Tracheal catheter fixing device with sputum suction channel and pressure sore prevention function

Abstract

The utility model discloses a tracheal catheter fixing device with a sputum suction channel and a pressure sore prevention function, and belongs to the technical field of medical tracheal catheter fixing tools. Comprising a soft rubber face covering part, a threaded push rod assembled and connected to the upper end face of the soft rubber face covering part, a sliding push block, a catheter / bite block fixing body and a face contact soft cushion attached and connected to the lower end face of the soft rubber face covering part. A catheter fixing C-shaped ring is arranged on one side of the catheter / bite block fixing body, a bite block extending downwards is vertically arranged close to the outer portion of the catheter fixing C-shaped ring, and a sputum suction catheter / stomach tube channel hole is formed in the center of the bite block. By conducting cambered surface treatment on all structures possibly making contact with the oral maxillofacial region, it can be guaranteed that the oral cavity and facial soft tissue are fully protected, the device can be well suitable for being worn by people with different facial forms, and meanwhile the device can effectively meet the application scene of lateral position and even prone position patients.

Description

TECHNICAL FIELD

[0001] The utility model relates to a kind of fixing device for medical tracheal catheter, specifically to a tracheal catheter fixing device with sputum suction channel and having pressure sore prevention function, belong to medical tracheal catheter fixing tool technical field. BACKGROUND

[0002] Tracheal intubation is a very important medical operation technique, which is to insert a specially-made tracheal catheter into the trachea through the patient's mouth or nose, thereby establishing an artificial airway. On the one hand, it can ensure the smoothness of the airway, allowing air to flow smoothly into the patient's lungs, maintaining the patient's respiratory function, especially in emergency situations such as respiratory failure and airway obstruction, tracheal intubation can quickly and effectively save the patient's life. On the other hand, after tracheal intubation, devices such as ventilators and anesthetizing machines can be connected for mechanical ventilation, providing sufficient oxygen supply for the patient and helping to expel carbon dioxide from the body. In addition, tracheal intubation can also prevent patients from aspirating, such as in patients with impaired consciousness or swallowing dysfunction, it can prevent serious lung infections or suffocation caused by reflux of stomach contents into the airway. At the same time, it is also convenient for respiratory tract management, such as removing respiratory tract secretions, performing bronchoscopy and other operations.

[0003] However, in clinical work, in order to prevent the depth displacement of tracheal intubation or the patient's bite closed tracheal intubation, which affects the ventilation effect, and also to protect the patient's teeth and lips, tracheal catheter fixator emerges as the times require. With the continuous development of medical technology, tracheal catheter fixator is also constantly improving and perfecting to better meet the clinical needs. Currently, three ways are commonly used to fix tracheal intubation in clinical practice:

[0004] 1) The first is ordinary dental pad, which is fixed by wrapping it with adhesive tape together with the tracheal catheter. This dental pad is made of plastic or other materials, which is cylindrical or flat, with high hardness, which can effectively separate the teeth from the tracheal catheter, but the material is hard, and long-term wearing can greatly increase the risk of tooth damage and pressure sores on the lips, tongue and other soft tissues. And the fixation with adhesive tape is not firm, and it is easy to loosen, causing displacement of the tracheal intubation, which is too deep or too shallow, affecting the quality of ventilation. Also, the long-term contact of the adhesive tape with the patient's facial skin can cause skin allergy or skin damage when the adhesive tape is torn off.

[0005] 2) The second is bandage roll, which is used in the same way as the first. The advantage is that the material is soft, and the risk of pressure sores on the oral soft tissues is low, but the disadvantage is that the user may insert it too deep if they lack experience, which can damage the lingual frenulum and other parts. And since it also uses adhesive tape or fixing belt to fix, it has the same problems as the first.

[0006] 3) The third is various types of tracheal tube fixator, using fixing belt to fix tracheal tube, effectively solving various hidden troubles of adhesive tape fixation, having good stability. However, there are few types of tracheal tube fixators on the market at present, and the structure design is generally lack of rationality, and the oral cavity and facial soft tissue are lack of sufficient protection, and the risk of pressure sores is high after long-time wearing, and the tracheal tube fixator can basically only be used in the scene of supine position, and it is difficult to meet the use demand of patients in lateral position or prone position.

[0007] Therefore, it is urgent to design a tracheal tube fixing device with pressure sore prevention function and capable of meeting the use demand of patients in lateral position or prone position. Content of the utility model

[0008] The utility model discloses a kind of tracheal tube fixing devices with sputum suction channel and pressure sore prevention function, by arc surface processing to tooth pad all around, and the inclined plane design of tooth pad part end is more close to tongue tip, and by design soft rubber facial covering and paste facial contact soft pad under it, to ensure that all possible contact oral cavity and facial soft tissue structure is fully protected to oral cavity and facial soft tissue, while it can be well adapted to different face shape person wearing, can effectively meet the application scene of patient in lateral position or even prone position.

[0009] To achieve the above object, the utility model adopts the following technical scheme: a kind of tracheal tube fixing device with sputum suction channel and pressure sore prevention function, including soft rubber facial covering, screw push rod, sliding push block and catheter / tooth pad fixed main body of assembly connection on the upper end surface of soft rubber facial covering, and facial contact soft pad of paste connection on the lower end surface of soft rubber facial covering;

[0010] The cavity structure for inserting tracheal tube is vertically provided on the catheter / tooth pad fixed main body, one side of the cavity structure is provided with an opening and outwardly extended guide plates are provided on both sides of the opening, wherein a threaded hole is provided on the side wall of the catheter / tooth pad fixed main body connected with one side guide plate, one end of the screw push rod is transversely connected in the cavity structure by penetrating the threaded hole, and a sliding push block is fixedly connected on the inner end of the screw push rod;The side of the catheter / tooth pad fixed main body connected with the other side guide plate is provided as a catheter fixing C-shaped ring, the inner wall surface of the catheter fixing C-shaped ring is correspondingly provided as an inner arc surface, an arc-shaped clamping groove is provided on the end surface of the sliding push block symmetrical to the inner arc surface, and the arc-shaped clamping groove and the inner arc surface jointly form a clamping mechanism matched with the shape of the tracheal tube;

[0011] The outer vertical of the C-shaped ring fixed to the catheter is provided with a downwardly extending tooth pad, the center of the tooth pad is provided with a sputum suction tube / gastric tube passage hole, the outer wall of the tooth pad near one side of the catheter fixed C-shaped ring is provided with a tooth pad guide inclined surface matching the inner arc surface, the tooth pad far from one side of the catheter fixed C-shaped ring is chamfered with a lip pressure sore prevention arc surface, and the bottom end of the tooth pad is also provided with a tooth pad guide arc surface.

[0012] The soft gel face covering is provided with a matching hole corresponding to the cavity structure and opening of the catheter / tooth pad fixing body, an adhesive boss is arranged on the upper end surface edge of the matching hole, a tooth pad position observation window for accommodating the tooth pad is further arranged on the soft gel face covering, the tooth pad position observation window is communicated with the matching hole and the inner contour size thereof is greater than the outer contour size of the tooth pad; the lower end surface of the catheter / tooth pad fixing body is pasted and connected on the adhesive boss, and the tooth pad is located in the tooth pad position observation window.

[0013] Further, one end of the outer side of the threaded push rod is fixedly connected with a rotating handle, one end of the inner side is provided with a fixed chuck, one side near the rotating handle is provided with an external thread, one side near the fixed chuck is provided with a straight rod, and the threaded push rod is rotationally connected on the catheter / tooth pad fixing body through the cooperation of the external thread and the threaded hole; the middle part of the sliding push block is provided with a fixed hole, and the sliding push block is fixed on the threaded push rod through the cooperation of the fixed hole and the fixed chuck.

[0014] Further, the outer wall of one side of the tooth pad and the outer wall of the guide plate, and the outer wall of the other side of the tooth pad and the outer wall of the threaded hole are both provided with reinforcing ribs.

[0015] Further, the inner surface of the arc-shaped clamping groove and the inner arc surface in contact with the tracheal tube, and the outer surface of the lower end of the tooth pad entering the oral cavity are both provided with a coating glue layer with a thickness not less than 1mm.

[0016] Further, the material of the coating glue layer is silica gel or soft glue, and the coating glue layer is fixed by secondary injection molding or gluing.

[0017] Further, the upper end surface of the soft gel face covering is also symmetrically provided with double-layer reinforced binding fixing ears on both sides of the matching hole and the tooth pad position observation window; the catheter / tooth pad fixing body and the adhesive boss are fixed by medical UV glue.

[0018] Further, the soft gel face covering is integrally injection molded by PC soft glue with a hardness of 90A.

[0019] Further, the face contact soft pad is closely attached to the lower end surface of the soft gel face covering by double-sided adhesive paste, and the outer shape edge size of the face contact soft pad is 3mm larger than the outer shape edge size of the soft gel face covering.

[0020] Further, the face contact soft pad is die cut from 5mm thick polyurethane foam material.

[0021] Further, the threaded push rod, sliding push block and catheter / dental pad fixing body are all PP materials and are integrally injection molded.

[0022] The beneficial effects of the utility model are:

[0023] 1) The utility model device processes the arc surface of the dental pad, adopts the inclined surface design more suitable for the tongue tip at the end of the dental pad part, and designs the soft rubber face covering piece and pastes the face contact soft pad under it, so that all structures that can contact the oral and maxillofacial parts are fully protected, the different face shapes of the wearer can be well adapted, and the application scene of the patient in the lateral position or even the prone position can be effectively met.

[0024] 2) The inclined surface design more suitable for the tongue tip is adopted at the end of the dental pad part in the utility model device, the effective support for the teeth is guaranteed, and the length is moderate and will not press the lingual frenulum to cause damage; the soft rubber is wrapped around the dental pad part, so that the damage to the oral mucosa, teeth and the like of the patient caused by the behavior of unconscious violent biting or friction is avoided.

[0025] 3) The soft rubber face covering piece and the face contact soft pad structure part in the utility model device are made of soft rubber material, so that they can better adapt to the face structure of various types of patients, the gasket is made of the same material as the anti-decubitus paste, the polyurethane foaming material is used as the buffer material between the tracheal catheter fixator and the skin, the outer shape and the peripheral size of the material are all larger than the outer shape and the size of the soft rubber component, every part contacting the skin of the patient is soft, the safety and comfort are guaranteed, the air permeability is considered, the probability of pressure ulcer is effectively reduced, the device can be worn for a long time, and the application scene of the patient in the lateral position or even the prone position can be effectively met.

[0026] 4) The dental pad center hole design in the utility model device can allow various commonly used types of sputum suction tubes to pass through, so that the nursing personnel can clean the oral secretions or other foreign matters of the patient, and the channel can even be used as the emergency stomach tube in special cases. BRIEF DESCRIPTION OF DRAWINGS

[0027] Figure 1 It is a three-dimensional structure schematic view of the utility model device;

[0028] Figure 2 It is Figure 1 It is a three-dimensional structure schematic view of the catheter / dental pad fixing body;

[0029] Figure 3 It is Figure 1The left inclined perspective view structure diagram of the middle catheter / dental cushion fixing body;

[0030] Figure 4 For Figure 1 The right inclined perspective view structure diagram of the middle catheter / dental cushion fixing body;

[0031] Figure 5 For Figure 4 The right view of the middle catheter / dental cushion fixing body;

[0032] Figure 6 For Figure 1 The explosion structure diagram of the middle screw rod and the sliding push block;

[0033] Figure 7 For Figure 1 The top view of the middle soft rubber face covering;

[0034] Figure 8 For Figure 1 The bottom view of the middle soft rubber face covering.

[0035] In the figure, 1 - screw rod, 101 - rotating handle, 102 - external thread, 103 - fixed clamp; 2 - sliding push block, 201 - fixed hole, 202 - arc-shaped clamping groove; 3 - catheter / dental cushion fixing body, 301 - threaded hole, 302 - catheter fixing C-shaped ring, 303 - reinforcing rib, 304 - sputum suction tube / gastric tube passage hole, 305 - dental cushion, 306 - guide plate, 307 - inner arc surface, 308 - lip pressure sore prevention arc surface, 309 - dental cushion guide inclined surface, 310 - dental cushion guide arc surface; 4 - soft rubber face covering, 401 - double-layer reinforced binding fixing ear, 402 - dental cushion position observation window, 403 - bonding boss; 5 - face contact soft pad. DETAILED DESCRIPTION

[0036] The utility model will be further explained in connection with the drawings and specific embodiments.

[0037] Embodiment: as Figure 1 The utility model provides a tracheal catheter fixing device with sputum suction passage and with pressure sore prevention function, including soft rubber face covering 4, screw rod 1, sliding push block 2 and catheter / dental cushion fixing body 3 of assembly connection on the upper end surface of soft rubber face covering 4 and face contact soft pad 5 of pasting connection on the lower end surface of soft rubber face covering 4.

[0038] As Figures 2-5As shown, it is the structural schematic view of the catheter / dental pad fixing body; the cavity structure for inserting the tracheal cannula is vertically arranged on the catheter / dental pad fixing body 3, an opening is arranged on one side of the cavity structure, and the guide plates 306 are connected outward on both sides of the opening, wherein the threaded hole 301 is arranged on the side wall of the catheter / dental pad fixing body 3 connected with one side of the guide plates 306, one end of the threaded push rod 1 is transversely connected in the cavity structure by penetrating the threaded hole 301, and the sliding push block 2 is fixedly connected on the inner end of the threaded push rod 1; the catheter fixing C-shaped ring 302 is arranged on one side of the catheter / dental pad fixing body 3 connected with the other side of the guide plates 306, the inner wall of the catheter fixing C-shaped ring 302 is correspondingly arranged as the inner arc surface 307, the arc-shaped clamping groove 202 is arranged on the end face of the sliding push block 2 symmetrical to the inner arc surface 307, and the arc-shaped clamping groove 202 and the inner arc surface 307 jointly form the clamping mechanism matched with the shape of the tracheal cannula.

[0039] The dental pad 305 extending downward is vertically connected to the outside of the catheter fixing C-shaped ring 302, the suction tube / gastric tube passage hole 304 is arranged in the center of the dental pad 305, the dental pad guide inclined surface 309 is arranged on the outer wall of the dental pad 305 close to the catheter fixing C-shaped ring 302 and intersects with the inner arc surface 307, the lip pressure sore prevention arc surface 308 is chamfered on the dental pad 305 away from the catheter fixing C-shaped ring 302, and the dental pad guide arc surface 310 is also obliquely arranged on the bottom end of the dental pad 305.

[0040] The reinforcing ribs 303 are connected between the outer wall of one side of the dental pad 305 and the outer wall of the guide plate 306, and between the outer wall of the other side of the dental pad 305 and the outer wall of the threaded hole 301.

[0041] As shown in the figure, Figure 6 The outer thread 102 is arranged on the side close to the handle 101, the straight rod is arranged on the side close to the fixed clamping head 103, and the threaded push rod 1 is rotatably connected to the catheter / dental pad fixing body 3 through the cooperation of the outer thread 102 and the threaded hole 301; the fixed hole 201 is arranged in the middle of the sliding push block 2, and the sliding push block 2 is fixedly connected to the threaded push rod 1 through the cooperation of the fixed hole 201 and the fixed clamping head 103.

[0042] The threaded hole 301 is an M8 internal thread hole, and the outer thread 102 is an M8 external thread rod.

[0043] As shown in the figure, Figure 7 and Figure 8As shown, the soft rubber face covering 4 is provided with a matching hole corresponding to the cavity structure and opening of the catheter / dental pad fixing body 3, and a bonding boss 403 is connected to the upper end face edge of the matching hole. The soft rubber face covering 4 is also provided with a dental pad position observation window 402 for accommodating the dental pad 305, which is communicated with the matching hole and has an inner contour size larger than the outer contour size of the dental pad 305. The lower end face of the catheter / dental pad fixing body 3 is bonded to the bonding boss 403, and the dental pad 305 is located in the dental pad position observation window 402.

[0044] The upper end face of the soft rubber face covering 4 is also symmetrically connected with double-layer reinforced binding fixing ears 401 on both sides of the matching hole and the dental pad position observation window 402. The catheter / dental pad fixing body 3 and the bonding boss 403 are bonded and fixed by medical UV glue.

[0045] The soft rubber face covering 4 is integrally injection molded by PC soft rubber with a hardness of 90A.

[0046] The face contact soft pad 5 is tightly attached to the lower end face of the soft rubber face covering 4 by double-sided adhesive, and the outer shape edge size of the face contact soft pad 5 is 3mm larger than that of the soft rubber face covering 4.

[0047] The face contact soft pad 5 is cut from polyurethane foam material with a thickness of 5mm.

[0048] The inner surface of the arc-shaped clamping groove 202 and the inner arc surface 307 in contact with the tracheal tube, and the outer surface of the lower end of the dental pad 305 entering the oral cavity are provided with a coating glue layer with a thickness of not less than 1mm; the material of the coating glue layer is silicone or soft rubber, and is fixed by secondary injection molding or glue.

[0049] The threaded push rod 1, the sliding push block 2 and the catheter / dental pad fixing body 3 are all made of PP material and are integrally injection molded.

[0050] Working process:

[0051] First, rotate the handle 101 counterclockwise to move the threaded push rod 1 to the leftmost side, and the sliding push block 2 will also be pulled to the leftmost side with the movement of the threaded push rod 1. Then, the tracheal tube or laryngeal mask airway is pushed into the catheter fixator C-shaped ring 302 through the guide plate 306. Then, along the oral axis, the dental pad 305 is first placed in the patient's mouth, and the dental pad position observation window 402 is used to determine that the dental pad 305 does not squeeze the patient's tongue. The dental pad guide slope 309 and the dental pad guide arc surface 310 can push the tongue away and make the dental pad 305 smoothly slide into the patient's oral cavity. The lips prevent pressure sores arc surface 308 contacts the patient's lips, which can reduce local stress and avoid the occurrence of lip pressure bed. In addition, the surface of the dental pad entering the oral cavity part is covered with silicone or soft rubber with a thickness of not less than 1mm, which can avoid damaging the patient's teeth.

[0052] Then the tracheal tube fixer is completely covered around the patient's mouth by pressing the soft rubber face cover 4, the 5mm thick polyurethane foam soft pad 5 is located between the soft rubber face cover 4 and the patient's skin, directly contacts the patient's skin and lips, and the outer shape edge size of the polyurethane foam soft pad is larger than that of the soft rubber face cover 4 by 3mm; then the tracheal tube fixer is fixed on the patient's mouth by using the sponge fixing band through the double-layer reinforced band fixing ears 401 on both sides of the soft rubber face cover 4, and the soft rubber face cover 4 is deformable and can better fit different face shapes of patients.

[0053] Finally, the handle 101 is rotated clockwise to drive the threaded push rod 1 to move the sliding push block 2 to the right, and the tracheal tube or laryngeal mask catheter is screwed and fixed between the arc-shaped clamping groove 202 and the inner arc surface 307, and the surfaces in contact with the tracheal tube between the two are covered with silicone or soft rubber with a thickness of not less than 1mm to increase the friction force; the reinforcing ribs 303 can ensure that the C-shaped ring 302 of the catheter fixer does not deform seriously under the extrusion of the threaded push rod 1, thereby reducing the clamping force between the arc-shaped clamping groove 202 and the inner arc surface 307.

[0054] If a stomach tube or sputum suction tube needs to be placed during the operation, the stomach tube / sputum suction tube can be inserted into the sputum suction tube / stomach tube passage hole 304 to operate.

[0055] The device of the utility model discloses through arc surface processing to the dental pad all around, and the dental pad part end adopts more close to the inclined surface design of the tongue tip, and through the design soft rubber face cover and the pasting face contact soft pad under it, to ensure that all possible contact to the oral cavity and facial structure of the maxillofacial department carries out the full protection to the oral cavity and facial soft tissue, in can very good adaptation different face shape person wears, can effectively satisfy the application scene of the patient of lateral position even prone position.

[0056] The above merely serves to illustrate the technical scheme of the utility model and not to limit, other modifications or equivalent replacements of the technical scheme of the utility model made by those skilled in the art should be covered in the claim range of the utility model.

Claims

1. A tracheal tube fixing device with a sputum suction channel and a pressure sore prevention function, characterized in that: It comprises a soft rubber face cover (4), a threaded push rod (1), a sliding push block (2) and a catheter / dental pad fixing body (3) assembled and connected on the upper end surface of the soft rubber face cover (4), and a face contact soft pad (5) attached and connected on the lower end surface of the soft rubber face cover (4); The catheter / dental pad fixing body (3) is vertically provided with a cavity structure for inserting a tracheal cannula, one side of the cavity structure is provided with an opening and outwardly extends on both sides of the opening and is provided with a guide plate (306), wherein the side wall of the catheter / dental pad fixing body (3) connected with the guide plate (306) on one side is provided with a threaded hole (301), one end of the threaded push rod (1) is transversely connected in the cavity structure by penetrating the threaded hole (301), and the inner end of the threaded push rod (1) is fixedly connected with the sliding push block (2); the side of the catheter / dental pad fixing body (3) connected with the guide plate (306) on the other side is provided with a catheter fixing C-shaped ring (302), the inner wall of the catheter fixing C-shaped ring (302) is correspondingly provided with an inner arc surface (307), the end surface of the sliding push block (2) symmetrical to the inner arc surface (307) is provided with an arc-shaped clamping groove (202), and the arc-shaped clamping groove (202) and the inner arc surface (307) jointly form a clamping mechanism matched with the shape of the tracheal cannula; A dental pad (305) extending downward is vertically arranged close to the outside of the catheter fixing C-shaped ring (302), the center of the dental pad (305) is provided with a sputum suction tube / gastric tube passage hole (304), the outer wall of the dental pad (305) close to the side of the catheter fixing C-shaped ring (302) is provided with a dental pad guide inclined surface (309) intersecting with the inner arc surface (307) and matching in shape, the dental pad (305) away from the side of the catheter fixing C-shaped ring (302) is chamfered with a lip pressure sore prevention arc surface (308), and the bottom end of the dental pad (305) is also obliquely provided with a dental pad guide arc surface (310); The soft rubber face cover (4) is provided with a matching hole corresponding to the cavity structure and the opening of the catheter / dental pad fixing body (3), an adhesive boss (403) is arranged on the edge of the upper end surface of the matching hole, the soft rubber face cover (4) is also provided with a dental pad position observation window (402) for accommodating the dental pad (305), the dental pad position observation window (402) is communicated with the matching hole and the inner contour size thereof is greater than the outer contour size of the dental pad (305); the lower end surface of the catheter / dental pad fixing body (3) is attached and connected on the adhesive boss (403), and the dental pad (305) is located in the dental pad position observation window (402).

2. The tracheal tube securement device of claim 1, wherein: The outer end of the threaded push rod (1) is fixedly connected with a handle (101), and the inner end is provided with a fixed chuck (103). The side close to the handle (101) is provided with an external thread (102), and the side close to the fixed chuck (103) is provided with a straight rod. The threaded push rod (1) is rotatably connected to the catheter / dental pad fixing body (3) through the cooperation of the external thread (102) and the threaded hole (301).

3. The tracheal tube securement device of claim 1, wherein: The outer wall of one side of the dental pad (305) and the outer wall of the guide plate (306) are provided with a reinforcing rib (303), and the outer wall of the other side of the dental pad (305) and the outer wall of the threaded hole (301) are provided with a reinforcing rib (303).

4. The tracheal tube securement device of claim 1, wherein: The inner surface of the arc-shaped clamping groove (202) and the inner arc surface (307) in contact with the tracheal tube, and the outer surface of the lower end of the dental pad (305) entering the oral cavity are provided with a coating glue layer with a thickness of not less than 1mm.

5. The tracheal tube securement device of claim 4, wherein: The material of the coating glue layer is silica gel or soft glue, and the secondary injection molding or glue sticking is adopted for fixing.

6. The tracheal tube securement device of claim 1, wherein: Double-layer reinforced binding fixing ears (401) are symmetrically arranged on the upper end surface of the soft glue facial covering piece (4) on both sides of the matching hole and the dental pad position observation window (402); the catheter / dental pad fixing body (3) and the bonding boss (403) are adhesively fixed by medical UV glue.

7. The tracheal tube securement device of claim 6, wherein: The soft glue facial covering piece (4) is integrally injection molded by PC soft glue with a hardness of 90A.

8. The tracheal tube securement device of claim 1, wherein: The facial contact soft pad (5) is tightly attached to the lower end surface of the soft glue facial covering piece (4) by double-sided adhesive tape, and the outer shape edge size of the facial contact soft pad (5) is 3mm larger than that of the soft glue facial covering piece (4).

9. The tracheal tube securement device of claim 8, wherein: The facial contact soft pad (5) is cut from 5mm thick polyurethane foam material.

10. The tracheal tube securement device of claim 1, wherein: The threaded push rod (1), the sliding push block (2) and the catheter / dental pad fixing body (3) are all made of PP material and are integrally injection molded.

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