FLUSHING ORDER

Description

[0001] The invention relates to a rinsing arrangement for rinsing systems for cleaning surgical wounds using rinsing fluid, comprising an outer tube in which an inner tube is arranged, wherein an annular gap is formed at least sectionally between the outer tube and the inner tube, and an attachment is provided at the free end of the outer tube, wherein outlet openings for the rinsing fluid are formed in the attachment, which are designed such that the rinsing fluid exits at an angle α and thus obliquely to the longitudinal centerline of the tubes.

[0002] Irrigation systems (so-called lavage systems) of the type discussed here are used to clean surgical wounds in order to flush out necrotic tissue, bacteria, and foreign material. These systems are particularly useful in bone surgeries, such as joint replacements, to remove surgical debris. This helps prevent postoperative complications and accelerate healing, as residual debris can compromise the durability of the artificial joint and lead to bone infections. The irrigation process should be thorough yet gentle.

[0003] The rinsing systems generate a laminar or pulsating jet that travels through a tube to a nozzle and exits the system through the nozzle. The fluid is predominantly sterile saline solution or an aqueous solution that may also contain pharmaceutically active substances. The fluid contaminated with residues is aspirated via a second channel using special suction devices. These suction devices are funnel-shaped and can be integrated into the rinsing system or designed as a separate unit.

[0004] Besides the irrigation volume, a key criterion for the quality of the irrigation is the pressure with which the fluid impacts the bone, cancellous bone, or tissue. If the jet is too forceful, this can lead to damage to the bone or similar issues. Harmful components can then be forced deeper into the bone instead of being flushed out.

[0005] Various designs for the flushing and suction pipes are used in flushing systems. For example, designs are known in which the flushing pipe is arranged coaxially within the suction pipe (see, e.g., DE 10 2012 000 392 A1). The flushing jet thus exits the nozzle in the center. The flushing fluid is drawn in through the annular gap formed around the flushing pipe. However, due to its small dimensions, this solution has the disadvantage that the annular gap can become clogged when suctioning larger quantities of contaminated liquid.

[0006] To avoid this disadvantage, designs are known in which the suction pipe is arranged coaxially within the flushing pipe (see, for example, DE 20 2010 011 728 U1). The nozzle on the flushing pipe thus surrounds the suction pipe. Suction therefore takes place centrally in the middle of the flushing and suction pipes, thereby avoiding the aforementioned disadvantage.

[0007] Furthermore, designs are known in which suction is carried out via a pipe located adjacent to and parallel to the nozzle. While this also counteracts the risk of clogging, it simultaneously obstructs the operator's view of the sprayed area.

[0008] In all known irrigation systems, the jet exits the system straight, i.e., along the imaginary extension of the nozzle's longitudinal centerline. Therefore, when used as intended, it strikes the bone or tissue surface to be irrigated perpendicularly. This results in a very small cleaning area. Furthermore, the jet impacts the bone or tissue surface at maximum pressure, which can lead to undesirable damage to the surface.

[0009] Irrigation systems are used to flush the tubular cavities of organs (so-called lumens). These systems have a baffle plate positioned in front of the nozzle, which deflects the irrigation fluid at a right angle after it exits the nozzle, allowing the bone or cancellous bone wall to be flushed. The jet therefore also strikes the bone or tissue surface to be irrigated perpendicularly. Suction is also performed here via an annular gap surrounding the nozzle, which can lead to the aforementioned clogging. In addition, there is a risk that healthy tissue can be damaged by the sharp edges of the outer tube when inserting the system.

[0010] From DE 20 2010 011 728 U1, CN 103480058 B, US 5 460 604 A and US 5 464 390 A, flushing devices are known in which the flushing fluid exits the device at an angle and in which the flushing fluid is extracted in the center.

[0011] Against this background, the invention aims to create a rinsing system that, on the one hand, increases the cleaning surface and, on the other hand, enables gentle rinsing. According to the invention, this objective is achieved with the features of claim 1.

[0012] The invention provides a rinsing system that, on the one hand, increases the cleaning surface and, on the other hand, prevents the suction pipe from clogging. The angled impact of the rinsing jet on the surface causes it to loosen and penetrate beneath the surface, resulting in gentler removal of the coating. Simultaneously, the material to be removed is flushed towards the central suction point.

[0013] The outlet openings, located in the constriction on the side of the tubes furthest from the main section and immediately adjacent to the section, direct a jet of irrigation fluid towards the center of the wound. This improves the suction of fluid from the wound because the suction occurs through the inner tube at the center of the irrigation assembly. Furthermore, this design ensures that the jet strikes the area to be irrigated at an angle.

[0014] The free end of the attachment is formed by a funnel-shaped section. This design ensures reliable absorption of the irrigation fluid. At the same time, it creates a kind of shield around the wound being irrigated, preventing uncontrolled discharge of the fluid.

[0015] In a further development of the invention, the attachment is cap-shaped and preferably rounded on the outside. This covers the sharp edges of the tube and protects the bone tissue when inserting it into Lumina.

[0016] In this embodiment of the invention, the attachment has bristles around its circumference. This improves the cleaning of deep lumens, for example, when cleaning bone cement or residues of special medical adhesives, which are frequently used in hip replacement surgery. The bristles enable mechanical cleaning of the surface, similar to a brush.

[0017] The bristles are preferably arranged in a helical pattern around the circumference of the attachment. The rows of bristles thus follow a spiral around the tube. In known solutions, the brushes have a linear and parallel arrangement of the bristle rows relative to the central axis. This necessitates moving the inserted tube both axially and radially within the lumen to reach all areas of the surface to be cleaned. Since the area to be cleaned is not visible to the user, the cleaning result cannot be monitored. The helical arrangement of the bristles eliminates this problem. Only axial insertion of the cleaning assembly is required. Due to the bristle arrangement, every area is reached and mechanically brushed during insertion.

[0018] In another embodiment of the invention, the bristles are conically shaped. The conical shape of the bristles creates a bending curve, ensuring sufficient bristle stiffness while simultaneously providing the gentlest possible cleaning action on the surface.

[0019] Other embodiments and configurations of the invention are specified in the remaining dependent claims. Exemplary embodiments of the invention are illustrated in the drawings and are described in detail below. The drawings show: Figure 1 a view of a flushing arrangement according to the invention as claimed; Figure 2 the front view of the in Figure 1 illustrated flushing arrangement; Figure 3 the cut along line III - III in Figure 2 ; Figure 4 the in Figure 3 longitudinal section through the adapter piece shown on an enlarged scale; Figure 5 the in Figure 3longitudinal section through the attachment shown on an enlarged scale; Figure 6 the detail "Z" from Figure 5 on an enlarged scale; Figure 7 the front view of the in Figure 1 The illustrated flushing arrangement is shown in an enlarged view; Figure 8 a view of a rinsing arrangement in a different design that does not correspond to the claimed invention; Figure 9 the front view of the in Figure 8 illustrated flushing arrangement; Figure 10 the section along line IX - IX in Figure 9 ; Figure 11 the in Figure 10 longitudinal section through the attachment shown on an enlarged scale; Figure 12 a view of a rinsing arrangement in a further embodiment that does not correspond to the claimed invention; Figure 13 the front view of the in Figure 12 illustrated flushing arrangement; Figure 14 the cut along line XIII - XIII in Figure 13 ; Figure 15 the in Figure 12View of the essay shown at an enlarged scale; Figure 16 the cut along line XIV - XIV in Figure 14 on an enlarged scale; Figure 17 The enlarged three-dimensional representation of a bristle.

[0020] The irrigation arrangements shown in the exemplary embodiments are intended for irrigation systems for cleaning surgical wounds using irrigation fluid. Each irrigation arrangement comprises an outer tube 1 in which an inner tube 2 is arranged. An annular gap 3 is formed section by section between the outer tube 1 and the inner tube 2. Depending on the design of the irrigation arrangement, the annular gap can also extend over the entire length of the outer tube 1 and the inner tube 2.

[0021] An adapter piece 4 for connection to a drive and actuation unit (not shown), as known from the prior art, is arranged at one end of the outer tube 1. An attachment 5 is provided at the end of the outer tube 1 opposite the adapter piece 4.

[0022] The adapter piece 4, with its end facing the attachment 5, fits snugly around one end of the outer tube 1. The adapter piece 4 widens towards the side opposite the attachment 5. An insert 6, comprising a pump receptacle 7 and a pipe section 8, is located within the adapter piece. The end of the inner tube 2 opposite the adapter piece 4 is received on one side of the pipe section 8. The other side of the pipe section 8 is designed for connecting another hose.

[0023] In the assembled state of the flushing assembly, a robust pump protrudes into the pump housing 7. This pump is sealed against the pump housing 7 by means of an O-ring and supplies the flushing fluid. A suction hose is connected to the pipe section 8 for use with the flushing assembly, and this hose carries away the contaminated flushing fluid. From this arrangement, it follows that the flushing fluid is supplied to the attachment 5 through the annular gap 3 and the contaminated flushing fluid is carried away through the inner pipe 2.

[0024] The design of the attachment 5 varies, as can be seen from the figures. In the exemplary embodiment according to the Figures 1 to 6The attachment 5 is essentially bell-shaped. In its region facing away from the adapter piece 4, the attachment 5 has a constriction 9, to which a funnel-shaped section 10 adjoins, forming the free end of the attachment 5. In the end of the constriction 9 facing section 10, and thus directly adjacent to section 10, outlet openings 11 for the rinsing fluid are formed adjacent to each other in the attachment 5. The outlet openings 11 form the ends of channels 12 that are formed in the attachment 5 and which are connected to the annular gap 3 at their ends facing away from the outlet openings 11.

[0025] The outlet openings 11 are recognizably designed such that the flushing fluid exits at an angle α and thus obliquely to the longitudinal centerline of the flushing arrangement or of the outer tube 1 and the inner tube 2 (cf. Figures 5 and 6In the context of the present invention, "oblique" means that the angle α deviates from the longitudinal centerline of the rinsing arrangement or from a line perpendicular to it at an acute or obtuse angle. The angle α is preferably between 5° and 85° to the longitudinal centerline of the rinsing arrangement.

[0026] In the representation according to Figure 7 Furthermore, two different embodiments of the inventive attachment 5 with the constriction 9 are shown. In the right half of Figure 7 The irrigation fluid exits the outlet openings 11 in such a way that it is directed at an angle α towards the center of the irrigation arrangement, as indicated by the arrows. Consequently, the irrigation fluid strikes the area to be irrigated at an angle in the center of the wound.

[0027] In the left half of Figure 7The rinsing fluid also exits the outlet openings 11 at an angle α. Simultaneously, due to the appropriate design of the outlet openings 11, the rinsing fluid also exits the attachment 5 at an angle β to the radial line, as indicated by the arrows in the left half of the figure. Figure 7 This is indicated. The rinsing fluid is thereby set into a kind of rotation, which creates a kind of turbulence, leading to a further improvement in the rinsing result.

[0028] In the (non-inventive) embodiment according to the Figures 8 to 11The attachment 5 is cap-shaped. It is recognizably rounded on the outside. It is provided with webs 13 whose wall thickness corresponds to the height of the annular gap 3. In the assembled state, the webs 13 are accommodated by the annular gap 3. At its center, the attachment 5 has an opening 14, which is aligned coaxially with the inner tube 2 and whose diameter essentially corresponds to the inner diameter of the inner tube 2. The contaminated rinsing fluid is thus drawn through the opening 14 to the inner tube 2 and discharged through it.

[0029] The attachment 5 has outlet openings 11 for the flushing fluid. In this embodiment, the outlet openings 11 are provided with a baffle surface 15, which is designed as an outwardly directed circular segment. In this embodiment, the circular segment extends over an area of ​​approximately 25°. The outermost end of the circular segment of the baffle surface 15 is clearly neither parallel nor perpendicular to the longitudinal centerline of the flushing assembly or the outer tube 1 and the inner tube 2. Consequently, the flushing fluid exits obliquely, namely at an angle α (see Figure 11). It is also possible to design the baffles 15 such that the flushing fluid exits the outlet openings 11 from the attachment 5 at an angle β to the radial line, which also improves the flushing effect in this embodiment.

[0030] In a variation of the exemplary embodiment, a type of comb can be provided at the opening 14, which can fulfill a filter function. This prevents clogging of the opening 14 or the inner tube 2.

[0031] In the (non-inventive) embodiment according to the Figures 12 to 16 The attachment 5 is essentially hollow and cylindrical. Its end facing the adapter 4 is pushed onto the end of the outer tube 1 and surrounds the portion of the inner tube 2 that projects beyond the outer tube 1. At its end opposite the adapter 4, the attachment 5 rests on the inner tube 2. In this area, the attachment 5 also has an opening 14. The diameter of the opening 14 corresponds essentially to the inner diameter of the inner tube 2. Consequently, in this embodiment as well, the contaminated rinsing fluid is drawn through the opening 14 to the inner tube 2 and discharged through it.

[0032] The inner diameter of the attachment 5 corresponds essentially to the inner diameter of the outer tube 1. Consequently, an annular gap 16 is formed between the inner tube 2 and the attachment 5, which is a continuation of the annular gap 3. In the region of the end facing away from the adapter piece 4, the attachment 5 is provided with outlet openings 11, which are designed like windows. In the exemplary embodiment, four outlet openings 11 are formed, arranged around the perimeter of the attachment 5. A different number of outlet openings 11 is possible. The outlet openings 11 can also be arranged at other locations on the attachment 5. It is also possible to provide several rings of outlet openings 11. Impact surfaces 15 are provided in the outlet openings 11, which are neither parallel nor perpendicular to the longitudinal centerline of the flushing arrangement or of the outer tube 1 and the inner tube 2.Consequently, in this embodiment as well, the rinsing fluid exits the attachment 5 at an angle, namely at an angle α. In this embodiment, too, it is possible to design the impact surfaces 15 such that the rinsing fluid exits the outlet openings 11 from the attachment 5 at an angle β to the radial line. In this way, the rinsing fluid can also be swirled in a rotational manner in this embodiment, which improves the rinsing effect.

[0033] In this embodiment, the attachment 5 has bristles 18 around its circumference. The bristles are made of the same material as the attachment and are integrally formed with it. The bristles 18 are arranged in rows around the circumference in a helical pattern. The rows of bristles thus follow a spiral around the attachment 5. Each row has two sharp edges 19 and a rounded section 20. The bristles 18 are also conical. The arrangement of the bristles around the circumference and the arrangement of the outlet openings between the bristles allow the rinsing fluid to escape between the bristles. Therefore, rinsing takes place where the mechanical processing of the surface is also performed.

[0034] The rinsing arrangement according to the invention makes it possible to direct the rinsing fluid at different angles and in different directions onto the areas to be rinsed. By varying the size, cross-section, and angles, the volume and direction of the emerging jet can be influenced. This makes it possible to adapt the invention for different surfaces.

[0035] Furthermore, by varying the exit angles of the intended impact bodies or the type of constriction, it is possible to direct the jet of irrigation fluid so that the fluid hits the areas of the wound to be cleaned at different points at a shallow angle and pushes the material to be removed towards the central suction opening.

Claims

1. Flushing arrangement for flushing systems for cleaning surgical wounds by means of flushing liquid comprising an outer pipe (1), in which an inner pipe (2) is arranged, wherein between outer pipe (1) and inner pipe (2) an annular gap (3) is formed at least in sections, and on the free end of the outer pipe (1) an attachment (5) is provided, wherein outlet openings (11) for the flushing liquid are formed in the attachment (5), which are designed in such a manner that the flushing liquid exits at an angle α and thus obliquely to the longitudinal centre line of the pipes (1, 2), characterised in that the free end of the attachment (5) is formed by a funnel-shaped section (10) and in that the outlet openings (11) are formed in the area of a constriction (9) facing away from the pipes (1, 2) and in the immediate vicinity of the section (10).

2. Flushing arrangement according to claim 1, characterised in that the angle α is between 5° and 85° relative to the longitudinal centre line.

3. Flushing arrangement according to claim 1 or 2, characterised in that the attachment (5) sectionally surrounds the inner pipe (2).

4. Flushing arrangement according to one of the previous claims, characterised in that the attachment (5) is substantially bell-shaped.

5. Flushing arrangement according to one of the previous claims, characterised in that the attachment (5) is of cap-like design.

6. Flushing arrangement according to claim 5, characterised in that the attachment (5) is rounded on the outside.

7. Flushing arrangement according to one of the previous claims, characterised in that the attachment (5) is provided with webs (13), the wall thickness of which corresponds to the height of the annular gap (3) and which are received by the annular gap (3) in the mounted state.

8. Flushing arrangement according to one of the previous claims, characterised in that the attachment (5) has an opening (14) passing through its centre, which is coaxially aligned with the inner pipe (2).

9. Flushing arrangement according to one of the previous claims, characterised in that the outlet openings (11) are provided with a baffle surface (15).

10. Flushing arrangement according to claim 9, characterised in that the baffle surface (15) is designed in the manner of an outwardly directed circular section.

11. Flushing arrangement according to one of the previous claims, characterised in that the attachment (5) is substantially hollow-cylindrical.

12. Flushing arrangement according to claim 11, characterised in that the inner diameter of the attachment (5) substantially corresponds to the inner diameter of the outer pipe (1).

13. Flushing arrangement according to claim 12, characterised in that an annular gap (16) is formed between the inner pipe (2) and the attachment (5).

14. Flushing arrangement according to one of the previous claims, characterised in that the attachment (5) is provided with bristles (18) on its circumference.

15. Flushing arrangement according to claim 14, characterised in that the bristles (18) are arranged in the manner of a helix on the circumference of the attachment (5).

16. Flushing arrangement according to claim 14 or 15, characterised in that the bristles (18) each have two sharp edges and a rounding.

17. Flushing arrangement according to one of the previous claims, characterised in that the bristles (18) are conical.

18. Flushing arrangement according to one of the previous claims, characterised in that the outlet openings are designed in such a manner that the flushing liquid exits the outlet openings in the attachment (5) at an angle β relative to the radial line.