EP0086834A1

EP0086834A1 - Surgical scrubbing device

Info

Publication number: EP0086834A1
Application number: EP82902931A
Authority: EP
Inventors: Nolan C. Rucker; Robert A. Taylor
Original assignee: FLUCO
Current assignee: FLUCO
Priority date: 1981-08-24
Filing date: 1982-08-12
Publication date: 1983-08-31
Also published as: EP0086834A4; WO1983000645A1; JPS58501311A

Abstract

Dispositif (10) et procédé permettant le nettoyage des mains et des avant-bras à partir d'une seule source de fluide de nettoyage sous pression comprenant au moins deux chambres (60) de volumes sensiblement différents servant à recevoir et à distribuer au travers d'une pluralité d'ouvertures orientées radialement et longitudinalement (66) un fluide de nettoyage et facultativement de l'air chauffé pour nettoyer efficacement une main et un avant-bras en définissant une zone (20), (21) pour l'insertion de la main et de l'avant-bras dans la zone de distribution du fluide de nettoyage.Device (10) and method for cleaning the hands and forearms from a single source of pressurized cleaning fluid comprising at least two chambers (60) of substantially different volumes used to receive and distribute through '' a plurality of radially and longitudinally oriented openings (66) a cleaning fluid and optionally heated air to effectively clean a hand and forearm by defining an area (20), (21) for the insertion of hand and forearm in the cleaning fluid distribution area.

Description

SURGICAL SCRUBBING DEVICE

This invention relates to the field of cleansing hands and forearms and more particularly to scrubbing devices which employ jets of pressurized cleansing fluids. The problem of providing a scrubbing device that can successfully eliminate the problems associated with manual scrubbing and in particular the frequent and time consuming manual preoperative scrubbing by surgeons and the members of a surgical team has been addressed by several prior patents.

Exemplary of these are the U.S. Patents to S. N.

Bhas ar et al., No. 3,757,806 issued September 11,

1973; Davis, No. 3,699,934 issued October 24, 1972 and

Kopfer, No. 3,918,987 issued November 11, 1975. These devices variously employed either a lavage fluid under constant pressure or pulsating in a manner so that the fluid will impinge on the arms and hands of the surgeon. None of these devices achieved commercial acceptance as a substitute for the manual preoperative scrubbing procedure traditionally employed by operating room personnel. Specifically, the elimination of the need for manual scrubbing is desirable since it is time consuming, has little effect on the resident bacteria present in the follicles, skin depressions and under the fingernails and in addition is frequently irritating to the skin. The frequency, vigor and length of time for a manual brush scrub as well as the kinds of bacteriostatic soap and fluids used can all contribute to creating serious skin .irritation. It is therefore highly desirable that an apparatus and method be provided that will effectively remove resident bacteria, clean under the fingernails, and produce less skin irritation than manual scrubbing. In addition it

MPI should do all of the foregoing quickly since in emergency situations the time consumed in manual scrubbing may be critical for the patient. The provision of such a device should also find utility in other scrubbing applications where the same drawbacks to manual scrubbing persist such as in food handling, clean work environments such as, in the electronics industry, the medical supplies industry and the like. Particular utility can be found in any application where the presence of bacteria in the work environment is to be controlled such as in microbiological laboratories and the like.

It is therefore a primary objective of the present invention to provide an apparatus and method for quickly and effectively scrubbing the hands and forearms that will produce less skin irritation while substantially eliminating resident bacteria and is effective in cleansing under the edges of exposed fingernails. It is a further objective to provide the foregoing with an economically attractive device for surgical applications as well as others where quick, effective non-irritating scrubbing is desirable or essential.

It is a further object of the present invention to provide a portable self-contained closed system for a hand and forearm scrubbing device.

The above and further objects and advantages are achieved by the employment of a fluid lavage unit for hand and forearm scrubbing that incorporates at least one inclined sleeve, and preferably two, for receiving an inserted hand and forearm for cleansing, with each comprising an open end sized to receive the hand and forearm and a closed end, with the longitudinal portion of the sleeve comprising at least two concentric walls wherein the outer wall is fluid-tight and the inner wall is foraminous; and the space defined by -the two walls communicating with a source of cleansing fluid under pressure. The outer and inner walls -terminate in a fluid-tight manner at a closed end comprising a foraminous disc and an outer wall also defining therebetween a second closed space also in communication with a source of cleansing fluid under pressure.

The cleansing fluid is pumped into the first space defined by the longitudinal walls and separately into the chamber or second space at the closed end to provide two different pressure sprays onto the forearm and ends of the fingers from the same fluid source. The invention will now be described by way of example, with reference to the accompanying drawings, in which:

Fig. 1 is a perspective view of the scrubber of the present invention with the enclosure partially broken away to show some details of the sleeves inside.

Fig. 2 is a perspective view, partially broken away to show the double walled construction of a sleeve and its end plate. Fig. 3 is an end view of the sleeve from the right hand end of Fig. 2.

Fig. 4 is a cross-sectional view of the end of the sleeve- taken along the lines and arrows 4-4 of Fig. 3. Fig. 5 is a cross-sectional view, of the entire end of the sleeve from the inside of the sleeve taken generally along the lines and arrows 5-5 of Fig. 4.

Fig. 6 is a schematic of all of the components for operation of the scrubber system of the present invention. The scrubber 10 in Fig. 1 consists of a base 11, an elevator support 12 and a cabinet 13. The cabinet 13 is shown with a transparent front panel 14 having a hinge 15 and a return cylinder 16. Disposed in the cabinet 13 are a pair of sleeves 20 and 21 with closed ends 22 and 23 and open ends 24 and 25, respectively, terminating a predetermined distance back of the access holes 26 and 27 formed in the front of the cabinet 13 by the intersection of the cover 14 and the base of the o cabinet (not numbered) .

Manifold 30 at the rear of cabinet 23 connects a fluid pump (not shown) and a source of fluid to the sleeves 20 and 21 and closed sleeve ends 22 and 23 through conduits shown generally as 31. A drain pan 32 with a depressed central hole is provided for draining the fluid that runs out of the front sleeve ends 24 and 25 due to the sleeves being slightly inclined, preferably -about 15° (degrees) upward from the horizontal from the front to the rear of the cabinet 13. The sleeve supports within the cabinet are not shown. Ideally, the elevator support 12 can be foot switch actuated to accommodate users of differing height for comfortable insertion of their hands and forearms into the sleeves 20 and 21 through access holes 26 and 2?. on the front of cabinet 13.

In addition the access holes 26 and 27 in cabinet 23 may optionally be provided with segmented pneumatically inflatable annular cuffs which can be controllably inflated to engage the μpper forearm of the user of the device throughout the scrubbing operation to help prevent cleansing fluid from getting to the outside of the cabinet by running down the forearm of the user. The inflatable cuff or guard can of course be designed and constructed in any manner that will accomplish the foregoing objective. One suitable way would be to provide at least three abutting annular segments which when inflated would gently engage the forearm while providing an essentially water-tight seal at the front of cabinet 23 in a manner such that excess fluid from the sleeve and forearms would fall into the drain pan 32 by virtue of the space between the cuffs

10 on the front panel of the cabinet and the edges of the open ends 24 and 25 of sleeves 20 and 21 respectively. Appropriate controls for controlling a source of inflating fluid to the cuffs would then be provided as part of the overall system control as shown ■_jc schematically in Fig. 6.

Referring to Fig. 2 a sleeve 20 is shown with an outer wall 40 and a concentric inner wall 41 with fluid communication into the space between the walls being provided by conduits 31 terminating into a connector 32 0 through the outer wall 40 of sleeve 20. Open end cap 24 is ring-shaped with a hole communicating with the interior of sleeve 20 into the space surrounded circumferentially by the foraminous inner wall 41. Closed end cap 22 is shown with its holes communicating 5 with the area surrounded by inner wall 41 and shows some of the detail for sealing the space between the walls 40 and 41 that is present on both end pieces 24 and 22. Two concentric grooves 44 and 45 are cut in the end caps 22 and 24 to receive the ends of sleeves 0 40 and 41. Additional water proof packing may be received in the grooves to insure a fluid-tight seal and the end caps are pulled tight onto the sleeve by the threaded rod fasteners shown generally as 50 which fasteners are received in holes spaced 5 circumferentially around the end caps at locations on a flange portion of the end caps outside of the outer sleeve 40.

Referring to Figs. 3, 4 and 5 the detail of the closed end 22 of the sleeve 20 is shown with the threaded rod fasteners 50 pulling the concentric outer wall 40 and inner wall 41 into fluid-tight engagement with the grooves 44 and packing material or 0-ring 45. The plenum 60 created by a recess cut in end 22 and covered with end cap 65 communicates with a source of fluid under pressure from conduit 31 received through the exterior of end cap 65. Conduit 31 can be threadably received or affixed in any manner which will provide a fluid-tight seal under the pressures employed. The plenum 60 also communicates with the interior of the sleeve 20 through holes 66. The end cap 65 can be affixed by adhesive or any water-tight mechanical fastening scheme to the end 20 to completely seal the plenum 60 so that fluid under pressure from conduit 31^*will fill the plenum 60 and exit only to the interior of the sleeve 20 through the holes 66.

Considerable adjustment can be made in constructing the scrubber of the -present invention including the use of other structure, adhesives or the like, for fastening together any of the components. It is also possible and may even be desirable under the pressures employed to vary the pattern of holes and the sizes of the holes in both the end 20 and the inner wall 41. Likewise the plenum and hoses can be_# used alternately as conduits for heated air if desired to perform a drying function after the cleansing cycle.

The optimum preferred sizes and locations for the holes if placed other than as shown herein should be selected in combination with the capacity of the fluid pump to provide between about 20 and 80 pounds per square inch of pressure and preferably around 40-60 pounds per square inch and most preferably about 50 pounds per square inch to the space between the walls 40 and 41 and to the plenum in the closed end.

Constructed in this manner with the sleeve inclined between 5° and 25° upward from the open end of the sleeve to the closed end, the apparatus is capable of achieving the desired cleansing function in from 90 to 180 seconds after actuation of the pump.

The successful achievement of quick effective presurgical cleansing without manual scrubbing achieved by the present invention which eluded the prior workers in this field is in part believed to be due to the provision of two separate fluid plenums or spaces.

Each of these manifolds is capable of being constructed with changes in hole size and number and overall volume in the space to provide for a predetermined pressure drop and therefore can be constructed in combination with the pump selected to each provide a different volume of fluid and resultant spray pressure for accomplishing the separate tasks required for effective cleansing. The larger manifold around the foraminous wall of the sleeve will by virtue of the greater number of holes in the foraminous wall provide a larger amount of fluid at a lower resultant spray pressure than the spray pressure from the holes communicating with the fluid in the small end manifold. The cleansing of the fingers, under the fingernails, etc.,, is therefore enhanced by selection or control of a pressure from the end manifold that is larger than the delivery pressure from the sprays delivered generally radially of the sleeve even though the pressure to these plenums are identical which pressure is sufficient to provide a uniform debride ent of the hands and under the nails while the lesser pressure and/or greater volume of fluid delivered radially provides the proper cleansing of the surface of forearms, the palms and back of the

5 hands. The provision of the ability in a predetermined way to separately control spray pressure and fluid volume from a single source of fluid under pressure optimally accomplishes the desired cleansing result without excessive debridement and the resultant

10 irritation. Further the provision of the separate manifolds for dispensing cleansing fluids accomplishes the requisite irritation-free cleansing in a substantially shorter period of time than is required for manual scrubbing with observably better cleansing

15 of the skin recesses and hair follicles resulting in substantially lower residual bacteria on the skin after cleansing with the apparatus described herein.

In operation, the scrubber apparatus and system (see Fig. 6) of the present invention can be utilized

20 in a closed cycle system for emergency or field use such as in military field hospitals. Likewise, it can be used in a typical presurgical scrub room. Hot and cold water connections to a mixer for dispensing water at a predetermined temperature can be provided and then

25 stored prior to use or mixed with a predetermined amount of cleansing or disinfecting or other bacteriostatic solution and the concentration of the mixture monitored if desired. The mixture of even plain or filtered water can then be delivered to the

30 plenums, open spaces or manifolds of the sleeve by a pump as shown, at a predetermined pressure and volume delivery rate. Optionally, the fluid can be heated and checked for the proper pressure and the like with appropriate controls for efficient operation.

*-^»5 Likewise, the delivery of the fluid from the pump can

be initiated in a wide variety of ways but typically, it is started with the insertion of the hands and forearms into the sleeves by appropriate sensors or directly through controls which provide a slight delay ^■-* for the convenience of the user. If a closed system is contemplated, minor additional plumbing and controls would be necessary as shown for recirculating the fluid back to the storage tank for rejuvenation of the solution mixture before reuse. Otherwise, the waste ⁰ from the sleeve can be discharged to a drain or other means of disposal.

Many of the commercially available Anti .Septic solutions can be employed effectively with the present system and available filters can be employed to provide 5 for their reuse. For example the following solutions can be employed alone or in combination or in a predetermined solution:

Benzethonium (Tradename V-Tergent 8x) - Pitman-Moore, Inc., Washington Crossing, NJ 08560 CHLORHEXIDINE (Tradename Nolvasau Surgical Scrub) - Fort Dodge Laboratories, Fort Dodge, IA 50501 (Virosan solution) Aio-Ceutic Laboratories, St. Joseph, MO 64502

Hexachlorsphene (pHisohex) Wiuthrop Laboratories, New York, NY 10016

Alcohol, ethyl or isopropyl, 70% w/w Povidone Iodine (Betadine Solution) - The Purdue Frederick Company, Newark, CT 06856. It is also possible to use water alone in either of the system configurations with surprisingly effective results•

Claims

WHAT IS CLAIMED IS:

1. An apparatus for effectively cleansing hands and forearms characterized by an enclosure (13) having at least, one opening (26, 27) on one side thereof for receiving horizontally therethrough an inserted hand and forearm; and at least one elongate sleeve (20, 21) in said enclosure having an open end and closed end with said open end positioned adjacent said opening in said enclosure; said sleeve sized both circumferentially and longitudinally to be capable of receiving a hand and forearm therein; and means (31, 32) for delivering cleansing fluid under pressure to said sleeve; said sleeve having a fluid-tight outer wall (40) and a foraminous inner wall (41) defining therebetween a first open space communicating with said fluid delivery means; the fluid pressure of said fluid delivery means and the size of the holes in said foraminous inner wall being preselected to respectively provide a sufficient fluid spray in the interior of the sleeve in the space defined by said inner wall to effectively cleanse the outer surfaces of an inserted hand and forearm positioned in said interior space during delivery of cleansing fluid; said sleeve having at the closed end thereof a fluid-tight outer wall (65) and a foraminous inner wall (22) defining therebetween a second and smaller open space (60) than the first said space communicating with said fluid delivery means whereby delivery of fluid at a predetermined pressure to said first open space sufficient to effectively cleanse the outer surfaces of a hand and forearm inserted into said sleeve simultaneously provides effective cleansing of the fingers and under the exposed edges of the^* fingernails when the hand is inserted, in the sleeve with the fingers extended and positioned adjacent to said foraminous inner wall of the closed end of said sleeve.

2. The cleansing apparatus of Claim 1 characterized in that said elongated sleeve is inclined upward from the horizontal from said open end to said closed end.

3. The cleansing apparatus of Claim 2 characterized in that said fluid delivery means comprises; means for fluid storage; and means for pumping fluid from said fluid storage means to said first and second open spaces in said sleeve.

4. The cleansing apparatus of Claim 3 characterized in that said fluid delivery means^' includes means for returning fluid delivered to said first and second open spaces in said sleeve after use to said fluid storage means for reuse.

5. A method of cleansing forearms and hands characterized by: spraying the hands and forearm with a fluid under pressure at a locus and in a manner to provide a first spray at a first predetermined pressure impinging generally radially in all directions toward the extended forearm and hand; and the provide a second spray generally toward the extended hand parallel to the plane_of extension at a higher pressure than said first spray.

6. The method of Claim 5 characterized in that the fluid sprayed includes water.*

7. The method of Claim 6 characterized in that the fluid sprayed includes a bacteriostatic agent.

8. The method of Claim 6 characterized in that the fluid sprayed includes a germicidai agent.

9. The method of Claim 6 characterized in-that the fluid sprayed includes a sanitizing agent.

10. The method of Claim 6 characterized in that the fluid sprayed includes fluid previously sprayed.