Note: Descriptions are shown in the official language in which they were submitted.
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FIE~D OF THE INVENTION
The present invention relates broadly to surgical
cover means. In particular, the invention relates to new and
improved surgical drapes of the type which comprise a flexible
sheet having a main portion and wing portions whose inner edges
define a slit or gap which extends inwardly from an ou-ter edge
of the drape. Such drapes are especially useful in orthopedic
surgery and similar surgical procedures.
In preparing for orthopedic and related surgery it
is common practice to cover the patient and operating table
with a sterile drape, or drapes, in such a way that only the
limb (or portions of the limb) on which surgery is to be
performed is presented to the surgeon and his assistants
DESCRIPTION OF THE PRIQR ART
One drape that has been provided for orthopedic and
similar surgery comprises a sterile sheet having a main
portion and an elongated gap extending outwardly from a central
region thereof to an outer edge to provide two spaced wing
portions Such drapes are frequently referred to as "split
sheet" drapes.
One draping procedure for using these drapes in-
volves raising the patient's limb and putting it through the
gap in the shee-t in such a way that, when the draping is com-
pleted, the limb on which the operation is to be performed
extends through the gap and lies on the upper surface of the
main portion of the drape. The wing portions of the drape are
then disposed to overlie parts of the patient's body at a
region adjacent the operative site. `
It is necessary, of course, -to insure that a sterile
surgical field be provided at the outset of the surgical
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procedure and that the integrity of the sterile field be
maintained until the surgical procedure is completed In order
to establish the sterile field and to prevent the contamination
thereof in the event the wing portions of the split sheet
should slip or be accidentally moved during surgery, it has
been found necessary, prior to placement of the split sheet,
to cover the patient with an auxiliary surgical drapeO The
auxiliary drape is placed ovsr that portion of the patient's
body which will underlie the gap in the split sheet when the
latter has been positioned.
In commonly assigned Canadian patent application
Serial No. 235,737, filed on September 16, 1975 and entitled
"Surgical Drape", there is disclosed a surgical drape of the
split sheet type in which a flap-like sheet is attached to at
least one of the wing portions of the drape. Durin~ surgery,
this flap-like sheet covers the slit or gap in the drape and '
eliminates the need for the use of auxiliary drapes, thus
reducing the number of drapes that need to be handled by the
operating room staff. However, such a drape, i.e., a split
sheet drape with a flap-like sheet attached to one of its wing
portions, still presents some difficulties. For example, the
wing portions may accidentally slip relative to one another
during surgery; such slipping causes the drape to undesirably
"bunch up" upon itself and indeed, in an extreme case, the ~;
wings could be separated to such an extent that the patient's
body and/or other drapes or the like could be exposed to con-
tamination. Another difficulty with the drape disclosed in -the
aforesaid commonly assigned patent application is that no means
are provided for securing surgical tubing, electrical wires and
the like to the surface of the drape in a position where they
would be prevented from interfering with the surgical procedure
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at hand, yet be readily accessible when needed during surgery
It is therefore an object of the present invention
to eliminate "bunching" or accidental movement of the wing
portions of a split sheet drape by providing means for
securing the wing portions in a closed, substantially flat
position during surgery.
It is another object of the present invention to
provide means for securing items such as surgical tubing and
the electrical wires of monitoring devices to the surface
of the drape in a position where they will be conveniently
accessible when needed and yet will not unduly interfere with
the surgical procedure
SUMMARY OF THE IN~ENTION
In accordance with the present invention there is
provided an improved surgical drape for use in orthopedic and
similar surgery which eliminates the aforementioned difficulties.
The drape of the present invention simplifies the draping ;~
procedure, saves valuable time, reduces costs, eliminates
"bunching" of the wing portions, and provides means for .
20 securing auxiliary tubing and electrical lines to the surface `
of the drape.
The improved drape of the invention comprises a
flexible unitary sheet, suitably of a plastic film or a woven
or nonwoven fabric, having a main portion and two wing portions -
The inner edges of the wing portions define an elongated gap
or slit which extends inwardly of the drape from an outer edge
thereof and joins a fenestration loca-ted generally inwaraly
of the perimeter of the drape Attached to one of the wing
portions, preferably at the inner edge thereof adjacent the
slit, is a flap-like sheet of woven, nonwoven, plastic or
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similar material which, when the drape is in use, covers a
substantial portion of the length of the slit, and lies
beneath the second of the two wing portions
Means (referred to as clipping means) are provided on
the drape for securing the wings of drape in their desired flat,
wrinkle-free position during surgery. me clipping means, as
will be seen hereinafter, may comprise relatively small tabs
of material affixed in hinge-like fashion to the upper surface
of the drape. Prior to use, the clipping tabs lie flat in a
position generally overlying the upper surface of the drape.
During use the tabs are extended upwardly from the surface of
the drape. Adjacent, upwardly extending tabs are brought into ;i
contact with each other and secured together by any convenient
means, Thus secured, the clipping tabs prevent "bunching'l
and/or accidental lateral movement of the wing portion of the
drape.
The surgical drape of the present invention also
comprises at least one tubing holder affixed at a suitable
location on the upper surface of the drape. A tubing holder,
as will be seen, is a relatively small piece of material made
from e.g., a nonwoven fabric or a piece of plastic. The tub-
ing holder must have at least one opening therein, Surgical
tubing, electrical wires or like materials may be threaded
through the tubing holder which then holds the tubing in its
desired position on the surface of the drape.
According to a broad aspect of the present invention, `
there is provided a surgical drape which comprises a sheet of
flexible drapable material. The sheet has a main portion at
one end thereof, and a pair of spaced wings at the other end I~.
thereof. The wings extend outwardly from a central region of
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the sheet and defines a slit in the sheet. The slit mexges
into a widened fenestration located generally inwardly of the
perimeter of the drape. A flap is secured to one of the wings
and is transversely extendible from the wing so as to cover at
least a portion of the length of the slit and to be in contact-
ing relationship with at least part of the other of the pair of
wings when the drape is in use. Clipping means is also provided
on the drape and having at least one securable tab -to prevent
the wings from moving with respect to each other when the drape
is in use.
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BRIEF DESCRIPTION OF THE DRAWINGS
The aforementioned and other advantages of the
present invention will become apparent upon reading -the
following detailed description and upon reference to the
drawings in which: ~,
Fig, 1 is a top plan view, with portions cut away, ,,
of one embodiment o~ the surgical drape of the present in-
ventionl wherein the flap-like sheet at-tached to one wing
portion is shown in a position underlying the second wing ~
10 portion, and the clipping means are shown in their flat ;-
position overlying the upper surface of the drape;
Fig, 2 is a cross-sectional view taken along lines
2-2 of Fig. l; ~
Fig, 3 is a perspective view of the surgical drape -
of Fig, 1 showing the flap-like sheet in a folded position
overlying the wing portion to which it is attached; `
Fig, 4 is a cross-sectional view taken along line
4-4 of Fig. 3;
Fig. 5 is a perspective view of the surgical drape `-
of Fig. 1 showing the ~lap-like sheet attached to one wing
portion in an extended position and with the other wing
- portion turned back to expose its under surface;
Fig, 6 is a detailed view in perspective o~ a ~ ,
portion of the drape of Fig, 1 showing the clipping means in
their upwardly ex-tended position;
Fig, 6a is a cross-sectional view taken along line
6a-6a of Fig, 6;
Fig. 7 is a view similar to Fig, 6 showing the -
tabs comprising the clipping means in an o~f-set position with
respect to each o-ther;
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Fig, 7a is a plan view of the -tabs in their off-
set position;
Fig, 7b is an enlarged fragmentary view showing an
alternative placement of one of the tabs comprising the
clipping means;
Fig, 7c is an enlarged fragmentary view wherein the
clipping means comprise an elongated tab at-tached to one of the '~
wings and a cooperating strip of pressure sensitive adhesive,
protected by a release sheet, attached -to the other wing;
Fig, 8 is a top plan view of another embodiment of
the surgical drape of the present invention wherein the
fenestration is lined with a sof-t elastomeric lining material; i,-
Fig, 8a is a cross-sectional view taken along line
8a-8a of Fig, 8; ~:
Fig, 9 is a top plan view of the surgical drape of
Fig, 1 with its flap-like sheet shown in a folded position
on the upper surface of the drape and showing in broken lines
the fold lines for the longitudinal folding of the drape; -
Fig. 10 is an enlarged cross-sectional view taken ~,
along line lO-lO of Fig, 9;
Fig, 11 is a perspective view showing the drape of
Fig, 9 after the wing portions have been folded longitudinally; ~ ;
Fig, 12 is a perspective view showing the drape of ~ "
Fig, 9 after the longitudinal folding thereof has been
completed;
Figs, 13-17 are perspective views showing -the
sequence of steps in draping a patient for leg surgery with
the drape of Figures 9-11; ;~
Fig, 18 is a plan view, with parts in perspective
30 and with portions cut away, of another embodiment of the drape ,'
of the presen-t invention wherein the wing portions are extended j~
transversely to form a T-shaped drape having covers for the ,
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armboards of an operating table;
Fig, 19 is a plan view of the drape of Fig. 18
with the flap-like sheet folded and overlying the wing portion
to which it is attached and showing one of the armboard flaps
in a folded position overlying the armboard cover to which
it is attached;
Fig, 20 is a cross-sectional view taken along line
20-20 of Fig. 19;
Fig, 21 is a plan view of -the drape of Fig, 18 with
its flap-like sheet, armboard covers, and armboard flaps in a
folded position and showing the fold lines for completion of
the longitudinal folding of the drape; and
Fig. 22 is an enlarged fragmentary view, with -,
portions cut away, of the upper left hand portion of the drape
of Fig. lô,
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DETAILED DESCRIPTION OF TXE INVENTION
While the invention will be described in connection
with its preferred embodiments, it will be understood that it
is not intended to limit the invention to -those embodiments.
On the contrary, it is intended to cover all alternatives,
modifications and equivalents as may be included within the ;
spirit and scope of the invention as defined by the appended
claims.
Referring more particularly to Figs. 1-5, which ~ -
show one embodiment of the present invention, surgical drape
10 comprises a flexible sheet 11 made from a single piece of
a suitable drapable material such as a woven or nonwoven ;~
fabric or a plastic film. Preferably, the material is a
drapable nonwoven fabric, such as a scrim reinforced tissue
or a wet-formed nonwoven containing long fibers. Even more
preferably, sheet 11 comprises a nonwoven fabric -that has
been treated according to known methods to render it liquid
repellent Flexible sheet 11 comprises a main portion 12 at
the lower end thereof, and a pair of spaced wings 20 and 30
at the upper end thereof The perimeter of the drape comprises
opposed side edges 16 and 1~ and lower edge 15.
Wing portions 20 and 30 are integral with, and ~
extend outwardly from, main portion 12. Wing portion 20 has ~-
an inner side edge 24 and an upper edge 26. Correspondingly, -
wing portion 30 has an inner side edge 34 and an upper edge
36 The upper edges of the wing portions define -the upper
edge of the drape. ~.
Drape 10 has a slit 45 which is defined by the
adjacent inner edges of the wing portions and which extends `
from the upper edge of the drape inwardly to a generally
central portion thereof. The sli-t has a first, or open end,
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which communicates with the outer edge of the drape The
other end of the slit merges into an enlarged or widened
fenestration 50 which, in the illustrated embodiment, is ;
shaped in the form of a tear-drop. I-t will be understood
that the precise configuration of the fenestration is no-t
critical and may be varied if so desired. The fenestration
is loca-ted generally inwardly of the perimeter of -the drape
but its precise location is not critical. It is preferred
-that the fenestration be centered from sides 16, 17 of the
main sheet. The position of the fenestration with relation
to the top and bottom ends of the drape is not critical. In
one commercial embodiment of the drape of Figs 1-~, the main
sheet is about one hundred fourteen inches long, -this leng-th
being sufficient, when the drape is in use, to cover both an
adult patient and the anes-thesia screen. In this embodiment,
fenestration ~0 is about fifteen inches long, with point 50'
on the curved portion thereof being about five feet from bottom
edge 15 of the main sheet. It will be understood that the
above mentioned dimensions are for purposes of illustration
only; these dimensions may be changed, for example, to provide
a drape which is adapted for a particular kind of surgery or
which is tailored to fit a child about to undergo surgery.
Inner side edge 34 of wing portion 30 carries a
flap 40 of drapable material, which, as illustrated in Figs
1 and 2 may be folded across slit 4~ to lie beneath wing
portion 20.
Flap 40 has a lower edge 41, an upper edge 42, and
side edges 43 and 44. The lower and upper edges of flap 40
are substantially equal in length and are sufficiently long -`
so that, when the flap is extended crosswise of the drape to
cover slit 4~ and lie beneath wing 20, edge 43 of the flap lies
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slightly beyond edge 17 of the main sheet. It will be under-
stood the length of the flap along its upper and lower edges
may vary considerably from the dimensions shown in Fig. 1. The
objects of the present invention are achieved if flap 40 is long -
enough along its upper and lower edges to cover slit 45 and lie
beneath at least part of wing 20. Referring especially to
Fig, 1, it is seen that the length of the flap along side edges
43, 44 is somewhat less than the length of slit 45. Flap 40
extends along inner edge 34 from a point inward of upper edge 36
of wing 30 to a point near where slit 45 merges into fenestra~
tion 50,
~ .
The particular part of wing 30 to which flap 40 is
attached is not critical, provlded, of course, that the flap can
be arranged, when in use, to lie beneath wing 20, Preferably,
however, flap-like sheet 40 is attached to wing 30 at or near
its inner side edge 34, since a minimum amount of material is
thus required and unnecessary bulkiness in the folded drape is
eliminated. As illustrated in Fig. 2, flap 40 is fastened,
along a narrow line adjacent its side edge 44, to the lower -
surface of wing 30 a slight distance from its inner side edge
34. This is conveniently accom~lished by stitching (not shown
in the drawings), but other fastening means, such as an ad-
hesive, may be employed if so desired. Other acceptable ways
of affixing flap 40 to wing 30 are illustrated in the afore- ,
mentioned Canadian patent application Serial No, 23$,737.
Drape 10 has a reinforcing panel 60 secured to the
upper surface of the main sheet. In the preferred embodiment,
the reinforcing panel is positioned inwardly of the perimeter
of the drape and extend inwardly to the edges of fenestration ;~
50 and to the edges of a portion of slit 45. The reinforcing
panel may comprise one or more layers of the same material used
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for the main sheet Preferably, however, the reinforcing ;
panel has an absorbent upper surface 61 and an impervious
plastic film 62 between the absorbent surface and -the main
sheet of the drape. The reinforcing panel can be secured -to
the upper surface of the main sheet by any suitable securing
means well known to those skilled in the art, an adhesive
being preferred, however, over stitching for this purpose
It will be recognized that the reinforcing panel, which
provides increased abrasion resistance and an absorbent
surface in the areas surrounding the fenestration, need no-t
be used if such qualities are not required.
Means (hereinafter referred to as clipping means) ~ -
are provided on -the upper surface of the drape so that,
during actual use, the wings thereof are maintained in a
flat, wrinkle free position and are prevented from moving
laterally with respect to each other The clipping means
as illustrated in Figs 1-5 comprise cooperating, generally ~ -
rectangular, flexible tab-like structures 65 that can be
easily fabricated from the same material used for flexible
sheet 11 or from any other suitable woven, nonwoven or plastic
sheet material. As best seen in Fig. 2, each tab is secured
to the drape in hinge-like fashion by gluing a part of it
between sheet 11 and impervious layer 62 comprising the
reinforcing panel. The remaining portion of each tab then
lies (prior to use of the drape) in a position overlying
absorbent surface 61 of the reinforcing panel.
Wh0re there is no reinforcing panel, or where the
tabs are positioned beyond the region where slit 45 is
bordered by the reinforcing panel, the tabs would be attached
directly to -the wing portions of the drape As seen in
Figs. 1 and 2, a tab is attached to each wing portion at the
inner edge thereof.
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Prior -to use, the clipping tabs lie flat on the
upper surface o~ the drape (see Fig. 1). During use the
clipping tabs are extended upwardly and joined together (see
Figs 6 and 6a), for example, with surgical clamps, whereby
the wing portions are securely held in position. It will be
recognized that when the clipping tabs are in their upwardly
extended positions, a portion of one tab must be able to come
into contact with at least a portion of the other clipping
tab. In other words, one tab may be offset with respec-t to
the other (see Figs. 7 and 7a), but not to such an extent
that the tabs will be unable to come into mutual contact wi-th
each other.
Furthermore, it will be understood that the wing
portions of the drape can be effec-tively secured during use by
placing the cooperating clipping tabs at any of several
positions on the upper surface of -the drape. Preferably, as
shown in Fig. 1, the clipping tabs are attached, one on either
side of slit 45, relatively near the point where slit 45
merges into fenestration 50. This arrangement is quite
advantageous because the clipping means then serve not only
to secure the wings during use but also to draw the edges of
fenestration 50 snugly around a limb protruding -through the
fenestration. Thus, the limb is "surrounded" by drape
material and the portion of the limb to be incised is
effectively isolated. Additional sets of cooperating clipping
means may be used on the arape if desired.
Other ways of positioning the clipping tabs to
achieve the aforementioned desirable results will be apparent -
to those skilled in the art. For example, one of the tabs 65
may be secured to flap-like sheet 40 near the inner side edge
34 of wing 30 and the other tab may be secured to wing 20 near
its inner side edge 24 (see Fig. 7b) Similarly, the shape
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of the exposed portions of the -tabs may be varied, e g.,
semi-circular tabs may be used if cLesired.
Referring to Fig 7c, there is illustrated another
form of clipping means that may be used to secure the wings
in place during use of the drape. The clipping means comprise
an elongated tab 66 of flexible material attached to the -
drape near inner side edge 34 of wing 30 and a cooperating
strip of pressure sensitive adhesive 67 adhered to wing 20
adjacent its inner side edge 24 The pressure sensitive
10 adhesive is protec-ted prior to use of the drape by a suitable ;`
release sheet 67'. After the wings of the drape have been
positioned on the patient, release sheet 67' is removed,
thus exposing pressure sensitive adhesive 67. Tab 66 may
then be folded across slit 45 and pressed into sealing
engagement with the pressure sensitive adhesive Thus the
wings may be quickly and conveniently secured in abutting
relationship and the edges of the fenestration can be drawn
snugly around the limb protruding therethrough.
The drape is provided with at least one, and
preferably two, tubing holders 70. The tubing holders are
rectangular pieces of a woven or nonwoven fabric or plastic
sheet material, and are typically about 2-6 inches long and
1-3 inches wide. Each tubing holder has a flexible portion
which is free of the rest of the drape and which has at leas-t
one opening therein for securing flexible members such as
surgical tubing, electrical lead wires and the like in position
on the upper surface of the drape (see Fig. ~). In the
preferred embodiment, the tubing holders are attached to the
wing portions adjacent the upper edge of the reinforcing ;~
panel and each tubing holder has two circular openings 71
therein.
Fig 8 illustrates a modification in which the
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perimeter of fenestration 50 is lined with a soft elastomeric ~;
film Film 75 lies substantially in the major plane of the
drape and allows adjustmen-t and conformation of the fenestra-
tion to the limb surrounded by the drape. The film lining
the fenestration can be made from an elastomeric material
such as, for example, synthetic or natural rubber. As seen
in Fig. 8a, film 70 is preferably attached in the regions
adjacent the edges of the fenestration by gluing it in place `~
between sheet 11 and reinforcing panel 60, It will be under-
stood that the film lining the fenestration must not interfere
in any way with the continuity of slit 45. As seen in Fig. 8,
opposed edge portions 76 and 77 of film 70 actually define
what might be described as an extended portion of slit 45 ~;
Typically, the film would extend about an inch or two inwardly `
from the edgee of the feneetration.
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FO~DING OF THE DRAPE
Drapes of the present invention may be folded into
a compact unit which facilitates handling during packaging
and storage and which permits the drape to be easily and ;
quickly applied to the patient prior to surgery.
As used herein a "forward fold" is a fold in which
the upper surface is turned toward the upper surface of the
drape around a fold line. A "reverse fold" is a fold in which
the upper surface of the drape is turned toward the bo-ttom
surface of the drape around a fold line. In the drawings, the
letter R indicates a reverse fold and the letter F indicates
a forward fold. The numbers preceding the letters F and R
refer to the order in which the folding is done.
The preferred method for folding drape 10 from end
to end is illustrated in Figs. 9-12. As seen in Figs 9 and 10,
flap 40 is initially fan-folded to form a stack of folds over-
lying wing 30. The folds may be any convenient size and number,
but, as illustrated, the folds are preferably arranged so that
edge 43 of flap 40 lies between the sides of the stack of folds
formed by the flap.
The wings (with flap 40 in folded position overlying
- flap 30 as explained above) are folded next.
A part of wing 30 adjacent upper edge 36 thereof is
reverse folded around fold line lR. Thereafter wing 30 is
forward folded around fold line 2F, reverse folded around fold
line 3R, and forward folded around fold line 4F It will be
observed that fold line 3R intersects the drape substantially
at the point where slit 45 merges into fenestration 50 and
that fenestration 50 lies generally between fold line 3R and
fold line 4F. This folding of wing 30 (including its
associated flap 40) provides a stack A of folds which
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overlies a generally central portion 59 of the drape lying
between fold line 4F and fold line 8F Wing 20 is then
folded in the manner just described for wlng 30 to provide
a stack B of folds which also overlies central portion 59.
Fig. 11 shows drape 10 after it has been folded in accordance
with the above described folding procedure It will be noticed
that slit 45 is exposed to view at the upper central portion
of the partially folded drape.
Main portion 12 of the drape is folded next
10 Bottom portion 58 is reverse folded around fold line 5R. The .'7'
main portion is then forward folded around fold line 6F,
reverse folded around fold line 7R, and forward folded
around fold line 8F. This folding sequence provides a stack
C of folds overlying stacks A and B of folds and resul-ts in
the elongated, longitudinally folded unit illustrated in
Fig. 14.
Each end of the drape in the elongated, par-tly
folded form shown in Fig. 14 may then be folded, toward the
center, to give a final compactly folded drape. Although an i'
ordinary fan-fold is suitable for this purpose, it is preferred
that a modified fan-fold be used. The term fan-folded refers
to a folding sequence in which the material being folded has
alternate forward and reverse folds. The term modified fan-
fold refers to a folding sequence which is similar to a fan-
fold but in which the first two folds thereof are of the same
type. An example of a modified fan-fold sequence is forward,
forward, reverse, forward..., etc
Thus, -the transverse folding of the drape as shown
in Fig. 14 is begun from side edge 16 with a forward fold The
second fold is likewise a forward fold while the third fold is
a reverse fold The forward and reverse fold sequence may
subsequently be repeated until -the desired degree of compactness
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is obtained. The transverse folding of the drape from side
edge 17 toward the center is accomplished in the same manner.
In the drape of Fig. 11, the distances between fold
lines lR and 2F, between fold lines 2F and 3R, and between
fold lines 3R and 4F are substantially the same. The
distance between the fold lines, and the resulting number of
fabric layers in the folded drape, is not particularly
critical and may be varied according to the degree of compact-
ness required or desired in the folded drape, In any event,
the distance between fold lines 4F and 8F should be slightly
greater than the distance between any two consecutive fold
lines above fold line 4F or any two fold lines below fold -
line 8F. This is so because all the other folds in the
drape as finally folded will lie above that portion of the
drape lying between fold lines 8F and 4F.
APPLICATION OF THE DRAPE TO THE PATIENT
Referring now to Figs, 13-17, there is illustrated
in stepwise fashion a method of applying the drape of Fig, 1,
folded as just described, to a patient about to undergo
surgery on the left knee. Fig. 13 shows drape 10, unfolded
from side to side, placed across the right leg and under the
left leg, in the general area of the patient's knees. The
patient's left leg is lifted upwardly and stack C of folds is
unfolded toward the foot of the operating table. The patient's
left leg is then lowered to overlie body portion 12 of main
sheet 11. By virtue of the above step, stacks A and B of folds
are exposed (see Fig. 14),
Wing portion 30 having the flap-like sheet 40 ~;
attached thereto (stack A of folds in the illustrations) is
then unfolded toward the top of the operating table. This
step e~poses flap 40 in its folded posi-tion overlying wing 30
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(see Fig, 15), Flap 40 is then unfolded (as indicated by
the arrow in Fig, 15) across the operating table to overlie
the upper portions of the patient's body, Stack B of folds
comprising wing portion 20 is then unfolded, as indicated by
the arrow in Fig. 16, toward the top of the opera-ting table,
Referring to Fig, 17, the entire lower portion of
-the patient's body (i,e,, the region from the upper chest
area to the toes), except for the left knee and lower portion ,`
of the left leg, is covered by the drape, The lower part of
the left leg extends through fenestration 50 and clipping
tabs 65, 65 and tubing holders 70, 70 are exposed on the
upper surface of the drape, `
.;,
The clipping tabs are extended upwardly -to a ;'~
vertical position and are brought into contact with one
another, The clipping tabs are then held together by any ~;
convenient means, such as a surgical clamp, illustrated in
Fig, 6a, The sécuring of the clipping tabs in this fashion
has two beneficial effects, First~ fenestration 50 now
surrounds the patient's leg at a point just above the knee
on which surgery is to be performed, At the same time the
wing portions are prevented from slipping or sliding laterally, .
The upper surface of the drape is free from any undesirable
wrinkling or bunching and the -tubing holders are available,
at the upper portion of the drape, where they will not
interfere with surgery and yet will be readily accessible
when needed, Reinforcing panel 60 is positioned in the ~i
general area where surgery is to be performed and where
increased exposure to abrasion is normally encountered,
Another embodiment of the drape of the present
invention is shown in Figs, 18-22, Drape 100 is generally
T-shaped in construction and is intended for use with an
operating room table having armboards extending laterally
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therefrom
Drape 100 is identical in many of its features to
drape 10 and includes a flexible sheet 11 comprising a main
portion 12 and wing portions 20 and 30. The drape has a flap-
like sheet 40 attached to wing 30; a slit 4~ merging into a
tear-shaped fenestration ~0, a reinforcing panel 60, clipping
means 6~, and tubing holders 70.
The upper portions of wing 20 and 30 are extended
transversely of the drape, i.e , beyond side edges 16, 17 of
flexible sheet 11 to provide armboard covers 110, 110' The
armboard covers have side edges 112, 112' and lower edges 114,
114', respectively. Referring especially to Fig 22, trans-
verse cuts 116, 116' are provided in sheet 11 just below lower
edges 110, 110' of the armboard covers. This construction
allows side portions 16a, 17a of flexible sheet 11 in the
areas of the drape below cuts 116', 116, respectively9 to fall -
over the sides of the operating table where they will be in a
generally vertical p:lane on either side of the table when the
drape is positioned on the patient
Armboard covers 110, 110' have armboard flaps 120,
120'. The armboard flaps are pieces of flexible drapable ;
material attached, preferably with an adhesive, to the armboard
covers and wings along a line, extending inwardly of the drape,
which lies just above the lower edge of the armboard cover and
; .
~ the upper edge of the cut at the side of the drapeO Fig. 22 ~ ~
, . . . .
shows the structural relationship between armboard cover 110'
and its associated armboard flap 120'. The outer edges 124,
124' of the armboard flaps are generally coextensive with the
outer side edges of the armboard covers, while the inner
side edges 126, 126' thereof extend somewhat inwardly of -the
innermost ends of cuts 116, 116', respectively As a result
of this structural arrangemen-t, the armboard flaps may hang
over the sides of the armboards of the operating table and `
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extend gerlerally vertically downward when the drape i9 in place.
The various possible structural relationships of the armboard
covers to the armboard flaps and of the armboard covers and -
-armboard flaps are discussed in an earlier patent of the
assignee.
The armboard covers, inasmuch as they are extensions
of the wing portions of the drape, and armboard flaps, are
suitably made from the same material as that used for flexible `-
sheet 11.
10FOLDING OF THE DRAPE HAVING
EXTE~DED WING PORTIONS `
~ .
Fig, 18 shows a plarl view of drape 100, with flap 40 '
thereof already in its folded position overlying wing 30. The
dot and dash lines indicate the fold lines ~or the folding of
the drape. As before, the letter "R" indicates a reverse fold, `
the letter "F" a forward fold, and the numbers indicate the
steps in the folding sequence. In thé figures, the lower sur-
faces of the drape are indicated by stippling, and the upper
surfaces are left plain,
Flap-like sheet 40 is folded in the manner explained
earlier for the folding flap 40 of drape 10. 1 ;
~- The longitudinal folding of the armboard flaps and
armboard covers is the next step in the folding sequence. The
; folding of armboard flap 120' and armboard cover 110' will be `,. .: . .
taken as illustrative. Referring to Fig. 18 a portion 128' of
armboard flap 120' adjacent its lower edge is preferably
reverse folded around fold line lR'. If desired, portion 128
could be forward folded, rather than reverse folded, around `
this fold line. The last fold in the longitudinal folding of
'
.
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3L~36121~
the armboard flap must be a forward fold around fold line
2F' Fold line 2F' extends inwardly of the drape from outer
side edge 124' of armboard flap 120' and coincides with lower
edge 114' of the armboard cover and the upper edge of trans-
verse cut 116' Although usually not necessary, addi-tional
folds may be made in the armboard flap between the above ;~
described first and last folds It will be apparen-t -that the
number and size of any such intervening folds will depend on
the size of the armboard flap and the degree of compactness
required in the finally folded drape. Too many folds, of
course, will undesirably add to the bulk of the folding
portions. Regardless of the number of intervening folds, if
there be any, the last fold given the armboard flap must be
a forward fold so that the armboard flap when folded, overlies ~-
the upper surface of armboard cover 110'. When this part of
the folding sequence is completed, the armboard flap lies in
its folded position on the upper surface of armboard cover
110 in the relationship shown in Fig. 20
The next step in the folding sequence is to fold
20 armboard cover 110', with its now overlying armboard flap 120',
transversely of the drape. This may be accomplished with any
number of folds starting from outer edge 112' but the last
fold must be a forward fold so that armboard cover 120', when
folded, overlies the upper surface of wing 30. Preferably,
armboard cover 110' is forward folded, without any other folds,
around fold line 3F' which coincides vertically with side edge
16 of sheet 11. When this step is completed, the armboard flap
and armboard cover are in a folded position overlying the upper `
- surface of wing 30 as may be seen in the left hand portion of -~ ~
30 Fig. 21. ;
Armboard flap 120 and armboard cover 110 are -then
folded, in the same fashion as just described for armboard
~ ; '
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~L~3612~L~
flap 120' and armboard cover 110', to overlie the upper ;
surface of wing 20 At this particular s-tage in the folding
sequence, the drape will have assumed -the configuration -
illustrated in Fig. 21.
The longitudinal folding of drape 100, in the
configuration shown in Fig. 21, is continued by folding each `
wing a plurality of times toward the center of the drape.
A portion 130 of wing 20 (with armboard cover 110
and armboard flap 120 folded thereover) adjacent the upper
lQ edge of the drape is forvard folded around fold line 4F The
wing is then reverse folded around fold line 5R, forward folded
around fold line 6F, and reverse folded around fold line 7R
The first fold in folding win~ 20, i.e., the folding of portion
130 around fold line 4F, must be a forward fold, and the last
fold in folding the wing, that is, the fold around fold line .
8F, must be a forward fold. Thus, when folded, wing 20 lies
on the upper surface of a generally central portion 135 of the
drape. Although three folds, a reverse fold (5R), a forward
fold (6F) and a reverse fold (7R) are illustrated in Fig 21, ,
20 it will be ~Tnderstood that the number of folds given wing 20 -
intermediate the first and last fold may vary, if the size of `~
the drape, for example, should so require.
Wing 30, with its armboard cover 110' and armboard
flap 120' in their aforementioned folded position, is subse-
quently folded in the same way just described for wing 20 with
its overlying armboard and armboard cover.
The wings, when their folding has been completed,
overlie the upper surface of a generally central portion 135
of the drape lying between fold]ines 8F and 12F Also it
will be noticed that the enlarged fenestration ~0 preferably
lies entirely within portion 13L~ of the drape. As seen in
Fig 21, the fenestration lies between that central portion
,
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~ 2 1~
of the drape between the last fold line (i e., fold line 8F)
and the next to the last fold line (i.e., fold line 7R) used
in folding the wing portions of the drape. The wing portions
may be folded along a line that runs transversely through
fenestration 50, but this is disadvantageous to the extent
that the material at either side of the fenestration will be
creased. ;
The longitudinal folding of the drape is comple-ted
by folding part of main portion 12 a plurality of times toward
the center of the drape. A portion 139 adjacent the bo-ttom
edge of main portion 12 of the drape is reverse folded around
fold line 9R; the main portion is then forward folded around
fold line loF, reverse folded around fold line llR, and forward
folded around fold line 12F. The number of folds used for the `~
main portion may vary, but the last fold must be a forward fold
so that the folded part of the main portion overlies the same --
central portion 135 as do the folded wings. Drape 100, when
thus folded, assumes the general configuration shown for drape
10 in Fig 12, In the preferred folding sequence, the folded ;~
20 part of the main portion of the drape overlies the folded wing
portions and central portion 135 of the drape.
The size of the various longitudinal portions 130-
139 of the drape will vary according to the length of -the
drape and according -to the number of folds that are made.
In the preferred embodiment under discussion, portion 135 (that -
portion of the drape on top of which the folded wings and the
folded main portion will lie) has the longest length (i.e.,
vertical dimension in Fig. 21), The lengths of portions 131,
132, 133, 134, 136, 137 and 138 are roughly equivalent to
` 30 each other and are somewhat, e.g., a half inch, less than
the length of portion 135. Portions 130 and 139 at either
end of the drape are abowt 1/4 the length of portion 131-134
and 136-138.
; 24
',' :
1~6~2~
After T-shaped drape 100 has been folded longitudinally
in the manner just described, it may be folded transversely,
from each side toward the center, using the modified fan fold-
ing described earlier herein for drape 10 This provides a
compactly folded drape which can be conveniently packaged e.g.,
in a paper bag. The packaged drape may be sterilized according
to well known techniques.
In applying drape 100 to a patient about to undergo
knee surgery, the procedure described herein for the appli-
cation of drape 10 (illustrated in Figs. 13-17) is used. After
main portion 12, wing 30, flap-like sheet 40, and wing 20 have
been unfolded and secured in place in the manner already des~
cribed for drape 10, armboard covers 110 and 110' are unfolded
outwardly to cover the armboards on the operating table.
Thereafter armboard flaps 120 and 120' are unfolded to lie in
their vertically downward position. Side portions 16a and 17a
are then free to fall over the sides of the operating table in
their vertically donward position.
It will be understood and recognized by those skilled
in the art that the folding sequence described above for drape
100 need not be limited to that specific drape, but can be used
for various kinds of generally T-shaped drapes.
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