US3856006A

US3856006A - Surgical drapes with improved arm coverage

Info

Publication number: US3856006A
Application number: US00384842A
Authority: US
Inventors: H Krzewinski
Original assignee: Johnson and Johnson
Current assignee: Johnson and Johnson
Priority date: 1973-08-02
Filing date: 1973-08-02
Publication date: 1974-12-24
Anticipated expiration: 1991-12-24
Also published as: IN142237B; AU7181274A; PH10954A; ES223903Y; EG11500A; AT357663B; ZA744935B; JPS5758944B2; ES223903U; RO69055A; ATA633074A; GB1476258A; ZM12274A1; CA1032426A; JPS5071187A

Abstract

A generally T-shaped disposable surgical drape for use with an operating table having armboards extending laterally from the upper portion thereof, this drape comprising novel flap construction to provide more secure sterile field. Drape comprises an elongated lower or body portion for covering the body of the patient and the lower end of the operating table, which body portion may have a fenestration opening therein, and a transversely disposed upper or crossarm portion integral with the upper end of the body portion, for covering the patient''s arms, while the same are extended on and supported by the armboards. In accordance with a main feature of the invention, a pair of generally rectangular armboard flaps are provided, the top edges of which are integral with the bottom edge of the upper or crossarm portion of the drape, on opposite sides thereof, which armboard flaps are detached from any other portion of the drape, these draping over the armboards to each lie in a generally vertical plane substantially perpendicular to the plane of the operating table, and to overlie a portion of the body portion of the drape, when the drape is positioned over a patient. In accordance with one preferred aspect of the invention, body portion is modified by two generally rectangular body flaps integral with the long side edges of the body portion of the drape but detached from the crossarm portion, these body flaps providing improved coverage in use, being draped over the sides of the operating table to lie in a generally vertical plane on either side thereof when the drape is positioned over a patient. The drape in general, and the armboard flaps and body flaps in particular, are dimensioned to provide overlap between the armboard flap and the lower or body portion of the drape and/or the adjacent body flap (if present), thus providing a more effective barrier to bacterial migration from the non-sterile regions of and surrounding the patient, especially in the vicinity of the armboards, to the sterile field of the operation.

Description

United States Patent [191 Krzewinski Dec. 24, 1974 SURGICAL DRAPES WITH IMPROVED ARM COVERAGE Henrietta K. Krzewinski, Old Bridge, NJ.

[73] Assignee: Johnson & Johnson, New

Brunswick, N].

[22] Filed: Aug. 2, 1973 [21] Appl. No.: 384,842

[75] Inventor:

[52] US. Cl 128/132 D [51] Int. Cl A61b 19/06 [58] Field of Search 128/132 D, 292; 297/225;

OTHER PUBLICATIONS Surg-o-Pak, Circular of Ruby Prods. Co., Milwaukee, Wis. 2/1/60.

Primary ExaminerRichard A. Gaudet Assistant ExaminerG. F. Dunne [57] ABSTRACT A generally T-shaped disposable surgical drape for use with an operating table having armboards extending laterally from the upper portion thereof, this drape comprising novel flap construction to provide more secure sterile field. Drape comprises an elongated lower or body portion for covering the body of the patient and the lower end of the operating table, which body portion may have a fenestration opening therein, and a transversely disposed upper or crossarm portion integral with the upper end of the body portion, for covering the patients arms, while the same are extended on and supported by the armboards. 1n accordance with a main feature of the invention, a pair of generally rectangular armboard flaps are provided, the top edges of which are integral with the bottom edge of the upper or crossarm portion of the drape, on opposite sides thereof, which armboard flaps are detached from any other portion of the drape, these draping over the armboards to each lie in a generally vertical plane substantially perpendicular to the plane of the operating table, and to overlie a portion of the body portion of the drape, when the drape is positioned over a patient. ln accordance with one preferred aspect of the invention, body portion is modified by two generally rectangular body flaps integral with the long side edges of the body portion of the drape but detached from the crossarm portion, these body flaps providing improved coverage in use, being draped over the sides of the operating table to lie in a generally vertical plane on either side thereof when the drape is positioned over a patient. The drape in general, and the armboard flaps and body flaps in particular, are dimensioned to provide overlap between the armboard flap and the lower or body portion of the drape and/or the adjacent body flap (if present), thus providing a more effective barrier to bacterial migration from the non-sterile regions of and surrounding the patient, especially in the vicinity of the armboards, to the sterile field of the operation.

9 Claims, 11 Drawing Figures PATENTEI] BEBE 4 I974 SHEET 2 [IF 4 SURGICAL DRAPES WITH IMPROVED ARM COVERAGE BACKGROUND OF THE INVENTION The present invention relates to surgical drapes and more particularly to a surgical drape providing improved coverage of the arm regions of a patient when the patient is reclining on an operating table having armboards extending laterally from the upper portion thereof, with the arms of the patient outstretched thereon.

Surgical drapes are presently used in many surgical techniques in order to provide a barrier between the surgical wound and microorganisms on non-sterile areas of the patient and the operating table. Such a drape must provide not only an effective barrier to bacterial penetration through the drape, but also sufficiently effective coverage of the patient and the operating table so as to prevent migration of microorganisms through openings or gaps left by the drape.

It is known in the surgical art to employ an operating table having armboards extending laterally from the upper portion thereof in order to provide support for, and ready access to, the outstretched arms of a patient during an operation. Such access might be desired for the administration of anaesthesia or blood to the patient, for the taking of blood samples from the patient, or for a variety of other reasons. Surgical draping of the patients body and arms is necessary to provide a barrier between the surgical wound and possible sources of contamination.

In general, prior art drapes used over a patient on an operating table having armboards have not provided a completely effective barrier to contamination because of the presence of openings or avenues adjacent the arm regions of the patient, through and along which bacteria may travel from non-sterile regions to the sterile field. These prior art drapes are generally of T- shape, having an elongated lower or body portion for covering the body of the patient, optionally, a fenestration opening therein, and a transversely disposed upper or crossarm portion for covering the patients extended arms. Generally, this crossarm portion is integral with the top end of the body portion.

Both the body portion and the crossarm portion of the prior art drapes are dimensioned so as to provide a barrier to contamination between the non-sterile regions of the body and legs of the patient and of the operating table, on the one hand, and the sterile field of the operation, on the other hand, and, to some extend, to drape over the sides of the operating table. However, the crossarm portion of the drape is dimensioned so that there is little or no overlap with the body portion of the drape in use, generally resulting in an incomplete barrier in the vicinity of the armboard portion of the operating table during the operation.

SUMMARY OF THE INVENTION According to the present invention there is provided a generally T-shaped surgical drape for use with an operating table having armboards extending laterally from the upper portion thereof, which drape has an elongated lower or body portion having top and bottom ends and side edges, which body portion may have a fenestration opening therein, and a transversely disposed upper or crossarm portion having relatively short side edges and relatively long top and bottom ends, said armboard portion ends being longer than the body portion ends, the bottom end of said armboard portion being integral with the top end of said body portion for substantially the entire width of said body portion." This is the basic T-sheet construction. The lower or body portion of the drape is dimensioned to cover the body and outstretched legs of the patient and the lower end of the operating table, thereby providing a generally horizontal barrier to contamination over the top of the operating table and the body of the patient as well as a vertical barrier to contamination at the lower end of the operating table and, to some degree, at the sides thereof. The upper or crossarm portion is dimensioned to extend over the free ends of the armboards and the arms of the patient outstretched thereon, thereby providing a barrier thereover.

In the drape of my invention there are also provided armboard flaps integral with the lower edges of the upper or crossarm portion of the drape, preferably on both sides of the lower or body portion of the drape, each said armboard flap extending along said lower edge of said crossarm portion from the outer edge thereof inwardly to overlie part of the body portion of the drape. The armboard flaps are dimensioned so that when draped over a patient each flap extends in a substantially vertical plane over the lower edge of an armboard and overlies a portion of said body portion of said drape, and preferably its lower edge is no higher than the bottom edge of the body portion, thus providing a secure barrier to microorganism migration from the non-sterile regions of and surrounding the patient in the vicinity of the armboard to the sterile surgical field.

In accordance with a preferred feature of my invention, the body portion of the drape comprises a central body portion, the top end of which is integral with the bottom end of said crossarm portion for overlying the operating table, and, integral with each elongated side edge of said body portion (but free from attachment to said crossarm portion) a flexible, generally rectangular body flap for draping over the sides of the operating table in a substantially vertical plane when the drape is positioned over a patient to thereby provide an improved lateral barrier to contamination between the sterile field of the operation and the operating table and the region therebelow. In drapes comprising this feature, the armboard flaps and body flap are so dimensioned that, when the drape is in use, there is some overlap between the adjacent free edges thereof to thereby provide a secure barrier to contamination in the vicinity of the junction between the armboard portion and the body portion of the operating table, while at the same time permitting the surgeon or other member of the operating room staff easy access to that area of the operating table.

The drape of the invention may be made of any conventional drapable material, such as cotton fabric or synthetic fabric, used in the surgical drape art, or combinations thereof, and is preferably made of disposable material, for example, the materials disclosed in US. Pat. No. 3,410,266. The drape of my invention may be constructed in any desired manner, using any desired number of pieces of drape material. These pieces may be attached to each other by any suitable means, such as sewing, gluing, heat sealing, etc.

BRIEF DESCRIPTION OF THE DRAWINGS i The invention will be more fully understood by reference to the attached drawings, which show illustrative embodiments thereof.

FIG. 1 is a perspective view of a presently preferred embodiment of the drape of my invention, in position over a patient on an operating table having armboards extending laterally from the upper portion thereof;

FIG. 2 is a plan view of the drape shown in FIG. 1;

FIG. 2a is a fragmentary section in perspective along line 2a2a of FIG. 2;

FIG. 3 is a fragmentary section in perspective along line 33 of FIG. 2;

FIG. 4 is a fragmentary section in perspective along line 4-4 of FIG. 2;

FIG. 5 is a plan view of the fenestration area of a second embodiment of a drape of my invention;

FIG. 6 is a fragmentary section in perspective along line 6-6 of FIG. 5; and

FIGS. 7 10 are plan views of four simple embodiments of the drape of my invention, with portions raised and parts broken away, showing in detail alternative constructions of drapes of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIGS. 1-4 illustrate a presently preferred embodiment of my invention. In FIG. 1 there is shown, partly in phantom, operating table 9 supported on a pedestal l0 and having armboards 11 extending laterally from the upper portion thereof. Patient 12 is shown reclining on said operating table with his arms extended on said armboards. Surgical drape 13, in the form of a T, is positioned over the patient to protect against contamination of the sterile field. As shown in FIGS. 1 and 2, the drape comprises a lower or body portion 14 and an upper or crossarm portion 15 attached in a central region thereof, indicated by the bracket 16, to the upper end of the body portion. Any conventional attaching means may be used, as sewing, gluing, heat sealing, etc.

Integral with the side edges of body portion 14 are body flaps 17, which are unattached to the crossarm portion of the drape, so that they drape over the-sides of the operating table and lie in a generally vertical plane on either side thereof when the drape is positioned over the patient. The body portion and body flaps of the drape are dimensioned to cover the body and legs of the patient and the sides and lower end of the operating table, thus providing a barrier to bacterial migration from non-sterile regions of the same to the sterile field of the operation. The upper or crossarm portion is dimensioned to cover the outstretched arms of the patient and the free ends of the armboards, thus providing a barrier to prevent bacterial migration from these non-sterile regions to the sterile field of the operation.

Secured to the bottom edge of crossarm portion 15 on each side of body portion 14 are arrnboard flaps 18, the junction between said flaps l8 and said crossarm portion 15 being indicated by brackets 19. As shown in FIG. 2, there preferably is some overlap between the line of securement (16) between body portion 14 and crossarm portion 15, and the line of securement (19) between each armboard flap 18 and crossarm portion 15 of the drape. As a result of this construction, armboard flaps 18 overhang the armboards and lie generally vertically on either side of the operating table when the drape is placed over a patient, each said flap 18 hanging between the adjacent outstretched arm and the sterile field of the operation, and being dimensioned so that it at least contacts body portion 14 and overlies a portion of the adjacent body flap l7 and so that its bottom edge preferably is no higher than the bottom edge thereof, thus completing the barrier over the arm regions of the patient and providing more effective barrier than heretofore available to bacterial migration from the non-sterile regions in the vicinity of the armboard to the sterile field of the operation.

Drape 13 has fenestration opening 20 in the body portion thereof. Although this opening is shown as being of rectangular configuration, and the drape in the illustration of FIGS. l-4 is of the type employed in laparotomy, it will be understood that the fenestration may be of any desired shape as, for example, circular, oval, etc., and in any desired location. About the fenestration opening is reinforcing, fluid-absorbent panel 21. The reinforcing fluid-absorbent construction is made up of fluid-impervious plastic film 22 secured to the drape by adhesive or otherwise and fluid-absorbent fibrous sheet 23 overlying said plastic film and secured thereto by adhesive or otherwise. This construction is disclosed in U.S. Pat. No. 3,410,266. When this embodiment of the drape of the invention is placed over a patient on an operating table, the reinforcing panel absorbs fluid emitted from the surgical wound. Fluid penetration through the drape is prevented, however, because of the fluid-impermeable plastic film located between the fluid-absorbent sheet and the drape.

Below the reinforced, fluid-absorbent construction is a non-slip instrument pad 24 having a substantially smooth and semi-nonskid surface, such as that disclosed in U.S. Pat. No. 3,738,359 issued June 12, 1973 to Lindquist et al. This pad may be located on the drape as described in said U.S. Pat. No. 3,738,359. By virtue of the properties of the top surface of this pad, surgical instruments and the like which are placed thereon are retained in position available for use by the surgeon.

On either side of this instrument pad and above the reinforcing panel are foldable tube attachment tabs 25, one end of each of which is secured at the periphery of said pad or panel by adhesive or otherwise and the other end of which tab freely overlies the adjacent portion of the main body of the drape. As disclosed in U.S. Pat. Application Ser. No. 222,854, filed Feb. 2, 1972 these tabs may be made of any conventional material, but preferably are of a material having a grab tensile strength of at least 14 lbs., for example, polyethylene film, vinylchloride film, and other similar flexible plastics or non-woven or woven fabrics. These tabs have holes 26 wherein tubes (as for suction) or cords may be inserted to secure the same to the drape without danger of damage thereto.

Integral with the opposed edges of the fenestration opening are foldable flaps 27, which flaps have pressure-sensitive adhesive 28 on at least part of top surfaces 29 thereof as seen in FIGS. 3 and 4 and releasable cover sheets 30 covering said adhesive. Said flaps are foldable to present the covered adhesive away from the body of the patient while positioning the drape thereon, for convenient removal of the releasable cover sheets, and foldable to present the uncovered adhesive toward the body of the patient for attachment of the drape thereto. This attachment means is disclosed and claimed in my copending application Ser. No. 384,843 entitled Self-Adhesive Surgical Apparel filed on even date herewith.

Referring to FIGS. 5 and 6, there are shown two views of an embodiment differing from that of FIGS. 1 through 4 in the means by which the drape is attached to the patient. In this embodiment, as in that of FIGS. 1-4, drape 13 has a fenestration opening 20, surrounded by a reinforcing fluid-absorbent panel 21, below which is a non-slip instrument pad 24. On either side of the instrument pad and above the reinforcing panel are secured foldable tube attachment tabs 25, having holes 26, whereby tubes or cords may be attached to the drape without danger of injury thereto.

Secured to the edges defining the fenestration opening and covering said opening is transparent plastic sheet 31 having clear, pressure-sensitive adhesive 32 on the bottom surface thereof. This adhesive is covered with conventional releasable cover sheet 33, made of wax-coated or silicone-coated paper, etc. The plastic sheet may be secured to said edges by any conventional means, preferably by means of the pressure-sensitive adhesive on its bottom surface. In the use of this embodiment of my invention, the releasable cover sheet is removed from the pressure-sensitive adhesive and the same is presented toward the incision site of the body of the patient for attachment of the drape thereof. The drape is then unfolded over the patient and the operating table and arranged thereon. The plastic sheet may have a hole therein, through which the incision may be made, but preferably is unbroken, the incision being made simultaneously through both the plastic sheet and the patients skin.

In FIGS. 7 through 10, there are shown four simple embodiments of the drape of my invention, illustrating different methods of constructing same. Thus, while the drape of my invention may have the fenestration and reinforcing panel construction, the non-slip instrument pad, the adhesive transparent film or adhesivesurfaced tab attachment means, and the tube attachment tabs shown in FIGS. 1-6, such elements are not essential to my invention and may be omitted.

Referring to FIG. 7, there is shown an embodiment differing from that shown in FIGS. 1-6 in that some optional elements listed above have been omitted. As shown, surgical drape 35 comprises lower or body portion 36 having fenestration opening 37, and an upper or crossarm portion 38 attached at its lower edge to the upper edge of body portion 36 in the region indicated by bracket 39. The body portion of the drape includes integral body flaps 40, the upper ends 41 of which are not attached to the crossarm portion. As in the previously described embodiments, the body flaps and body portion of the drape are dimensioned so that the body flaps fall in a generally vertical plane on either side of the operating table and the lower end of the body portion extends over the lower end of the operating table when the drape is placed over a patient.

Attached to the lower edge on either side of crossarm portion 38 of the drape, along the lines indicated by brackets 42 are two armboard flaps 43, as in the construction shown in FIGS. 14. The crossarm portion and the armboard flaps are dimensioned as explained above for the preferred embodiment shown in FIGS. 1-4, to provide a barrier to bacterial migration from the non-sterile arm regions of the patient to the sterile field of the operation.

In FIG. 8, there is shown an embodiment differing from that shown in FIG. 7 in that the entire drape, except for the armboard flaps is cut from a single piece of material, the armboard flaps being secured to the crossarn portion of the drape in the same manner as described for the embodiment of FIG. 7. As is apparent, the body flaps are formed by horizontal slits in the crotch of the T along the line of the lower edge of the crossarm portion of the T-shaped material, to form edges 41. The same numerals as employed in FIG. 7 are used to refer to the same parts.

Referring to FIG. 9, there is shown drape 45 comprising a central sheet 46, having a central fenestration opening 47 and running the full length of the drape. In this embodiment, the body flaps 49 are separate, generally rectangular pieces of material secured along the side edges 48 of central sheet 46.

The crossarm and armboard flaps portions of drape 45 are formed by securing separate sheets 50 to said side edges 48 at the upper end of central sheet 46, as shown by brackets 51, to approximately meet the upper ends of flaps 49.

As shown, sheets 50 are dimensioned so that their upper attached portions, together with adjacent upper portion of central sheet 46 to which they are attached, form the crossarm portion of the drape, while the lower portions of sheets 50, detach from sheet 46, form the armboard flaps. As is apparent, that part of sheet 46 adjacent body flaps 49 forms the body portion of the drape. As will be noted, this drape is formed of five separate sheets of material.

Referring to FIG. 10, there is shown a drape formed of three pieces of material. Thus, body portion 56, crossarm portion and armboard flaps 62 are formed from a single sheet of T-shaped material, armboard flaps 62 being formed by vertical slits 61 in the crotch of the T along the lines of the side edges of the body portion of the T-shaped material. Attached to sides 58 of the body portion of the T-shaped material are generally rectangular body flaps 59. The portions of the drape are dimensioned as explained for the previously discussed embodiments.

Although the embodiments of FIGS. 7 through 10 are constructed of pieces of material of various dimensions attached in different arrangements to make the drape, they are all dimensioned as described above for the preferred embodiment illustrated in FIGS. 1 through 4, to provide an effective barrier to bacterial migration from the non-sterile regions of the patient and the operating table to the sterile field of the operation when the drape is positioned over a patient. In particular, all embodiments of the invention, including those illustrated in FIGS. 7 through 10, have armboard flaps dimensioned so as to more effectively seal the routes for bacterial migration from the non-sterile arm regions of the patient to the sterile surgical field, without hindering access thereto.

While several specific embodiments of the drape of my invention have been described with particularity, they are provided by way of illustration, and many variations and modifications thereof may be made without departing from the spirit and scope of the invention.

What is claimed is:

l. A generally T-shaped surgical drape for use on an operating table having a laterally extending board for supporting a patients arm, said drape comprising an elongated, generally rectangular body portion having top and bottom ends and a pair of side edges, an elongated rectangular crossarm portion having top and bottom ends and side edges, said crossarm portion being disposed transversely of said body portion, the top end of said body portion being shorter than and integral with the bottom end of said crossarm portion, and an armboard flap having top and bottom ends and side edges, said armboard flap extending along the bottom end of said crossarm portion from a side thereof to a point overlying said body portion, the top end of said armboard flap being integral with the bottom end of said crossarm portion, said armboard flap being substantially free of attachment to said body portion.

2. The surgical drape of claim 1, which comprises a pair of said armboard flaps.

3. The surgical drape of claim 2, further comprising a generally rectangular body flap integral with each side edge of said body portion but detached from said crossarm portion and from the armboard flap adjacent thereto.

4. A generally T-shaped surgical drape for use with an operating table having an armboard extending laterally therefrom, said drape comprising an elongated generally rectangular body portion having top and bottom ends and two side edges; a fenestration opening in said elongated body portion; a transversely disposed generally rectangular crossarm portion having top and bottom ends and two side edges, the bottom end of said crossarm portion being longer than and integral with the top end of said body portion; two generally rectangular body flaps integral with the side edges of said body portion; and two generally rectangular armboard flaps having top and bottom ends and side edges, each said armboard flap extending along the bottom end of said crossarm portion from a side thereof to a point overlying said body portion, the top ends of said armboard flaps being integral with the bottom end of said crossarm portion, said armboard flaps being substantially free of attachment to said body portion.

5. The surgical drape of claim 4, wherein each said body flap extends the entire length of the edge of the body portion with which said body flap is integral and is free of attachment to the crossarm portion and the adjacent armboard flap, said armboard flap being free of attachment to said body portion and to said body flap.

6. The surgical drape of claim 5 further comprising a reinforcing panel surrounding said fenestration opening, an instrument receiving pad having a coefficient of friction greater than 1 secured to the top surface of the drape below the lower end of said fenestration opening and a plurality of attachment tabs arranged about said fenestration opening, each said tab having a flexible portion free of the drape, said flexible portion having at least two openings which extend therethrough and through which a tube or a cord may be inserted to secure same thereto, at least one said tab being positioned at the periphery of that end of the reinforcing panel nearest the top end of said body panel, and at least one tab at the periphery at that end of the instrument pad nearest the bottom end of said body panel.

7. The surgical drape of claim 5, further comprising adhesive attachment means associated with said fenestration opening for securing said drape to a patient.

8. The surgical drape of claim 7, wherein said attachment means comprises a pair of foldable flaps integral with opposed edges defining said fenestration opening, which flaps are normally folded back on top of the drape, pressure-sensitive adhesive on at least part of the top surfaces of said flaps when the same are folded back on top of the drape, and releasable cover sheets covering said adhesive; said flaps being foldable into the fenestration opening so as to present the same toward the body of the patient for attachment of the drape thereto after removal of the cover sheets from the pressure-sensitive adhesive.

9. The surgical drape of claim 7, wherein said attachment means comprises a transparent plastic film secured to the edges defining said fenestration opening, clear pressure-sensitive adhesive on the bottom surface of said film, and a releasable cover sheet covering said adhesive; said cover sheet being removable from the pressure-sensitive adhesive so that the same may be presented toward the body of the patient for attachment of the drape thereto.

UNITED STATES PATENT AND TRADEMARK OFFICE CERTIFICATE OF CORRECTION PATENT NO. 3,856,006 DATED December 21%, 197AL INV,ENT0R(5) I Krzewinski, Henrietta K.

It is certified that error appears in the above-identified patent and that seidLetters Patent are hereby corrected as shown below;

In the Drawings, Figure 9, reference numeral "57" should read. --5l-- Signed and Scalcd thus sixteenth Day Of December 19 7 5 [SEAL] v v A ttes t:

RUTH C. MASON (0mmissimur nfParents and Trademarks

Claims

1. A generally T-shaped surgical drape for use on an operating table having a laterally extending board for supporting a patient''s arm, said drape comprising an elongated, generally rectangular body portion having top and bottom ends and a pair of side edges, an elongated rectangular crossarm portion having top and bottom ends and side edges, said crossarm portion being disposed transversely of said body portion, the top end of said body portion being shorter than and integral with the bottom end of said crossarm portion, and an armboard flap having top and bottom ends and side edges, said armboard flap extending along the bottom end of said crossarm portion from a side thereof to a point overlying said body portion, the top end of said armboard flap being integral with the bottom end of said crossarm portion, said armboard flap being substantially free of attachment to said body portion.