CN114344545A - Bacteriostatic hemostatic dressing and preparation method thereof - Google Patents
Bacteriostatic hemostatic dressing and preparation method thereof Download PDFInfo
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- CN114344545A CN114344545A CN202210084958.8A CN202210084958A CN114344545A CN 114344545 A CN114344545 A CN 114344545A CN 202210084958 A CN202210084958 A CN 202210084958A CN 114344545 A CN114344545 A CN 114344545A
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- 230000003385 bacteriostatic effect Effects 0.000 title claims abstract description 33
- 230000002439 hemostatic effect Effects 0.000 title claims abstract description 28
- 238000002360 preparation method Methods 0.000 title claims abstract description 10
- VNWKTOKETHGBQD-UHFFFAOYSA-N methane Chemical class C VNWKTOKETHGBQD-UHFFFAOYSA-N 0.000 claims abstract description 67
- 229920006237 degradable polymer Polymers 0.000 claims abstract description 34
- 239000002131 composite material Substances 0.000 claims abstract description 26
- 239000000725 suspension Substances 0.000 claims abstract description 11
- BQCADISMDOOEFD-UHFFFAOYSA-N Silver Chemical compound [Ag] BQCADISMDOOEFD-UHFFFAOYSA-N 0.000 claims abstract description 9
- 239000004332 silver Substances 0.000 claims abstract description 7
- 229910052709 silver Inorganic materials 0.000 claims abstract description 7
- 239000002904 solvent Substances 0.000 claims abstract description 7
- 239000000835 fiber Substances 0.000 claims abstract description 6
- -1 silver ions Chemical class 0.000 claims abstract description 6
- 150000003242 quaternary ammonium salts Chemical class 0.000 claims abstract description 5
- VAZJLPXFVQHDFB-UHFFFAOYSA-N 1-(diaminomethylidene)-2-hexylguanidine Polymers CCCCCCN=C(N)N=C(N)N VAZJLPXFVQHDFB-UHFFFAOYSA-N 0.000 claims abstract description 4
- 229920002413 Polyhexanide Polymers 0.000 claims abstract description 4
- 238000005096 rolling process Methods 0.000 claims abstract 2
- 239000002245 particle Substances 0.000 claims description 16
- 238000010438 heat treatment Methods 0.000 claims description 8
- CSCPPACGZOOCGX-UHFFFAOYSA-N Acetone Chemical compound CC(C)=O CSCPPACGZOOCGX-UHFFFAOYSA-N 0.000 claims description 6
- YMWUJEATGCHHMB-UHFFFAOYSA-N Dichloromethane Chemical compound ClCCl YMWUJEATGCHHMB-UHFFFAOYSA-N 0.000 claims description 6
- XEKOWRVHYACXOJ-UHFFFAOYSA-N Ethyl acetate Chemical compound CCOC(C)=O XEKOWRVHYACXOJ-UHFFFAOYSA-N 0.000 claims description 6
- WYURNTSHIVDZCO-UHFFFAOYSA-N Tetrahydrofuran Chemical compound C1CCOC1 WYURNTSHIVDZCO-UHFFFAOYSA-N 0.000 claims description 6
- 238000001035 drying Methods 0.000 claims description 6
- HEDRZPFGACZZDS-UHFFFAOYSA-N Chloroform Chemical compound ClC(Cl)Cl HEDRZPFGACZZDS-UHFFFAOYSA-N 0.000 claims description 5
- 239000012535 impurity Substances 0.000 claims description 5
- 239000000463 material Substances 0.000 claims description 5
- 238000000034 method Methods 0.000 claims description 4
- 238000003756 stirring Methods 0.000 claims description 4
- 238000001291 vacuum drying Methods 0.000 claims description 4
- AEMRFAOFKBGASW-UHFFFAOYSA-N Glycolic acid Polymers OCC(O)=O AEMRFAOFKBGASW-UHFFFAOYSA-N 0.000 claims description 3
- 229920000954 Polyglycolide Polymers 0.000 claims description 3
- 239000012299 nitrogen atmosphere Substances 0.000 claims description 3
- 229920001610 polycaprolactone Polymers 0.000 claims description 3
- 229920000166 polytrimethylene carbonate Polymers 0.000 claims description 3
- YLQBMQCUIZJEEH-UHFFFAOYSA-N tetrahydrofuran Natural products C=1C=COC=1 YLQBMQCUIZJEEH-UHFFFAOYSA-N 0.000 claims description 3
- FOIXSVOLVBLSDH-UHFFFAOYSA-N Silver ion Chemical group [Ag+] FOIXSVOLVBLSDH-UHFFFAOYSA-N 0.000 claims description 2
- 229920000747 poly(lactic acid) Polymers 0.000 claims description 2
- 229920001577 copolymer Polymers 0.000 claims 1
- 238000005507 spraying Methods 0.000 claims 1
- 238000002604 ultrasonography Methods 0.000 claims 1
- 241000238413 Octopus Species 0.000 abstract description 31
- 230000000844 anti-bacterial effect Effects 0.000 abstract description 17
- OKTJSMMVPCPJKN-UHFFFAOYSA-N Carbon Chemical compound [C] OKTJSMMVPCPJKN-UHFFFAOYSA-N 0.000 abstract description 6
- 229920000049 Carbon (fiber) Polymers 0.000 abstract description 4
- 208000007536 Thrombosis Diseases 0.000 abstract description 4
- 230000023597 hemostasis Effects 0.000 abstract description 2
- 239000000843 powder Substances 0.000 abstract description 2
- 206010072170 Skin wound Diseases 0.000 abstract 1
- 238000000889 atomisation Methods 0.000 abstract 1
- 206010052428 Wound Diseases 0.000 description 6
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- 208000024172 Cardiovascular disease Diseases 0.000 description 4
- 239000000243 solution Substances 0.000 description 4
- 238000005406 washing Methods 0.000 description 4
- VTYYLEPIZMXCLO-UHFFFAOYSA-L Calcium carbonate Chemical compound [Ca+2].[O-]C([O-])=O VTYYLEPIZMXCLO-UHFFFAOYSA-L 0.000 description 2
- 239000003146 anticoagulant agent Substances 0.000 description 2
- 229960001701 chloroform Drugs 0.000 description 2
- 210000000416 exudates and transudate Anatomy 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 229920000642 polymer Polymers 0.000 description 2
- SQGYOTSLMSWVJD-UHFFFAOYSA-N silver(1+) nitrate Chemical compound [Ag+].[O-]N(=O)=O SQGYOTSLMSWVJD-UHFFFAOYSA-N 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- SCYULBFZEHDVBN-UHFFFAOYSA-N 1,1-Dichloroethane Chemical compound CC(Cl)Cl SCYULBFZEHDVBN-UHFFFAOYSA-N 0.000 description 1
- IQRAGNMEYWPLKC-UHFFFAOYSA-N 1-(diaminomethylidene)-3-methylideneguanidine Chemical compound NC(=N)NC(=N)N=C IQRAGNMEYWPLKC-UHFFFAOYSA-N 0.000 description 1
- 241001474374 Blennius Species 0.000 description 1
- 229920002101 Chitin Polymers 0.000 description 1
- 229920001661 Chitosan Polymers 0.000 description 1
- 230000001133 acceleration Effects 0.000 description 1
- 239000004480 active ingredient Substances 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 239000003242 anti bacterial agent Substances 0.000 description 1
- 229940127218 antiplatelet drug Drugs 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 229910000019 calcium carbonate Inorganic materials 0.000 description 1
- 239000004917 carbon fiber Substances 0.000 description 1
- 208000026106 cerebrovascular disease Diseases 0.000 description 1
- 239000003153 chemical reaction reagent Substances 0.000 description 1
- 230000015271 coagulation Effects 0.000 description 1
- 238000005345 coagulation Methods 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 238000007334 copolymerization reaction Methods 0.000 description 1
- 238000011161 development Methods 0.000 description 1
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- 239000000106 platelet aggregation inhibitor Substances 0.000 description 1
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- 102000004196 processed proteins & peptides Human genes 0.000 description 1
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- 229910001961 silver nitrate Inorganic materials 0.000 description 1
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- 238000006467 substitution reaction Methods 0.000 description 1
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- A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
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Abstract
本发明属于医疗器械技术领域,公开了一种抑菌止血敷料及其制备方法。主要技术方案如下:抑菌止血敷料包括两层,一层为抑菌活性炭纤维层,另一层为海螵蛸可降解聚合物复合活性炭纤维层;抑菌活性炭纤维层含有聚六亚甲基双胍、银离子或纳米银、有机硅季铵盐抑菌成分;海螵蛸超细粉末和可降解聚合物先加入溶剂制成悬浮液,通过雾化喷涂于活性炭纤维上,再经过真空干燥制得海螵蛸可降解聚合物复合活性炭纤维层;两层通过纤维的粘附性能,碾压组装而成。与现有技术相比,敷料同时具有抑菌和止血的作用,止血成分在第二层,不与皮肤创口直接接触,可避免进入体内,引发血栓的问题。
The invention belongs to the technical field of medical devices, and discloses a bacteriostatic and hemostatic dressing and a preparation method thereof. The main technical scheme is as follows: the antibacterial and hemostatic dressing includes two layers, one layer is an antibacterial activated carbon fiber layer, and the other layer is a sea octopus degradable polymer composite activated carbon fiber layer; the antibacterial activated carbon fiber layer contains polyhexamethylene biguanide , silver ions or nano-silver, organosilicon quaternary ammonium salt bacteriostatic components; sea octopus ultrafine powder and degradable polymer are first added into a solvent to make a suspension, sprayed on activated carbon fibers by atomization, and then vacuum-dried to obtain Sea octopus degradable polymer composite activated carbon fiber layer; two layers are assembled by rolling through the adhesion properties of fibers. Compared with the prior art, the dressing has both bacteriostatic and hemostasis functions. The hemostatic component is on the second layer and does not directly contact the skin wound, which can avoid the problem of entering the body and causing thrombosis.
Description
技术领域technical field
本发明涉及医用制造技术领域,具体涉及一种抑菌止血活性炭纤维敷料及其制备方法。The invention relates to the technical field of medical manufacturing, in particular to a bacteriostatic and hemostatic activated carbon fiber dressing and a preparation method thereof.
背景技术Background technique
随着社会经济的发展,国民生活方式发生了深刻的变化。尤其是人口老龄化及城镇化进程的加速,中国心血管病危险因素流行趋势呈明显上升态势,导致了心血管病的发病人数持续增加。由于心血管疾病的增长,进行支架手术的人越来越多,但在接受支架手术之后因为血管植入支架的部分,在缺乏有效抗血小板药物的保护下非常易于形成血栓,其后果无异于再次心肌梗塞,术后必须要长期服用抗凝血类的药物。长期服用抗凝血药物患者体内缺少凝血物质,一旦受伤便流血不止,需要快速止血,一般是将止血成分研磨成粉末直接敷在创面,存在不易清除的问题。而且对于心脑血管疾病人群而言,止血成分不能直接接触创口,因为一旦止血成分进入体内,又有导致血栓形成的风险。With the development of social economy, people's way of life has undergone profound changes. In particular, with the aging of the population and the acceleration of urbanization, the prevalence of cardiovascular disease risk factors in China is on the rise, leading to a continuous increase in the number of people with cardiovascular disease. Due to the increase of cardiovascular diseases, more and more people are undergoing stent surgery. However, after stent surgery, the part of the blood vessel where the stent is implanted is very prone to thrombosis without the protection of effective antiplatelet drugs. The consequences are the same as After another myocardial infarction, it is necessary to take anticoagulant drugs for a long time after the operation. Patients who take anticoagulant drugs for a long time lack coagulation substances in their bodies. Once they are injured, they will bleed continuously and need to stop the bleeding quickly. Generally, the hemostatic components are ground into powder and applied directly to the wound surface, which is difficult to remove. Moreover, for people with cardiovascular and cerebrovascular diseases, the hemostatic components cannot directly contact the wound, because once the hemostatic components enter the body, there is a risk of thrombosis.
发明内容SUMMARY OF THE INVENTION
本发明旨在提供一种安全的抑菌止血活性炭纤维敷料及其制备方法,以解决上述背景技术中提出的问题。该活性炭纤维敷料具有吸收组织渗出液,抑菌和安全止血作用。The present invention aims to provide a safe antibacterial and hemostatic activated carbon fiber dressing and a preparation method thereof, so as to solve the problems raised in the above-mentioned background technology. The activated carbon fiber dressing has the functions of absorbing tissue exudate, bacteriostasis and safe hemostasis.
为达到上述目的,本发明采用以下技术方案:To achieve the above object, the present invention adopts the following technical solutions:
一种抑菌止血敷料,由抑菌活性炭纤维层和海螵蛸可降解聚合物复合活性炭纤维层构成,抑菌活性炭纤维层厚度为0.2~1mm;海螵蛸可降解聚合物复合活性炭纤维层厚度为1~5mm。An antibacterial and hemostatic dressing is composed of a bacteriostatic activated carbon fiber layer and a sea clam degradable polymer composite activated carbon fiber layer, the thickness of the bacteriostatic activated carbon fiber layer is 0.2-1 mm; the thickness of the sea clam degradable polymer composite activated
进一步的,所述的海螵蛸可降解聚合物复合活性炭纤维层以活性炭纤维为骨架材料,海螵蛸微粒和可降解聚合物填充在骨架内。Further, the octopus degradable polymer composite activated carbon fiber layer uses activated carbon fiber as a skeleton material, and the octopus particles and the degradable polymer are filled in the skeleton.
一种抑菌止血敷料的制备方法,将活性炭纤维水洗干燥后,分成两层,一层浸泡在抑菌成分中加热处理后,取出干燥至恒重,作为抑菌活性炭纤维层,另一层用于制备海螵蛸可降解聚合物复合活性炭纤维层,将海螵蛸洗净除去表面杂质,然后破碎研磨;取可降解聚合物溶于溶剂,再加入海螵蛸微粒,搅拌均匀,制成悬浮液;采用超声将悬浮液雾化成小液滴喷涂于活性炭纤维上,取出后真空干燥,即制得海螵蛸可降解聚合物复合活性炭纤维层;最后将抑菌活性炭纤维层和海螵蛸可降解聚合物复合活性炭纤维层顺着纤维的方向重叠碾压组装。A method for preparing a bacteriostatic hemostatic dressing. After washing and drying activated carbon fibers, it is divided into two layers, one layer is immersed in bacteriostatic components and heat-treated, then taken out and dried to a constant weight, as the bacteriostatic activated carbon fiber layer, and the other layer is used for To prepare the degradable polymer composite activated carbon fiber layer of octopus, the octopus is washed to remove surface impurities, and then crushed and ground; the degradable polymer is dissolved in a solvent, and then the octopus particles are added, and the octopus is stirred evenly to form a suspension. liquid; the suspension was atomized into small droplets and sprayed on the activated carbon fiber by ultrasonic, and vacuum-dried after taking it out to obtain the sea cricket degradable polymer composite activated carbon fiber layer; finally, the antibacterial activated carbon fiber layer and sea cricket can be obtained The degraded polymer composite activated carbon fiber layers are stacked and assembled along the direction of the fibers.
进一步的,所述的抑菌成分为聚六亚甲基双胍、银离子、纳米银、有机硅季铵盐中的任意一种。Further, the antibacterial component is any one of polyhexamethylene biguanide, silver ion, nano-silver, and organosilicon quaternary ammonium salt.
进一步的,所述加热处理的条件为加热至40-50℃恒温1-2小时,当抑菌成分为银离子或纳米银时,加热处理后取出控干表面水分,在氮气气氛中300℃下热处理1小时,即制得载银活性炭纤维,作为抑菌活性炭纤维层。Further, the condition of the heat treatment is to heat to a constant temperature of 40-50°C for 1-2 hours. When the antibacterial component is silver ions or nano-silver, after the heat treatment, the surface moisture is taken out to control the dry surface, and the temperature is 300°C in a nitrogen atmosphere. After heat treatment for 1 hour, the silver-loaded activated carbon fiber was prepared as a bacteriostatic activated carbon fiber layer.
进一步的,所述的海螵蛸微粒破碎研磨至粒度10μm以下。Further, the octopus particles are crushed and ground to a particle size of less than 10 μm.
进一步的,所述的可降解聚合物,可以选用如下任一或两种共聚材料:聚丙交酯、聚乙丙交酯、聚ε-己内酯、聚三亚甲基碳酸酯。Further, the degradable polymer can be selected from any one or two of the following copolymerization materials: polylactide, polyglycolide, polyε-caprolactone, and polytrimethylene carbonate.
进一步的,所述溶剂为四氢呋喃、丙酮、乙酸乙酯、二氯甲烷、三氯甲烷的其中一种或两种。Further, the solvent is one or both of tetrahydrofuran, acetone, ethyl acetate, dichloromethane and chloroform.
进一步的,所述海螵蛸微粒、可降解聚合物和溶剂的质量比为1:0.1~2:50~500。Further, the mass ratio of the sea octopus particles, the degradable polymer and the solvent is 1:0.1-2:50-500.
进一步的,所述真空干燥的条件为40℃下真空干燥6小时。Further, the condition of the vacuum drying is vacuum drying at 40° C. for 6 hours.
与现有技术相比,本发明的有益效果是:Compared with the prior art, the beneficial effects of the present invention are:
本发明采用活性炭纤维作为敷料的基质材料,利用其丰富的微孔结构吸附抑菌成分,具有更好的抑菌效果同时又可以吸收组织渗出液。海螵蛸为常用海洋中药,含有碳酸钙、蛋白多肽、海螵蛸多糖、甲壳素/壳聚糖等多种活性成分,具有止血凝血、抗炎抗菌、表皮修复等多种药理作用,适用于创面的治疗与修复,还可降解聚合物复合活性。敷料同时具有抑菌和止血的作用,止血成分在第二层,炭纤维层将止血作用的海螵蛸固定在活性炭纤维上,不与创口直接接触,避免止血成分进入血液引发血栓问题,同时不易粘附在创口上。The present invention adopts activated carbon fiber as the matrix material of the dressing, utilizes its rich microporous structure to absorb bacteriostatic components, has better bacteriostatic effect and can absorb tissue exudate at the same time. Sea octopus is a commonly used marine traditional Chinese medicine. It contains calcium carbonate, protein peptides, octopus polysaccharides, chitin/chitosan and other active ingredients. In the treatment and repair of wounds, it can also degrade the composite activity of polymers. The dressing has both bacteriostatic and hemostatic effects. The hemostatic component is on the second layer, and the carbon fiber layer fixes the hemostatic octopus on the activated carbon fiber, and does not directly contact the wound, so as to prevent the hemostatic component from entering the blood and cause thrombosis. adhered to the wound.
附图说明Description of drawings
图1是本发明的结构示意图;Fig. 1 is the structural representation of the present invention;
图2是海螵蛸可降解聚合物复合活性炭纤维层的结构示意图。Figure 2 is a schematic diagram of the structure of the sea octopus degradable polymer composite activated carbon fiber layer.
图中:1、抑菌活性炭纤维层;2、海螵蛸可降解聚合物复合活性炭纤维层;21、活性炭纤维层;22、海螵蛸微粒;23、可降解聚合物。In the figure: 1, antibacterial activated carbon fiber layer; 2, sea octopus degradable polymer composite activated carbon fiber layer; 21, activated carbon fiber layer; 22, sea octopus particles; 23, degradable polymer.
具体实施方式Detailed ways
下面结合实施例对本发明的技术方案进行进一步详细的说明。这些说明只是举例说明本发明的特征和优点,而非限制本发明的保护范围。如无特殊说明,本发明所采用的实验方法均为常规方法,所用实验器材、材料、试剂等均可从商业途径获得。The technical solutions of the present invention will be described in further detail below with reference to the embodiments. These descriptions merely illustrate the features and advantages of the present invention, but do not limit the scope of protection of the present invention. Unless otherwise specified, the experimental methods used in the present invention are all conventional methods, and the experimental equipment, materials, reagents, etc. used can be obtained from commercial sources.
实施例1Example 1
将活性炭纤维水洗干燥后,分成两层。一层浸泡在0.5%聚六亚甲基双胍溶液中加热至50℃恒温2小时后,取出干燥至恒重,作为抑菌活性炭纤维层1。另一层用于制备海螵蛸可降解聚合物复合活性炭纤维层2。将海螵蛸洗净除去表面杂质,然后破碎研磨至粒度10μm以下;取0.1g的聚乙丙交酯溶于50g二氯乙烷,再加入0.5g海螵蛸微粒,搅拌均匀,制成悬浮液;采用超声将悬浮液雾化成小液滴喷涂于活性炭纤维上,取出后在40℃下真空干燥6小时,即制得海螵蛸可降解聚合物复合活性炭纤维层2;最后将载聚六亚甲基双胍的抑菌活性炭纤维层1和海螵蛸可降解聚合物复合活性炭纤维层2顺着纤维的方向重叠用小型滚轮碾压在一起,即制得抑菌止血敷料,使用时抑菌活性炭纤维层1贴近创口。After washing and drying the activated carbon fiber, it is divided into two layers. One layer was soaked in a 0.5% polyhexamethylene biguanide solution, heated to a constant temperature of 50° C. for 2 hours, taken out and dried to a constant weight, and used as the antibacterial activated
实施例2Example 2
将活性炭纤维水洗干燥后,分成两层。一层浸渍于0.2mol/L的硝酸银溶液中加热至50℃恒温2小时,取出控干表面水分后,在氮气气氛中300℃下热处理1小时,即制得载银活性炭纤维,作为抑菌活性炭纤维层1。另一层用于制备海螵蛸可降解聚合物复合活性炭纤维层2,将海螵蛸洗净除去表面杂质,然后破碎研磨至粒度10μm以下;取0.3g的聚ε-己内酯溶于50g四氢呋喃,再加入0.5g海螵蛸微粒,搅拌均匀,制成悬浮液;采用超声将悬浮液雾化成小液滴喷涂于活性炭纤维上,取出后在40℃下真空干燥6小时,即制得海螵蛸可降解聚合物复合活性炭纤维层2;最后将载银的抑菌活性炭纤维层1和海螵蛸可降解聚合物复合活性炭纤维层2顺着纤维的方向重叠碾压在一起,即制得抑菌止血敷料。After washing and drying the activated carbon fiber, it is divided into two layers. One layer was immersed in a 0.2mol/L silver nitrate solution and heated to a constant temperature of 50 °C for 2 hours. After removing the surface moisture to control drying, heat treatment at 300 °C for 1 hour in a nitrogen atmosphere to obtain silver-loaded activated carbon fibers, which were used as antibacterial agents. Activated
实施例3Example 3
将活性炭纤维水洗干燥后,分成两层。一层浸渍于2%的有机硅季铵盐溶液中加热至40℃恒温1小时,取出干燥至恒重,即制得抑菌活性炭纤维层1。另一层用于制备海螵蛸可降解聚合物复合活性炭纤维层2,将海螵蛸洗净除去表面杂质,然后破碎研磨至粒度10μm以下;取0.5g的聚三亚甲基碳酸酯溶于50g三氯甲烷,再加入0.5g海螵蛸微粒,搅拌均匀,制成悬浮液;将活性炭纤维反复浸没入悬浮液10次,取出后在40℃下真空干燥6小时,即制得海螵蛸可降解聚合物复合活性炭纤维层2;最后将载有有机硅季铵盐的抑菌活性炭纤维层1和海螵蛸可降解聚合物复合活性炭纤维层顺着纤维的方向重叠碾压在一起,即制得抑菌止血敷料。After washing and drying the activated carbon fiber, it is divided into two layers. One layer is immersed in a 2% organosilicon quaternary ammonium salt solution, heated to a constant temperature of 40° C. for 1 hour, taken out and dried to a constant weight, thereby obtaining an antibacterial activated
本发明的实施方式并不限于上述实施例所述,在不偏离本发明的精神和范围的情况下,本领域普通技术人员可以在形式和细节上对本发明做出各种多种变化、修改、替换和变型,而这些均被认为落入本发明的保护范围。The embodiments of the present invention are not limited to those described in the above-mentioned embodiments, without departing from the spirit and scope of the present invention, those of ordinary skill in the art can make various changes, modifications, and changes to the present invention in form and detail. Substitutions and modifications are considered to fall within the scope of the present invention.
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