Abstract:
An apparatus for treating or preventing decubitus ulcers includes: a garment sized and shaped to be worn by a patient; a first plurality of fluid channels and a second plurality of fluid channels coupled to the garment and disposed adjacent to one another, at least some of the first plurality of fluid channels being independently inflatable and deflatable as compared with at least some of the second plurality of fluid channels; and a fluid control mechanism coupled to the first and second plurality of fluid channels and operating to repeatably and sequentially inflate and deflate the independently inflatable and deflatable fluid channels from among the first and second plurality of fluid channels such that there is less than a predetermined level of pressure exerted on the patient&#39;s tissue under one or more of the deflated channels.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation of U.S. patent application Ser. No. 10/952,349, pending and allowed, filed Sep. 27, 2004, the entire disclosure of which is hereby incorporated by reference. 
     
    
     BACKGROUND 
       [0002]    The present invention relates to a therapeutic pressure-relieving device and method for preventing and treating decubitus ulcers on a portion of a patient&#39;s body. 
         [0003]    Decubitus ulcers (commonly referred to as “bedsores”) may form on parts or portions of a patient&#39;s body when in contact for a prolonged period of time with an object such as, for example, a bed, a wheelchair, or other type of furniture. The pressure exerted on the skin covering or surrounding the bony prominences on the portions of the patient&#39;s body that are in contact with a surface on the furniture may result in the skin becoming inflamed, and may obstruct or restrict the blood flow to the skin and/or the underlying tissue, causing the skin and underlying tissue to become ischemic, eventually resulting in the formation of decubitus ulcers. Decubitus ulcers can form in any area of tissue covering a bony prominence that is in contact with the surface of the bed or sofa or other furniture upon which the patient is resting, e.g., parts of the spine, heels, elbows, and shoulders, shoulder blades, as well as the sacral, trochanteric and ischial areas in the coccyx, hips and buttocks. 
         [0004]    Specifically, although arterial inflow can continue and withstand pressure upwards of 170-mm Hg or greater, venous return or blood flow from a region is restricted or obstructed with pressures as low as 32-mm Hg on the skin and underlying tissue. The restriction or obstruction of the venous return of blood from the skin and underlying tissue may lead to the buildup of toxins and waste products that may lead to the formation of decubitus ulcers. Initially, pressure on the skin and tissue may lead to pink coloration and/or mild inflammation, which may disappear within a few hours of relieving pressure on the area. If pressure is not relieved, superficial lesions may form on the skin, then turning into ulcers which continue growing deeper until extending through the bone to internal organs, eventually becoming fatal to the patient. 
         [0005]    A traditional means for preventing the formation of decubitus ulcers is to physically turn the patient from side to side at short intervals of time, thus alleviating the amount of time a specific body part is subjected to straining pressures. However, this method of prevention often proves ineffective since the turning of the patient only relieves pressure from certain regions of the body. Moreover, a patient will many times return to a default position even after having been rotated. In addition, since nurses or other aids must be present to physically rotate the patient, this method is laborious, time-consuming and costly. 
         [0006]    An alternative method for preventing the formation of decubitus ulcers is the use of air mattresses. Since air mattresses reduce the solidity of the contact surface, the mattresses relieve some of the pressure on the patient&#39;s body. However, these devices can be costly and not readily available to all patients. Furthermore, the mattresses are not easily portable in case the patient is moved to another unit or bed. 
       SUMMARY 
       [0007]    This invention relates to a therapeutic device and method for treating and preventing decubitus ulcers on parts or portions of a patient&#39;s body by alleviating pressure on the tissue covering and immediately surrounding the bony prominences in the body portion and by alleviating pressure on the blood vessels in the angiosomes in the body portion to allow blood flow to continue throughout the body portion, including venous return, as well as arterial inflow. The device may be configured to act upon a particular body portion. The device may include inflatable channels or pockets positioned within the device based on the distribution of one or more angiosomes in the body portion, and pressure relievers to protect the tissue covering and immediately surrounding the bony prominences in the body portion. The channels may be sequentially or periodically inflated and deflated to alleviate pressure on the body portion while allowing blood flow throughout the angiosomes. 
         [0008]    In an example embodiment, the device may include a portable, washable, removable, durable garment that provides pressure relief from sacral, trochanteric and ischial pressure sores or decubitus ulcers. The device may use sequential air channel technology to relieve pressure and allow blood flow to and from the sacral, trochanteric and ischial regions of the coccyx, hips and buttocks based on the angiosome distribution or location of angiosomes in the coccyx, hips and buttocks. 
         [0009]    The garment may include rib-shaped or rib-patterned inflatable cushions, pockets or channels radially oriented around a position of an angiosome in each area. The channels are sequentially inflated and deflated to vary and relieve pressure around a center of the angiosome and maximize blood flow around the angiosomes. Air, water or other fluids may be pumped into the channels and removed from the channels with a bedside pump or motor attached to ports that are connected to the channels in the garment. The garment may be made with plastic or another material that may be washable and collapsible for storage purposes. The garment may also be made with a breathable fabric. For example, an inner liner made out of cotton can be provided to line the interior of the garment. The inner liner may be washable and replaceable or disposable. The garment may also have one or more ports to releasably connect the pump or motor to the garment. 
         [0010]    The pump or motor can inflate and/or deflate the channels in the garment through the ports on the garment. For example, the garment may have two ports, with each half of the channels in the garment being inflated and deflated by the pump through each of the ports. Specifically, one set of channels may be deflated through one port, while the channels in between the deflated channels are being inflated through the other port. 
         [0011]    In an example embodiment, an apparatus includes a portable garment configured to be placed on a portion of a body to provide a varying pressure on the body portion. The provided pressure varying within a range sufficient for at least one of treating and preventing a decubitus ulcer in the body portion. 
         [0012]    In an example embodiment, an apparatus includes a mechanism configured to alleviate pressure on a portion of a body. The mechanism provides a varying pressure on the body portion. The mechanism may include channels or pockets that are inflatable with a fluid (e.g., air or water), or with a gel-like substance (e.g., silicon or another pliable material or substance). The pressure provided by the sequential or periodic inflation and deflation of the channels or pockets may vary continuously, e.g., by fluctuating through a range of pressures, or it may vary periodically, providing different levels of pressure at different time periods. The mechanism is positioned based on, inter alia, the location or distribution of one or more angiosomes in the body portion. 
         [0013]    In an example embodiment, an apparatus comprises a device including a plurality of inflatable channels configured to be periodically or sequentially inflated and deflated to provide a varying pressure on a portion of a body of a patient that varies within a range sufficient for at least one of treating and preventing a decubitus ulcer. 
         [0014]    In an example embodiment, a garment for treating and preventing decubitus ulcers around one or more of the coccygeal, hip and buttocks areas of a patient&#39;s body includes one or more cushions in the garment, and one or more adjustable bands removably attaching the garment to the body. The cushions are positioned radially away from one or more of the sacrum, ischial and trochanter areas. The cushions are positioned in the garment as a function of the location or distribution of the angiosomes in one or more of the sacrum, ischial and trochanter areas. 
         [0015]    In an example embodiment, an apparatus for treating and preventing decubitus ulcers around at least one of a coccygeal, buttocks and hip areas of a body includes a garment and a pump releasably connectable to the garment. The garment includes a plurality of inflatable channels and a plurality of pressure relievers. The channels are configured to be alternately inflated and deflated in order to provide a variety of pressures on a body portion in or around the coccygeal, buttocks and hip areas of the body. The channels and the pressure relievers are positioned in the garment based on the locations of angiosomes or angiosome distribution in one or more of the sacrum, ischial and trochanter regions in the coccygeal, buttocks and hip areas. The pump is configured to pump and remove air from the inflatable channels in the garment. 
         [0016]    In an example embodiment, a method for treating and preventing decubitus ulcers on a portion of a body includes the step of sequentially or periodically inflating and deflating channels in a garment worn on the body portion. The maximum pressure provided by the channels in the garment on the body portion is sufficient to treat and/or prevent decubitus ulcers treating or preventing a decubitus ulcer on the body portion. 
         [0017]    In an example embodiment, a method for treating and preventing decubitus ulcers on a portion of the body includes the step of sequentially or periodically inflating and deflating air channels in a garment worn on the body portion. The channels are positioned in the garment as a function of the location of angiosomes in the body portion. 
         [0018]    In accordance with one or more further embodiments, methods and apparatus provide for: a garment sized and shaped to be worn by a patient; a first plurality of fluid channels and a second plurality of fluid channels coupled to the garment and disposed adjacent to one another, at least some of the first plurality of fluid channels being independently inflatable and deflatable as compared with at least some of the second plurality of fluid channels; and a fluid control mechanism coupled to the first and second plurality of fluid channels and operating to repeatably and sequentially inflate and deflate the independently inflatable and deflatable fluid channels from among the first and second plurality of fluid channels such that there is less than a predetermined level of pressure exerted on the patient&#39;s tissue under one or more of the deflated channels. 
         [0019]    The predetermined level of pressure may be about 32 mm Hg. 
         [0020]    The fluid control mechanism may operate to sequentially: inflate the independently inflatable and deflatable fluid channels from among the first plurality of fluid channels while deflating the independently inflatable and deflatable fluid channels from among the second plurality of fluid channels; and deflate the independently inflatable and deflatable fluid channels from among the first plurality of fluid channels while inflating the independently inflatable and deflatable fluid channels from among the second plurality of fluid channels. 
         [0021]    According to one or more aspects, such inflation/deflation is carried out such that there is less than about 32 mm Hg pressure exerted on the patient&#39;s tissue under one or more of the deflated channels. According to one or more additional or alternative aspects, such inflation/deflation is carried out to provide a rocking motion for moving the patient from one position to another. 
         [0022]    At least one of the independently inflatable and deflatable fluid channels from among the first plurality of fluid channels may extend in a longitudinal direction; and at least two of the independently inflatable and deflatable fluid channels from among the second plurality of fluid channels extend along either side of the at least one of the independently inflatable and deflatable fluid channels from among the first plurality of fluid channels. In such case, the fluid control mechanism may operate to sequentially and repeatably: inflate and deflate the at least one of the independently inflatable and deflatable fluid channels from among the first plurality of fluid channels; and inflate and deflate the at least two of the independently inflatable and deflatable fluid channels from among the second plurality of fluid channels, such that there is less than about 32 mm Hg pressure exerted on the patient&#39;s tissue under the at least one of the independently inflatable and deflatable fluid channels from among the first plurality of fluid channels, while in a deflated state. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0023]      FIG. 1  illustrates a bone structure of a lower portion of a human body. 
           [0024]      FIG. 2  illustrates angiosome distribution and location, and locations of blood vessels and tissues surrounding bony prominences in the lower portion of a standing human body. 
           [0025]      FIG. 3  illustrates angiosome distribution and location, and locations of blood vessels and tissues surround bony prominences in the lower portion of a seated human body. 
           [0026]      FIG. 4  illustrates a perspective frontal view of an embodiment of a device for preventing and treating decubitus ulcers according to the present invention. 
           [0027]      FIG. 5  illustrates a perspective rear view of the embodiment of the device for preventing and treating decubitus ulcers of  FIG. 4 . 
           [0028]      FIG. 6  illustrates a perspective rear view of a person in a standing position wearing the embodiment of the device for preventing and treating decubitus ulcers of  FIG. 4 . 
           [0029]      FIG. 7  illustrates a perspective frontal view of a person in a seated position wearing the embodiment of the device for preventing and treating decubitus ulcers of  FIG. 4 . 
           [0030]      FIG. 8  illustrates a partial view of a portion of an embodiment of a device for preventing and treating decubitus ulcers and a partial view of the underlying blood vessels and angiosomes, according to the present invention. 
           [0031]      FIG. 9  illustrates a partial view of a portion of an embodiment of a device for preventing and treating decubitus ulcers and a partial view of the underlying blood vessels and angiosomes, according to the present invention. 
           [0032]      FIG. 10  illustrates a frontal perspective view of an embodiment of a device for preventing and treating decubitus ulcers according to the present invention. 
           [0033]      FIG. 11  illustrates a rear perspective view of an embodiment of a device for preventing and treating decubitus ulcers according to the present invention. 
       
    
    
     DETAILED DESCRIPTION 
       [0034]    The present invention relates to a device and method for preventing and treating decubitus ulcers.  FIGS. 1 through 3  illustrate the underlying anatomy and conditions that lead to the formation of decubitus ulcers.  FIGS. 4 through 7  illustrate various aspects of the device and method according to the present invention. 
         [0035]    As described above, a patient who is confined to a bed, a wheelchair or other types of furniture, and cannot move or be moved for prolonged periods of time, may be prone to decubitus ulcers (also referred to as bed sores or pressure sores) in the parts of their bodies having bony prominences that are subject to constant pressure when the parts of their bodies are resting or being constrained against a surface of the furniture.  FIGS. 1 through 3  illustrates a basic bone structure, highlighting the bony prominences in the middle portion  5  of a person&#39;s body  1  over which pressure sores may form in tissue  3 ,  7  and  11  after a period of continuous and static pressure to the overlying tissue, when a patient is left or restrained to lie or sit in a bed or in a chair for prolonged periods of time without movement. Ischial decubitus ulcers or pressure sores may form in the tissue  3  covering the ischium  4  in the buttocks  2 . Trochanteric decubitus ulcers or pressure sores may form in the tissue  7  covering the trochanters  6  (the broad flat bony prominence at the top of the femur  9 ) in the hips  8 . Sacral decubitus ulcers or pressure sores may form in the tissue  11  covering the sacrum or sacral  12  in the area of the coccyx  10 . 
         [0036]    Decubitus ulcers  3 ,  7  and  11 , may be prevented and/or treated with a device  20  that alleviates pressure on the tissue  3 ,  7  and  11  that is on and surrounds the bony prominences  4 ,  6  and  10  in a portion  5  of the body  1 , while allowing blood to flow through the angiosomes  18  and blood vessels  5  in the portion  5  of the body  1 , while the patient is resting or is confined or constrained in a particular position in or on a piece of furniture  13 . 
         [0037]    There are angiosomes  18  distributed throughout the middle portion  5  of the body  1 , and through other parts or portions of the human body  1 . An angiosome  18  is a three dimensional block of tissue supplied by a single source artery. The distribution of angiosomes  18  refers to a mapping of blood vessels  19  in a block of tissue, or the tree-line pattern or arborization of blood vessels in a certain area, e.g., in the body portion  5 , or for the tissue  3 ,  7  and  11  on and surrounding the ischial or ischium  4 , trochanteric  6 , and sacral or sacrum  12 . If external pressure cuts off the blood flow through one or more blood vessels  19  (e.g., venous return), then there may be a lack of nutrients and/or build up of toxins or waste product in the 3 dimensional block of tissue being serviced by those blood vessels  19  in a particular angiosome  18 , which may lead to the formation of decubitus ulcers in the tissue. Thus, if any device that purports to relieve pressure on a part or portion  5  of the body  1  cuts off blood flow in an angiosome  18 , the device may still affect the viability of the tissue being supplied by the blood vessels  19  in the angiosome  18 . 
         [0038]    Thus, a device  20  that alleviates pressure on areas of tissue  3 ,  7  and  11  while taking into account the location or distribution of angiosomes  18  and blood vessels  19  in a portion of a body  1 , will be able to alleviate pressure, while allowing for blood flow to continue in the portion  5  of the body  1 . Since the mapping of blood vessels  19  or distribution of angiosomes  18  tends to be similar from person to person, it is possible to standardize a design of a device  20  based on the location or distribution of angiosomes  18  and blood vessels  19  in a portion  5  of the body  1 , and use the device  20  on more than one person. 
         [0039]    The device  20  illustrated in  FIGS. 4 through 9  is configured to alleviate pressure on a middle portion  5  of the body  1  including the buttocks  2 , hips  8  and coccyx  10 . The device  20  includes a garment  25  and a pump  50  releasably attached or coupled or connected thereto to pump air, water or other fluids or gel-like substances and/or remove such fluids or substances from the garment  25  when the pump  50  is activated or actuated. The garment  25  is portable and configured to fit around the waist  15 , and may be worn as a pair of shorts  26  on the body  1 , alleviating pressure on and around the trochanteric bony prominences  6  in the hips  8 , the ischial bony prominences  4  in the buttocks  2 , and the sacral bony prominences  12  in the coccyx  10 , and allowing blood flow based on the distribution of angiosomes  18  and the blood vessels  19  in the angiosomes  18  in the body portion  5 . 
         [0040]    The garment  25  provides pressure varying in a range sufficient for treating and/or preventing decubitus ulcers in the body portion  5 . Unlike products that provide higher pressures that periodically cut off blood flow to simulate the pumping action of arterial inflow to prevent and/or treat deep vein thrombosis, the maximum pressure provided by the device  20  on the body portion  5  is set below the pressure for preventing and/or treating deep vein thrombosis. 
         [0041]    The garment  25  includes sequential air technology to provide varying pressure on the body portion  5 , based on the location or distribution of angiosomes  18  in the body portion  5  to allow for maximal blood flow throughout the angiosomes  18  in the body portion  5 , including through the blood vessels  19  therein. The sequential air technology includes sequentially or periodically inflating and deflating channels  30  in garment  25 . The channels  30  may be integrated or intertwined in a middle layer  22  or an outer layer  21  in the garment  25 , and channels  30  may also refer to or include pockets or cushions. 
         [0042]    The channels  30  are inflatable with a fluid, e.g., air or water, or with a gel-like substance, e.g., a silicon-based gel. The channels  30  are positioned in the garment  25  based on the location or distribution of angiosomes  18  in the body portion  5 , and the blood vessels  19  in the body portion  5 . The channels  30  are configured to be sequentially or periodically inflated and deflated. The channels  30  may provide a fluctuating pressure by continuously inflating or deflating, or the channels may provide an otherwise varying pressure by remaining inflated and then deflated for certain periods of time, e.g., 5 minutes in each phase. The pressure applied by the inflated channels  30  on the body portion  5  and/or the pressure on the parts of the body portion  5  under the deflated channels  30  may be configured or set not to exceed the pressure that stops blood flow in the blood vessels, e.g., 32 mm Hg. The time periods and patterns of inflation and/or deflation of channels  30  may be configured to minimize the obstruction or reduction of blood flow in the blood vessels  19 , and blood supply in the angiosomes  18  in the body portion  5 . 
         [0043]    Some of the channels  38  may be rib-shaped, parallel to one another, and arranged in a rib-like pattern, as illustrated in  FIG. 5 . Additionally, at least some of the channels  30  may be configured to be offset from the locations of angiosomes  18  or blood vessels  19  when the garment  25  is on the body portion  5 . If the channels  30  were positioned in the garment  25  to cross blood vessels  19 , then inflation of the channels  30  may obstruct or restrict blood flow through the blood vessels  19 . In order to allow or promote maximal blood flow through the blood vessels  19  and angiosomes  18 , some of the channels  30  may be positioned or configured to run adjacent to or parallel to blood vessels  19  in the angiosomes  18 , as illustrated in  FIGS. 8 and 9 . The parallel placement of channels  30  helps to minimize any interruption or disturbance to the blood flow in the body portion  5 , when the channels  30  are being inflated and/or deflated. 
         [0044]    Some or all of the channels  30  may be spaced apart from one another, as illustrated in  FIG. 9 . Some or all of the channels  30  may be interwoven or intertwined, as illustrated in  FIG. 8 . Even if the channels are interwoven or intertwined, as illustrated in  FIG. 8 , there is no or little pressure (e.g., less than 32 mm Hg) on the blood vessels  19  under the deflated channels  36 , in part due to the support provided by inflated channels  37 , to allow blood flow, including venous return as well as arterial inflow to continue through the blood vessel  19 . 
         [0045]    The garment  25  may also include pressure relievers  44 , and  42  to protect the underlying tissue from any excess pressure, such as pressure from contact with a surface of the furniture  13 . Pressure relievers  44 ,  46  and  42  may include or be made with a cushion or padding that alleviates some of the excess pressure on the tissue  3 ,  7  or  11 , when in contact with a surface of the furniture  13 . Alternatively, pressure relievers  44 ,  46  and  42  may lack any cushion or padding, but be surrounded by padded support, and the surrounding channels  30 , so that the tissue thereunder does not come into contact or encounters minimal pressure from the garment  25  and from any surface on the furniture  13 . The pressure relievers  44 ,  46  and  42  may not be inflated or inflatable to reduce or eliminate pressure placed on the underlying tissue. 
         [0046]    Pressure reliever  44  is positioned in garment  25  to protect at least part or all of the tissue  3  in the area of the ischium bony prominence  4  in the buttocks  2 . Pressure reliever  46  is positioned in garment  25  to protect at least part or all of the tissue  7  in the area of the trochanteric bony prominence  6  in the hips  8 . Pressure reliever  42  is positioned in garment  25  to protect at least part of or all of the tissue  11  in the area of the sacral bony prominence  12  in the coccyx  10 . The garment  25  may include a sacral ring  48  to surround or encircle pressure reliever  42 . The sacral ring  48  may provide extra support for the garment  25 . For example, if the sacral ring  48  is integrated with the outer layer  21 , the sacral ring  48  may maintain the integrity of the garment  10  around the sacrum  12 . The sacral ring  48  may be made of a rigid material or a more flexible material, such as, e.g., plastic. Alternatively, the garment  25  may have no sacral pressure reliever  42 , but the tissue in the sacral area  11  may be protected from excess pressure by the sacral ring  48  alone, for example, if it is of sufficient thickness to protect tissue  11  from direct contact with a surface of furniture  13 . 
         [0047]    Some of the channels  30  in the garment  25  may include one or more channels  35  configured around the pressure relievers  44 ,  46  and  42 . The channels  35  may be configured or positioned to be offset from the center of the tissue on and surrounding a bony prominence, e.g., centers  45 ,  47  and  43  of the areas of tissue  3 ,  7  and  11 , covering the ischium, trochanteric and sacral bony prominences  4 ,  6  and  12 , in the region of the buttocks  2 , hips  8  and coccyx  10 , respectively, also referred to as the ischial, trochanteric and sacral areas of the body portion  5 . The channels  35  may be referred to as additional channels, and may be positioned to extend radially from the centers  45 ,  47  and  43  when the garment  25  is on the body portion  5 . The channels  35  arranged radially around the pressure relievers  44 ,  46  and  42 , and around the tissue centers  45 ,  47  and  43 , may extend radially through the part of tissue  3 ,  7  and  11  that surround the centers  45 ,  47  and  43  (which may also be referred to as pressure centers). The remainder of the channels  30  may be positioned in rib-like patterns outside of the pressure relievers  44 ,  46  and  42 , and the additional channels  35  positioned around the pressure relievers  44 ,  46  and  42 . 
         [0048]    The device  20  also includes a pump  50  releasably connectable to the garment  25  via one or more valves or ports on garment  25 . The pump  50  may be small and lightweight, to be portable, and may be configured to be releasably attachable to one or more pieces of furniture (including a chair  13 , or for example, the intravenous pole), or directly to the person using the garment  25 , e.g., as on a belt around the waist  15 . 
         [0049]    As illustrated in  FIGS. 4 through 6 , pump  50  is releasably connectable to ports  27  and  28  on garment  25 . The pump  50  is configured to periodically or sequentially inflate and deflate one or more of the channels  30  in the garment  25  through valves or ports  27  and  28  on garment  25 , e.g., by pumping and/or removing air, water or other fluids or gel-like substances into and/or out of the channels  30  through ports  27  and  28 . The pump  50  may be configured to be able to regulate the amount of fluids or substance being pumped or removed from channels  30 . The pump  50  may also be configured to time the periods for each of the inflation and deflation cycles. The pump  50  may be configured to inflate and deflate all of the channels at the same time. Alternatively, the pump  50  may be configured to inflate one subset of channels  30  through port  27  while deflating another subset of channels  30  through port  28 . As illustrated in  FIGS. 8 and 9  with arrows indicating directions of fluid movement, one subset of channels  37  may be inflated through port  27  while another subset of channels  36 , alternating between channels  37 , are being deflated through port  28 . 
         [0050]    Alternatively, the first subset of channels  30  may be configured to be one side of the garment  25 , and the second subset of channels  30  may be configured to be on another side of the garment  25 . The sequential or periodic inflation and/or deflation of the first and second subsets of channels  30  under this configuration provides a rocking motion, and may be implemented to periodically move the patient from one position to another. The pump  50  may be supplied with additional ports (not shown), so that the pump  50  may be configured to act on one set of channels  30  at a time, for example, leaving a third subset of channels entirely deflated if it is on a portion of the body not in contact with a piece of furniture  13 . In any case, alternately inflating and deflating different portions of garment  25  or different subsets of channels  30  according to different patterns will prevent pressure from inflated channels remaining on any specific location of the body portion  5  for an extended amount of time. 
         [0051]    The garment  25  itself may be made with a durable washable material, e.g., plastic. The garment  25  may be configured with layers, as illustrated in  FIG. 4 . The channels  30  may be integrated into a middle layer  22  of garment  25 . Outer layer  21  may provide a protective plastic covering over the channels  30  and the remainder of the garment  25 . The outer layer  21  may have holes or pores  29  to allow air to pass through to and from the middle layer  22 , the inner layer  23  and the body portion  5 . Outer layer  21  may be detachable from the rest of the garment  25 , to be washed or rinsed off, or replaced. 
         [0052]    The inner layer  23  may include a liner or lining  24  that is made with a breathable or softer or hypoallergenic fabric or other material, e.g., cotton, nylon, polyester, rayon, or lycra, or a combination or blend of any two or more of the foregoing materials. The lining  24  may be releasably attachable to the inner layer  23  of the garment  25 . The lining  24  may cover all or part of the inner layer  23  of the garment  25 . The lining may be removable to be washable or disposable, and in any case, replaceable. 
         [0053]    The garment  25  may be releasably attachable to the body portion  5  via one or more straps  60  on a front side  70  of the garment  25 , as illustrated in  FIG. 4 . The straps  60  may be elastic bands  61  or otherwise adjustable, as adjustable band  62 . The straps  60  may be made with a material including cotton, to increase the comfortability of the device  20 . The straps  60  may make it easier for the garment  25  to be placed on or removed from the body portion  5 . 
         [0054]    The straps  60  may be spaced apart from one another in order to permit the frontal area of the body portion  5  to remain exposed for further examination and follow up by a doctor, nurse or other care giver. The straps also provide a way of attaching the garment  25  to the body portion  5 , without unnecessarily covering the frontal area of the body portion  5 . The straps  60  may allow the person wearing the garment  25  to be more comfortable and cooler, then if the frontal area of the body portion  5  were fully covered as well. 
         [0055]    The straps  60  may be permanently attached at a distal end  64  to a first side  72  of the garment  25 , and releasably attached at a proximal end  65  to an opposite side  73  of the front side  70  of the garment  25 . The straps  60  may be releasably attachable with velcro  63  on sides  73 , or with buttons, snaps, zippers and other modes of releasably attaching or fastening the straps  60  to the sides  73  of the garment  25 . 
         [0056]    The device  20  illustrated in  FIGS. 4 through 9  is configured for body portion  5 , including the buttocks  2 , hips  8 , and coccyx  10 . As illustrated in  FIG. 10 , the device  20  may extend further down the legs and further along the arms, with channels  30  and pressure relievers  41  and  49  for the elbows and calves. As illustrated in  FIG. 11 , device  20  may include a garment  80  configured to fit on an upper body portion, with shoulder blade pressure relievers  84 , and with elbow pressure relievers  82 . The device  20  may be configured with pressure relievers in a variety of locations, and a variety of patterns for the distribution of channels  30 , depending on the position of the body  1 , the type of furniture  13 , and other conditions. 
         [0057]    In the preceding specification, the present invention has been described with reference to specific exemplary embodiments thereof. It will, however, be evident that various modifications and changes may be made thereunto without departing from the broader spirit and scope of the present invention as set forth in the claims that follow. The specification and drawings are accordingly to be regarded in an illustrative rather than restrictive sense.