WO1999036019A1

WO1999036019A1 - Compression bandage

Info

Publication number: WO1999036019A1
Application number: PCT/GB1999/000190
Authority: WO
Inventors: Paul Bennet
Original assignee: Neopress Limited
Priority date: 1998-01-20
Filing date: 1999-01-20
Publication date: 1999-07-22
Also published as: GB9801038D0; AU2175899A

Abstract

A compression bandage (10, 110) includes a sheet of elastic material and attachments (22, 24, 26, 28, 122, 123) for releasably maintaining the sheet of elastic material in a stretched condition around a patient's leg. A visual indication (36, 136) may be provided to show when the correct amount of pressure is applied by the bandage (10, 110).

Description

Compression Bandage

The invention relates to a compression bandage for the management of venous insufficiency in the lower limb and in particular the control of extra vascular fluid in the treatment of venous ulcers.

Venous ulcers are common and result from venous stasis and result in areas of skin becoming devitalised which become ulcerated. Early intervention can reduce the severity of the ulceration and cure them. Recent development of bandaging systems that help with venous return have radically changed the treatment and the results in that treatment. They work by creating external pressure at predetermined levels to assist venous return and encourage reduction in extracellular fluid.

Conventionally, a "four layer bandage" is used as a compression bandage, the four layer bandage comprising: a layer of orthopaedic wool; a layer of crepe; a layer of highly elastic compression bandage and finally a layer of light-weight elastic cohesive bandage. The bandages are applied carefully one at a time, usually by an experienced nurse.

The bandages are left on the leg for usually around three days and then removed and disposed of. The bandages are not re-used because once the elastic material in the bandages has been stretched it loses much of its elasticity. The above method is thus very wasteful.

A further disadvantage is that the application of a four layer bandage is highly time consuming. Further, a skilled person is required to apply the bandage correctly, at the correct pressure. Even such a skilled person cannot be sure that the pressure is correct.

According to the invention there is provided a compression bandage including a sheet of elastic material and means for releasably maintaining the sheet of elastic material in a stretched condition around a patient's limb.

Preferably the sheet of material has a maximum length of at least 200 mm, and preferably at least 300 mm, the length being generally in a direction along a patient's limb when the material is in a stretched condition around the patient's limb. Preferably the sheet of material has a maximum width of at least 200 mm, and preferably at least 250 mm, in the stretched condition, the width being in a direction generally around the patient's limb when the material is in the stretched condition around the patient's limb.

Preferably the sheet of material has an upper edge which extends around the patient's limb when the material is in the stretched condition around the patient's limb, and a lower edge spaced from the upper edge.

Preferably the sheet of material has side edges each extending generally from the upper to the lower edge. Preferably the side edges extend generally along the length of the material, the side edges overlapping when the material is maintained in the stretched condition around the patient's limb. Preferably the area of overlap does not extend all around the patient's limb. Preferably the means for maintaining the material around the patient's limb includes means for varying the extent of overlap.

The means for maintaining the material around the patient's limb may include frictional fastening means.

The means for maintaining the material around the patient's limb may include hook fastening means.

The means for maintaining the material around the patient's limb may include an outer attachment associated with one of the side edges. Preferably the outer attachment includes hook fastenings for releasably engaging a portion of the sheet of material. In a first embodiment of the invention, an outer layer of the sheet of material includes a plush material, engagable with the hook fastenings.

The outer attachment may include a plurality of tabs each provided with hook fastenings on an inner face thereof. Preferably the tabs are provided substantially along one whole side edge of the bandage. Each tab is preferably at least about 50mm long and about 20mm wide.

In a second embodiment of the invention, means are provided for attaching the outer attachment to a complementary inner attachment on the sheet of material. The attachments may comprise tabs, which may be elongate and which may be affixed to the sheet of material towards one of their ends. Preferably the tabs are at least about 50 mm long. The outer and inner attachments may be releasably attachable to each other by means of hook and fleece fastenings. A pair of an outer and an inner attachments may be provided, the attachments being in alignment across the width of the sheet of material. A plurality of outer attachments may be provided at a side edge of the sheet of material. Preferably the attachments are spaced along the side edge, and preferably the attachments are spaced between 40 mm to 100 mm apart. Preferably a plurality of outer attachments are provided at each side edge, and preferably the outer attachments at a first side edge of the material are not aligned across the width of the material with the outer attachments at a second side edge of the sheet of material. Two rows of inner attachments may be provided, each row comprising inner attachments aligned generally along the length of the material, and the two rows being spaced from one another across the width of the material. Preferably the attachments in the two rows of inner attachments engage outer attachments from respectively different side edges. An opening may be provided in the sheet of material adjacent each inner attachment in one of the rows, the opening allowing an outer attachment to pass through the sheet of material.

In the second embodiment of the invention, the means for maintaining the material around the patient's limb preferably includes an attachment having means for spreading a tensile force within the material away from the location of the attachment. The side edges are preferably not straight. Preferably they are shaped such that the sheet of material includes at least one portion which protrudes in the direction of the width of the material. At least one outer attachment may be affixed to a protruding portion of the side edge. Preferably the protruding portion tapers towards the attachment. Preferably the tapered edge includes a substantially straight portion which preferably tapers at an angle of between 40° and 70° and most preferably about 60°, to the direction of the length of the sheet of material. Preferably each side edge includes a plurality of such protruding portions, spaced along the side edge. Preferably the protruding portions spread a tensile force within the material away from the location of the attachment.

In both embodiments of the invention, the bandage preferably includes a visual indication of the extent to which the elastic material has stretched. This may include a representation of a shape on the elastic material which alters in a recognisable way when the elastic material has stretched the required amount. A plurality of such visual indicators may be provided, each forming an identifiable shape at the same extent of stretch or alternatively at different extents of stretch.

Embodiments of the invention will be described for the purposes of illustration only with reference to the accompanying drawings in which:

Fig. 1 is a partial diagrammatic plan view, showing an upper part of a bandage according to a first embodiment of the invention laid out flat in its unstretched state;

Fig. 2 is a partial diagrammatic view showing an upper part of the bandage of Fig. 1 being moved into a wrapped position as if around a patient's leg;

Fig. 3 is a diagrammatic side view of a bandage of according to the first embodiment of the invention fitted onto a patient's leg;

Fig. 4 is a diagrammatic perspective view of the bandage of Fig. 1 fitted to a patient's leg; Fig. 5 is a partial diagrammatic plan view, showing a foot portion of a bandage according to the first embodiment of the invention laid out flat in its unstretched state.

Fig. 6 is a diagrammatic side view of a bandage according to a second embodiment of the invention, fitted onto a patient's leg;

Fig. 7 is a diagrammatic side view of the bandage of Fig. 6, not fitted onto a patient's leg;

Fig. 8 is a diagrammatic perspective view of the bandage of Fig. 6, wrapped around as if to be fitted onto a patient's leg;

Fig. 9 is a partial diagrammatic plan view, showing an upper part of the bandage of Fig. 6, laid out flat in its unstretched state; and

Fig. 10 is a plan view of a flat piece of neoprene cut into a shape suitable for stitching up into a bandage according to the second embodiment of the invention.

Referring to the drawings, a first compression bandage 10 according to the first embodiment of the invention includes an upper part having a body 12 consisting of a sheet of elastic material having at least about 15% stretch. The body 12 may consist of neoprene covered with a soft stretchy material which is comfortable against the patient's skin. Neoprene is suitable for manufacturing the body 12 because it has a highly consistent elasticity between different batches of material, and has excellent elastic recovery.

In the following description, where a direction is described as along the length of the body 12, it is meant that this is generally along the length of a patient's leg when the compression bandage is fitted to the patient's leg, i.e. generally in the direction of the arrow A in the figures. Where a direction is described as along the width of the body 12, it is meant that this is generally in the direction of the arrow B in Fig. 1. Anything extending in this direction of course wraps around the leg when the bandage is in place.

The body 12 is bounded by an upper edge 14 and a lower edge 15. Extending generally between the upper and lower edges 14 and 15 are scalloped, or approximately sinusoidal, side edges 16 consisting of projecting portions 18 and recessed portions 20 the function of which is described in more detail below. Affixed to the projecting portions 18 are rectangular outer attachments 22, 24 consisting of tabs of material provided with VELCRO (trade mark) hooks on their undersides as viewed in Fig. 1, and located approximately 85 mm apart in the direction of the length of the body 12. Affixed to the body 12 are two rows of rectangular inner attachments 26, 28 aligned across the width of the body 12 with the attachments 22 and 24 respectively and provided with VELCRO (trade mark) fleece on their upper sides as viewed in Fig. 1. Adjacent to each attachment 28 is an opening 30 in the body 12. The bandage 10 may be wrapped and stretched around a leg as illustrated in Figs. 2 and 3, and maintained in a stretched state around the leg by engagement of the outer attachments 22, 24 with the inner attachments 26, 28.

A foot portion of the bandage, shown laid out flat in Fig. 5, is of irregular shape to enable it to wrap around a patient's foot. The foot portion also includes outer attachments 22, 24 and inner attachments 26, 28.

The upper leg part of the bandage and the foot portion are attached together by stitching or by hook and fleece fastenings.

As shown in Figs. 2, 3 and 4, the bandage is first wrapped around the leg so that it extends from just below the knee to the foot, near the toes. The outer attachments 24 are threaded through the openings 30, pulled to stretch the body 12, and pressed onto the inner attachments 26 so that the hooks on the outer attachments 22 engage the fleece on the inner attachments 26 and maintain the body 12 in a stretched state. The outer attachments 22 are then stretched over the opposite edge 16 of the body 12 and their hooks pressed into engagement with the fleece on the inner attachments 26. The body 12 is thus stretched around the leg to apply a compressive force to the leg. The outer attachments 22, 24 and inner attachments 26, 28 are each about 80 mm long to allow for variations in calf diameter. Arrows on Fig. 5 show the way in which the inner and outer attachments engage one another in the foot part of the bandage.

Each inner attachment 26, 28 is affixed to the body 12 by two rows of stitching 32 applied towards one of its ends only. This ensures that if the attachments are made from non-elastic material they do not significantly inhibit the stretching of the elastic body 12.

Various aspects of the design of the bandage 10 ensure that it exerts an even pressure along a patient's leg. The outer attachments 22 and inner attachments 26 are out of alignment with the outer attachments 24 and inner attachments 28, across the width of the body 12. This ensures that any lines of high pressure created within the bandage 10 when it is stretched around the leg are spread out along the length of the leg. Any lines of pressure created by the pulling of the outer attachments 22 onto the inner attachments 26 are spaced from those created by the pulling of the outer attachments 24 onto the inner attachments 28.

The likelihood of high pressure lines occurring is also minimised by the use of sloping sides 34 on the projections 18. The sides 34 slope at an angle of approximately 60° to the direction of the length of the body, and are edged with a very low elasticity cotton material. When tabs 22, 24 pull the projections 18 away from a central portion of the body 12, the cotton edging is unable to stretch and therefore spreads the force away from the point of fixing of the outer attachments 22, 24 on the projections 18 towards the recesses 20. Therefore no band of high pressure is created, and instead the bandage applies an even pressure along the length of the leg. This avoids the incidence of uncomfortable high pressure areas, and low pressure areas which may lead to a bulging out of the flesh, particularly at the back of the calf.

The level of pressure to be applied to the leg is very important, and the bandage is designed such that the correct pressures can be applied even by those not skilled in bandaging. The pressure should preferably increase from about 17 mm Hg at the knee to about 35 to 40 mm Hg at the ankle.

It is important that a person applying the bandage 10 knows just how much the body 12 should be stretched in order to apply the optimum pressure to the leg. Fig. 1 shows the bandage in its unstretched state, and it can be seen that a rectangle 36 is printed onto the body 12. The rectangle 36 is shaped such that when the bandage is stretched to give the correct pressure, the rectangle becomes a square, as shown in Fig. 3. This enables the compression bandage to be applied to the correct pressure easily and consistently. Several similar or differently sized rectangles may be printed down the length of the bandage to ensure that the desired pressure is provided throughout the entire bandage.

Figs. 6 to 10 illustrate a compression bandage 110 according to a second embodiment of the invention. This bandage 110 represents a preferred embodiment of the invention.

The bandage 110 includes an upper part having a body 112 including a sheet of perforated neoprene. The perforations are not illustrated in the drawings, but are approximately 2mm in diameter, and 10mm apart. The perforations allow moisture to leave a patient's leg through the bandage 110. An inner side (in use) of the neoprene is covered with a soft nylon lining, which is comfortable against a patient's leg. The nylon is bonded to the neoprene layer. An outer side (in use) of the neoprene is covered with a layer of cotton plush material, also bonded to the neoprene layer, the function of which is described in more detail hereinafter.

The body 112 is bounded by an upper edge 114. A lower edge 115 of the body is stitched to a foot portion 117, which is also made from perforated neoprene enclosed within inner and outer layers of nylon and plush cotton respectively.

The body 112 is made up of two shaped sheets of neoprene 150 and 152 (see Figs. 7 and 9). The sheets 150 and 152 are cut with curved edges 154 which are stitched together to form the body 112. This results in a body shape which fits snugly around a patient's leg, taking account of variations in leg diameter between the ankle and calf.

The foot portion 117 is made from a simple sheet of neoprene but small slits are cut from the neoprene and the resulting exposed edges 155 joined with stitching 156 to form an appropriately shaped foot portion.

Fig. 10 illustrates a flat piece of neoprene cut into a shape suitable for stitching up into the bandage 110, showing the places where stitching occurs to form the shaped bandage. Fig. 9 shows the body 112 and foot portions 117 joined but they may be formed from separate sheets of material.

The stitching on both the body 112 and foot portion 117 is omitted from Fig. 8, for the sake of clarity.

Extending between the upper and lower edges 114 and 115 of the body 112 are side edges 116A and 116B. The side edge 116A is substantially straight and the side edge 116B slightly scalloped. The foot portion 117B includes corresponding straight and scalloped side edges 119A and 119B respectively. Affixed to the side edges 116A are a plurality of attachments 122 consisting of rectangular tabs of material provided with VELCRO (trade mark) hooks on their inner sides. The attachment 122 are each approximately 50mm in width (along the length of the patient's leg in use) and 120mm in length (around the patient's leg in use) in their unstretched states. The attachments 122 are affixed to the body 112 by two rows of stitching 132, shown in Fig. 7 and on the uppermost attachment only in Fig. 6. The attachments 122 are made of stretchy nylon material.

The foot portion 117 is also provided with similar attachments 122 affixed to the side edge 199 A and a narrower end attachment 123. Fig. 6 shows the bandage 110 in place on a patient's leg and Fig. 8 illustrates diagrammatically the shape of the bandage during application to the leg. To apply the bandage 110, the bandage is wrapped around the leg and the edge 116A is pulled over the edge 116B such that the two overlap as illustrated by the arrows in Fig. 8. The bandage is stretched around the leg, and the attachments 122 are laid onto the cotton plush material such that their hooks engage the material. In the stretched condition, the hooks open up slightly and engage the cotton plush material very firmly.

As discussed with reference to the previous embodiment, it is most important that the bandage applies the correct pressure all along the leg from the top of the calf to the foot. The preferred pressure is likely to vary from about 35 to 40 mm Hg in the foot to 15 to 20 mm Hg at the top of the calf. Rectangles 136 provided on the attachments 122 become square when the correct pressure is achieved. Such rectangles may be provided on all the attachments to ensure that the correct pressure is applied along the entire leg. It may be seen that the rectangles 136 of Fig. 8 become square in Fig. 6, when the correct pressure is applied by the bandage to the leg.

Because the attachments 122 are provided essentially along the whole length of the bandage, a gradually varying pressure is exerted along the patient's leg. No lines of high or low pressure are established if the bandage is used correctly.

There is thus provided a compression bandage which is straightforward and quick to apply and which provides even and consistent pressure. The bandage is fully re-usable and washable.

Various modifications may be made to the above compression bandage while still falling within the scope of the invention. The body 12 need not be manufactured from neoprene but may be made from any stretchy material, for example material incorporating rubber or elastane. The attachments need not incorporate hook or hook and fleece fastenings but may include tapes, cords or other similar materials attached together by hooks, loops, buckles or similar devices.

The rectangle 36, 136 may be replaced with any means for indicating the extent to which the body has stretched. For example, any shape may be printed onto the body. A plurality of such shapes may be used, for example, one adjacent to each projection to ensure an even pressure is exerted throughout the entire bandage. The bandage may be designed to be used at a single optimum pressure or it may be provided with different indications to provide different pressures depending on the circumstances. For example three adjacent rectangles could become square at respectively different pressures.

The bandage may be manufactured in a range of different lengths and/or widths. Alternatively a single size bandage may be manufactured, which may accommodate a wide range of calf widths due to the length of the attachments. The lengths of people's calves vary very little, and the bandage can be made to fit a relatively long calf. When applied to a shorter calf, the top set of attachments may be left loose such that an upper portion of the body wraps loosely around the knee area.

The bandage may be applied over a disposable absorbent under-bandage to improve the comfort of the bandage and prevent it from becoming soiled.

Whilst endeavouring in the foregoing specification to draw attention to those features of the invention believed to be of particular importance it should be understood that the Applicant claims protection in respect of any patentable feature or combination of features hereinbefore referred to and/or shown in the drawings whether or not particular emphasis has been placed thereon.

Claims

1. A compression bandage (10, 110) including a sheet of elastic material and means (22, 24, 26, 28, 122, 123) for releasably maintaining the sheet of elastic material in a stretched condition around a patient's limb.

2. A compression bandage (10, 110) according to claim 1 wherein the sheet of material has a maximum length of at least 300mm and a maximum width of at least 250mm.

3. A compression bandage (10, 110) according to claim 1 or claim 2 wherein the sheet of material has side edges (16, 116A, 116B) extending between upper (14, 114) and lower (15, 115) edges, the side edges (16, 116A, 116B) overlapping when the material is maintained in the stretched condition around the patient's limb.

4. A compression bandage according to claim 4 wherein the means (22, 24, 26, 28, 122, 123) for maintaining the material around the patient's limb includes means for varying the extent of overlap.

5. A compression bandage according to any preceding claim wherein the means (22, 24, 26, 28, 122, 123) for maintaining the material around the patient's limb includes frictional fastening means.

6. A compression bandage according to any preceding claim wherein the means (22, 24, 26, 28, 122, 123) for maintaining the material around the patient's limb includes an outer attachment (22, 24, 122, 123) associated with one of the side edges.

7. A compression bandage according to claim 6 wherein the outer attachment (22, 24, 122, 123) includes hook fastenings for releasably engaging a portion of the sheet of material.

8. A compression bandage according to claim 7 wherein an outer layer of the sheet of material includes a plush material, engagable with the hook fastenings.

9. A compression bandage according to any of claims 6 to 8 wherein the outer attachment includes a plurality of tabs (22, 24, 122, 123) each provided with hook fastenings on an inner face thereof.

10. A compression bandage according to claim 9 wherein the tabs (22, 24, 122, 123) are provided substantially along one whole side edge (16, 116A) of the bandage (10, 110).

11. A bandage according to any preceding claim, including a visual indication (36, 136) of the extent to which the elastic material has stretched.

12. A bandage according to claim 11 wherein the visual indication (36, 136) includes a representation of a shape on the elastic material or the attachment, the shape altering in a recognisable way when the elastic material has stretched the correct amount.

13. A bandage according to any preceding claim wherein the sheet of elastic material includes neoprene.

14. Any novel subject matter or combination including novel subject matter disclosed herein, whether or not within the scope of or relating to the same invention as any of the preceding claims.