WO2000025717A2 - Device for covering and protecting an injury, especially a wound, of an indwelling venous cannula or the like - Google Patents

Abstract

The invention relates to a device (1) for covering and protecting an injury, especially a wound, of an indwelling venous cannula or the like while maintaining a distance therefrom. The device comprises a fastening device (20) for fastening to the body surface (2) surrounding the injury, and has a covering piece (10) which extends over the injury. The device is provided with one or several means for adapting the device to the shape of the body.

Description

 description

Device for covering and protecting an injury, in particular a wound, a venous cannula or the like

Field of the Invention

The invention relates to a device for covering and protecting an injury, in particular a wound, a venous cannula or the like while maintaining a distance therefrom, the device having a fastening device for fastening on the body surface surrounding the injury and a covering section extending over the injury .

The use of plasters and bandages on wounds can result in the plaster or wound dressing sticking to the wound itself. Since it is often necessary for wound care to constantly change the plaster or bandage, for example also to supply the wound with ointment, each time the plaster or bandage is removed from the wound, the wound is opened again and the healing process is thereby disturbed, thereby delaying healing itself.

Background of the Invention

Devices for covering and protecting an injury while maintaining a distance from it are known to avoid the disadvantages described, for example from US Pat. No. 4,667,666. The devices disclosed therein include a dome-shaped piece extending over the wound with relatively hard impermeable side walls and a flexible flange lying on the body surface and projecting outwardly beyond the outer jacket of the dome-shaped piece. The flange is coated with a layer of suitable adhesive, which is covered by a protective layer. The surface of the dome-shaped part is provided with openings to allow air to circulate to the wound. Due to its flexibility, the flange protruding outwards from the dome-shaped section can fit well on the body surface. With the device described in this document, however, it is only possible to cover wounds on relatively straight body surfaces or relatively small wounds.

Furthermore, a wound dressing or a plaster is known from US Pat. No. 4,399,816, which is essentially flat and has a central opening which can be closed by means of a cover. Above the central opening, the outer wall of the essentially flat base body of the plaster is provided with a recess into which a wound insert can be inserted. The lid is made of a transparent, semi-rigid plastic material. The patch is made of a felt-like or thermoplastic material, primarily a material that does not trigger allergic reactions is to be used, as is the adhesive that is provided on the underside of the patch, for adhering it to the body surface. The plasters and small bandages described in this publication are essentially only suitable for small injuries and are used like normal plasters.

A similar plaster can be seen in US 5,562,107, which, however, provides a smaller distance between the lid and the wound than the plaster according to US 4,399,816.

With the devices for covering and protecting injuries described in the prior art, it is not possible to cover larger wounds, the course of which has a change in direction, without contact while maintaining a distance from the wound or injury. Especially with The two last-discussed devices of the prior art are only possible in a small form, and due to the small thickness of the base material, shock and pressure loads on the wound cannot be ruled out despite the device being applied in the form of the plaster with a lid.

The invention is therefore based on the object of developing a device for covering and protecting an injury, in particular a wound, a vein indwelling canal or the like in accordance with the preamble of claim 1 in such a way that the disadvantages of the prior art are avoided. At the same time, sticking of the wound with bandage or plaster material should be avoided and the rest of the wound should not be disturbed by changed tensile or stretching forces in the area of the body surface. After the device has been attached to the surface of the body, the injury should be completely immobilized so as not to interrupt the healing process and at the same time to reduce the penetration of germs as much as possible. In particular, it should also be possible to easily adapt to changes in direction in the course of the wound.

Description of the invention

The object is achieved by a device according to the preamble of claim 1 in that the device is provided with one or more means for adapting the device to the body shape. Further developments of the invention are defined in the dependent claims.

This creates a device for covering and protecting an injury, in particular a wound, a venous cannula or the like, in which simple adaptation is also possible to strongly rounded body parts such as arms and legs. Since the device is made in any size and, depending on the embodiment, can also be expanded can, it can be adapted to any change of direction in the course of the wound. In addition, with the device according to the invention it is also possible to follow a wound course by correspondingly pivoting its elements relative to one another without having to make complex changes to it. Regardless of the direction of the wound, it is always possible to keep the wound calm even when the tensile or tensile forces change on the surface of the body. Advantageously, an optical wound control can be carried out at any time without problems by disturbing the healing process by preferably providing a device made of transparent or translucent material and / or by providing corresponding openings and / or cutouts. In any case, sticking of the wound with bandage or plaster material is reliably prevented. Follow-up care or follow-up medication by ointments, syringes or the like is also possible at any time without problems with the device according to the invention attached to the body surface. Means for taking up wound secretions or absorbent gauze or gauze material can also be subsequently stored in the device. Conversely, however, the penetration of germs to the injuries can advantageously be avoided since the device does not have to be removed from the body surface during wound healing. As a result, a secure germ barrier over the injury or surgical wound can be provided by attaching the device already in the early stage, that is to say as soon as possible after the injury has been obtained, in particular following an operation, as a result of which the wound is healed quickly and safely with formation in particular of dry scab is possible. The device is advantageous but also suitable if the dressing material is to be kept moist without the effect of condensation and without the formation of condensation. Here, the device according to the invention can be at least partially covered with a corresponding covering element, which can be removed from the device at any time as soon as it is no longer desirable to keep the dressing material moist. When dressing material is applied over the device according to the invention, there is advantageously no longer any danger that the blood circulation in the corresponding part of the body will be interrupted or pinched off due to excessive pressure when the part of the body swells due to the injury or due to a bandage which is too tight.

The device according to the invention is particularly advantageously shaped in such a way that it can be worn under clothing without problems, without the clothing interfering with wound healing by mechanical stress. Subconscious scratching of the wound, which can occur particularly easily during sleep, especially in children, is also advantageously avoided. Due to the special shape and the adaptation of the device according to the invention to the body shape, the injury is protected against impact and other injuries.

It proves to be particularly advantageous that the device according to the invention can additionally be stiffened by the use of known roller plasters and / or attached to the patient's body surface. The device proves to be particularly advantageous when it is used for burn wounds, since burn blisters often occur in them, which not only extend over a large area but also at a large distance from the other body surface and are particularly sensitive. Due to the advantageous adaptability of the device to the corresponding body shape, in particular also in terms of size, it is possible to completely cover even large burns, to immobilize them and to keep them away from external interventions.

It has proven to be particularly advantageous that, by enabling air circulation and freedom from contact of the wound and its surroundings, largely natural healing conditions are possible which accelerate the healing process of the wound. As a result, the patient is less burdened by his injury, which also means a psychological represents an advantage. Since the devices according to the invention are not only suitable for small scratches, for example on a finger, but also for particularly large wounds, for example after abdominal surgery, they can be used in a wide variety of fields. Since the individual design variants of the device according to the invention are advantageously constructed from a manageable number of different individual parts, they can be individually combined with one another, in particular also expanded by using a plug-in system. This not only leads to reduced manufacturing costs, but also to optimal storage for wound care, for example in hospitals and medical practices. As a result, the costs in this area can advantageously be greatly reduced, which is a great advantage in today's time aimed at savings in the area of care and hospitals.

The adaptation means or the adjustment means are preferably provided in the area of cover part pieces and / or edge part pieces and / or fastening devices. This provides a special degree of mobility, and the injury can still be optimally protected from external influences. Since the cover section is the highest elevation of the device above the surface of the body, the provision of the adaptation means in this section allows adaptation to the body shape to be covered by the device. This is especially important for body shapes with a small radius, such as a knee or arm. The device is therefore suitable for covering large and / or small injuries, which can be done in particular by providing a multi-part of the cover piece or of several interconnectable cover pieces. But also the edge section and / or fastening device can be in several parts. Since the adapting means can have a wide variety of shapes, the dimensions of the device are freely selectable depending on the choice of embodiment. bar, whereby the embodiment can also be selected according to the dimensions of the device or the wound to be covered. An air- and / or water-impermeable cover element, in particular a film, is preferably provided for at least partially covering the device, in particular the cover part, for moist wound healing. Alternatively, however, an air- and / or water-permeable cover element, in particular a bandage or plaster material for at least partially covering the device, in particular the piece of cover part, can be provided for dry wound healing. Any type of wound healing is thus advantageously possible with the device according to the invention, including partially moist or partially dry, which is achieved by partially covering the device with a covering element.

Preferably, an edge section connecting the fastening device to the cover section is provided. By means of the edge piece, the height of the arrangement of the cover piece above the body surface can advantageously be determined and adapted to the respective application. For this purpose, folds or folded areas can be provided in the edge section and / or in the transition areas of the individual sections or to the fastening device.

The adaptation means are particularly preferably provided as one or more incisions or grooves, which are provided in particular in the or one of the cover sections and / or the edge section and / or the or the fastening devices. This allows a very good flexibility of the device to be achieved, whereby it can be adapted to any body shape and also to any direction of the injury.

Alternatively or additionally, the adapting means can be a shaped, in particular curved, preferably tunnel-shaped and / or bellows-like cover part. The cover section preferably has at least some material stiffeners, especially shaped and / or curved elements. The bellows-like and / or tunnel-shaped cover section preferably has shaped, in particular curved, elements and at least one film-like element, which are in particular connected to one another. In addition, one or more preformed tunnel-like sheet-like elements can be provided. Alternatively, a material can be selected that allows deformability, such as, for example, a plastic or textile material with inserted, for example, woven-in threads made of a stiffening material such as metal or the like. By providing a tunnel-shaped cover part, straight or essentially straight injuries to an arm or leg can be covered very well. The tunnel-shaped covering part has the advantage that due to the curvature there is good stability against bending or denting. Either the tunnel-shaped cover part is formed in one piece with a suitable stability and dimensional stability in order to enable a self-supporting construction which in particular allows a certain deformability.

In addition, the film-like element or elements can be formed as a coherent or as individual elements and be attachable to the outside or inside of the shaped elements. This also proves to be advantageous when bellows-like cover sections are provided, since a mobility similar to that of an embodiment with incisions or grooves in the cover section is possible and given. In the case of the bellows-like cover sections, however, there is already further protection of the wound against the ingress of dirt even without additional application of a bandage over the device. The mobility of the device is not disturbed by the bellows, but is even further supported, since mobility across the bellows is also possible. The film-like element or elements are preferably provided with viewing openings and / or transparent areas. This makes it possible to inspect the injury during the healing process without removing the device or a bandage placed over it. The climate under the device is maintained and even wounds that are highly susceptible to infection or contagious can remain covered during the entire treatment phase.

The provision of the device in roll form or as an elongated element for application-specific shortening is also a particular advantage, which is not given in the known devices.

In order to enable a further or different adaptation to the body shape and / or mobility of the injured body part, the film-like element or elements are preferably folded or foldable in the areas between the shaped stiffened elements. In this case, the adapting means can be formed as foldable elements and formable web-shaped elements which are shaped as a blank, in particular from a roll material. This proves to be inexpensive, since only one roll material with the correspondingly prefabricated elements needs to be offered, which can subsequently be tailored to the specific application and effortlessly folded into the appropriate size. The folded or foldable, in particular film-like elements are preferably shorter than the shaped or moldable elements, in order to be able to understand lower curve radii and any body shapes and changes in direction of the wound course.

The moldable web-shaped elements are preferably in one piece with the fastening device or devices, which are formed in particular by surfaces provided in the end region of the web-shaped elements and provided with an adhesive or adhesive. On the other hand, the device can also be attached to the body surface using separate adhesive or adhesive strips. before being attached. The surfaces provided with an adhesive or adhesive are advantageously limited by folds and / or perforations against the remaining surface of the web-shaped element. Additionally or alternatively, the foldable element or elements are provided with folds and / or perforations arranged essentially parallel to the web-shaped elements. By providing the folds and / or perforations, any length and flexible devices can be adapted by folding some of the folds or perforations and not folding others.

Instead of the tunnel-shaped cover piece or in addition to this, bow-shaped elements, in particular a double bow-shaped cover piece, can be provided as an adaptation means, which can be connected to one another in particular by connecting webs. The bow-shaped element or elements have at least one stiffening element for conformable adaptation to the body shape and / or the course of the wound. Due to the shape of the bracket, the injury is overlapped by the curvature, as in the case of the tunnel shape, and is optimally protected against impact and bending of the device. If several bow-shaped elements are provided side by side in the form of a chain connected by connecting webs, longer wounds can be protected, whereas if only one bow-shaped element or double bow-shaped cover part, in particular provided with a stiffener, particularly small wounds, for example on a finger, can be cared for .

The adaptation means can alternatively preferably be formed by one or more substantially strip-shaped cover sections. The one or more stripe-shaped cover sections can be preformed or mouldable and provided with a reinforcing agent. The strip-shaped cover part pieces are preferably provided as a carrier for a bandage or the like. They are preferably connectable to one another, with the adaptation means for adapting the device to the body shape which it is provided for can have at least one connecting means for connecting, in particular pivotably connecting, the cover part or parts with one or more further cover parts. At least two cover part pieces can be provided, which are provided with connecting means essentially in the center and / or outside their center. With the off-center connection, a chain shape is created, with the central connection, the cover parts can be rotated one above the other and / or laid crosswise.

To connect the cover pieces, it proves advantageous that they protrude plate-shaped in the area of the or the connecting means. This creates a wider connection area. In addition, larger areas covered by the device are possible, since the individual cover parts can be pivoted more strongly against each other.

The connecting means preferably have peg-shaped or pin-shaped elements which can be engaged and / or latched in particular in openings in at least one of the two cover sections to be connected. However, other embodiments of the connecting means can also be provided, as long as they enable the individual cover parts to be pivoted relative to one another and, if appropriate, offer a latching possibility so that a set position of the cover parts can be maintained relative to one another. This also keeps tensile and compressive forces away from the wound. At least one of the openings can advantageously be formed as an elongated hole for producing an adjustability. This makes it possible to allow changes in length when moving the body part in a certain frame predetermined by the size of the elongated hole.

The connection means or connections preferably have slot-shaped openings for inserting an end or end region of a cover part piece, the end regions being in particular displaceable and / or adjustable within the slot-shaped openings. As a result, in particular, several web-shaped narrow and / or flat cover sections can be arranged in any desired manner and with any pivoting angles to one another, without special additional devices having to be provided. The connecting means can also have articulated parts or a device which enables the pivoting relative to the cover part, in particular can be connected to the web-shaped cover parts by means of pins, pins or similar devices.

In addition, the device can advantageously be mounted on and / or combined with a fixator, in particular in the form of strip-shaped cover sections which can be connected or connected to one another in an articulated manner. A bandage can be applied to these in order to keep them away from the injuries caused by the fixation rods inserted into the body surface while maintaining a distance from the body surface. Alternatively or additionally, at least one carrier rail, carrier shell and / or carrier rod can be attached to the fixator for carrying a bandage or the like. The dressing can then be draped easily. By providing adhesive, adhesive or other fastening means, in particular Velcro, on the surface of the carrier rail, carrier shell and / or carrier rod and / or on the bandage itself, the corresponding counter-elements preferably being provided on the fixator, the bandage can easily be there be fixed, whereby it is secured against sliding off the fixator or moving on its surface.

In an alternative embodiment, the edge section piece and the fastening device are preferably formed in one piece in the form of a longitudinal element, in particular with at least one guide device. The cover section is preferably provided with at least one edge-side engagement device for engagement, in particular displaceable engagement in the guide device. The guide device is particularly preferably groove-shaped, channel-shaped, tubular, bead-like and / or formed with undercuts and / or overhangs. Adaptation to the shape of the body is possible here by preferred provision of relatively flexible longitudinal elements and, in combination with this, flexibility and at the same time stability-giving cover section. The cover piece can be partially or completely moved like a blind with longitudinal elements attached to the surface of the body and even removed from the guide devices and subsequently reinserted there. Alternatively, the cover part can be releasably attached to the longitudinal elements, for example using Velcro devices or the like. The longitudinal elements have the corresponding counter elements. The longitudinal elements are preferably provided with incisions transverse to their longitudinal extension and / or in several parts in order to offer a means of adapting to the respective course of injury and the body shape.

For use with a tunnel-shaped cover section, a deflection device can preferably be provided for specifically deflecting a tube to be arranged and fixed on the body surface, in particular a medical tube. This can be attached to the body surface and fastened there and have a locking device for locking in the selected position. The deflecting device is preferably provided with a deflecting body, the deflecting body forming at least one opening through which the hose can be guided. The device is particularly preferably in two parts, the two parts being mounted rotatably and / or lockable and / or fixable relative to one another. Two openings are preferably provided, one of the two openings being provided in one part and the other in the other part. The two parts are preferably connected to one another with respect to the openings in such a way that the hose can be inserted through one opening and out of the device through the other opening. Such a deflection device is particularly useful in patients who are attached to a drip advantageous application. In these, it often happens that the intravenous cannula can shift when the arm is moved, which is not only painful but can also lead to the unwanted pulling out of the cannula from the arm or hand of the patient. In order to avoid this, the tube coming from the drip can be fixed in place on the patient's arm by the deflection device in such a way that a strain relief for the tube is created. At the same time, turning or aligning the hose in the desired direction is possible without any problems, since the deflection device enables free rotation until it is prevented by locking.

The two parts of the deflection device can therefore preferably be fixed in position relative to one another, in particular by means of screwing, crimping, clamping, detenting, toothing or similar fixing means. In addition, a fastening means for fastening the device on a surface, in particular the body surface of a patient, is provided, which can be connected or connected to one of the two parts of the device and / or is integral therewith. The fastening means therefore preferably has an adhesive surface, in particular a tab-shaped and / or foil-like adhesive surface. On the side of the one part facing away from the other part, at least one latching means is provided which interacts with a counterpart that can be provided on the fastening means. The latching means is particularly preferably in the form of a push button or a button, in particular provided with a latching edge or a latching groove which can be engaged in a corresponding recess in the counterpart or can be attacked on the counterpart at a corresponding edge. As a result, the fastening device can first be fastened to the body surface. Subsequently, the deflection device, after being provided with the corresponding hose, can advantageously be clipped or buttoned into the fastening device. If required, it can advantageously be released again from the fastening device at any time. Are there preferably the locking means and / or the counterpart are provided with fixing devices, in particular toothing means, for the stationary and non-rotatable adjustment of the device.

The fastening devices preferably consist of an elastic material and in particular are at least partially provided with a skin-compatible adhesive and / or adhesive and / or Velcro. In addition or as an alternative to this, the fastening device or devices can be attached to the edge section (s) and / or the cover section (s) by means of a Velcro fastener-like element. The fastening devices are preferably strip-shaped and / or flat, in particular round or oval or elongated and / or multi-membered or part-shaped, in particular V-shaped. As a result, the device according to the invention can make the difference! Most of the body surfaces are attached, even those with a small radius of the surface to be bonded or those whose hair is more pronounced, although usually a shave of the body surface in question will take place before the device is applied. In addition, the fastening devices can be manufactured from a cushioned material in order to laterally support the cover and edge sections that create and maintain the distance to the body surface. At the same time they generate a height compensation or adjustment of the attachment device, or surrounding the edge portions face opposite to the vertical extent of edge sections and covered waste ^'1stücken.

The cover parts preferably consist of an essentially flexible and / or pliable material which, at least in some areas, is provided with a stiffness which is suitable for secure contact-free covering and ensures free carrying. They consist in particular of a plastic, acrylic, rubber, rubber, textile and / or a single or multi-layer composite material, preferably with stiffening elements that provide formability, such as fibers or threads or corresponding other material. They are preferably transparent or translucent. A film material that is at least partially reinforced and / or has a degree of flexibility that allows deformation, but at the same time creates a stable, self-supporting element, is particularly suitable for this. If a translucent or transparent material is used, it is advantageously possible to visually inspect the wound without removing or partially removing the cover parts. Due to the stability and at least partial flexibility of the cover sections with the ability to maintain a distance from the injury to be protected at all times, the covered wound is also protected against impacts and other external influences. In addition, the patient can move relatively freely despite the device being attached, without the freedom of movement being restricted too much by the device. At the same time, however, the wound to be rested is kept completely free of tension and pressure and is therefore immobilized.

When using film-like elements, these are preferably air-permeable or diffusion-permeable and / or provided with an antibacterial coating. This allows air to be exchanged with the wound without the device and / or the covering parts having to be at least partially removed from the wound. However, they can also be impermeable to air for moist wound treatment. The device is preferably to be opened at least at one point or left open, e.g. at one end or in the area of incisions or the like, in order to be able to carry out subsequent medication with a spatula or other medical device or instrument, without the device needing to be completely opened or even removed.

Brief description of the drawings To explain the invention in more detail, several exemplary embodiments are described in more detail below with reference to the drawings. These show in:

FIG. 1 shows a sectional side view of a first embodiment of a device according to the invention, which is provided with incisions,

FIG. 2 shows a top view of the device according to FIG. 1,

FIG. 3 shows a perspective view of a second embodiment of a device according to the invention with folded elements and web-shaped elements,

FIG. 4 shows a top view of the device according to FIG. 3,

5 shows a third embodiment of a device according to the invention in the form of a tunnel-shaped cover part with viewing openings in a perspective view,

FIG. 6 shows a perspective view of a device according to the invention with a tunnel-shaped cover part with shaped elements and viewing opening,

FIG. 7 shows a perspective view of a device according to the invention with a tunnel-shaped cover section with stiffening elements, folded elements and viewing opening,

FIG. 8 shows a perspective view of a further embodiment of a device according to the invention with incisions, FIG. 9 shows a perspective view of another embodiment of a device according to the invention with bellows-like cover section,

FIG. 10 shows a perspective view of a further embodiment of a device according to the invention with a film-like element or film-like cover element,

FIG. 11 shows a perspective view of a further embodiment of a device according to the invention with a double bracket-shaped cover part,

FIG. 12 shows a perspective view of a further embodiment of a device according to the invention with a plurality of bow-shaped cover sections connected to one another,

FIG. 13 shows a further embodiment of a device according to the invention with a stiffened cover section for small wounds in a perspective view,

FIG. 14 is a perspective view of pieces of cover part 1 which are attached to one another in a chain-like manner and which protrude in the form of a plate in the region of the connection means or connections,

FIG. 15 shows a perspective view of two pieces of cover parts which are joined one above the other and have plate-shaped projections which are pivotally connected to one another in the center,

FIG. 16 shows a perspective view of a further embodiment of a device according to the invention with a strip-shaped cover part with openings in the longitudinal direction, FIG. 17 shows a perspective view of a further embodiment of a device according to the invention with a plurality of strip-shaped cover sections according to FIG. 16 which are pivotally connected to one another,

FIG. 18 shows a perspective view of another connection possibility of the strip-shaped cover parts according to FIGS. 16 and 17,

FIG. 19 shows a perspective view of another embodiment of a strip-shaped cover part of a device according to the invention,

FIG. 20 shows a perspective view of a plurality of strip-shaped cover sections which are joined together and provided with connecting means with slot-shaped openings and which are arranged at an angle to one another,

FIG. 21 shows a perspective view of a fixator part with a strip-shaped cover part of a device according to the invention,

FIG. 22 shows a perspective view of another embodiment of the strip-shaped cover part according to FIG. 21,

FIG. 23 shows a perspective view of a further embodiment of the strip-shaped cover part according to FIG. 21,

FIG. 24 shows a perspective view of the fixator detail according to FIG. 21 with a bandage applied over the device according to the invention, FIGS. 25 a, b, c are perspective views of a fixator with a cover piece in the form of a carrier rail mounted on an arm and further possible modifications thereof,

FIG. 26 perspective views of another embodiment of the carrier rail according to FIG. 25 with different surfaces,

FIG. 27 shows a perspective view of a fixture with a holding plate and a holding rod for the support rails according to FIGS. 25 a, b and c,

FIG. 28 shows a perspective view of a further embodiment of a cover part piece according to the invention for combination with a fixator with carrier shells for wearing a bandage,

FIG. 29 shows a perspective view of a further embodiment of cover parts according to the invention in the form of a bracket for combination with a fixator,

FIG. 30 shows a perspective view of a fixator detail with attached support rail and dressing material,

FIG. 31 shows a perspective view of a fixator with a carrier rail and another embodiment of a bandage with a gatherable edge area and a Velcro / adhesive device for connecting the carrier rail and bandage, FIG. 32 shows a perspective view of another embodiment of a cover part piece for use with a fixator in the form of a flexible and / or flexible support rod,

FIG. 33 shows a sectional view of the support rod according to FIG. 32,

characters

34 a, b, c are perspective views and a sectional view of two further embodiments of a device according to the invention with two longitudinal elements and a cover section connecting these two to one another,

Figure 35 is a perspective view and a sectional view of a first embodiment of a device for deflecting a hose, in particular a medical hose for

Use with a device according to the invention for covering and protecting injuries,

FIG. 36 shows a perspective view of a second embodiment of the device for deflecting a hose,

FIG. 37 is a perspective view of a further embodiment of the device for deflecting a hose,

FIG. 38 shows a further embodiment of a device according to the invention for deflecting a hose with an external hose in a perspective view,

FIG. 39 is a bottom view of the device according to FIG. 38, FIG. 40 shows a perspective view of a fastening device for fastening the device according to FIGS. 38 and 39 on the body surface,

FIG. 41 shows a perspective view of a further embodiment of a device according to the invention for deflecting a hose,

FIG. 42 shows a bottom view of the device according to FIG. 41,

FIG. 43 shows a perspective view of a fastening device for the device according to FIGS. 41 and 42 for fastening it on the body surface and

FIG. 44 shows a perspective view of an alternative fastening device for the device for deflecting a hose, shown in the preceding figures, for fastening it on a body surface.

Description of preferred embodiments

1 shows a side view of a perspective view of a first embodiment of a device 1 according to the invention. The device is arranged over a curved body surface 2. It has a covering part 10 and a fastening device 20 for fastening the device 1 on the body surface 2. The fastening device projects beyond the outer extent of the cover part 10. The cover section and the fastening device are connected via an edge section 30 connecting the two parts to one another. The length of the edge piece 30 is decisive for how far the top 11 of a cover piece 10 is from the body surface 2 is removed. The choice of the length or height of the edge part above the body surface 2 can also be used to adapt to wounds or injuries, in particular burn blisters, which may protrude particularly strongly outwards over the body surface 2.

To adapt the device 1 to the curved shape of the body surface 2, the cover section 10 is provided with incisions 12. Instead of the incisions, grooves can also be provided, which are in particular V-shaped. As a result, the covering part 10 can expand more in the area of its surface 11, that is, form a larger area than in the area of the fastening device 20. With an appropriate design of the incisions 12, the reverse is also the creation of an at least partially smaller surface in the area of the surface 11 of the cover part piece is possible in comparison to the surface in the area of the fastening device 20.

If this is desired, the device 1 can be divided into different parts in the area of the incisions, so that the incisions can also be formed in the area of the fastening device 20 at least in the form of predetermined breaking or tearing points. In this way it is advantageously possible to provide a band with continuous incisions in the cover part, similar to that indicated in FIG. 2. A corresponding section can subsequently be cut off from this band as required, in order to provide this over an injury and to attach it to the corresponding body surface 2 by means of the fastening device 20. For this purpose, the fastening device 20 preferably has an adhesive or adhesive layer provided with a removable protective film. The underside 21 is particularly preferably not only provided with the adhesive and / or adhesive layer, but also additionally with an insulating soft layer made of, in particular, foam rubber, hollow-profile rubber or nonwoven material, in order to make the patient more comfortable to wear. As an adhesive and / or adhesive, preferably a skin-friendly material is provided, which in particular does not cause allergies. A Velcro material can also be used, in which case corresponding counterparts are provided on the body surface. For example, a bandage piece as a counterpart can also connect the ends of the device in the area of the fastening devices.

Particularly preferably, as also indicated in FIG. 2, if an elongate device 1 is provided, the incisions 12 are arranged transversely to the longitudinal extent of the device. By providing the incisions, the device can even be applied to body surfaces which are strongly curved with a small radius, such as an arm, in particular even in the area of a child's wrist. At the same time, however, the relatively high rigidity of the cover part piece 10 is retained as such. This further enables protection against impact and further injury to the area to be protected. When the device provided with the incisions is bent, it fans out in this area of the piece of cover part. Instead of the cuts, another segmentation of the cover part piece can achieve this effect.

It has proven to be particularly advantageous that the individual incisions make it possible to treat the wound from the outside without removing the device, for example, after-medication using a spatula, for example the application of ointment to the wound without problems. The device provided with incisions can be attached particularly advantageously above a knee joint. Alternatively, the fastening device can be fastened to the body surface by means of adhesive strips, in particular in the form of roller patches, attached to the body surface.

3 shows a perspective view of a second embodiment of a device 1 according to the invention with foldable elements 13 and malleable web-shaped elements 14 shown. The foldable elements are each arranged between the web-shaped elements. This results in flexibility in the surface of the cover part formed from the foldable and the web-shaped elements, as well as perpendicular to this surface. A bend, as shown in Figure 3, can be created as well as a height offset can be followed on the body surface.

The foldable elements 13 are shorter than the web-shaped elements 14, an edge section 30 is not present in this area between two adjacent web-shaped elements, but only on these, whereby even smaller radii of curvature of a wound can be followed by means of the device. In contrast to the first embodiment according to FIGS. 1 and 2, the end regions 3, 4 of the device 1 are left open. But they can also be closed like this.

In the embodiment shown in FIGS. 3 and 4, it is advantageously possible to obtain the entire device from a blank by folding. Such a blank is shown in top view in FIG. The fastening devices 20 are also integrated into the blank. All elements are separated from one another by folds and / or perforations 15, 16, 22, which means that the device can also be adapted to the conditions on the body surface by only partially unfolding the device along the folds. The folds or perforations 15 of the foldable elements are preferably arranged essentially parallel to the web-shaped elements. The position of the folds 16 determines the height or the distance of the upper side 11 from the injury. Here too, for example, a plurality of folds aligned parallel to one another can be provided in order to be able to adapt to higher injuries such as blisters, as indicated in the case of the two left web-shaped elements 14 or edge sections 30. A cut from one with perforations or is particularly preferred Folded roll material is made, only as many web-shaped and foldable elements 13, 14 can be separated from the roll material as are required to cover the respective injury.

As can be seen from FIG. 4, the moldable web-shaped elements 14 are arranged essentially parallel to one another. However, they can also be aligned with one another in some other way. For example, curved incisions which, when the device is bent, sometimes leave larger gaps between them have proven to be advantageous for post-medication, e.g. by means of a spatula or the like.

The fastening devices, which are delimited from the web-shaped elements 14 by the folds 22, are preferably provided on their underside 21 with an adhesive and / or adhesive. However, adhesive strips, in particular roller plasters, can also be provided on the folded surfaces of the fastening devices.

5 to 7 show embodiments of the device 1 according to the invention, each of which has a tunnel-shaped cover section 17. In the first variant according to FIG. 5, the tunnel-shaped covering part is formed as a shell from a plastic or a suitable other material, which has flexibility to be able to bend it and at the same time stiffness in order to remain in the arched position, wherein it preferably has a resetting effect if it is removed from a set position, for example if it is temporarily removed from the body surface. After opening the device, it can later resume its original or impressed shape. A material which is suitable for medical purposes and is in particular transparent or translucent is preferably used. In order to enable the healing wound to be checked visually, viewing openings 19 are provided which, when using a piece of tunnel-shaped covering part which is otherwise made of an opaque material, are transparent or have a are covered with a transparent material. The covering can be provided permanently on the viewing openings or can be removed from them, for example in order to provide the wound with subsequent medication. The viewing openings can also remain open if the particular application of the device so requires.

After the device has been fastened, for example by gluing one fastening device 20 to the body surface in addition to the injury, the body shape and / or the size of the injury to be covered is adjusted by moving the second fastening device into the desired position and, for example, also gluing it to the body surface the opposite side of the injury next to this. The curvature of the tunnel-shaped cover part can be adjusted stronger or weaker. It subsequently covers the injury. Depending on the material used, its thickness and any structure, the curvature shows a stiffening effect for the tunnel-shaped cover section. For this purpose, for example, stiffening elements, such as fibers or threads made of e.g. Metal or other formable stiffening material.

In a special embodiment, the fastening devices and the tunnel-shaped cover section are made in one piece and made from a blank. The dimensions of the cut are, for example, 5x5 cm up to 40x60 cm, whereby, depending on the choice of material, smaller or larger cuts can of course also be produced and used. Width dimensions of 1 to 4 cm are sufficient for the fastening device in order to obtain a good fastening on the body surface.

The tunnel-shaped cover section shown in FIG. 6 is provided with elements 18 that stiffen and / or form or pre-form the curvature. hen. As a result, the strength and the targeted formability of the cover piece can be increased. The number and position along the cover section 17 of the elements 18 to be provided is advantageously selected depending on the respective application. Instead of providing individual elements 18 inserted into or connected to the material of the tunnel-shaped cover section, this material itself can also be partially stiffened or in some areas, in particular while maintaining deformability in this area as well.

In the embodiment shown, instead of an adhesive or adhesive surface, a Velcro-like felt or hook layer is provided on one fastening device 20. This can cooperate, for example, with an appropriately trained additional element such as a band or a bandage. Wrap a band or bandage around the device, e.g. on one arm the area of the arm not enclosed by the device.

In the embodiment according to FIG. 7, in addition to the stiffening and / or moldable or preformed elements 18, folded elements 13 are also provided in the film-like areas between two elements 18 and in the two end areas 3, 4 of the device. Stiffer elements 18 are preferably used in this variant, since the folded elements 13 give less stability than the curvature of the film-like element in FIGS. 5 and 6. However, by providing the folded elements 13, an even better adaptation to the body shape is possible and possible to change direction with longer wounds.

The device with a tunnel-shaped cover section is particularly suitable for use with a venous cannula on one hand for temporarily connecting the patient to a drip, catheter or the like. The intravenous cannula thus remains against accidental Pulling out or moving the cannula protected, which provides protection for the veins.

Another embodiment of the device provided with incisions 12 according to FIG. 1 is shown in FIG. The incisions are made wider than shown in Fig.l, making it easier to care for the covered wound from the outside in particular. In the embodiment according to FIG. 1 or 8, the device can consist of a plastic material, acrylic, latex, rubber or another flexible and at the same time rigid material which is in particular transparent or translucent. The web-like elements remaining between the incisions and covering the wound are preferably stiff or stiffened. The width of the protruding fastening device 20 is preferably selected depending on the location of the injury and the conditions there on the body surface and can, for example, are between 1 and 8 cm. The width of the web-shaped elements between the incisions 12 is also selected depending on the stiffness or flexibility to be achieved of the device for adapting to the body shape and surface and can e.g. are between 0.5 and 5 cm. The height of the edge part piece 30 is chosen depending on the injury to be covered and can e.g. are between 1 and 3 cm, the material thickness of the cover part and fastening device and edge part in the case of smaller areas to be bridged, preferably at lower values, e.g. about 0.2 mm to about 1.5 cm than is the case with larger areas to be bridged, e.g. if the length of the injury has to be bridged 2 to 30 cm.

The embodiment shown in FIG. 9, in contrast to the one shown in FIG. 8, has film-like elements 40 between the web-shaped elements 14, as a result of which the appearance of the cover part 1 becomes bellows-like. The film-like elements are inserted between the web-shaped elements so that stretching and folding of the Cover part 1 piece is easily possible. The film-like elements can be formed as a coherent, in particular one-piece element or as individual elements. They are preferably provided on the outside of the web-shaped elements, it also being possible to provide them on the inside of the web-shaped elements. They can either be attached to the web-shaped elements or rest on them as a separate element.

Such a variant is shown in Fig.10. The film-like element can also rest on the covering part only in a partial area. In particular, the film-like element 40 has a protruding edge region 41 which can be placed on the fastening device. In this case, a detachable or fixed connection between the edge region 41 and the fastening device 20 can take place, or the edge region only adheres directly to this or the surrounding body surface, the film-like element at least partially protruding beyond the outer edge of the fastening device. As a result, the edge region 41 can be pulled off at any time without the device itself having to be removed. The film-like or the film-like element can also consist of a relatively thin, diffusion-open material, in particular provided with openings and / or antibacterial material. If one or more such film-like elements are provided, it is advantageously possible to create a dry, moist or partially moist wound environment, depending on the degree of air permeability. As long as the film-like element is completely impermeable to air, e.g. a moist wound environment can be created.

FIGS. 11 and 12 show further embodiments of the device 1 according to the invention, which are provided with pieces in the form of a bow-shaped cover. FIG. 11 shows a double bow-shaped cover section 51, the double bow-shaped cover section having a curvature under which a wound can be positioned. The device has essentially an elongated plaster-like shape and is provided with two tab-shaped fastening devices 23. The tab-shaped fastening devices are fastened in the region of connecting webs 52 between the two brackets of the cover part or are connected to the latter.

A similar structure is also shown in the embodiment according to FIG. 12, in which the connecting webs 52 are however arranged between the individual bow-shaped elements 50 in such a way that the fastening devices 23 are alternately attached to the connecting webs 52. A separation of two bow-shaped elements 50 arranged next to one another is preferably also possible in the region of the connecting webs, in particular a half connecting web being arranged on each bow-shaped element 50. A connection can be made by means of the tab-shaped fastening devices, for example by turning over the connecting webs. With this embodiment variant, very good flexibility and adaptability to the respective body shape and the course of the wound are possible. In addition, any length of a chain formed from the bow-shaped elements 50, as shown in FIG. 12, can be formed according to the length of the wound.

Suitable materials for the bow-shaped elements 50 are a plastic that is flexible and stiff at the same time or another suitably designed material. In particular, the bow-shaped elements can also be formed from a combination of several materials, for example to produce a flexible stiffness also from a spring tension wire which is sheathed with a flexible plastic and / or a hose material, in particular a hose made of rubber material or soft plastic. Diameters of the wire from 0.2 mm to 3 mm and a thickness of the sheath from 5 mm to 15 mm are sufficient. The individual bow-shaped elements can be provided, for example, at a distance of 1 to 8 cm. preferably chosen on the one hand by the length of the connecting webs 52, on the other hand adapted to the particular circumstances of the body shape and the course of the wound direction. The tab-shaped fastening devices 23 preferably have the same width as the connecting webs and can in particular have a length of 2 to 10 cm. The dimensions of the fastening devices should also be selected for specific applications, the device being positioned firmly on the body surface by the fastening devices and remaining there in a stationary manner even when the respective body part provided with the device is moved, preferably until the wound has completely healed.

Both the bow-shaped elements and the connecting webs can have any cross section, in particular a round or angular one. However, they can also be essentially flat or oval, as shown in the embodiment in FIG. The embodiment shown there is particularly suitable for covering an injury to a finger, since the bow-shaped element 50 provided is narrow and can be deformed as desired and can therefore be adapted to any length of a finger. In addition, the provision of a flat, bow-shaped element means that the corresponding wound on a finger is very well covered due to its relatively small lateral extension. The bow-shaped element is preferably formed from a flexible plastic strip, it also being possible to use any other material which produces flexible rigidity, such as, for example, also a material mixture such as a rubber or rubber mixture. The material thickness can preferably be selected in the range from 1 to 15 mm, the width of the bow-shaped element between 1 and 20 cm and the length between 2 and 50 cm.

V-shaped fastening devices 23 are provided at both ends of the bow-shaped element for fastening the device. Instead of The fastening devices could also be strip-shaped, flat, in particular round or oval or otherwise multi-part or multi-part. However, it proves to be particularly advantageous to choose an attachment device with several parts or with several parts, since this improves the hold on a finger, in particular when the device according to the invention is attached. The fastening devices therefore preferably have adhesive surfaces with a size of 1 to 20 cm ² .

In order to obtain a further stiffening, stiffening elements 53 are inserted into the bow-shaped element 50 according to FIG. 13, which are preferably deformable, such as in particular metal wires or a metal braid or similar materials, which enable the bow-shaped element to be flexible as well as its stiffening.

FIGS. 14 and 15 show further embodiments of the device according to the invention. The individual cover sections 54 protrude in the form of a plate in their central region. In the edge region of the plate-shaped projections 55, the individual cover parts are pivotally connected to one another by a connecting means 60. In the case shown, the connecting means are peg-shaped, and they engage in corresponding openings 56 in the edge region 57 of the plate-shaped projections 55.

By pivotably connecting the individual plate-shaped projections of the cover sections, pivoting in the plane of these cover sections is possible in order to be able to adapt the device to a wound course provided with changes in direction. Since any number of cover sections 54 projecting in the manner of a plate can be pivotally connected next to one another, particularly long wounds or injuries can thus be covered very well. The chain of individual pieces of cover can be easily put in by simply inserting the shorten and lengthen peg-shaped connecting means 60 into two superimposed openings 56 of two adjacent cover sections. As a result, longer, wounded wounds in particular can be optimally treated by means of this embodiment of the device according to the invention. Stockpiling at hospitals or doctors is also very possible due to the small amount of covering parts with connecting means. In order to adapt to differences in length while the device is being worn, the openings 56 can be designed as elongated holes, as a result of which the protection of the injury is retained, but the mobility of the device is additionally increased. Tighter curve radii are also possible.

Another possibility of connecting two cover sections provided with a plate-shaped projection 55 is shown in FIG. 15, the opening 56 being provided there in the central region 58 of the two cover sections 54. Again, a peg-shaped or pin-shaped connecting means 60 can be inserted into the two openings 56, as a result of which the two cover sections lying one above the other can be pivoted as desired, in particular in order to align the position of the fastening devices 20 in such a way that a secure fastening on the body surface around the wound to be treated is possible becomes. The dimensions and shape of the cover sections provided with a plate-shaped projection 55 are preferably selected as a function of the respective application. Since the embodiment shown in FIG. 15 is particularly suitable for attachment over an ankle, on a shin or also over a small abdominal wound, swiveling the two over one another is also an example! pieces of cover so that the fastening devices lie on top of one another. In this case, preferably only the fastening device of the cover part closest to the wound is glued to the body surface or otherwise fastened there. Medication of the wound is also possible without removing the device, since between the fastening devices of the two each cover section remains a gap that allows the insertion of a spatula provided with an ointment or the like. Of course, this is also possible with the chain-shaped embodiment variant according to FIG. 14. In this case, the individual fastening devices can either be glued individually to the body surface or fastened there, or, for example, by means of an elongated adhesive strip which extends over the entire length of the device. The chain-like design variants are also particularly suitable for large abdominal scars, since optimal adaptation to the body shape is also advantageously possible there, while allowing mobility for the patient.

A further embodiment of the device according to the invention is shown in FIGS. 16 to 20, strip-shaped cover sections 70 being provided in each case. In the embodiment variant according to FIG. 16, the edge section 30 is provided with a fold part 31 in the region of the kink to the fastening device 20. The fold part 31 can enable and accommodate changes in the height of the arrangement of the upper side of the cover part above the wound to be covered as well as lateral adjustments, the fold part in particular permitting compressibility and twistability. The strip-shaped cover section has a plurality of openings 71 in its longitudinal extent. Like the openings 56 in FIGS. 14 and 15, a connecting means 60 can be inserted into the openings 71 in order to pivotably connect two cover parts. A pin or rivet is shown in FIG. Instead of the openings 71 provided in the central region of the longitudinal extent of the cover parts, cutouts can also be provided in the edge region, which can cooperate with the connecting means 60 in such a way that it is possible to latch around the connecting means.

In FIG. 17, four such strip-shaped cover parts 70 are pivotally connected to one another. The connection points each lie in the region of the transition to the edge section 30, where there in each case a pin is also introduced to enable the pivotability, as a result of which the individual pieces of covering part can be folded apart and folded together like a folding rule. The resulting angle between two adjacent sections can be chosen as desired and should be adjusted to the corresponding body shape. By providing the openings 71, two adjacent cover sections can be connected at any desired location, as a result of which any shapes can be formed by connecting the cover sections to one another differently. Any lengthening or shortening of the overall device is also possible, which means that both minor and major injuries can be optimally covered. Instead of providing adhesive or adhesive surfaces on the underside 21 of the fastening devices, not only Velcro or other fastening systems can be provided there, but also the fastening devices arranged next to one another can be fastened to the body surface by means of additional adhesive strips.

Another embodiment is shown in FIG. 18, wherein in this embodiment the four strip-shaped cover sections are connected to one another like scissors, that is to say two cover sections in the middle and the two cover section pairs are pivotally connected to one another at the edge in the transition region to the edge sections. Here, two cover sections are shaped as shown in FIGS. 16 and 17, whereas the other two cover sections are each provided with a fastening device at their two ends. For example, two cover part pieces according to FIG. 16 could be connected to one another by inserting a pin in such a way that they receive the design of the strip-shaped double-strap cover part pieces 72.

The embodiment shown in FIG. 19 corresponds essentially to that according to FIG. 16, but this does not have any openings in the form of a strip Cover piece 73 has. The strip-shaped cover piece is provided with a sleeve 74 which can reinforce the strip-shaped cover piece in any area. The sleeve consists of two sections, which are connected to each other by a sleeve 75 and can be fixed at the same time. In this way, the stiffness of the strip-shaped cover part can be changed and adapted to the respective situation as desired. Instead of the openings and connecting means in the form of pins, the embodiment according to FIG. 19 has a connecting means 61 with a slot-shaped opening 62, into which an end or an end region 76 of a further strip-shaped cover piece 73 can be inserted. In addition, the connecting means 61 is provided with a clamping device 63, on the one hand to clamp the end region 76 of the further cover part in the slot-shaped opening 62 and on the other hand also to enable, for example, a cover part piece according to FIG. 16 to be connected there for connection. By means of the connecting means 61, the strip-shaped cover section 73 can not only be connected to a corresponding cover section, but also to a differently designed cover section, in particular a cover section provided with openings according to FIG. The connecting means 61 is pivotally fastened on the upper side of the cover part, in particular via a pin which is arranged on the lower side of the connecting means and is latched or clipped in through an opening in the region of the transition to the edge section of the cover part.

In the embodiment according to FIG. 19, the fastening device 20 is essentially round or oval, the middle part 24 of the fastening device being made of a soft plastic or rubber or a similar soft adhesive material, whereas the outer edge region 25 is made with a Adhesive, in particular a protective film is provided. In FIG. 20, a plurality of strip-shaped cover sections are connected to one another via connecting means with slot-shaped openings. The protruding end regions can be cut off or cut off after the device has been installed or attached to the body surface. The embodiment of the connecting means in FIG. 20 is button-shaped, any shape of the connecting means 61 being possible as long as a slit-shaped opening is provided for receiving the end or end region of an adjacent cover part. For example, several such connecting means can also be pivotably arranged on a cover part, in particular two. In this case, the connection of two such cover sections with connection means provided at both ends would be possible by only an essentially flat strip-shaped cover section 73, which neither has an edge section nor a fastening device.

The cover sections shown in the previous figures can have lengths up to, for example, 70 cm and widths up to 10 cm, and the edge sections can even be up to 15 cm long, as a result of which a height difference between the fastening device plane and the top of the strip-shaped cover part of approximately 15 cm can be adjusted. If necessary, on the one hand, much smaller dimensions of the covering parts can be provided, and also much larger ones. For example, the strip-shaped cover parts shown in FIG. 20 are particularly well suited for use with a fixator. Here, lengths of 5 to 15 cm, widths of 0.5 to 3 cm and a thickness of the material of the covering parts of 0.3 to 3 mm have proven to be particularly advantageous. When used with a fixator, the fixator rods can be inserted between two adjacent cover sections arranged at an angle to one another. Subsequently, it is advantageously possible to place a bandage over the device fanned out in this way, thereby further protecting the injury. It is essential to apply a bandage or plaster over the device. additionally possible in all embodiments, in particular also in those shown in FIGS. 16 to 19.

In addition to the very good adaptability to any curvatures, elevations or height differences of the body shape, individual cover sections can also be very easily removed from a chain of cover sections for subsequent medication and then reinserted there, with the fastening devices in particular being able to remain on the body surface. This also proves to be advantageous, particularly with long abdominal scars, since there is almost unlimited freedom of movement for the patient even in the sitting position. The device can also be placed around a leg, a dressing also subsequently being able to be placed over this leg.

When using the device according to the invention together with a fixator, as shown in FIGS. 21 to 33, it is possible, by adding an additional bandage around the device according to the invention, on the one hand to prevent the injuries caused by the installation of the fixator against the penetration of pathogens from the outside to protect and also to enable visual protection for the patient himself and against the eyes of third parties. In addition, as a result of the inventive easy loosening and re-creation of the device according to the invention, it is also possible to remove it at least partially for wound control after removing the dressing and subsequently again around the fixator on the body surface as a support and carrier for a dressing to fix. FIG. 21 again shows a strip-shaped cover section, as can already be seen in FIGS. 16 to 18. These can once again be better seen in FIGS. 22 and 23, FIG. 23 showing an embodiment of the strip-shaped cover part in which fastening devices and edge sections are provided on both sides of the cover part and a recess 77 in the central region rod 80 of a fixator which rises essentially vertically from the body surface. At the lower end of the fixator rod, a disk element 81 provided with a slot opening 82 is arranged. In the area of this end of the fixator rod 80, it is mounted in the body, in particular in the bone of an arm of a patient. The disk element 81 subsequently lies on the body surface. In the end of the fixator rod 80 facing away from this end, a hood element 83 is arranged which has a projecting partial area 84. In addition, it is provided with a through opening 85 for attachment to the fixator rod 80 and optionally with an additional slot-shaped opening 86 for other attachment to the fixator. In addition, an end piece of a bandage 5 is shown in FIG.

After the fixator rod has been installed in the bone, the disk element 81 is first placed over the installation site. A strip-shaped cover part is fastened above this through an opening or, as shown in FIG. 23, with the recess 77 around the fixator rod, on the body surface. The distance that the upper side of the covering part 1 should have from the body surface can be adapted to the respective situation, in particular by changing the kinks between the covering section, edge section and fastening device. For this purpose, folds and perforations 31 in particular can be provided in this area. The cover parts can also be severed in the area of the openings 71, in particular the remaining hole section, which is similar to a recess, can be placed around the fixator rod. In addition, shorter cover sections can be produced in this way in order to be able to adapt to the respective local conditions at the injury site to be supplied. Before covering with a bandage of the cover sections arranged around the fixator rod, which are pivotally connected to one another in particular by means of pins or other connecting means are, the disc element 81 can be additionally fixed on the body surface, in particular by means of roller plasters.

The dressing 5, which preferably consists of an elastic textile or plastic film material, is subsequently arranged around the device according to the invention. The bandage preferably consists of two parts which are guided in parallel and are connected to one another around the fixation rod, in particular by means of a Velcro fastener. Alternatively, both dressing parts can also be connected to one another by gluing. The bandage is tightened and tensioned over the device according to the invention on the side of the body or body part to be connected, which faces away from the fixator and the device according to the invention. An additional fixation can also be carried out on this side, for example by gluing using a roller adhesive button. The dressing is preferably given an antiseptic treatment.

After the dressing and / or plastic film material has been applied over the device according to the invention, the hood element 83 is supported along the fixator rod 80 on the upper side of the cover part located on the fixator rod. This is preferably done before the bandage is applied, the projecting portion 84 being an additional safeguard for the respective covering section arranged around the fixator rod. The hood element 83 can be placed on the bandage after the bandage has been applied, and in particular the disc element 81 can also be placed on the top of the cover part to apply the bandage, in order to enlarge the area for supporting the bandage or the film there and also to enlarge the area To be provided for the later pressure absorption when installing the hood element. The diameter of the hood element 83 preferably corresponds to that of the disk element 81, both of them in particular having a diameter of 2 to 6 cm and the hood element in particular having a material thickness of 0.2 to 10 mm. It turns out It is particularly advantageous to manufacture the cover element from a stronger material than the disc element in order to enable a more stable device and connection between the fixator and the device according to the invention as well as the bandage or film. If the hood element is to be applied to the fixator only after it has been installed, this is done with the aid of the slit-shaped opening 86. The through opening 85 of the hood element 83 preferably has a diameter such that, after being added to the fixator rod, there is an essentially hermetic seal against, for example seeping germs in the rain is produced. The hood element is therefore preferably made of a relatively soft material which nestles particularly well and tightly in the area of the through opening to the fixator rod. For example, a soft plastic or rubber can be used, in particular with the addition of a further seal, in particular a lip seal. The hood element can be connected to the bandage either by providing a Velcro fastener or by gluing, the projecting portion also being used to compensate for protrusions in the bandage material at locations one above the other.

A fixator provided in this way with a bandage or a cuff as a bandage together with the device according to the invention is shown in FIG. Here, a transverse fixator rod 87 is additionally attached to the fixator.

FIG. 25 shows an alternative embodiment of a cover part piece in the form of a carrier rail 90 which can be fastened to a plurality of fixator rods 80. In FIG. 25a, the connection to the fixator rods takes place via a clamp fastening device 91. This can be adjusted on the one hand along the carrier rail 90 and on the other hand along the fixator rods 80. Instead of the clamp fastening device, other fastenings can also be selected, such as, for example, screwing them into the fixator rods provided with an internal thread provided openings. In addition, additional fixation devices surrounding the fixator rods can be provided, into which corresponding devices of the support rail can engage or can act on the latter.

In the embodiment according to FIG. 25b, a connection to the fixator rods via clip devices 92 is provided. In the embodiment according to FIG. 25c, hook elements 93 are also provided for hanging the carrier rail on a transverse fixator rod 87. An additional rod can also be provided on which the support rail can be hung. Either the fixation rod 87 or a corresponding additional clamping rod is preferably also used to fasten the clip devices 92. If a fixator bandage carrier basket, bandage carrier bracket or a carrier shell is provided as in FIG. 28, the carrier rail can also be fastened to it.

The surface 94 of the carrier rail can either be provided with a Velcro device 95 or adhesive surfaces 96. A bandage is then attached to this and, as already described above, applied to the body part, in particular an arm 7. Providing the support rail makes connecting patients much easier, since the tedious application of a bandage in the transverse direction to the fixator can now advantageously be avoided. The bandage can be applied parallel to the fixator over the patient's body part, fixed on the support rail and at a predetermined distance from the body surface in the area of the fixator, ie injuries. This makes it much easier and faster to connect fixator patients. In addition, wound control is much easier, as already explained above.

In the embodiment according to FIG. 26, the carrier rail is formed in one piece with the fixator rod 87. It is important to ensure that the fastening points 88 on the fixator rods 80 ensure a non-slip fit of the carrier rail plus the transverse fixator rod. The support rail can in this case be flat or curved or provided with curves, in order to be adapted to a certain extent, in particular to the shape of the body. In the embodiment shown, a partial area of the carrier rail is also provided, which has neither a Velcro device nor an adhesive surface. Instead of a Velcro device and adhesive surfaces, other adhesives such as hooks or the like can also be used. The bandage used is preferably provided with a corresponding Velcro device and / or adhesive surface and / or adhesive surface and / or hook or the like and / or untreated.

The carrier rail can have a width of, for example, 0.5 to 10 cm, the thickness of the rail essentially corresponding to the required fixator rod thickness, which can be a few millimeters. In the area where only the bandage rests on the carrier rail, it can have a thickness of a few tenths of a millimeter.

FIG. 27 shows further fastening options for a carrier rail according to FIG. 25. On the one hand, the carrier rail can be supported from below by a relatively short bandage carrier rod or holding rod 97, which can preferably be arranged in the direction of the carrier rail width. The holding rod 97 can be connected to the fixator rod 80 by clamping or screwing. Alternatively, a holding plate 98 can also be provided, which is preferably also clamped to the fixator rod. Both the holding plate 98 and the holding rod 97 can be provided on their surface with adhesive surfaces and / or adhesive and / or Velcro surfaces and in particular have a slit-shaped opening 99 and / or recess and / or through-opening in order to allow the fixation rods to be attached 80 can be assembled too can. Clamping on the fixator rods can be provided by screws or additional clamping devices, it being possible in particular for the holding plate 98 to be clamped to the fixator rod by appropriate shaping. Handrail and holding plate can be made of plastic or metal, for example.

The holding rod and holding plate can have lengths or diameters of up to 20 cm, the material thickness in particular being between 0.2 and 10 mm. In certain applications, however, other dimensions can also prove to be advantageous.

In the embodiment according to FIG. 28, carrier shells 100 are provided instead of the carrier rail. The carrier shells consist of rods 101 arranged essentially parallel to the fixator rod 87 and curved connecting rods 102 connecting them. On the fixator rods 80, they are attached to the fixator on both sides of the fixator by means of holding rods 104 correspondingly provided with grooves 103. The two rods 101 provided on the side of the body part opposite the fixator are also connected to one another by a connecting device 105. For example, the connecting device is an adjusting screw for adjusting the distance between the two carrier shells 100 from one another. As a result, the two carrier shells can be secured to one another and, on the other hand, adjusted to one another. A bandage can then be placed around the two carrier shells.

The embodiment according to FIG. 29 has bracket elements fastened to the fixator rods 87, which at least partially surround the body part 7 provided with the fixator. The bracket elements 106 are therefore made up of a bow-shaped section 107 and an essentially straight section 108. The straight section 108 is fastened to the fixator rods 87 and is connected to the bow-shaped device via a joint device 109 Section connected. The straight sections 108 are alternately fastened to the fixator rods 87 between the fixator rods 80.

The choice of the radius of the bow-shaped part piece 107 is preferably chosen depending on the body part to be protected, in particular the extremity to be protected, the bow-shaped part piece being attached to the fixator at a distance of in particular a few millimeters to centimeters from the body surface. The radius of the bow-shaped sections is then set by means of the joint device, the bow-shaped sections preferably not completely enclosing the body part for this purpose.

To apply a bandage, one of the support rails according to FIG. 25 can additionally be attached to the fixator. The bracket elements in particular have a material thickness of 3 to 15 mm and are preferably made of metal or another hard and rigid material.

FIG. 30 shows the application of a bandage 5 by attaching its Velcro device or adhesive layer to the surface of the carrier rail. Instead of the adhesive or Velcro layer, the bandage itself or the carrier rail or the fixator can be provided with other, in particular mechanical, devices for fastening the bandage to the fixator or the carrier rail. Hook-shaped elements can preferably be provided on the bandage, which can be suspended in the carrier rail surface and / or the fixator directly without providing the carrier rail, in particular in the rod 87. This also results in a distance or a distance above the injury caused by the fixator Distance created to protect them.

In Figure 30 it can clearly be seen that the dressing can now be applied parallel to the fixator, whereby it is first placed on the support rail. is fixed and subsequently after turning over around the body part to be protected, in particular by attaching it to the surface of the edge region which is already provided on the carrier rail and which is already resting on the carrier rail. The bandage can be incised in the area of the fixation rods and shortened accordingly before the two ends or edges of the bandage are attached to one another.

An alternative variant of a bandage is shown in FIG. 31. The bandage according to this embodiment is provided with a gathering device 6 at one end. As a result, this end can be drawn around an arm or leg, for example, and thereby closed up to the surface of the body. The gathering device can also be incorporated at intervals in the area of the total extent of the bandage in order to be adaptable to different arm and leg lengths, for example in children and adults. This makes it possible to gather the bandage accordingly and thereby shorten it. As a result, one and the same bandage can be used for a large number of people, thereby saving costs for additional embodiments. The bandage is cut off in each case in the area of the gathering device, as a result of which a gathering device provided at one end of the dressing is subsequently present. When gathering the gathering device on the surface of the body, this should be done, if possible, in such a way that excessive wrinkling is prevented in order not to disturb the blood circulation.

The bandage is provided on the upper side of the edge region added to the carrier rail 90 with an adhesive strip 96 provided with a protective film.

Another embodiment of a covering device for use in a fixator is shown in FIG. Instead of the one in the previous The support rail and support shell shown in the figures is now provided with a support rod 110, which consists of a flexible and in particular flexible material. Due to its flexibility and flexibility, it can also be arranged without interruption on the fixator, for example, in the area of the elbow. The support rod is preferably fastened to the fixator at a short distance from the body surface, in particular by means of clamping devices, screw connections or detachable other devices. In order to prevent the bandage added to the carrier rod from sliding off, it has an adhesive layer on its surface, as can be seen in the sectional view as a schematic diagram on the carrier rod 110. The adhesive layer 111 can be either a Velcro layer or an adhesive layer or another adhesive coating. The flexible support rod itself preferably consists of a plastic and / or metal and / or rubber material which is at least partially encased by the adhesive layer. Alternatively, a steel wire or braid, similar to flexible shafts or hoses, can be used, in particular with a diameter of the support rod of 3 mm to 4 cm. The length of the support rod preferably depends on the length of the fixator or his fixator rods 87. Instead of providing a flexible material, the flexibility can also be achieved by incisions or grooves or an external toothing of the rod and / or a partial weakening of the material of the rod . The bandage is applied as already described above. The carrier rod can also be provided as a replacement for at least one of the fixator rods 87.

FIGS. 34 a and b show a further embodiment of a device according to the invention, in which the edge sections and fastening devices are formed in one piece in the form of two longitudinal elements 120. Both longitudinal elements are provided with guide grooves 121 in the longitudinal direction in the area of the edge sections. Sub-areas of the cover part are arranged within the guide grooves. The cover piece 125 has appropriately designed edge thickenings 122 for engaging in the guide grooves 121. The remaining covering part can either be formed as a substantially flat, sheet-like element made of a flexible material. In particular, a thick film can also be provided, which makes it possible to move the cover section within the guide grooves and even pull it completely out of the guide grooves for wound treatment. Instead of a flat film, as shown in FIG. 34b, web-like elements 123 with flexible regions 124 inserted between them can also be provided, in particular in the form of a thin flexible film or a film-like element. The web-shaped elements 123 and the film-like elements 124 can be designed as already described in the previous figures, that is to say also with foldable elements, the advantages of adaptability to any body shape being mentioned also being obtained in particular. For this purpose, in particular the longitudinal elements 120 are also made of an elastic or flexible material, in particular plastic, acrylic, rubber and / or rubber mixture. As can be seen from the cross section in FIG. 34 a, they are made narrower in the area of the edge sections than in the support area on the body surface 2 in the area of the fastening devices 126.

The covering part can in particular be offered as rolls, the respective length being cut depending on the wound to be treated. The same applies essentially to the longitudinal wires, whereby these can preferably be manufactured in rod form. If no film-like elements 124 are provided between the individual web-shaped elements 123, an additional cover film or a similar element that represents further protection, such as, for example, a roller plaster adapted to the size or a bandage, can be arranged via this embodiment of the device according to the invention and either on the longitudinal elements or attached to the body surface. The longitudinal elements have, for example, a height of 2 to 6 cm with an intended width of the fastening device of 1 to 5 cm. Depending on the application, however, completely different dimensions can also be useful.

FIG. 34 c shows a perspective view of an alternative embodiment with two longitudinal elements 120. In this variant, the longitudinal elements are provided with incisions 127 and / or are provided as individual segments in order to allow good flexibility for adaptation to the body shape on which the device is applied. In addition, this flexibility makes it possible for the user to move with the attached device without this restricting mobility. In addition, by such flexibility, the device can also be adapted to any wound course, even a very curvy one. A complete separation of the individual segments is also possible in order to achieve an even better adjustment. On their upper side, the longitudinal elements are covered with a layer that enables detachability, e.g. a Velcro layer. Detachably web-shaped elements 128 with foil-like elements 129 inserted therebetween or with a film layer that is attached to the web-shaped elements can be attached to them. The web-shaped elements are attached to the longitudinal elements at such a distance from one another that the film layer is undulated with an elasticity between them. As a result, bending of the longitudinal elements is not hindered by the film-like elements. By releasably attaching the film layer to the longitudinal elements, the web-shaped elements with their adhesive or Velcro layer are advantageously not attached to the body surface.

FIG. 35 shows an additional device in the form of a device for deflecting a hose, in particular a medical hose, shown, which can be used in particular in connection with the tunnel-shaped cover part 17, as shown in Figures 5 to 7. As already mentioned, the problem with the provision of indwelling vein cannulas is that they can be pulled out of the puncture site, in particular in the case of catheters connected to them, when the patient's arm is moved. It has therefore proven to be advantageous to provide the deflection device as an additional device which is gentle on the vein in connection with the tunnel-shaped cover part. In addition, the deflection device can prevent a supply hose from kinking. The deflection device 130 in its first embodiment consists of a turntable element 131 on which a dome-shaped housing 132 is attached. The dome-shaped housing is provided with two openings 133, at least one opening being provided with a device for locking the hose which is passed through. In the case shown, the locking device has a conically tapering opening and, in the interior of the dome-shaped housing, a screwable element 161, in particular a rotating spindle for engaging the hose 160. The provision of a conically tapering opening has the further advantage that the hose can be inserted better as a result.

The dome-shaped housing is rotatably fastened on the turntable element, in particular via a pin or a similar device not shown in FIG. 35. The rotary tenter can, for example, consist of a thin or thicker film, which is provided on its underside with an adhesive and / or adhesive in order to be attached to the body surface.

By locking the hose in the deflection device, strain relief and at the same time fixing the hose to the patient's arm is made possible. Between the tunnel-shaped covering part and the deflection device, the hose can therefore be fixed on the Position the top of the patient's arm. For example, when using indwelling cannulas in children, it can also be advantageous to design the tunnel-shaped cover section so long that it covers the hose over its entire length, in particular up to the deflection device for the hose.

By using a turntable, any angle can be set by means of the deflection device, and in particular the hose, which is relieved of tension by means of the device, can be continued in any direction on the side of the deflection device facing away from the intravenous cannula, without slipping or pulling out the intravenous cannula from the respective puncture site is to be feared.

FIG. 36 shows another embodiment of a deflection device which is designed, in particular, to be attached to the hand, that is to say, to be stored underneath a tunnel-shaped covering part 17, as shown in FIGS. 5 to 7. The deflection device is essentially semicircular and consists of an essentially flat arch element 135, which is provided with several elevations 136 on the side pointing inwards towards the arch center. In the illustrated embodiment, two elevations 136 are provided so that they can receive the hose to be deflected between them and hold it by clamping. Three pairs of such elevations are arranged here, the elevation pairs being provided at the ends of the arch element and in the central region thereof.

Instead of an arch element, a right-angled element or any other angle element or a corresponding deflection can also be provided. The height and material thickness of the arch element are selected depending on the tube thickness and can be, for example, a height of 0.5 to 5 cm and a material thickness of Have walls between 0.5 mm and 1.5 cm with a diameter of the arch element of 2 to 10 cm.

An embodiment of the deflection device according to FIGS. 37 to 44 can be provided preferably in the area of the elbow joint. The embodiment shown in FIGS. 37, 41, 42 and 44 has two housing parts 137, 138, each of which is provided with an opening 139. The two housing parts are rotatably supported relative to one another, in particular by providing a central pin. They can be fixed in their position by a locking device 140, which is also provided and penetrates the two housing parts in the middle. In the illustrated case, the locking device 140 in the form of a compression screw connection ends in the fastening device 141 that can be attached to the body surface. The fastening device is preferably relatively thin and flexible, in particular in the form of a tab or film, and preferably with an adhesive surface on its side facing away from the deflection device Mistake.

The two housing parts 137 and 138 are connected to one another in the interior such that the adjustment of any angle of the two openings 139 to one another is possible without any problems, in particular also because the two housing parts pivot at an angle of 0 to 360 ° around the locking device 140 to let. The access to the deflection device and the outlet thereof can therefore be selected independently of one another, which also enables correct hose deflection in a confined space. The possibility of any adjustment of the angle between the inlet and outlet tubing enables the tubing, in particular the catheter, to be fixed in a manner which is gentle on the veins, which in particular by correct guidance of the tubing, by an adapted position of the opening into which it goes into the deflection device Tearing out the tube and injuries to the veins can advantageously be prevented.

The deflection devices shown in FIGS. 41 to 44 each have the same advantages as the deflection devices already described. The difference from the deflection device according to FIG. 37 is that the locking device 140 is provided in a depression 142 in the surface of the one housing part 137. In addition, the housing part 138 is not firmly connected to the fastening device 141, but is detachable. The releasability arises from the two interacting clip or button elements 143 shown in FIGS. 42 and 43 and the corresponding associated opening 144. Since the button element 143 is provided with external teeth, this is also the opening 144 on its inside . This allows the two elements to mesh with one another, as a result of which it is no longer possible for the housing part 138 to be rotated unintentionally relative to the fastening device 141. In order to prevent the housing part 138 from inadvertently falling off, in particular in connection with the housing part 137 from the externally toothed button element, this is preferably also provided with an additional securing device 145, in particular in the form of a projection, which fits into a corresponding recess in the Housing part 138 engages locking.

In the embodiment according to FIG. 44, the housing part 138 is provided on its underside with a bead-like projection 147, whereas the fastening device 141 has a clip ring 148 in which the bead-starting projection can engage in a latching manner. As in the embodiment according to FIGS. 42 and 43, the clip ring can also be provided with an internal toothing and the bead-shaped projection can be provided with an external toothing in order to avoid an undesired adjustment of the deflection device. The embodiment shown in FIGS. 38 to 40 has a deflecting body 149 with two bracket elements 150 instead of the completely closed housing parts 137, 138. The deflecting body is provided with a circumferential groove 151 into which a hose can be embedded. The hose is held in the circumferential groove by the two bracket elements 150, an adjustment of the angle at which the two hose ends should enter and exit the deflection device being determined by the position of the bracket elements. The bracket elements are therefore releasably secured to the deflection body 149 by means of a locking device 152. They can be rotated against each other independently of one another.

The deflection device can preferably be attached to the body surface by means of a corresponding clip element or an opening combination, as is also already shown and explained in FIGS. 42 and 43, or by a combination of a bead-like projection with the clip ring, as in FIG Figure 44 shown and described.

In addition to the above-described embodiment variants of the device according to the invention for covering and protecting injuries, in particular wounds, a venous cannula or the like, any other embodiments can also be formed. In this respect, the described embodiments merely represent an exemplary list. Numerous other design variants are also possible in which the device has means for adapting to the body shape to which it is to be applied. Reference numerals

1 device

2 body surface

3 end area

4 end area

5 bandage

6 gathering device

7 arm

10 pieces of cover

11 top

12 incisions

13 foldable element 14 web-shaped element

15 fold / perforation

16 fold / perforation

17 tunnel-shaped cover section

18 stiffening and / or moldable or preformed element 19 viewing opening

20 fastening device

21 bottom

22 fold / perforation 23 tab-shaped fastening device

24 middle part

25 edge area

30 edge piece 31 fold part film-like element edge area

bow-shaped element double bow-shaped cover section connecting web stiffening element cover section with plate-shaped projection plate-shaped projection opening edge area middle area

Lanyard slit-shaped opening clamping device

strip-shaped cover piece 1 piece

Openings strip-shaped double 1 ash cover part 1 strip-shaped cover part

Sleeve

sleeve

End area

Recess

Fixation rod

Disc element

Slot opening

Protective part of the hood element 85 through opening

86 slit-shaped opening

87 fixation rod

88 attachment point

90 carrier rail

91 clamp fastening device

92 clip device

93 hook elements 94 surface

95 Velcro device

96 adhesive surfaces

97 handrail

98 holding plate 99 slit-shaped opening

100 carrier shell

101 rod

102 connecting rod

103 groove 104 support rod

105 connecting device

106 bracket element

107 U-shaped part

108 straight section 109 articulation device

110 support bar

111 adhesive layer

120 longitudinal element 121 guide groove

122 Thickened edges

123 web-shaped element 124 film-like element

125 cover piece

126 fastening device

127 incision 128 web-shaped element

129 film-like element / film layer

130 deflection device

131 turntable element

132 dome-shaped housing 133 opening

134 locking device

135 arch element

136 survey

137 housing part 138 housing part

139 opening

140 locking device

141 fastening device

142 trough 143 cl ip element / button element

144 serrated opening

145 Safety device, cantilever

146 locking recess

147 Bead-like projection 148 Clip ring

149 deflecting body

150 bracket element

151 circumferential groove

152 locking device

160 hose

161 screwable element

Claims

Expectations

1. Device (1) for covering and protecting an injury, in particular wound, a venous cannula or the like while maintaining a distance therefrom, the device comprising a fastening device (20) for fastening to the body surface (2) surrounding the injury and a the covering section (10) extending the injury, characterized in that the device is provided with one or more means for adapting the device to the body shape.

2. Device according to claim 1, characterized in that at least one the fastening device (20) with the cover piece (10) connecting edge section (30) is provided.

3. Apparatus according to claim 1 or 2, characterized in that the one or more adaptation means are provided in the area of the cover part and / or edge section and / or fastening device.

4. Apparatus according to claim 1, 2 or 3, characterized in that the cover section is designed to be self-supporting and essentially to maintain the distance from injury or the like.

5. Device according to one of the preceding claims, characterized in that the cover section consists of one or more parts which are in particular connectable and / or connected.

6. Device according to one of the preceding claims, characterized in that an air- and / or water-impermeable cover element, in particular a film, is provided for at least partially covering the device, in particular the cover piece, for moist wound healing.

7. Device according to one of claims 1 to 5, characterized in that an air- and / or water-permeable cover element, in particular a bandage or plaster material for at least partially iron covering the device, in particular the cover piece, is provided for dry wound healing.

8. Device according to one of the preceding claims, characterized in that the device (1) is suitable for covering large and / or small injuries, in particular by providing a multi-part of the cover piece (51) or of several interconnectable cover pieces (54 , 70, 72, 73, 90, 100, 125).

9. Device according to one of the preceding claims, characterized in that the adaptation means are one or more incisions (12) or grooves, in particular in the or one of the cover pieces and / or the one or more edge sections (30, 120) and / or the or the fastening devices (20, 23, 141).

10. Device according to one of the preceding claims, characterized in that the cover section is fabric-like and / or mesh-like and / or provided with web-shaped elements (14, 123, 128) and / or is basket-like and / or perforated.

11. Device according to one of the preceding claims, characterized in that

Adapting means is a shaped and / or curved, in particular equipped with restoring cover piece.

12. Device according to one of the preceding claims, characterized in that

Adapting means is a bellows and / or tunnel-shaped cover part (17).

13. The apparatus of claim 9 or 10, characterized in that the bellows-like and / or tunnel-shaped cover section has at least partially material stiffeners, in particular shaped and / or curved elements (18).

14. Device according to one of the preceding claims, characterized in that one or more preformed film-like elements (13, 40, 124, 129) are provided.

15. The apparatus according to claim 13 or 14, characterized in that the or the film-like elements (13, 40, 124, 129) formed as a coherent, in particular one-piece element or as individual elements and on the outside or inside of the shaped elements ( 18) can be added.

16. The apparatus according to claim 14 or 15, characterized in that the or the film-like elements (13, 40, 124, 129) are provided with viewing openings (19) and / or transparent areas.

17. The apparatus according to claim 12 or 13, characterized in that the or the film-like elements (13, 40) are folded or foldable in the areas between the shaped stiffened elements (18).

18. Device according to one of the preceding claims, characterized in that adaptation means are foldable elements (13) and formable web-shaped elements (14) which are formed as a blank, in particular from a roll material.

19. The apparatus according to claim 18, characterized in that the folded or foldable, in particular film-like elements (13) and are shorter than the shaped or moldable elements (14).

20. The apparatus according to claim 18 or 19, characterized in that the moldable web-shaped elements (14) are in one piece with the or the fastening devices (20), in particular formed by surfaces provided in the end region of the web-shaped elements and provided with an adhesive or adhesive are.

21. The apparatus according to claim 18, characterized in that the surfaces provided with an adhesive or adhesive are delimited by folds and / or perforations (22) against the remaining surface of the web-shaped element and / or in that the cover part and / or edge part and / or fastening device with further folds and / or perforations (15) are provided.

22. Device according to one of claims 1 to 9, characterized in that bow-shaped elements (50), in particular a double bow-shaped cover piece (51), are provided as adaptation means, which can be connected to one another in particular by connecting webs (52).

23. The device according to claim 22, characterized in that the bow-shaped element (50) at least one stiffening element

(53) for malleable adaptation to the body shape and / or the

Has a wound course.

24. Device according to one of claims 1 to 9, characterized in that the adapting means is formed by one or more substantially strip-shaped covering pieces (70, 72, 73).

25. The device according to claim 24, characterized in that the or the strip-shaped cover sections is preformed or mouldable.

26. The apparatus according to claim 24 or 25, characterized in that the one or more strip-shaped cover sections is or are provided with a stiffening means.

27. The device according to one of claims 24 to 26, characterized in that the adaptation means at least one connecting means (60, 61) for connecting, in particular pivotally connecting, the one or more cover sections (54, 70, 72, 73) to one or more others Cover piece has pieces.

28. Device according to one of claims 24 to 27, characterized in that at least two cover pieces (54, 70, 72, 73) are provided, which are provided essentially in the center and / or outside their center with connecting means (60).

29. The device according to claim 28, characterized in that the cover pieces (54) in the region of the or the connecting means (60) project in a plate shape.

30. Device according to one of claims 27 to 29, characterized in that the connecting means (60) have peg-shaped or pin-shaped elements which can be engaged and / or in particular in openings (56) in at least one of the two cover parts (54) to be connected can be snapped into place.

31. The device according to claim 30, characterized in that at least one of the openings (56) is formed as an elongated hole for generating an adjustability.

32. Device according to one of claims 27 to 31, characterized in that the or the connecting means (61) have slot-shaped openings (62) for inserting an end or end region (76) of a cover part 1 piece (73, 70, 72), the End areas within the slot-shaped openings are in particular displaceable and / or adjustable.

33. Device according to one of claims 27 to 32, characterized in that the connecting means (60, 61) have articulated parts or a device which enables the pivoting relative to the cover part, in particular by means of pins, pins or similar devices with the web-shaped cover parts (70, 72, 73) are connected.

34. Device according to one of the preceding claims, characterized in that the device can be mounted on and / or combined with a fixator.

35. Apparatus according to claim 34, characterized in that at least one carrier rail (90), carrier shell (100) and / or carrier rod (110), in particular flexible carrier rod, can be fastened to the fixator for the purpose of maintaining a bandage, a cuff or the like.

36. Device according to one of claims 1 to 9, characterized in that Edge section and fastening device in one piece in the form of a longitudinal element (120) with at least one guide device (121) and / or a connecting device for detachable connection to the cover piece (128, 129), in particular an adhesive, adhesive, Velcro device.

37. Device according to claim 36, characterized in that the cover section (125) is provided with at least one edge-side engagement device (122) for engaging, in particular displaceable engagement in the guide device (121).

38. Apparatus according to claim 34 or 35, characterized in that the guide device (121) is groove-shaped, channel-shaped, tubular, bead-like and / or with undercuts and / or projections.

39. Device according to one of the preceding claims, characterized in that for use with the device (1) a deflection device (130) is provided for the targeted deflection of a hose, which can be attached to the body surface (2) and fastened there and a locking device ( 134, 140, 146) for locking the deflection device in the selected position.

40. Device according to one of the preceding claims, characterized in that the fastening devices (20, 23, 141) consist of an elastic material and in particular at least partially with a skin-compatible adhesive and / or adhesive and / or Velcro are provided and / or the fastening device or devices on the edge section (s) (30) and / or the cover section (s) (10, 17, 51, 54, 70, 72, 73, 125) can be fastened by means of a Velcro fastener-like element and / or that the fastening devices are fen-shaped and / or flat, in particular round or oval, and / or multi-membered or part-shaped, in particular V-shaped.

41. Device according to one of the preceding claims, characterized in that the cover pieces consist of a substantially flexible and / or pliable material which are provided at least in some areas with a stiffness suitable for safe contact-free covering and ensuring free carrying, and in particular from a plastic, acrylic, rubber, rubber, textile, in particular with stiffening threads or fibers that provide formability, and / or a single or multi-layer composite, in particular are transparent

42. Device according to one of the preceding claims, characterized in that the film-like elements are air-permeable or diffusion-permeable or air-impermeable and / or are provided with an antibacterial coating.

43. Device (130) for deflecting a hose, in particular a medical hose, with a deflection body, in particular for use with the device according to one of the preceding claims, characterized in that the deflection body (137, 138) forms at least one opening (139) through which the hose (160) can be guided.

44. deflection device (130) according to claim 43, characterized in that the deflection device is in two parts, the two parts (137, 138) are rotatably supported and / or locked and / or fixed.

45. deflection device (130) according to claim 43 or 44, characterized in that two openings (139) are provided, one of the two openings in one part (137) and the other in the other part (138) is provided, and the two parts being connected to one another with respect to the openings such that the hose (160) can be inserted through one opening and out of the device through the other opening.

46. deflecting device (130) according to claim 43, 44 or 45, characterized in that the two parts (137, 138) can be fixed in position relative to one another, in particular by means of a screw connection, compression fitting, clamping, detent, toothing or similar fixing means.

47. deflection device (130) according to any one of claims 43 to 46, characterized in that a fastening means (141) for fastening the deflection device on a surface, in particular the surface of the body (2) of a patient, can be connected to one of the two parts of the device or connected, in particular in one piece.

48. deflection device (130) according to claim 47, characterized in that the fastening means has an adhesive surface, in particular a tab-shaped and / or foil-like adhesive surface.

49. deflection device (130) according to claim 45, characterized in that at least one locking means is provided on the side of the one part (137) facing away from the other part (138), which engages with a counterpart provided on the fastening means (141) , in particular the locking means is like a push button or like a button, in particular is provided with a locking edge (147) or a locking groove (148) which can be engaged in a corresponding recess in the counterpart or can be attacked on a corresponding edge on the counterpart.

50. deflection device (130) according to any one of claims 44 to 49, characterized in that the latching means and / or the counterpart are provided with fixing devices, in particular toothing means, for stationary and non-rotatable adjustment of the device.