US3521631A - Dressing - Google Patents

Description

July 28, 1970 J. H. GARDNER ETAL '73,521,631

DRESSING Filed Nov. 8. 1967 INVENTORS.

ATTORNEY 3,521,631 DRESSING Jack H. Gardner, Highland Park, and David T. Rovee,`

U.S. Cl. 128-156 16 Claims ABSTRACT OF THE DISCLOSURE An occlusive dressing for wounds, the dressing comprising an impervious flexible fihn adapted to contact and cover the area of the wound, an absorbent pad backing the wound-contacting film and extending beyond a substantial portion of the periphery of the impervious film and a flexible imperforate fllrn backing extending beyond the edges of both the Wound-contacting film and the absorbent pad. At least the portion of the film backing which extends beyond the outside edges of the woundcontacting film and absorbent pad contains a pressuresensitive adhesive coating for securing the same to the skin of a patient around the edges of the absorbent pad and wound-contacting film so as to completely enclose the same when the dressing is applied. The absorbent pad extending beyond the edges of the wound-contacting film removes wound exudate from the proximate area of the wound without the pad coming in contact with the open wound itself.

BRIEF SUMMARY OF THE INVENTION It has heretofore been proposed to utilize a smooth, flexible sheet in Contact with a wound surface in the treatment of wounds as the healing wound tissue will generally not adhere to such smooth surfaces. Thus, both thin metal sheets and organic films have been proposed for this purpose. However, because of the need for removing wound exudate, these protective film coverings have been perforated or cut to permit wound exudate to pass therethrough to a backing absorbent. This perforating of the film, however, has exposed the fibrous backing absorbent with the result that some Wound adherence occurs in these exposed areas. If the perforations in the wound-contacting film are made too small, then Wound exudate soon plugs the openings with the result that the exudate cannot be picked up by the backing absorbent.'

This causes puddling to occur under the film, forming pockets of wound exudate which tends to push the film up away from the wound surface. Such pockets of wound exudate provide an excellent environment for bacteria proliferation and should be avoided where possible. Recent work has shown that there is a tendency for Wounds to heal more rapidly if the dressing used is occlusive in nature, i.e., if it either prevents or substantially inhibits the escape of moisture from the wound area (Nature, Dec. 216, 1963. Biology-Effect of Air Exposure and Occlusion on Experimental Human Skin Wounds, pp. 377- 379).

The present invention combines the advantages of the wound release of continuous film dressings and the more rapid healing of occlusive film dressings Iwhile avoiding some of the disadvantages. In accordance with the present invention there is prepared a dressing in which the wound-contacting surface is a flexible imperforate sheet, the same being designed to cover the Wound area so that edge portions of the flexible Wound-contacting sheet are relatively close to an open Wound when applied to the same. The flexible wound-contacting sheet is backed by an absorbent pad which extends appreciably beyond such edges of the wound-contacting flexible sheet, the absorb- Patent 3,521,63 l Patented July 28, 1970 ent pad acting to draw off Iwound exudate from the edges of the wound-contacting sheet. The wound exudate is thus not permitted to build up in the area between the wound and the Wound-contacting sheet with the result that the wound and wound-contacting sheet are kept in intimate contact. A substantially impervious backing 'film is provided which extends beyond the edges of both the flexible wound-contacting sheet and absorbent pad to completely cover the same when the dressing is applied to a patient. The border of this backing film preferably contains adhesive whereby the'same is adhesively-secured to the underlying skin to occlude the entire dressing. The extending border of the backing film may, however, be secured in place through the use of adhesive tape if desired.

DETAILED DESCRIPTION OF THE INVENTION The invention is more readily described by reference to the drawings which show certain embodiments of the same. The embodiments illustrated in the drawings, however, are for purpose of illustration only and the invention is not limited solely to the specific embodiments shown.

Referring to the drawings:

FIG. v1 is a bottom plan view of a dressing made in accordance with the present invention;

FIG. 2 is a cross-sectional view of the dressing of FIG. 1 taken along line 2 2;

FIG. 3 is the dressing ofFIGS. 1 and 2 with the protective facing still on prior to removal;

FIG. 4 is a different modification of a dressing made in accordance with the present invention;

FIG. 5 is a cross-sectional view taken along line 5-5 of FIG. 4.

Referring to FIG. 1, the occlusive dressing there illustrated has a flexible sheet 10 adapted to contact the wound surface when the dressing is in place. The flexible sheet 10\ is hereinafter referred to as the wound-contacting portion of the dressing. The Wound-contacting portion or flexible sheet 10, is so formed that no part thereof is more than 0.75 inch distance from an edge 13 of the sheet 10. In the particular dressing illustrated in FIG. l the wound-contacting flexible sheet 10 has somewhat the shape of a cross with arms 11 and center circular imperforate wound cover portion 12. The area of sheet 10 of furthest distance from an edge 13 is the area situated in the exact center of the circular wound cover portion 12. Thus the dimensions of the wound-contacting sheet 10 should be such that the diameter of the circular portion 12 not be greater than 1.5 inches.

The sheet 10 may be formed of any of the flexible materials known to be relatively nonadhering to healing wound surfaces and inert to the same. The preferred flexible sheet materials for the wound-contacting portion 10 are organic polymer films such, for example, as polyethylene, polypropylene, Mylar, polyvinyl chloride, Saran films, ethylene-vinyl acetate copolymer, and nylon.

An absorbent 14 in the form of a pad is placed back of sheet 10 and extends beyond the edge 13 of the same. The absorbent pad 14 may extend beyond the entire edge 13 of the wound-contacting sheet 10' or only beyond a portion thereof as occurs in the specific embodiment illustrated wherein it extends beyond most of the edge portion with a part of the edge, such as illustrated at 13', not being backed by the absorbent. The exposed portion 15 of the absorbent, however, should be sufficient to provide a substantial amount of absorbent extending beyond most of the peripheral edge -13 of the woundcontacting film so positioned with respect to the film 12 that at least a portion thereof is within about 0.75 inch distance of any area within the wound-contacting film 10. By this construction there is a minimum distance for wound exudate to travel before contact with absorbent which rapidly removes the exudate from the peripheral edge of the wound-contacting flexible sheet 10, thus preventing buildup of exudate under the film with formation of pockets of exudate.

The wound-contacting flexible sheet 10 and the absorbent 14 are backed by an imperforate flexible sheet 16 which is sufiiciently large to extend beyond the peripheral edges of both the wound-contacting flexible sheet 10 and the backing absorbent 14.

The fiexible backing sheet 16 may be formed of any exible organic film-forming material and is adapted to be secured around its edges 17 to the skin of a patient after the dressing is placed over a wound. This securing of the edges 17 may be done by taping along the edges 17 of the backing film 16 but in the preferred construction is done by means of pressure-sensitive adhesive 18 which may be coated over the entire surface of film 16 as in the particular embodiment illustrated in FIGS. 1 through 3, or may be placed only around the peripheral edge 18 of the backing film to form an adhesive border for sealing the same to the skin of the patient.

This backing film 16 is relatively impervious to moisture and forms an occlusive environment under the same which environment, as previously indicated, is beneficial from the standpoint of promoting more rapid healing of the wound.

The absorbent 14 should wet readily and rapidly so that any wound exudate which contacts the same from the edge 13 is rapidly drawn away and dispersed in the absorbent. The absorbent 14 is preferably in the form of a cushioning pad which may be formed of fibers, such as ccllulosic fibers bonded together either mechanically or through the use of bonding agents to give a resilient absorbent body. The absorbent 14 may also be in the form of a hydrophilic cellular resin sheet such as foamed polyurethane formed of wettable or hydrophilic polyurethane resin.

Although in FIGS. 1 and 2 the dressing is shown without any protective covering for the pressure-sensitive adhesive coating 18 the dressing, prior to application, is provided rwith protective cover facings 19 and 20, as illustrated in FIG. 3. These protective facings are removed prior to application of the dressing. Protective facings 19 and .20 extend over both the adhesive edge portion 17 and over the center Iwound-contacting flexible sheet portion 10 to protect the same in handling prior to application of the dressing. When the dressing is to be applied, tabs 21 and 22 are grasped and the protective sheets 19 and 20 removed by pulling the tabs away from each other. The protective facings 19 and 20 may be formed of any of the conventional protective facing materials used, for example, in the preparation of adhesive bandages.

The dressing illustrated in FIGS. l through 3 is designed primarily for the treatment of relatively small wounds. In FIGS. 4 and 5 is illustrated a dressing designed for treatment of relatively large long Wounds of the incision type. In the dressing of FIGS. 4 and 5 the woundcontacting flexible sheet 21 is designed so as to have scalloped edges 22 with the scallops 24 extending Well towards the center longitudinal axis 23 of the flexible sheet 21. The fiexible sheet 21 has appreciable length in its lengthwise direction so that the same contains a relatively long imperforate wound cover portion that will cover relatively long incisions without any portion of the incision extending beyond the edge 22 in the scallops 24 of the fiexible wound-contacting sheet 21. It will be noted that the relatively deep scallops 24 along the edges 22 of the flexible sheet 21 provide a construction in which there is no area of the wound cover portion of flexible sheet 21 which is more than 0.75 inch from an edge thereof beyond which extends a portion of absorbent 25.

The flexible wound-contacting sheet 21 is backed by an absorbent pad 25 in a manner similar to that of the dressing of FIGS. l through 3. The absorbent p-ad 25 of the dressing of FIGS. 4 and 5, however, is rectangular in shape and its dimensions are such that pad 25 extends beyond the peripheral edge 22 of most of the fiexible wound-contacting sheet 21. Thus, at no point in the dressing is there a distance of more than 0.75 inch from an area of the iiexible wound-contacting sheet 21 to a peripheral edge beyond which the absorbent 25 extends. Although in the particular embodiment illustrated the edge portions 26 between the scallops 24 are shown as extending beyond the absorbent '25, such construction is only for aiding in the manufacture of the particular dressing embodiments illustrated. These extending end portions 26, indicated as 13 in FIGS. l through 13', are for the purpose of helping to hold all of the parts of the dressing in a single unitary dressing construction. In constructions of dressings illustrated these extending end portions of the facing film are anchored to the adhesive of the backing film. This flexible backing film 27, in FIGS. 4 and 5, is also of rectangular shape, the same being larger than the absorbent pad 25 so as to provide a peripheral edge 28 which extends beyond both the peripheral edge of the absorbent 25 and all edges of the wound-contacting exible sheet 21. The backing 27 has a pressure-sensitive adhesive coating 29 on one side thereof which serves to adhere the edge 28 of the dressing to the skin of a patient rwhen the same is applied over a wound. The extending tabs 13', for example, in FIGS. l, 2 and 3, and 26 in FIGS. 4 and 5 are adhered to this pressure-sensitive adhesive coating, thus securing the flexible wound-contacting sheet to the fiexible backing sheet. If desired, however, the absorbent, such as absorbent 25 of FIGS. 4 and 5, could extend beyond all edges of the flexible woundcontacting film 21, the same then being secured to the absorbent through an adhesive coating applied to the interface between the absorbent 25 and the flexible Woundcontacting film 21. The preferred construction, however, is that illustrated in the particular embodiments shown in the drawings.

Although, in the dressing embodiment as illustrated in FIGS. 4 and 5, there is no protective covering shown for the pressure-sensitive adhesive 29, protective facings similar to that illustrated in FIG. 3 may be used.

The backing film 27 of the dressing of FIGS. 4 and 5 is similar to that of the dressing of FIGS. 1 through 3, the same being formed of flexible, organic polymer film material. The adhesive coating 29 may be spread over the entire surface of the backing 27 or only around the peripheral edge to give an adhesive border. As previously indicated, in the description of the dressing of FIGS. 1 through 3, however, the pressure-sensitive adhesive border could be dispensed with and the dressing applied and secured in place through the use of pressure-sensitive adhesive tape applied along the edge for securing the same and sealing the edges of the dressing to the underlying skin of a patient. However, in the preferred practice the dressing is provided with the pressure-sensitive adhesive at least around the peripheral edge of the backing film 27 to provide a seal and secure the dressing in place.

Certain specific embodiments have been utilized in illustrating the present invention. The invention, however, is not limited to these specific embodiments and may be practiced in the form of other embodiments which would be apparent to one skilled in the art after having the advantage of the teaching of the present specification. The invention, accordingly, is not to be limited except by the appended claims.

Having thus described our invention, we claim:

1. A surgical dressing comprising a flexible sheet having a permanently imperforate wound cover portion adapted to be placed in contact with and cover a wound and remain imperforate while on said wound surface, an absorbent for wound exudate, and a fiexible imperforate film backing, said absorbent being positioned between said fiexible backing and said flexible sheet having said imperforate wound cover portion and extending beyond at least a portion of the edge of said flexible sheet there being no area in said mperforate Wound cover portion of said flexible sheet greater in distance than 0.75 inch from an edge of said ilexible sheet beyond which said absorbent extends and said backing extending beyond the edges of said flexible sheet and said absorbent to provide a border extending around said dressing for securing said dressing to the skin of a patient.

2. A dressing of claim 1 in which said border extending around said dressing is an adhesive border.

3. A dressing of claim 2 in which said border contains a pressure-sensitive adhesive coating.

4. A dressing of claim 1 in Iwhich said flexible sheet contains a plurality of tabs, extending outwardly from said imperforate wound cover portion the ends of said tabs being secured to said flexible backing.

5. A dressing of claim 4 in which said flexible backing is coated with a pressure-sensitive adhesive and the ends of said tabs are adhesively secured thereto.

6. A dressing of claim 1 in which said imperforate Wound cover portion is substantially circular in shape with a diameter not exceeding 11/2 inch.

7. A dressing of claim 6 in which said border extending around said dressing is an adhesive border.

8. A dressing of claim 7 in which said border contains a pressure-sensitive adhesive coating.

9. A dressing of claim 8 in which said flexible sheet contains a plurality of tabs, extending outwardly from said imperforate wound cover portion the ends of said tabs being secured to said exible backing.

10. A dressing of claim 9 in which said exi'ble backing is coated with a pressure-sensitive adhesive and the ends of said tabs are adhesively secured thereto.

11. A dressing of claim 1 in which said imperforate wound cover portion has a length appreciably greater than its width.

12. A dressing of claim 11 in which said border extending around said dressing is an adhesive border.

13. A dressing of claim 12 in which said border contains a pressure-sensitive adhesive coating.

14. A dressing of claim 13 in which said flexible sheet contains a plurality of tabs, extending outwardly from said imperforate Wound cover portion the ends of said tabs being secured to said flexible backing.

15. A dressing of claim 14 in which said exible backing is coated with a pressure-sensitive adhesive and the ends of said tabs are adhesively secured thereto.

16. A dressing of claim 14 in which the edge of said flexible sheet is scalloped to form said tabs the inner p0rtion of the scallops defining the general area of said imperforate wound cover portion.

References Cited UNITED STATES PATENTS L. W. TRAPP, Primary Examiner

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