Abstract:
A bandage for use to apply pressure to the wound area of a patient who has undergone a mastectomy includes a main body panel formed from a fabric that is non-elastic and breathable. The bandage is secured adjacent the side of the body of the patient to avoid the formation of a seam adjacent the wound area, yet allow application and removal of the bandage by the patient without assistance and with minimal pain and discomfort. An elastic member enables adjustment of the bandage for proper fit around the torso of the patient and ensures the application of adequate pressure. The bandage is configured so that the material that contacts the person&#39;s skin is non-elastic and breathable for increased comfort.

Description:
FIELD OF THE INVENTION 
     The present invention relates to a medical bandage, and more particularly, to a bandage for use to secure a dressing over the chest area of a person. Although the bandage of the present invention is described in relation to a patient who has undergone a mastectomy, it should be understood that the present invention is not limited to such use but may be employed to apply pressure over other types of wounds and to other areas of the body. 
     BACKGROUND OF THE INVENTION 
     After a mastectomy, it is necessary for the mastectomy patient to wear a dressing over the wound area. The patient is required to wear the dressing throughout the recovery period which typically is about four to six weeks. The dressing must be changed at least once every day. Initially the patient is assisted by hospital personnel or other persons in changing the dressing. However, in view of the relatively lengthy recovery period, it is desirable that the patient eventually be able to change the dressing by herself with minimal pain and discomfort, since oftentimes there may not be anyone available to assist the patient. Moreover, since a dressing is required continually throughout the recovery period, it is especially important that the means used to secure the dressing to the patient be comfortable. For example, it should not chafe the skin nor trap excessive moisture against the skin. Furthermore, the patient experiences significant swelling in the wound area. This swelling decreases over time. The bandage should be easily adjustable to achieve proper fit in conformance with the amount of swelling experienced at any given time. 
     It is known to use nonadhesive bandages (i.e., bandages that do not use adhesive tape) that encircle the chest of a patient to secure a dressing to a mastectomy area. However, these bandages are characterized by the use of elastic material that contacts the skin and tends to entrap excessive moisture so as to create further discomfort for the person. Elastic material returns with force to substantially, if not completely, its original shape when released after stretching. As a result of this tendency to return to its original shape, elastic material when pulled over a surface exerts pronounced pressure on that surface. Thus, a bandage that uses elastic material to cover a wound applies a substantial amount of pressure to the area of the body contacting the elastic material. In contrast, a non-elastic material tends to resist stretching or to lose shape upon stretching (i.e., it does not have a tendency to rebound to its original shape). 
     Although some elastic materials breathe to a limited extent, they tend to entrap significantly more moisture against the skin as compared to a breathable material such as cotton, gauze, flannel, or other fabric materials. Also, elastic materials tend to create a &#34;binding&#34; sensation that many persons find uncomfortable. Moreover, in some prior art bandages, the edges of the elastic material tend to roll up and/or the elastic material chafes the skin. Furthermore, some prior art nonadhesive bandages cause undue discomfort in that they fasten at the center of the person&#39;s chest, thereby forming a seam that lies adjacent the mastectomy area. The mastectomy wound and surrounding areas are extremely tender, especially during the early part of the recovery period. The pulling of the two sides of the seam adjacent the mastectomy area may cause undue pain and discomfort. 
     U.S. Pat. No. 3,561,442 to Goswitz describes a mastectomy compression bandage consisting of a strip that fastens at the front. The strip includes an elastic portion that covers the area of the mastectomy. A brassiere cup made of non-elastic material is provided to cover the remaining breast. This brassiere cup would appear to limit the range of adjustablility of the bandage. 
     U.S. Pat. No. 5,011,452 to Kelly describes a brassiere for use during sporting activities or for use by persons in post-surgical rehabilitation. In some embodiments, the brassiere is configured in a closed loop form. In order to apply or remove the brassiere, the person must slide the brassiere over her head and neck as if it was a t-shirt. In another embodiment, the brassiere is provided with an opening at the front that is closed by hook/eye fasteners or hook and loop fasteners. All embodiments are provided with a drawstring on the front panel for tightening the front panel around the chest. It would seem the tightened drawstring causes discomfort in the mastectomy area. Further, the back panel of the brassiere is made of an elastic material. 
     A mastectomy bandage providing increased comfort and that is easily adjusted to apply adequate pressure in conformance with the amount of swelling experienced at any given time is desirable. 
     SUMMARY OF THE INVENTION 
     The present invention is a mastectomy bandage that provides increased comfort and is easily adjusted to accommodate changes in the amount of swelling in the wound area. Moreover, the bandage has a simple and inexpensive construction. 
     The bandage comprises a main body panel formed of a non-elastic, breathable material. The main body panel is configured to encircle the torso of a person, the ends of the main body panel being located adjacent one side of the person&#39;s body when the bandage is applied. An elastic member is attached at one side of the main body panel. When the bandage is applied, the main body panel is wrapped around the chest of the person and secured on the side of the person&#39;s body on which surgery was not performed (assuming the person has undergone only a single mastectomy). First and second shoulder straps attached to the main body panel further serve to hold the bandage in place. The provision of the fastening means at the side of the person&#39;s body minimizes the pain and discomfort in the mastectomy area, yet enables the person, in the case of a single mastectomy, to use the arm on the side of the body that has not been operated on to easily apply and remove the bandage. It should be apparent that the bandage of the present invention may be used by a patient who has undergone a double mastectomy. In that case, the patient most likely will require assistance applying and removing the bandage, so the bandage could be configured to be closed at some place other than the side of the body, e.g., at the back. 
     Use of a hook and loop fastener as a securing means is preferable because it allows a wide range of adjustability to accommodate variations in swelling and is easy to manipulate. When the bandage is applied, the inner side of the elastic member at least substantially, and preferably completely, overlaps the outer side of the main body panel so that very little, and preferably none, of the elastic member contacts the skin of the person. Since substantially all, if not all, of the material that contacts the skin of the person is non-elastic and breathable, greater comfort is achieved while still maintaining adequate pressure on the chest. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The foregoing aspects and many of the attendant advantages of this invention will become more readily appreciated as the same becomes better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein: 
     FIG. 1 is a perspective view of a mastectomy bandage in accordance with the present invention, with a corner of the main body panel turned back to show the overlapping relation of the elastic means and the main body panel; and 
     FIG. 2 is a plan view of a mastectomy bandage in accordance with the present invention when the bandage is not in use and is laid flat with the inner side facing upwardly. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT 
     The mastectomy bandage 10 of the present invention will be described with reference to FIGS. 1 and 2 herein. The bandage 10 includes a main body panel 12 having a generally elongate rectangular shape when laid flat as shown in FIG. 2. It should be understood that the main body panel 12 may be formed in a variety of shapes so long as it is sufficient to cover the wound area and apply adequate pressure when the bandage is applied. The main body panel 12 is made of a non-elastic, breathable material. The material is breathable in that it permits indirect contact through the bandage between the atmosphere and the skin and wound area. Although any suitable non-elastic, breathable material may be used, the present inventor has found muslin to work especially well. The main body panel 12 has an upper edge 14, bottom edge 16, inner side 18, outer side 20, first end portion 22, and second end portion 24. Although the main body panel 12 may be a single layer of material, the present inventor has found it preferable to use a two-layer construction in order to provide greater support. As shown in FIG. 2, two pieces of material 26, 28, having substantially the identical size, are arranged so that one piece of material overlaps the other. The two pieces 26, 28 are fastened together, e.g., by sewing, along their perimeters. The width of the main body panel 12 (i.e., the dimension from the first end portion to the second end portion) is preferably equal to or slightly greater than the circumference of the person&#39;s torso. In that regard, the bandage can be made in a variety of sizes (e.g., small, medium, large), each size accommodating a range of different chest dimensions. 
     The mastectomy bandage 10 is further provided with elastic means to enable adjustment of the bandage to properly fit around the person&#39;s torso and ensure the application of adequate pressure. As shown in FIG. 2, the elastic means comprises an elastic strip 29 that is attached, for example, by sewing, to the second end portion 24 of the main body panel 12. This configuration is suitable when it is desired to close the bandage 10 on the right side of the body (e.g., when the patient has had a single mastectomy on the letf side). The elastic strip 29 is attached to the first end portion 22 of the main body panel 12 when it is desired to close the bandage 10 on the left side of the body (i.e., when the wound is on the right side of the body). Although the elastic strip 29 may be attached to one of the inner or outer sides 18, 20 of the main body panel 12, it has been found preferable to sandwich one end of the elastic strip 29 between the pieces 26, 28 of the main body panel 12 and then close that edge of the main body panel 12, e.g., by sewing. The elastic strip 29 has an inner side 30 and an outer side 32. The height of the elastic strip 29 preferably is approximately the same as that of the main body panel 12, but may be of a different height. However, the width of the elastic strip 29 is comparatively narrow, preferably in the range of two to five inches. The elastic strip preferably is made of a material capable of stretching both longitudinally and transversely along the strip, e.g., lycra or a nylon/lycra blend. 
     The mastectomy bandage 10 is configured so that it closes at one side of the person&#39;s body. It should be apparent that for other types of wounds and on other areas of the body, it may be desirable to configure the bandage to close at some location other than the side of the person&#39;s body. Although various conventional fasteners may be used, in the preferred embodiment, a hook and loop fastener such as that distributed under the trademark VELCRO is used to secure the bandage 10. For example, as shown in FIG. 2 (which is a plan view of the bandage laid open with the inner side facing upwardly), a strip of loop material 36, preferably about 3/4&#34; to 1&#34; wide, is provided along the height of the inner side 30 of the elastic strip 29. However, on the outer side of the main body panel 12 at the first end portion 22 are provided one or more horizontal strips of hook material that cooperate with the loop material 36 to secure the bandage 10 closed. In the illustrated embodiment, three horizontal strips 38 of hook material, each about 3/4&#34;  to 1&#34; high by 5&#34; wide, are provided at the top, center, and bottom portions of the first end portion 22 of the main body panel 12. This yields a wide range of adjustability so that a person can properly fit the bandage 10 to accommodate various degrees of swelling experienced by the person throughout the healing period. The multiple strips 38 at the top, center, and bottom of the main body panel 12 enable the person to separately adjust these areas of the bandage 10. This is particularly advantageous because swelling tends to be of different degrees in the wound area. For example, swelling may be greater near the top of the wound area and less near the bottom. 
     It should be apparent that the hook and loop material may be cut in other configurations. For example, a single large piece of hook material may be provided on the outer side 20 of the main body panel 12. As another example, a strip of loop material 36, preferably about 3/4&#34; to 1&#34;wide, may be provided along the height of the inner side 30 of the elastic strip 29. On the outer side of the main body panel 12 at the first end portion 22 may be provided two or more spaced strips of hook material, preferably about 3/4&#34; to 1&#34; wide, running along the height of the main body panel 12. The strips preferably are spaced about 1&#34; to 1 1/2&#34; apart. 
     The mastectomy bandage 10 may further be provided with a pair of conventional adjustable shoulder straps 40 as is well known in the art. In the preferred embodiment, the straps 40 are attached adjacent the upper edges 14 of the front and back sides of the main body panel 12. 
     To apply the mastectomy bandage 10, a person arranges the bandage 10 so the first and second end portions 22, 24 of the bandage will be on the side of the body opposite the mastectomy area (assuming the person has undergone a single mastectomy). If the bandage is provided with shoulder straps 40, the user places the straps 40 over her shoulders. Then, with the arm on the side of the body opposite the mastectomy area, she pulls the end portion of the main body panel to which the elastic means is attached until a proper fit is obtained. At that point, she secures the fastening means at the side of her body. Since the elastic means overlaps the main body panel, all of the material contacting the skin is non-elastic and breathable. Moreover, no uncomfortable seam is formed near the mastectomy area. A mastectomy patient should be able to apply the bandage without assistance and with minimal pain or discomfort. Furthermore, once the bandage is applied, it is relatively comfortable. 
     While the preferred embodiment of the invention has been illustrated and described, it will be appreciated that various changes can be made therein without departing from the spirit and scope of the invention. Moreover, although the bandage of the present invention has been described in connection with use on the chest wound of a mastectomy patient, it should be understood that the bandage may be used on other types of wound and on other areas of the body.