Surgical dressings

The invention relates to a surgical dressing for use in closing incisions while healing, comprising at least two strips (2, 16) of adhesive plaster each adapted to lie alongside but slightly spaced from lengthwise extending edges of the wound, each plaster strip having secured therein at spaced intervals along its length end portions of a plurality of threads (4, 20) or filaments, each thread or filament of one adhesive strip being adapted in use to co-operate under tension with at least one thread or filament of an adhesive strip on the opposite side of the wound to draw the edges of the wound together, the length of the thread (.varies., 20) or filament extending from each strip (2, 16) being greater than the width of the strip itself. The threads may either have free ends which may be tied or may be secured in a second plaster strip 22 which adheres to the skin at a region farther away from the wound.

BACKGROUND OF INVENTION 
The invention is concerned with improvements in or relating to surgical 
dressings, particularly surgical dressings for use in maintaining elongate 
slit-type wounds in a closed condition while healing takes place. 
While slit wounds are commonly the result of surgery, it is intended that 
the term wound as used in this specification shall also cover any 
accidental wound of this kind which may have been inflicted by contact 
with a relatively sharp edge. 
Although various attempts have been made to close this type of wound by 
surgical dressings, by far the most common method of closing is by 
suturing, that is the insertion of stitches which bridge the wound. This 
suturing process is painful, often requiring extended periods during which 
the patient is anaesthetised, often produces an inflamatory reaction and 
tends to leave unsightly scars, both from the stitch holes themselves and 
from the varying tension applied to the wound between the suturing points 
themselves and at intervening spaces. Moreover, a return visit to hospital 
is often necessary for the removal of stitches, whereas a surgical 
dressing may be readily removed by a nurse or the patient himself. 
BRIEF DESCRIPTION OF INVENTION 
It is therefore an object of the invention to provide an improved surgical 
dressing for use as an acceptable alternative to conventional suturing 
techniques. 
The invention therefore provides a surgical dressing for use to maintain 
elongate slit-type wounds in a closed condition comprising at least two 
strips of adhesive plaster each adapted to lie alongside but slightly 
spaced from lengthwise extending edges of the wound, each plaster strip 
having secured therein at spaced intervals along its length end portions 
of a plurality of threads or filaments, each thread or filament of one 
adhesive strip being adapted in use to co-operate under tension with at 
least one thread or filament of an adhesive strip on the opposite side of 
the wound to draw the edges of the wound together, the length of the 
thread or filament extending from each strip being greater than the width 
of the strip itself. 
It is important that the strips of adhesive plaster, by which is meant 
lengths of fabric or other material adapted to temporarily adhere to skin 
by means of a pressure-sensitive adhesive layer, are spaced slightly away 
from the wound so that the adhesion of the strips and therefore the 
tension of the threads or filaments is not diminished by the effect of 
seepage from the wound. Moreover, the progress of the healing of the wound 
may be readily inspected without disturbing the dressing. 
In one of the examples of the invention to be described hereinafter, the 
dressing comprises two strips, each thread or filament extending from a 
first of the two strips having a free end suitable for tying with the free 
end of an appropriate thread or filament extending from a further strip 
situated on the opposite side of the wound. In this case, a method of 
applying the dressing to a wound includes the step of tying each thread or 
filament of the first strip to an appropriate thread or filament of the 
further strip with selected tension so as to draw the edges of the wound 
together progressively as each pair of threads or filaments are tied 
together with a tension appropriate to the requirements of the wound in 
the region of each tied pair of threads or filaments. 
In another example of the invention, each thread or filament extending from 
a first of the strips is secured at its opposite end portion to a second 
of the strips to form a pair of first and second strips, one pair of first 
and second strips being associated with a second pair of first and second 
strips by the interlacing of the threads or filaments in an alternate 
manner. 
A method of applying this example of a dressing according to the invention 
includes the step of applying tension to the interlaced threads or 
filaments by pulling upon said second strips thereby causing the first 
strips to move slightly together to close the wound, tension in the 
interlacing threads or filaments being maintained by causing the second 
strips of each pair of strips to adhere to the patient's skin at regions 
beyond the adhered first strips, so that each thread or filament spans the 
wound and completely traverses the first strip of the other pair of 
strips. 
The strips may be rectangular in shape and therefore suitable for use with 
straightline wounds but many surgical incisions are curved to some extent 
and therefore the shape of the strips may be curved or otherwise 
non-rectilinear to permit use with variously shaped wounds.

DETAILED DESCRIPTION OF THE DRAWINGS 
FIG. 1 shows a surgical dressing comprising two strips of adhesive plaster 
2, each strip being provided with a plurality, in the present example, 
five, of threads 4 extending from a lengthwise edge thereof. After removal 
of a conventional protective layer from the adhesive surface, each strip 
is positioned on an area of skin alongside but spaced from a gaping, 
elongate wound 6, the skin being already rendered sterile and having been 
shaved if necessary. 
The fixing of the threads 4 to the strips must be strong and may be secured 
by trapping end portions 8 of the threads 4 between two superimposed strip 
portions 10 as shown in FIG. 2 or between a folded strip member 12 as 
shown in FIG. 3. The length of the threads 4 is approximately three times 
the width of the strips 2. 
The threads 4 are then subjected to tension in turn by pulling one thread 4 
from one strip 8 together with the corresponding thread from the opposite 
strip. When sufficient tension has been applied to close the wound edges 
together the threads are then tied in a firm knot 14. This action of 
pulling and tying is repeated with each succeeding pair of threads until 
the entire wound is closed. 
FIG. 5 shows the second example of the invention which comprises two first 
strips 16 which are arranged alongside but spaced from a wound 18 in a 
manner similar to that in which the strips 2 are placed in the first 
example. Threads 20 are provided, five for each strip 16; however, in this 
example the remote ends of the threads are not free, but are secured in 
one of two second strips 22. The length of each thread 20 is twice the 
width of the strips 16. 
In applying the dressing, once the strips 16 have been positioned, the 
strips 22 will be grasped as shown in FIG. 6 so that tension is applied to 
the interlaced threads 20 by pulling in opposite directions. When 
sufficient tension has been produced to pull the edges of the wound 18 
together, the strips 22 will be brought into contact with the patient's 
skin and caused to adhere firmly thereto. It will be appreciated that the 
length of the threads is selected such that there is no overlapping of the 
first and second strips, each thread from each strip 16 spanning the 
closed wound and completely traversing the strip 16 on the opposite side. 
The manner in which the dressings achieve the desired action is illustrated 
in FIGS. 7 to 10. 
It will be understood that a wound tends to gape as shown in FIG. 7 because 
of tension forces A, B in the surrounding tissue 24. These forces must be 
matched by equal and opposite forces applied through the plaster strips 
and threads. Thus, in FIG. 8, for the sake of illustration, one strip 16 
has been positioned adjacent the wound edge and a pulling force is being 
applied (arrows C) to the strip 22 to equal and overcome the force of 
tension at B. Similar pulling force on the other strip 22 (see FIG. 9) 
results in the wound being closed. The strips 22 are then pressed into 
place (D) to maintain the tension in the threads 20. Thus the adhesion 
strength of the strips 16, 22 must at least equal and preferably be 
greater than the tension forces A and B. 
It will be understood that in practice pulling forces are exerted by both 
strips 22 at the same time, with individual variation and adjustment as 
deemed appropriate by the practitioner. 
It is essential that the materials selected for the manufacture of the 
surgical dressing described herein are capable of sterilisation by 
conventional methods such as ionising radiation and should be packed in a 
sealed sterile envelope. 
Various modifications may be made within the scope of the invention as 
defined in the following claims.