend to hunch over in an attempt to splint the wound, and need frequent reminders to straighten up. It may help to explain that good posture promotes healing by exerting just enough tension on abdominal muscles to strengthen them without disrupting the wound. Slouching, on the other hand, throws the patient off balance, discourages deep breathing, and strains back muscles.
Frequently, when a patient wakes up in recovery he inadvertently coughs and immediately discovers how painful the wound is. Thereafter, the patient may intentionally or subconsciously suppress future coughs in order to minimize the painful experience. This is of course counter to the prescribed necessity of initiating deep breathing, coughing and ambulation. The nurse in the unit may teach the patient how to splint the wound with a pillow to lessen the pain. But often, when the nurse leaves, the patient puts down the pillow and fails to continue his or her instructions. Application of the binder allows the patient to perform required breathing and other activities in a manner that is more comfortable, less painful and without supervision.
The present invention helps to overcome the patient's reluctance to engage in therapeutic activities. The present invention used with Velcro® fasteners is more effective and easier to apply than the many-tailed scultetus binder that fastened with safety pins.
Gall Bladder Surgery
Patients recovering from traditional gall bladder surgery are especially prone to pulmonary complications as are all patients with upper abdominal incisions. It is recommended that these postoperative patients be gotten out of bed as soon as possible to prevent pulmonary complications. The present invention can insure greater comfort while aiding and encouraging coughing and deep breathing.
Bariatric Procedures
In surgical treatments of the morbidly obese such as vertical banded gastroplasty or gastric resection, an abdominal binder has many applications for the patient in the early postoperative period. It lessens the danger of pulmonary complications by encouraging deep breathing and coughing and helps to counteract the patient's natural tendency toward shallow breathing. The present invention makes it easier for the patient to move and turn comfortably. It allows earlier ambulat
Dula Arthur M.
Hamilton Lalita M
Yu Mickey
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