DEVICE FOR CLOSING THE OPERATION WOUND AFTER PUNCTURE OF ARTERIA FEMORALIS OR VENA FEMORALIS

Abstract: The arrangement comprises a head (1) which is mounted displaceably in the vertical direction on a swing arm (2) on an upright member (3) which can be fastened to the bottom frame (4) of a hospital bed (5). The head (1) is equipped with two pressure rods (7, 8) to whose lower end a pressure shoe (9 and 10, respectively) is attached with a limited amount of swing and covered on the underside with a skid-proof material (12). The pressure rods (7, 8) can be moved from a starting position to a working position in which the pressure shoes (9, 10) rest against a compress (20) in which position the pressure shoes exert equally large pressures in the vertical direction and in the horizontal direction of one pressure shoe towards the other. The arrangement can replace the manual work of closing an operation wound after a stab insertion into arteria femoralis or vena femoralis, and it is consequently labour-saving.

Description: Device for Closing the Operation Wound after Puncture of Arteria Femo¬ ralis or Vena Femoralis. The present invention relates to an arrangement for closing an operation wound after a stab insertion into arteria femoralis or vena femoralis. Numerous medical operations for the purpose of diagnosis and treatment are undertaken via the patient's blood paths. These operations are performed in connection with diseases in the vessel system, such as arteriosclerosis or malformation or diseases in organs such as the brain, heart or kidneys. The examinations are often undertaken via the artery in the groin, arte- ria femoralis, into which is inserted a probe or catheter. The physician is given a possibility of examination or probably post-treatment of a patient without too many complications. When the examination is over the probe or catheter is withdrawn from the vessel leaving a bleeding opening. This opening is closed by the physi- cian or a trained nurse pressing the vessel together (called compress¬ ing) for at least 20 minutes. In certain cases it is necessary to com¬ press for several hours for the opening in the vessel to close. Then the patient must lie with a sand bag on the place of the insertion for at least two hours or with a bandage of the kind which is the object of i European Patent Application No. 0 295 775. A medium-sized hospital carries out more than a thousand of these operations annually. The work of closing a wound after these operations is time-consuming and therefore takes up a large number of doctors' hours on an annual basis. From US patent No. 3 669 118 an apparatus is known for displacement of a uterus. From DE patent No. 219012, CH patent No. 149242, US patent No. 1 281 653 and EP patent application No. 0 082 009 are known various contraptions designed to exert a pressure on an artery in such a way that the trans- port of blood through the artery is hampered or stopped. Fro US patent No. 2 455 068 an apparatus is known which can be inserted into the throat of a patient whose tonsils have been taken out. From AT patent No. 295027 and US patents Nos. 3 625 219, 3 779 249, 4233 980, 4 572 182 and 4 742 825 apparatuses are known which can be used to exert pressure on the actual place of stab insertion after the catheter is removed. These apparatuses have the drawback that they either only exert a pressure in the vertical direction or a pressure in the vertical direction in combination with horizontal pressures with no resulting composant in a defined direction. Furthermore, they are embo- died in such a way that - when arranged in position - they prevent inspection of the place of insertion. These known apparatuses have not proved well-suited in practice, and therefore manual compression is used. It is the purpose of the present invention to describe an arrangement which is without the drawbacks of the known apparatuses, and which when in use can greatly reduce the work of closing a wound after a stab in¬ sertion of the described nature. This purpose can be achieved according to the present invention in that the described arrangement mentioned at the beginning of this description is characteristic as described in the characterizing part of claim 1. By this it is a chieved, among other things, that the place of stab insertion can be inspected, and that the arrangement therefore can be placed in the correct position. It has been demonstrated in scientific examinations that the arrangement according to the invention can be used on 94% of all patients and that there is an average time saving of 15 minutes per patient. Claim 2 describes a preferred embodiment and arrangement of the pressure rods. Claim 3 describes a special embodiment of the head. Claim 4 describes means for the raising and lowering of the pressure rods, and Claim 5 describes means for the registration and regulation of the pressure in the pressure rods. The invention will be explained in detail below with reference to the drawing in which fig. 1 is a schematic presentation of an arrangement according to the invention mounted on a hospital beds, and fig. 2 shows in a larger scale a preferred embodiment of a head for an arrangement according to the invention with certain components left out. As shown in fig. 1 an arrangement according to the invention comprises a head 1, which is mounted displaceably in the vertical direction on a swing arm 2 on an upright member 3, which is equipped with wheels, and which can be fastened to the bottom frame 4 on an elevatable hospital bed 5 by means of a mount 6. As shown in fig. 2 a head 1 for an arrangement according to the inven¬ tion is embodied with two pressure rods 7,8. At the lower end of each pressure rods 7,8 a pressure shoe 9.and 10 re¬ spectively, is attached with a limited amount of swing by means of pins 11. The underside of each pressure shoe has a coating 12 which is skid-proof and elastic. The pressure rods 7,8 can be raised to a starting position and lowered to a working position, for example by means of a compressed air cylinder 13. The compressed air cylinder 13 can be single-acting and loaded with a spring pressure in the downward or upward direction, or it can be double-acting. The pressure exerted by the compressed air cylinder can be regulated, for example by means of an adjustable reduction valve 14, which can be equipped with a pressure indicator showing the set pressure. The compressed air cylinder can be activated in the downward and upward directions through push buttons 15 and 16, respectively. The head 1 can be embodied with two handles 17 and firmly held in a swing arm 2 with a clamping mount 18 with a tightening screw 19. The head 1 may also be raised and lowered in relation to the swing arm 2 by means of a separate, not shown, drive cylinder in which latter case the pressure rods 7,8 can be activated by an arrangement of weights and/or springs. In the working position each pressure shoe 9,10 rests against a compress 20, which covers the wound to be heeled. The pressure rods 7,8 exert a vertical, downward directed pressure, each through its own shoe 9 and 10, respectively, on the compress 20. This pressure is of the same force in both rods. In addition, a horizontal pressure is exerted from the pressure rods on each pressure shoe 9,10 in the direction of one pressure shoe towards the other. These horizontal pressures are of the same force in the two pressure rods and of the order of 12.5 - 15 kp. As shown in fig. 2 the two pressure rods 7 and 8 can be arranged so that they converge in the downward direction and form equally wide angles, e.g. 45°, to the horizontal. The pressure rods can be displaceably mounted each in its own sliding shoe 21. The sliding shoes can be adjustably mounted on the head 1, for example by means of screws 22. The sliding shoes can be adjusted so that the mutual distance between the pressure shoes 9 and 10 in the working position is 0.2 - 2.0 mm. At its upper end each pressure rod 7,8 is embodied with a stud or roll 23 which can move in a track 24 in a traverse 25 fastened to the piston rod 26 of the drive cylinder 13. Instead of a compressed air cylinder it is also possible to use a push/pull mechanism driven by an electric motor, which can be coupled to an end stop, e.g. a microswitch. Between this mechanism and the traverse 25 it iβ possible also to install a friction clutch. Furthermore, the upright 3 can be detached and dimensioned so that a certain vertical overload will tilt it.

Claims: P A T E N T C L A I M S 1. Arrangement for closing an operation wound after a stab insertion into arteria femoralis or vena femoralis, and comprising a head (1), which can be displaceably mounted on a swing arm (2) on an upright member (3) on wheels, c h a r a c t e r i z e d by the fact that the head (1) comprises two pressure rods (7,8) to which a pressure shoe (9 and 10, respectively) is attached with a limited amount of swing. The underside of these shoes is furnished with a skid-proof, preferably elastic layer (12), and means (13) for raising the pressure rods (7,8) to a starting position and lowering them to a working position in which the pressure shoes (9,10) rest against and exert an equal, yielding and constant, vertical pressure and in the direction of one pressure shoe towards the other a horizontal pressure on a compress (20), which covers the wound to be heeled, and that the pressure rods (7,8) are mounted and /or embodied in such a way that the two pressure shoes (9,10) have a mutual distance between them of o.2 — 2 mm in the working position. 2. Arrangement according to claim 1 c h a r a c t e r i z e d by the fact that the pressure rods (7,8) are embodied as two inclined, downward converging rods forming equally wide angles to the horizontal and being mounted displaceably in the longitudinal direction each in its own journal bearing or sliding shoe (21) which is adjustably mounted on the head (1). χ 3. Arrangement according to claims 1 and 2 c h a r a c t e r i z e d by the fact that the head (1) can be raised and lowered by means of a lifting device, for example a pneumatic or hydraulic cylinder, and that the pressure rods_ (7,8) in the working position are spring- or weight- loaded. 4. Arrangement according to claim 1 c h a r a c t e r i z e d by the fact that the means (13) comprise a pneumatic or hydraulic cylinder or an electric motor in combination with a friction clutch and a spindle drive. 5. Arrangement according to any of the above claims c h a r a c t e r¬ i z e d by the fact that there are means (14) for registration and regulation of the pressure in the pressure rods (7,8) in the working position.

Inventors: PETERSEN ANNE LETH, PETERSEN, ANNE, LETH
Applicants: LL MEDICO APS
Application year: 1992
Main classification: A61B17
IPC codes: A61B17, A61B19