Abstract:
A facial support cushion for supporting the face of a person lying in a face down prone position, wherein the cushion is an annular, generally torus shaped body having a hollow interior with a plurality of generally radially extending partitions extending across the interior of the body, dividing it into a plurality of individual chambers spaced sequentially around the body. Apparatus is connected with the chambers to sequentially expand and contract them in an alternating pattern so that some of the chambers are expanded to contact and support the face while other chambers are contracted to relieve the pressure exerted against the face by the other chambers, whereby the formation of pressure sores and other deleterious effects are avoided by periodically and temporarily relieving pressure exerted by the chambers against different areas of the face.

Description:
FIELD OF THE INVENTION  
       [0001]     This invention relates generally to cushions or pillows. In particular, the invention is a facial support cushion for supporting the face of a person lying prone on their stomach, with means to alternately and periodically relieve pressure exerted by the cushion on different areas of the face.  
       DESCRIPTION OF THE PRIOR ART  
       [0002]     Prolonged immobilization of a person, with the resultant constant pressure on parts of the body, can lead to formation of pressure sores, decubitus ulcers, nerve damage, and/or other problems. During long surgical procedures, for example, an anesthetized patient cannot move voluntarily, and pressure sores or other tissue damage can result on parts of the patient&#39;s body that rest on supporting surfaces. During spinal surgery, for instance, the patient typically lies prone on his or her stomach, with the face resting on a cushion. Although these cushions have recessed areas to provide clearance in the vicinity of the mouth, nose and eyes, substantially constant pressure is applied to those areas of the face that rest on the cushion.  
         [0003]     U.S. Pat. No. 6,510,574 discloses in FIG. 4 an inflatable cushion for supporting the face of a patient during surgery. The cushion disclosed in this patent is generally U-shaped, with an opening or recessed area in a central portion thereof to provide clearance in the vicinity of the mouth, nose and eyes of the patient. Although the patent discloses that the extent of inflation of the cushion can be increased or decreased, there is no suggestion of alternately and periodically relieving pressure exerted by the cushion on different areas of the face. This patent is concerned merely with providing support, and does not suggest any means for periodically relieving pressure on different areas of the body to prevent the formation of pressure sores or other damage to body tissue caused by prolonged pressure on the body.  
         [0004]     U.S. Pat. No. 6,065,166 discloses a pneumatic support cushion that is intended to maintain a person in a lateral decubitus or lateral inclined position, for support of the flank portion, for example, during surgical procedures, or at rest. In particular, the cushion disclosed in this patent has at least one member suitable for preventing rotation or rolling of the person out of the lateral decubitus position, and a section providing cushioned support above a surface so that the arm and shoulder are relieved of the forces of the body while distributing the body weight on the skin surface. By adjustment of the inflation pressure, the position of the patient may be adjusted. In one embodiment, plural separate chambers may be provided, especially in the weight distributing portion of the cushion, and the inflation pressure or volume of one or more of the chambers can be varied separately or together over time to relieve local pressure on the skin briefly to allow microcirculation to return, or to act as a peristaltic pump to assist in circulation in the supporting tissue. The separate chambers disclosed in this patent are elongate tubular members arranged parallel to one another, thus forming a plurality of parallel systems that will support the person even if one system is punctured during surgery or the like.  
         [0005]     Numerous other inflatable cushions and support devices are known in the art, including inflatable splint devices that can be placed about the limb of a person and inflated to immobilize the limb, and massage devices that can be placed about portions of the body, e.g., the legs, and pressurized in a cyclic manner to massage the tissue of the body to prevent formation of blood clots or other adverse effects.  
         [0006]     Applicant is not aware of any prior facial support cushion that has a plurality of chambers or sections with means to cyclically and alternately temporarily relieve pressure on different areas of the face to prevent pressure sores or other adverse effects on tissue contacting and supported by the cushion.  
       DESCRIPTION OF THE INVENTION  
       [0007]     The present invention is a facial support cushion that has a plurality of chambers or sections with means to temporarily remove or reduce the support provided by each section to thereby relieve pressure on different areas of the face to prevent pressure sores or other adverse effects on tissue contacting and supported by the cushion.  
         [0008]     Alternately increasing and decreasing the support provided by the different cushion sections can be achieved by alternately inflating and deflating the sections, or by use of a mechanical device associated with each section. A control apparatus connected with the cushion via suitable means preferably achieves control of this cyclic operation. For instance, if the chambers of the cushion are inflated and deflated with a gaseous or liquid fluid medium, the control apparatus can comprise a system of valves that operate to supply and exhaust pressurized fluid to and from the respective chambers in a timed sequence. The control apparatus can function to simply control the flow of fluid to the cushion from a separate source of pressurized fluid, or it can function to pressurize the fluid as well as to control the flow of the fluid to and from the cushion. Similarly, if mechanical devices are used to expand and contract the different sections of the cushion, the control apparatus can supply electrical energy or the like as necessary.  
         [0009]     The cushion is generally torus-shaped, with a generally T-shaped central opening to provide clearance for the mouth, nose and eyes of a person lying face down on the cushion. In a preferred embodiment, the cushion has separate inflatable chambers, and a tube extends from the control apparatus to each chamber to alternately supply pressurized fluid to the chamber and exhaust fluid from the chamber in a timed sequence. A valve and control system such as that disclosed in U.S. Pat. No. 6,065,166, for example, can be employed in the present invention. The preferred embodiment also includes one chamber that remains deflated to provide a space for passage of an endotracheal tube.  
         [0010]     The tubes leading from the control apparatus to the cushion preferably are bundled together for neatness and order, with the tubes leading to individual chambers extending around the periphery of the cushion and either enclosed in a sleeve or lying close to the surface of the cushion. The tubes for conveying fluid, or electrical wires for conducting electrical energy when mechanical or electromechanical devices are used to expand and contract the different sections of the cushion, can approach and be connected to the cushion on any side thereof.  
         [0011]     In some instances it may be desirable to construct the cushion so that either surface of it can be oriented upwardly. Thus, it would be possible to invert the cushion to place the collapsed or deflated chamber on either side of the cushion. Also, the tubes or wires and the like leading to the cushion could be placed at the top or distal end of the cushion, rather than at one side. This would result in location of these tubes in a position away from the sides of an operating table, and less likely to get in the way of a surgeon or other member of an operating team.  
         [0012]     The cushion can be made of any suitable material for the intended purpose, including flexible sheets of a polymeric resin such as polyvinyl chloride, or polyurethane, and the like. Further, the cushion can be made disposable or reusable, and can have means associated with it for attaching it to a supporting surface such as an operating table. For example, Velcro® straps, or hooks, or snaps, or flaps like those employed in U.S. Pat. No. 6,510574, for example, could be provided to maintain the cushion in place during use. Alternatively, the cushion could simply be placed on the supporting surface without any means for attaching it to the surface.  
         [0013]     Initially during use, all chambers of the cushion except that left collapsed for passage of an endotracheal tube or other apparatus are inflated or expanded. The control apparatus is then operative to alternately and sequentially deflate selected chambers to periodically relieve pressure on different areas of the face, and then reinflate those chambers while others are deflated. The chambers preferably are deflated in pairs, with the deflated chambers located on opposite portions of the face so that the patient&#39;s face does not slip or move when the chambers are deflated. For example, in one embodiment of the invention the cushion has eight chambers arranged sequentially around its circumference in a clockwise direction, with chamber number one located between the 10 and 12 o&#39;clock positions, chamber number two located between the 12 and 2 o&#39;clock positions, chamber three located approximately between the 2 and 3 o&#39;clock positions, chamber four located approximately between the 3 and 4 o&#39;clock positions, chamber five located approximately between the 4 and 6 o&#39;clock positions, chamber six located approximately between the 6 and 8 o&#39;clock positions, chamber seven located approximately between the 8 and 9 o&#39;clock positions, and chamber eight located approximately between the 9 and 10 o&#39;clock positions. Chambers one and two are first deflated for a set time, e.g., one or two minutes, and then reinflated. Chambers three and eight are next deflated for the set time and then reinflated, followed by deflation and reinflation of chambers seven and five, then chamber six, then back to chambers one and three. This cycle is repeated as many times and as often as necessary so that no chamber exerts continuous pressure on an area of the face for more than about two minutes. Chamber four is left deflated at all times to form a passageway for an endotracheal tube. It should be understood that although eight chambers are shown and described in the preferred embodiment, a different number could be employed so long as alternate inflation and deflation of the chambers functions to temporarily relieve pressure on areas of the face supported by the cushion, while the cushion continues to support the head of the patient so that it does not move or slip on the cushion. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0014]     The foregoing, as well as other objects and advantages of the invention, will become apparent from the following detailed description when taken in conjunction with the accompanying drawings, wherein like reference characters designate like parts throughout the several views, and wherein:  
         [0015]      FIG. 1  is a top plan view of a cushion according to the invention.  
         [0016]      FIG. 2  is a transverse sectional view of the cushion of  FIG. 1 , taken along line  2 - 2  in  FIG. 1 .  
         [0017]      FIG. 3  is a transverse sectional view of the cushion of  FIG. 1 , taken along line  3 - 3  in  FIG. 1 .  
         [0018]      FIG. 4  is a somewhat schematic sectional view of the cushion, taken along line  4 - 4  in  FIG. 1 , and showing the relationship between the cushion and the face of a person using the cushion.  
         [0019]      FIG. 5  is a schematic diagram of one possible arrangement of a system according to the invention. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0020]     A cushion according to the invention is indicated at  10  in  FIGS. 1-4 . The cushion comprises a generally torus or donut shaped body  11  having an upper surface  12  and a lower surface  13 , with a generally T-shaped opening  14  in its center. The toroidally shaped cushion supports the head of a patient lying prone in a face down position, as shown in broken lines in  FIG. 4 , and the T-shaped opening  14  provides clearance for the mouth, nose and eyes of the patient.  
         [0021]     The interior of the torus-shaped cushion is divided by generally radially extending partitions  15  into a plurality of individual sections or chambers  1  through  8  of substantially  20  equal size spaced sequentially around the cushion. In the specific example shown in the drawings, succeeding chambers are arrayed in a clockwise direction, with chamber  1  located approximately in an area between the 10 and 12 o&#39;clock positions, chamber  2  located approximately between the 12 and 2 o&#39;clock positions, chamber  3  located approximately between the 2 and 3 o&#39;clock positions, chamber  4  located approximately between the 3 and 5 o&#39;clock positions, chamber  5  located approximately between the 5 and 6 o&#39;clock positions, chamber  6  located approximately between the 6 and 8 o&#39;clock positions, chamber  7  located approximately between the 8 and 9 o&#39;clock positions, and chamber  8  located approximately between the 9 and 10 o&#39;clock positions.  
         [0022]     In the preferred embodiment the cushion is inflated with air or other gas, although a liquid could be used, or the chambers could be expanded and contracted by a mechanical means, not shown. To alternately inflate and deflate the chambers with either pneumatic or hydraulic means, lengths of tubing  16  through  22  are connected between the respective chambers and a suitable control means  23 .  
         [0023]     As shown in  FIG. 1  the control means  23  may include a compressor or pump device of conventional construction (not shown) and a set of valves of conventional construction (not shown) that are operative to open and close in timed sequence to either supply a pressurized fluid (gas or liquid) to the chambers or exhaust fluid from the chambers. Suitable electrical energy can be supplied to the control means via wires  24 . The lengths of tubing extending between the control device and the cushion can be enclosed in a sheath or sleeve  25 , if desired, although it is intended that the control device and cushion both will be attached to the table (not shown) on which the patient is supported. The wires  24  can comprise an electrical cord that can be plugged into a suitable outlet in the vicinity of the table.  
         [0024]     Alternatively, as shown in  FIG. 5 , the control means may comprise a set of valves  26  connected in the lengths of tubing  16 - 22  to control flow of fluid to the chambers from a separate source  27  of pressurized fluid, and to exhaust fluid from the chambers in predetermined timed sequence. Further, it will be noted that in this embodiment the lengths of tubing extend from the valves  26  to the top end of the cushion body  11 .  
         [0025]     Chamber  4  remains deflated at all times to provide space for passage of an endotracheal tube or other apparatus.  
         [0026]     The cushion in both forms of the invention can be constructed so that either side can be oriented upwardly, whereby the lengths of tubing can be positioned to extend toward a desired side of the table. In the embodiment of  FIG. 5  this would not be a factor since the tubing extends toward the head of the table, but the deflated chamber  4  could be oriented toward a desired side of the table by appropriately inverting the cushion.  
         [0027]     In operation, all chambers except chamber  4  are initially inflated. Chambers  1  and  2  are then deflated for a predetermined interval of time and then reinflated. Chambers  3  and  8  are next deflated for a predetermined time interval and then reinflated, followed by deflation and reinflation of chambers  7  and  5 , then chamber  6 , and then back to chambers  1  and  2 . Other sequences could be employed to temporarily relieve pressure on different areas of the face. For example, chambers  1  and  5  could be deflated and then reinflated, followed by chambers  2  and  6 , then chambers  3  and  7 , then chamber  8 , and then repeating the sequence. Or, the sequence of deflation and reinflation could comprise chambers  1  and  3 , followed by chambers  2  and  8 , then chambers  7  and  5 , then chamber  6 ; or, chambers  2  and  7 , followed by chambers  8  and  3 , then chambers  1  and  5 , then chamber  6 ; etc. Temporary relief of pressure on each area of the face supported by the cushion, while maintaining stability of the face, is more important than the particular sequence employed. In this regard, reinflation of deflated chambers can begin while deflation of the next pair of chambers is commencing, or more than one pair of chambers could be deflated at the same time, so long as the face remains supported by multiple chambers to prevent movement of the head and face. For example, chambers  1  and  5  could be deflated at the same time that chambers  3  and  7  are deflated, etc. The timing of each sequence is about one minute, and no more than about two minutes.  
         [0028]     The support cushion of the invention provides secure and reliable support for the face of a patient lying in a face down prone position, affords great flexibility in its use, and avoids the formation of pressure sores that are frequently caused by pressure exerted on the skin of a patient while the patient remains immobile during prolonged periods of time.