Wound drainage system with anti-spill device

Abstract: In a wound drainage system, blood, water and other body fluids withdrawn from a patient enter a collection chamber (303) through a port (310). A conduit (323) for carrying collected fluids in excess of the capacity of the chamber (303) to a further collection chamber (305) extends from a wall (311) dividing the chambers (303,305) into the chamber (303). The lowermost entrance portion of the conduit (323) is arranged on an imaginary vertical line extending through the centre of gravity of the chamber (303); preferably at a distance d from the uppermost wall (317) defining the chamber (303) where d is given by the formula w/(2 tan ϑ), w being the distance between the closest [at the level of the lowermost entrance portion (333)] of the walls (309,311,319,321) defining the chamber (303) and 90-ϑ being the maximum angle of rotation about an axis perpendicular to the imaginary vertical axis before spillage occurs. This arrangement will minimise overspill, prior to full capacity caused by tilting the collection chamber (303).

Description: The invention relates to an apparatus for draining fluids from a portion of a patient's body, typically his chest cavity. The fluids drained from the body are collected in a collection chamber, and the invention is particularly concerned with reducing the likelihood of the collected fluids spilling from the collection chamber into other chambers in the apparatus. This Application is divided from our European Patent Application No. 85904212.9. US 4296748 describes an apparatus for draining fluids from the pleural cavity of a patient. The apparatus has a plurality of collection chambers arranged to be filled successively. Between each chamber there is a passageway which is closed by a polyvinyl alcohol film seal. As each chamber fills, the fluid level reaches the level of the seal which closes the passageway to the next chamber, and dissolves the seal so opening the passageway. If such an apparatus should be tilted, shaken or dropped, it is possible that the fluids may dissolve one or more of the film seals prematurely, allowing spillage of the fluids from one chamber to another. The invention provides apparatus (1) for draining fluids from a portion of a patient's body, the apparatus comprising a container (303,305,307) for receiving the body fluids, the container (303,305,307) including a first collection chamber (303) including an entrance port (310) for admitting the body fluids to the chamber (303) and a second collection chamber (305) for receiving overflow body fluids from the first collection chamber (303) when the latter is full, the first and second collection chambers (303,305) being divided by a wall (311), CHARACTERISED BY the provision of means for limiting spill-over of the body fluids from the first collection chamber (303) when the latter is not full to the second collection chamber (305) resulting from tilting or other movement of the apparatus, the spill-over limiting means comprising a conduit (323) for the body fluids extending from a port (325) in the wall (311) to a conduit entrance (333) within the first collection chamber (303), the conduit (323) being inclined to the horizontal, when the apparatus is in its normal usage attitude, with the conduit entrance (333) lower than the port (325). The invention is illustrated by the drawings, of which: Figure 1 is a schematic diagram of a wound drainage apparatus; Figure 2 is a schematic diagram of a suction regulator for incorporation into the apparatus of Figure 1; Figure 3 is a schematic diagram of a device for measuring suction pressure, the device being for incorporation into the apparatus of Figure 1; Figure 4 is an enlargement of a part of Figure 1, showing devices for measuring patient negativity and maximum patient negativity; Figure 5 is a schematic diagram, in perspective, of an anti-spill device according to the invention, such as may be incorporated in the wound drainage apparatus of Figure 1; and Figures 6 and 7 are side and front views, respectively, of the device shown in Figure 5. With reference to Figure 1, a wound drainage apparatus 1 comprises a suction chamber 3 from which air can be evacuated by an external vacuum source such as a centrally located vacuum pump in a hospital, a suction port 4 for interconnecting chamber 3 with the external vacuum source, a suction regulator 5 for controlling the pressure in chamber 3, a suction measuring device 6, an instrument chamber 7, three collection chambers 303, 305, 307 for collecting fluids withdrawn from a patient, and an inlet port 308 for connecting chamber 303 to the patient. The collection chambers 303, 305, 307 are in fluid communication with each other as described hereinbelow and with the instrument chamber 7 through a vent 15. A conduit 32 having a one way valve 203 installed therein is provided in the wall which divides chambers 3 and 7. Air evacuated from a patient follows the path shown by the broken line a , passing through the one way valve 203 whenever the pressure in the collection chambers 303, 305, 307 and the instrument chamber 7 exceeds that in the suction chamber 3. The valve 203 is configured to close when the pressure in the suction chamber 3 exceeds that in chambers 7, 303, 305, 307. When it is a pleural chest cavity being drained, the patient air flow is usually the result of air flowing through a hole in the patient's lung into chambers 7, 303, 305, 307. The rate of air flow depends upon the pressure differential between chambers 3 and 7. This principle enables the provision of an air flow gauge 120, which includes a diaphragm 121 mounted in an opening in the wall between chambers 3 and 7. Diaphragm 121 is adapted to flex according to the extent of the pressure differential between the suction pressure in chamber 3 and the higher pressure in chamber 7. A rod 123 is attached to the diaphragm 121 and is movable therewith. A dial 125 is attached to the end of rod 123 by means of a swivel joint 127, and is rotatable about a pivot 129 in response to movement of diaphragm 121. A scale 131 is disposed adjacent the free end of dial 125 and is calibrated to indicate the air flow rate in litres per minute according to the position of dial 125. A fuller understanding of the operation of the air flow gauge 120 will be obtained from the description below of the other gauges shown in Figure 1. Occasionally, as when a hole in the patient's lung closes during the drainage process, chambers 7, 303, 305, 307 develop a pressure even more negative than the control suction of suction chamber 3, and one way valve 203 closes to isolate chamber 7 from chamber 3. It is important for the medical personnel to know the extent of that negativity, and a patient negativity measuring device 151 is provided for this purpose, together with a device for storing the maximum value of patient negativity recorded over a period of time. The devices 151 and 152 are described with reference to Figure 4. The maximum value storage device 152 is contained within an atmospheric pressure chamber 153 which communicates with the ambient air through a port 155. The chambers 7 and 153 are divided by a wall 157 having an opening which is sealed by a diaphragm 159. A rod 161 is attached to the diaphragm 159 and has components 162 and 163 extending in opposite directions therefrom. Diaphragm 159 is flexible and moves between the unflexed position shown in solid lines and the flexed position shown in broken lines. Rod portion 162 is attached to a dial 165 by means of a swivel joint 167, and rod portion 163 terminates in an upstanding flange 169. Dial 165 rotates clockwise about a pivot 171 in response to the flexing of diaphragm 159, and a scale 173 at the free end of dial 165 indicates the instantaneous patient negativity in appropriate units such as -cm. of water. A dial 175 is pivotally mounted on a pivot mechanism 177 which retains the dial in its position of maximum (clockwise) rotation. Mechanism 177 can for example be a ratchet device. Flange 169 engages the lower end of dial 175 and rotates the dial in the clockwise direction when diaphragm 159 flexes according to the amount by which the atmospheric pressure in chamber 153 exceeds the patient pressure in chamber 7. A knob 179 is provided for releasing dial 177 to allow its resetting to 0. A scale 181 preferably calibrated in the manner of scale 173 cooperates with dial 175 to indicate the maximum patient negativity during any period of time prior to the release of dial 175 by knob 179. The suction regulator 5 is now described with reference to Figure 2. (The suction regulator in Figure 2 is shown as an independent unit which would be modified for a particular application such as incoorporation in the apparatus of Figure 1). Suction regulator 5 includes a wall 41; a horizontal partition 43 dividing regulator 5 into an upper chamber 45 and a lower chamber 47; an opening 49 in partition 43 in which is seated a collar 51, the collar being a section of a sphere and having a diameter which increases from top to bottom; a light ball 53 whose diameter is slightly more than the diameter of the sphere of which collar 51 is a section so that the ball can fit and be seated in the collar but not pass upwardly through it; a cantilever support arm 55 having a threaded bore through which extends a threaded bolt 57 with an adjustment knob 58 (which could have detents to avoid accidental changes) and disposed on a support shelf 59; a vertical guide rod 60 mounted between shelf 59 and the top wall of the unit for extending through a smooth bore in arm 55 to guide the vertical movement of arm 55; a spring 61 attached at one end to a flange 63 on ball 53 and at its other end to support arm 55 for biassing ball 53 upwardly; and a dashpot 65 composed of a piston 67 attached to ball 53 and a cylinder 69 receiving the piston in sliding engagement and mounted on a support block 71 by means of a pivot 73. Collar 51 preferably includes a set of notches 72 for enhancing the stabilizing effect of collar 51 on ball 53 as air flows between the collar and the ball. A piston chamber 74 is defined between the head of piston 67 and the closed bore of cylinder 69. Atmospheric air flow at pressure P A enters chamber 45 through an entrance port 75. Lower chamber 47 includes an entrance port 77 from suction chamber 3, and is connected to the hospital suction source 79 at pressure P S . Port 79 could be located in some other wall defining suction chamber 3. The path of flow is shown by the dotted arrows "a". The gauge pressure in suction chamber 3 is measured by negative pressure gauge 6 which is shown in detail in Figure 3. Gauge 6 includes a diaphragm 81 which covers an opening 83 in wall 41 between the upper chamber (which is at atmospheric pressure) of suction regulator 5 and gauge 6 (which is located in suction chamber 3), and a push rod 85 attached at one end to diaphragm 81 and at its other end to a dial 87. Push rod 85 should be light in weight to avoid drooping of the diaphragm. Dial 87 is mounted on a pivot 89 and has a free end which is movable across a negative pressure scale 91 shown calibrated in cm. of water. Diaphragm 81 flexes as shown in dotted lines according to the pressure differential between the pressure in chamber 3 and atmospheric pressure P A in chamber 45 (i.e. gauge pressure), and such flexure is reflected in the linear movement of push rod 85. Push rod 85 in turn pivots dial 87 about pivot 89 to reflect the negative pressure on scale 91. (If the short end of the dial lever arm 87 which is shown below pivot 89 is doubled back to extend in the same direction from pivot 89 as the long part of dial 87, the direction of movement of the dial and its corresponding scale can be reversed. Also, the direct coupling of the push rod to the dial for effecting dial rotation could be replaced with magnetic drag between the end of the dial and the diaphragm push rod. Likewise, the push rod and dial could be connected through a gear train with the gear ratio set to any value to accomodate different deflection or diaphragm sensitivities expected under different parameters.) The operation of suction regulator 5 will now be explained. During the operation of system 1, the attendant will have selected some desired negative pressure in chamber 3. Knob 58 is turned to raise or lower cantilever arm 55 to achieve a desired elongation of spring 61 according to the negative pressure sought. Normally, the pressure in upper chamber 45 will exceed the pressure in chamber 47, and the resultant force F A from atmospheric pressure P A applied over the exposed surface area A A of ball 53 in chamber 45 exceeds the resultant force F S from the negative or suction pressure P S applied over the area A S of ball 53 in chamber 47. However, as long as the upward forces F X of spring 61 and F S exceed F A , the resultant force F R =F X -(F A -F S ) is upward and it causes ball 53 to remain seated in collar 51 to seal off chamber 47. Whenever F R is downward because the atmospheric pressure force F A exceeds the combined spring force F X and suction force F S , ball 53 is unseated and atmospheric air flows through opening 49 until the resultant force F R is again upward and ball 53 returns to its seated position. The following indicates the various force values: F X = Kx where F X = spring force K = spring constant x = spring deflection F A ∝A A P A where F A = atmospheric air pressure force on ball 53 A A = area of the portion of ball 53 in chamber 45 P A = atmospheric pressure F S ∝A S P S where F S = suction air pressure force on ball 53 A S = area of the portion of ball 53 in chamber 47 P S = suction air pressure F R =F X -(F A -F S ) where F R is the resultant of the preceeding forces The foregoing force analysis is actually slightly simplified since the respective forces are integrals of the respective vertical pressure components over the surfaces of the ball to which those pressures are applied. Suction regulator 5 as described thus far would provide for the rapid modulation of ball 53 as the pressure differential across it varies. In order to reduce this modulation, dashpot 65 is provided. Thus, when resultant force F R becomes downward, ball 53 does not immediately pop open. Rather, the downward movement of ball 53 urges piston 67 downwardly to compress the air in piston chamber 74. The downward movement of piston 67 is slowed down, since air in chamber 74 compresses slowly and air can only leak out between piston 67 and the inner wall of cylinder 69 slowly. Likewise, when the resultant force F R is upward, the movement of ball 53 from its open to its closed position is also slowed down. The air leakage about cylinder 69 reduces the effect of friction between the cylinder wall and piston 67. Wound drainage apparatus of Figure 1 includes a negativity release valve 205. This valve vents atmospheric air into chamber 7 when the patient negativity exceeds the closing bias on valve 205. Valve 205 can be adjusted by means of spring tension in the manner of regulator 5, a weighted ball if a fixed value is acceptable, or a button actuated release. When the patient negativity is less than (i.e. more negative) the suction in suction chamber 3, air cannot flow from the suction chamber into conduit 32 because one way valve 203 closes conduit 32. A positive pressure vent 207 is provided to open suction chamber 3 to the atmosphere to avoid a build-up of positive pressure air (i.e. above atmospheric pressure air) in chamber 3 should there be a failure of the suction source. The drainage systems, suction regulators and other devices provided in the apparatus described offer numerous advantages over the prior art. The apparatus in its various forms is dry, and thus avoids the various shortcomings of systems relying on water for regulating and measuring the various pressure values. The apparatus and its components are of very simple construction, contributing to the ease of manufacture, use and general economy thereof. The apparatus and its components are compact and light, rendering it easy to store and use. Yet, despite its simplicity, it is highly effective in use. In prior wound drainage systems, there is a likelihood of spill-over of fluids from the collection chamber into adjoining chambers. It can occur because of the tilting, shaking or dropping of the wound drainage system by persons attending the patient, or because the unit, the patient or the patient's bed is moved excessively. The device described below addresses the spill-over problem. Referring next to Figures 5 to 7, anti-spill device 301 pursuant to the invention is shown. Device 301 is composed of vertical side walls 309, 311 and 313, which with a bottom wall 315, a top wall 317, rear wall 319 and a front wall 321 define adjoining prismatic fluid collection chambers 303 and 305. A fluid entrance port 310 is located in top wall 317. A triangular conduit 323 extends perpendicularly from a triangular opening 325 in side wall 311. Conduit 323 is composed of side walls 327 and 329, and a top wall 331. The lowermost entrance to conduit 323 is a point 333 at the juncture of walls 327 and 329 and an imaginary plane across that entrance. Point 333 is located midway both between rear wall 319 and front wall 321 and a distance ℓ/2 from side wall 309. The measurement ℓ/2 is optional but can be chosen to move point 333 as close as possible to side wall 309 without interfering with fluid flow, blood clots or the like. Since the diameter of the entrance tubes is normally in the range of 3/8" (9.53 mm), the minimum length of ℓ/2 will be comparable with that dimension as well. The positioning of the lowest entrance point of the conduit from chamber 303 to chamber 305 effectively enables the maximum amount of rotation of chamber 303 in either the x-axis or the z-axis for any given amount of fluid in chamber 303 before there can be any spill-over of fluid from chamber 303 to chamber 305. In order to maintain a predetermined maximum angle of tilt or rotation before spilling occurs (angle of anti-spill tilt) as the fluid level rises in chamber 303, the minimum distance of point 333 below upper wall 317 will depend on, and can be calculated from, the other dimensions of chamber 303. The manner in which the construction of the device 301 reduces spillage of fluid from chamber 303 is shown in Figures 6 and 7. Referring first to Figure 6, chamber 303 is shown tilted such that rear wall 319 is at an angle ϑ from horizontal, angle 90-ϑ being the maximum amount of tilt permissible in that axis for preventing spilling of the fluid in chamber 303 under all conditions of fluid level. Walls 327 and 329 intersect at an angle 2ϑ. Collection chamber 303 can be rotated by an angle 90°-ϑ about an axis perpendicular to wall 309 before any fluid can enter conduit 323 and flow out of chamber 303. Were point 333 any closer to either of walls 319 or 321, spill-over would occur sooner for rotation in one direction or the other. By decreasing the angle of intersection of walls 327 and 329, the greater the amount chamber 303 can be tilted before spill-over begins. The distance of point 333 from top wall 317 for a maximum permissible amount of rotation or tilt of chamber 303 just prior to spillage can be calculated as follows: where 90-ϑ = max. angle of rotation of chamber 303 about the z axis before spillage as shown in Figure 6 w = distance between side walls 319 and 321 d = the minimum distance of point 333 from top wall 317 for a given maximum angle level. If point 333 were any closer to top wall 317 than d, the fluid would have insufficient room to travel up side wall 319 (or wall 321) and the fluid would be forced to the right (or left) before rotation of 90°-ϑ had occurred. That is, spillage would occur sooner than if point 333 were located closer to the top wall than at the distance d as calculated above. With regard to Figure 7, it can be seen that chamber 303 can be rotated around the x-axis well in excess of the indicated tilt angle  before any fluids enter conduit 323 leading to the adjacent collection chamber 305. As indicated earlier, by moving point 333 closer to side wall 309, the amount chamber 303 can be rotated clockwise about an axis perpendicular to wall 321 (x-axis) is increased, in fact, if the calculation for d (as derived above) is satisfied,  can be increased to 90° with no danger of spillover. However, for counterclockwise rotation, fluid would begin entering the conduit sooner but would not spill over into chamber 305 until the fluid level exceeds point 335. Finally, should fluid entering the conduit in any way pose a problem for certain applications, the conduit length could be shortened to lie midway between walls 309 and 311 and a geometric/trigonometric relationship can be formulated for rotation about the x-axis similar to that for rotation about the z-axis. In this case, point 333 is situated at the horizontal centre of gravity of chamber 303. Figures 5 to 7 show the collection chamber arrangement to include two chambers. Any number of chambers can be arranged adjacent each other with spill-over reducing conduits 323 provided therein. In Figure 1, three such chambers 303, 305, and 307 are provided, with chambers 303 and 305 having spill-over reduction conduits 323 and 337, respectively, incorporated therein.

Claims: Apparatus (1) for draining fluids from a portion of a patient's body, the apparatus comprising a container (303,305,307) for receiving the body fluids, the container (303,305,307) including a first collection chamber (303) including an entrance port (310) for admitting the body fluids to the chamber (303) and a second collection chamber (305) for receiving overflow body fluids from the first collection chamber (303) when the latter is full, the first and second collection chambers (303,305) being divided by a wall (311), CHARACTERISED BY the provision of means for limiting spill-over of the body fluids from the first collection chamber (303) when the latter is not full to the second collection chamber (305) resulting from tilting or other movement of the apparatus, the spill-over limiting means comprising a conduit (323) for the body fluids extending from a port (325) in the wall (311) to a conduit entrance (333) within the first collection chamber (303), the conduit (323) being inclined to the horizontal, when the apparatus is in its normal usage attitude, with the conduit entrance (333) lower than the port (325). Apparatus according to claim 1 wherein the first collection chamber (303) has a prismatic configuration defined by opposing parallel top (317) and bottom (315) walls, opposing parallel front (321) and rear (319) walls extending between the top (317) and bottom (315) walls, and opposing parallel side walls (309,311) connecting said front (321) and rear (319) walls and said top (317) and bottom (315) walls, and wherein the lowermost point of the conduit entrance (333) is located at a distance d from the top wall (317) to enable the collection of the maximum amount of fluid without spillage through the conduit entrance (333) when the first collection chamber (303) is rotated about an axis perpendicular to the side walls (309,311) by a maximum angle before spillage according to the following calculation: where 90-ϑ = said maximum angle of rotation before spillage about an axis perpendicular to the side walls (309,311) w = the distance between the side walls (319,321) d = the distance from the top wall (317) to the lowermost point of the conduit entrance (333) for enabling the maximum amount of rotation without spillage through the conduit entrance (333). Apparatus according to claim 1, wherein the fluid collection chamber (303) is defined by surfaces symmetrical about a first plane containing a central vertical axis and wherein said lowermost point of the conduit entrance (333) is located at a distance d from the juncture of the uppermost one of said surfaces and said vertical axis to enable the collection of the maximum amount of fluid without spillage through said conduit entrance (333) when said chamber (303) is rotated about a first axis perpendicular to said vertical axis by a maximum angle before spillage according to the following calculation: where 90-ϑ = said maximum angle of rotation before spillage about a first axis perpendicular to said vertical axis w = the distance between the closest walls defining said chamber (303) taken on a line perpendicular to said vertical axis at the location of the lowermost point of the conduit entrance (333) d = the distance along said vertical axis from the juncture of the uppermost surface defining said chamber (303) and said vertical axis to the lowermost point of the conduit entrance (333).

Inventors: ANTONIO NICHOLAS F D, ANTONIO NICHOLAS J D, D'ANTONIO, NICHOLAS F., D'ANTONIO, NICHOLAS J.
Applicants: ANTONIO NICHOLAS F D, ANTONIO NICHOLAS J D, D'ANTONIO, NICHOLAS F., D'ANTONIO, NICHOLAS J.
Application year: 1985
Main classification: A61M1
IPC codes: A61M1, F16K21, F16K15