WO1991010406A1 - A bone wax applicator and method for dressing bone tissue - Google Patents

A bone wax applicator and method for dressing bone tissue Download PDF

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Publication number
WO1991010406A1
WO1991010406A1 PCT/US1990/000479 US9000479W WO9110406A1 WO 1991010406 A1 WO1991010406 A1 WO 1991010406A1 US 9000479 W US9000479 W US 9000479W WO 9110406 A1 WO9110406 A1 WO 9110406A1
Authority
WO
WIPO (PCT)
Prior art keywords
applicator
bone
pattie
bone wax
wax
Prior art date
Application number
PCT/US1990/000479
Other languages
French (fr)
Inventor
Arnold G. Phillips
Original Assignee
Phillips Arnold G
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Phillips Arnold G filed Critical Phillips Arnold G
Priority to PCT/US1990/000479 priority Critical patent/WO1991010406A1/en
Priority to JP90503709A priority patent/JPH05505945A/en
Priority to AU51559/90A priority patent/AU652715B2/en
Priority to US07/915,806 priority patent/US5383879A/en
Priority to EP90903686A priority patent/EP0511955B1/en
Priority to DE69022249T priority patent/DE69022249T2/en
Publication of WO1991010406A1 publication Critical patent/WO1991010406A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers

Definitions

  • the present invention is related to surgery and surgical procedures and, more specifically, to surgery involving cutting of bone tissue, such as orthopedic, cardiac, and neurological surgery, wherein bleeding of bone tissue is to be stopped.
  • bone tissue of animals and humans bleeds when it is cut. Accordingly, a means for stopping the bleeding is required.
  • compositions generally known as bone wax have been used to dress the bone tissue and retard its bleeding. While bone wax compositions have been found that are effective, no devices or surgical procedures have been developed so that the bone wax can be effectively and conveniently applied to the bleeding bone tissue.
  • surgical bone wax is sold in sterile packages that are opened at the time when the bone wax is to be applied.
  • the bone wax is applied to the tissue in various ways. Some surgeons shape an amount of bone wax into a suitable form such as a ball and press it into the tissue either with their gloved hand or a suitable surgical instrument. When the bone wax is applied in this manner, it must then be distributed over the entire surface where the bone tissue has been cut to the entire surface where the bone tissue has been cut to dress the bleeding tissue. If this is done with a surgical instrument, an incomplete distribution of bone wax sometimes results. The bone wax can be better distributed, if the surgeon uses his gloved hand to smooth the bone wax over the bleeding bone tissue.
  • surgeons risks contamination of the operative field if he should tear or puncture his glove on the exposed bone, and risks infection of his hand as well if it is punctured by a bone spicule. Accordingly, many surgeons have used surgical patties to distribute the bone wax over the bone tissue.
  • the presently disclosed invention includes an applicator for applying bone wax to bleeding bone tissue, the applicator comprising a pattie of pliable surgical fibre having a layer of bone wax covering at least a portion thereof.
  • the bone wax layer is disposed on one end of a surgical pattie comprised of a cotton or cotton-like material.
  • the applicator may be further provided with identification means, including x-ray detectable strips, for physically or radiologically locating the applicator both during and after the operation.
  • the bone wax applicator is packaged in a sterile package that can be readily opened onto the surgical field.
  • the presently disclosed invention further includes a surgical method for dressing bleeding bone tissue with bone wax in which a bone wax layer located on a surgical fibre pattie is placed against the bone tissue and then drawn across the bone tissue such that a portion of the bone wax is deposited on the bone- tissue. The deposited bone wax is then molded over the entire portion of bleeding bone tissue with an exposed surface of the pattie.
  • Figure 2 shows another perspective view of the embodiment of Figure 1.
  • Figure 3 shows a cross sectional view of Figure 2 through lines A-A illustrating a further preferred embodiment of the invention.
  • Figure 4 shows a perspective view of another preferred embodiment of the invention.
  • Figure 5 shows a perspective view of yet another preferred embodiment of the present invention wherein the surface of the bone wax is stippled.
  • Figures 6A-E show cross-sectional views of Figure 5 through lines B-B illustrating various raised bone wax surfaces.
  • the presently preferred bone wax applicator includes a pattie 10 of surgical fibre or surgical gauze.
  • the surgical fibre can be a natural fibre, such as cotton, or a synthetic fibre, such as rayon, or a combination of natural and synthetic fibers.
  • the term fibre, as herewith used, includes random unwoven fibres and oriented fibres, and in particular includes woven fibres such as gauze.
  • pattie 10 could be a surgical pattie. While pattie 10 as shown in Figures 1 and 2, is generally rectangular, it could also have a square or other shape. Covering a portion of a major surface of pattie 10 is a layer 12 of bone wax.
  • Bone wax layer 12 can be comprised of any natural or synthetic composition that has accepted usage as bone wax.
  • a natural composition is Horseley's wax which includes seven parts of beeswax to one part each of almond oil and salicylic acid. While bone wax layer 12 can be otherwise disposed on pattie 10, it is preferred that bone wax 12 be located at one end thereof for the reason that is believed to be easier to apply the bone wax to bleeding bone tissue with this arrangement.
  • bone wax layer 12 can be made to cover an entire major surface of pattie 10. Surfaces of pattie 10 that are not covered by bone wax layer 12 are hereafter referred to as exposed surfaces.
  • the applicator includes an identification string 14 that can be used as an aid in physically locating the applicator within the suture.
  • Identification string 14 can be comprised of silk or other suitable material.
  • X-ray strips 16 that are detectable by radiological examination and would be useful in detecting an applicator inside the patient after the operation is completed and the sutures are closed.
  • the applicator is kept in sterile condition in a suitable package. Upon opening the package onto the operation field, the applicator is ready for immediate use without preliminary preparation.
  • the applicator is placed against the bleeding bone tissue such that bone wax layer 12 is in contact with the bone tissue.
  • the applicator is then drawn tangentially across the bone surface such that bone wax is abraded-from layer 12 and becomes deposited on the bone tissue.
  • the surgeon then dresses the bone wax over uncovered areas of bone tissue by spreading the deposited bone wax with exposed portions of pattie 10.
  • pattie 10 include a layer of fabric 11 on upper and lower surfaces, 13 and 15 respectively, the four edges of the bone wax 12 adjacent the pattie 10 may be beveled in order to aid in the elimination * ,of stray pieces of bone wax and/or fabric from breaking off from the applicator.
  • the fraying of the bone wax and fabric is aseptic and is thus undesirable.
  • the bone wax may be heat- sealed onto the fabric 15. Through heat sealing, the bone wax 12 is bonded more securely to the fabric 15 thereby allowing the user to apply more pressure to the bone wax during application of the wax, over rough-edged bleeding bone tissue.
  • the longitudinal elevations of fabric or creases 20 may be oriented variously (vertically, horizontally or diagonally) and may be located at various positions about the upper surface 13 of the pattie 10 depending on the requirements of the user.
  • Figure 4 illustrates one such arrangement.
  • the applicator or free surface 19 of the pattie may be smooth as shown in Figure 2 or may be stippled i.e. having multiple raised surfaces 18 distributed throughout the free surface 19, as shown in figure 5.
  • the purposes of providing a stippled surface is for greater exposure, of volume with respect, to surface area, of bone wax to bleeding bone tissue and to provide increased gripping or catching power of the bone wax during application. It is understood that the shape of the raised surfaces 18 may be variable as shown in
  • Figures 6A-E and the distribution of the "stippling" may be uniform or non-uniform although uniform distribution is preferable as is illustrated generally in Figure 5. While a presently preferred embodiment of the invention has been shown and described, and a presently preferred method of practicing the same has been illustrated, it is to be understood that the invention is not limited thereto but may be otherwise variously embodied and practiced within the scope of the following claims.

Abstract

An applicator for applying bone wax to bone tissue in which a layer (12) of bone wax covers selected surface portions of a pattie (10) of surgical fibre, and a method of applying bone wax from an applicator having a layer (12) of bone wax covering portions of a pattie wherein the bone wax layer is drawn across the bone to deposit the bone wax, and the deposited bone wax is then molded over the bone tissue with exposed portions of the applicator pattie (10).

Description

A BONE WAX APPLICATOR AND METHOD FOR DRESSING BONE TISSUE
BACKGROUND OF THE INVENTION
FIELD OF THE INVENTION The present invention is related to surgery and surgical procedures and, more specifically, to surgery involving cutting of bone tissue, such as orthopedic, cardiac, and neurological surgery, wherein bleeding of bone tissue is to be stopped.
DESCRIPTION OF THE PRIOR ART Various medical, veterinary, and dental surgical procedures involve the cutting of bone tissue during the operation. Examples of such procedures are laminectomies, craniotomies, and cardiac surgery procedures involving splitting of the sternum. Typically, the bone tissue is cut with a rongeur or a saw.
As with other living tissue, bone tissue of animals and humans bleeds when it is cut. Accordingly,, a means for stopping the bleeding is required. For many years, compositions generally known as bone wax have been used to dress the bone tissue and retard its bleeding. While bone wax compositions have been found that are effective, no devices or surgical procedures have been developed so that the bone wax can be effectively and conveniently applied to the bleeding bone tissue.
Typically, surgical bone wax is sold in sterile packages that are opened at the time when the bone wax is to be applied. The bone wax is applied to the tissue in various ways. Some surgeons shape an amount of bone wax into a suitable form such as a ball and press it into the tissue either with their gloved hand or a suitable surgical instrument. When the bone wax is applied in this manner, it must then be distributed over the entire surface where the bone tissue has been cut to the entire surface where the bone tissue has been cut to dress the bleeding tissue. If this is done with a surgical instrument, an incomplete distribution of bone wax sometimes results. The bone wax can be better distributed, if the surgeon uses his gloved hand to smooth the bone wax over the bleeding bone tissue. However, the surgeon risks contamination of the operative field if he should tear or puncture his glove on the exposed bone, and risks infection of his hand as well if it is punctured by a bone spicule. Accordingly, many surgeons have used surgical patties to distribute the bone wax over the bone tissue.
Disadvantages and difficulties have appeared with all these prior art devices and techniques. The package in which the bone wax is provided is small and somewhat awkward to open in a sterile operative field. Moreover, each application of bone wax required at least two steps in the surgical procedure. In a typical orthopedic or neurosurgical operation in which bone wax is used, as many as several dozen separate applications of bone wax may be made. Therefore, the additional steps for applying bone wax consume a considerable portion of the time necessary for the operation. For example, in a neurosurgical operation requiring four hours, as much as 10 to 30 minutes may be spent in merely applying bone wax. Accordingly, a device and method for applying bone wax more efficiently and effectively would benefit the patient by lowering his exposure to possible sources of contamination, and by reducing the time that he would be under anesthesia.
SUMMARY OF THE INVENTION The presently disclosed invention includes an applicator for applying bone wax to bleeding bone tissue, the applicator comprising a pattie of pliable surgical fibre having a layer of bone wax covering at least a portion thereof. Preferably, the bone wax layer is disposed on one end of a surgical pattie comprised of a cotton or cotton-like material. The applicator may be further provided with identification means, including x-ray detectable strips, for physically or radiologically locating the applicator both during and after the operation.
Also preferably, the bone wax applicator is packaged in a sterile package that can be readily opened onto the surgical field.
The presently disclosed invention further includes a surgical method for dressing bleeding bone tissue with bone wax in which a bone wax layer located on a surgical fibre pattie is placed against the bone tissue and then drawn across the bone tissue such that a portion of the bone wax is deposited on the bone- tissue. The deposited bone wax is then molded over the entire portion of bleeding bone tissue with an exposed surface of the pattie. Other details, objects and advantages of the invention will become apparent as the following description of the preferred embodiment of the invention and the preferred method of practicing the same proceeds.
BRIEF DESCRIPTION OF THE DRAWING Figure 1 shows a perspective view of the preferred embodiment of the invention; and
Figure 2 shows another perspective view of the embodiment of Figure 1.
Figure 3 shows a cross sectional view of Figure 2 through lines A-A illustrating a further preferred embodiment of the invention.
Figure 4 shows a perspective view of another preferred embodiment of the invention.
Figure 5 shows a perspective view of yet another preferred embodiment of the present invention wherein the surface of the bone wax is stippled.
Figures 6A-E show cross-sectional views of Figure 5 through lines B-B illustrating various raised bone wax surfaces.
PREFERRED EMBODIMENT OF THE INVENTION As shown in Figures 1 and 2, the presently preferred bone wax applicator includes a pattie 10 of surgical fibre or surgical gauze. The surgical fibre can be a natural fibre, such as cotton, or a synthetic fibre, such as rayon, or a combination of natural and synthetic fibers. The term fibre, as herewith used, includes random unwoven fibres and oriented fibres, and in particular includes woven fibres such as gauze. Preferably, pattie 10 could be a surgical pattie. While pattie 10 as shown in Figures 1 and 2, is generally rectangular, it could also have a square or other shape. Covering a portion of a major surface of pattie 10 is a layer 12 of bone wax. Bone wax layer 12 can be comprised of any natural or synthetic composition that has accepted usage as bone wax. One example of such a natural composition is Horseley's wax which includes seven parts of beeswax to one part each of almond oil and salicylic acid. While bone wax layer 12 can be otherwise disposed on pattie 10, it is preferred that bone wax 12 be located at one end thereof for the reason that is believed to be easier to apply the bone wax to bleeding bone tissue with this arrangement. Alternatively, however, as for example where pattie 10 is sufficiently small that an adequate amount of bone wax would not be otherwise carried on the pattie, bone wax layer 12 can be made to cover an entire major surface of pattie 10. Surfaces of pattie 10 that are not covered by bone wax layer 12 are hereafter referred to as exposed surfaces.
Preferably, the applicator includes an identification string 14 that can be used as an aid in physically locating the applicator within the suture. Identification string 14 can be comprised of silk or other suitable material. Also preferably included are X-ray strips 16 that are detectable by radiological examination and would be useful in detecting an applicator inside the patient after the operation is completed and the sutures are closed.
The applicator is kept in sterile condition in a suitable package. Upon opening the package onto the operation field, the applicator is ready for immediate use without preliminary preparation.
In accordance with the use of the presently disclosed applicator, the applicator is placed against the bleeding bone tissue such that bone wax layer 12 is in contact with the bone tissue. The applicator is then drawn tangentially across the bone surface such that bone wax is abraded-from layer 12 and becomes deposited on the bone tissue. The surgeon then dresses the bone wax over uncovered areas of bone tissue by spreading the deposited bone wax with exposed portions of pattie 10. As shown in Figure 3 which illustrates a preferred embodiment of the invention, pattie 10 include a layer of fabric 11 on upper and lower surfaces, 13 and 15 respectively, the four edges of the bone wax 12 adjacent the pattie 10 may be beveled in order to aid in the elimination*,of stray pieces of bone wax and/or fabric from breaking off from the applicator. The fraying of the bone wax and fabric is aseptic and is thus undesirable. Furthermore the bone wax may be heat- sealed onto the fabric 15. Through heat sealing, the bone wax 12 is bonded more securely to the fabric 15 thereby allowing the user to apply more pressure to the bone wax during application of the wax, over rough-edged bleeding bone tissue. In a further embodiment of the present invention, as illustrated in Fig. 4, it may also be desirable to include one or more longitudinal elevations of fabric or creases 20, on the upper surface 13 of the pattie 10 to provide means for the user to grip the pattie with a surgical instrument, such as forceps, if manipulation of the pattie with the aid of a surgical instrument is required. The longitudinal elevations of fabric or creases 20 may be oriented variously (vertically, horizontally or diagonally) and may be located at various positions about the upper surface 13 of the pattie 10 depending on the requirements of the user. Figure 4 illustrates one such arrangement.
If desirable, the applicator or free surface 19 of the pattie may be smooth as shown in Figure 2 or may be stippled i.e. having multiple raised surfaces 18 distributed throughout the free surface 19, as shown in figure 5. The purposes of providing a stippled surface is for greater exposure, of volume with respect, to surface area, of bone wax to bleeding bone tissue and to provide increased gripping or catching power of the bone wax during application. It is understood that the shape of the raised surfaces 18 may be variable as shown in
Figures 6A-E and the distribution of the "stippling" may be uniform or non-uniform although uniform distribution is preferable as is illustrated generally in Figure 5. While a presently preferred embodiment of the invention has been shown and described, and a presently preferred method of practicing the same has been illustrated, it is to be understood that the invention is not limited thereto but may be otherwise variously embodied and practiced within the scope of the following claims.

Claims

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. An applicator for applying bone wax to bleeding bone tissue, said applicator comprising: a pattie of pliable, surgical fibre; and a layer of bone wax that covers one end of a major surface of the pattie, such that said bone wax can be applied to the bone tissue by scraping the bone wax layer against the tissue.
2. The applicator of Claim 1 wherein said pattie is comprised of a surgical pattie.
3. The applicator of Claim 1 further comprising: an identification string attached to said pattie for determining that the pattie is removed from the suture before it is closed.
4. The applicator of Claim 1 further comprising: an x-ray detectable string attached to said pattie for revealing the presence of the pattie upon radiological examination.
5. The applicator of Claim 1 wherein said surgical fibre is comprised of cotton-like material.
6. The applicator of Claim 1 wherein said pattie is comprised of surgical gauze.
7. The applicator of claim 1, 2, 3, 4, 5 or 6 wherein layer of bone wax has beveled located on the applicator surface of said bone wax.
8. The applicator of claim 1-6 or 7 wherein said pattie includes an outer layer of fabric having one or more elevations or creases therein to provide means to manipulate the applicator with a surgical instrument.
9. The applicator of claim 1-7 or 8 wherein the bone wax layer is secured to the pattie by heat sealing.
10. The applicator of any of the claims 1-9 wherein said layer of bone wax has an applicator surface which is smooth.
11. The applicator of any of claims 1-9 wherein said layer of bone wax has an applicator surface which is stippled in the form of raised points.
PCT/US1990/000479 1990-01-22 1990-01-22 A bone wax applicator and method for dressing bone tissue WO1991010406A1 (en)

Priority Applications (6)

Application Number Priority Date Filing Date Title
PCT/US1990/000479 WO1991010406A1 (en) 1990-01-22 1990-01-22 A bone wax applicator and method for dressing bone tissue
JP90503709A JPH05505945A (en) 1990-01-22 1990-01-22 Bonwax applicator and how to apply Bonwax to bone tissue
AU51559/90A AU652715B2 (en) 1990-01-22 1990-01-22 A bone wax applicator and method for dressing bone tissue
US07/915,806 US5383879A (en) 1990-01-22 1990-01-22 Bone wax applicator and method for dressing bone tissue
EP90903686A EP0511955B1 (en) 1990-01-22 1990-01-22 A bone wax applicator for dressing bone tissue
DE69022249T DE69022249T2 (en) 1990-01-22 1990-01-22 Bone wax applicator for the treatment of bone tissue.

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1990/000479 WO1991010406A1 (en) 1990-01-22 1990-01-22 A bone wax applicator and method for dressing bone tissue

Publications (1)

Publication Number Publication Date
WO1991010406A1 true WO1991010406A1 (en) 1991-07-25

Family

ID=22220643

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1990/000479 WO1991010406A1 (en) 1990-01-22 1990-01-22 A bone wax applicator and method for dressing bone tissue

Country Status (6)

Country Link
US (1) US5383879A (en)
EP (1) EP0511955B1 (en)
JP (1) JPH05505945A (en)
AU (1) AU652715B2 (en)
DE (1) DE69022249T2 (en)
WO (1) WO1991010406A1 (en)

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Also Published As

Publication number Publication date
EP0511955B1 (en) 1995-09-06
DE69022249D1 (en) 1995-10-12
JPH05505945A (en) 1993-09-02
AU652715B2 (en) 1994-09-08
EP0511955A1 (en) 1992-11-11
AU5155990A (en) 1991-08-05
US5383879A (en) 1995-01-24
DE69022249T2 (en) 1996-05-09
EP0511955A4 (en) 1993-01-13

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