US3831593A

US3831593A - Therapeutic tub for the treatment of burned patients

Info

Publication number: US3831593A
Application number: US00378863A
Authority: US
Inventors: J Ochoa
Original assignee: Individual
Current assignee: Individual
Priority date: 1972-07-14
Filing date: 1973-07-13
Publication date: 1974-08-27
Anticipated expiration: 1991-08-27

Abstract

An improved therapeutic tub for the treatment of burned patients comprises a container having a shape suitable to maintain a patient submerged in a leaned positioned thereinto, an isotonic or hypertonic liquid medium in said container, recycling means connected to said container to recycle said liquid medium, filtering and purifying means connected to said recycling means, uretral and rectal probe means to continuously carry human fluids and defecations outside of said container, thermostat means to maintain the temperature of said liquid medium at a constant level, percolating means at the discharge holes of the container to avoid passage of fragments released from the wounds, head support means and body support means within said container, said body support means having a small contact area to avoid injuries to the body of the patient, irrigation nozzle means to irrigate difficulty accessible areas of the body of the patient, and removable cover means on the top of the container to isolate the nude body of the patient from the environment. The liquid medium in said container, when hypertonic, can also contain medicaments to be absorbed by osmosis through the skin of the patient.

Description

United States Patent [191 Ochoa [1111 3,831,593 [451 Aug. 27, 1974 THERAPEUTIC TUB FOR THE TREATMENT OF BURNED PATIENTS [76] Inventor: Jose Corona Ochoa, Bezares 40,

Mexico City, Mexico [22] Filed: July 13, 1973 [21] Appl. No.: 378,863

[30] Foreign Application Priority Data July 14, 1972 Mexico 137020 [52] US. Cl. 128/66, 128/369 [51] lint. Cl A6lh 9/00 [58] Field of Search 128/65, 66, 369, 370, 373; 4/178 [56] References Cited UNITED STATES PATENTS l,059,3l4 4/l9l3 Petter 128/369 1,943,888 l/l934 Ewald 128/369 3,366,110 l/l968 Gaylord 128/369 X 3,776,223 12/1973 Yeager et al. 128/66 Primary Examiner-Lawrence W. Trapp Attorney, Agent, or Firm-Sughrue, Rothwell, Mion, Zinn & Macpeak ABSTRACT An improved therapeutic tub for the treatment of burned patients comprises a container having a shape suitable to maintain a patient submerged in a leaned positioned thereinto, an isotonic or hypertonic liquid medium in said container, recycling means connected to said container to recycle said liquid medium, filtering and purifying means connected to said recycling means, uretral and rectal probe means to continuously carry human fluids and defecations outside of said container, thermostat means to maintain the temperature of said liquid medium at a constant level, percolating means at the discharge holes of the container to avoid passage of fragments released from the wounds, head support means and body support means within said container, said body support means having a small contact area to avoid injuries to the body of the patient, irrigation nozzle means to irrigate difiiculty accessible areas of the body of the patient, and removable cover means on the top of the container to isolate the nude body of the patient from the environment.

The liquid medium in said container, when hypertonic, can also contain medicaments to be absorbed by osmosis through the skin of the patient.

10 Claims, 4 Drawing Figures PATENTED AUG 2 71974 sum 1 a; 3

PATENTED 2 3.831593 sum 2 W 3 illlllllilllli BACKGROUND OF THE INVENTION The present invention refers in general to a therapeutic tub for the treatment of patients seriously burned such as by fire, boiling liquids, freezing or chemical agents and, more particularly, it is related to a therapeutic tub containing a suitable isotonic or hypertonic liquid medium which permits total and permanent immersion of the body of a patient to be treated generally by means of medicaments incorporated in said liquid medium or locally as prescribed by the physician.

The prior art therapeutic tubs for the treatment of burns in seriously injured patients are very inefficient devices which do not permit a permanent immersion of the body or of the injured areas of the patient both for relaxation and therapeutic purposes. Also, prior art therapeutic tubs do not provide for the local and direct irrigation of wounds nor do they provide for the continuous purification of the liquid medium to permit a permanent immersion of the burned patient thereinto, so that said prior art tubs have left much to desire and have not gained the favor of the physicians, who generally prefer to use traditional bandaging methods and external medication, with the consequent inconveniences to the patients due to adherence of the bandages and to frequent malformations in the skin and muscle tissue injured.

One of the best and most widely known therapeutic tubs for the treatment of burned patients is the socalled Hubbard tub, which represents an improvement over other prior art therapeutic tubs of this nature. The Hubbard tub, however, does not solve at all the very intricate problems faced by physicians when treating seriously burned patients, inasmuch as it is a tub which merely contains water at the body temperature and is provided with a stretcher and means to lift the same, whereby the patient laying on said stretcher can be lifted from outside the tub to then be lowered into the tub for a temporary immersion in the water bath, in which a turbulence is caused by means of an external pump or a suitable stirrer. The only therapeutic effect of the Hubbard tub is to soak the wounds to release the bandages previously applied, in line with traditional treatment methods, so as to expose the wounds, wash them, rub the same to release dead tissue and thus prepare said wounds for further periodical treatment. The residence time of the patient within the liquid in the Hubbard tub is not generally beyond to minutes each time, and then the patient is taken to the surgery room for applying the prescribed local treatment, such as sprays, ointments or medicinal solutions and protection of the wounds by bandages or any other protective means.

It can be thus seen thatthe prior art therapeutic tubs do not avoid the use of the traditional treatment methods and therefore do not avoid the normal inconveniences both to the patient and to the physician in charge of the treatment of said patient, because resource must be had to external local medication and to bandaging or other type of coverage of the wounds to avoid infection by air-entrained germs and the like. Also, with traditional procedures for treating burns, the said wounds are normally exposed to ambient air and dry up and tend to create symphysis and other malformations in the skin and muscle tissue of the patient,

with the cosequent necessity of having to periodically remove said tissues to force the proper healing thereof.

BRIEF SUMMARY OF THE INVENTION Having in mind the defects of the prior art therapeutic tubs, the present invention provides a therapeutic tub for the treatment of burnedpatients, which is of a very simple construction and avoids the above mentioned defects of the prior art tubs for the treatment of burns.

The present invention also provides a therapeutic tub of the above described character, which permits the permanent immersion of the body of the patient during the full time of treatment of the wounds, thus minimizing the possibility of infection, as well as pain and shock.

The present invention further provides a therapeutic tub of the above mentioned character, which prevents application of bandages and other types of protective devices directly applied to the wounds of the patient, whereby it also avoids the highly painful treatment for releasing said bandages or coverage.

The present invention also provides a therapeutic tub which minimizes the time of healing of the wounds by continuously eliminating the dead tissue from said wounds, while maintaining the same in a highly comfortable environment.

The invention further provides a therapeutic tub for the treatment of burned patients, in accordance with the above, which further provides for the comfortable support of said patient within the tub. I

The present invention more particularly provides a therapeutic tub for the treatment of burned patients, which provides for the recycling and purification of the liquid medium contained therein, as well as for the control of its temperature.

The present invention further provides a therapeutic tub of the above mentioned character, which provides for the profuse irrigation of difficulty accessible regions of the body of the patient.

The present invention additionally provides a therapeutic method-for the treatment of burned patients, which completely overcomes all the drawbacks of the prior art methods which use bandaging and external local medication for the wounds.

BRIEF DESCRIPTION OF THE DRAWINGS dance with the present invention, with its cover removed and showing the different connections of the piping circuits thereof;

FIG. 2 is a side elevational view of the tub built in accordance with the present invention, showing the disposition of its purifying means as well as the interconnections thereof;

FIG. 3 is an elevational view of the feet-end of the tub shown in the preceeding figures; and

FIG. 4 is a cross sectional elevational view taken along lines 4 4 of FIG. 1 and looking in the direction of the arrows.

DETAILED DESCRIPTION OF THE INVENTION Having now more particular reference to the drawings, there is shown a highly preferred embodiment of a therapeutic tub for the treatment of burned patients, which comprises a container 22, provided with an upper discharge opening or overflow opening 20 and a lower discharge opening or drainer 21, both covered by a suitable mesh to avoid passage of large particles therethrough. The container is also provided with a liquid inlet through a plurality of valves 19 which distribute a corresponding plurality of liquid streams along the sides of the container 22 for the purpose of providing for an efficient recycling of said liquid through the container 22. A direct irrigation hose or flexible pipe 15b is also provided at a suitable location inside the container 22, said hose 15b being provided with a suitable nozzle lc, said hose being made of a highly flexible plastic material to enable the physician to effect every possible movement with said irrigating hose b for the purpose of reaching every difficulty accessible region of the body of the patient. The container 22 is also provided with an uretral probe 28 which can be directly and permanently connected to the ureter of the patient in order to provide for the continuous elimination of urine and at the same time avoiding any possible contamination of the liquid medium in the tub. A rectal probe 27 is also provided for the proper continuous elimination of defecations. The uretral probe 28 is connected to the drainage or to a sampling flask by means of a pipe 24 whereas the rectal probe 27 is in turn connected to the drainage or to a sampling vessal 36 by means of a pipe 25.

The rectal probe 27 is also connected to a pipe 26 for the purpose of enabling the physician to inject liquid materials, either in the form of an enema into the intestine of the patient, or as a washing solution through the expelling pipe 25.

A support 29 for the head of the patient is provided at one end of container 22, in order to avoid undue immersion of the head when the patient is sleeping, said support 29 having the shape of a concave basket and being in turn supported from the walls of the container by means of suitable belts 29a which comprise a device such as a buckle to extend or retract the same for the purpose of accomodating the head of the patient in different positions within the tub. One or more transverse flexible straps are provided evenly distributed along the sides of the container, to provide for a comfortable support of the back of the patient with a very small area of contact with the skin of the patient, said straps being suitably padded to avoid painful pressure on the patient.

The tub of the present invention is also provided with a plurality of semi-rigid and disengageable arches 23 for the purpose of supporting a fabric or plastic cover to protect and cover the patient. The tub is also provided with four or more legs 34 supported on isolating bases 34a to place the tub at the proper height and position for manipulation purposes.

The therapeutic tub built in accordance with the present invention is provided with a plurality of piping circuits to effect the flow of liquid contained in the container 22 in different sequences so as to perform the various functions which the tub of the present invention is capable of carrying out.

As it can be clearly seen in FIGS. 1 and 2 of the drawings, the piping system of the tub of the present invention comprises a pump 1 to force the liquid medium through the several systems of the tub.

A purifying and filtering system is provided through pump 1, line 3, valve 3a, a filter having a relatively open mesh to pre-filter large particles and which is designated by the reference character 4, a fine mesh filter 5 capable of retaining all particles larger than 0.3 microns in order to provide full sterilization of the liquid medium, a temperature thermostatic control 6, capable of regulating the temperature of the liquid medium in order to maintain a proper temperature to provide comfort to the patient, a couple 7, a check valve 8, a cross 11 with one of its arms connected to check valve 8 and its opposite arm connected to a couple 7 and to another cross 14 which provides for the distribution of the liquid medium to the different circuits in the tub. Another arm of cross 11 is connected, through a valve 12, to a hopper 13 in which different types of medicaments in solution can be charged to be incorporated into the liquid medium which carries them toward the container 22. The purifying and filtering system described above is bypassed directly from pump 1 to cross 11, through a line 9 provided with a valve 9a, which line 9 is also connected to a valve 10 having a nozzle for engaging a hose or a flexible pipe of any desirable length to carry the liquid medium discharged from the tub to a drainage system if it is desired to empty the system when the treatment of the patient requires the change of the liquid medium.

From the distributing cross 14, several circulating circuits can be provided as it can be more clearly seen in FIG. 1 of the drawings. Thus, the liquid medium coming from the purifying and filtering system described above or coming from the bypass provided by line 9, can be sent through line 18 provided with a valve 18a, to the plurality of valves 19 which discharge the liquid medium through the side walls of the container 22, into said container. The valves 19 can be opened or closed to a degree suitable for providing the circulating pattern desired for the treatment of the wounds of the patient, depending on the areas where a more vigorous turbulence is required, and from the container 22, the liquid medium is discharged through both drainers 20 and 21 to be carried by

lines

20a and 21a, through

suitable fittings

7 and 8, through a return line 33 leading to pump 1. The line 21a communicates,-through a cross 31, with a valve 32 which can be connected to a nearby drainage system to drain the tub as desired.

The distributing cross 14 can also send the liquid medium, through line 16 and valve 16a, bypassing the container 22, directly to the return line 33 when it is desired to intensively purify the liquid medium without causing inconveniences to the patient within the container 22. When effecting this purifyication process, valves may be regulated to distribute the liquid medium'suitably between

lines

18 and 16 for the above mentioned purpose.

The distributing cross 14 is also connected through a line 15 having a valve 15a, to the irrigating hose 15b which can be voluntarily directed to any difficulty accessible area of the body of the patient which needs an intensive irrigation with the liquid medium.

Finally, the rectal probe 27 is provided with a pipe 26 for enema injection to dissolve fecal matters in order to fluidize the same to permit discharge thereof through pipe 25 down to the collector 36 as shown in FIG. 1 of the drawings, or directly to drainage.

From the above description of the piping system of the tub built in accordance with the present invention it can be seen that a plurality of functions may be carried out by said tub. For instance, a purifying and filtering action can be provided from pump 1 to line 3, valve 3a, pre-filter 4, filter 5, thermostatic control 6 and cross 11 to the distributing cross 14. Also, a direct circulating system can be provided from pump 1, line 9, valve 9a and cross 11 to the distributing cross 14. As mentioned above, from line 9 a discharge function can be performed by the apparatus of the present invention by opening valve connected to drainage.

From the distributing cross 14, three different possibilities of circulating the liquid medium can be provided by the apparatus of the present invention, namely, a first system from cross 14 to tee 17, lines 18 on both sides of the container 22, control valves 19 into the container 22, drainers 20 and 21, lines 200 and 21a and line 33 back to the pump 1, or through valve 32 to drainage whereby a continuous change of the liquid medium within the container 22 is provided for the suitable treatment of the patient; a second system from cross 14 through line 16 and valve 16a directly to return line 33 back to pump 1 in order to bypass the container 22 in the desired degree for purposes of intensively purifying the liquid medium; and a third system from cross 14 through line 15 and valve 15a, directly to the irrigating hose 15b for the purpose of obtaining a very vigorous stream of liquid medium to be voluntarily directed toward any desired area of the body of the patient.

Finally, the hopper 13 connected through valve 12 to the cross 11 is used to provide desired amounts of medicaments and the like for the treatment of the patient upon incorporation thereof into the stream of liquid medium.

The liquid medium used in connection with the tub of the present invention is preferably an isotonic liquid medium, for instance, a water solution of sodium chloride having a concentration of around 0.75 percent w./v. Also, said liquid medium can be a hypertonic solution of sodium chloride, provided with suitable concentrations of medicaments to be applied to the patient through the skin by an osmotic action.

It can thus be seen that an absolutely novel concept for the treatment of seriously burned patients has been provided by the tub built in accordance with the present invention, inasmuch as said tub permits the permanent immersion of the wounded portions of the patient or of all the body of the patient into a liquid medium, without however excluding any parentheral treatment of the patient. The use of the tub of the present invention provides numerous advantages as compared to any prior art device, such as immediate minimizing of pain and shock, absence of bandages applied on the wounds and thus full elimination of the very painful release thereof, a shorter time for the healing of wounds, inasmuch as destruction of newly formed tissue is avoided and continuous elimination of dead tissue is secured, accurate control of the temperature of the liquid medium, absence of supporting pressure on the injured tissues and maximum comfort on account of the fact that the body of the patient is constantly floating in the liquid medium, thus avoiding the formation of ulcers. Also, in view of the fact that the patient is fully covered and protected, aerobial microorganisms do not grow and dehydration of the patient is maintained to a minimum value. The skin of the patient is also continuously cleansed by the bath of liquid medium or by the irrigation with the stream of liquid provided by the irrigating hose. The patient can easily move to any desired position for comfort or inspection of wounds, and the patient can exercise the limbs thus avoiding trombophlebitis and ankylosis of articulations. Finally, scar-type malformations are prevented on the skin of the patient.

In accordance with the above, the treatment of a patient suffering of serious burns comprises: analgesia, sedation, general shower, phlyctena separation, catheterization of veins and then immersion of the patient into the liquid bath contained in the tub of the present invention. The patient will remain immersed in the liquid medium until the first degree burns and the superficial second degree burns have been healed and the deep second degree burns and third degree burns are ready to receive the grafting treatment necessary. During the residence time of the patient within the tub of the present invention, the liquid medium can be modified as to its composition and/or its temperature in accordance with the progress of the patient and with the examination of body fluids This treatment does not exclude or substitute general oral or parentheral treatment of the patient, inasmuch as it merely provides a local treatment of the wounds and aids said general treatment.

Although certain specific embodiments of the invention have been shown and described, it is to be understood that many modifications thereof are possible. The present invention, therefore, is not to be restricted except insofar as is necessitated by the prior art and by the spirit of the appended claims.

What is claimed is:

1. An improved therapeutic tub for the treatment of burned patients which comprises, in combination, a container having discharge holes and of a shape suitable to accomodate a patient in a leaned position thereinto, a liquid medium in said container, recycling means connected to said container for recycling said liquid medium, filtering and purifying means connected to said recycling means, uretral and rectal probe means to continuously carry human fluids and defecations out of said container, thermostat means in said recycling means for controlling the temperature of said liquid medium, percolating means at the discharge holes of said container to avoid passage of fragments released from the wounds of the patient, adjustable head support means and body support means for the patient within said container, said body support means having a small contact area to avoid injuries to the body of the patient, and removable cover means arranged on the top of said container to isolate the nude body of the patient from the environment.

2. An improved therapeutic tub as claimed in claim 1 wherein said liquid medium is an isotonic solution of sodium chloride.

3. An improved therapeutic tub as claimed in claim 1 wherein said liquid medium is a hypertonic solution of sodium chloride with suitable concentrations of medicaments added to provide for the osmotic absortion thereof through the skin of the patient.

4. An improved therapeutic tub as claimed in claim 1 wherein said recycling means comprise a pump, a bypass line to bypass said filtering and purifying means, a drainage line laterally connected to said bypass line, a plurality of valve means individually controllable and evenly distributed along the side walls of said container, an upper or overflow discharge line from said container, a lower or drainage discharge line from said container, a bypass line to bypass said container, and a return line from said container and said bypass to the pump.

5. An improved therapeutic tub as claimed in claim 4 wherein a flexible pipe having an irrigation nozzle is connected to said recycling means to provide for the intensive irrigation of predetermined areas of the body of the patient.

6. An improved therapeutic tub as claimed in claim 1 wherein said rectal probe means is provided with an injection line for injecting liquid enema into the patient intestine for the purpose of fluidizing the fecal matters, said rectal probe means being connected to a drainage pipe to remove defecations from the tub.

7. An improved therapeutic tub as claimed in claim 4 wherein said filtering and purifying means comprise a first open mesh filter to retain relatively large particles and a second or fine mesh filter to retain particles larger than about 0.3 microns to sterilize the liquid medium.

8. An improved therapeutic tub as claimed in claim 4 wherein hopper means are provided to feed suitable solutions of medicaments into the stream of liquid medium which flows through said recycling means.

9. An improved therapeutic tub as claimed in claim 1 wherein said head support means are concave and basket-shaped and an adjustable mounting is provided to suspend said head support means from said container, and said body support means comprises at least one flexible adjustable strap transversely arranged with respect to the container.

10. An improved therapeutic tub as claimed in claim 1 wherein said uretral and rectal probe means are connected to sampling vessels to provide for the collection of samples of urine and defecations.