A post-cardiovascular surgery drainage and fixation device

Abstract

The present application belongs to the technical field of postoperative drainage fixation, and specifically discloses a cardiovascular surgery postoperative drainage fixing device, which comprises a fixing shell, a drainage tube adaptive anti-bending device, a drainage bag anti-falling piece and a bandage. According to the contradictory characteristics that the existing drainage tube needs to be fixed (to prevent the drainage tube from being bent and blocked) and cannot be fixed (to adaptively move with the person's activities) during use, the flexible iron wire is wrapped around for protection, so that the multiple technical effects of the curve type movement and the anti-bending and blocking of the drainage tube are realized. According to the different thicknesses of the drainage tube, the rotating and expanding support mode is adopted, so that the technical effect of customized ring protection is realized, and the adaptability is high.

Description

Technical Field

[0001] This invention belongs to the field of postoperative drainage and fixation technology, specifically referring to a postoperative drainage and fixation device for cardiovascular surgery. Background Technology

[0002] A drainage device is a medical auxiliary instrument used to aspirate and collect fluid. After cardiovascular surgery, due to the presence of fluid in the body cavity, a drainage device is typically used to remove this fluid to prevent infection and promote wound healing. Currently, the drainage tube is primarily secured with medical tape, but this method is prone to knotting, tangling, and excessive bending post-operatively. If these bends are non-curved (i.e., direct bends without a curved transition), they can easily cause blockage of the suction tube. Furthermore, the high stress at these corners can affect the overall stability of the suction tube, potentially leading to safety hazards. Summary of the Invention

[0003] To address the above issues and overcome the shortcomings of existing technologies, this invention provides a postoperative drainage fixation device for cardiovascular surgery. Addressing the contradictory nature of existing drainage tubes—which require both fixation (to prevent bending and blockage) and inability to be fixed (due to adaptive movement with human activity)—this invention employs a flexible wire wrapping method for protection, achieving multiple technical effects of both allowing for curved movement of the drainage tube and preventing bending and blockage. Furthermore, based on the varying diameters of the drainage tubes, a rotating expansion and contraction support method is used to achieve customized ring protection, resulting in strong adaptability.

[0004] The technical solution adopted by this invention is as follows: This invention provides a drainage fixation device after cardiovascular surgery, including a fixation shell, an adaptive anti-bending device for the drainage tube, an anti-fall device for the drainage bag, and a strap. The adaptive anti-bending device for the drainage tube is disposed in the fixation shell, the anti-fall device for the drainage bag is disposed in the fixation shell, and the anti-fall device for the drainage bag is disposed on one side of the adaptive anti-bending device for the drainage tube. The strap is disposed on the outer wall of the fixation shell. The adaptive anti-bending device for the drainage tube includes a driving winding component, a diameter adaptive expansion component, and a flexible wire. The driving winding component is disposed in the fixation shell, the diameter adaptive expansion component is disposed on the fixation shell, and the flexible wire is movably disposed on the fixation shell and the adaptive anti-bending device for the drainage tube.

[0005] Furthermore, the driving winding component includes a winding toothed disc, a heart-shaped limiting disc, a winding screw, a spring, and a driving component. The winding toothed disc is rotatably disposed in a fixed housing. The other end of the winding screw is provided with a winding hole. The heart-shaped limiting disc is disposed on the winding toothed disc. One end of the winding screw is rotatably disposed in the fixed housing. A fixing post is provided on the winding screw. One end of the spring is disposed on the inner bottom wall of the fixed housing. The other end of the spring is disposed on the fixing post. The winding screw contacts the heart-shaped limiting disc. The driving component is disposed on the fixed housing. The winding toothed disc is meshed with the driving component.

[0006] Preferably, the driving component includes a rotating column, a driving gear, a rotating wheel, and a handle. The rotating column is rotatably mounted on a fixed shell, the driving gear is located at one end of the rotating column, the rotating wheel is located at the other end of the rotating column, the handle is located on the rotating wheel, and the driving gear is meshed with the rotating gear.

[0007] Furthermore, the adaptive ring diameter expansion component includes a fixed plate, a fixed rod, a fixed disk, a ring diameter adjustment component, and a rotary motor. The fixed plate is disposed on the fixed shell, one end of the fixed rod is disposed on the fixed plate, the fixed disk is connected to the other end of the fixed rod, the ring diameter adjustment component is disposed on the fixed disk, the rotary motor is disposed in the fixed shell, and the output end of the rotary motor is connected to the fixed plate.

[0008] The diameter adjustment component includes a diameter adjusting disc, a drive disc, a locking element, a diameter adjusting column, a telescopic plate, and a support plate. The diameter adjusting disc is rotatably mounted on a fixed disc, and the drive disc is rotatably mounted on the fixed disc. The drive disc is engaged with the diameter adjusting disc. The locking element is mounted on the fixed disc and contacts the drive disc. The fixed disc has a locking groove, and the telescopic plate is engaged and slidably mounted in the locking groove. The support plate is mounted on the telescopic plate. The diameter adjusting disc has a diameter adjusting groove, and one end of the diameter adjusting column is engaged and slidably mounted in the diameter adjusting groove, while the other end of the diameter adjusting column is mounted on the telescopic plate.

[0009] Furthermore, the locking component includes a fixing block, a spring plate, and a locking plate. The fixing block is disposed on a fixing plate, the spring plate is disposed on the fixing block, the locking plate is rotatably disposed on the fixing block, and the spring plate is in contact with the locking plate.

[0010] As a further preferred embodiment of the present invention, the drive disk is provided with a rotary knob.

[0011] Furthermore, the drainage bag anti-fall component includes a drainage bag support and placement cavity, a hanging rod, and a liquid outlet groove. The drainage bag support and placement cavity is located in the fixed shell, the hanging rod is located on the drainage bag support and placement cavity for hanging the drainage bag, and the liquid outlet groove is located on the bottom wall of the drainage bag support and placement cavity.

[0012] The fixed shell is provided with a wire leveling and fixing component, which includes a fixed frame, a wire leveling and fixing hole and a clamping screw. The fixed frame is located on the fixed shell, the wire leveling and fixing hole is located on the fixed frame, and the clamping screw is movably located in the wire leveling and fixing hole. The clamping screw is bolted to the fixed frame and is used to clamp the flexible wire.

[0013] Furthermore, the strap includes a first strap and a second strap. The first strap is disposed on the outer side wall of the fixed shell, and the second strap is disposed on the outer side wall of the fixed shell. The first strap and the second strap are arranged symmetrically. The first strap is provided with round hook and loop fasteners, and the second strap is provided with barbed hook and loop fasteners. The round hook and loop fasteners and the barbed hook and loop fasteners are attached together.

[0014] The beneficial effects achieved by the present invention using the above structure are as follows: This solution provides a drainage fixation device after cardiovascular surgery. Addressing the contradictory characteristics of existing drainage tubes—that they must be fixed (to prevent bending and blockage) yet cannot be fixed (due to adaptive movement with human activity)—this invention employs a flexible wire wrapping protection method, achieving multiple technical effects of curved movement of the drainage tube and prevention of bending and blockage. Furthermore, based on the different diameters of the drainage tubes, a rotating expansion and contraction support method is used to achieve customized ring protection, resulting in extremely high adaptability. Attached Figure Description

[0015] Figure 1 This is a schematic diagram of the overall structure of a cardiovascular surgery drainage and fixation device proposed in this invention. Figure 2 This is a front view of a postoperative drainage and fixation device for cardiovascular surgery proposed in this invention; Figure 3 This is a right view of a postoperative drainage and fixation device for cardiovascular surgery proposed in this invention; Figure 4 This is a top view of a postoperative drainage and fixation device for cardiovascular surgery proposed in this invention; Figure 5 This is a bottom view of a postoperative drainage and fixation device for cardiovascular surgery proposed in this invention; Figure 6 This is a schematic diagram of the structure of the driving winding component; Figure 7 This is a structural schematic diagram of a diameter adaptive expansion support component; Figure 8 for Figure 7 A magnified view of part A in the middle; Figure 9 This is a schematic diagram of the fixed shell structure; Figure 10 for Figure 9 A magnified view of part B in the middle section.

[0016] Among them, 1. Fixed shell, 2. Adaptive anti-bending device for drainage tube, 3. Anti-fall component for drainage bag, 4. Strap, 5. Drive winding component, 6. Adaptive expansion component for ring diameter, 7. Flexible iron wire, 8. Winding gear plate, 9. Heart-shaped limiting plate, 10. Winding rod, 11. Spring, 12. Drive component, 13. Winding hole, 14. Fixed column, 15. Rotating column, 16. Drive gear plate, 17. Rotating wheel, 18. Handle, 19. Fixed plate, 20. Fixed rod, 21. Fixed plate, 22. Ring diameter adjustment component, 23. Rotary motor, 2 4. Diameter adjustment plate; 25. Drive plate; 26. Locking component; 27. Diameter adjustment column; 28. Telescopic plate; 29. ​​Support plate; 30. Engaging slide groove; 31. Diameter adjustment groove; 32. Fixing block; 33. Spring plate; 34. Locking plate; 35. Rotating knob; 36. Drainage bag support placement cavity; 37. Hanging rod; 38. Liquid outlet groove; 39. Wire leveling fixing component; 40. Fixing frame; 41. Wire leveling fixing hole; 42. Pressing screw; 43. Strap 1; 44. Strap 2; 45. Round loop Velcro; 46. Barbed Velcro.

[0017] The accompanying drawings are provided to further illustrate the invention and form part of the specification. They are used together with the embodiments of the invention to explain the invention and do not constitute a limitation thereof. Detailed Implementation

[0018] The technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings of the embodiments of the present invention. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. All other embodiments obtained by those skilled in the art based on the embodiments of the present invention without creative effort are within the scope of protection of the present invention.

[0019] In the description of this invention, it should be understood that the terms "upper", "lower", "front", "rear", "left", "right", "top", "bottom", "inner", "outer", etc., indicate the orientation or positional relationship based on the orientation or positional relationship shown in the accompanying drawings. They are only for the convenience of describing this invention and simplifying the description, and do not indicate or imply that the device or element referred to must have a specific orientation, or be constructed and operated in a specific orientation. Therefore, they should not be construed as limitations on this invention.

[0020] like Figure 1 , Figure 3 , Figure 4 , Figure 5As shown, the present invention provides a drainage fixation device after cardiovascular surgery, including a fixation shell 1, a drainage tube adaptive anti-bending device 2, a drainage bag anti-fall device 3, and a strap 4. The drainage tube adaptive anti-bending device 2 is disposed in the fixation shell 1, the drainage bag anti-fall device 3 is disposed in the fixation shell 1, the drainage bag anti-fall device 3 is disposed on one side of the drainage tube adaptive anti-bending device 2, and the strap 4 is disposed on the outer wall of the fixation shell 1.

[0021] like Figure 1 , Figure 2 , Figure 6 , Figure 7 , Figure 8 , Figure 10As shown, the adaptive anti-bending device 2 for the drainage tube includes a driving winding component 5, a diameter adaptive expansion component 6, and a flexible wire 7. The driving winding component 5 is located in the fixed housing 1, the diameter adaptive expansion component 6 is located on the fixed housing 1, and the flexible wire 7 is movably located on the fixed housing 1 and the adaptive anti-bending device 2 for the drainage tube. The fixed housing 1 is provided with a wire leveling and fixing component 39, which includes a fixing frame 40, a wire leveling and fixing hole 41, and a clamping screw 42. The fixing frame 40 is located on the fixed housing 1, the wire leveling and fixing hole 41 is located on the fixing frame 40, and the clamping screw 42 is movably located in the wire leveling and fixing hole 41 and is bolted to the fixing frame 40. The driving winding component 5 includes a winding toothed disc 8, a heart-shaped limiting disc 9, and a winding screw 10. A spring 11 and a drive component 12 are included. A rotating gear 8 is rotatably mounted in a fixed housing 1. A winding hole 13 is provided on the other end of a lead screw 10. A heart-shaped limiting disk 9 is mounted on the rotating gear 8. One end of the lead screw 10 is rotatably mounted in the fixed housing 1. A fixing post 14 is provided on the lead screw 10. One end of the spring 11 is located on the inner bottom wall of the fixed housing 1, and the other end of the spring 11 is located on the fixing post 14. The lead screw 10 contacts the heart-shaped limiting disk 9. The drive component 12 is mounted on the fixed housing 1, and the rotating gear 8 is meshed with the drive component 12. The drive component 12 includes a rotating post 15, a drive gear 16, a rotating wheel 17, and a handle 18. The rotating post 15 is rotatably mounted on the fixed housing 1. The drive gear 16 is located at one end of the rotating post 15, and the rotating wheel 17 is located at the other end of the rotating post 15. At one end, a handle 18 is mounted on a rotating wheel 17, and a drive gear 16 meshes with a revolving gear 8. The diameter adaptive expansion member 6 includes a fixed plate 19, a fixed rod 20, a fixed disk 21, a diameter adjustment member 22, and a rotary motor 23. The fixed plate 19 is mounted on the fixed housing 1, one end of the fixed rod 20 is mounted on the fixed plate 19, and the fixed disk 21 is connected to the other end of the fixed rod 20. The diameter adjustment member 22 is mounted on the fixed disk 21, and the rotary motor 23 is located in the fixed housing 1. The output end of the rotary motor 23 is connected to the fixed plate 19. The diameter adjustment member 22 includes a diameter adjustment disk 24, a drive disk 25, a locking member 26, a diameter adjustment column 27, a telescopic plate 28, and a support plate 29. The diameter adjustment disk 24 is rotatably mounted on the fixed disk 21, and the drive disk 25 is rotatably mounted on the fixed disk. On the fixed plate 21, the drive disc 25 is engaged with the diameter-changing disc 24. The locking element 26 is located on the fixed plate 21 and contacts the drive disc 25. The fixed plate 21 is provided with a locking groove 30. The telescopic plate 28 is engaged and slidably disposed in the locking groove 30. The support plate 29 is located on the telescopic plate 28. The diameter-changing disc 24 is provided with a diameter-changing groove 31. One end of the diameter-changing column 27 is engaged and slidably disposed in the diameter-changing groove 31, and the other end of the diameter-changing column 27 is located on the telescopic plate 28. The locking element 26 includes a fixed block 32, a spring plate 33, and a locking plate 34. The fixed block 32 is located on the fixed plate 21, the spring plate 33 is located on the fixed block 32, and the locking plate 34 is rotatably disposed on the fixed block 32. The spring plate 33 contacts the locking plate 34. The drive disc 25 is provided with a rotary knob 35.

[0022] like Figure 1 , Figure 9 As shown, the drainage bag anti-fall component 3 includes a drainage bag support and placement cavity 36, a hanging rod 37, and a liquid outlet groove 38. The drainage bag support and placement cavity 36 is located in the fixed shell 1, the hanging rod 37 is located on the drainage bag support and placement cavity 36, and the liquid outlet groove 38 is located on the bottom wall of the drainage bag support and placement cavity 36.

[0023] like Figure 1 , Figure 4 , Figure 9 As shown, the strap 4 includes a first strap 43 and a second strap 44. The first strap 43 is located on the outer side wall of the fixed shell 1, and the second strap 44 is located on the outer side wall of the fixed shell 1. The first strap 43 and the second strap 44 are arranged symmetrically. The first strap 43 is provided with a round hook and loop fastener 45, and the second strap 44 is provided with a barbed hook and loop fastener 46. The round hook and loop fastener 45 and the barbed hook and loop fastener 46 are attached together.

[0024] In practical use, one end of the flexible iron wire 7 is inserted through the wire leveling and fixing hole 41, and the clamping screw 42 is tightened. The clamping screw 42 rotates and moves downward to fix one end of the flexible iron wire 7. Then, the other end of the flexible iron wire 7 is inserted into the winding hole 13. According to the thickness of the drainage tube, the expansion and contraction of the coil diameter adjustment component 22 is adjusted. The rotating knob 35 is rotated, which drives the drive disc 25 to rotate. The drive disc 25 rotates, which drives the diameter-changing disc 24 to rotate. The diameter-changing disc 24 rotates, which drives the diameter-changing column 27 to move along the diameter-changing groove 31. The movement of the diameter-changing column 27 drives the telescopic plate 28 to move along the engaging slide groove 30. The movement causes the support plate 29 to expand, thus achieving a perfect match with the diameter of the drainage tube. After adjustment, stop rotating the knob 35. At this time, the locking plate 34, under the action of the spring plate 33, locks the drive plate 25. Hold the handle 18 and rotate it. The rotation of the handle 18 causes the rotating wheel 17 to rotate, which in turn causes the rotating column 15 to rotate. The rotation of the rotating column 15 causes the drive gear plate 16 to rotate, which in turn causes the circular gear plate 8 to rotate. The rotation of the circular gear plate 8 causes the heart-shaped limiting plate 9 to rotate, which in turn causes the winding screw 10 to move. The movement of the winding screw 10 causes the flexible iron inserted into the winding hole 13 to move. The movement of wire 7 simultaneously drives the rotary motor 23. The rotation of the rotary motor 23 causes the fixed plate 19 to rotate, which in turn causes the fixed column 14 to rotate. The rotation of the fixed column 14 causes the fixed disk 21 to rotate, which in turn causes the coil diameter adjusting component 22 to rotate. The rotation of the coil diameter adjusting component 22 causes the flexible wire 7 to rotate, thereby winding the flexible wire onto the support plate 29. After winding, the linear flexible wire 7 becomes a wire loop. The wire loop is removed from the support plate 29 and can be stretched according to the length of the drainage tube. The drainage tube is then fitted into the wound wire loop, providing curved support for the drainage tube without obstructing the flow. In the case of the drainage tube's direction, the technical effect of preventing the drainage tube from bending is achieved. The drainage bag is placed in the drainage bag support placement cavity 36 and hung on the hanging rod 37. The liquid outlet is placed in the liquid outlet groove 38 to support and protect the drainage bag, effectively preventing it from falling due to increased weight and also preventing the drainage bag from being squeezed. Finally, it is tied around the waist with strap 43 and strap 44. When the diameter of the drainage tube changes, the wire ring can be inserted into the wire leveling and fixing hole 41 and pulled to level the 7 turns of flexible wire. Then, the above steps are repeated according to the diameter of the drainage tube. The above is the specific working process of the present invention.

[0025] It should be noted that, in this document, relational terms such as "first" and "second" are used only to distinguish one entity or operation from another, and do not necessarily require or imply any such actual relationship or order between these entities or operations. Furthermore, the terms "comprising," "including," or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but also other elements not expressly listed, or elements inherent to such process, method, article, or apparatus.

[0026] Although embodiments of the invention have been shown and described, it will be understood by those skilled in the art that various changes, modifications, substitutions and alterations can be made to these embodiments without departing from the principles and spirit of the invention, the scope of which is defined by the foregoing and its equivalents.

[0027] The present invention and its embodiments have been described above. This description is not restrictive, and the accompanying drawings are only one embodiment of the present invention; the actual structure is not limited thereto. In conclusion, if those skilled in the art are inspired by this description and design similar structures and embodiments without departing from the spirit of the invention, such designs should fall within the protection scope of the present invention.

Claims

1. A drainage and fixation device for cardiovascular surgery, characterized in that: The device includes a fixed shell (1), a drainage tube adaptive anti-bending device (2), a drainage bag anti-fall component (3), and a strap (4). The drainage tube adaptive anti-bending device (2) is located in the fixed shell (1), the drainage bag anti-fall component (3) is located in the fixed shell (1), and the drainage bag anti-fall component (3) is located on one side of the drainage tube adaptive anti-bending device (2). The strap (4) is located on the outer wall of the fixed shell (1). The drainage tube adaptive anti-bending device (2) includes a driving winding component (5), a ring diameter adaptive expansion component (6), and a flexible iron wire (7). The driving winding component (5) is located in the fixed shell (1), and the ring diameter adaptive expansion component (6) is located on the outer wall of the fixed shell (1). On the shell (1), the flexible iron wire (7) is movably disposed on the fixed shell (1) and cooperates with the driving winding component (5) and the diameter adaptive expansion component (6); the driving winding component (5) includes a winding toothed disc (8), a heart-shaped limiting disc (9), a winding rod (10), a spring (11) and a driving component (12). The winding toothed disc (8) is rotatably disposed in the fixed shell (1). The other end of the winding rod (10) is provided with a winding hole (13). The heart-shaped limiting disc (9) is disposed on the winding toothed disc (8). One end of the winding rod (10) is rotatably disposed in the fixed shell (1). The winding rod (10) is provided with a fixing post (14). The spring (11) is rotatably disposed on the fixed shell (12). 1) One end of the spring (11) is located on the inner bottom wall of the fixed shell (1), and the other end of the spring (11) is located on the fixed column (14). The winding screw (10) is in contact with the heart-shaped limiting plate (9). The driving member (12) is located on the fixed shell (1), and the winding gear plate (8) is meshed with the driving member (12). The driving member (12) includes a rotating column (15), a driving gear plate (16), a rotating wheel (17), and a handle (18). The rotating column (15) is rotatably located on the fixed shell (1). The driving gear plate (16) is located at one end of the rotating column (15), the rotating wheel (17) is located at the other end of the rotating column (15), and the handle (18) is located at the other end of the rotating column (15). On the rotating wheel (17), the drive gear disk (16) is meshed with the rotating gear disk (8); the diameter adaptive expansion member (6) includes a fixed plate (19), a fixed rod (20), a fixed disk (21), a diameter adjustment member (22), and a rotary motor (23). The fixed plate (19) is located on the fixed shell (1), one end of the fixed rod (20) is located on the fixed plate (19), the fixed disk (21) is connected to the other end of the fixed rod (20), the diameter adjustment member (22) is located on the fixed disk (21), and the rotary motor (23) is located in the fixed shell (1). The output end of the rotary motor (23) is connected to the fixed plate (19).The diameter adjustment component (22) includes a diameter adjustment disc (24), a drive disc (25), a locking component (26), a diameter adjustment column (27), a telescopic plate (28), and a support plate (29). The diameter adjustment disc (24) is rotatably mounted on a fixed disc (21), and the drive disc (25) is rotatably mounted on the fixed disc (21). The drive disc (25) is engaged with the diameter adjustment disc (24). The locking component (26) is mounted on the fixed disc (21). (26) Contacts with the drive plate (25). The fixed plate (21) is provided with a locking groove (30). The telescopic plate (28) is locked and slidably disposed in the locking groove (30). The support plate (29) is disposed on the telescopic plate (28). The diameter-changing plate (24) is provided with a diameter-changing groove (31). One end of the diameter-changing column (27) is locked and slidably disposed in the diameter-changing groove (31). The other end of the diameter-changing column (27) is disposed on the telescopic plate (28).

2. The cardiovascular surgery postoperative drainage and fixation device according to claim 1, characterized in that: The locking component (26) includes a fixing block (32), a spring plate (33) and a locking plate (34). The fixing block (32) is disposed on the fixing plate (21), the spring plate (33) is disposed on the fixing block (32), and the locking plate (34) is rotatably disposed on the fixing block (32). The spring plate (33) and the locking plate (34) are in contact.

3. The postoperative drainage and fixation device for cardiovascular surgery according to claim 2, characterized in that: The drive disk (25) is provided with a rotary knob (35).

4. The postoperative drainage and fixation device for cardiovascular surgery according to claim 3, characterized in that: The drainage bag anti-fall component (3) includes a drainage bag support placement cavity (36), a hanging rod (37), and a liquid outlet groove (38). The drainage bag support placement cavity (36) is located in the fixed shell (1), the hanging rod (37) is located on the drainage bag support placement cavity (36), and the liquid outlet groove (38) is located on the bottom wall of the drainage bag support placement cavity (36).

5. A postoperative drainage and fixation device for cardiovascular surgery according to claim 4, characterized in that: The fixed shell (1) is provided with a wire leveling fixing component (39). The wire leveling fixing component (39) includes a fixing frame (40), a wire leveling fixing hole (41), and a clamping screw (42). The fixing frame (40) is located on the fixed shell (1), the wire leveling fixing hole (41) is located on the fixing frame (40), and the clamping screw (42) is movably located in the wire leveling fixing hole (41). The clamping screw (42) is bolted to the fixing frame (40).

6. A postoperative drainage and fixation device for cardiovascular surgery according to claim 5, characterized in that: The strap (4) includes a first strap (43) and a second strap (44). The first strap (43) is located on the outer side wall of the fixed shell (1), and the second strap (44) is located on the outer side wall of the fixed shell (1). The first strap (43) and the second strap (44) are arranged symmetrically. The first strap (43) is provided with a round hook and loop fastener (45), and the second strap (44) is provided with a barbed hook and loop fastener (46). The round hook and loop fastener (45) and the barbed hook and loop fastener (46) are attached together.

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