RU231345U1 - Device for drainage of subcutaneous emphysema - Google Patents

Abstract

The utility model relates to medicine, in particular to medical instruments, and can be used in surgery, traumatology practice, military field surgery, as well as in disaster medicine for draining subcutaneous emphysema. The device for treating emphysema, allowing for minimal trauma to the patient, accessible for its installation by mid-level medical personnel, consists of a main part - a metal plate made in the form of a rectangle, two long sides of which are penetrated through with metal tubes, protruding with two ends from opposite sides of the plate. Moreover, on one side of the plate, the lower ends of the tubes are beveled and pointed, and on the other side, at a distance of 2/3 from the plate, the upper ends of the tubes are bent at an angle of 45 °. On two short sides of the plate, fasteners are made having a technological hole located in the center. Allows to simplify the process of its installation in the subcutaneous fat space. 1 Fig.

Description

The utility model relates to medicine, in particular to medical instruments, and can be used in surgery, traumatology practice, military field surgery, as well as in disaster medicine for drainage of subcutaneous emphysema.

The prior art discloses a drainage device consisting of a drainage tube with a radiopaque strip, a second channel, and a stylet having an atraumatic tip coated with a protective polymer composition and designed for installation in the drainage tube (RU 202237, published 02/08/2021).

A trocar device is known, made in the form of a movable stylet placed in a tubular body equipped with a ring clamp, the tubular body is equipped with a branch for connecting a drainage tube, a movable limiter for insertion depth of the stylet is located on the outer surface of the tubular body, the ring clamp covers the limiter for fixing it at a selected distance, and the maximum diameter of the stylet corresponds to the internal diameter of the body, at the front end of which holes are made for draining the contents of the pleural cavity (RU 2677604, published 17.01.2019).

However, both devices have a number of disadvantages:

Only a physician can place a trocar;

the need for local anesthesia;

possibility of infection of the wound surface;

inconvenience regarding access to the subcutaneous fat space;

it is impossible to control the depth of insertion of the device;

- there is no way to fix the device.

The closest to the declared technical solution, selected as a prototype, is the universal trocar of Koretsky V.A., including a stylet with a flange in the middle part, a tube located on the stylet, made of parts joined together along the longitudinal axis of the stylet, which are connected to the flange of the stylet, characterized in that the ends of the tube parts facing the flange of the stylet are made with half-flanges located with the possibility of joining them together and fixing them on the flange of the stylet, each part of the tube in cross-section is made with projections embracing the stylet from its lateral sides, and the distance between the edges of the projections is chosen to be less than the distance between the lateral sides of the stylet (RU 2207074 27.06.2003).

However, the use of this trocar for the treatment of subcutaneous emphysema has a number of disadvantages:

Only a physician can place a trocar;

high risk of contamination of the wound surface;

local anesthesia is required;

-there is a risk of damage to the vascular-nerve bundles;

there is no possibility of fixing the trocar at the place of its installation.

The objective of the utility model is to develop a device for treating emphysema that allows for minimal trauma to the patient and is accessible for installation by mid-level medical personnel.

The task is solved due to the fact that the device for drainage of subcutaneous emphysema includes the main part - a metal plate made in the form of a rectangle, two long sides of which are penetrated through with metal tubes, coming out with two ends from opposite sides of the plate, and on one side of the plate the lower ends of the tubes are beveled and pointed, and on the other side at a distance of 2/3 from the plate the upper ends of the tubes are bent at an angle of 45°, while on the two short sides of the plate there are fasteners having a technological hole located in the center. The fasteners are made of plastic.

The technical result of the proposed device is to simplify the process of installing the proposed device in the subcutaneous fat space. The proposed utility model is illustrated by drawings:

Fig. 1 shows a diagram of the proposed device, where

1 – plate,

2 – tube,

3 – beveled end of the lower protruding part of the tube,

4 – place of bending at an angle of 45° of the upper protruding part of the tube,

5 – fixing fastener,

6 – technological hole in the fixing fastener.

In chest injuries, a complication such as subcutaneous emphysema often occurs, and its treatment involves the doctor installing a trocar into the subcutaneous fat layer.

The proposed device allows treatment of subcutaneous emphysema not only by a doctor, but also by mid-level medical personnel.

The device for drainage of subcutaneous emphysema consists of a plate (base) 1, metal tubes 2 having a beveled end of the lower protruding part of the tube 3, on the other side a place of bending at an angle of 45° 4, a fixation fastener 5, a technological hole in the fixation fastener 6.

The device for drainage of subcutaneous emphysema is the main part - a metal plate 1, made in the form of a rectangle, two long sides of which are pierced through by metal tubes 2, coming out with two ends from opposite sides of the plate. In this case, the lower ends of the tubes are beveled and pointed 3, on the other side, at a distance of 2/3 from the plate, the upper ends of the tubes are bent at an angle of 45 ° 4. On two short sides of the plate there are fasteners 5, made of plastic in the form of a flat plate with a technological hole 6 located in the center.

The sharp and beveled ends of the tubes 3 ensure easier subcutaneous insertion of the device with minimal resistance. The 45° angle of the tubes 2 helps to minimize the risk of contamination of the wound surface with infection. Due to the fasteners 5 with the technological holes 6 in them, it is possible to fix this device not only with a plaster, but also by suturing. The plate itself serves as a stop preventing the device from penetrating into the layers below the subcutaneous fat layer.

The claimed device can be used as follows:

After treating the surgical field with an antiseptic solution, the device is installed at the crepitus site in the subcutaneous fat. To do this, the device is taken in such a way that the side with sharp beveled ends 3 is directed towards the patient, then with pressure the device is inserted into the subcutaneous fat layer until the plate 1 rests against the patient's body, i.e. until they are in complete contact. Plate 1 limits the depth of penetration, minimizing trauma to the underlying tissues, and therefore no special skills are required for its installation. Then fixation is performed: the patch is glued over the fasteners 5, or sutures are applied to the skin, fixing the device by the technological holes 6 in the fixation fasteners 5, thereby ensuring rigid fixation of the device.

The guarantee of limited penetration depth with minimal trauma to surrounding tissues allows the procedure to be performed by mid-level medical personnel.

Example 1. Patient A., 45 years old, complained of pain in the area of the fifth intercostal space along the anterior axillary line on the left, after an injury sustained during a fall from the stairs, objectively determined subcutaneous crepitus over the chest area. X-ray revealed a fracture of the 5.6 rib on the left, pneumothorax, subcutaneous emphysema.

Based on the anamnesis data, clinical picture and additional examination methods, the patient was diagnosed with subcutaneous emphysema of the chest.

The patient was prescribed a procedure for installing a device for drainage of subcutaneous emphysema. The location of subcutaneous crepitus was determined. The surgical field was treated with an antiseptic solution. The device was placed in the hand, directing the side with sharp beveled ends 3 towards the patient. Under pressure, the sharp beveled ends of the rods were inserted until they stopped, until the metal plate was in close contact with the patient's skin. Then the device was fixed by applying a patch to the fixation fasteners. During installation, the patient experienced minimal pain, since the sharp ends encounter the least resistance when inserted into the subcutaneous fat space through the skin. After insertion, air began to evacuate from the subcutaneous fat space through the tubes. Then, upon achieving a negative crepitus symptom, the device was removed. An aseptic bandage was applied over the place where the device was. The patient was then referred for treatment of concomitant diseases.

Example 2. Patient S., 35 years old, complained of pain in the area of the third intercostal space along the midclavicular line on the right, after an injury sustained during military operations, subcutaneous crepitus is objectively determined over the chest area. An X-ray shows a fracture of the 3rd and 4th rib on the right, subcutaneous emphysema.

Based on the anamnesis data, clinical picture and additional examination methods, the patient was diagnosed with subcutaneous emphysema of the chest.

The patient was scheduled for a procedure to install a device to drain subcutaneous emphysema.

The location of subcutaneous crepitus was determined. The surgical field was treated with an antiseptic solution. The device was installed by inserting the sharp beveled ends of the rods until they stopped, until the metal plate was in close contact with the patient's skin. Then the device was fixed by applying nodal sutures through the technological holes in the fixation fasteners. During the installation, the patient experienced minimal pain. After the introduction, air began to evacuate from the subcutaneous fat space through the tubes. Then, upon reaching a negative crepitus symptom, the device was removed. An aseptic bandage was applied over the place where the device was. The patient was then discharged and referred to an outpatient surgeon for removal of the bandage after 24 hours.

Thus, the useful model simplifies the process of treating patients with subcutaneous emphysema. The installation procedure itself is virtually painless, providing maximum comfort to the patient. The device for drainage of subcutaneous emphysema reduces the risk of developing soft tissue phlegmon.

Claims (2)

1. A device for draining subcutaneous emphysema, comprising a main part - a metal plate made in the form of a rectangle, the two long sides of which are pierced through with metal tubes, protruding at two ends from opposite sides of the plate, wherein on one side of the plate the lower ends of the tubes are beveled and pointed, and on the other side at a distance of 2/3 from the plate the upper ends of the tubes are bent at an angle of 45°, while on the two short sides of the plate there are fasteners having a technological hole located in the center. 2. The device according to item 1, characterized in that the fasteners are made of plastic.