阅读说明：本技术 用于管理从手术引流管切口渗漏的体液的方法和装置 (Method and apparatus for managing body fluid leakage from surgical drain tube incisions ) 是由 德米特里·奥尔登 保罗·穆勒豪森 于 2019-02-11 设计创作，主要内容包括：提供了一种流体收集系统。该流体收集系统大体上包括基板,基板具有配置为将基板耦合到患者皮肤的粘合背衬并且限定具有大致居中定位的开口的薄片和薄片连接器,开口接收手术引流管的第一端。器具包括渗漏流体去除器,渗漏流体去除器包括可操作以与薄片连接器可拆卸地耦合的流体去除器连接器。渗漏流体去除器包括用于接收手术引流管的外隔膜和内隔膜。外隔膜能够径向地、轴向地和/或枢转地到处运动,以减轻由手术引流管的移位而引起的隔膜上的侧向负载拉力。(A fluid collection system is provided. The fluid collection system generally includes a base plate having an adhesive backing configured to couple the base plate to the skin of a patient and defining a flap having a generally centrally located opening that receives a first end of a surgical drain and a flap connector. The appliance includes a leakage fluid remover including a fluid remover connector operable to detachably couple with the sheet connector. The leakage fluid remover comprises an outer membrane for receiving a surgical drain and an inner membrane. The outer septum is movable radially, axially, and/or pivotally about to mitigate side load pulling on the septum caused by displacement of the surgical drain.)

1. A fluid collection system, comprising:

a base plate having an adhesive backing configured to couple the base plate to a patient's skin and defining a sheet having a generally centrally located opening and an annular, radially extending sheet connector coupled to the sheet and disposed about the opening, the opening configured to receive a first end of a surgical drain; and

an appliance comprising a leakage fluid remover having a fluid remover connector operable to detachably couple with the sheet connector, the leakage fluid remover connector comprising a first housing element and a second housing element received by the first housing element and a spacer having an upper surface and a lower surface, the first housing element comprising an outer membrane having a lower surface positioned on or coupled to the upper surface of the spacer and the second housing element comprising an inner membrane positioned on or coupled to the lower surface of the spacer; and

a leaked fluid collector having an outer membrane and an inner membrane, the outer membrane coupled to an upper portion of the first housing component and the inner membrane coupled to a lower portion of the first housing component thereby coupling an interior of the leaked fluid collector to the fluid remover connector, wherein the coupling of the fluid remover connector and the sheet connector forms a fluid flow chamber therebetween through which leaked fluid from the cutout flows and into the leaked fluid collector.

2. The fluid collection system of claim 1, wherein the outer septum comprises an aperture for receiving a surgical drain from a front side of the septum or a back side of the septum, the septum being radially, axially, and/or pivotally movable within the septum volume of space to mitigate side load pull on the septum when the surgical drain is displaced.

3. The fluid collection system of claim 1, wherein the weep fluid remover connector is removably coupled to the base plate in a snap-fit arrangement.

4. The fluid collection system of claim 1, wherein the first housing element limits radial, axial, and/or pivotal movement of the outer diaphragm.

5. The fluid collection system of claim 4, wherein the leaked fluid collector is operatively coupled to the leaked fluid collector along a periphery of the leaked fluid remover.

6. The fluid collection system of claim 5, wherein a fluid flow path for leaked fluid extends from a surgical incision, through the flap opening, through the leaked fluid remover to a fluid flow chamber in the leaked fluid remover, and out to the leaked fluid collector.

7. The fluid collection system of claim 1, wherein the spacer is configured to space the inner septum from the outer septum such that a septum lip can expand upward and downward when a surgical drain is inserted from one direction or the other.

8. The fluid collection system of claim 1, wherein the outer septum comprises a substantially central opening.

9. The fluid collection system of claim 8, wherein the substantially central opening is punched, molded, or cut through the outer membrane.

10. The fluid collection system of claim 8, wherein the substantially central opening is circular and compliant and configured to provide a fluid tight seal over the fluid flow chamber when the fluid collection system is coupled to a surgical drain.

11. The fluid collection system of claim 1, wherein the inner membrane comprises a slit positioned along a central portion of a centerline of the inner membrane.

12. The fluid collection system of claim 11, wherein the slit is configured to enable a surgical drain tube to pass through the inner septum.

13. The fluid collection system of claim 11, wherein the slit is configured to seal without a surgical drain to prevent gas and liquid flow from escaping from the fluid flow chamber.

14. The fluid collection system of claim 1, wherein the inner membrane comprises an elastomeric material having a thickness of from 3 to 4 mm.

15. The fluid collection system of claim 11, wherein opposing sides of said slit flex to resist outward pressure.

16. The fluid collection system of claim 15, wherein said outward pressure on said inner septum creates an interference fit between opposing sides of said slit.

17. The fluid collection system of claim 1, wherein the outer septum is configured to provide a sealed closure to prevent leakage of fluid from the inner septum when a surgical drain is inserted therein.

Technical Field

The present invention relates to methods and devices for managing body fluid leaking from a surgical drainage incision in a patient.

Background

Surgical drains are tubes that are placed near a surgical incision in a post-surgical patient in order to remove pus, blood, or other fluids (collectively referred to herein as "fluids") from accumulating in the body. The type of drainage system inserted is based on the needs of the patient, the type of procedure, the type of wound, how much drainage is expected, and the preferences of the surgeon. Millions of surgical drains are placed in various body cavities and spaces every day. Placing a surgical flow diverter typically involves matching the skin incision to the size of the flow diverter and then perforating the flow diverter through the incision, placing the flow diverter in the appropriate space depending on the application, and securing the flow diverter to the skin with sutures. Other methods of securing the flow director in place include crimping or wrapping the flow director within the lumen. Regardless of the manner in which the flow diverter is placed, it is not possible to match the size of the incision consistently with the size of the flow diverter. In addition, the ability of the human skin to stretch results in a mismatch in size between the incision size and the caliber of the flow director. The result is a small skin opening around the flow director that causes fluid leakage.

Fluid leakage around surgical drainage incisions is a consistent problem in surgical units around the world. The leaking fluid has a significant impact on the increased use of disposable surgical dressings, which results in increased supply costs, increased hospital laundry turnover, and significant impact on personnel usage in the surgical unit (requiring increased staff attendance and position). Moreover, leaking fluid may cause skin irritation and maceration, which results in skin infections that may be extremely severe in some settings. Furthermore, open communication with the lumen may lead to infection of the subcutaneous tissue and the lumen itself. Continuous use of various skin barriers and protective dressings that require frequent replacement is required, thus resulting in increased costs.

Open leakage of fluid poses a challenge to the sterility of the surgical site. In addition, leaking fluid increases the risk of infection. Both of these problems significantly affect the ability to record the proper output of the site at which the flow director is placed, and thus affect surgical decision and outcome. The result of this problem is extremely expensive for hospitals from the perspective of the hospital in the value procurement (VBP) based age. A leaking drain causes surgical/drainage site infections, skin infections and irritation, resulting in readmission. Patients lying in bed with wet sheets and clothing will reflect a lower overall hospital experience and care level in the survey, reducing hospital scores and ultimately reducing compensation. Patients and family members feel increased stress and anxiety to see the surgical drain leaking unknown fluid. This results in people feeling of poor quality of care, distrust and tension on physicians and staff.

Any wound management cost depends on three main factors such as the cost of supplies, the care time and the extra time spent by the patient in the hospital. The fourth factor is the VBP patient and family experience that affects compensation and overall hospital scores.

It is estimated that a single gauze dressing change costs $6.36 on material and $9.14 on care services, totaling $ 15.54. For patients with active leak drainage sites, it is not uncommon to change dressings every hour.

Accordingly, there is a need for methods and devices that minimize or eliminate the problem of leakage of fluid from a surgical drainage incision, thereby eliminating the need for frequent dressing changes.

Disclosure of Invention

The above-described problems are solved by a method and apparatus for managing body fluid leaked around a surgical drain according to the present invention.

In one aspect, the device includes a fluid collection system. The fluid collection system generally includes a leakage fluid remover, an adhesive backing sheet for securing the leakage fluid remover to the skin of a patient, and a leakage collection bag for capturing fluid leaking from a surgical drainage incision. A leakage fluid remover is positioned over the opening in the sheet. In some aspects, the leakage fluid remover may include a connector or connection assembly configured to sealably couple to a mating connector on the adhesive wafer assembly.

In another aspect, the leakage fluid remover may include a housing having a central opening that receives a surgical drain from a surgical incision and a spaced apart coaxial second opening through which the surgical drain passes to exit the leakage fluid remover housing. The second opening may be configured with a liquid-tight elastomeric septum for receiving and sealing around a series of various sized surgical drains.

Fluid leaking from the surgical incision that does not pass through the surgical drainage tube is captured by the leaked fluid remover and transferred to a collector bag in fluid communication with the leaked fluid remover.

Drawings

For a better understanding of the present invention, and to show how the same may be carried into effect, reference will now be made, by way of example, to the accompanying drawings, in which:

fig. 1 is a perspective view of a fluid collection system according to an aspect of the present invention.

Fig. 2a is a perspective view of a fluid collection system including a drainage collection container according to an aspect of the present invention.

Fig. 2b is a perspective view of a fluid collection system according to an aspect of the present invention, showing an alternative way of draining the leaking fluid collector of the leaking fluid.

Fig. 3 is an exploded perspective view of a fluid collection system according to an aspect of the present invention showing the fluid tight seals of the overall system.

Fig. 4a and 4b are cross-sectional views of an appliance of a fluid collection system according to an aspect of the invention.

Fig. 5a and 5b are perspective views illustrating dynamic radial movement of an elastomeric septum of an appliance according to an aspect of the present invention.

FIG. 6 is a cross-sectional view illustrating another aspect of a fluid collection system according to the present invention.

Fig. 7a and 7b are cross-sectional views of a fluid collection system according to an aspect of the present invention showing the static and dynamic states, respectively, of an elastomeric wiper seal.

Figure 8 is a perspective view of an aspect of a leakage fluid remover according to the present invention, showing a septum orifice plug.

Figure 9a is a cross-sectional view of an appliance including a leakage fluid remover having an alternative configuration.

Fig. 9b is a perspective view of the appliance of fig. 9a attached to the skin of a patient.

Fig. 10a and 10b are perspective views of a fluid collection system according to the present invention showing other ways of coupling an appliance to a patient.

Figure 11a is a cross-sectional view of an alternative implement or leakage fluid remover in a static position for use with a fluid collection system according to the present invention.

Fig. 11b is a cross-sectional view of the instrument/leakage fluid remover of fig. 11a, illustrating fluid flow through the front side of the instrument and into the patient.

Fig. 11c is a cross-sectional view of the device of fig. 11a, showing fluid flow exiting through the back side (or patient side) of the device to reach the collection pouch.

Figure 11d is a cross-sectional view of the device showing the surgical tube and the flow of fluid exiting through the patient side of the instrument, showing the septum capable of moving radially, axially and/or pivotally around to relieve side load pull on the septum caused by displacement of the surgical drain tube.

Figures 11e and 11f are partial perspective views of alternative embodiments including spaced apart inner septa with slits and outer septa with openings, showing no and with drains therethrough, respectively.

FIGS. 11g and 11h are partial cross-sectional views of the alternative inner septum embodiment of FIGS. 11e and 11f showing the closed slit and the slit traversed by the drain tube, respectively, without the drain tube.

Detailed Description

As used herein, leaked fluid refers to fluid that leaks around a surgical incision after surgery without being captured by a surgical drain that is inserted into the incision to assist in the removal of fluid. Accordingly, surgical fluid or drained surgical fluid refers to fluid captured by a surgical drain.

Like elements of the fluid collection system 100 according to the present invention are labeled with like reference numerals in the drawings and throughout the disclosure.

Referring generally to fig. 1-3, a fluid collection system 100 in accordance with an aspect of the present invention is illustrated. The fluid collection system 100 generally includes a base plate 120 and an implement 140. The fluid collection system 100 can be used in conjunction with other surgical products known to those skilled in the art, including various types of surgical drains and surgical drainage containers.

Substrate 120 includes a sheet 121, an adhesive backing 122, and a generally central sheet opening 124. The sheet 121 includes a sheet opening 124. In some aspects, the connector 132 may be attached to and substantially centered over the sheet opening 124. Adhesive backing 122 may be composed of a material that is non-sensitizing to skin contact, tough enough to remain adhered to the skin for several days, and capable of being removed without pain. Such materials may include silicone, acrylic, hydrocolloid, and other similar adhesive materials known to those skilled in the art. The sheet 121 may be constructed of an elastic material so as to be easily deformed and bent when adhered to the patient's skin 105. The outer perimeter shape of the sheet 121 may be circular, square, rectangular, diamond, and other similar shapes. In use, the base plate 120 can be adhesively attached to the patient's skin 105 with the flap opening 124 generally centered over the surgical drainage incision 104 for receiving the surgical drainage tube 111. In this manner, the surgical drain 111 may be anchored to the skin 105 surrounding the incision 104 by sutures, such as may be accessed through the flap opening 124. In addition, the drains 111 may be anchored by adhesive tape to the adjacent skin 105 and/or portions of the sheet surrounding the opening 124, and into the sheet collars 132.

As configured, the fluid collection system 100 enables the sheet opening 124 in the base plate 120 to be positioned over a previously placed surgical drain 111. Alternatively, if the base plate 120 was previously adhered to the patient's skin 105 surrounding the surgical incision 104, the drains 111 may be placed through the sheet openings 124 in the base plate 120. A first end of a surgical drain 111 may be inserted into the skin 105 of a patient through a surgical incision 104 or wound. The surgical drain tube 111 may pass through the sheet 121 and, in addition, through the leakage fluid remover 141.

The implement 140 includes a leakage fluid remover 141. The leakage fluid remover 141 may include a rearward fluid remover connector 134. The appliance 140 may also be sealably connected to a leakage fluid collector 160. The seepage fluid collector 160 may comprise a forward outer membrane 163 and a rearward inner membrane 162. The film material may comprise any thermoplastic material known to those skilled in the art, such as polyethylene and polyvinyl chloride, which readily adheres and seals to itself and other thermoplastic injection-molded materials, such as by radio frequency, ultrasonic, and/or heat sealing processes. The forward outer film 163 may be transparent to facilitate visualization of the color and other characteristics of the leaked fluid by a medical care professional, while the rearward inner film 162 may be opaque to facilitate visualization of the leaked fluid.

The seepage fluid collector 160 may generally be configured as a bag. The leaky fluid collector 160 is depicted as having an elongated form in order to more easily visualize the volume of fluid collected therein. However, one skilled in the art will appreciate that the weep fluid collector 160 may have any shape, such as square, rectangular, circular, conical, cylindrical, etc., and such shapes are within the scope of the present invention. A graphic scale 166 may be applied to the front-facing outer membrane 163, for example, by a pad printing process, to enable a medical care professional to discern the relative volumes of fluid collected. The scale 166 may be marked, for example, in 10ml increments up to 100ml, or may comprise any other suitable scale known to those skilled in the art.

The implement 140 may be mechanically and fluidly connected to the substrate 120 by sealingly coupling the fluid remover connector 134 to the sheet connector 132 (e.g., by snap-fitting, quarter-turn, bayonet, and other types of connectors known to those skilled in the art). After coupling, fluid leaking from the surgical incision 104 may pass through the flap opening 124 via flow path F (best seen in fig. 4 b) and enter the leakage fluid remover 141 and then further into the leakage fluid collector 160.

Typically, the surgical drain 111 is positioned through the rear of the implement 140 and then through an elastomeric septum 151 positioned within the leakage fluid remover 141. Then, the surgical drain tube 111 exits from the opposite front side of the instrument 140. The surgical drain 111 can be positioned through the septum 151 from either direction. In this manner, the instrument 140 may be coupled to the baseplate 120 after the surgical drain 111 is placed in the surgical incision 104 or, alternatively, before the surgical drain 111 is placed in the surgical incision. Thus, advantageously, the instrument 140 may be removed from the surgical drain 111 as necessary, for example, for servicing the surgical incision 104 or the skin 105 surrounding the incision 104, or replacing the baseplate 120, or replacing the instrument 140 or any component part without disturbing the surgical drain 111.

The fluid collection system 100 is thus able to drain the debris from the viscera from the surgical incision 104 uninterrupted by the surgical drain 111 axially through the leakage fluid remover 141, while the leakage fluid remover 141 removes the leakage fluid away from the surgical incision 104 and diverts it to be captured and collected into the leakage fluid collector 160.

The weep fluid collector 160 may include a port 175 at a proximal end thereof. The port 175 is configured to allow a user to drain the leaked fluid from the leaked fluid collector 160. The port 175 may include an openable/closable outlet valve 171 having a valve actuator 173, such as a lever, collar, knob, or paddle. The port 175 may also optionally include a removable cover 176 to prevent any residual waste material from dripping. The cover 176 may optionally include a tether 177 for adjacent attachment to the port 175 for ease of use and access.

Referring now to fig. 2a, a perspective view of the fluid collection system 100 is depicted in use. The fluid collection system 100 is depicted as a closed system used in conjunction with a drain collection container 114 a. Appliance 140 is shown coupled to substrate 120 by a sheet 121 adhesively attached to the skin 105 of the patient. A length of surgical drain 111 passes through the leakage fluid remover 141 and exits the implement 140 through the elastomeric septum 151. The second end 112 of the surgical drain tube 111 is shown connected to a remotely located surgical drain collection container 114a and configured to collect drained (non-leaked) surgical fluid. Surgical drainage balloons are known and are typically positioned away from and below a bedridden patient, often for example to a bed frame, to facilitate optimal passive gravity flow through the surgical drain and into the drainage collection container 114 a.

Referring now to fig. 2b, the overall system configuration of fig. 2a is depicted and alternate ways 178a, 178b, 178c of emptying the leaked fluid from the leaked fluid collector 160 are shown in phantom. The leaked fluid may be evacuated from the leaked fluid collector through valve 171 to port 175 where the leaked fluid may be directed to a selected optional waste receptacle for disposal. The first end 109 of the bleed fluid drain conduit 178a may be connected to the bleed fluid collector port 175 and the second end 113 wired to an optional waste container or receptacle (not shown). Alternatively, the second end 113 of the leaked fluid drain catheter 178b may be connected to a second drain collection container, as may be desired for further monitoring the overall leaked fluid volume over an extended period of time. Alternatively, the second end of the leakage fluid drainage catheter 178c may be connected to a 'Y' connector 179 that is inserted downstream into the length of the surgical drain tube so that leakage fluid may be added to and collected with the accumulated surgical drainage.

Referring now to FIG. 3, the location of the substantially fluid tight seal through the fluid collection system 100 is depicted. The appliance 140 and foil 120 can be easily assembled using custom fixtures in combination with conventional types of ultrasonic, radio frequency or heat sealing methods to achieve a liquid tight joint. Thus, the components can be assembled manually for lower trial production volumes. Alternatively, assembly may be automated by web-fed film input and automated component placement.

The flange 131 is positioned over the sheet opening 124 and is circumferentially coupled to the sheet 121 at a joint 133 along a circumference. The joint 133 may include welding or other methods known to those skilled in the art. The housing 142 and/or the fully assembled weep fluid remover 141 may also be joined 165 to the inner membrane 162 about its periphery, centrally located with respect to the inner membrane opening 167. The sub-assembly valve 171 may be joined 172 to the lower end of the outer membrane 163, centrally located with respect to the valve opening 174. Finally, outer membrane 163 may be bonded 165 to housing 142 such that outer membrane opening 168 is centered about central axis 144 of the housing, and outer membrane 163 may be bonded 164 to inner membrane 162, thereby forming a sealed perimeter around leaked fluid collection chamber 169.

Referring now to fig. 4-7, cross-sectional views of the implement 140 and the fluid collection system 100 are depicted. Each of the components depicted, with the exception of the sheet 121 and the seepage fluid collector 160, is generally circular in form and configured radially about the central axis 144. Thus, when the component is shown in a static state, the cross-sectional view is shown as left-right symmetric, except for the particular features in the circular form.

Referring to fig. 4a, an exploded view of the base plate 120 is shown below the implement 140. In various aspects, the base plate 120 includes a circumferential wafer connector 132 having a radially disposed wafer seal 135 around its inner surface, both integrally molded on the flange 131. In various aspects, flange 131 can be bonded or heat sealed to flexible sheet 121 and centered over sheet opening 124.

The implement 140 generally includes a leakage fluid remover 141 and a diaphragm 151 positioned within the housing 142. Those skilled in the art will appreciate that the housing 142 may be injection molded and may comprise a single part or two or more parts. The two-piece housing 142 includes a housing component 142.1 and a housing component 142.2 configured to receive the diaphragm rim 151.2 therein. The housing parts 142.1 and 142.2 may be coupled, for example, by a mating snap-fit arrangement, ultrasonic welding or adhesive bonding. In other aspects, the housing 142 provides structure for interconnecting adjacent spaces and components in a functional relationship. In other aspects, the housing includes a pair of spaced apart circular platform surfaces for the membrane-to-housing interface 165, one for sealably engaging the outer membrane 163 and the other for the inner membrane 162.

The housing 142 is depicted here as a structural body, for example, consisting of two injection-molded thermoplastic housing parts 142.1 and 142.2. Those of ordinary skill in the art will appreciate that such a structure having this particular function may be configured in a number of different ways and still fall within the scope of the present invention. For example, in some aspects, housing component 142.1 includes fluid remover connector 134, weep fluid remover opening 145a (above the diaphragm), and membrane-to-housing joint 165 for inner membrane 162 and for outer membrane 163, viewed proximate to cross-sectional lines of housing components 142.1 and 142.2. The mating member 142.2 includes a weep fluid remover opening 145b (below the diaphragm) and captures the diaphragm edge 151.2 from below. In other respects, as best shown in fig. 6, an alternative structural embodiment of the housing 142 is shown. The component 142.1 includes the fluid remover connector 134 and a membrane-to-housing joint 165 for the inner membrane 162. However, the membrane-to-housing joint 165 for the outer membrane 163 and the leakage fluid remover opening 145a (above the membrane) are now positioned on the mating part 142.2 instead. Furthermore, the leakage fluid remover opening 145a (above the membrane) and the membrane-to-housing joint 165 for the outer membrane 163 are now part of the mating member 142.2. These and other design variations are contemplated, for example, to optimize the molding, manufacturing, heat sealing, and/or assembly sequence.

Referring again to FIG. 4b, the substrate 120 and the implement 140 are shown matingly coupled by the wafer connector 132 and the fluid remover connector 134. The fluid remover connector 134 is inserted into the lower portion of the housing 142 as a matching circular passage. An annular wafer connector 132 extends radially upward from the flange 131 and couples to the fluid remover connector 134 in a snap-fit arrangement. However, those skilled in the art will appreciate that other coupling means besides a snap-fit arrangement may be used. The mating mechanical interlock 136 mates the connector components upon assembly. The hoop stresses inherent in the mating circular connector components 132 and 134 injection molded from the selected thermoplastic material facilitate a secure yet releasable attachment and a tight, fluid-tight interference fit over the compression seal 135. When the base plate 120 and the instrument 140 are coupled together in this manner, a fluid flow chamber 143 is created for fluid leaking from the surgical incision to flow into and through the leaked fluid remover 141 and onward to be captured and collected within the leaked fluid collector 160 through the flow path F.

The elastomeric septum 151 housed within the housing 142 is molded, for example, from a highly elastic silicone or thermoplastic elastomer, such as 20 to 30 shore a. The diaphragm orifice 151.1 is generally centered on the diaphragm 151 and may also be generally centered on the central axis 144 of the housing 142 when in a static state. The septum orifice 151.1 may be generally circular, cylindrical, or frustoconical in shape over its length, and may be sized to be smaller than the inner diameter of the surgical drain 111 for which it is intended. One skilled in the art will appreciate that various septum 151 sizes may be provided depending on the outer diameter of a commercially available surgical tube. Thus, it is contemplated that a range of appliance 140 products may be made available, each having a diaphragm 151 of various sizes.

Alternatively, a single instrument 140 may include a small number of easily interchangeable, alternatively sized diaphragms 151, each diaphragm 151 being for use in conjunction with various types of surgical drains 111 or for a particular type of procedure. For example, one septum port 151.1 of about 2.3mm/.09 "in diameter may be used to achieve a positive interference fit around a surgical drain 111 intended for drainage of abscesses, for which the diameter of the surgical drain 111 typically ranges from 2.7mm/8French up to 4.7mm/14 Fr. Other sizes of septum ports 151.1 may be used for other specific surgical applications, for example, about 8mm diameter septum ports may be used for thoracic/bronchial procedures, for which surgical drains are typically in the range of about 9.3mm/28Fr to about 11.3mm/34 Fr. Alternatively, as another example, the fluid collection device 100 may be provided with two or more alternatively sized diaphragms 151 having different sized orifices 151.1-ranging from a smaller size of about 2.3mm diameter to a larger size of about 5mm diameter, so that a sealing fit may be achieved for surgical drains 111 required for small abscesses up to those surgical drains 111 required for larger thoracic/bronchial procedures-typically ranging up to about 34Fr/11.3mm diameter.

The diaphragm 151 may include an integrally molded thin thick section and alternative feature geometries to achieve a particular function. In other aspects, a generally circular elastomeric membrane 151 can be captured around a peripheral edge 151.2 between mating injection molded housing 142 components to achieve a fluid tight closure of the leakage fluid remover orifice 147 a. In other aspects, the septum 151 includes a highly elastic septum port 151.1 that can be stretched to receive a range of surgical drain tube sizes and still remain sealed. The septum orifice 151.1 is centered within the stiffer septum body 151.3. The highly flexible septum membrane 151.4 surrounds the stiffer septum body 151.3 such that the stiffer septum body 151.3 is able to move radially, axially, and/or pivotally around in order to relieve lateral load tension on the septum orifice 151.1-caused, for example, by pulling a surgical drain through the septum orifice 151.1-which could otherwise cause a leak condition if the septum orifice 151.1 were elongated. In other aspects, the diaphragm membrane 151.4 and diaphragm body 151.3 are enclosed within a loosely fitting diaphragm space 152, which may be used to controllably restrict axial and radial and/or pivotal movement of the diaphragm body 141.3.

The appliance 140 is presented in a static state in fig. 4a and 4b and in a dynamic state in fig. 5a and 5b to illustrate and describe the dynamic internal functions of the fluid collection system 100, which functions are only generally described by the previous figures. Referring to both fig. 5a and 5b, the fluid collection system 100 is shown in place with the sheet 121 attached to the patient's skin 105 by the adhesive backing 122. The septum port 151.1 is shown expanded to accommodate various sizes of surgical drains 111. The diaphragm body 151.3 is shown as it may move around axially, radially and/or pivotally within the confines of the diaphragm space 152.

Referring to FIG. 5a, an instrument 140 may be installed or replaced on a surgical drain 111, which was previously placed through the surgical incision 104. Similarly, the instrument 140 can be detached from the base plate 120 and further removed over the second end of the surgical drain 111 without replacing or disturbing the surgical drain 111 — which may be needed, for example, to clean or treat the surgical incision 104 and/or adjacent areas of the patient's skin 105. In addition, the implement 140 can be removed as needed to easily replace the surgical drain 111 without removing the base plate 120 from the patient's skin 105.

As previously described, the surgical drain 111 may be inserted through the instrument 140 from either direction, i.e., from the top or from the bottom of the instrument 140. Thus, the housing 142 may include two weep fluid remover openings 145, an outward opening 145a above the diaphragm 151 and an inward opening 145b below the diaphragm 151. The two openings 145a, 145b may be approximately the same size and may clear the largest size of surgical drain 111 for which the instrument 140 is intended. A34 Fr/11.3mm surgical drain tube 111 for thoracic/bronchial procedures is typically the largest used. Accordingly, the size of such openings 145 may range up to about 12 or 14mm diameter. Although the septum aperture 151.1 is visible to the user through the outward opening 145a (through which the user is required to insert a surgical drain), the inward opening 145b and associated septum aperture 151.1 are substantially hidden from view. Thus, the inward opening 145b may include a bidirectional inner funnel 147a and an outer funnel 147b to help guide the surgical drain through the septum orifice.

Referring again to both fig. 5a and 5b, the skilled person will understand that it is important that pulling the surgical drain tube 111 does not cause leakage from the instrument 140 by elongating the septum orifice 151.1 through which it passes, especially for smaller diameter drains which pass through the larger outward opening 145.1. Thus, the size of the leakage fluid remover opening 145 can be coordinated with respect to the size of the smallest expected surgical drain tube 111 and the controllable radial movement of the septum orifice 151.1 within the septum space 152. That is, if a pulling force is exerted on the surgical drain tube 111 relative to the fixed position of the housing 142, the force will generally be transmitted through the septum orifice 151.1. If the periphery of the septum orifice 151.1 is to be secured in place, such as to the housing 142 or, for example, within a septum body 151.3 that may be secured in place to the housing 142, a radially applied pulling force on the surgical drain tube 111 may stretch, twist, and elongate the elastomeric septum orifice 151.1 through which it passes. The deformed and elongated septum aperture 151.1 may become large enough to allow fluid to escape from the fluid flow chamber 143 outwardly, flowing between the surgical drain 111 and the inner periphery of the twisted septum aperture 151.1.

To mitigate this potential leakage problem, the leakage fluid remover 132 may include a specially configured diaphragm 151. The elastomeric septum orifice 151.1 may be generally centered within the outward opening 145a and also generally centered on and contained within the septum body 151.3, which in turn is generally centered within the flexible elastomeric membrane, which in turn may be affixed within the housing 142, e.g., the septum edge 151.2 is clamped between the housing components 142.1 and 141.2 of the housing 142.

As generally shown in fig. 5a and 5b, the elastomeric septum membrane 151.4 may move the septum body 151.3 and the attached septum port 151.1 together around within the septum space 152-in the direction of the pulling force on the surgical drain 111 through the septum port 151.1.

If the leakage fluid remover 141 is configured for use with a defined/limited range of different sized surgical drains 111, the smallest sized tube 111 will inherently move farther radially around in the outward opening 145a of the leakage fluid remover 141 than the larger surgical drain 111.

Thus, the amount of radial movement of the septum body 151.3 within the septum space 152 should be greater than the amount of radial movement of the minimum diameter surgical drain 111 within the outward opening 145 a. In this way, when pulled radially, the surgical tube 111 will be supported on the periphery of the outward opening 145a before the septum body is supported on the periphery of the septum space — so as to limit the pulling of the surgical drain tube 111 over the septum orifice and thereby reduce the elongation of the septum orifice 151.1 and the consequent leakage of the fluid flow chamber 143.

In at least one aspect, the septum orifice 151.1, septum body 151.3, septum membrane, and septum rim may be a single integrally molded component. In other aspects, the diaphragm features may be produced as an assembly. In yet another aspect, elastomeric septum orifice 151.1 and elastomeric septum membrane 151.4 may be over-injection molded or two-liquid injection molded onto plastic septum body 151.3.

Referring now to fig. 6, fluid collection system 100 is shown in a vertical orientation to more clearly describe how leaked fluid will passively flow under gravity from surgical incision 104 through fluid flow path 143 and into leaked fluid collection chamber 169. The exploded cross-sectional view depicts appliance 140 spaced from substrate 120, substrate 120 being attached to patient's skin 105 by adhesive backing 122 of sheet 121. Alternatively, the base plate 120 is configured to comprise a folding member (often referred to as folding member in ostomy products) 125. The flap 125 generally includes a flap flange 127 and a flap flange interface 128. The flap 125 in the present application is generally circular, formed from a flexible film that includes a central opening corresponding to the sheet opening 124 and is heat sealed 133 to the periphery of the sheet opening 124 around the outer periphery and along the inner periphery of the sheet 121. In this manner, the outer periphery of the sheet 121 may be spaced from the sheet to create a finger space 129 below the flap flange 127, thereby making it easier to dock the sheet connector 132 on the fluid remover connector 134. As can be seen, the fluid flow path F of the leakage fluid exits the patient's skin through the flap opening 124, flows into the fluid flow chamber 143 and out to the leakage fluid collector chamber 169, ultimately to the leakage fluid collector 160.

Referring now to FIG. 7, another aspect of the present invention is shown. The weep fluid remover 141 now comprises a diaphragm 151 and a mating elastomeric pressure seal 155, the pressure seal being placed on the same axis as the elastomeric diaphragm 151. This feature advantageously allows for the removal of the surgical drain 111, for example, in various patient care settings, such as during a patient's stay in the hospital or when the patient returns home. The elastomeric pressure seal 155 prevents leakage fluid from leaking and ensures that the leakage fluid exits via flow path F and enters the leakage fluid collector 16, as described below.

The surgical incision 104 may need to remain open after removal of the surgical drain 111 until the leakage fluid stops flowing. Without the surgical drain 111 passing through the septum orifice 151.1, the unobstructed septum orifice 151.1 could potentially leak fluid from the appliance 140. An elastomeric pressure seal 155 (such as a one-way duckbill valve) may act in conjunction with the elastomeric diaphragm orifice 151.1 to block flow without the surgical drain tube 111. While elastomeric diaphragm type valves may be eliminated without an obstructed surgical drain 111, elastomeric duckbill pressure seals may be eliminated when inserted into the surgical drain 111. However, together they ensure that a secure seal is maintained both with and without the surgical drain 111.

Configured as shown, for example, in a static state in fig. 7a, and in a dynamic state in fig. 7b, an elastomeric diaphragm 151 having a diaphragm orifice 151.1 and a diaphragm body 151.3 may be configured to act in conjunction with an elastomeric wiper 155, a wiper bore 155.1, and an alternatively configured funnel-shaped channel 147b within a diaphragm space 152-in a similar manner as previously described-both positioned along a common central axis 144. The diaphragm 151 may be sealably captured on the diaphragm edge 151.2 and the pressure seal sealably captured on the mating pressure seal edge 155.2, both captured together between the first and second housing components 141.1, 141.2.

In other aspects of the invention, other methods may be implemented to achieve a sealed instrument 140 without the surgical drain 111. Referring to fig. 8, a septum port plug 158 is shown. The diaphragm orifice plug 158 is sized and configured to be press-fit into the open diaphragm orifice 151.1. The membrane orifice plug 158 may, for example, include a fluid remover cap 157, the fluid remover cap 157 being connected to the housing 142 of the appliance 140, for example, by a cap tether 159. Those skilled in the art will appreciate that all or part of these components may be integrally molded. In this way, the septum orifice plug 158 may be readily available and properly positioned for insertion into the open septum orifice 151.1 along the central axis 144 without the surgical drain 111.

Referring now to fig. 9a, there is shown an appliance 940 comprising a leakage fluid remover 941, which is alternatively configured with an outlet port 949 in place of an attached leakage fluid collector 960, e.g. without the inner membrane 962 or the outer membrane 963. Thus, as previously described, leakage fluid remover 941 includes a housing 942 that includes a housing member 942.1 sealably connected to housing member 942.2, together sealably capturing a septum 951 about septum edge 951.2; septum 951 functions similarly with septum port 951.1, septum body 951.3, and septum membrane 951.4; an outward opening 945a and an inward opening 945 b; funnel-shaped passages 947a and 947 b; a fluid flow chamber 943 and a fluid remover connector 934, which in a similar manner couples to a sheet connector 933 on a substrate 920 having a flange 931 on a sheet 921 having an adhesive backing 922 and a central opening 924. The appliance 940 differs from the previous embodiments in that its housing 942 completely encloses a fluid flow chamber 943 and has an outlet port 949 through which the leakage fluid remover 941 may be coupled to, for example, the drain collection container 914 via a leakage fluid collection conduit 978.

An embodiment of an appliance 940 as described in fig. 9a is more generally shown in fig. 9 b. Thus, the appliance 940 is coupled to a substrate 920, the substrate 920 being shown with a sheet 921 and being attached to the patient's skin 905 by an adhesive backing 922. The instrument has a fluid outlet port 949 to which a leakage fluid collection conduit 978 may be connected to divert removed leakage fluid through, for example, a 'Y' connector 979 to accumulate with drainage surgical fluid discharged from the surgical drain tube 911.

Referring now to fig. 10a and 10b, an alternative method of attaching the fluid collection system 100 to the skin 105 of a patient is provided. In fig. 10a, a one-piece adhesive attachment system 191 is shown. The one-piece adhesive system includes an adhesive backing applied directly to the skin of the patient. Fig. 10b shows a two-piece adhesive attachment system 194. The pad 195 includes an adhesive backing 197. An adhesive backing 197 is applied to the wafer 196, the wafer 196 further including an adhesive backing 199 applied to the patient's skin 105. The sheet 196 may have a smooth outer surface to which the pad 195 may be adhered. A pad 195 having an adhesive backing 197 is applied to the sheet 196 so that the two-piece adhesive attachment system 194 can be easily removed if necessary.

Referring now to fig. 11 a-11 d, an alternative embodiment of an appliance 1100 according to the present invention is depicted. Like features are labeled with like reference numerals. The appliance 1100 shown in fig. 11 a-11 d does not show the substrate 120, sheet 121, adhesive backing 122, and connector 132 coupled thereto. However, the substrate system 120 was previously disclosed above and is best shown in fig. 3.

The instrument 1100 generally includes a leakage fluid remover 1110 having an outer membrane 1112 and an inner membrane 1114 positioned within the housing 142. The housing 142 is identical to the housing 142 of fig. 1-10 disclosed above. Those skilled in the art will appreciate that the housing 142 may be injection molded and may comprise a single part or two or more parts. The two-piece housing 142 comprises a housing part 142.1 and a housing part 142.2. The housing parts 142.1 and 142.2 may be coupled, for example, by a mating snap-fit arrangement, ultrasonic welding or adhesive bonding. As shown, the two-piece housings 142.1, 142.2 are matingly coupled by threaded fasteners 1118. In other aspects, the housing 142 provides structure for interconnecting adjacent spaces and components in a functional relationship. In other aspects, the housing includes a pair of spaced apart circular platform surfaces for the membrane-to-housing joint 165, one for sealably engaging the outer membrane 163 and the other for the inner membrane 162.

The housing 142 is depicted here as a structural body, for example, consisting of two injection-molded thermoplastic housing parts 142.1 and 142.2. Those of ordinary skill in the art will appreciate that such a structure having this particular function may be configured in a variety of different ways and still fall within the scope of the present invention. For example, in some aspects, looking proximally of housing components 142.1 and 142.2, housing component 142.1 includes fluid remover connector 134, weep fluid remover opening 145a (above outer membrane 1112), and membrane-to-housing interface 165 for inner membrane 162 and for outer membrane 163. The mating member 142.2 comprises a leakage fluid remover opening 145b (below the membrane). In other respects, an alternative structural embodiment of the housing 142 for the appliance 1100 may include a membrane-to-housing interface 165 for the outer membrane 163 and a weep fluid remover opening 145a (above the membrane) positioned on the mating member 142.2, similar to that seen in fig. 6. These and other design variations are contemplated, for example, to optimize the molding, manufacturing, heat sealing, and/or assembly sequence.

Implement 1100 includes a spacer 1116, spacer 1116 including an upper spacer surface 1120 and a lower spacer surface 1122. The lower surface of outer diaphragm 1112 is positioned on or integral with upper spacer surface 1120, while the upper surface of inner diaphragm 1114 is positioned on or integral with lower spacer surface 1122. As best shown in fig. 11 b-11 d, the spacer 1116 is configured to space the inner and outer diaphragms 1112, 1114 apart to provide a space between the two diaphragms such that the diaphragm lips 1124, 1126 can splay upward and downward when the surgical drain is inserted from one direction or the other, without the curved lip 1124 of the outer diaphragm 1112 interfering with the curved lip 1126 of the inner diaphragm 1114, and vice versa.

Those skilled in the art will appreciate that the spacer 1116 may be constructed of an elastomeric or plastic material. The spacer 1118 may be molded as a separate component or may be integrally formed as part of either or both diaphragms.

Outer membrane 1112 and inner membrane 1114 may be constructed of an elastomeric material such as a thermoplastic elastomer, silicone, or the like. The elastomeric inner and outer septa may be compliant, for example, having a hardness of about 20-40 shore a, in order to accommodate the diameter through the surgical drain 111.

Referring to fig. 11e and 11f, outer membrane 1112 includes a generally central opening 1128 that is stamped, molded, or cut through the body of the outer membrane. The opening 1128 can be produced in a variety of diameters, each sized to extend around a defined range of surgical drains 111 having a maximum to minimum diameter. Opening 1128 through outer membrane 1112 is preferably circular, thin and compliant so as to sealably contain an air and liquid tight seal over fluid flow chamber 143 when opening 128 is penetrated by surgical drain tube 111.

In addition, as shown in fig. 11e and 11f, the inner membrane 1114 includes a slit 1130 therein substantially along a central portion of a centerline thereof. The slit 1130 enables the surgical drain tube 111 to pass through the inner membrane 1114. In the absence of the surgical drain 111, the slit 1130 through the inner membrane 1114 acts as a seal to prevent gas and liquid flow from escaping from the fluid flow chamber 143.

Figure 11g is a cross-sectional view of the inner membrane 1114 of figure 11e, showing the slit 1130 sealably closed in its quiescent state. The inner membrane should preferably be an elastomeric material about 3-4mm thick, making it thick enough to prevent air or fluid pressure from forcing the inner membrane open without the draft tube 111. Figure 11h is a cross-sectional view of the inner diaphragm showing the opposite side 1131 of the slit 1130 when the opposite side 1131 may flex to resist an outward pressure 1132, for example, if a force is exerted on the flexible fluid collection chamber 169 and the force is transmitted through the fluid flow chamber 143. An outward pressure 1132 on the inner diaphragm 1114 will create an interference fit 1133 between the opposing sides 1131 of the slit 1130, thereby sealing against the escape of air or fluid. While the slit 1130 achieves an effective seal through the inner septum 1114 without a draft tube 111, fluid and air may pass through the void 1134 at either end of the slit 1130 when an inserted draft tube 111 is present (FIG. 11 f). Thus, the outer membrane 1112 provides a sealed closure when used with an inserted surgical drain 111.

While the invention has been described in connection with a number of different aspects, as shown in the various figures and discussed herein, those of ordinary skill in the art will understand that other similar aspects or features may be used and modifications and additions may be made without departing from the scope of the invention. For example, various features are described in particular detail with respect to one aspect of the invention, but these features can be incorporated into other aspects described herein without departing from the scope of the invention as contemplated by this disclosure. Accordingly, the invention is not to be limited by what has been particularly shown and described.