Patent Publication Number: US-2023157866-A1

Title: Universal wrap for securing a thermal pack

Description:
CROSS-REFERENCES TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 16/537,678, now issued as U.S. Pat. No. 11,559,427. This application lists the same inventor as the parent application. 
    
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
     Not Applicable 
     MICROFICHE APPENDIX 
     Not Applicable 
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     This invention relates to the field of medical products. More specifically, the invention comprises a wrap that can be used to secure a thermal pack against a selected portion of a patient&#39;s anatomy. 
     2. Description of the Related Art 
     Thermal packs are used in a wide variety of medical therapies. The term “thermal pack” should be understood to include any device intended to transfer heat to a patient&#39;s body or to remove heat from a patient&#39;s body. Examples include ice packs, cold gel packs, and hot packs. 
     There are numerous prior art examples of strap and wrap devices configured to hold a thermal pack against a specific anatomical region. There are wraps designed to press a thermal pack against a patient&#39;s knee. There are different designs intended to hold a thermal pack against a patient&#39;s ankle. Each of these designs are functionally dissimilar. Each works well for its intended application but lacks the flexibility to accommodate a different application. 
     Therapy based on heat transfer must often be applied shortly after an injury occurs. This is particularly true for cold therapy, where the efficacy is greatest in the few hours immediately following an injury. Thus, a medical practitioner needs to have the ability to apply a wrap upon the presentation of an injured patient. It is not practical to order a specialized wrap and then wait a day or more for its delivery. It is also impractical to stock a wide range of specialized wraps so that a suitable wrap for any type of injury is always on hand. A more versatile wrap is needed, so that a provider can stock one type of wrap and adopt it to various injuries as needed. The present invention provides such a solution. 
     BRIEF SUMMARY OF THE PRESENT INVENTION 
     The present invention comprises a system and method for providing a universal wrap that can apply a thermal pack to many different regions of a patient&#39;s body. The universal wrap is provided in a standardized form. The medical provider is provided with options to modify the standardized form in order to adapt the wrap to many different applications. 
    
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS 
         FIG.  1    is a perspective view, showing a wrap assembly made according to the present invention. 
         FIG.  2    is a perspective view, showing the wrap of  FIG.  1    with a tab in the open position. 
         FIG.  3    is a perspective view, showing the configuration of  FIG.  1    from a different vantage point. 
         FIG.  4    is a perspective view, showing an alteration to the standard configuration. 
         FIG.  5    is a perspective view, showing the configuration of  FIG.  4    in an assembled state. 
         FIG.  6    is a perspective view, showing the addition of a pair of thermal packs. 
         FIG.  7    is a perspective view, showing two exemplary thermal packs. 
         FIG.  8    is a sectional elevation view, showing internal details of a thermal pack. 
         FIG.  9    is a sectional elevation view, showing internal details of an alternate embodiment of a thermal pack. 
         FIG.  10    is an exploded perspective view, showing a sub-bag used in one of the thermal packs. 
         FIG.  11    is a perspective view, showing a sub-bag 
         FIG.  12    is a sectional elevation view, showing internal details of a sub-bag. 
         FIG.  13    is a perspective view, showing the addition of a temperature indicating area to a sub-bag. 
         FIG.  14    is a perspective view with a cutaway, showing the use of bulk thermal media and a plurality of sub-bags in a thermal pack. 
         FIG.  15    is a perspective view, showing one assembled state for the inventive wrap. 
         FIG.  16    is a perspective view, showing how the width of the body of the wrap can be modified. 
         FIG.  17    is a perspective view, showing the embodiment of  FIG.  16    with the addition of a thermal pack. 
         FIG.  18    is a perspective view, showing the inventive wrap applied to a lumbar region of a patient. 
         FIG.  19    is a perspective view, showing the configuration of  FIG.  18    from an anterior vantage point. 
         FIG.  20    is a perspective view, showing the inventive wrap applied to a shoulder of a patient. 
         FIG.  21    is a perspective view, showing the inventive wrap applied to a shoulder of a patient. 
         FIG.  22    is a perspective view, showing the inventive wrap applied to a shoulder of a patient. 
         FIG.  23    is a perspective view, showing the inventive wrap applied to a knee of a patient. 
         FIG.  24    is a perspective view, showing the inventive wrap applied to a knee of a patient. 
         FIG.  25    is a perspective view, showing the inventive wrap applied to a knee of a patient. 
         FIG.  26    is a perspective view, showing the inventive wrap applied to an ankle of a patient. 
         FIG.  27    is a perspective view, showing the inventive wrap applied to an ankle of a patient. 
     
    
    
     REFERENCE NUMERALS IN THE DRAWINGS 
     
         
         
           
               10  universal wrap 
               12  body 
               14  strap 
               15  outer surface 
               16  tab 
               18  inner surface 
               20  hook panel 
               22  outer surface 
               24  inner surface 
               26  hook surface 
               28  hook surface 
               30  cut 
               32  first segment 
               34  second segment 
               36  thermal pack 
               38  inner layer 
               40  outer layer 
               42  expansion valve 
               44  hook panel 
               45  inner sealing layer 
               46  hook panel 
               48  bulk thermal media 
               49  interior volume 
               50  sub-bag 
               51  sealed seam 
               52  first panel 
               54  second panel 
               56  outer surface 
               58  indicating area 
               60  inner surface 
               62  sealed perimeter 
               64  cut 
               65  patient 
               66  cut 
               67  lumbar region 
               68  knee 
               70  ankle 
               72  interior volume 
               74  back surface 
           
         
       
    
     DETAILED DESCRIPTION OF THE INVENTION 
       FIG.  1    shows an embodiment of the wrap used in the present invention. The various features and options of the wrap will be explained initially. Then an explanation of how these features and options may be used to secure the wrap to a patient will be provided. 
     Universal wrap  10  includes a flat and rectangular body  12 . The body has two lateral edges. Strap  14  attaches to a first lateral edge and extends away from the body as shown. Tab  16  connects to the second lateral edge. In  FIG.  1   , tab  16  is shown folded over and secured to inner surface  18  of body  12 . Inner surface  18  is covered in loop covering. The side of tab  16  facing away from the viewer is covered in hooks. Thus, pressing tab  16  against inner surface  18  secures the tab to the inner surface. Back surface  74  of tab  16  is provided with a loop covering so that other hook panels may be secured to it. 
     In the context of this disclosure the term “loop covering” means any hook-compatible material. In other words, any fabric to which a hook panel can be secured when using hook-and-loop fasteners. An example of hook-and-loop fasteners is VELCRO brand materials such as marketed by Velcro, BVBA. As those skilled in the art will know, many hook-compatible fabrics are soft and smooth in appearance. They do not necessarily include coarse pile-type loops such as commonly used several decades ago (though the term hook-compatible material would certainly include coarse pile-type loops as well). 
     Strap  14  has outer surface  22  and inner surface  24 . Outer surface  22  is provided with a loop covering as well. Hook panel  20  includes a hook surface—facing away from the viewer in  FIG.  1   . Hook panel  20  can be secured to the distal end of strap  14  by pressing the hook panel onto outer surface  22 —as will be explained subsequently. 
       FIG.  2    shows the same universal wrap with tab  16  flipped open to reveal hook surface  26 . One edge of tab  16  remains attached to the second distal edge of body  12  as shown. Soft fabrics are preferably used for many of the components of the wrap. Body  12  in this embodiment is an assembly of multiple layers. These layers can be assembled by sewing. It is preferable, however, to join the layers by laminating. A laminated assembly can be cut to a reduced side without the trimmed edges fraying or separating. In the example shown in  FIG.  2   , a bias band is attached around the perimeter of body  12 . A stitch line can be used to connect the bias band and if this is present the stitch line also attaches the proximal end of strap  14  and the attached edge of tab  16 . Adhesives or lamination techniques can also be used to assemble these components if desired. 
       FIG.  3    shows the assembly of  FIG.  1    from a different vantage point. In this view outer surface  15  of body  12  is shown. This outer surface is preferably provided with a loop covering. The reader can also see how hook panel  20  is attached to the distal end of strap  14  by pressing hook surface  28  against outer surface  22 . The hooks on hook surface  28  engage the loop covering of outer surface  22  and hold the hook panel in place. The reader will also note how only approximately half of hook panel  20  has been pressed onto strap  14 —leaving the balance of the hook panel free. The free portion of hook surface  28  can be pressed onto another loop covered surface. Hook panel  20  thereby becomes a connector. 
     The fabric used for strap  14  preferably has the following properties: (1) It is elastic so that a degree of stretch and compression can be applied to secure the wrap, (2) At least inner surface  24  is smooth and comfortable for wearing against a patient, and (3) The band may be cut without creating a frayed or unstable edge. This third preferred property allows the wrap to be fitted to a wide variety of patients. Strap  14  is provided in a long un-stretched length, such as 42 inches (107 cm). This can accommodate large patients, but will be too long for smaller patients. The user can cut strap  14  to a shorter length and move hook panel  20  to the newly created distal end. 
       FIGS.  4 - 6    show an additional configuration that provides added flexibility. In  FIG.  4   , strap  14  has been cut along 30 to create first segment  32  and second segment  34 . The proximal end of first segment  32  remains attached to body  12 . A newly-created distal end for first segment  32  lies at cut  30 . Second segment  34  has a newly created proximal end at cut  30 . Hook panel  20  remains affixed to the distal end of second segment  34  (though the hook panel can of course be removed at any time by pulling it free). 
     Second segment  34  is typically flipped over and its proximal end is then placed over tab  16 . The proximal end is then pressed down onto the exposed hook surface  26  of tab  16 . The loop covering on the outer surface of second segment  34  engages the hook surface on the tab and the second segment is thereby secured.  FIG.  5    shows this configuration—with second segment  34  secured in place. Second segment  34  can then be looped over first segment  32  as shown. The exposed portion of hook panel  20  is pressed into the loop covering on first segment  32 . A secure and adjustable band is thereby formed. This band can be used to hold body  12  against a selected area of a patient. 
     Of course, a central purpose of the universal wrap is to hold a thermal pack in position.  FIG.  6    shows the universal wrap in the configuration of  FIG.  5   , but with the band opened by unhooking hook panel  20  from first segment  32 . As explained previously, inner surface  18  of body  12  is provided with a loop covering. This loop covering is used to attach one or more thermal packs  36 . 
     In the example of  FIG.  6   , the thermal packs are provided in a rectangular form. Each thermal pack has one or more hook panels that engage the loop covering on inner surface  18  when the thermal pack is pressed against inner surface  18 . 
       FIGS.  7 - 14    provide detail regarding some exemplary thermal packs. In reviewing these descriptions, the reader should bear in mind that the present invention is by no means limited to any particular type of thermal pack.  FIG.  7    shows two examples of the same type of thermal pack  36 . This example is a cold pack intended to receive heat transferred from a patient. The lower of the two thermal packs shown in  FIG.  7    has inner layer  38  facing upward. This is the layer intended to press against the patient. It is covered in a smooth and comfortable material. 
     The upper of the two thermal packs shown in  FIG.  7    is flipped over to expose outer layer  40 . This outer layer will face away from the patient. It includes a pair of hook panels  44 ,  46 . These hook panels are configured to secure the thermal pack in place when they are pressed against a panel having a loop covering. Expansion valve  42  selectively admits air when the thermal media within the thermal pack expands upon freezing (assuming that such a type of thermal media is used). At least a portion of outer layer  40  is preferably made transparent so that a user can see the contents of the thermal pack and observe whether the contents are liquid or frozen. 
     A heat transfer medium that undergoes a phase change offers advantages for the thermal packs  36 . First, the use of a phase change allows the absorption of much more heat that would be possible in its absence. Second, the use of a phase change provides a steady temperature for the heat transfer medium as it is transitioning from a solid to a liquid (the temperature of a substance being constant in that process). 
     One suitable heat transfer medium is disclosed in U.S. Pat. No. 5,800,491 to Kolen and Nebolon. This patent discloses a composition of discrete hydrophilic absorbers that are hydrated with a liquid comprising a solution of water and a humectant selected from the group consisting of propylene glycol, ethylene glycol, glycerin, dimethyl sulfoxide, dimethyl formamide, and combinations thereof. The hydrophilic absorbers are discrete acrylic polymer granules, such as discrete cross-linked polyacrylamide copolymer granules. Upon freezing, this composition creates a solid state that is akin to packed snow or crushed ice. It remains pliable instead of freezing into a unified solid mass. 
     The interior of each thermal pack contains a heat transfer medium. This preferably includes the aforementioned hydrating liquid consisting of a solution of water and a humectant selected from the group consisting of propylene glycol, ethylene glycol, glycerin, dimethyl sulfoxide, dimethyl formamide, and combinations thereof (as described in the prior art section of this disclosure). Air is admitted to the interior through expansion valve  42  during the freezing process. When the medium melts, valve  42  allows air out of the enclosed interior but not the liquid medium. 
       FIG.  8    shows a section view through thermal pack  36 . Two layers of sealing material—outer layer  40  and inner sealing layer  45  (the water impermeable layer) are heat staked together along sealed seam  51  (which runs along the entire perimeter of the thermal pack). The inward facing surface (the side intended to face the patient) also includes inner layer  38 . This cover material is preferably a soft and compliant material that may be comfortably worn against the user&#39;s thin clothing (such as a T-shirt) or even directly against the user&#39;s skin. This material preferably wicks moisture away from the user. One of its main purposes is to serve as a barrier separating the user from direct contact with the thermal transfer pack. The material thereby regulates the rate of heat transfer to a desired level. 
     Inner layer  38  may be bonded to the thermal pack by any suitable method—including adhesives or stitching. It is preferable for the side facing the user to have no exposed discontinuities as these may be irritating. Bulk thermal media  48  is contained within interior volume  49  formed between the two layers of sealing material. Hook panel  44  is affixed to the outward-facing side of the assembly. 
       FIG.  9    shows an enhancement to the cooling pack shown in  FIG.  8   . Rather than placing the cooling media in a single compartment, the version of  FIG.  9    places numerous small bags of cooling media into a larger bag. Sub-bags  50  are relatively small—on the order of 0.5 to 2 inches square (1.25 cm to 5.0 cm). In many instances it will be preferable to make them even smaller—such as 0.2 inches square (0.5 cm). The most preferred size is 0.75 inches square (1.25 cm square). 
     As explained previously, the cooling media contained within the interior is preferably a substance such as shown in U.S. Pat. No. 5,800,491 to Kolen and Nebolon. This substance forms an organized crystalline solid with a consistency similar to snow. Even as a solid, it remains soft and malleable. However, the substance such as disclosed in the &#39;491 Patent does not absorb as much energy during the transition from a solid to a liquid as pure water. Water can absorb more thermal energy, yet water has an undesirable property in that it solidifies into a hard mass (ice). If the entire volume within the thermal pack were simply filled with water and frozen, the result would be a rigid object that would be quite uncomfortable to the patient. 
     The thermal pack of  FIG.  9    provides the advantageous latent heat of water while retaining most of the beneficial aspects of the substance described in the &#39;491 Patent. Each sub-bag  50  is filled with water. Small amounts of other substances may be present as well, but water is by far the main constituent. The volume contained within the interior of the thermal pack but outside sub-bags  50  is filled with a substance that creates a snow-like solid (such as described in the &#39;491 Patent). The result is an advantageous combination of features. Each individual sub-bag  50  freezes into a hard object (containing ice). The surrounding volume freezes into a malleable snow-like substance. The sub-bags are relatively small—preferably less than 3 cm on a side. Thus, the overall thermal pack  36  can still bend and flex because the sub-bags  50  can move about within the snow-like frozen substance surrounding them. The user employs the thermal pack of  FIG.  9    in the same way as the thermal pack of  FIG.  8   . However, the composite nature of the bag allows a greater absorption of thermal energy for the same unit volume. 
     In some versions of the composite thermal transfer pack the sub-bags or outer bag can include a thermochromatic material. This material changes color when the media freezes—thereby clearly indicating to the user whether all the sub-bags are fully transitioned to a solid. In some versions a thermochromatic ink may be added to the water within sub-bags  50 . In other versions, the thermochromatic material will be a film added to the sub-bags, the overall bag, or both. 
       FIGS.  10 - 14    show a preferred embodiment employing thermochromic materials to indicate when the water in the sub-bags is frozen.  FIG.  10    depicts an individual sub-bag in a disassembled state. First panel  52  is configured to join second panel  54  by joining the perimeter of the two panels together to form a continuous seal (such as by heat fusing or ultrasonic welding). 
       FIG.  11    shows the two panels joined together to form sub bag  50 . The bag is filled with water. Sealed perimeter  62  is formed around the perimeter of the two panels so that the water cannot escape. 
     The present invention is by no means limited to any particular method for making the sub bags, and in fact the sub bags may be made using many different methods and materials. One approach is to fold a single piece of flexible material over on itself. One “sealed edge” is created by the fold and the remaining three edges may then be sealed using a suitable method. Another approach is to cut lengths from a continuous tube of flexible material (possibly stored on a roll). The two cut ends can then be sealed using a suitable method. 
     The operation of sub bag  50  is quite simple. When the sub bag is exposed to temperatures below 0 degrees centigrade for a sufficient period the water within the bag freezes. As is widely known, water displays the unusual characteristic of expanding as it transitions from a liquid to a solid. The material used for the panels  52 ,  54  is preferably sufficiently elastic to accommodate many freezing and thawing cycles without breaking down. Another option is the inclusion of an air pocket within the sub bag so that the volumetric change is accommodated by varying air pressure. Yet another option is including some type of air valve. However, it is preferable to maximize the heat transfer to and from the bag and to minimize complexity. Thus, the preferred embodiments contain plain water and do not incorporate any sort of valve. The term “plain water” shall mean pure water and solutions in which water makes up 95 percent of the total solution by mass. In some embodiments a small amount of other material may be added to the water to adjust the freezing point, to inhibit growth of organic materials, or for some other purpose. However, the other material shall not exceed 5% of the total solution by mass. 
     Returning to  FIG.  10   , the reader will note that the two panels  52 ,  54  each have an outer surface  56  and an inner surface  60  (referring to the inner and outer surfaces that will result once the two panels are joined together). Each of the two panels  52 ,  54  also has an indicating area  58 . The indicating area may be located on an inner surface, an outer surface, or both (and may in fact comprise the entire surface). However, in the embodiment shown, indicating area  58  is located on the inner surface of each panel. 
     Indicating area  58  preferably includes a thermochromic material applied to the surface of the panel. The thermochromic material preferably changes color at a set point that indicates a complete freezing of the water within the bag. As an example, the set point might be −2 degrees centigrade. At this point, the thermochromic material can be configured to change from clear to opaque (such as a medium blue color). When a user sees this color, it indicates that the contents of the particular sub bag have completely frozen. Certain other thermochromic materials may change from one color to another color (such as white to indigo). 
     A thorough discussion of thermochromic materials is beyond the scope of this disclosure. However, an exemplary choice is a leuco dye secured in microcapsules. Commonly used leuco dyes include sprirolactones, fluorans, spiropyrans, and fulgides. The microcapsule containing the dye is a small enclosed volume that retains the dye without leakage. The encapsulating material is thermally conductive so that the surrounding temperature is quickly assumed by the leuco dye within the microcapsule. Because the mass of leuco dye within each microcapsule is very small, it can change temperature rapidly. These microcapsules can be adhered to the inner surfaces of the panels  52 ,  54 . A sufficiently dense array of such microcapsules will be in contact with the water within the sub bag. 
     Those skilled in the art will know that leuco dye microcapsules can be printed on a surface or sprayed on a surface. They may even be embedded in the material itself as it is manufactured. Leuco dyes are known to have limited accuracy in their indication, since the color change usually occurs in about a 3 degree centigrade band. With this in mind, one could select a leuco dye that transitioned to the opaque state between −1 and −4 degrees centigrade. With such a selection, the dye would reliably indicate the frozen state. 
     Those skilled in the art will also know that liquid crystal thermochromic agents generally have a better temperature accuracy than leuco dyes. One could employ liquid crystal materials though this would likely drive up the cost and limit the color choices. The present invention is by no means limited to any particular thermochromic agent, nor is it limited to any particular method of applying the thermochromic agent. 
     As an example, one may consider an embodiment where the sub-bags are made from a long length of flexible tube. The tube may be cut at suitable intervals to create a short, tubular section with two open ends. The two open ends are sealed to form the sub-bag. In this example the leuco dye may be a printed continuously along the entire inward-facing surface of the flexible tube. The result is that the inward-facing surface of the sub-bag is covered by the leuco dye. From the user&#39;s perspective, the entire sub-bag will appear to include the leuco dye. Thus, the color change will appear to be the entire sub-bag. 
       FIG.  11    provides a perspective view of sub bag  50  filled with water.  FIG.  12    provides a sectional elevation view through the bag depicted in  FIG.  11   . A volume of water  72  is trapped between the panels  52 ,  54  and contained by sealed perimeter  62 . The thermochromic agent is preferably placed on the inner surface of each panel so that it has more direct contact with the water. 
       FIG.  13    shows a perspective view of the same sub bag  50  after the thermochromic material has transitioned to an opaque state. The material selected for panels  52 ,  54  should be transparent or semi-transparent if the thermochromic material is placed on the inner surface of the panels. In the example of  FIG.  13    the material of the panels is transparent and the thermochroic material is deposited on the inner surface of the panels. Indicating area  58  is visible from the exterior of the sub bag as shown. The indicating area is depicted as a cross-hatched area. In reality, the indicating area will appear as an opaque region. For example, if a medium blue thermochromic agent is used, then indicating area  58  will appear as a blue rectangle on the panels (and the user will likely not perceive the fact that the thermochromic agent is on the inner surface but will instead just perceive the appearance of a blue rectangle on the visible outer surface). 
     As explained previously, the inventive thermal transfer pack places a plurality of sub bags  50  into a larger bag.  FIG.  14    shows a thermal pack  36  made by placing a number of sub bags  50  and surrounding bulk thermal media  48  into a sealed bag. A cutaway is included in the view to clearly show sub bags  50 . 
     The sub bags are surrounded by the bulk transfer media that freezes into a highly crystalline structure akin to snow. Upon freezing, this duplex composition creates a solid state that remains pliable instead of freezing into a unified solid mass. The composition has been previously referred to as a “heat transfer medium.” In the context of the inventive duplex thermal transfer pack the use of the term “heat transfer medium” is a bit vague, since both the water and the mixture of hydrophilic absorbers and water with a humectant as a “heat transfer medium.” Accordingly, the water and humectant solution shall be referred to as a solid-pliable heat transfer medium in the context of the duplex thermal transfer pack. A solid-pliable heat transfer medium is one which remains pliable after the water it has contained transitions from a liquid to a solid. 
     The sealing material that is used in the creation of outer layer  40  preferably has a transparent surface that allows the user to see the condition of the sub bags within. A user typically places thermal pack  36  in a freezer for a long enough period to convert the heat transfer medium to a crystalline solid and to freeze the water within the sub bags  50 . The user can visually confirm the freezing of the water in the sub bags by noting the change of color on the indicating areas on the sub bags (the areas containing the thermochromic material). The transparent surface should be sufficiently clear to allow a user to perceive the color change of the sub bags that are pressed up against the other side of the surface. A thin and clear plastic material is sufficient. 
     The transparent surface may only extend for part of one side of the bag, or it may extend for more than that. In the example of  FIG.  14   , portions of transparent surface are covered by the hook panels. Other portions of the transparent surface may be covered by the expansion valve. 
     Most of the volume within thermal pack  36  is consumed by the sub bags  50 . Each sub bag is relatively small compared to the thermal transfer pack as a whole, however. Preferably, the longest dimension of a sub bag is less than ⅓ of the longest dimension of the thermal pack as a whole. Even more preferably the longest dimension of a sub bag is less than 1/10 of the longest dimension of the thermal pack as a whole. 
     As an example, the thermal transfer pack of  FIG.  14    has a longest dimension of 28 cm. A sub bag  50  used in this example might have a longest dimension of 2.5 cm. The sub bags are preferably pillow-shaped. In this example, the sub bag dimension are 1.25 cm×2.5 cm×0.50 cm. When the thermal transfer pack is placed in the freezer, the sub bags freeze into hard little “plates.” The surrounding solution of water and a humectant freezes into a crystalline structure resembling packed snow. It remains soft and malleable. Because the now-hard sub bags are small in comparison to the overall volume of the thermal transfer pack—and because the interstices between the sub bags are packed with the soft “snow”—the thermal transfer pack as a whole retains a soft and malleable feel. 
       FIGS.  15 - 17    illustrate exemplary configurations for the universal wrap. In  FIG.  15   , outer surface  15  of body  12  is facing toward the user. Strap  14  is in an uncut state. It is formed into a loop as shown. Hook panel  20  has been used to secure the strap to outer surface  15  by pressing the exposed portion of the hook surface on the hook panel into outer surface  15  of body  12 . An encircling loop is thereby formed. This loop can be placed around the patient&#39;s waist or chest in order to press thermal packs affixed to body  12  (on the side facing away from the viewer) against the patient. The outer surface of strap  14  and body  12  are provided with a loop covering. Thus, the overall circumference can be adjusted by adjusting the overlap of the strap and securing hook panel  20  to a desired position on the body or the strap. 
       FIG.  6    shows a configuration where the strap has been cut in two and the two segments are then joined on the side of the loop opposite to body  12 . This configuration has been described previously and will not be repeated here. 
       FIGS.  16  and  17    illustrate still another configuration—in which the size of body  12  is reduced. Body  12  is preferably made of a fabric that can be cut to produce a clean and stable edge. Cuts  64 ,  66  have been made in  FIG.  16    to match the width of body  12  to that of strap  14 . Turning to  FIG.  17   , a single rectangular thermal pack  36  has been affixed to the modified body  12 . This configuration provides a smaller contact area that is suitable for some applications. 
     Returning to  FIG.  16   , it is also possible to make a single cut that is perpendicular to the orientation of the cuts shown. This single cut would remove the region of tab  16 , resulting in a “T” shape with the strap being the long part of the T and the remaining shape of the body being the cross piece. This configuration is a good shape for use on the back of a patient&#39;s elbow. Of course, the practitioner is not limited to perpendicular cuts. In some instances an angled or curved cut will be advantageous and these are available as well. 
       FIGS.  18 - 27    illustrate examples of how the universal wrap can be applied to a patient.  FIG.  18    shows the example of a patient needing cold therapy for the lumbar region. The goal is to place thermal packs affixed to body  12  over lumbar region  67 . This example starts with the configuration of  FIG.  6   . One or more thermal packs are affixed to inner surface  18  of body  12  as shown. 
     The assembly is then lifted into position with the thermal packs pressed against the patient&#39;s lumbar region as shown in  FIG.  18   . First segment  32  is pulled around the left side of the patient&#39;s waist and second segment  34  is pulled around the right side of the patient&#39;s waist. Looking now at  FIG.  19   , the patient adjusts the amount of pressure by stretching the first and second segments. When the pressure is at the desired level, she secures the first and second segments into a belt by pressing hook panel  20  into the loop covering on first segment  32 . 
     For a patient having a waist size as depicted in  FIG.  19   , it will often be advisable to cut a segment off the distal end of first segment  32 , second segment  34 , or both. These cuts can be made to place hook panel  20  in a convenient location. This is desirable because the user will periodically remove and reinstall the wrap assembly (or a healthcare provider will do so). If the thermal packs are cold packs as shown in  FIG.  9   , they will need to be replaced approximately every four hours. In order to replace the packs the user will typically remove the wrap, peel the old packs off of body  12 , and stick on new packs that have just been removed from a freezer. The old packs will then be placed in a freezer. In some applications the packs can be removed by folding down a portion of body  12  while leaving the wrap in place. This is an optional method. 
       FIGS.  20  and  21    show a first approach to placing the universal wrap on a patient&#39;s shoulder. A pair of thermal packs are affixed to body  12  and the assembly is then placed on the left shoulder of patient  65 . Strap  14  is passed around her back and brought through the gap between her torso and her right arm. The strap is tightened to a desired extent and then hook panel  20  is secured to the loop covering on outer surface  15 . The tension on the strap urges the thermal packs beneath body  12  against the patient&#39;s shoulder. 
       FIG.  21    shows the secured configuration with hook panel  20  secured to outer surface  15 . This configuration can be difficult to remove for some patients. The left arm is likely immobile, since an injury to the left shoulder is being treated. The patient must therefore pull hook panel  20  free by crossing her right arm over her body and using her right hand to grasp the hook panel. In patients with limited mobility this motion can be difficult. 
       FIG.  22    shows an alternate method of using the universal wrap to place a thermal pack on a shoulder. This version starts with the configuration of  FIG.  4   , except that cut  30  is made much further away from body  12  so that second segment  34  is quite short. Returning now to  FIG.  22   , tab  16  is pulled out from body  12  and second segment  34  is secured to tab  16  by pressing the second segment against the hook surface on the tab. First segment  32  is pulled around the patient&#39;s body and through the gap between her torso and her right arm. Hook panel is transferred to the distal end of first segment  32  as shown. The loop is then formed by securing hook panel  20  to the distal end of first segment  32  and pressing the free end of the hook panel into second segment  34 . The advantage of this configuration is the fact that hook panel  20  is much easier for the user to reach with her right hand. 
       FIGS.  23 - 25    show a method of applying the inventive universal wrap to a patient&#39;s knee. This process starts with the configuration of  FIG.  1   . A pair of thermal packs  36  are affixed to the inner surface of body  12 . Strap  14  is passed around the area of knee  68 —as shown. Hook panel  20  is placed on the distal end of the strap. 
     The reader will recall that strap  14  is preferably elastic. In the knee application, the strap can be stretched in a fashion similar to an ACE bandage in order to create a compressive wrap.  FIG.  24    shows the process after strap  14  has been stretched and wrapped around the lower thigh. The distal end of the strap is then wrapped around the inferior knee region.  FIG.  25    shows the final result. The strap is wrapped nearly three times around the knee and secured in place by pressing the exposed portion of hook panel  20  back against the outer surface of the strap itself. Tension on the strap urges the thermal packs beneath body  12  against the knee. 
       FIGS.  26  and  27    show an example of applying the inventive universal wrap to a patient&#39;s ankle. This process starts with the configuration of  FIG.  17   .  FIG.  17    shows a single thermal pack  36  affixed to a body  12  that has been reduced in size. Turning to  FIG.  26   , thermal pack  26  is placed over the anterior portion of the patient&#39;s ankle. Strap  14  is passed around the ankle with hook panel  20  affixed to its distal end. The strap is then stretched and wrapped around the ankle one or more times (possibly after being cut to a shorter length).  FIG.  27    shows this configuration after hook panel  20  has been secured to the outward facing portion of the strap. 
     The inventive wrap system can be combined with the thermal packs in additional ways that have not been illustrated. The following paragraphs provide additional examples: 
     1. The cold packs can be replaced with hot packs containing thermal media that are designed to be heated in a microwave. 
     2. The hook material and the loop material can be reversed in most any situation. 
     3. Inelastic material can be used for the strap where desired. 
     4. The hook panel can be placed on either strap or on the body itself in some circumstances. 
     5. One or more air bladders can be added in addition to the thermal packs, or in some instances combined with the thermal packs. Air bladders are disclosed in detail in commonly-owned U.S. patent application Ser. No. 16/427,457. 
     6. The aforementioned air bladders can be provided with hook panels so that a user can place them on a desired interior surface of the universal wrap. 
     7. A coolant circulation bladder can be added in addition to the thermal packs or in the place of some or all of the thermal packs. An external circulation pump and cooling system can be used with the coolant circulation bladder. As for the air bladder, a coolant circulation bladder can be provided with hook panels so that a user can place them on a desired interior surface of the universal wrap. 
     Although the preceding descriptions present considerable detail they should be properly viewed as illustrating embodiments of the present invention rather than limiting the scope of the invention. Many more embodiments following the same principles will occur to those skilled in the art. Accordingly, the scope of the invention should be fixed by the following claims rather than by the examples given.