Abstract:
One aspect of the present invention relates to a covering member for a protruding portion of a patient&#39;s body. This cover is flexible and collapsible so that it conforms to the shape of the encased portion of the body. This prevents the cover from being noticed while it is worn under clothing. The cover can contain a medicament or agent for pretreating a portion of the body before an examination or procedure. When the cover is used to apply a topical anesthetic to a portion of the body for a recommended period of time prior to the procedure or examination commencing, the amount of discomfort experienced by the patient can be significantly reduced compared to the amount experienced by the patient who has the anesthetic applied for just a few moments before the procedure begins. Alternatively, the cover can be used to hold a medicament or agent on the intended portion of the body in order to heal a wound or cure a condition such as a skin rash or the like.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation of U.S. patent application Ser. No. 13/486,999, filed Jun. 1, 2012, which is a continuation of U.S. patent application Ser. No. 13/083,442, filed Apr. 8, 2011, now U.S. Pat. No. 8,191,554, which is a continuation of U.S. patent application Ser. No. 12/368,257, filed Feb. 9, 2009, now U.S. Pat. No. 7,921,851 which is a continuation of U.S. patent application Ser. No. 11/291,738, filed Dec. 1, 2005, now U.S. Pat. No. 7,487,779, which is a continuation of U.S. patent application Ser. No. 09/793,110, filed Feb. 27, 2001, now abandoned, all of which are hereby incorporated by reference herein in their entireties. 
     
    
     BACKGROUND 
       [0002]    1. Field of the Inventions 
         [0003]    The present invention relates to a device for covering and applying a medicament to a protruding portion of a mammalian body. More specifically, the present invention relates to a flexible, continuous covering apparatus that surrounds the protruding body portion in order to protect it and/or retain a medical agent on it before or after an operation or other medical procedure has been performed. 
         [0004]    2. Description of the Related Art 
         [0005]    Certain medical procedures require that an agent, such as a medicament, be topically applied to, and maintained on, a portion of a patient&#39;s body. The need for the agent can arise before or after the medical procedures have been performed. These procedures can comprise patient examinations, minimally invasive diagnostic operations, exploratory operations and invasive therapeutic operations. The patient examinations may include the step of positioning a medical device, such as a probe, scope or catheter, within a body passageway to perform an examination or retrieve material from within the passageway or a related body cavity, such as a duct. 
         [0006]    Topical anesthetics are an example of one class of medicaments that may be applied to the portion of the body hours before and/or after the intended procedure is performed. For example, topical anesthetics can prepare the body portion to receive a medical device that will be positioned within a body opening or incision during the procedure. A composition including an anesthetic and another active agent may also be used. In the situation where the composition is applied to a breast to prepare it for ductal access, a dekeratinizing agent and/or a ductal orifice dilating agent such as capsicum may be used. Agents applied post procedure might include topical antibiotics or well-known wound healing agents. 
         [0007]    When the anesthetic is applied before the procedure, a cover, such as a bandage, is normally positioned over the anesthetic to prevent it from being prematurely wiped off. However, conventional covers do not offer the patient an effective option for covering the anesthetic for an hour or any other extended period of time that is sufficient to prepare (numb) the body portion. Instead, these covers lay like a flat drape, are normally ineffective and are uncomfortable to wear, especially when the patient is active between the time the anesthetic is applied and the procedure is performed. Hence, the patient may only wear the cover and the anesthetic for a short time before the procedure begins. Unfortunately, when this occurs, the amount of discomfort experienced by the patient during the procedure may be significantly increased. 
         [0008]    Alternatively, the bandages can be wrapped circumferentially around the portion of the body being treated like an open ended cylinder if the treated portion is part or all of a protruding body member. However, these bandages do not cover, encapsulate and isolate the portion of the body from its normal environment. Examples of the protruding body portions that do not form effective seals with conventional bandages include, but are not limited to, nipples, fingers, toes, noses and pediatric penises. 
         [0009]    When either of the conventional bandages is used on one of these protruding body portions, they cannot effectively cover and enclose the applied agent so that it does not leak out. Instead, the applied medicament may leak out from under the bandage and onto other parts of the patient including her clothing. This can result in less than a preferred amount of the agent remaining on the protruding body portion for the prescribed period of time. If enough leaks out from under the bandage, the overall effectiveness of the agent will be significantly reduced and the procedure may have to be postponed. If the procedure is not postponed, as discussed above, the patient may experience an unnecessary amount of pain and discomfort. When either circumstance occurs, the patient and the healthcare facility can become frustrated. If excessive amounts of the agent are applied in anticipation of some of it leaking out from under the bandage, the added amount may adversely effect the adhesive portion of the bandage and prevent any portion of it from adhering to the patient. If this occurs, the amount of the agent that will leak out from under the bandage will be excessive. 
         [0010]    Other problems may also occur with the use of flat bandages. For example, it could be very embarrassing if the applied agent leaks out from under the bandage and stains the patient&#39;s shirt, pants, etc. The embarrassment may be enhanced depending on the location of the stain. Additionally, the cost of cleaning or replacing the garment that has been stained can be significant. These additional costs may frustrate the patient and possibly discourage her from having the same procedure or examination performed again. Moreover, problems and embarrassment can result if the stains cause other people to question their origin and learn about the procedure that the patient is about to undergo. 
         [0011]    Covers for specific protruding body portions are well known. One such type of cover includes nipple covers for lactating nipples that permit expelled fluid to dry on the nipple. Examples of these covers are disclosed in U.S. Pat. No. 3,840,012 to Rushton, Jr., U.S. Pat. No. 5,032,103 to Larsson and French Patent No.  792,353 to  Proquitte et al. These nipple covers include openings along their outer surface that permit air to enter the interior of the cover and dry any fluid expelled from the breast. As a result, these covers cannot be used to hold a medicament on a nipple. If they were, the medicament would leak out through the air hole(s) and onto the clothes of the patient. Therefore, the use of these covers would be pointless. 
         [0012]    Other types of devices without ventilation holes are also used to cover nipples. One such nipple cover is used to cover the nipples of male long distance runners. Such a cover is disclosed in U.S. Pat. No. 5,743,272 to Kocher, Jr. Unlike the above-discussed covers for lactating nipples, the male nipple covers do not include ventilation openings. Instead, these covers have large, flat outer end surfaces. Additionally, these covers are not laterally or longitudinally flexible. As a result, they do not collapse around the nipple and conform to its shape. Therefore, others will readily notice these nipple covers when worm. This is not acceptable for women who need to wear a medicament containing nipple cover under their clothing during work or other activities in order to prepare their nipples for an examination or procedure such as ductal lavage. These nipple covers will be conspicuous and possibly embarrass the person using them because they can be easily seen under clothing when worn. 
       SUMMARY 
       [0013]    One aspect of the present invention relates to a covering member for a protruding portion of a patient&#39;s body. This cover is flexible and collapsible so that it conforms to the shape of the encased portion of the body. This prevents the cover from being noticed while it is worn under clothing. The cover can contain a medicament or agent for treating a portion of the body before and/or after an examination or procedure. When the cover is used to apply a topical anesthetic to a portion of the body for a recommended period of time prior to the procedure or examination commencing, the amount of discomfort experienced by the patient can be significantly reduced compared to the amount experienced by the patient who has the anesthetic applied for just a few moments before the procedure begins. Alternatively, the cover can be used to hold a medicament or agent on the intended portion of the body in order to heal a wound or cure a condition such as a skin rash or the like. 
         [0014]    One embodiment includes a cover for a protruding portion of a mammalian body. This cover comprises first and second flexible members. The first member includes a securing portion, at least one sidewall and at least one end wall. The sidewall and end wall form a continuous, uninterrupted well for receiving and covering the protruding body portion. The second flexible member has a first surface for attaching to the securing portion of the first member and a second surface for securing to the body so that the second surface does not move relative to the body. 
         [0015]    Another embodiment includes a flexible nipple covering apparatus for enclosing a mammalian nipple. The covering apparatus comprises an anchoring member for securing to a portion of a body carrying the nipple. The cover also includes an uninterrupted nipple receiving well that has at least one sidewall and at least one end wall. The well is secured to the anchoring member in order to form a sealed enclosure about the nipple when the anchoring member is fixed to the body. As a result, the anchoring member and body are free of relative movement. 
         [0016]    A further embodiment includes a flexible apparatus for covering and isolating a nipple of a mammalian body. The apparatus comprises a base for positioning proximate an areola and an internal well for receiving the nipple. The well includes at least one sidewall and at least one end wall at an opposite end of the apparatus from the base. The well, the base and the end wall form a continuous, uninterrupted nipple enclosure for holding an agent on the nipple. 
         [0017]    The present invention also includes a method of preparing a portion of a body for a medical procedure. The method includes the steps of positioning a flexible covering apparatus including a well and an anchoring member over the body portion and locating the body portion so that it extends within the well. The method also includes the steps of fixing the covering apparatus to the body around the covered body portion so that a seal is formed between the anchoring member and the body and applying an agent to the body portion. 
     
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         [0018]      FIG. 1  is a perspective view of a cover for a protruding body portion according to the present invention; 
           [0019]      FIG. 2  is a top view of the cover illustrated in  FIG. 1 ; 
           [0020]      FIG. 3  is an exploded perspective view of the cover; 
           [0021]      FIG. 4  is schematic view of the cover illustrated in  FIG. 1  secured over a nipple; 
           [0022]      FIG. 5  illustrates the cross section of an alternative embodiment of the cover according to the present invention; and 
           [0023]      FIG. 6  illustrates the cross section of a third embodiment of the cover according to the present invention. 
       
    
    
     DETAILED DESCRIPTION 
       [0024]    The present invention relates to a flexible cover  10  for enclosing a protruding body portion and effectively isolating the body portion from its surrounding environment as shown in  FIG. 1 . The cover  10  can be applied to the body before or after a medical procedure is performed. In one embodiment, the cover  10  is applied prior to a procedure being conducted in order to prepare the body portion  1  for the procedure. In another embodiment, the cover  10  can be used to enclose a protruding portion of the body  1  after a procedure has been performed in order to isolate the body portion  1  and prevent infection. With either embodiment, the cover  10  can hold a desired amount of an effective topical agent  100  on the body portion  1  and prevent the agent  100  from leaking to other parts of the patient&#39;s body or his/her clothes. The cover  10  can be repeatedly used as an applicator for initial or supplemental amounts of the agent  100 . Alternatively, the cover  10  can be disposed after the first application of the agent  100 . 
         [0025]    The agent  100  can be any type of topical agent used on the body. For example, the agent  100  can be, but is not limited to, a topical anesthetic capable of anesthetizing a region of a patient&#39;s body portion in preparation for a diagnostic examination or another medical procedure. Additionally, the agent discussed herein could include any of the agents disclosed and defined in U.S. Provisional Patent application No. 60/252,090 to Hung and Patel, which was filed on Nov. 21, 2000 and entitled “Preparation for Breast Duct Fluid Collection.” This provisional application is hereby fully incorporated by reference. Additional agents that are customarily used on the body after an operation can also be retained and/or applied on the body portion  1  by the cover  10 . 
         [0026]    As used herein, the term procedure can include any of the medical procedures discussed above or any additional procedures that are known to medical practitioners. For ease of explanation, the cover  10  will be described as it is used to prepare a breast nipple for a diagnostic examination such as ductal lavage. Ductal lavage includes the introduction of a fluid into a mammalian breast duct and the retrieval of a composition from within the duct via a lumen that extends through the nipple and into the duct. U.S. patent application Ser. No. 09/473,510 to Hung et al., which is hereby incorporated by reference, provides a more detailed description of ductal lavage. While, the present invention is being described with respect to ductal lavage, its use is not limited to this procedure. For example, as discussed above, it may be used to cover and retain a medicament on other portions of a body including a pediatric penis and a nose. The cover  10  can also be applied over one or more fingers or toes. 
         [0027]      FIG. 1  illustrates a first embodiment of the cover  10  for positioning over a protruding body portion. While this embodiment of the cover  10  and the others disclosed below can be used to cover many different body parts, such as those discussed above, for clarity, the cover  10  will only be discussed as it is used to cover a nipple  110 , shown in  FIG. 4 , in order to prepare the nipple  110  for a medical procedure. The preparation includes the steps of (1) applying an anesthetizing agent to the nipple  110 , (2) positioning the cover  10  over the nipple  110  and (3) forming a seal between the cover  10  and the patient&#39;s body. The formed seal prevents the agent from leaking out of the cover  10  and onto other parts of the patient, including her clothes. According to the present invention, the agent can be applied directly to the nipple  110 , applied only within the cover  10  or a combination of both. The cover  10  then encloses the nipple  110  for a predetermined period of time that is sufficient to prepare it for the intended procedure. The cover  10  and agent can be securely positioned over the nipple  110  for about two minutes to about forty-eight hours prior to the procedure. In a preferred embodiment, the cover  10  and agent are securely positioned over the nipple  110  for about one hour to about ten hours prior to the procedure. In another preferred embodiment, the cover  10  and agent are securely positioned over the nipple for about two hours to about four hours prior to the procedure. 
         [0028]    The cover  10  is a unitary, continuous uninterrupted enclosure that isolates the nipple  110  from its surrounding environment. As shown in  FIG. 1 , the cover  10  includes a body portion covering chimney  20  and a base  30  that is secured to the patient after the cover  10  has been positioned over the nipple so that a seal is formed between the patient and the cover  10 . As used herein, the term “chimney” refers to an elongated portion of the cover  10  that includes an internal receiving well and that extends longitudinally away from the base  30  in the same direction that the nipple  110  protrudes from the body. The shape and size of the chimney  20  and the base  30  will depend on the portion of the body they are intended to cover. For example, the cover  10  for a nipple may have different dimensions than a cover  10  for a toe. 
         [0029]    As shown in  FIG. 3 , the chimney  20  includes an agent and a nipple receiving well  21 . The chimney  20  also includes portion that forms a securing ring  28  having a lower surface  29  for attaching to the base  30  as discussed below. The well  21  is defined by at least one sidewall  22  and a distal end wall  23 . The number of sidewalls  22  will vary with the shape of the well  21 . For example, a well  21  that has a circular, substantially circular or elliptical cross section may have only one sidewall  22 . However, a well  21  with a triangular, square, rectangular, diamond, or other known polygonal cross section will include more than one sidewall  22  as shown in  FIGS. 5 and 6 . The distal end wall  23  forms a continuous barrier at one end of the sidewalls  22  of the well  21 . The securing ring  28  and end wall  23  are integrally formed with the sidewall(s)  22  so that the sidewall(s)  22 , end wall  23  and securing ring  28  form a continuous, uninterrupted, flexible enclosure around the nipple  110 . In a preferred embodiment, sidewall(s), end wall  23  and securing ring  28  are formed from the same piece of material. Alternatively, they can be formed of separate pieces of material and secured together. Well known securing techniques such as RF welding can be used. The end wall  23  can be flat, rounded or stepped in between the outer edge(s)  26  of the sidewall(s)  22 . 
         [0030]    In an embodiment, the sidewall(s)  22 , end wall  23  and securing ring  28  are formed of a flexible, easily manipulated material that can be stretched into any desired shape. The material is preferably biocompatible and hypoallergenic. The material can also be resilient. A resilient material will permit the cover  10  to stretch and conform to the shape of the nipple  110 . In another embodiment, the material holds its shape after it experiences elastic deformation. For example, in one embodiment, the flexible, easily manipulated material includes a linear low density polyethylene (LLDPE). Other known flexible, stretchable and/or elastic materials may be used to form the chimney  20 . Examples of these well-known materials include, but are not limited to, other types of polyethylene, plastics, thermoset polymers, thermoforming polymers, paper, TYVEK®, webbed materials, composites, and polyesters. 
         [0031]    In an embodiment, the flexible material used for at least the sidewall(s)  22  and the end wall  23  is partially transparent so that the nipple  110  can be seen through the cover  10 . In another embodiment, the material is completely transparent so that the patient, attendant and/or physician can easily view the nipple  110  and determine the extent of its preparation or healing without having to remove the cover  10 . The transparent aspect of the material permits someone to determine if additional amounts of the agent need to be applied to the nipple  110  without having to break the seal between the base  30  and the patient. The securing ring  28  does not need to be formed of a transparent material. However, if it is formed from the same sheet of material as the transparent chimney  20  than it may be transparent. Alternatively, the securing ring  28  may also be transparent if the base  30  is at least partially transparent. In this alternative embodiment, the cover  10  could be easily and accurately positioned on a particular portion of the body. 
         [0032]    The chimney  20  is easily deformable (elastic) under pressure. As a result, it will collapse around and substantially conform to the shape of the nipple  110  as the cover  10  is being applied to the body. Typically, the patient or attendant applying the cover  10  will apply pressure to the chimney  20  as the cover  10  is applied so that air is expelled from the well  21  and the sidewall(s)  22  and end wall  23  conform to the shape of the nipple  110 . Since the chimney is able to collapse and substantially conform to the shape of the nipple  110 , the cover  10  will not be visible when it is worn under a patient&#39;s clothing. This is especially important for a woman who may feel self conscious and uncomfortable when a strange shape protrudes from underneath her blouse. The cover  10  illustrated in the figures allows a patient to discreetly wear a cover  10  over her nipple  110 . This can encourage the use of the cover  10  in the future. Additionally, as the chimney  20  collapses, any agent within the well  21  will be forced into contact with the nipple  110 . 
         [0033]    As shown in  FIG. 1 , the portion of the chimney  20  that forms the securing ring  28  is secured to an upper surface of the base  30  by adhesives. In another embodiment, the securing ring  28  has a cohesive on its lower surface  29 . The cohesive cooperates with a cohesive carried by the upper surface of the base  30  that is already secured onto the areola or another portion of the body surrounding the nipple  110 . The use of cohesives permits easy removal of the chimney  20 . The cohesives also allow for the chimney  20  to be repeatedly removed without the patient feeling any uncomfortable tugs on her areola. Additionally, the cohesives will not stick to the person removing or replacing the chimney  20  when the base  30  is left on the patient for an extended period of time. 
         [0034]    The base  30  includes a main body ring  31  that makes the cover  10  easy to handle and position over the protruding nipple  110 . The ring  31  extends in a direction away from the body (thickness) between about 0.0156 inch and 0.25 inch. In one embodiment, the ring has a thickness of about 0.0625 inch. In another embodiment, the ring  31  is about 0.03125 inch thick. 
         [0035]    In one embodiment, the ring  31  is formed of biocompatible, hypoallergenic cross-linked polyethylene foam that is available from Scapa Medical® having a tensile strength of at least about 160 psi and an elongation of at least about 290%. Other materials that can be used for ring  31  include, but are not limited to, other polyethylene foams, polyesters, papers, polyethylene liners, plastics and polypropylenes. 
         [0036]    The ring  31  is semi-rigid. It is stiff enough that a person can firmly hold onto it an easily manipulate the cover  10  without adhesive carrying portions of the cover  10  becoming secured to each other. The ring  31  can be stiff enough to permit one-handed application of the cover  10 . Yet, the ring  31  is flexible enough to conform to the shape of the person&#39;s body that surrounds the nipple  110 . The ring  31  is defined by an outer edge  32  and an inner edge  33 . As shown in  FIG. 4 , the inner edge  33  extends around the base of the nipple  110  when the base  30  is secured to the patient as discussed below. The inner edge  33  defines an opening  35  that forms a nipple receiving entrance to the well  21 . When the cover  10  is positioned on the patient, the nipple  110  will be received in the opening  35  and extend into the well  21 . 
         [0037]    The base  30  is shown as being circular in shape for ease of explanation. However, the base  30  can have any shape that permits it to securely hold an agent carrying chimney  20  over the nipple  110 . Also, while the opening  35  is shown to match the shape of the opening to the well  21 , the opening  35  can have any shape that cooperates with one of the above listed cross sections of the chimney  20  to receive the nipple  110 . Additionally, the shape of the outer edge  32  of the base  30  does not need to match the shape of the inner edge  33 . Instead, as mentioned above, the outer edge  32  can have any shape that permits the cover  10  to be securely positioned on the patient and over the nipple  110 . 
         [0038]    The ring  31  also has a lower surface  36  for contacting and being secured to the patient&#39;s body. When the cover  10  is positioned over the nipple  110 , the lower surface  36  is sized so that it covers a portion of the epidermis and/or the areola around the nipple  110 . An adhesive or other well-known securing element covers the lower surface  36  so that is can be securely positioned on the patient. The adhesive can be any known, medically approved skin adhesive, such as those approved by 3M®. In one embodiment, the adhesive is a synthetic rubber based medical approved skin adhesive ( 1 - 832 ) available with the ring  31  from Scapa Medical®. When an adhesive is used on the lower surface  36 , a removable release sheet  75  extends over the lower surface  36  to prevent the cover  10  from erroneously adhering to the body portion. In one embodiment, the release sheet  75  includes a polyethylene coated paper having a silicone release coating on one side. 
         [0039]    The adhesive can secure the lower surface  36  to the patient&#39;s body for either a short or an extended period of time. The surface  36  can be secured to the patient for between about two minutes and about forty-eight hours prior to (and/or after) the procedure. In one embodiment, the surface  36  is secured to the patient for about one hour to about ten hours. In another embodiment, the surface is secured to the patient for about two hours to about four hours. 
         [0040]    In one embodiment, the chimney  20  is removed and the ring  31  stays secured on the patient throughout the procedure. In this embodiment, the ring  31  acts as a location to place or affix other items such as tubes and/or tethers etc. The adhered ring  31  may remain or be replaced with a post procedure cover  10 , for example containing an antibiotic and/or a wound healer, etc. 
         [0041]    As can be clearly understood, during the application of the cover  10 , the release sheet  75  is removed immediately before the cover  10  is applied over the nipple  110  and secured to the body. Alternatively, the release sheet  75  could include two separate pieces. In this embodiment, one piece is removed after the cover  10  has been positioned over the nipple  110 . Then, the exposed adhesive can be applied against the body so that a partial seal is formed between the cover and the body. Next, the second release sheet will be removed and the base  30  pressed against the body. This will close the seal between the body and the cover  10 . The seal will prevent any of an applied agent from leaking out of the cover. 
         [0042]    In an alternative embodiment, the lower surface  36  can be free of an adhesive. If the lower surface  36  does not include an adhesive, strips of adhesive carrying tape could be extended across the base  30  to secure the cover  10  to the patient. In another embodiment, the cover  10  could have a cohesive on the lower surface  36  that will cooperate with a cohesive carried by an outer surface of a ring that is already secured onto the areola or another portion of the body surrounding the nipple  110 . The use of cohesives allows the cover  10  to be positioned on the body without the chance of the lower surface  36  becoming erroneously secured to the attendant applying the cover  10  or on another portion of the patient&#39;s body. Additionally, the cohesives permit the cover  10  to be removed without the patient feeling the discomfort of having an adhesively secured cover being ripped off their sensitive areola. In this alternative embodiment, the body contacting ring is secured to the patient using an adhesive or other well-known securing arrangement. 
         [0043]    No matter the manner in which the cover  10  is secured to the patient&#39;s body, the lower surface  36  must have enough surface area that it forms an effective seal with the patient&#39;s body. The seal must be strong enough to prevent the cover  10  from separating from the body. The size of the lower surface  36  will vary depending on a number of factors. These factors include at least the following: the length of the chimney  21 , the amount of pressure that will be normally applied to the chimney  21  in order to form it to the shape of the nipple  110  and the weight of the amount of the agent that will be applied to the patient and carried by the cover  10  when the chimney is filled with the agent. The surface area of the lower surface  36  is larger for the covers  10  having longer chimneys  21  and/or the covers  10  having large wells  21  intended to carry large amounts of the agent. No matter the length of the well  21 , the lower surface  36  must have enough surface area that it forms an effective seal with the patient&#39;s body. The seal must be strong enough to prevent the cover  10  from separating from the body. 
         [0044]    As seen in the figures, the chimney  20  has a length L of about 0.001 inch to about 3.0 inches. In one embodiment, the length L is about 0.25 inch to about 2.0 inches. In another embodiment, the preferred length L is about 0.63 inch. The diameter D of the base  30  and securing ring  28  is about 0.5 inch to about 3.0 inches. In one embodiment, a preferred diameter D is about 2.0 inches. The diameter I of the opening  35  is about 0.25 inch to about 2.5 inches, with a preferred diameter being about 1.0 inch. The diameter O of the well  21  at the securing ring is about 0.5 inch to about 2.0 inches. A preferred diameter O is about 1.0 inch. The diameter of the end wall  23  can be the same as diameter O or it can be slightly smaller so that the chimney  20  has a tapered profile. The term diameter can refer to corresponding widths for those embodiments that do not have circular cross sections. 
         [0045]    The above-discussed dimensions are exemplary. Each dimension of the cover  10  can be individually set to match the size of the patient&#39;s nipple. For example, it is possible to make the diameter O slightly smaller than the diameter of the patient&#39;s nipple  110  so that the chimney forms a secure fit with the base of the nipple  110 . The diameter of the opening  35  does not need to be a function of the length of the chimney  20 . Instead, the size of the opening  35  is chosen based on the diameter of the nipple  110  that it will cover. 
         [0046]    The cover  10  can be manufactured using any known method for forming a well in a sheet of flexible material. One method of forming the cover  10  according to the present invention includes the stop of cold working the material until the well  21  is formed. The step of cold working the material includes advancing a blunt object, such as a flat or rounded head punch, into the material until a well having sufficient depth to cover the nipple  110  and hold the agent is achieved. Another known way of forming the cover  10  includes thermoforming it using the method currently used to form bubble wrap. Additional forming methods include injection molding, compression molding and transfer molding. 
         [0047]    Although the foregoing invention has been described in some detail by way of illustration and example for purposes of clarity of understanding, it will be readily apparent to those of ordinary skill in the art in light of the teachings of this invention that certain changes and modifications may be made thereto without departing from the spirit or scope of the appended claims.