ES2716764A1 - UTERINE SIMULATOR FOR OBSTETRIC EMERGENCIES DISPOSABLE AND BIODEGRADABLE (Machine-translation by Google Translate, not legally binding) - Google Patents

Abstract

Uterine simulator for obstetric emergencies, disposable and biodegradable, a tool for learning and consolidating suture techniques applicable in obstetric emergency, specifically in postpartum haemorrhage. Its main characteristic is to be disposable, and formed entirely by biodegradable materials so it is respectful with the environment. In addition, its possible production process is based on low cost materials and simple industrial technique, so its market price would be reduced and therefore affordable to a high number of obstetric simulation equipment. With all this (low cost, biodegradable, easy production, simple technology) it could be possible to systematize the implementation of obstetric emergency workshops to a greater number of hospitals, improving the quality of care, the quality perceived by the patient and the safety of the patient. medical professional. (Machine-translation by Google Translate, not legally binding)

Description

DESCRIPTION

UTERINE SIMULATOR FOR OBSTETRIC EMERGENCIES DISPOSABLE AND BIODEGRADABLE

SECTOR OF THE TECHNIQUE

The present invention belongs to the field of Medicine and specifically to the learning of advanced techniques in obstetric emergency (learning by simulation)

The main object of the present invention is a uterine simulator for the learning and consolidation of techniques of sutures (capitonaje) applicable in postpartum hemorrhage.

It brings as an advantage its low price and being biodegradable .

STATE OF THE ART

In recent years the generalized use of simulations in Medicine has been progressively assisted, with these workshops it is possible to consolidate the learning of medical-surgical techniques and improve the safety and quality offered to the patient. In the case of obstetrics in particular, there are different clinical situations that are not frequent, but with the capacity to endanger the life of the pregnant woman and / or her fetus; These include postpartum hemorrhage (scenario of application of our invention), which according to the World Health Organization (WHO) represents the first cause of maternal death.

Postpartum hemorrhage is a situation of incoercible bleeding, which without the proper pharmacological and / or surgical measures lead to death to the woman, with all the social and psychological cost of losing a young patient (in addition to leaving a newborn) . But health professionals are also affected by this situation, generating stress, depression, insecurity ...

In the surgical treatment of postpartum hemorrhage, capitonaje techniques have a fundamental indication. These techniques consist of a series of resorbable ligatures which are applied to the atonic (bleeding) uterus in order to inhibit the blood loss by compression of the uterus. Basically, 3 techniques are described: B-Lynch, Hayman and Cho.

Since severe postpartum haemorrhage has a low incidence, specialist professionals often lack sufficient surgical skills to perform capitonaje techniques, so it is an essential need that all Obstetric Services periodically perform such sutures in simulators. uterine

The Spanish Society of Gynecology and Obstetrics (SEGO) recommends the periodic simulation of unusual obstetric situations but with a great impact on maternal and fetal morbidity and mortality (Level of Evidence 1A).

EXPLANATION OF THE INVENTION

The biodegradable uterus simulator for obstetric emergencies of the present invention comprises a body in the form of a puerperal uterus (truncated cone or truncated cone flattened in its anteroposterior diameter) inverted of ± 23x16x6cm in its larger diameters), made with 2 layers of plates of pressed cellulose that provides elasticity so it is possible to simulate the compression of the uterine body prior to performing the sutures and simulate the result after knotting them. On the other hand, after the removal of the sutures the material recovers its initial state so it is possible to reuse it in new emergency simulation workshops.

The 2 layers of pressed cellulose plates are joined by their sides and upper face (thicker area of the cone that corresponds to the fundus uterus), leaving an inner breast representing the endometrial cavity. The union of the lateral layers and the bottom will be made by sewing with cotton thread (medium size: 70/2 or 60/2) in order to ensure the biodegradability of all its components. Its lower end is conical in order to mimic the uterine cervix. At 4 cm from the lower base (lower end) it has a central horizontal opening of / -6 cm mimicking the uterotomy (incision and cut in the uterine wall for fetal extraction during the cesarean section). This incision is essential when performing the capitonaje technique called B Lynch suture.

The equipment is completed with a 60 mm natural cork agglomerate base where the uterine simulator can be fixed.

Currently there is a "uterus simulator for obstetric emergencies" (ES 2485 190 A2) made of foam or latex, the only problem is the price, which makes it impossible for most Spanish hospitals to carry out systematic and periodic workshops of the capitonaje techniques Also after use in 3-4 practices the material will tear and can not be reused.

The model of simulator that we present has the advantage that it is made with several layers of pressed cellulose (cellulose plates), with which we obtain a cheap simulator (therefore accessible to all hospitals and maternity hospitals and even in low-income countries) , disposable and biodegradable in all its components (does not generate environmental pollution such as plastics, rubber or latex). Given their low expected price, they could be sold in packs of 10 simulators with 1 cork base.

MODE OF REALIZATION

Below we proceed to detail an example of embodiment, making reference to the figures of the previous section, without this implying any limitation in the scope of protection of the present invention.

The biodegradable uterine simulator for the performance of capitonaje techniques in the field of obstetric emergency, is formed by a body in the shape of an inverted truncated cone flattened in its anteroposterior diameter that imitates the morphology of a puerperal uterus (Figure 1). It will be made with 2 cellulose plates of 15 mm thickness and an estimated density of 30 Kg / m3 joined at their sides (c of figure 2) and top (d of figure 2), leaving a virtual space inside that simulates the uterine cavity. The preferred method of joining will be by sewing with cotton thread of medium size: 70/2 or 60/2, thus ensuring its biodegradability. The measures of the invention will be 23x16x6cm, the diameter of the base smaller than 8cm (Figure 3).

At 4 cm from the lower base, it presents a horizontal, centered opening of 6 cm that mimics the uterotomy (uterine incision that is performed in the cesarean section for the extraction fetal). The edges of the uterotomy simulation should be topped with medium-gauge cotton thread (figure 4). This opening is essential when simulating the B-Lynch technique (the technique consists of incising with curved needle and absorbable suture, at a distance of 3 cm below the uterotomy and 3 cm inside the uterine border. it is directed upwards to leave 3 cm above the uterotomy at 4 cm inside the uterine border.

The posterior face of the uterine simulator does not present any type of opening, it is homogeneous and uniform (figure 5). It allows us to complete the simulation of the B-Lynch technique, but also if we reconverted it on the anterior side it would be possible to simulate the Hayman sutures (it consists of making a suture point, with resorbable synthetic material and straight needle, given above the place where the vesicouterine peritoneum is reflected, passing from anterior to posterior face, the suture is passed above the uterine fundus, then it is knotted at antero-superior level, two points are made, one on the right side and one on the left side).

The lower and lower base represents the uterine cervix and is grooved in its interior.

The invention has the possibility of being fixed by means of 2 pieces of 38 mm long T-shaped pins in nickel-plated steel with sharp point to the natural cork agglomerate base of 60 mm, with dimensions of 35 x 30 cm (figure 4).

DESCRIPTION OF THE DRAWINGS

In order to improve the description that we have presented and to facilitate the understanding of its characteristics, following with a preferred example of practical realization thereof, a set of drawings is included as an integral part of said description, in an illustrative and non-illustrative manner. limiting, the following has been represented:

Figure 1.- Presents a perspective of the uterine simulator on its anterior side, where its shape can be observed, the presence of the uterotomy and the simulation of the sutures using the B-Lynch technique.

Figure 2.- Perspective of the uterine simulator with indications of its main elements:

a) Cervix uterine simulation

b) uterotomy simulation

c) Lateral aspects of the uterus

d) Uterine fund

Figure 3.- Anteroposterior view of the invention with its corresponding measurements.

Figure 4.- Shows a perspective view of the uterine simulator on its anterior face as well as its anchorage to the cork base, which gives it greater realism when performing the simulation practices of suture techniques. At the same time the measures of "uterotomy" and its distance to the cervix are outlined.

Figure 5.- Shows a perspective view of the uterine simulator for obstetric emergencies of the present invention on its rear side where different sutures carried out on it have been represented.

Figure 6: Prototype of the invention. Real image, of manual elaboration, of the biodegradable uterine simulator.

Claims (7)

1. - Disposable and biodegradable uterine obstetric emergencies simulator comprises an inverted truncated cone shaped body flattened in its anteroposterior diameter that mimics the morphology of a puerperal uterus (figure 1), it will be made with 2 cellulose plates of 15 mm thickness, joined by its side and bottom sides by sewing with medium-sized cotton yarn. 2. - Disposable and biodegradable uterine obstetric emergencies simulator, according to claim 1, being formed by plates of pressed cellulose, sewn with cotton thread and base of natural cork agglomerate, gives us one of its differential characteristic and is fundamental to be biodegradable in all its components and not generate polluting waste. The plastics with which other models are made are difficult to degrade and contribute to long-term environmental pollution. 3. - Disposable and biodegradable uterine obstetric emergencies simulator , according to claim 1, since it is formed by plates of pressed cellulose, it provides elasticity, so it is possible to simulate the compression of the uterine body prior to performing the sutures and simulate the result after the knotted of them. On the other hand, after the removal of the sutures the material recovers its initial state so it is possible to reuse it in new emergency simulation workshops. 4. - Biodegradable uterine obstetric emergencies simulator will be characterized by having a preferential size of 23 cm in its major and superior diameter, 16 cm in height, 6 cm in anteroposterior diameter and 8 cm in diameter of the minor base and lower (figure 3). 5. - Biodegradable uterine obstetric emergencies simulator presents a centered horizontal opening of 6 cm that mimics the uterotomy located 4 cm from the lower and lower base (Figure 4). This opening is essential when simulating the B-Lynch technique (figure 1). 6. - Biodegradable uterine obstetric emergencies simulator, according to reinvidication 5, presents a horizontal opening in the anterior face, however the posterior face is totally homogeneous (without openings), so there is the possibility of reversing the uterus in such a way that previous becomes posterior and the later in previous in order to simulate the techniques of Hayman and Cho. 7.- Biodegradable uterine obstetric emergencies simulator includes a natural cork agglomerate base that facilitates the fixation of the uterus on a surface, facilitating the practice of capitonaje sutures (Figure 4). Its dimensions are 35 cm long by 30 cm wide and 6 cm thick.