| CLAIMS 1. A costume (1) used in the treatment of subcutaneous emphysema comprising: a body with an elastic fabric (2); at least two slits (3) on both sides of the body (2) up to the arm pit of the patient which enables the placement of drain to the patient; at least one lower belt (5) on the front side of the body (2); at least one space (4) ensuring air drainage channels like fasciotomy and IV cannula for the patient and ensuring the preparation of the patient for the maintenance of these; and characterized with at least one lower belt (5) on the lower side of the body (2) preventing the air release from around thoracic tube; and at least one upper belt (6) on the upper side of the body (2), ensuring the exit of subcutaneous emphysema from the area of fasciotomy. |
COSTUME USED IN THE TREATMENT OF SUBCUTANEOUS
EMPHYSEMA
Technical Field
This invention concerns a costume that efficiently helps the treatment of the subcutaneous emphysema disease developed in the thorax, when worn by patients.
By the belts on the costume, the air around thoracic tube is prevented from being released. Because the costume has an elastic structure, it ensures that the air beneath the skin is released out of the skin by being directed to air drainage channels such as the IV cannula or fasciotomy placed on the skin.
Previous Technique
The current basic principles in the treatment of the subcutaneous emphysema disease are the following;
1) Prevention of the air escaping from the lung parenchyma or other organs beneath the skin,
2) Facilitating the release of the existing air beneath the skin to outside of the skin. For this purpose, methods such as only monitoring (no intervention), placing of a thoracic tube to the body, tissue massage (rubbing of the air), opening a fasciotomy, placing an IV cannula inside the skin, wrapping the thorax with an elastic bandage are used. When necessary, the area with the air can be rehabilitated with thoracotomy or VATS. These methods can be used by themselves or combined during treatment.
The application and the failing aspects of these methods are as the following; Monitoring; In cases with minimal emphysema, the air can be expected to be resorbed slowly by the soft tissues. Monitoring as such can be done for a couple of weeks.
Tube thoracostomy; The standard treatment is the placement of a thoracic tube which ensures the necessary air drainage. This is usually enough. In order to not allow air enter beneath the skin, the place of the tube where is passes intercostal should not be dissected too much. As the patients with thoracic tubes cough a lot, it enables the lung to expand and with the air release the lung paranchyma is recovered more rapidly. However, if large dissection was done, excessive coughing can lead to an increase in emphysema by causing more air to escape beneath the skin from this point.
Placing IV cannula; On front side of the thorax, generally between the clavicle and the mamma, on the 2 nd -3 rd costas, a cannula with a large lumen is pricked to areas with few subcutaneous lipid tissues and the plastic part of the cannula is left beneath the skin so as to form channels where the air beneath the skin can escape. If skin rubbing (skin massage) is done by hand from the areas with emphysema to this point, air drainage shall be more rapid. This process is a rapid and easy-to- apply method, but it might have to be repeated for many times.
Fasciotomy; In endemic emphysema, on front side of the thorax, beneath clavicle, on the pectoral muscle, an approximately 2cm cutaneous-subcutaneous cut reaching to the fascia can be performed. In mediastinal emphysema, pretracheal fasciotomy can be done on the jugular incisura. The purpose here is to create an exit channel for the air existing beneath the skin. Again using hand rubbing in this method increases the speed of the drainage of emphysema.
Thoracotomy- VATS; In cases where despite the interventions performed emphysema continues, the paranchyma with the escape of air can be determined by VATS or thoracotomy and the necessary fixation can be done. The difficulties faced in the existing technique are listed below;
-For the patients on whom only monitoring is applied, remission of emphysema might take long, infection beneath the skin may develop, treatment of primary pathology like bullous lung may become more difficult.
-If the patient to whom tube thoracostomy is applied to has to cough for the expansion of lung and if large dissection was performed on the point where tube entered the thorax, emphysema increases once again with each cough.
- If for the intubated patient the requirement of high pressure and volume ventilation continues, parenchymal air passage and emphysema may continue and increase.
- The patient's lung tissue where there is an air passage should recover rapidly while, the lung should rapidly expand and emphysema should rapidly recover. For this reason, the channel of air passage beneath the skin should be closed, and it should be ensured that the existing emphysema is rapidly resorbed. This vicious cycle have been able to be broken in cases where we used emphysema corset.
In the United States the patent document numbered US 2007 275 635 regarding the technique, a convenient costume used in female chest treatment is mentioned. However the costume in question is applied in breast treatment.
In another United States patent document numbered US 336 8550, a single piece costume motor integrated with the body is mentioned.
As stated above, in the known applications within the existing technique, any costume which enables the patient to recover in a shorter period and more effectively and which is applied during treatment is not mentioned. Brief description of the invention
This invention is a costume that prevents the escaping of the air beneath the skin from around drainage with its belts and provides the air passed beneath the skin to be resorbed more rapidly thanks to its pressurized-elastic structure.
Another purpose of this invention is that when it is used in combination with one of the methods providing drainage channel for the air beneath the skin (such as IV cannula, fasciotomy), it becomes a costume used in the treatment of subcutaneous emphysema, which decreases air passage beneath the skin on the one hand and ensures a more rapid discharge from the drainage channel of the air beneath the skin by its continuous compression impact on the other.
Detailed Description of the Invention
A costume which was created for the purposes of this invention and which is used in the treatment of subcutaneous emphysema is shown in the annexed figures.
These figures are;
Figure-1 The front view of the costume, which is the subject the invention, used in the treatment of subcutaneous emphysema. .
Figure-2 The back view with belts fixed of the costume, which is the subject the invention, used in the treatment of subcutaneous emphysema.
Figure-3 The side view of the costume, which is the subject the invention, used in the treatment of subcutaneous emphysema.
The parts of the costume, which is the subject the invention, used in the treatment of subcutaneous emphysema are numbered as the following in the annexed figures: 1. Costume
2. Body
3. Slit
4. Space
5. Lower Belt
6. Upper Belt
A costume(l) which is the subject of the invention worn in the treatment of subcutaneous emphysema and comprises the following;
- A body(2) which is elastic
- at least two slits (3) on both sides of the body (2) up to the ami pit of the patient that enables the placement of a drain on the patient
- at least one space (4) on the front side of the body (2) enabling air drainage channels like fasciotomy and IV cannula for the patient and enabling the preparation of the patient for the maintenance of these
- and at least one lower belt (5) on the lower side of the body (2) preventing the air release from around the thoracic and at least one upper belt (6) on the upper side of the body (2) ensuring the exit of subcutaneous emphysema from the area of fasciotomy.
The costume (1) is produced with lycra and polyamid or any other type of cloth which is elastic in all directions and which has a compression (pressure- constraint) effect. The costume (1) can be produced as in forms of sleeved, short sleeved, sleeveless, crew neckline, and short turtleneck.
There is a slit (3) on one side or on both sides of the costume (1) reaching up to the arm pit from the lower end. There is a button, zip or velcro on the slit (3) for this slit (3) to be closed when necessary. For patients to whom drainage is placed, the slit (3) ensures ease of use. The front part of the costume (1) is opened with a whole zip like a shirt and can be easily worn by intubated patients. The belts (5-6) on both sides of the costume (1) extending from the middle line to the back from the front side or from the middle line to the front from the back side can be tied to each other on either the back or front, can be fixed with velcro or tied.
The lower belt (5) prevents the passing of air beneath the skin from around drainage, if drainage is placed on the patient. The upper belt (6) directs the existing air beneath the skin to the air drainage points prepared by the fasciotomy or IV cannula.
There are spaces (4) on both sides or there is a space (4) on one side on the front part of the costume (1). These are prepared for air drainage channels such as fasciotomy and IV cannula and for their maintenance.
Around this fundamental concept, the costume (1), which is the subject of the invention, used in the treatment of subcutaneous emphysema may have very various applications to be developed and the invention can not be limited with the examples explained here, it is fundamentally as in explained in the claims.