Package of strung medical sponges

A package of strung medical sponges, particularly neurosurgical sponges comprising a plurality of sponges releasably held on a planar member such as a card which is self-supporting and suitable for grasping in one's hand. The strings of the sponges are threaded upon the card in a manner that permits the ready removal of the sponges one by one and which captures the tails of the strings to provided a neat and efficient package.

FIELD OF THE INVENTION 
This invention relates to the packaging of surgical sponges for 
presentation in the course of surgery, and particularly is directed to the 
packaging of strung medical sponges of the neurosurgical class. 
BACKGROUND OF THE INVENTION 
Medical sponges, and in particularly neurological sponges, commonly 
comprise a fibrous web, the fibers of which may be cotton, rayon, 
polyester or other synthetic or a combination of these. The fibers are 
bonded one to another by mechanical and/or chemical bonds, either with or 
without bonding additives. Neurological sponges, generally are of two 
types, strung and unstrung. In the strung sponges the absorbent web 
commonly is relatively small, ranging from about 1/4 inch square upwards. 
Most such sponges are less than about 3 inches in length and about 3 
inches wide. The webs commonly are of about 1/32 inch thick. The strung 
sponges have attached thereto one or two strings, commonly a textile 
thread having one of its ends anchored to the web and the remainder of the 
string extending from the web to serve as a locator element. The unstrung 
sponges most often are larger than the strung sponges, ranging up to 6 
inches in length and 3.5 inches in width. These sponges have no depending 
string attached thereto. 
Neurological sponges are employed for absorbing blood and body fluids, but 
most frequently are saturated with saline or other solution and used to 
protect tissue or applied to the tip of a suction device for protecting 
the tissue when suction is applied. 
In the course of a surgical procedure, the medical sponges are sterilized 
and supplied to the operating room table in units of 10 and are carefully 
counted after use. Because absorbent sponges very closely resemble tissue 
when the sponge is soaked with blood, it is at times difficult to 
distinguish the small blood-soaked sponge from the surrounding body 
tissue. Thus, it is common practice to attach to the sponge a locator 
string, commonly about 12 inches in length, of a textile material, for 
example, such string being kept at all times outside the surgical incision 
so that the presence of the sponge may be readily noted through observing 
the string. These sponges further are provided with a separate and 
distinct x-ray opaque element fixed to the sponge in a manner as prevents 
its dislodgement. In the event the count of the sponges following the 
surgery indicates that one or more of the sponges is missing and a search 
of the operating room fails to locate the missing sponge, while the 
patient is still in the operating room, a portable x-ray unit may be 
brought in and the surgical site x-rayed in an attempt to determine 
whether the sponge has been left inside the patient. 
One of the major problems in the prior art packaging of medical sponges, 
particularly neurosurgical sponges, has been the ability to present the 
sponges individually. The problem of presenting these sponges is 
compounded by the presence of the long locator strings that are attached 
to the relatively small pads. Heretofore it has been proposed to mount the 
small sponges on a card with a string from the sponge passing through a 
slit, thence along one face of the card to engage one or more slits or 
slots until substantially the entire length of the string has been "wound" 
onto the card. These prior art packages have been difficult to grasp in 
the user's hand while attempting to remove one of the sponges, either the 
pad portion of the sponge or the string being disposed on the card in a 
position such that when the user grasps the card, the fingers of the hand 
contact either the string or the sponge thereby presenting opportunity for 
compromising the sterility of the sponge. Further, the slits or slots 
provided in the prior art cards are of a nature and/or location on the 
card that develops substantial and inordinate friction between the string 
and the card as the string is withdrawn through the slit. This friction 
may result in disengagement between the sponge and the string thereby 
rendering the sponge non-usable. Even though the friction may not be so 
great as to cause the pad to break away from its string, the force 
required between the pad and forceps in withdrawing the string from the 
slits is sufficiently great to dislodge fibers of the pad or even to tear 
the pad. Still further, the withdrawal of the strings from the slits or 
slots in the prior art cards is further compounded where the angle of 
direction change of the string as the string is wound onto the card is 
substantially acute, thereby increasing the friction between the string 
and the slit or slot as the string is pulled from the packaging. A further 
problem with the prior art devices is that the tail ends of the strings of 
the several sponges in the package are not anchored and tend to become 
entangled one with another and/or become entangled with other objects 
employed in the surgery; such as, forceps, retractors, etc. 
In my copending application entitled SURGICAL SPONGE, there is disclosed a 
novel locator string for neurological sponges which application is 
incorporated herein by reference. My novel locator string comprises a 
plurality, e.g. 20 or more, monofilaments bundled together and helically 
wrapped with a yarn. This locator string is particularly sensitive to the 
friction encountered when withdrawing the string from the slits or slots 
of the prior art sponge packaging in that such friction can fray my new 
locator string under certain conditions. Further, my new locator string is 
slightly greater in cross-sectional area than the prior art textile 
strings thereby making it more difficult to withdraw from the prior art 
packaging. 
In the prior art it has also been suggested that several, e.g. ten, sponges 
be arranged in a stack in or on the packaging. This arrangement has 
resulted in unacceptable entanglement of the strings in the immediate 
vicinity of the sponge pads so that withdrawal of a single sponge is 
further complicated. 
It is therefore an object of the present invention to provide a package of 
strung medical sponges in which the several sponges are mounted 
individually in the packaging for ready withdrawal at the time of their 
use. It is another object of the present invention to provide a package of 
medical sponges in which the friction between the string and packaging is 
minimized. It is another object to provide a package of strung medical 
sponges which is readily sterilizable with either steam, radiation, or 
ethylene oxide gas. 
SUMMARY OF THE INVENTION 
In accordance with the present invention there is provided a package of 
strung medical sponges comprising a plurality of such sponges releasably 
held on a planar member such as a relatively stiff, self-supporting card. 
In one embodiment the card is of rectangular geometry with one of its ends 
having defined therein openings that pass through the thickness of the 
card and which are of a geometry and size sufficient to receive 
therethrough one of the strings of a strung sponge. Preferably this 
opening includes a slit that extends from the opening and opens outwardly 
of a first end of the card. A string is passed through such opening and 
caused to overlie the second, i.e. reverse, surface of the card and extend 
to and be received in a slot that opens outwardly of the right hand edge 
of the card, as the card is held in one's hand with the first major 
surface of the card facing the viewer. This first slot is of a geometry 
and size that is substantially greater than the cumulative cross-sectional 
area of all strings of all sponges received on the card. The strings are 
then caused to overly the face of the card and pass diagonally thereacross 
to engage a second slot in the left hand edge side margin of the card. The 
second slot is generally like the first slot and substantially a mirror 
image thereof. The strings passing through the second slot are then caused 
to overlie the reverse surface of the card with the tail of the strings 
being captured in a capture zone defined by a flap that is provided on the 
bottom margin of the card. As viewed in the manner described hereinabove, 
such flap is adapted to be folded back upon the reverse surface of the 
card to define such capture zone. In a preferred embodiment, the flap is 
of a dimension sufficient that it covers at least the closed end of the 
second slot to aid in retaining the strings that pass through such slot. 
Further, the flap may be provided with means such as a tab which is 
receivable in a further slot through the thickness of the card such that 
when the tab is received in such further slot, the flap is maintained in 
its folded position, thereby retaining the tails of the several strings in 
the capture zone defined between the flap and the back surface of the card 
.

DETAILED DESCRIPTION OF THE INVENTION 
With specific reference to the figures, in FIG. 1 there is depicted one 
embodiment of a planar member 10 which in the preferred embodiment 
comprises a rectangular section of cardboard. The planar member 10 
includes a first end margin 12, a second end margin 14, these end margins 
being connected by a first side margin 16 and a second side margin 18. The 
planar member, i.e., card 10, is sufficiently stiff as to be 
self-supporting and to be readily grasped in the hand 20 by placing the 
user's fingers on a first major surface 26 comprising the reverse surface 
of the card as depicted in FIG. 1, along the second side margin 18, and by 
positioning the thumb on a second major surface 28, i.e. face, of the 
planar member to thereby grasp the second side margin of the card between 
the thumb and fingers. It is important to note in this respect that the 
present package provides ample room for the thumb and fingers of the user 
without engaging the string or pad portion of the sponges held on the card 
as will appear more fully hereinafter. Furthermore, the card is of 
sufficient stiffness as to resist substantial bending when grasped between 
the thumb and fingers as described. The card preferably is of a cellulose 
fiber composition, but may be of other materials such as a polymeric 
material. In the latter instance, the material may be of a foam or 
cellular construction or of a relatively more solid construction. 
In a preferred embodiment, the card has a width dimension between the first 
and second side margins of preferably about 5". The card has an end-to-end 
dimension of about 7" including an additional length of about 11/4" which 
defines a flap 30. The thickness of the cardboard is not critical but 
preferably is relatively thin, e.g., less than about 1/64". 
The first end margin 12 of the card 10 is provided with a plurality of 
openings 32 that extend through the thickness of the card. Notably these 
openings are of a geometry, e.g. preferably round, and a size that is 
sufficient to permit the ready passage of a string 74 therethrough without 
substantial frictional drag upon the string. In the depicted embodiment 
each of the openings 32 includes means defining a slit 34 extending from 
the opening 32 and opening outwardly at 36 of the first end margin 12. 
Still further, in the preferred embodiment the opening 36 to the slit 34 
is preferably flared as indicated by the arrow 38 to provide guidance for 
moving the string 74 through the slit 34 and into the opening 32. In the 
preferred embodiment, there are ten openings 32 aligned substantially 
parallel to and across the width dimension of the first end margin 12 
adjacent its edge 37. Preferably each of the openings 32 has associated 
therewith a numerical indicia for identifying the respective openings. 
As seen in FIG. 1, there is a first slot 40 defined along the first side 
margin 16 of the card 10 and extends from its closed end 42 to open 
outwardly at 44 of the first side margin 16. In the depicted and preferred 
embodiment, this slot is located approximately equidistant between the 
first and second end margins 12 and 14. This slot is substantially larger 
in size than is required to receive ten of the strings 74 therein, thereby 
affording free movement of the strings into and out of the slot and/or 
sliding movement of the strings through the slot in the direction of the 
thickness of the planar member 10. Further, the preferred positioning of 
the first slot 40 provides for clearance for larger sponges mounted on the 
face 28 of the card without interfering with the winding of their strings 
on the card as described herein. 
A second slot 46 is defined in the second side margin 18 of the card 10 
with its closed end 48 directed inwardly of the card 10 and opening 
outwardly as at 50 of the second side margin 18. Like slot 40, slot 46 is 
of a size and geometry that permits ready access and removal of at least 
ten of the strings 74 through the slot without undue friction between the 
slot and the string. As shown in FIG. 1, in the preferred embodiment, the 
second slot 46 is disposed approximately two-thirds of the distance 
between the first and second end margins 12 and 14 and nearer the second 
end margin 14 than the location of slot 40. In a preferred embodiment, the 
second slot is located a linear distance from the edge 37 of the first end 
margin 12 of about 31/2 inches thereby providing adequate room to receive 
the user's fingers 22 and thumb 24 without contacting either the pad or 
the string. For similar reasons, and others the preferred width dimension 
is not less than about 2 inches. 
The second end margin 14 of the planar member 10 includes a flap 52 which 
is foldable along a fold line 54 against the reverse surface 26 of the 
planar member 10 to define a capture zone 56 between the surface 26 and 
the flap 52 for the ends 58 of the strings 74 therebetween. In the 
depicted embodiment, the flap includes a tab 60 which is adapted to be 
received within a third slot 62 which extends through the thickness of the 
planar member 10 for maintaining the flap in the folded position. 
Notably, the flap 52 is of a dimension such that it includes a portion 30 
which overlies the closed end 48 of the second slot 46 and serves to 
capture the string 74 between the surface 64 of the flap 52 and the 
surface 26 of the planar member 10 at the location where the string passes 
through the slot 46, thereby enhancing the retention of the string within 
the slot against inadvertent falling out of the string, while not 
materially impeding the withdrawal of the string as the sponge is 
withdrawn from the card. 
A plurality of strung medical sponges 70 are mounted on the card 10, such 
sponges being disposed in overlying relationship to the surface (face) 28 
of the planar member 10 in the region of the first end margin 12. Only two 
sponges 70 and 72 are depicted in FIG. 1 for purposes of clarity but it 
will be recognized that the package normally includes ten such strung 
sponges. Each of the sponges 70 and 72 includes a string member 74 and 76 
respectively. For purposes of clarity of description only, the positioning 
of the sponge 70 on the card 10 will be described, it being understood 
that the remaining sponges are similarly mounted in the package. 
Specifically, and with reference to FIG. 1, the string 74 of the sponge 70 
is passed through the slit 34 and into the opening 32 to position the pad 
80 of the sponge 70 in overlying relationship to the surface 28 and in a 
location close to the opening 32. Preferably, the sponge is substantially 
in contact with the margin of the opening 32 to limit its ability to move 
about relative to the opening 32 and/or the surface 28. As shown, the 
string 74 is caused to overlie the reverse surface 26 of the planar member 
10 in a substantially straight line between the opening 32 and the closed 
end 42 of the slot 40, and enter into the slot 40, thence passing through 
the thickness of the card 10 and extend in a substantially straight line 
in overlying relationship to the surface 28 to enter the slot 46 and cause 
the tail 58 of the string 74 to pass through the thickness of the card 10 
and enter the capture zone 56 defined by the flap 52. Each of the other 
sponges and their respective strings are similarly threaded upon the card 
10 with the respective tails of the strings being contained and captured 
within the capture zone 56 so that these tails do not hang loose from the 
card to engage or become entangled with external objects. Further, the 
capturing of the tails in the capture zone maintains the tails against 
entanglement one with another so that these strings can be readily 
withdrawn individually from the capture zone. 
In use, a surgeon or assistant grasps the card 10, as in their left hand. A 
sponge 70 commonly is withdrawn from the package by grasping it with 
forceps or the like and pulling on the sponge in a direction substantially 
perpendicular to the surface 28. As the sponge is pulled away from the 
surface 28, its string 74 is pulled through the slot 46, the slot 40, and 
the opening 32. It will be recognized that the size of the opening 32 and 
the relatively large size of the slots 40 and 46 permit substantially 
uninhibited movement of the string through these openings. Further, it is 
noted that as the string is threaded through the several openings and/or 
slots, the angle of directional change of the string at no time is an 
acute angle, but such directional change is of a substantial angle, e.g. 
at least about 90.degree. or greater. This is important in reducing the 
friction exerted between the string and the card 10 at the points of 
directional change, for example at the slots 40 and 46 in particular.