IMPROVED RETAINER FOR SURGICAL SUTURES

Abstract: An improved retainer for surgical sutures having a suture winding panel (11), suture holding panels (16, 17), suture enclosing panel (19) and retainer interlocking panels (24, 25). The panels of the retainer are folded to totally enclose the suture.

Description: The present invention relates to a retainer for surgical sutures and more particularly to a multiple panel retainer for securely holding surgical sutures. Packages for surgical sutures are constructed according to the nature of the suture and its intended use. The packages are designed taking into consideration the economics of the package and the method of placing the sutures in the package. In general, the ideal package protects the suture during handling and storage yet allows the suture to be removed with the minimum of difficulty and the package itself should be economical to produce. The more popular suture packages consist of a folded paper retainer with a suture therein and with the retainer contained in a sterile hermetically sealed envelope. In many instances, the sterility of the suture in the envelope is maintained by a second sealed outer wrap. When the suture is to be used, the outer wrap is opened in the sterile area. Sterile personnel thereupon tear open the sterile envelope to gain access to the suture. Many packages have been developed to provide: easy access to the sutures, simplified winding of the suture, dispensing of a single suture from a package containing multiple sutures, and the like. Representative packages are more fully described in U.S. Patent Nos. 3,936,696, 3,280,971, 3,490,192, 4,089,409, 4,126,221, 4,253,563, 4,249,656, 4,491,218, 4,483,437, 4,413,727, 4,412,614, 3,985,227, and 4,120,395. As mentioned above, packages for surgical sutures are often constructed according to the nature of the suture being packaged. For example, if the suture is made from material that is heat sensitive it is important the package totally enclose the suture to protect it from heat during the sterilization or storage of the suture. If the suture is made from a monofilament material; i.e., a material which tends to take a set in a configuration which is held for any period of time, the package should be designed to take that property into consideration. Also, suture packages should be designed for efficiency in use; i.e., when the nurse is opening a suture package in the surgical environment, the nurse should have control of the opening of the package and the package should not open prematurely or unwarrantedly. It is desirable that the package be easily opened and in many instances opened using one hand, i.e. the package held in the hand and readily opened by a finger because the other hand of the person who desires to open the package may be occupied. EP-A-060080 discloses a container for surgical sutures comprising a centre panel, for receiving a major part of a suture, having a pair of longitudinal edges and a pair of transverse edges; a pair of first side panels, an edge of one of the first side panels being foldably connected to one of the longitudinal edges of the centre panel and an edge of the other of the first side panels being foldably connected to the opposite longitudinal edge of the centre panel; a lower panel having a pair of longitudinal edges and a pair of transverse edges, one of the transverse edges of the lower panel being foldably connected to one of the transverse edges of the centre panel; and a pair of second side panels, an edge of one of the second side panels being foldably connected to one of the longitudinal edges of the lower panel and an edge of the other of the second side panels being foldably connected to the opposite longitudinal edge of the lower panel; whereby a suture may be placed on the centre panel, held in place by folding the first side panels thereover, enclosed by folding the lower panel over the first side panels and the panels locked in their folded condition by folding the second side panels behind the centre panel and interlocking the second side panels. The present invention presents a very simple suture package. The package is inexpensive to produce and the method for placing sutures in the package and folding the package are simple and economical. The package totally encloses the suture and may be used with heat sensitive suture materials. It is an object of the present invention to produce a package that can hold monofilament sutures in as gentle curves as possible to avoid undue set of the suture. A further object of the present invention is to provide a suture package that is securely locked and will not open inadvertently. It is yet a further object of the present invention to provide a suture package which the user may readily open utilizing only one hand. These and other objects of the present invention will be apparent from the ensuing description and claims. Summary of the Invention The present invention provides a retainer for surgical sutures comprising: A continuous suture winding panel having a pair of longitudinal edges and a pair of transverse edges; a pair of suture holding panels, an edge of one of said suture holding panels being foldably connected to one of said longitudinal edges of said suture winding panel and an edge of the other of said suture holding panels being foldable connected to the opposite longitudinal edge of said suture winding panel, said foldably connected edges of said suture holding panels extending along only a portion of the longitudinal edges of said suture winding panel whereby portions of a suture wound on said suture winding panel extend beyond the foldably connected edges of said suture holding panels; a suture enclosing panel having a pair of longitudinal edges of substantially the same length as said longitudinal edges of said suture winding panel and a pair of transverse edges substantially the same length as said transverse edges of said suture winding panel one of said transverse edges of said suture enclosing panel being foldably connected to one of said transverse edges of said suture winding panel; a pair of retainer interlocking panels, an edge of one of said retainer interlocking panels being foldably connected to one of said longitudinal edges of said suture enclosing panel and an edge of the other of said retainer interlocking panels, being foldably connected to the opposite longitudinal edge of said suture enclosing panel; whereby the suture may be wound on said suture winding panel, held in place by folding said suture holding panels on top of said wound suture, enclosed by folding said suture enclosing panel on top of said suture holding panels and the folded panels locked in their folded condition by folding said retainer interlocking panels behind said suture winding panel and interlocking said retainer interlocking panels. In certain embodiments of the present invention there is a needle holding means, such as a piece of foam, placed at the free end of the suture winding panel on the same side of the suture panel on which the suture is to be wound. The needle(s) of either a single or double armed suture may be inserted in this holding means so that the needle is held in place. In other embodiments of the present invention the free end of the suture enclosing panel is deflectable so that it may readily be displaced away from the suture enclosing panel to expose a portion of the suture and in many instances the needle attached to the suture. In other embodiments of the present invention, the fold lines include gussets to reduce the pressure placed on the suture during handling of the folded retainer. In still other embodiments of the present invention, there is a slot placed at the free end of the suture winding panel and a complimentary tab placed at the free end of the suture enclosing panel so that the free ends of the winding panel and the enclosing panel may be interlocked even further to lock the folded retainer in place. The invention will now more fully be described with reference to the accompanying drawings. Description of the Drawings Fig. 1 is a plan view of the retainer of the present invention; Fig. 2 is a plan view of the retainer of Fig. 1 showing a needle and suture disposed on the suture winding panel; Fig. 3 is the retainer of Fig. 2 showing the suture holding panels folded on top of the suture; Fig. 4 is a plan view of the retainer of Fig. 3 showing the suture enclosing panel folded on top of the suture holding panels; Fig. 5 is a plan view of the retainer of Fig. 4 in its fully folded condition; and Fig. 6 is a plan view showing the opposite surface of the retainer of Fig. 5 with the interlocking retainer panels folded and locked in position; Detailed description of the Drawings Figs. 1-6 illustrate the various stages in preparing and folding the retainer of the present invention. Similar features of the retainer are designated by the same number throughout the drawings. The term "suture" when used in this application relates to both a needled or unneedled strand of suture material. In Fig. 1 there is depicted an unfolded suture retainer 10 of the present invention. The retainer comprises a suture winding panel 11 which is generally rectangular in shape and has a pair of longitudinal side edges 12 and 13 and a pair transverse ends 14 and 15. Foldably connected to each side edge is a semicircular shaped suture holding panel 16 and 17. The straight side of the semicircular suture holding panel is foldably connected to the longitudinal edge of the suture winding panel. Adjacent to the free tranverse end of the suture winding panel is a foam member 18. This member holds needles attached to the suture. The free transverse end of the suture winding panel is slightly arched i.e. it is slightly concave for improved interlocking of the folded retainer as will be hereinafter described. Foldably connected to the opposite transverse end of the suture winding panel is the suture enclosing panel 19. This panel is rectangular in shape and is substantially coextensive with the suture winding panel when folded. This suture enclosing panel has a pair of longitudinal sides edges 20 and 21 and a pair of transverse ends 22 and 23. Foldably connected to each longitudinal side edge is a retainer interlocking panel 24 and 25. The retainer interlocking panels are triangular in shape with the long side of the triangles foldably connected to the longitudinal edge of the suture enclosing panel. One of the retainer interlocking panels has a slit 26 which is used to interlock with the free end of the opposite retainer interlocking panel as will be hereinafter described. Disposed adjacent the free transverse end of the suture enclosing panel is a complimentary slit 27 which engages with the free end of the suture winding panel when the retainer is folded as hereinafter described. In a preferred embodiment the fold lines between the suture winding panel and the suture enclosing panel and the fold lines between the suture enclosing panel and the retainer interlocking panels are dual fold lines to provide gussets between the enclosing panel and the suture winding panel. These gussets prevent undue pressure from being placed on the suture in the retainer and allow the suture to be readily removed from the retainer and not held therein by excess friction. The suture enclosing panel also includes a scored line 28 to provide a deflectable end portion 29 of the suture enclosing panel. Referring to Fig. 2 there is shown the retainer of Fig. 1 which has been placed in four pins 30. The pins are adjacent the longitudinal side edges of the suture winding panel and just outside the semicircular holding panels. Positioning the pins in this manner eliminates openings or holes in the retainer and, hence, the panel may totally contact the suture and protect the suture during sterilization, storage, transportation and the like. As shown in Fig. 2, the suture 31 with the needle 32 attached is wound about the pins in a figure 8 configuration. The suture may be wound about the pins in other desired configurations. In winding the suture, the needle is first placed in the needle holding member and the suture wound about the pins with the free end of the suture disposed in the center of the suture winding panel. Once the suture has been wound, the two suture holding panels are folded on top of the wound suture as shown in Fig. 3. Once the suture holding panels are folded over the suture to hold the suture in place the retainer may be removed from the pins. It should be noted that by placing the pins outside the suture winding panel very gentle curves may be obtained in winding the suture and the propensity for placing an undesirable set in monofilament sutures is reduced. As is shown in Figs. 4 and 5, the suture enclosing panel is then folded on top of the suture holding panels. The pair of retainer interlocking panels are folded behind the suture winding panel and interlocked by placing the free end of one of the retainer interlocking panel in the slit of the other retainer interlocking panel as shown in Fig. 6. To fully lock the retainer in place, the slightly arched transverse free end of the suture winding panel is interlocked with the slit at the transverse free end of the suture enclosing panel as shown in Fig. 5. Referring to Figs. 1 and 2, adjacent the ends of the retainer interlocking panels closest to the free end of the suture enclosing panel there is a scored area 28 extending transversely of the suture enclosing panel. The purpose of this scored portion will be hereinafter described. The folded retainer shown in Figs. 5 and 6 with the suture therein may then be wrapped in a suitable foil-film overwrap as is well known in the art and sterilized by any of the techniques well known in the art depending on the type of suture material used. As can be appreciated, this is a simple and economical package to produce. The package totally encloses and protects the suture and the needle, yet it is a simple matter to hold the package in one hand, unlock the interlocking tab at the transverse end of the suture winding panel and the suture enclosing panel and fold back the scored portion of the suture enclosing panel with the same fingers of the hand holding the retainer. This allows ready and simple one handed access to the suture in the package. The package does not contain holes and, hence, is inexpensive to produce, produces no debris and makes the entire operation very economical. The retainer interlocking panels and the locking at the transverse ends of the suture winding panel and the suture holding panel make a very secure folder as compared with most folded retainers which have slide locks on the foldable portion of the suture retainer. By placing the locking means in the positions as shown in Figs. 5 and 6, this folder will not open when the nurse or surgeon goes to use the folder. With the two suture holding panels positioned inside the pins, once the suture is wound and held in place by folding these panels on top of the suture, the suture is under control and when the retainer is removed from the pins the suture remains under control and will not be damaged by having an end of the suture hung up on a panel or a pin and the like. Furthermore, by eliminating the side locks, the possibility of a portion of the suture getting caught in one of these locks and being damaged is also eliminated. The arched portion of the suture winding panel allows for a space between the panels of the needle holder and eliminates undue stress on the needle holder while still retaining a very secure lock. As previously mentioned, the fully folded suture retainer may be subsequently sealed and sterilized within a sterile outer envelope. Generally, these envelopes are formed by heat sealing two coextensive panels; for example, one of a non-woven fabric and the other of a thermoplastic film coated on their interior surface with a heat sealable polymeric composition, together about their periphery. The laminate is bonded together about the periphery with the retainer within this periphery. Other means for sealing an envelope may be used at the discretion of the practitioner. If desired, an indentation or gore may be placed in the outer envelope to aid in tearing open that envelope to expose the folded retainer. The sutures so packaged are sterile and hermetically sealed and may be stored for extended periods of time. The suture retainers of the present invention are preferably constructed of a heavy-weight relatively stiff sulfate paper board. This paper board is relatively foldable and yet sufficiently strong and stiff to support the suture and provide a rigid package. Other materials including plastics, foils, and laminates combined with each other or with paper may also be used.

Claims: A retainer (10) for surgical sutures (31) comprising: a. a continuous suture winding panel (11) having a pair of longitudinal edges (12,13) and a pair of transverse edges (14,15), b. a pair of suture holding panels (16,17), an edge of one of said suture holding panels (16) being foldably connected to one of said longitudinal edges (12) of said suture winding panel (11) and an edge of the other of said suture holding panels (17) being foldably connected to the opposite longitudinal edge (13) of said suture winding panel (11), said foldably connected edges of said suture holding panels (16,17) extending along only a portion of the longitudinal edges (12,13) of said suture winding panel (11) whereby portions of a suture (31) wound on said suture winding panel (11) extend beyond the foldably connected edges of said suture holding panels (16,17), c. a suture enclosing panel (19) having a pair of longitudinal edges (20,21) of substantially the same length as said longitudial edges (12,13) of said suture winding panel and a pair of transverse edges (22,23) of substantially the same length as said transverse edges (14,15) of said suture winding panel one of said transverse edges (22) of said suture enclosing panel (19) being foldably connected to one of said transverse edges (15) of said suture winding panel (11), d. a pair of retainer interlocking panels (24,25), an edge of one of said retainer interlocking panels (24) being foldably connected to one of said longitudinal edges (20) of said suture enclosing panel (19) and an edge of the other of said retainer interlocking panels (25) being foldably connected to the opposite longitudinal edge (21) of said suture enclosing panel (19), whereby the suture (31) may be wound on said suture winding panel (11), held in place by folding said suture holding panels (16,17) on top of said wound suture (31), enclosed by folding said suture enclosing panel (19) on top of said suture holding panels (16,17) and the folded panels locked in their folded condition by folding said retainer interlocking panels (24,25) behind said suture winding panel (11) and interlocking said retainer interlocking panels (24,25). A retainer for surgical sutures according to claim 1 wherein needle holding means (18) is disposed adjacent the transverse edge (14) of the suture winding panel (11) opposite the transverse edge (15) foldably connected to the suture enclosing panel (19). A retainer for surgical sutures according to claim 1 or claim 2 wherein the free end of said suture enclosing panel (19) has a hinged portion (29) which may be deflected away from the remainder of said suture enclosing panel (19) to expose a suture (31) wound on the suture winding panel (11). A retainer for surgical sutures according to any one of claims 1 to 3 wherein the fold lines connecting the suture winding panel (11) to the suture enclosing panel (19) and the fold lines connecting the retainer interlocking panels (24,25) to the suture enclosing panel (19) are dual fold lines to form gussets between said fold lines. A retainer for surgical sutures according to any one of claims 1 to 4 wherein the suture holding panels (16,17) are semicircular in shape. A retainer for surgical sutures according to any one of claims 1 to 5 wherein the retainer interlocking panels (24,25) are triangular in shape. A retainer for surgical sutures according to any one of claims 1 to 6 wherein one of the retainer interlocking panels (24) has a slit (26) disposed in said panel for engaging the free end of the other retainer interlocking panel (25) to interlock the folded retainer. A retainer for surgical sutures according to any one of claims 1 to 7 wherein the free end of the suture enclosing panel (19) has a transverse slit (27) therein for engaging with the free end of the suture winding panel (11) to lock the folded retainer in place. A retainer for surgical sutures according to claim 8 wherein the free end of the suture winding panel (11) is concave.

Inventors: ALPERN, MARVIN, CERWIN, JAMES, ROSHDY, CONSTANCE ELIZABETH
Applicants: ETHICON INC.
Application year: 1986
Main classification: A61B17
IPC codes: A61B17