CA2097852A1

CA2097852A1 - Retention device

Info

Publication number: CA2097852A1
Application number: CA002097852A
Authority: CA
Inventors: Barry L. Schneider
Original assignee: Hollister Inc
Current assignee: Hollister Inc
Priority date: 1992-06-08
Filing date: 1993-06-07
Publication date: 1993-12-09
Also published as: ATE136998T1; JP2568368B2; NO931880L; AU655396B2; ES2085721T3; FI932405A; NZ247792A; EP0574163A1; US5267967A; DE69302218D1; DE69302218T2; ZA933712B; FI932405A0; JPH06238006A; AU3985893A; EP0574163B1; US5346479A; NO931880D0

Abstract

RETENTION DEVICE

Abstract of the Invention A retention device, particularly useful for drainage tubes and the like, having a pad for adhesive attachment to a patient's skin at the exit/entry site for a post-surgical drainage tube. The device includes a retainer body secured to the pad and provided with a strap to be looped and tightened about the drainage tube for immobilizing that tube. A passage in the body receives the free end of the strap and a latching mechanism prevent retraction of the strap unless a pair of side flanges of the body are squeezed towards each other to alter the configuration of the body' B top wall and cause upward disengagement of a restraining pawl from the ratchet teeth of the strap. In one form of the invention, the strap is oriented horizontally and the passage is spaced well above the pad so that the horizontal plane of the passage substantially bisects the loop along its axis, thereby allowing portions of the loop to be located above and below the entrance to the passage. In another embodiment, the strap is oriented in a vertical plane and the pawl is cammed laterally and upwardly to disengage the strap when the side flanges are squeezed towards each other.

Description

~ 0~'7~5 ~
Background and summary Co-owned u.S. patent 5,073,170 discloses a retention device having an adhesive pad and a tube xetainer secured to the pad's upper surface. A flexible strap extend from one side of the retainer and may be looped about a drainage tube so that when the strap~ 8 free end is inserted through a passage in the retainer body containing a detent or latch mechanism, the strap may be drawn tightly about the tube to immobilize the same. The Y-shaped configuration of the strap with its diverging arms secured to the retainer on opposite sides of the entrance opening to the pa3sage permits the strap to be drawn tightly about even the smallest drainage tubes or catheters in common use.
While the patented device i~ highly effective in securing immobilizing drainage tubes over a wide range of sizes, the procedure for releasing the latching mechanism may not be immediately apparent to an attendant unfamiliar with the device. Such release involveo lifting an exposed extension or handle of the latching member located within the passage. Th- lifting action may be awkward to perform and, even if don~ properly, may result in the transmission of pulling forces to the skin areas surrounding the exit site. Pulling or lifting forces applied to that site may cause considerablo patient discomfort. To reduce such discomfort, the attendant may use the fingers o~ his/her other hand to restrain movement o~ the adhesive pad as the latching membar is raised. While such a measure may avoid or reduce discomfort, it requires the use of both hands, ~ 0~785~
leaving no hand free for the attendant to retract the strap from the passage when the latching member has been so raised.
In addition, it has now been found that while the patented device operates with a wide range of tube sizes and is especially effective in retaining drainage tubes of the smaller ~izes (which prior retention devices often failed in securely restraining), the forces required to draw the strap tightly about larger-sized tubes tends to be greater than for smaller tubes because of the sharper directional change of the strap a~ it enters the retainer body. Again, the need for applying added force not only presents operational problems but would be expected to add to patient discomfort.
Accordingly, it i~ a main aspect of this invention to provide an improved tube retention device which is easily operated with tubes over the ~ull range of sizes and which minimizes if not eliminates patient discomfort when the device is op-rated to secure or rolease a drainage tube.
ProblemJ of patient discomfort caused by the transmission of push$ng or pulling forces toward~ or away from the skin surface are eliminatQd, or at least greatly reduced, becau~e th- forceJ required to operate the device are balanced and are not exerted in directions perpendicular to that surface. To release the latch mechanism, a user simply squeezes a pair of side flanges o~ the tube retainer with such opposing and offsetting force~ being applied in directions parallel with the patient's skin.

;~0~85;~
Briefly, the device takes the form of a flexible pad having upper and lower surfaces and with a pressure-sensitive adhesive layer along its lower surface for adherence to a patient's skin A tube retainer is mounted upon the pad's upper surface and includes a retainer body having a passage extending therethrough An elongated strap has one end portion ~oined to the body ad~acent the entrance to the passage and an opposite free end portion insertable into and through the passage When ~o inserted, the strap forms a loop for receiving and holding a drainage tube In a prefèrred embodiment, the retainer body includes a pair of ~ido walls extending along th- pa~age, the side w~118 being pivotally connected along their upper edges to a pair Or lever arm~ or ~ide flange- Such lever arms have relativ-ly rigid low r portion- xt-nding downardly below th- upp-r edg-~ of th- ~ld- wall~ and ~pac-d laterally from thoo- ~ld- wall~ Th arm~ al~o hav upper portions pro~ecting abov th dge~, and a flexible top wall ~oins such upp-r portion~ Th- top wall include~ a central portion that nor~Qlly curves downwardly into the passage but i~ forced into a partially ~traightened or raised conditlon whon th rigid lower portion~ of the lever arms are pivoted toward~ ach other A pawl or latch member extend~ downwardly from the central portion o~ the top wall .
for engaging the ratchet teeth of the strap and preventing reverse movement of the strap in the passage unle~a and until the depending portions of the lever arms are squeezed toward~ each other between the operator's fingers s~
The device may have its strap oriented so that the axis of the loop (or the plane of the strap~ extends either horizontally or vertically In an embodiment in which the orientation is horizontal, the strap is joined to the retainer body well above the plane of the pad, at approximately the level of th- imperforate guide wall that definQ~ the bottom sur~ace o~ the passage through the retainer body Ideally, that ~urface lies along a plane that substantially bisects the loop ~ormed by the strap when the strap is tightened about a drainage tube Approximately equal portions o~ th- loop are thereby di~pos-d above and below that plan- to reduce th- sharpness Or curvature of th- etrap that would otherwi~e develop at the entrance to the passage lr ~uch portion~ were unequal in ~ize A similar re~ult occur~ in an embodiment in which the strap is vertically oriented In such a conJtruction, how-ver, th- pawl hac a lat-rally-dir-ct-d and prererably angular latching ~urface and, in addition, th- strap may hav cam~ing ~hould r for directing th- flexible latching memb r laterally out of engag-ment with the ratchet teeth of th strap wh-n that m mber i~ rai~-d by sque-zing forces applied to th- d-p-nding lev-r arm~ or ~lange~
Oth-r r-ature-, advantag-~, and ob~-ct- o~ th-invention will become apparent rrOm th~ specification and drawing~
Drawing~
Figure 1 i~ a fragmentary persp-ctive view Or a drainag- tube attachment device embodying the $nvention Pigure 2 i~ an enlarged ~ectional vi~w Or the strap taken along line 2-2 of Figure 1 .
.

209~85~
Figure 3 is a fragmentary longitudinal sectional view showing the free end of the strap positioned for insertion into the passage of the retainer body, Figure 4 is a sectional view similar to (but on a scale slightly larger than) Figure 3, showing the strap in latched condition drawn tightly about a drainage tube.
Figure 5 is a still further enlarged cross sectional view taken along line 5-5 of Figure 3.
Figure 6 i9 a cross sectional view similar to Figure 5 but taken along line 6-6 of Figure 4.
Figure 7 is a cross sectional view similar to Figures 5 and 6 but showing the chanqes occurring when the lever arms of the retainer body are sgueezed towards each other.
Figure 8 i9 a fragmentary perspectivo view depicting a second embodiment of the invention in which the plane of the strap extends vertically.
Figure 9 is a cro~s sectional view illustrating the embodiment of Figure 8 with the strap inserted and latched.
Figure 10 i9 a sectional view similar to Figure 9 but showing the lever arms squeezed toward~ each other for relea~ing the latch mechanism.

Detailed Description of Preferred Embodiment~

Referring to Figures 1-7 of the drawings, numeral lo generally designates a drainge tube retention device composed of a flexible adhesivs pad 11 and retaining means 12 in the form of a retainer body 13 and an integral strap 14. The illustrated pad is planar and may have a periphery (not shown) of various shapes although circular is believed 20~785Z
preferable. A radial entry slit 15 extends transversely with respect to the tube retainer, terminating in close proximity to that retainer. Preferably, the slit terminates with its inner end 15a near the center of the pad with the retainer 12 being offset from the pad's center point. Such a relationship, as disclosed in aforementioned patent 5,073,170, allows the pad to be centered over an exit oponing for a drainage tube or catheter with the tube then extending generally upwardly through the center of the pad.
The materials and construction of the pad may be as disclosed in the aforementioned patent. In one such con~truction, pad 11 is composed of an upper layer 16 of resilient, flexible, fine-celled thermoplastic foam, such as polyolefin or polyurethane foam, and a lower layer 17 of soft, deformable skin barrier material having both wet and dry tack. If de~ired, the upper layer 16 may bQ formed of materials other than foam, such as a film of flexible polyurethane or other polymeric film having similar propertie~, and lowor layer 17 may in3tead be formed of a suitabl- pres~ure-~ensitive adhe~ive (e.g., a medical-grade acrylic adhesive).
Th~ tube retainer 12 is a unitary part molded from polypropylene, nylon, or other ~lexible thermopla~tic material and includes a generally planar plate 18 which i9 secured by adhesive or any other auitable mean~ to the upper surface o~ pad 11. The retainer body 13 extends upwardly from the plate and includes a transverse front wall 19 to which one end of strap 14 i9 integrally joined.
As in patent 5,073,170, strap 14 is Y-shaped in X0~'~85~
configuration and includes an elongated central tongue portion 14a and a pair of diverging limb portions 14b. The strap may also include a central limb portion 14c between the diverging portions 14b of the Y-shaped strap, although such central portion may be omitted if desired. The tongue portion of the strap is of sub~tantially uniorm width throughout its full length and the free end 14d is rounded and tapered. Free end 14d may also have a series of transverse ridges 20 to facilitate gripping the end of the strap between the fingers when the device is being readied for immobilizing a drainage tube. The underside of the tongue i8 provided with a longitudinal serie~ of transversely extending ratchet teeth 21 and the upper sur~ace may be provided with a pair o~ parallel, longitudinally-extending ribs 22.
The retainer body 13 has a horizontal passage 23 aligned with strap 14, the entrance 23a to the passage being located in the tran~verse rront wall 19 between and slightly above the diverging arms or limbs 14b of the strap (Figures 1, 3). Referring to Figure 5, the body 13 includes a pair of upstanding side walls 24 extending along passag~ 23 and pivotally connected at their upper ends by thin, flexible web portions 25 to a pair of lever arm~ or flangas 26. The lever arms 26 have relatively thick, rigid lower portions 26a extending downwardly below th~ w~bs (and below the upper edges 24a of the side walls) and upper portion~ 26b pro~ecting above web portions 25. A flexible top wall 27 joins the upper portions of the two lever arms and, as shown clearly in Figure 5, th~ top wall normally curves downwardly toward passage 23 when the body is in a 0 ~ ~5Z
relaxed or untensioned state (Figure S). In that state, the lever arms 26, and particularly the lower portions 26a of those arms, are spaced substantially from the outer surfaces of side walls 24.
Detent means in the form of a latching member 27 is formed integrally with top wall 28 and pro~ects downwardly from the central portion of that top wall. The latching member i5 provided with one or more teeth 29 (Figure 3~ and functions as a pawl for engaging the ratchet teeth of strap 14 when the strap is inserted into the passage as depicted in Figures 4 and 6.
Body 13 also includes a guide wall 30 which is parallel with plate 18 and pad 11 and has a top surface 30a spaced well above the upper surface of the pad. The guide wall is imperforate and includes an upwardly-facing channel 30b that extends ths length of passage 23 and receives the longitudinal rib~ 22 of the strap (Figur- 6).
The parts are dimensioned so that when the free end of th- strap is in~erted into passage 23 the ratchet teeth of the strap will sngage the teeth of the pawl or latch member 28, cau~ing top wall 27 to flex slightly upwardly as the teeth o~ the respective part~ clear each other and then return a limited distance downwardly to maintain the teeth of the re~pQctive parts in forceful interlocking engagement. Retraction of the strap is prevented by the intermeshing teeth unles~ the top wall 27 and latch member 28 are lifted to shift the teeth of the pawl out o~
engagement with those of the strap.
Release of the latch mechanism occur~ when the lever arms 26 along each side of the body 13 are ~queezed towards 20~3~85X
each other in the directions of arrows 32 ~Figure 7), causing the arms to pivot about the webs 25 at the upper edges 24a of side walls 24 and producing at least a partial straightening of top wall 27 As the curvature i~ the top wall is reduced, the central portion of that wall shifts upwardly in the direction of arrow 33, lifting the teeth 29 of the latching member or pawl 28 out of engagement with teeth 21 of strap 14 Since tho lower portions of the lever arms may be ea~ily pivoted toward~ each other by the ~ingers of one hand, the user's other hand remains available to retract the strap from pa~sage 23 The squeezing of the lever arms i9 facilitated by the fact that the outer surfaces of those arm~ are elongated in the direction of the passage and have concave curvatures rev-aled mo~t clearly in Figure 1 Since the lever arms 26 extend downwardly in the same dir-ction~ a~ the u~er's fingers, the pivoting action of the lever arms corresponds with the clo~ing action of th- thumb and an opposing index or middle fing-r engaging the re~pective concave surfaces of the two arm-0~ particular importance is the fact that the ~orcesexerted upon the retainer 12 to release the latching mechani~m are applied in two oppo~ing directions extending in a plan~ p~rallel with that o~ plate 18 and pad 11 As a result, relea~e of the strap may be accomplished without pulling the device away from the wound site or pushing it towards that site While lateral forces are applied to th~
device, those forces neutralize or balanced of~ against each other and, therefore, are not transmitted to any appreciable extent to the patient , . :

~ 7~
As shown in Figure 4, when the device is in operative position strap 14 forms a loop 36 about a drainage tube or catheter C. Since the top surface 30a of guide wall 30 is spaced well above the upper surface of pad 11, the loop is free to center itself so that surface 30a is in a plane that substantially bisects the loop 36 and tube c along axial directions. Approximately equal portions of the loop are disposed above and below the plane of guide s~rface 3Oa. The change in direction of the strap loop as it enters passage 23 i8 generally matched by the change in direction of the strap at its point of origin where it commences its loop about tube C. The result is that the sharpness of the directional change of the strap ad~acent pa~sage entrance 23a is considerably less than would occur if the surface 30a of guide wall 30 were coplanar with the upper surface of pad 11. The disclosQd construction permits tighter engagement of the strap about the tube for any given amount of tightening force applied to the strap and is particularly helpful in retaining larger-size tubes which require more abrupt changes in direction Or the strap in the immodlate vicinity of passago entrance 23a.
Figuxe~ 8-10 depict a second embodiment which is similar to th- on~ already described except that the strap 14' of the tube retaining means 12' is oriented vertically rather than horizontally. The loop that is formed by the strap therefore has its axis extending vertically and wraps about the portion of a tube or catheter that exits the patient's body in a direction sub3tantially perpendicular to the skin surface. Like retainer 12, retainer 12' includes a body 13' having side wall~ 24' that extelld ;~0~3~7~X
upwardly fro~ a plate or base 18 ' secured to the upper surface of a pad 11'. Thin, flexible webs 25' connect the upper edge portions 24a' of the side walls 24' to relatively rigid lever arms or flanges 26'. When the lever arm~ are squeezed towards each other, they pivot about the connecting webs 25' to cause the flexible top wall 27 ' to straighten, at least partially, and its central portion to shift upwardly along with the latching member or pawl 28' that extends downwardly into passage 23'. Teeth 29' of the pawl face laterally to engage the teeth 21l of the strap when the part~ are latched together. It will be observed from Figure~ 9 and 10 that the upper ends of latching teeth 29' slope to define camming surfaces 40 and the strap 14' may also have a mating sloping surface or shoulder 41. As a result, when lever arms 26' are pivoted inwardly to raise the latching member, the 510pe of surfaces 40 and/or 41 cams the flexible latching membQr laterally to release the strap for withdrawal from the pas~age.
In both of the embodiments of Figures 1-7 and 8-10, the squeezing forces for releasing the latch mechani~ms are applied in oppoaing direction~ extending generally in plano- parallel with plate~ 18 and 18'. While it is preferr-d that such squeezing forc~s cau~e the lever arms 26, 26' on both ~ides of the retainer bodies to pivot inwardly, thereby raising the central portions o~ top walls 27, 27', it should be understood that a similar lifting action might result i~ only one of the lever arms of each pair were capable of pivoting inwardly with the other arm of the sam~ pair being stationary and simply serving as a brace against which ths sgueazing ~orce would be applied.

~ 0 ~'7~ ~
For example, referring to Figure 9, if the tapered space between the left lever arm 26~ and side wall 24~ were instead occupied by the plastic material from which the remainder of the retainer is formed, the left arm would be non-pivotal but would nevertheless serve as a brace when squeezing forces are applied to both of the arms 26~. In such a case, the lifting action on pawl 28' would result solely from the inward pivotal movement of right arm 26' and the resulting changes in configuration of top wall 27'. Therefore, while it is preferred that both of the lever arms of the two embodiments be capable of pivotal movement, many of the advantage~ of tho invention may be accomplished if only one of the arms i9 pivotally mounted.
In either case, the squeezing force for releasing the latch mechanism will be applied in a direction parallel with plate member 18, 18'.
The retention device~ embodying thi~ invention are bolieved particularly useful in the medical area, especially where such device~ includo adhesive pad~ for attachment to a patient's skin in the vicinity o~ the entry or exit ~ite of a catheter or other tube. However, the retain r body with its elongated strap, and the releasable latchinq m chanism provided by the body which releases when a squeezing force i9 applied to arm~ on oppo~ite sides of the body, at least ono of which i9 mounted for inward pivotal movement, may have other use~, some of which may be non-medical. Embodiments of the invention have therefore been disclo~ed in considerable detail for purposes of illu~tration, but it will be under~tood by those skilled in the art that many of these details may bo varied without departing from the spirit and scope of the invention.

Claims

1. A retention device for tubes and the like, comprising a retainer body (13,13') having a passage (23,23') extending therethrough and having an elongated strap (14,14') with one end portion (14b,14c,14b',14c') joined to said body and an opposite free end portion (14d,14d') insertable into and through said passage (23,23') to form said strap into an object-retaining loop;
said strap (14,14') having a longitudinal series of transversely-extending ratchet teeth (21,21') along one surface thereof; said body (13,13') including a pair of side walls (24,24') having upper edges (24a,24a') and extending along said passage; a pair of side arms (26,26') joined to said side walls (24,24') along opposite sides of said body; at least one of said arms (26,26') being pivotally connected to one of said side walls (24,24') along said upper edge (24a,24a') thereof for pivotal movement towards and away from said one side wall; said arms (26,26') also including upper portions (26b,26b') projecting above said upper edges of said side walls; a flexible top wall (27,27') joining said upper portions (26b,26b') of said arms and having a central portion that is flexed into raised condition when said one arm (26,26') is pivoted towards said one side wall (24,24'); and latching means (28,28') extending downwardly from said central portion of said top wall (27,27') for engaging said teeth (21,21') and preventing reverse movement of said strap (14,14') in said passage (23,23'); said latching means (28,28') being lifted out of restraining engagement with said teeth (21,21') when said arms (26,26') are squeezed towards each other to cause pivotal movement of said one arm (26,26') and upward flexure of said central portion of said top wall (27, 27 ' ).

2. The device of Claim 1 in which said passage (23,23') has an entrance (23a,23a') located adjacent the junction of said body (13,13') and said one end portion of said strap (14,14').

3. The device of Claim 1 in which both of said side arms (26,26') are pivotally connected to said upper edges of said side walls (24,24') for pivotal movement towards and away from said side walls.

4. The device of Claims 1 or 3 in which said side arms (26,26') include relatively rigid lower portions (26a,26a') extending downwardly below said upper edges of said side walls (24,24').

5. The device of Claim 4 in which said central portion of said top wall (27,27') normally curves downwardly into said passage (23,23') but is at least partially straightened when said latching means (28,28') is lifted out of restraining engagement with said teeth of said strap (14,14').

6. The device of Claim 1 in which said body (13,13') is mounted upon a flexible pad (11,11') having upper and lower surfaces and having a pressure-sensitive adhesive layer (17,17') along its lower surface for adhesive attachment to a patient's skin when said device is used as a medical drainage tube retainer.

7. The device of Claim 7 in which said arms (26,26') are elongated in the direction of said passage (23,23').

8. The device of Claim 7 in which said arms (26) have outer surfaces with concave longitudinal curvatures dimensioned-for engaging and guiding a user's fingers when said arms are squeezed between the fingers and towards each other.

9. The device of Claim 6 in which said body (13) also includes a guide wall (30) along said passage (23) having an upper surface parallel with said pad (11).

10. The device of Claim 9 in which said upper surface of said guide wall (30) is spaced substantially above said pad (11).

11. The device of Claims 9 or 10 in which said guide wall (30) is imperforate.

12. The device of Claims 9 or 10 in which said guide wall (30) includes an upwardly-facing channel (30b) extending the length of said passage.

13. The device of Claim 12 in which said strap (14) includes longitudinal rib means (22) along the surface thereof opposite from said one surface; said rib means (22) being slidably received in said channel (30b).

14. The device of Claim 10 in which said upper surface of said guide wall (30) extends along a plane that substantially bisects said loop in an axial direction when said strap (14) retains a drainage tube.

15. The device of Claim 6 in which said body (13') also includes a guide wall (30') for said passage (23') that is substantially perpendicular to said pad (11').

16. The device of Claim 15 in which said guide wall (30') is imperforate.

17. The device of Claim 15 in which said guide wall (30') includes a laterally-facing channel extending the length of said-passage.

18. The device of Claim 17 in which said strap includes longitudinal rib means along the surface thereof opposite from said one surface; said rib means being slidably receivable in said channel.

19. The device of Claim 9 in which said latching means (28( includes a downwardly-facing pawl (29) engagable with the upwardly-facing ratchet teeth (21) of said strap (14) when said strap extends into said passage (23) and is supported by said guide wall (30).

20. The device of Claim 15 in which said latching means (28') is provided with an end portion having a pawl (29') that faces laterally towards said guide wall for engagement with said ratchet teeth (21') when said strap extends into said passage (23') and is supported by said guide wall; said latching means (28') being laterally flexible; and camming means (41) for directing said pawl (29') out of engagement with said ratchet teeth (21') when said latching means is raised.