(19)
(11) EP 0 388 200 B1

(12) EUROPEAN PATENT SPECIFICATION

(45) Mention of the grant of the patent:
14.09.1994 Bulletin 1994/37

(21) Application number: 90302781.1

(22) Date of filing: 15.03.1990
(51) International Patent Classification (IPC)5A61H 23/04

(54)

Full length compressible sleeve

Auf der ganzen Länge kompressible Manschette

Manchon compressible sur toute sa longueur


(84) Designated Contracting States:
AT BE CH DE DK ES FR GB GR IT LI LU NL SE

(30) Priority: 16.03.1989 US 324513
12.04.1989 US 336984
13.04.1989 US 337606
12.04.1989 US 336979

(43) Date of publication of application:
19.09.1990 Bulletin 1990/38

(73) Proprietor: THE KENDALL COMPANY
Mansfield, Massachusetts 02048 (US)

(72) Inventor:
  • Dye, John F.
    Elgin, Illinois 60120 (US)

(74) Representative: Kearney, Kevin David Nicholas et al
KILBURN & STRODE 30 John Street
London, WC1N 2DD
London, WC1N 2DD (GB)


(56) References cited: : 
EP-A- 0 168 085
US-A- 4 153 050
US-A- 4 374 518
US-A- 4 029 087
US-A- 4 370 975
   
       
    Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


    Description


    [0001] This invention relates to pressurizable, multi-chambered, therapeutic devices, and more particularly to sleeves for applying compressive pressures against a patient's leg.

    [0002] Blood flow in patient's extremities, particularly the legs, markedly decrease during extended terms of confinement. Such pooling or stasis, is particularly acute in surgery and during recovery periods immediately thereafter.

    [0003] Blood flow compressive devices, such as shown in U.S. Patents 4,013,069 and 4,030,488, develop and facilitate the application of compressive pressures against a patient's limbs and in so doing promoting venous return. The devices comprise a pair of sleeves which are wrapped about the patient's limbs, with a controller for supplying the pressurized fluid to the sleeves.

    [0004] These sleeve devices may be seen in U.S. Patents 4,402,312 and 4,320,746.

    [0005] US-A-4029087 shows another form of such device in which a sleeve having chambers for pressure fluid is wrapped around a patients leg and secured at one side by a multiplicity of tapes all of which have to be secured individually.

    [0006] EP-A-168085 shows a boot having means for pressurizing its interior. The boot is secured on the leg by a zipper or boot laces, the location of which not shown.

    [0007] One use for the above mentioned sleeves is the prevention of deep vein thrombosis (DVT) which sometimes occurs in surgical patients who are confined to bed. When a DVT occurs, the valves that are located within the veins of the leg can be damaged which in turn can cause stasis and high pressure in the veins of the lower leg. Patients who have this condition often have leg swelling (edema) and tissue breakdown (venous stasis ulcer) in the lower leg.

    [0008] It has been shown that pneumatic compression can be highly effective in the treatment of such edema and venous ulcers. This treatment is usually performed by the patient themselves at home on a daily basis and requires that the patient be able to put on and remove the sleeves unassisted. The sleeve devices which are wrappable from a flat configuration as shown in the aforementioned patents, are difficult to apply by the patients themselves.

    [0009] It is therefore an object of the present invention, to provide a compressible sleeve device which is easily utilizable at home by the patient himself.

    [0010] A further object of the present invention is to optimize therapy for venous ulcers and edema associated with poor venous return.

    [0011] According to the present invention a sleeve for applying compressive pressures against a patient's limb from a source of pressurized fluid comprises an elongated sheath preferably multi layered defining a plurality of compressive chambers which may be generally limb encircling, the said sheath having an open proximal end and a closed distal end, the said sheath being adapted to receive a patient's limb through its open proximal end; the said sheath having a front portion for juxtaposition with the front surface of a patient's limb, and a back portion for juxtaposition with the back surface of a patient's limb; the said front and back portions of the said sheath having transversely extending side elements, the said side elements having an outer gripping edge thereon, the said front portion having gripping means thereon being adapted to be wrapped over the said side elements and secured on to the said gripping means of the said front portion to permit girthwise adjustment of the said sleeve about a patient's limb, for example the front and back portions of the sheath having transversely extending side elements, the said side elements having a gripping edge thereon and the said front portion having gripping means thereon, preferably on an outer lateral central surface thereof, the said side elements being wrappable over and securable to the said front portion of the sheath.

    [0012] The said front portion and the said back portion of the said sheath are preferably joined along their common edges coinciding between the said proximal end and the said distal end, to define the said sheath.

    [0013] The said front portion and the said rear portion preferably have a common coinciding edge only partway along the length of the side of the said sheath from the said proximal end to the said distal end, to permit openability of the said sheath, thus facilitating entry of a patient's limb into the sheath.

    [0014] The said back preferably includes a cushion pad for the juxtaposition of a patient's foot thereagainst.

    [0015] A compressive chamber is preferably disposed in the said back portion of the said sheath, about the said foot cushion pad.

    [0016] A compressive chamber is preferably longitudinally disposed in the said front portion of the said sheath, extending from the distal end thereof, to or towards the proximal end thereof, said compressive chamber about the said foot cushion pad and the said longitudinally disposed compressive chamber in the said front portion are preferably in fluid communication with one another.

    [0017] The sleeve preferably includes a plurality of compressive chambers extending transversely across the said back portion of the said sheath so as to extend only around the fleshy portions of a leg when the sheath is wrapped therearound.

    [0018] The chambers preferably extend across the back portion of the said sheath including the said side elements. Thus these chambers and the longitudinally extending chambers at the front together generally encircle a limb placed in the said sheath.

    [0019] Indicia, e.g. a centre line, are preferably disposed longitudinally along, e.g. the middle of said gripping means, the front portion to assist a patient in properly aligning the said sleeve on his limb. The sheath is preferably a multi-layered sheath and comprises an innermost film of flexible extensible plastic, and an outermost sheet of flexible material, preferably less extensible, which between them define the said compressive chambers. The sleeve preferably includes a plurality of conduits to duct pressure fluid e.g. air from a pressure source to the said compressive chambers, at least one of the said conduits preferably ducting the said air to more than one of the said compressive chambers. The sheath preferably comprises an outer sheet which is relatively stiff and inelastic so that it remains relatively flat upon inflation on introduction of pressure fluid within the said compressive chambers; and an inner sheet which is soft and compliant, so that upon inflation the said inner sheet conforms substantially to the shape of the said limb.

    [0020] In a preferred form of the invention the said front portion is adapted for placement against the bony front of a patient's leg, the said front portion being substantially inelastic, whereby when compression occurs by introducing the said fluid within the said chambers, tension is applied across the curvature of the said front portion, which tension translates into a pressure over the radius of curvature along the front of the said leg.

    [0021] In this preferred form of the invention the said inelastic front portion and the said back portion of the said sheath when secured to enclose a patient's leg provide pressure chamber means for filling the hollow portions at either side of the said bony portion of the leg, whereby tension on the said inelastic front portion will result in compression at that portion of the leg.

    [0022] The said pressure chamber means in the said front portion is preferably partially bifurcated. The bifurcation of the front portion chamber has the advantage of avoiding any pressurizable chamber along the mid portion of the front portion of said proximal end of the said sheath.

    [0023] Desirably the sleeve is provided with a portion adapted to enclose a patient's foot when the said front and back portions are wrapped over and secured together, the said foot portion in juxtaposition with the bottom of the said patient's foot containing no compressive chamber and thereby being non-inflatable.

    [0024] Preferably the said portion enclosing the said foot contains cushion means for the bottom of the said foot.

    [0025] The present invention provides an elongated compressible sleeve device for enclosing a length of a patient's limb, the sleeve having a plurality of sets of adjoining laterally extending fluid pressure chambers.

    [0026] The sleeve is preferably comprised of a single elongated outermost sheet of flexible fluid-impervious material such as urethane-coated nylon.

    [0027] An "inner" film of a suitable flexible fluid-impervious material such as urethane is preferably disposed against the upper side of the "outer" elongated sheet, having common sealed peripheral margins. The film is preferably sealed with respect to the outer sheet to define a plurality of pressurizable chambers. The outer sheet is most preferably stiffer and inelastic or less elastic relative to the inner film, thereby permitting the inner layer to conform appreciably better to the shape of the leg. Thus, the outer sheet will remain relatively flat upon inflation while the inner film inflates and the areas of the film defining adjacent chambers press together, which in turn substantially inhibits zero pressure areas. The elongated sheet and attached film is preferably folded upon itself along a transverse fold near its longitudinal mid-point. The sheet is then preferably joined along all of one and a portion of its other longitudinal edges when folded upon itself to leave one side open from the midpoint upwardly for ease of inserting the limb, thereby forming a two-layered sheath-like structure, open at its proximal end to define an inner film and outer sheet arrangement. A plurality of conduits are preferably arranged in fluid communication with their respective chambers, each conduit preferably terminating in a connector adjacent the open end of the sleeve.

    [0028] The sleeve has a distal end which is preferably closed by its transverse fold, for the enclosed emplacement of a patient's foot. An oblong or generally oval non-inflatable pad is preferably enclosed between the inner and outer sheets at the distal end of the sleeve, on top of the film, to provide a cushion base for the patient's foot.

    [0029] The outer film of the topmost layer is arranged to be positionable over the front side of a patient's limb. An adhering or securement means is preferably disposed along the front of the topmost layer.

    [0030] The side edges of the topmost layer, from the proximal end of the foot chamber, to the uppermost end of the sleeve, preferably have an adhering strip attached therealong. The longitudinal side portions of the sleeve preferably include margins or flap portions which are foldable onto the adhering means, so as to adjustably encase the wearer's limb in the sleeve.

    [0031] The topmost layer preferably comprises a pair of longitudinally directed pressurizable chambers which are in fluid communication with the pressurizable chamber above and alongside the patient's foot.

    [0032] A longitudinally directed centrally disposed sight line may be arranged along the middle of the adhering means to permit the patient to line up the sleeve, so that the sight line is aligned up the middle of the limb, permitting most effective utilization and location of the compressive chambers on the limb.

    [0033] When the sleeve fully encloses a patient's limb, and the marginal side flaps of the sleeve are wrapped over and adhered to their respective sides of the adhering means, the patient's limb is almost completely surrounded by inflatable chambers, awaiting sequential pressurization. However, the front of a patient's leg is bony and hence requires no pressurizable chambers. The important area is the muscular area on the sides and back of a patient's leg, which contains the veins to which compressive pressure needs to be applied in accordance with this invention. The front side of the sleeve, which comprises the tongue portion thereof, is preferably inelastic, so that when compression occurs in the remainder of the sleeve and onto the leg, tension is applied across the curvature of the tonge which in effect translates into pressure over the radius of curvature along the front of a patient's leg.

    [0034] The invention may be put into practice in various ways and one specific embodiment will be described by way of example to illustrate the invention with reference to the accompanying drawings, in which:

    Figure 1 is a perspective view of a full limb length compressible sleeve constructed according to the principles of the present invention;

    Figure 2 is another perspective view of the sleeve shown in Figure 1, with a patient's limb depicted therein;

    Figure 3 is a plan view of the elongated outer sheet, which when folded generally along its transverse mid-point, comprises the outer layer of the sleeve;

    Figure 4 is a plan view of an inner film disposed upon the outer sheet having the chambers defined by seal margins between the inner film and the outer sheet; and

    Figure 5 is a plan view on an enlarged scale of the sleeve, with the inner and the outer sheet joined at their appropriate peripheral locations.



    [0035] The present invention comprises an elongated compressible sleeve 10 for enclosing a patient's limb, and is of a form and shape appropriate for a leg. The sleeve 10, shown in perspective view in Figure 1, includes a plurality of adjoining generally transversely extending fluid pressurizable chambers 12, which are shown more clearly in Figure 4.

    [0036] The sleeve 10 is comprised of an outermost flexible fluid-impervious sheet 14, made of urethane-coated nylon, or the like, in an elongated form, as shown in Figure 3. The outermost sheet 14 has a first end 16 and a second or opposed end 18, each of which has a transverse dimension that narrows (tapers) slightly to a general mid-point of the sheet 14, defined by a transverse fold line 20.

    [0037] The sleeve 10 is also comprised of an innermost flexible fluid-impervious film 22, made of plastic material such as urethane, having a peripheral outline, as shown in Figure 4, which is generally similar to the configuration of the outermost sheet 14. As previously stated, the outermost sheet is stiffer and less elastic or inelastic relative to the innermost film so that the latter conforms well to the shape of the leg while the former remains relatively flat upon inflation.

    [0038] The film 22 has a first end 24 and a second end 26, each of which has a transverse dimension that narrows slightly to a general mid-point of the film 22 defined by the common transverse "fold" line 20. The peripheral outline of the innermost film 22 is substantially the same as the periphery of the outermost sheet 14. Preferably, however, the length of the film 22, to the right of the common "fold" line 20 as shown in Figure 4, is shorter than the corresponding length of the outer sheet 14, e.g. of the order of 20% shorter.

    [0039] In both the outermost sheet 14, and the innermost film 22, the longer portion of each to one side of their common fold line 20, comprises the backside portion 17 of the sleeve 10 having elongated side marginal portions 70 which wrap about the patient's limb from the backside thereat, which portions are to the left of the fold line 20, viewing Figure 2.

    [0040] The innermost film 22 is placed over the outermost sheet 14, with their common fold line 20, and their first ends 24 and 16 also contiguous, as shown in Figure 4. The section of the sleeve 10, to the right of the fold line 20, as shown in Figure 4, will comprise the frontside portion 19, of the sleeve 10, when the film 22 and sheet 14 are folded along the fold line 20, onto themselves, to form the sleeve.

    [0041] The innermost film 22 may then be sealed to the outermost sheet 14 generally at the periphery 23 of the film 22 and at seal lines 32 which also define a plurality of longitudinally spaced transversely directed pressurizable chambers 12 between the innermost film 22 and the outermost sheet 14. The seal lines 32 and the chambers 12 are shown in Figure 4 prior to the folding of the elongated sheet 14 and the film 22 and subsequent peripheral joining. Suitable sealing means, e.g. radio frequency (RF) sealing means, will be readily suggested to those skilled in the art.

    [0042] A foot pad 36, of generally oval shape, is non-pressurizably disposed between the sheet 14 and the film 22, to form a cushion against which a patient's foot is placed, as may be seen in Figure 2. A front pressurizable chamber 34, partially bifurcated, is disposed to the right of the fold line 20 of Figure 4. The front chamber 34 is in fluid communication with a chamber 35 which extends around the side portions of the foot pad 36. The bifurcated chamber 34 eliminates any pressure chamber juxtaposed against the very forwardmost bony part of a patient's leg, when it is enclosed in the sleeve 10. This in turn applies compression to the flat leg sections on either side of the forwardmost bony portion of the lower leg. Since these flat leg sections are the sites of many ulcers, it follows that they are important areas for applying compressive pressure in accordance with this invention. The backside portion 17 of the sleeve 10 includes a lowermost pressurizable ankle chamber 38, an intermediate calf chamber 40, a first thigh chamber 42 and an upper thigh chamber 44. Each chamber 38, 40, 42 and 44 has an orifice 46 for the supply of pressure fluid e.g. for the sequential pressurization and depressurization of those chambers, through a plurality of conduits 50, through a coupling adapter 51, which is in fluid communication through further conduits 53 with a compression generator. This arrangement may be as identified in various patents including those previously incorporated by reference herein. The chamber 35, disposed about the sides and forepart of the pad 36, as well as the pressurizable chamber 34 in the frontside of the sleeve 10, including the top of the foot, is preferably maintained at a constant base pressure of about 10 pounds pressure, from a pressure generating source as aforementioned.

    [0043] During assembly of the sleeve 10, the frontside 19 of the sleeve 10 is folded over onto the backside portion 17 of the sleeve 10, along their common fold line 20, and are joined, as by stitching or the like, along their common peripheral points, as indicated by "P", shown in Figure 5. The common peripheral points P may be recited as one generally longitudinally common side edge 52, and another side edge 54, only a portion of which is common to the frontside 19 and the backside 17. A longitudinal opening 56 extends almost half-way along one longitudinal side, and the sleeve 10 is open at its proximalmost end 60, to permit, in conjunction with the side opening 56, a patient to easily slide his leg "L" into the sheath-like arrangement of the sleeve 10.

    [0044] A generally rectangular (slightly truncated) patch of receiving cloth 62 is secured to the outside upper portion of the frontside 19, of the sleeve, as shown in Figures 1, 2, 3, and 5. A narrow strip 64 of hook means, such as the trademarked "Velcro" material, is attached adjacent the elongated marginal side elements 70 or edges, as shown in Figures 1, 2, and 5.

    [0045] After a patient has placed his leg or limb in the sheath-like sleeve 10, the longitudinal side portions along the proximal segment of the sleeve 10, may be wrapped about the patient's limb "L" as shown in Figure 2, so that the narrow strip 64 of hook means engages the receiving cloth 62 to encircle the patient's limb and hold the sleeve closely around the leg. A marker (or sight) line "M" as shown in Figure 1, may be disposed on the topside of the receiving cloth 62, to facilitate alignment of the sleeve with the front mid-portion of the patient's limb (leg). The sheath shown in Figure 5 is of a size such as to reach just above the knee. Longer sheaths may be used.

    [0046] Air or other pressurizable fluid may then be directed through the conduits 46 into the chambers 34, 38, 40, 42 and 44 in the manner, e.g. of sequence and pressure profile, created by the pressure generator aforementioned.

    [0047] In view of the foregoing description and illustrative drawings, it will thus be appreciated that the present invention provides a therapeutic device for applying compressive pressure against the leg, which device is easily applied and removed by the patient and is accordingly particularly suitable for home care.

    [0048] Apart from this advantage, the construction and arrangement of elements of the therapeutic device of this invention provides further significant advantages which can best be described by reference to the physiology of the patient's leg.

    [0049] As was previously stated, the important area to be subjected to compression is the muscular area on the sides and particularly on the back of the leg. The front of the leg is bony and hence does not require this treatment. Accordingly, the front side of the sleeve, which we can call the tongue portion thereof is not provided with sequential compression chambers. Moreover, the tongue portion is inelastic so that compression occurring at the back of the leg causes tension to be applied to the inelastic tongue portion which is in turn translated to pressure over the radius of curvature at the front of the leg.

    [0050] It will also be seen from the foregoing description that there is no compression applied to the bottom of the foot. Since blood does not pool there, edema does not occur and consequently there is no need to apply compression. On the other hand, if the bottom of the foot portion were inflated to apply compression, the resulting pressure patterns would be changed if the patient stood on his feet, which the patient is indeed permitted to do when wearing the therapeutic device of this invention.

    [0051] Yet another important advantage is obtained from the use of an outer sheet which is relatively stiff and inelastic and an inner film which is soft and compliant. Apart from the fact that it is desirable to have an abrasion resistant outer surface, this combination of outer sheet and inner film permits the inner film to conform substantially to the shape of the individual leg. Accordingly, zero pressure points are substantially precluded, thus avoiding or lessening the so-called corrugation effect typically seen when prior hospital compressible sleeve devices are used on edematous legs.


    Claims

    1. A sleeve for applying compressive pressures against a patient's limb from a source of pressurized fluid, comprising an elongated sheath (10) defining a plurality of compressive chambers (12), the said sheath having an open proximal end (60) and a closed distal end, the said sheath being adapted to receive a patient's limb through its open proximal end; the said sheath having a front portion (19) for juxtaposition with the front surface of a patient's limb, and a back portion (17) for juxtaposition with the back surface of a patient's limb; characterised in that the said front and back portions of the said sheath having transversely extending side elements (70), the said side elements having an outer gripping edge (64) thereon, the said front portion having gripping means (62) thereon, the said side elements (70) being adapted to be wrapped over and secured on to the said gripping means (62) of the said front portion to permit girthwise adjustment of the said sleeve about a patient's limb.
     
    2. A sleeve for applying compressive pressures about a patient's limb as claimed in Claim 1 characterized in that the said front portion and the said rear portion have a common coinciding edge (54) only partway along the length of the side of the said sheath from the said proximal end to the said distal end, to permit openability of the said sheath, thus facilitating entry of a patient's limb into the sheath.
     
    3. A sleeve for applying compressive pressures about a patient's limb as claimed in Claim 1 or Claim 2 characterized in that the said back portion includes a cushion pad (36) for the juxtaposition of a patient's foot thereagainst.
     
    4. A sleeve for applying compressive pressures about a patient's limb as claimed in any one of Claims 1 to 3 characterized in that a compressive chamber (34) is longitudinally disposed in the said front portion of the said sheath, extending from the distal end thereof, to or towards the proximal end thereof.
     
    5. A sleeve for applying compressive pressures about a patient's limb as claimed in any one of Claims 1 to 4 characterized in that it includes a plurality of compressive chambers (38,40,42,44) extending transversely across the said back portion (17) of the said sheath so as to extend only around the fleshy portions of a leg when the sheath is wrapped therearound.
     
    6. A sleeve as claimed in any one of Claims 1 to 5 characterized in that the sheath comprises an outer sheet (14) which is stiff and inelastic so that it remains flat upon inflation on introduction of pressure fluid within the said compressive chambers; and an inner sheet (22) which is soft and compliant, so that upon inflation the said inner sheet conforms substantially to the shape of the said limb.
     
    7. A sleeve as claimed in any one of Claims 1 to 6 characterized in that the said front portion is adapted for placement against the bony front of a patient's leg, the said front portion being substantially inelastic, whereby when compression occurs by introducing the said fluid within the said chambers, tension is applied across the curvature of the said front portion, which tension translates into a pressure over the radius of curvature along the front of the said leg.
     
    8. A sleeve as claimed in Claim 7 characterized in that the said inelastic front portion and the said back portion of the said sheath when secured to enclose a patient's leg provide pressure chamber means (34) for filling the hollow portions at either side of the said bony portion of the leg, whereby tension on the said inelastic front portion will result in compression at that portion of the leg.
     
    9. A sleeve as claimed in Claim 8 characterized in that the said pressure chamber means (34) in the said front portion is partially bifurcated.
     
    10. A sleeve as claimed in any one of Claims 1 to 9 characterized in that it includes a portion adapted to enclose a patient's foot when the said front and back portions are wrapped over and secured together, the said foot portion in juxtaposition with the bottom of the said patient's foot containing no compressive chamber and thereby being non-inflatable.
     


    Ansprüche

    1. Manschette zur Ausübung von Druckkräften auf eine Gliedmaße eines Patienten aus einer Druckmittelquelle, mit einer länglichen, mehrere Druckkammern (12) begrenzenden Hülle (10), die ein offenes proximales Ende (60) und ein geschlossenes distales Ende aufweist sowie zur Aufnahme der Gliedmaße des Patienten durch das offene proximale Ende ausgebildet ist und einen vorderen Abschnitt (19) zum Anlegen an die Vorderseite der Gliedmaße des Patienten sowie einen hinteren Abschnitt (17) zum Ablegen an die Hinterseite der Gliedmaße des Patienten besitzt, dadurch gekennzeichnet, daß der vordere und der hintere Abschnitt der Hülle quer verlaufende Seitenteile (70) aufweist, die einen außenliegenden Griffrand (64) aufweisen, daß der vordere Abschnitt Greifmittel (62) aufweist, daß die Seitenteile (70) zum Übereinanderlegen und Befestigen an den Greifmitteln (62) des vorderen Abschnittes ausgebildet ist, um eine gürtelförmige Anordnung der Manschette rund um die Gliedmaße des Patienten zu ermöglichen.
     
    2. Manschette zur Ausübung von Druckkräften auf eine Gliedmaße eines Patienten, nach Anspruch 1, dadurch gekennzeichnet, daß der vordere und der hintere Abschnitt bloß über einen Teil der Länge der vom proximalen zum distalen Ende verlaufenden Hüllenseite zusammentreffende Ränder (54) aufweisen, um das Öffnen der Hülle zu ermöglichen und somit das Einführen der Gliedmaße des Patienten in die Hülle zu erleichtern.
     
    3. Manschette zur Ausübung von Druckkräften auf eine Gliedmaße eines Patienten, nach Anspruch 1 oder 2, dadurch gekennzeichnet, daß der hintere Abschnitt eine Kissenauflage (36) zum Anlegen an den Fuß des Patienten aufweist.
     
    4. Manschette zur Ausübung von Druckkräften auf eine Gliedmaße eines Patienten, nach den Ansprüchen 1 bis 3, dadurch gekennzeichnet, daß im vorderen Abschnitt der Hülle eine längsverlaufende Druckkammer (34) angeordnet ist, die sich vom distalen Ende aus bis zum oder in Richtung zum proximalen Ende erstreckt.
     
    5. Manschette zur Ausübung von Druckkräften auf eine Gliedmaße eines Patienten, nach den Ansprüchen 1 bis 4, dadurch gekennzeichnet, daß sie mehrere Druckkammern (38, 40, 42, 44) aufweist, die sich quer über den hinteren Abschnitt (17) der Hülle und bloß über die fleischlichen Bereiche eines Beines erstrecken, wenn das Bein damit umhüllt ist.
     
    6. Manschette nach den Ansprüchen 1 bis 5, dadurch gekennzeichnet, daß die Hülle eine außenliegende Bahn (14), die steif und unelastisch ist, so daß sie bei Aufblähen beim Einleiten eines Druckmittels in die Druckkammern flach bleibt, und eine innenliegende Bahn (22) aufweist, die weich und nachgiebig ist, so daß sich beim Aufblähen die innenliegende Bahn im wesentlichen der Form der Gliedmaße anpaßt.
     
    7. Manschette nach den Ansprüchen 1 bis 6, dadurch gekennzeichnet, daß der vordere Abschnitt zum Anlegen an die knöcherne Vorderseite des Beines eines Patienten ausgebildet und im wesentlichen unelastisch ist, wodurch bei Auftreten von Druckkräften durch Einleiten des Druckmittels in die Kammern entlang der Krümmung des vorderen Abschnittes eine Zugkraft ausgeübt wird, die sich entlang dem Krümmungsradius längs der Vorderseite des Beines in eine Druckkraft umsetzt.
     
    8. Manschette nach Anspruch 7, dadurch gekennzeichnet, daß der unelastische vordere Abschnitt und der hintere Abschnitt der Hülle im befestigten, das Bein eines Patienten umschließenden Zustand eine Druckkammereinrichtung (34) zum Ausfüllen der hohlen Bereiche an beiden Seiten des knöchernen Bereiches des Beines bilden, wodurch Zugkräfte im unelastischen vorderen Abschnitt zu Druckkräften an diesem Beinbereich führen.
     
    9. Manschette nach Anspruch 8, dadurch gekennzeichnet, daß die Druckkammereinrichtung (34) im vorderen Abschnitt teilweise gegabelt ist.
     
    10. Manschette nach den Ansprüchen 1 bis 9, dadurch gekennzeichnet, daß sie einen Abschnitt aufweist, der zum Umschließen des Fußes eines Patienten ausgebildet ist, wenn der vordere und hintere Abschnitt übereinandergelegt und aneinander befestigt sind, und daß der Fußabschnitt in Anlage an der Sohle des Fußes des Patienten keine Druckkammer enthält und daher nicht aufblähbar ist.
     


    Revendications

    1. Manchon destiné à appliquer des pressions compressives contre un membre d'un patient à partir d'une source de fluide sous pression comprenant une gaine allongée (10) délimitant une multiplicité de chambres de compression (12), la gaine en question possédant une extrémité proximale ouverte (60) et une extrémité distale fermée, la gaine concernée étant adaptée à recevoir un membre d'un patient par son extrémité proximale ouverte, cette gaine possédant une partie frontale (19) destinée à la juxtaposition avec la surface frontale d'un membre d'un patient et une partie arrière (17) destinée à la juxtaposition avec la surface arrière d'un membre d'un patient, caractérisé en ce que la partie frontale et la partie arrière précitées de la gaine concernée comportent des éléments latéraux s'étendant transversalement (70), ces éléments latéraux possédant un bord d'agrippage externe (64), la partie frontale précitée comportant des moyens d'agrippage (62), les éléments latéraux (70) précités étant adaptés à couvrir les moyens d'agrippage (62) et à être fixés à ces moyens d'agrippage (62) de la partie frontale pour permettre l'ajustement du manchon précité à la manière d'une sangle autour d'un membre d'un patient.
     
    2. Manchon pour appliquer des compressions compressives autour d'un membre d'un patient suivant la revendication 1, caractérisé en ce que la partie frontale précitée et la partie arrière précitée possèdent un bord coïncidant commun (54) seulement partiellement le long de la longueur du côté de la gaine précitée à partir de ladite extrémité proximale jusqu'à ladite extrémité distale, pour permettre de donner de l'ampleur à ladite gaine, afin d'ainsi faciliter la pénétration d'un membre d'un patient dans la gaine.
     
    3. Manchon pour appliquer des pressions compressives autour d'un membre d'un patient suivant la revendication 1 ou la revendication 2, caractérisé en ce que la partie arrière précitée comprend un tampon formant coussin (36) pour la juxtaposition contre celui-ci d'un pied d'un patient.
     
    4. Manchon pour appliquer des pressions compressives autour du membre d'un patient suivant l'une quelconque des revendications 1 à 3, caractérisé en ce qu'une chambre compressive (34) est disposée longitudinalement dans ladite partie frontale de la gaine précitée, s' étendant à partir de l'extrémité distale de celle-ci, jusqu'à ou en direction de l'extrémité proximale de celle-ci.
     
    5. Manchon pour appliquer des pressions compressives autour du membre d'un patient suivant l'une quelconque des revendications 1 à 4, caractérisé en ce qu'il comprend une multiplicité de chambres compressives (38, 40, 42, 44) qui s'étendent transversalement à travers la partie arrière (17) précitée de la gaine concernée, de manière à ne s'étendre seulement qu'autour des parties charnues d'une jambe lorsque la gaine est amenée à recouvrir cette jambe.
     
    6. Manchon pour appliquer des pressions compressives autour du membre d'un patient suivant l'une quelconque des revendications 1 à 5, caractérisé en ce que la gaine comprend une feuille externe (14) qui est rigide et non élastique, de manière à ce qu'elle demeure plate lors du gonflement par introduction d'un fluide sous pression dans lesdites chambres compressives et une feuille interne (22) qui est molle et souple, de façon que lors du gonflement cette feuille interne se conforme sensiblement au contour du membre précité.
     
    7. Manchon pour appliquer des pressions compressives autour du membre d'un patient suivant l'une quelconque des revendications 1 à 6, caractérisé en ce que ladite partie frontale est adaptée au placement contre la partie frontale osseuse d'une jambe d'un patient, cette partie frontale étant sensiblement non élastique, si bien que lorsqu'une compression s'opère par l'introduction du fluide précité dans les chambres en question, une tension est appliquée en travers de la courbure de cette partie frontale, laquelle tension se traduit par une pression exercée sur le rayon de courbure le long de la partie frontale de la jambe précitée.
     
    8. Manchon suivant la revendication 7, caractérisé en ce que ladite partie frontale non élastique et ladite partie arrière de ladite gaine lorsqu'elle est assujettie pour enfermer une jambe d'un patient constituent un dispositif à chambre de pression (34) pour remplir les parties creuses de chaque côté de ladite partie osseuse de la jambe, si bien qu'une tension exercée sur ladite partie frontale non élastique va provoquer une compression à cette partie de la jambe.
     
    9. Manchon suivant la revendication 8, caractérisé en ce que le dispositif à chambre de pression (34) dans ladite partie frontale bifurque partiellement.
     
    10. Manchon suivant l'une quelconque des revendications 1 à 9, caractérisé en ce qu'il comprend une partie adaptée à enfermer ou enclore un pied d'un patient lorsque lesdites parties frontale et arrière se chevauchent et sont mutuellement assujetties, ladite partie formant pied en juxtaposition avec la partie inférieure du pied du patient en contenant pas de chambre compressive et étant ainsi non gonflable.
     




    Drawing