This application is the U.S. National Stage of International Application No. PCT/EP2018/080110, filed on Nov. 5, 2018, which designates the U.S., published in German, and claims priority under 35 U.S.C. § 119 or 365(c) to German Application No. 102017125933.3, filed Nov. 7, 2017, German Application No. 102018113789.3, filed Jun. 8, 2018, and German Application No. 102018121591.6, filed Sep. 4, 2018. The entire teachings of the above applications are incorporated herein by reference.

The invention relates to a cushion for use when lying or sleeping in a prone position after breast surgery. The cushion comprises a base body with a recess.

After breast surgery, the breast having undergone surgery usually has to be specially protected against forces to prevent any sutures closing surgical wounds from coming loose or the wound itself from healing poorly. Hence, patients are usually advised to lie and sleep in supine position for eight to twelve weeks after the surgery to avoid contact of the breast having undergone surgery and a mattress or an underlay.

From EP 2 420 216 A2 a device for the therapeutic treatment and care of the female breasts with a cushion is known. The cushion is designed for use in a prone position. The cushion is formed by a body triangular in longitudinal cross section and has a rounded ridge and wedge-shaped parts sloping to both sides. In the area of the ridge, a recess is formed to accommodate the breast. The cushion can be made of several components made of different materials.

Publication DE 101 57 305 A1 describes a support cushion, especially for the thorax or pelvic area when patients are positioned on their stomachs. The cushion has a core with a height of 10 to 35 cm made of an elastic material and at least one layer of viscoelastic foam with a thickness of 3 to 7 cm. For the guidance of a tube in the neck area of the patient, a frontal, open-edge recess with a depth in the range of 3 to 7 cm is suggested. Publication DE 603 11 012 T2 describes a cushion adapted to the female body shape with a cushion main body having a central opening surrounding the breast and an elongated cushion secondary body arranged transversely to the opening and positioned between the breasts at the sternum. The cushion consists of a ring-shaped core surrounded by a cushion filling, which is placed in a cotton cover. Publication DE 10 2006 010 298 A1 describes a cushion consisting of a non-equilateral part filled with foam, air, water or gel, with a sufficiently large opening for the female breast at its apex. Further cushions with recesses can be found in publications US 2008/0 307 580 A1, DE 202 09 274 U1 and DE 10 2009 004 604 A1.

Object of the present invention is to provide a cushion, which can be used after a breast surgery for lying or sleeping in a prone position and which also offers a high degree of lying comfort and protection for the operated breast.

To solve this object, a cushion comprising a base body with a recess is proposed, wherein the base body is formed of two layers and comprises a first harder layer of foamed plastic and a second softer layer of a viscoelastic material.

The base body of the cushion serves as a support of the patient's body and especially the torso, with the patient's breasts being accommodated within the recess. In particular, the base body has a closed shape and encloses the recess over its entire circumference. This provides the cushion with a particularly good stability.

The first harder layer of foamed plastic provides a basic rigidity of the base body. When charging the cushion with a load while lying on it, the first harder layer of foamed plastic will only yield slightly and will be compressed a little. The height of the first harder layer is designed sufficiently, so high that the cushion always has a sufficient height, even under the weight load from the patient's torso, which guarantees that no unacceptably high pressure is exerted on the operated breast. Preferably, the breast does not come into contact with an underlay placed underneath the cushion. The so-called solid height, which the first layer exhibits under compression due to weight load, is selected for a patient at least sufficiently high to ensure that the operated breast is accommodated in the recess free of contact with the underlay. The foamed plastic can be an open-pored plastic in particular.

For a pleasant feeling when lying down, a cushion made purely of foamed plastic has proven to be comparatively hard and uncomfortable. In order to increase lying comfort, the cushion according to the present invention features a second softer layer of viscoelastic material. The viscoelastic material is more easily compressed under load than the first harder layer of foamed plastic and, compared to the first harder layer, is compressed further or more intensely in relation to its original height under load. The layer of viscoelastic material has the property to return to its original position and height after exposure to a load. Hence, after exposure to a load, the cushion extends back to its original shape. Viscoelastic material is known for the production of mattresses. It is also called “memory foam” and is a shape memory polymer based on polyurethane, which is particularly known under the registered trademark Tempur.

The height of the first harder layer and/or the height of the second softer layer can be adjusted individually according to the patient's weight, on the one hand to ensure that the height is sufficient to support the body without the breast touching the underlay and on the other hand to provide a pleasant lying comfort.

In practice, the cushion is used so that the first harder layer is positioned towards the underlay, i.e. at the bottom, and the second softer layer is in contact with the patient. The cushion according to the invention enables patients to lie and sleep comfortably in the prone position after breast surgery.

In particular, the first harder layer and the second softer layer are glued together. Alternatively or in addition, the first layer and the second layer are sewn together.

In practice, the height of the base body decreases continuously in the longitudinal direction towards an end an abdominal end. For example, the height of the base body can decrease linearly, i.e. the base body is wedge-shaped in the direction of the abdominal end. In practice, the height of the base body can decrease from the edge of the recess positioned towards the abdominal end to the abdominal end. The abdominal end of the cushion is understood to be that part of the cushion which, when the cushion is used as intended, is positioned towards the patient's abdomen.

The length of the wedge-shaped contour may vary depending on the patient and especially on the time that has already passed since the breast surgery.

In a practical embodiment, the outer contour of the base body may have a concave, arcuate shape in plan view at the abdominal end to form an accommodation for the abdomen in order to further increase the patient's lying comfort. The arcuate shape extends in such a way that the length of the cushion at the abdominal end decreases from the lateral edges of the cushion towards the center. This results in an indentation at the abdominal end. Due to the curved shape, a lateral wing section is formed towards each of the lateral edges, the patient's abdomen being accommodated in the indentation between the two lateral wing sections. The patient is mainly supported laterally by the two wing sections and the abdomen is relieved. Due to the arcuate shape, the cushion is particularly ergonomic and uncomfortable pressure on the patient's abdomen is avoided.

In another practical embodiment, the outer contour of the base body may have a concave, arcuate shape in plan view at its head end to form an accommodation for a pillow or to form an accommodation for the neck. The head end of the base body or the cushion is the end, which is oriented towards the patient's head during use of the cushion.

Due to the different transverse extension of the neck compared to the abdomen, it is advisable to design the indentation for forming the neck accommodation smaller than the indentation for forming the abdominal accommodation.

As an additional measure to avoid excessive pressure on the neck and/or abdomen, the height of the main body, or at least the height of the first harder layer, at least in the area of the abdominal end may be lower in a central area than at the lateral edges. In other words, at least at the abdominal end, the harder layer of the base body surrounding the recess is higher at the sides than in the longitudinal center of the base body. This causes the solar plexus to be significantly relieved and the patient's weight to rest mainly via the lateral rib arches on the cushion. Also in the area of the neck at the head end of the main body, the height of the first harder layer may be reduced so that the patient's weight does not rest on the cushion via the neck but via the shoulders. The sensitive parts of the body are thus not or only slightly charged. The cushion has a particularly ergonomic design. Reducing only the height of the harder layer in the center means that the cushion can be manufactured with a uniform height and can be easily fitted with a cover of a uniform height. Weight relief is achieved by arranging only soft, compressible base body material in the central area. In practice, as described further below, the first harder layer may be completely left out in the center of the base body at the abdominal end, so that there, the base body consists only of the second softer layer. Alternatively, the entire base body may have a lower height in the center than at the sides, in particular in the area of the abdominal end of the base body and/or in the area of the head end of the base body.

The base body may have rounded edges in plan view. The width of the cushion in the transverse direction may be at least equal to the width of the patient's shoulders, and the length of the cushion may extend approximately from the lower rib arch to the patient's neck, so that the patient is supported on the cushion with the largest possible contact area of the upper body. The curvatures of the cushion prevent unpleasant sharp edges that can cause pressure marks on the arms when the patient grasps the cushion.

In practice, the recess may be oblong with rounded lateral sections or oval in plan view. An oblong recess with approximately semicircular ends or an oval recess, each with the long axis in the transverse direction, is particularly well adapted to the anatomy of a patient and surrounds the patient's breasts as accurately as possible. In this way, while providing optimum pressure relief of the breasts, the largest possible supporting area of the cushion distributing the pressure evenly is achieved.

For flexible adjustment of the cushion to the size of the patient, a pull means can be provided, by means of which the length of the base body from the head end to the abdominal end may be varied and fixed. Such a pull means may be e.g. a strap connected to the base body and extending between the head end and the abdominal end, the length of which may be varied. The strap forms an adjustable loop and may have a hook and loop fastener or other suitable device for adjusting and fixing the length of the loop. Alternatively, a strap may be attached to each side of the recess and connected to the opposite strap. Again, a hook and loop fastener with the two complementary parts arranged at the free ends of the straps may be used for the connection.

In practice, the cushion may have a cover, with the pull means attached to the cover. Hence, the pull means is accessible from the outside and the extension of the cushion in the longitudinal direction can be adapted and adjusted to the patient's needs as easily as possible without removing the cover. The external pull means can be washed together with the cover.

The ratio of the heights of the first layer and the second layer influences the compression of the cushion caused by the weight load and the resulting height. Sufficient height is particularly important to prevent the operated breast from coming into contact with the pad. The second, softer layer provides enhanced lying comfort. Tests have shown that an optimal lying sensation is achieved and at the same time the loaded cushion maintains sufficient height if the height of the first harder layer is at least twice the height of the second softer layer.

The invention also relates to the use of a cushion as described above as a support for the chest and shoulders of a patient resting in a prone position. With regard to the advantages, reference is made to the above description.

In practice, a pillow can be placed at the head end, on which the patient's head rests. The cushion according to the invention can therefore be used as a supplement to a conventional pillow.

