US 3648291 A
A garment for protecting an elbow or other protuberance of a bedridden patient includes sleeve for encompassing such protuberance. The sleeve is made from a cloth having a relatively low coefficient of friction with respect to sheets and other bedclothes and employing a nonabsorbent monofilament fiber such as nylon. The sleeve has a stretchability at least in direction transverse of the axis of the sleeve. A nonslip cushion constituted as a sheet of foam rubber is adhered to the interior of the sleeve to provide a protuberance-covering pressure-bearing portion constituted as a laminate of foam rubber sheeting directly in contact with the flesh and covered by the cloth layer, this portion being devoid of any seams or other obstructions which can cause localized pressure on the flesh at the pressure-bearing portions of the protuberance. A casing in the end of each sleeve completely covers an elastic cord. Together they tend to prevent the sleeve from rolling up and they act to stabilize the garment to maintain the cushion in contact with the pressure bearing portion of the flesh adjacent the protected protuberance.
Description (OCR text may contain errors)
United States Patent Pankers  PROTECTIVE GARMENT FOR BEDRIDDEN PEOPLE  Inventor: Alva L. Pankers, Bloomington, Minn.
 Assignee: William A. Braddock, Minneapolis, Minn.
 Filed: July 6, 1970  App1.No.: 52,570
 US. Cl ..2/l6, 128/149, 128/165, 2/22  Int. Cl. ..'..A4ld 13/08  Field of Search ..2/16, 22, 24, 240; 128/165, 128/166, 149, 153
[561 References Cited UNlTED STATES PATENTS 3,322,118 5/1967 Sotherlin ..2/16 X 2,130,552 9/1938 Kuhn ..2/240 1,081,245 12/1913 McCall ..2/24 2,140,598 12/1938 Rhorer ..2/24 X 2,431,287 1 H1967 Washington 2/24 UX 2,552,177 5/1951 Hurt ..2/24 3,458,867 8/1969 Moore et al. ....2/16 3,508,544 4/1970 Moore et al ..2/24 X Primary Examiner-James R. Boler Attorney-Burd, Braddock 8L Bartz  ABSTRACT A garment for protecting an elbow or other protuberance of a bedridden patient includes sleeve for encompassing such protuberance. The sleeve is made from a cloth having a rela' tively low coefficient of friction with respect to sheets and other bedclothes and employing a nonabsorbent monofilament fiber such as nylon. The sleeve has a stretchability at least in direction transverse of the axis of the sleeve, A nonslip cushion constituted as a sheet of foam rubber is adhered to the interior of the sleeve to provide a protuberance-covering pressure-bearing portion constituted as a laminate of foam rubber sheeting directly in contact with the flesh and covered by the cloth layer, this portion being devoid of any seams or other obstructions which can cause localized pressure on the flesh at the pressure-bearing portions of the protuberance. A casing in the end of each sleeve completely covers an elastic cord. Together they tend to prevent the sleeve from rolling up and they act to stabilize the garment to maintain the cushion in contact with the pressure bearing portion of the flesh adjacent the protected protuberance.
8 Claims, 6 Drawing Figures PROTECTIVE GARMENT FOR BEDRIDDEN PEOPLE BACKGROUND OF THE INVENTION A continuing problem in the care of bedridden patients involves the pain and discomfort and the breakdown of tissue which develops in the pressure-bearing portions of flesh surrounding the various protuberances of the body. Specifically, the flesh around the bony protuberances of the elbows, knees, and the heels are subject to this kind of damage. Causes include breakdown of tissue due to constriction of capillary flow within the flesh, the pinching and abrading of nerves in the same area, and the abrasion initially on the skin and, as this wears away, on subcutaneous layers due to movement over the sheets and other bedclothes.
For many years it has been known that some relief can be obtained for the heels and the toes of the foot by providing a footboard along the bottom of the bed and draping the bedclothes over that footboard thus to keep the weight of the bedclothes off of the feet, minimizing the direct pressure on the toes, for example, while limiting the pressure which must be carried by the heel to the weight of the foot.
Various garments and wrappings have been suggested for further alleviating this problem, but each has been subject to one or more objections. Specifically, U.S. Pat. No. 3,322,118 to Sotherlin discloses a device for projecting the elbow or heel of a bedridden patient, but discloses elastic cuffs of substantial longitudinal dimension which are supposed to be for the purpose of preventing the device from moving out of proper alignment with the part to be protected. In order to get sufficient nonslip action, these cuffs have a substantial width and are fairly tight on the arm. This wide band of pressure causes many capillaries to be cut 05. Thus the flesh underneath these cuffs has been found to be subject to the same kind of discomfort and pain, if not damage, which the device is intended to alleviate. Furthermore, these cuffs have been found to roll up along the edge, thus causing even more constriction to the circulation clear around the limb, and thus more pain and discomfort.
The prior art shows cushions positioned in cloth envelopes; but this placement of cloth between the cushion and the arm prevents the cushion from clinging to the flesh to deter relative movement of the cushion and flesh. Thus the device of Sotherlin is subject to the objection that this slides easily from its intended position and off of the protuberance which is designed to protect.
Other devices in which a seam is situated in line with the area of the protuberance subject to the damage are objectionable because the localized pressure of such seams induces the discomfort and pain and ultimately the damage the garment is designed to eliminate.
SUMMARY OF THE INVENTION Protective garments of the present invention have been designed to overcome the difiiculties in the prior art and to inhibit or completely prevent tissue breakdown due to prolonged interruption of circulation through the capillaries in the pressure-bearing flesh between the protuberance and the bed on which the patient is resting.
In a protective garment made according to the present invention as shown, a cloth sleeve made from monofilament, hard-surface nonabsorbent fiber is provided with a protuberance-covering, presure-bearing area which is completely devoid of seams or other obstructions, and this area is covered with a cushioning sheeting of expanded foam material or the like which, over the same area, is also devoid of seams, folds or other obstructions. The expanded foam material is adhered to the cloth material on the inside of the sleeve so that the foam cushion comes in direct contact with the flesh over the protuberance to be protected. The cushion has a high coefficient of friction with respect to this flesh and thus will lie in nonskid" relationship to such flesh, to tend to prevent relative movement there between.
The cloth sleeve is provided with a continuous casing around each of outer end portions thereof, and an elastic cord is situated inside of each such casing, the casing and cord being of dimension to make a single line contact with the limb at positions on either side of the protected protuberance and to be held smoothly and snugly against the flesh of the patient at such positions. Because of the nonskid relationship between the foam cushion and the flesh over the protuberance, the tendency of the garment to slide with respect to the protuberances is substantially lessened, but as the joint is flexed, the line contact between the casing and elastic cord and the flesh will tend to move, from time to time, thus permitting circulation through capillaries immediately adjacent the cord, to the end that the flesh 'does not tend to break down as is the case when a wide band of elastic blocking circulation in many capillaries was employed. Use of nylon or similar cloth which tends to cling to the limb also help keep the garment in position.
The cloth of the garment is stretchable in direction transverse of the longitudinal axis of the sleeve so that flexure of the joint which is related to the protuberance will not in and of itself put pressure of the garment on the flesh.
By positioning the soft cushion in nonslip relationship over the protuberance, and by providing a hard surface cloth on the outside thereof, the friction between the protuberance and the bedclothes is reduced, and the friction-generating relative movement takes place between this cloth and the bedclothes rather than between the flesh over the protuberance and the garment or bedclothes.
BRIEF DESCRIPTION OF THE DRAWING FIG. 1 is a side-elevational view of the foot of a bedridden patient resting with the heel on the bedclothes and showing a first form of the invention in position on said foot;
FIG. 2 is a perspective view of the protective garment of FIG. 1;
FIG. 3 is a bottom plan view of the protective garment of FIGS. 1 and 2;
FIG. 4 is an enlarged sectional view of the garment of the first three figures taken as on the line 4-4 in FIG. 3;
FIG. 5 is a perspective view of a protective garment of the invention designed to go on an elbow or knee; and
FIG. 6 is an enlarged sectional view of the garment of FIG. 5 taken as on the line 6-6 in that figure.
DESCRIPTION OF PREFERRED EMBODIMENTS As seen in the first four figures, a protective garment 9 for protecting the heel of a bedridden patient includes a continuous hollow sleeve 10 made from a piece of nonabsorbent, hard surface clot 11, made from a monofilament fiber such as nylon. Longitudinal edges of this cloth have been sewn together at the longitudinal seam 12 to form the sleeve I0, and darts l3 and 14 have been taken in top portions of the sleeve in order to shape it to better fit over the foot and ankle on either side of the heel. Castings 15, 15 are formed by turning under opposite end portions of the sleeve 10, and each such casing encompasses an elastic cord 16 which will have sufficient resiliency to snugly hold the casing in place adjacent the heel as best seen in FIG. 1. It is to be noted that the contact on the flesh of the foot and ankle is virtually a line contact. It is to be understood that the force holding the casings 15, I5 and hence the ends of the sleeve in place is light enough so that there'will be some shifting of this line contact as the patient moves in bed, thus restricting circulation permanently to no portion of the flesh.
of the heel on the bedclothes will always fall within that portion. it is to be noted that this portion is constituted as a laminate of the nylon cloth 11 and the foam rubber sheeting l7 and that this entire area is devoid of any seams or other obstructions which can cause localized pressure on or around the flesh of the heel.
Referring now to FIGS. and 6, a protective garment 29 for protecting the elbow or knee of a bedridden patient will consist of a continuous hollow sleeve 30 made from a hard surface cloth 31. A longitudinal seam 32 joining longitudinal edges of the cloth 31 makes the sleeve continuous, and a pair of casings 35, 35 each enclose an elastic cord 36. Foam rubber sheeting 37 is stitched as at 38 to the inside of the hollow sleeve 30 to form a protuberance-covering, pressure-bearing portion 39.
To put either of the garments in use, it will be slid over the end of the limb to be protected and the flesh between the bony protuberance of the heel, elbow or knee, will be situated in contact with the foam rubber cushion. The properties of this expanded foam sheeting material are such that there is a high coefficient of friction between the flesh and the sheeting material, thus virtually assuring that the garment will not become displaced and thereby assuring that the cushioning effect of this sheeting material on the flesh between the protuberance and the bedclothes will not be disturbed. This positioning is aided by the gentle but snug holding of the elastic cord and easing against portions of the limb on either side of the protuberance, and by the clinging qualities of the nylon cloth, for example. Since there is only a line of contact at the casings, any capillary vessel which might possibly be cut off by the pressure of the casing and its elastic cord will only be cut off at one point, and the other capillaries will sufficiently nourish the flesh in that general vicinity so that breakdown of the flesh will not occur. Also, since this line of contact does tend to move as the patient moves in bed and as the casing moves correspondingly over the limb, the closed off capillary will be allowed to open, and blood will flow therein even though an adjacent capillary may then be closed off due to the action of the casing and cord.
Although nylon cloth has been mentioned throughout the specification to this point, it is to be understood that any cloth which will tend to cling to the limb and/or which has a hard, low friction surface can be employed to make gan'nents of the invention. While, for the purposes of shading, diagonal lines to represent woven cloth have been used, it is to be understood that the cloth will be sewed into the sleeve in such a manner that a substantial ability to stretch will be afforded the garment in direction transverse of the longitudinal axis of the sleeve as seen in FIGS. 4 and 6, for example.
Because pain and discomfort afforded bedridden patients arises from the abrasion and/or pinching of nerves for an extended period on a localized area and from the destruction of tissues due to lack of circulation in localized areas, the provision for all of the friction of movement to take place between the cloth and the bedclothes (on the other side of the foam rubber sheeting from the flesh) and the provision that there are no seams to cause localized pressure to be put through the foam rubber sheeting onto the flesh adjacent the protuberance effectively eliminates such pain, discomfort and/or breakdown of tissue.
While the foam rubber sheeting is illustrated and described as being stitched to the cloth, it is to be understood that there are other effective ways of adhering the sheeting to the cloth and that these will be satisfactory as long as the pressure-bearing portion is maintained devoid of obstructions which can cause localized pressure to be transmitted through the garment to the flesh adjacent the protected protuberance.
The embodiment of the invention in which an exclusive property or privilege is claimed are defined as follows:
1. A garment to protect the flesh adjacent a bony protuberance of a limb of a bedridden patient, said garment including a hollow sleeve of flexible, hard surface cloth having a relatively low coefficient of friction with respect to bed clothes, a
smooth resilient flesh contacting cushion sheet having a relatively high coefficient of friction with respect to flesh, said sheet being adhered to an interior surface of a portion of said sleeve to provide a laminate, protuberance-covering, pressure-bearing garment portion devoid of obstruction, at least one casing at an end portion of said sleeve, and an elastic cord in said casing tensioning said casing to tend to hold said end portion snugly in contact with portions of the limb of such patient adjacent said protuberance when said cushion is in contact with the flesh adjacent the protuberance.
2. The combination of claim 1 wherein said casing and cord make substantially only a line of contact with the flesh around the limb.
3. The combination of claim 2 wherein the elastic causes such tensioning of the casing against the flesh that the casing will tend to be easily displaced due to movement of the patient in bed, and wherein the cushion will have a sufficiently high coefficient of friction with respect to the flesh to tend to strongly resist movement with respect thereto due to movement of the patient in bed.
4. The combination of claim 1 wherein the cloth sleeve is further characterized as having a tendency to cling to a limb around which said sleeve is positioned.
5. The combination of claim 4 wherein said cushion is made of an expanded foam material.
6. The combination of claim 5 wherein said cloth is made from a monofilament nylon fiber.
7. The combination of claim 2 wherein the casing completely encompasses the cord and wherein the cord is formed as a continuous loop inside the casing.
8. The combination of claim 1 wherein the cloth of said sleeve is made up of nonabsorbent material.