US2749914A - braley - Google Patents

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US2749914A
US2749914A US2749914DA US2749914A US 2749914 A US2749914 A US 2749914A US 2749914D A US2749914D A US 2749914DA US 2749914 A US2749914 A US 2749914A
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limb
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/02Compresses or poultices for effecting heating or cooling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F2007/0001Body part
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/02Compresses or poultices for effecting heating or cooling
    • A61F2007/0225Compresses or poultices for effecting heating or cooling connected to the body or a part thereof
    • A61F2007/0228Compresses or poultices for effecting heating or cooling connected to the body or a part thereof with belt or strap, e.g. with buckle
    • A61F2007/023Compresses or poultices for effecting heating or cooling connected to the body or a part thereof with belt or strap, e.g. with buckle with pockets for receiving packs or pouches
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/02Compresses or poultices for effecting heating or cooling
    • A61F2007/0244Compresses or poultices for effecting heating or cooling with layers
    • A61F2007/026Compresses or poultices for effecting heating or cooling with layers with a fluid absorbing layer
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F7/00Heating or cooling appliances for medical or therapeutic treatment of the human body
    • A61F7/02Compresses or poultices for effecting heating or cooling
    • A61F2007/0268Compresses or poultices for effecting heating or cooling having a plurality of compartments being filled with a heat carrier

Definitions

  • This invention relates to a therapeutic hot pack device.
  • hot packs are prescribed which require over long periods frequent attention of nurses to remove the towels or dressing from the affected part, dip them in hot water, wring them out and replace them on the patient. Not only does this treatment require an exorbitant amount of attention by nurses or aides, but the frequent disturbance of the patient, especially if the affected part is inflamed or sensitive, as in phlebitis, is objectionable and may interfere with most rapid recovery.
  • My invention accordingly combines these features by use of a tough, flexible, waterproof sheet which is impervious to water vapor and which is less subject to radiation and convection losses than exposed toweling.
  • This sheet is provided with fasteners to hold it with edge portions overlapped in a tight wrapping on the affected part.
  • On the inside of this wrapper sheet I secure liquid cell units which contain a heat storage liquid (i. e., a stable liquid of relatively high specific heat) in flexible impervious bags or cells, so that any constrictive pressure caused by the wrapper is evenly distributed as hydraulic pressure by these cells and thus may be kept at a minimum at every point.
  • a heat storage liquid i. e., a stable liquid of relatively high specific heat
  • Figure 1 is a plan view of the device laid out flat
  • Figure 2 is a cross-section taken on line 22 of Figure 1;
  • Figure 3 shows, in side elevation, the device applied to the leg of a patient
  • Figure 4 is a cross-section taken on line 4-4 of Figure 3 showing the structure of the therapeutic hot pack device but without attempting to show any of the structure of the patients leg;
  • Figure 5 is an isometric view of a liquid cell unit as used in my device.
  • the wrapper sheet 1 is made from a tough, flexible, elastomeric plastic such as plasticized vinyl chloride-vinyl acetate copolymer, polyethylene, or synthetic rubber, etc.
  • Polyethylene film is most advantageous because of its combination of flexibil- States Patent ity, toughness, softness to the tactile sense of the patients skin, resistance to surface heat loss, and, in some instances, tranparency (in cases where observance of the affected part is desirable without removal of the device).
  • this plastic sheet advantageously is laminated with aluminum foil or is compounded with aluminum flake or bronzing powder or otherwise treated with a heat reflective material in thin form so that the sheet is rendered substantially impervious to thermal radiation. Its outer surface is smooth so that convection losses therefrom are minimized.
  • a second sheet 3 which advantageously is also of a plastic such as those mentioned above, but ordinarily not embodying reflective pigment or laminate, is secured to the inside of the first and along its end edges 4 so as to form a pocket 5 for the liquid cell units 7.
  • the width of these pocket areas on the device is advantageously a little less than the circumference or girth of the affected part-in this case shown as a leg.
  • the sheet 3 is secured along its longitudinal center line 6 to the central portion of the first-mentioned wrapper sheet 1, so that actually pockets 5L and SR are formed opening to opposite sides.
  • Each unit 7, as shown, has three parallel cells, each hermetically sealed and filled with a stable liquid of relatively high specific heat.
  • Water may be used.
  • Diethylene glycol or a strong aqueous solution of such glycol is better.
  • Hydrocarbon liquids such as di-phenyl or kerosene can also be used.
  • the term high specific heat is used herein to indicate specific heats within the range established by the compounds given above, i. e., water, diethylene glycol, di-phenyl, and kerosene, which are representative of the liquids commonly used as heat exchange liquids or coolants.
  • the edge portions 8 and the separating lines 9 in the example shown are heatsealed together to give permanent hermetically sealed cells and tabs 11 and 12 provided with holes as at 14 facilitate handling when hot.
  • Tie straps 16 attached to the center on the outside of Wrapper sheet I serve to hold the device in place and under the desired pressure.
  • the shape of the sheets 1 and 3 as shown, is approximately trapezoidal in outline but with the end edges bent upwardly, the upper edge 13 thus being convex and the lower edge 15 concave, while the side edges 17 and 19 diverge upwardly.
  • this is advantageous to assure ready location and better fit on the afifected part.
  • the several heat cells 7 are removed from their pocket and placed in a hot water bath of about F. until they are heated to approximately the temperature of the bath.
  • the wrapper portion of the device of the present invention 1, 3, 16 is placed under the limb or other affected portion with the larger end toward the broader portion of the limb.
  • Towels 18 as in the presently used treatment are dipped in water of about 115 F. and then wrung out and wrapped around the limb or other affected part to be treated.
  • the heat cells 7 are now removed from the hot bath and placed in the pocket 5L and SR under the limb and the two sides of the wrapper sheet 1 are respectively brought up and wrapped around the limb and then tied by the ties 16 snugly, but, in cases of phlebitis, with as little pressure as possible.
  • the device is shown in position in Figure 3, and a diagrammatic cross-section shown in Figure 4 shows the relation of the parts as thus applied without attempting to show any of the structure of the limb.
  • a therapeutic hot pack device which comprises a sheet of tough, flexible elastomeric plastic composition of width substantially greater than the girth of an affected limb whereby it is adapted to wrap around said'limb with edge portions overlapped, a second sheet of plastic secured to the first along a central longitudinal line and transversely at its ends, forming pockets between said sheets, liquid cell units held insaid pockets, each comprised of a pair of flexible sheets of tough elastomeric plastic sealed together at their edges to form a liquid-tight cell and a liquid therein of high specific heat, and flexible tie straps secured to the outside of said first-named sheet at spaced points along a centrally positioned longitudinal line, said straps being no longer than the width of the plastic sheet and extending transversely thereof.
  • a therapeutic hot pack device as defined in claim 1 in which the liquid cell units are also sealed together along a plurality of lines spaced from the edges and from 4 each other to provide a plurality of sealed cells, each of said cells being filled with a liquid of high specific gravity. 3. A therapeutic hot pack device as defined in claim 1 in which the liquid cell units are also sealed together along a plurality of lines spaced from the lateral edges and from each other to provide a plurality of sealed cells, each of said cells being filled with a liquid of high specific gravity, the units being arranged with their said sealing lines parallel to the longitudinal side edges of the first-mentioned sheet, whereby in use the liquid cells are arranged parallel to the axis of the limb around which they are tied.

Description

June 12, 1956 M. T. BRALEY 2,749,914
THERMAL PACK FOR BODY APPLICATION Filed Sept. 1'7, 1952 THERMAL PACK FOR BODY APPLICATION Margaret T. Braley, Riverside, Conn.
Application September 17, 1952, Serial No. 310,076
3 Claims. (Cl. 128-402) This invention relates to a therapeutic hot pack device.
In various therapeutic treatments such as those for poliomyelitis and phlebitis, among others, hot packs are prescribed which require over long periods frequent attention of nurses to remove the towels or dressing from the affected part, dip them in hot water, wring them out and replace them on the patient. Not only does this treatment require an exorbitant amount of attention by nurses or aides, but the frequent disturbance of the patient, especially if the affected part is inflamed or sensitive, as in phlebitis, is objectionable and may interfere with most rapid recovery.
I have now found that such therapy can be greatly improved by use of a novel device which serves both to provide a reservoir of heat and a barrier against loss of heat to the atmosphere-both direct loss by radiation and convection and indirect loss by evaporation of water from the hot towels. I have found furthermore that the therapy, especially for phlebitis, is improved by use of an hydraulic device to distribute a uniform pressure over the flesh of the affected part.
My invention accordingly combines these features by use of a tough, flexible, waterproof sheet which is impervious to water vapor and which is less subject to radiation and convection losses than exposed toweling. This sheet is provided with fasteners to hold it with edge portions overlapped in a tight wrapping on the affected part. On the inside of this wrapper sheet I secure liquid cell units which contain a heat storage liquid (i. e., a stable liquid of relatively high specific heat) in flexible impervious bags or cells, so that any constrictive pressure caused by the wrapper is evenly distributed as hydraulic pressure by these cells and thus may be kept at a minimum at every point.
In the accompanying drawings, I have shown an example of my invention which has received enthusiastic approval of leading doctors and is being sought for as regular equipment by some of the most up-to-date hospitals where it has been used experimentally by such doctors.
In these drawings:
Figure 1 is a plan view of the device laid out flat;
Figure 2 is a cross-section taken on line 22 of Figure 1;
Figure 3 shows, in side elevation, the device applied to the leg of a patient;
Figure 4 is a cross-section taken on line 4-4 of Figure 3 showing the structure of the therapeutic hot pack device but without attempting to show any of the structure of the patients leg;
Figure 5 is an isometric view of a liquid cell unit as used in my device.
Referring to these drawings, the wrapper sheet 1 is made from a tough, flexible, elastomeric plastic such as plasticized vinyl chloride-vinyl acetate copolymer, polyethylene, or synthetic rubber, etc. Polyethylene film is most advantageous because of its combination of flexibil- States Patent ity, toughness, softness to the tactile sense of the patients skin, resistance to surface heat loss, and, in some instances, tranparency (in cases where observance of the affected part is desirable without removal of the device). Where transparency is not required, this plastic sheet advantageously is laminated with aluminum foil or is compounded with aluminum flake or bronzing powder or otherwise treated with a heat reflective material in thin form so that the sheet is rendered substantially impervious to thermal radiation. Its outer surface is smooth so that convection losses therefrom are minimized.
A second sheet 3 which advantageously is also of a plastic such as those mentioned above, but ordinarily not embodying reflective pigment or laminate, is secured to the inside of the first and along its end edges 4 so as to form a pocket 5 for the liquid cell units 7. The width of these pocket areas on the device is advantageously a little less than the circumference or girth of the affected part-in this case shown as a leg. Advantageously, as shown, the sheet 3 is secured along its longitudinal center line 6 to the central portion of the first-mentioned wrapper sheet 1, so that actually pockets 5L and SR are formed opening to opposite sides.
It is satisfactory in most cases to have one long pocket at each side into which several liquid cell units '7 are inserted side by side; but there is some advantage in making individual pockets by securing the sheets together along the transverse lines 10 between the units 7 so that each pocket is snugly fitted to a single unit 7.
Each unit 7, as shown, has three parallel cells, each hermetically sealed and filled with a stable liquid of relatively high specific heat. Water may be used. Diethylene glycol or a strong aqueous solution of such glycol is better. Hydrocarbon liquids such as di-phenyl or kerosene can also be used. The term high specific heat is used herein to indicate specific heats within the range established by the compounds given above, i. e., water, diethylene glycol, di-phenyl, and kerosene, which are representative of the liquids commonly used as heat exchange liquids or coolants. The edge portions 8 and the separating lines 9 in the example shown are heatsealed together to give permanent hermetically sealed cells and tabs 11 and 12 provided with holes as at 14 facilitate handling when hot.
Tie straps 16 attached to the center on the outside of Wrapper sheet I serve to hold the device in place and under the desired pressure.
The shape of the sheets 1 and 3 as shown, is approximately trapezoidal in outline but with the end edges bent upwardly, the upper edge 13 thus being convex and the lower edge 15 concave, while the side edges 17 and 19 diverge upwardly. Although not essential to the invention in its broader aspect this is advantageous to assure ready location and better fit on the afifected part.
In the use of the device as shown in the drawings and described above the several heat cells 7 are removed from their pocket and placed in a hot water bath of about F. until they are heated to approximately the temperature of the bath. The wrapper portion of the device of the present invention 1, 3, 16 is placed under the limb or other affected portion with the larger end toward the broader portion of the limb. Towels 18 as in the presently used treatment are dipped in water of about 115 F. and then wrung out and wrapped around the limb or other affected part to be treated. The heat cells 7 are now removed from the hot bath and placed in the pocket 5L and SR under the limb and the two sides of the wrapper sheet 1 are respectively brought up and wrapped around the limb and then tied by the ties 16 snugly, but, in cases of phlebitis, with as little pressure as possible. As thus finally applied, the device is shown in position in Figure 3, and a diagrammatic cross-section shown in Figure 4 shows the relation of the parts as thus applied without attempting to show any of the structure of the limb.
I claim:
1. A therapeutic hot pack device which comprises a sheet of tough, flexible elastomeric plastic composition of width substantially greater than the girth of an affected limb whereby it is adapted to wrap around said'limb with edge portions overlapped, a second sheet of plastic secured to the first along a central longitudinal line and transversely at its ends, forming pockets between said sheets, liquid cell units held insaid pockets, each comprised of a pair of flexible sheets of tough elastomeric plastic sealed together at their edges to form a liquid-tight cell and a liquid therein of high specific heat, and flexible tie straps secured to the outside of said first-named sheet at spaced points along a centrally positioned longitudinal line, said straps being no longer than the width of the plastic sheet and extending transversely thereof.
2. A therapeutic hot pack device as defined in claim 1 in which the liquid cell units are also sealed together along a plurality of lines spaced from the edges and from 4 each other to provide a plurality of sealed cells, each of said cells being filled with a liquid of high specific gravity. 3. A therapeutic hot pack device as defined in claim 1 in which the liquid cell units are also sealed together along a plurality of lines spaced from the lateral edges and from each other to provide a plurality of sealed cells, each of said cells being filled with a liquid of high specific gravity, the units being arranged with their said sealing lines parallel to the longitudinal side edges of the first-mentioned sheet, whereby in use the liquid cells are arranged parallel to the axis of the limb around which they are tied.
References Cited in the file of this patent UNITED STATES PATENTS 2,273,873 Klein Feb. 24, 1942 2,403,676 Modlinski July 9, 1946 2,547,886 Poux Apr. 3, 1951 2,577,945 Atherton Dec. 11, 1951 FOREIGN PATENTS 821,150 France Aug. 17, 1937
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Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2911974A (en) * 1956-10-22 1959-11-10 Beatrice M Spence Therapeutic method and apparatus
US3092112A (en) * 1960-10-17 1963-06-04 Emanuel M Zelony Therapeutic compress
US3429315A (en) * 1966-11-04 1969-02-25 Chemi Temp Corp Chemical refrigerant blanket
US3589366A (en) * 1970-12-02 1971-06-29 Biophysical Research & Dev Cor Reducing shorts
US3683902A (en) * 1970-06-24 1972-08-15 Anatoly Ivanovich Artemenko Medical splint apparatus
US3780732A (en) * 1968-08-19 1973-12-25 S Leibinsoh Non-gravitational infusion set
US4139004A (en) * 1977-02-17 1979-02-13 Gonzalez Jr Harry Bandage apparatus for treating burns
US4357009A (en) * 1980-06-18 1982-11-02 Baker Phillip L Water-filled weight bag
US4509750A (en) * 1980-04-09 1985-04-09 Last Anthony J Surface vibration absorbing strap
US4592358A (en) * 1984-08-17 1986-06-03 Westplate Wayne J Therapeutic device
US4676247A (en) * 1985-08-21 1987-06-30 Cleve Ardry J Van Multi-pocket therapeutic anatomical wrap
US5113877A (en) * 1991-03-06 1992-05-19 Aircast Incorporated Ankle sprain management system
US5152285A (en) * 1991-12-20 1992-10-06 Hufmeister Aluminum Horseshoe Company Therapeutic boot for applying heat or cold to the leg of a horse
US5835983A (en) * 1996-09-13 1998-11-10 Sunbeam Products, Inc. Heating device and method of manufacturing the same
US20080039913A1 (en) * 2006-08-09 2008-02-14 Hagay Mizrahi Aromatherapy blanket pack
US20080051860A1 (en) * 2006-08-22 2008-02-28 Wyk Johan D V Cosmetic mask and method of using
US20080119916A1 (en) * 2006-10-05 2008-05-22 Ramsey Joe Choucair Cold Compress for Therapeutic Cooling
US20110314640A1 (en) * 2010-06-26 2011-12-29 Reynolds Patrick M Attachable Gel Strap Wrap and Method
US20160178264A1 (en) * 2014-12-23 2016-06-23 The Trustees Of Dartmouth College Temperature gradient system and method
US20160228266A1 (en) * 2015-02-11 2016-08-11 Randall D. Alley Skeletal Stabilization Liner System

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR821150A (en) * 1936-05-14 1937-11-27 Apparatus for the application of thermotherapy
US2273873A (en) * 1938-11-28 1942-02-24 Raritan Bay Holding Company Adhesive surgical dressing and method of applying the same
US2403676A (en) * 1944-08-03 1946-07-09 Modlinski Michael Heat and cold applicator
US2547886A (en) * 1947-06-24 1951-04-03 Noel J Poux Therapeutical device
US2577945A (en) * 1947-12-06 1951-12-11 Atherton Harold Starr Plaster or bandage for skin application

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR821150A (en) * 1936-05-14 1937-11-27 Apparatus for the application of thermotherapy
US2273873A (en) * 1938-11-28 1942-02-24 Raritan Bay Holding Company Adhesive surgical dressing and method of applying the same
US2403676A (en) * 1944-08-03 1946-07-09 Modlinski Michael Heat and cold applicator
US2547886A (en) * 1947-06-24 1951-04-03 Noel J Poux Therapeutical device
US2577945A (en) * 1947-12-06 1951-12-11 Atherton Harold Starr Plaster or bandage for skin application

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2911974A (en) * 1956-10-22 1959-11-10 Beatrice M Spence Therapeutic method and apparatus
US3092112A (en) * 1960-10-17 1963-06-04 Emanuel M Zelony Therapeutic compress
US3429315A (en) * 1966-11-04 1969-02-25 Chemi Temp Corp Chemical refrigerant blanket
US3780732A (en) * 1968-08-19 1973-12-25 S Leibinsoh Non-gravitational infusion set
US3683902A (en) * 1970-06-24 1972-08-15 Anatoly Ivanovich Artemenko Medical splint apparatus
US3589366A (en) * 1970-12-02 1971-06-29 Biophysical Research & Dev Cor Reducing shorts
US4139004A (en) * 1977-02-17 1979-02-13 Gonzalez Jr Harry Bandage apparatus for treating burns
US4905997A (en) * 1980-04-09 1990-03-06 Rainbow Star Licensing Heat Pod Body Muscle Treatment Device
US4509750A (en) * 1980-04-09 1985-04-09 Last Anthony J Surface vibration absorbing strap
US4905998A (en) * 1980-04-09 1990-03-06 Rainbow Star Licensing Tennis elbow prevention and treatment device and method
US4357009A (en) * 1980-06-18 1982-11-02 Baker Phillip L Water-filled weight bag
US4592358A (en) * 1984-08-17 1986-06-03 Westplate Wayne J Therapeutic device
US4676247A (en) * 1985-08-21 1987-06-30 Cleve Ardry J Van Multi-pocket therapeutic anatomical wrap
US5113877A (en) * 1991-03-06 1992-05-19 Aircast Incorporated Ankle sprain management system
WO1992015263A1 (en) * 1991-03-06 1992-09-17 Aircast, Inc. Ankle sprain management system
US5152285A (en) * 1991-12-20 1992-10-06 Hufmeister Aluminum Horseshoe Company Therapeutic boot for applying heat or cold to the leg of a horse
US5835983A (en) * 1996-09-13 1998-11-10 Sunbeam Products, Inc. Heating device and method of manufacturing the same
US20080039913A1 (en) * 2006-08-09 2008-02-14 Hagay Mizrahi Aromatherapy blanket pack
US20080051860A1 (en) * 2006-08-22 2008-02-28 Wyk Johan D V Cosmetic mask and method of using
US20080119916A1 (en) * 2006-10-05 2008-05-22 Ramsey Joe Choucair Cold Compress for Therapeutic Cooling
US20110314640A1 (en) * 2010-06-26 2011-12-29 Reynolds Patrick M Attachable Gel Strap Wrap and Method
US20160178264A1 (en) * 2014-12-23 2016-06-23 The Trustees Of Dartmouth College Temperature gradient system and method
US20160228266A1 (en) * 2015-02-11 2016-08-11 Randall D. Alley Skeletal Stabilization Liner System
US10806606B2 (en) * 2015-02-11 2020-10-20 Randall D. Alley Skeletal stabilization liner system

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