US2122121A - Surgical aspirated drainage cup - Google Patents

Description

`Fune 28, 1938. J. E. TlLLoTsoN 2,122,121

SURGICAL ASPIRATED DRAINAGE CUP mam/to@ `lune 28, k1938.

J. E. TILLOTSON SURGICAL ASPIRATED DRAINAGE CUP Filed Feb. 2, 1937 2 Sheets-Sheet 2 Patented June 28, 1938 NiTED srrs ZJZZLM 12 Claims.

In urologic surgery, drainage apparatus employing suction is frequently used, as following cystotomy and prostatectomy. It is important that such drainage apparatus be applied in such v'5 a way as to avoid injury to the bladder mucosa,

as by pressure necrosis due to the mucosa pressing against an indwelling bladder tube.

It is an object of my invention to provide an aspirated drainage cup which may be applied eX- ternally to the body over a wound, and will gently but effectively and continuously remove all waste products which accumulate at such wound.

It is another object of my invention to provide a drainage cup which will performl drainage effectively without damage to any tissues.

It is a further object of my invention to provide a drainage cup wherein a current of air blows continuously over the surface of the wound and carries away the discharge present.

In suprapubic cystotomy, the incision may be 6 to 8 centimeters in length, ordinarily parallel to the length of the body. Primary closure of the wound following the operation is not usual, and some kind of drainage must be applied. A cystotomy tube which may be as large as 2.5 centimeters caliber is often inserted after the operation, at least at first. A Siphon drainage tube has been frequently applied, but the comparatively large value of vacuum required to get effective drainage through such a tube is likely to cause the bladder mucosa to press against the tube, resulting in necrosis.

I provide a drainage cup which is held tightly sealed against the abdomen over the wound, and wherein a relatively low value of vacuum is suiiicient to maintain a satisfactory seal so that there is substantially no injury to any tissue. I also provide restricted air orifices adjacent the inner rim of the cup for flowing jets of air continuously over the surface of the wound. A pneumatic rubber cushion is applied around the rim of the cup for comfort and to assure a tight seal.

A rubber mat and a muslin abdominal binder are attached to the cup to steady it on the abdomen. The cup is simple in structure and easily removable for cleansing and for replacing the gauze dressing. The cup may be applied immediately following a suprapubic cystotomy operation, and may be used following suprapubic prostatectomy. It is also adapted for other operations. lVIy cup includes means for receiving and retaining a cystotomy tube for as long as such tube must be used, as for removing large clots of 55, obstructing material. Comfort to the patient and (Cl. 12S- 350) cleanliness of the wound are found in using this device.

Advantages of my device are:

The patient is kept dry and comfortable. The usual discomfort of continuous large wet dressings is eliminated. The nervous strain and potential complications of large wet dressings are reduced.

The cup can be employed where no drain of any kind is in the bladder, or it may be employed where a cystotomy tube of large caliber is required.

Continuous gentle decompression with removal of urine and exudate is assured, thus promoting cleanliness of the bladder and wound, and protection against infection.

Toilsome and unpleasant nursing care is min-r imiZed, and there is large economy in dressings.

Where the condition of the patient permits, he

may get in and out of bed with the apparatus atd tached and in operation, maintaining complete dryness.

My invention will be better understood by reference to the following description and the accompanying drawings wherein the same reference characters denote corresponding parts in all iigures, and wherein:

Figure 1 shows a general assembled top plan view of my apparatus, with parts broken away, showing the drainage cup with its inlet and out-y let, and the mat, muslin belt or binder, and thigh straps attached;

Figure 2 shows a bottom plan view with parts broken away, of the cup with the pneumatic rubber rim, mat, belt or binder, and thigh straps, showing the perforated plate in the cup, and the air jet apertures;

Figure 3 is an elevation of the cup with pneumatic rubber rim, inlet and outlet, with belt or binder attached; Figure 4 is a general sectional view taken onv the line ion Figure 1, showing the cup in position on the abdomen, with gauze in place above the wound, and showing the outlet from the cup;

Figure 5 is a general sectional view taken on the liney 5 5 of Figure 1, showing the perforated plate intermediate of the cup, and the restricted air inlet;

Figure 6 is a top plan view partly in section of the inflatable rubber cushion, partly in section, showing the inlet inating tube; and

Figure 7 is a detailed sectional view of the pneumatic rubber cushion and the inlet tube for inating it, taken on the line 1-1 of Figure 1.

Referring to the drawings in detail, I is the Cil drainage cup which may be of suitable metal preferably nickel plated and comprising the upper base portion 2, the projecting edge portion 3, and the lateral intermediate portion '5. The cup I as shown is essentially frustoconical, or in the shape of a small cake tin. The cup is ordinarily substantially circular and has a central opening 4 which is of the order of l2 centimeters in diameter. A rubber apron t is cut from thin sheet rubber, ,such as is used for inner tubes of automobile tires, and is fitted to surround the side of cup I and extend along and beyond the edge 3 thereof. A pneumatic rubber cushion 8 is in the form of an annulus of approximately elliptical section, is attached as by cementing to apron Il at point 9, and is inflatable by inlet tube I Il which has a closure valve.

Attachment studs 1 are positioned around the rim of apron 6, and comprise `a base and stem 1a to which the upper portion of the stud is attached. A metal ring 31 which is preferably iiexible as of lead is provided for mounting these studs, and is positioned over the base of the stud. A rubber mat II has a substantially circular aperture which fits substantially against the sloping side 5 of cup I, over apron 5, and is apertured to receive the stems of studs 1, and is tted over the base of studs 'I and beneath the upper portions of the studs 1.

A buckle structure I3 has engaging fingers I2 which are slotted to engage studs 1. This buckle `is large, of the same size as the binder, with a number of engaging fingers extending therefrom. Abdominal binder or belt I4 which may be of muslin passes through and is held by buckle I3, with its free end I5 projecting therefrom, is relatively wide, and is adaptable to fit any shaped person.

A perforated partition or shelf I6 is provided within cup I approximately half way intermediate its base 2 and edge 3, and has a lateral frustooonical flange portion I1 which is attached at I8 to the edge portion of cup I as by soldering, or may be attached to cup I by other suitable structure. The small circular aperture I9 extends around the edge portion of cup I close to the inner rim of the edge portion forming a ring. Within aperture I9 a small pipe 2E) passes, which may be of copper, and is provided with a plurality of apertures 25 which communicate with corresponding apertures extending through the cup structure substantially at the inner rim where frustoconical portion I1 bends around to edge portion 3. These apertures are relatively small, of the order of 0.30 centimeter in diameter, and are positioned so that jets of air projected through these apertures will pass approximately radially inwardly and across the plane of the edge of the cup.

One end of pipe is in the inner rim of the cup and may have a terminal aperture of the kind described. The other end of pipe 2u passes upwardly and through an aperture in the upper base 2 of cup I, and terminates in a threaded portion 2I to which a knob 22 is threadedly fitted. Knob 22 has a narrow lateral slot 23 which is adapted to extend from near the inner end of knob 22 well up to its outer larger or knurled end, so that by screwing knob 22 up tight on terminal portion 2l, the air inlet aperture may be reduced to a minimum opening or entirely closed, and by screwing knob 22 away from terminal portion 2|, any desired value of inlet opening may be obtained. v

In the upper base portion 2 of the cup I, and

relatively near the circumferential edge thereof, an outlet aperture 26 is provided, to which is connected outlet pipe 21 which is provided with terminal threads. A coupling terminal member 28 provided with a terminal portion 29 adapted to receive a rubber hose 30 or the like is threadedly attached to pipe 21. A receptacle 3I is provided which is adapted to receive waste liquid or material discharged from the cup. Receptacle 3| is connected by a rubber hose or the like 32 to suction apparatus or aspirator 33. This may be an electrically driven or other air pump, or as shown may be a running water aspirator of the type attachable to an ordinary water faucet, and providing a leading tube as shown, or a restricted Venturi passage or the like, for producing a lowered pressure as a stream of water passes. In the form of vacuum producing apparatus shown particularly in Figure 4, there is shown an aspirator consisting of a pipe 34 within which is a smaller leading tube 35 opening in the direction of flow of the stream of water flowing through pipe 34 from a faucet 36. Leading tube 35 is connected to receptacle outlet 32, and the flow of water thru pipe 34 produces a lowered pressure or vacuum in tube 35 and thereby in receptacle 3I. Other suitable means of producing a vacuum may be employed.

'I'he intermediate partition I6 of cup I is provided with a large central aperture 38 which may advantageously be approximately 2.5 cm. in diameter and which is adapted to receive a large caliber cystotomy tube. Partition I6 is further provided with a ring of smaller apertures 39 which may be circular, Iextending in a ring around central aperture 38.

The cup I and the partition I6 and its flanges I1 are adapted to receive and hold in the space a light packing of surgical gauze III), which receives the discharge from the wound.

In Figure 4, the cup is shown in position on the abdomen. 'I'he abdomen is shown at A, incised at C, and the bladder is shown at B, incised at D. Urine, blood, pus, or other matter discharged through the incision, is met immediately upon reaching the surface by the jets of air which are discharged from apertures because of the relatively low pressure within the cup, and such discharge is thereby largely evaporated and passes upwards through the small fold of lightly packed gauze 4I] and apertures 38, 39, and pipe 21 to receptacle 3I, due to the reduced pressure applied thereto from vacuum source 33. In the space between cup base 2 and partition I 6, there is therefore air and vapor containing urine.

Attached to the belt or binder Ill are the leg straps 43, having free ends Q4, and provided with slotted terminal engaging members 4I on buckles 62, adapted to engage studs 1. These leg straps provide a further element of stability in keeping the cup in place on the abdomen, although as stated, the slight vacuum applied is the principal means by which the cup is held in place. These leg straps are rarely necessary in stout individuals.

In operation, the vacuum applied causes a stream of air of volume determined by the setting of the adjustable knob 22 to be drawn in through pipe 2,0 and apertures 25 and discharged as jets over the surface of the abdomen across the wound.

When the pneumatic rubber cushion is inflated to a degree to give proper resilience, and wet, it adheres water-tightly to the skin of the abdocharge portal, a receptacle for waste matter conmen, and there is required only slightly diminished interior pressure to maintain this fixation, and this is without undue suction on the skin or bladder. There is no marked vacuum applied, since air is rushing in continuously through the jet apertures. The binder and the rubber mat merely act as a steadying influence and not as a major factor maintaining the water-proof adherence of the inated rim to the skin. The discharge will be carried away effectively from the abdominal surface of the wound if conditions are such that no cystotomy tube is required to be in place.

The light gauze dressing is easily changed once a day or oftener as required.

I have employed my invention here described with very satisfactory results in a variety of lbladder drainage cases, with the discharge quickand odor-free and with rapid due to the high degree of ly becoming mucushealing of the wound cleanliness produced.

It will be obvious that my invention is susceptible of various modifications which will be obvious to those familiar with this art, and all such modifications as are within the scope of the appended claims I consider to be comprised within the spirit of my invention.

Having thus described the invention what I claim is:

l. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion applicable to the body, and further having a lateral portion intermediate said base portion and said edge portion, an' air conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures adapted to supply restricted jets of air to the interior of said cup-shaped member, said cup-shaped member having a discharge portal, means for maintaining a pressure below atmospheric pressure at said discharge portal, means connected to said discharge portal for conducting and receiving waste matter, and means for supplying a restricted stream of air to said air conducting pipe member.

2. In aA surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion applicable to the body, and further having a lateral portion intermediate said base portion and said edge portion, an air conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures adapted to supply restricted jets of air to the interior of said cup-shaped member, said cup-shaped member having a discharge portal in said base portion near the edge of said base portion, means for maintaining a pressure below atmospheric pressure at said discharge portal, means connected to said discharge portal for conducting and receiving waste matter, and means for supplying .a restricted stream of air to said air conducting pipe member.

3. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion applicable to the body, and further having a lateral portion intermediate said base portion and said edge portion, an air conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having' a plurality of restricted apertures adapted to supply restricted jets of air to the interior of said cup-shaped member, said cup-shaped member yhaving a disnectedto said discharge portal, means for maintaining pressure below atmospheric pressure connected to said receptacle, and means for supplying a restricted stream of air to said air conducting pipe member.

4. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion applicable to the body, and further having a lateral portion intermediate said base portion and said edge portion, an air conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures adapted to supply restricted jets of air to the interior of said cup-shaped member, said cup-shaped member having a discharge portal, means for maintaining a pressure below atmospheric pressure at said discharge portal, means connected to said discharge portal for conducting and receiving Waste matter, and adjustably controllable means for supplying a restricted stream of air of adjustably variable volume to said air conducting pipe member.

5. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion applicable to the body, and further having a lateral portion intermediate said base portion and said edge portion, an air conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures adapted to supply restricted jets of air to the interior of said cup-shaped member, said cup-shaped member having a discharge portal, means for maintaining a pressure below atmospheric pressure at said discharge portal, means connected to said discharge portal for conducting and receiving waste matter, means for supplying a restricted stream of air to said air conducting pipe, member belt means adapted to iit around the body, and engaging means adapted for attachment to said cup-shaped member and said belt` means for retaining the same in fixed relative position and for holding said cup-shaped member in desired fixed position on the body.

6. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion applicable to the body, and further having a lateral portion intermediate said base portion and said edge portion, an air conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures adapted to supply restricted jets of air to the interior of said cup-shaped member, said cup-shaped member having a discharge portal, means for maintaining a pressure below atmospheric pressure at said discharge portal, means connected to said discharge portal for conducting and receiving Waste matter, means for supplying a restricted stream of air to said air conducting' pipe, member and pneumatic sealing means carried on the edge of said cupshaped member and adapted to be applied against the body for applying an air-tight seal of said cup-shaped member against the body.

7. In a surgical drainage cup, a substantially cup-shaped member having a base portion and an edge portion applicablev to the body, said cupshaped member further having a lateral portion intermediate said base portion and said edge portion, a perforated partition within said cupshaped member spaced from said base portion and said edge portion thereof, the wall of said cup-shaped member having a discharge portal communicating with the space between said base portion and said partition, means for supplying a restricted stream of air to a point within said cup-shaped member between said partition and said edge portion, means for maintaining a pressure below atmospheric pressure at said discharge portal, and means connected to said discharge portal for conducting and receiving waste matter.

8. In a surgical drainage cup, a. substantially cup-shaped member having a base portion and an edge portion applicable to the body, said cupshaped member further having a lateral portion intermediate said base portion and said edge portion, a perforated partition within said cupshaped member spaced from said base portion and said edge portion thereof, the wall of said cup-shaped member having a discharge portal communicating with the space between said base portion and said partition, means for supplying a restricted stream of air to a plurality of spaced points within said cup-shaped member between said partition and said edge portion, means for maintaining a pressure below atmospheric pressure at said discharge portal, and means connected to said discharge portal for conducting and receiving waste matter.

9. In a surgical drainage cup, a substantially cup-shaped member having a base portion and an edge portion applicable to the body, said cupshaped member further having a lateral portion intermediate said b-ase portion and said edge portion, a perforated partition within said cupshaped member spaced from said base portion and said edge portion thereof, said partition having a relatively large central aperture of the order of 2.5 centimeters in diameter and further having a plurality of relatively smaller spaced apertures positioned around said central aperture, the wall of said cup-shaped member having a discharge portal communicating with the space between said base portion and said partition, means for supplying a restricted stream of air to a point within said cup-shaped member between said partition and said edge portion, means for maintaining a pressure below atmospheric pressure at said discharge portal, and means connected to said discharge portal for conducting and receiving waste matter.

10. In a surgical drainage cup, a substantially cup-shaped member having a base portion and an edge portion applicable to the body, said cupshaped member further having a lateral portion intermediate said base portion and said edge portion, a perforated partition within said cupshaped member spaced from said base portion and said edge portion thereof, the space in said cup-shaped member between said partition and said edge portion being adapted to receive surgical dressingmaterial, the wall of said cupshaped member having a discharge portal communicating with the space between said base portion and said partition, means for supplying a restricted stream of air to a point within said cupshaped -member between said partition and said edge portion, means for maintaining a pressure below atmospheric pressure at said discharge portal, and means connected to said discharge portal for conducting and receiving waste matter.

ll. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion, and further having a lateral portion intermediate said base portion and said edge portion, and an air-conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures positioned to discharge inwardly-directed jets of air substantially in the plane of the edge of said cup.

l2. In a surgical drainage cup, a substantially cup-shaped member having a base portion, an edge portion, and further having a lateral portion intermediate said base portion and said edge portion, an 'air-conducting pipe member extending around the inside of said cup-shaped member adjacent said edge portion thereof and having a plurality of restricted apertures positioned to discharge inwardly-directed jets of air substantially in the plane of the edge of said cup, said cupshaped member'having a discharge portal in said base portion near the edge of said base portion, means for maintaining a pressure below atmospheric pressure at said discharge portal, means connected to said discharge portal for conducting and receiving Waste matter, and means for supplying a restricted stream of air to said air conducting pipe. JOSEPH ELMER TILLOTSON.

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