various embodiments of the present invention and its advantages are best understood by reference to fig1 - 10 wherein like numbers refer to same and like parts . apparatus and methods incorporating teachings of the present invention may be satisfactorily used to releasably secure a wide variety of appliances to a person or surface adjacent to a person . various features of the present invention may be described with respect to releasably securing medical appliances with a patient &# 39 ; s skin or surfaces adjacent to a patient . however , apparatus and methods incorporating teachings of the present invention may also be satisfactorily used to releasably secure a wide variety of appliances to a person or surfaces adjacent to a person . examples of such appliances include wires , fiber optic conductors or other conduits associated with communication equipment or monitor equipment . the present invention is not limited to medical appliances associated with treatment of patients . the present invention is not limited to attachment to a person &# 39 ; s skin . various features of the present invention , will be described with respect to using apparatus such as reclosable holding devices 20 , 120 , 120 a and 120 b to releasably securing catheter tubes or other types of tubular members with a person &# 39 ; s skin . see fig1 , 9 and 10 . however , apparatus and methods incorporating teachings of the present invention may be satisfactorily used to releasably secure a wide variety of appliances including , but not limited to , lumens , tubes , wires , fiber optic conductors , communication equipment , monitoring equipment , feeding tubes , water tubes and oxygen tubes . such appliances may be releasably secured to a person &# 39 ; s skin ( see fig7 and 8 ), clothing ( not expressly shown ) or a surface adjacent to a person ( not expressly shown ). examples of such surfaces include , but are not limited to , hospital bed rail , desk , night stand , hospital gurney and surgery table . fig1 , 9 and 10 show schematic top plan views of securing devices 20 , 120 , 120 a and 120 b which incorporate various teachings of the present invention . securing devices 20 , 120 , 120 a and 120 b may also be described as general purpose releasable holding devices . for some specific applications securing devices 20 , 120 , 120 a and 120 b may be referred to as “ reclosable tube holders ” or “ reclosable wire holders ” as appropriate . for embodiments such as shown in fig1 and 3 securing device 20 may include two or more layers of material . for example , device 20 may include first layer or base 30 with first release liner 40 attached thereto . for some applications release liner 40 may be formed in two segments , 40 a and 40 b , to aid in removal of release liner 40 from base 30 . see fig2 and 5 . securing device 20 may also include top layer 50 with second release liner 60 disposed therebetween . see fig3 . release liners 40 and 60 may be formed from various types of material such as paper or plastic film . release liners 40 and 60 may also be referred to as “ removable liners ”. for embodiments such as shown in fig1 and 3 , securing device 20 may have a generally elongated rectangular configuration with generally rounded corners 22 . corners 22 cooperate with each other to reduce potential stress concentrations which might result in inadvertent peeling of base 30 when attached to a person or a surface adjacent to a person . first layer or base 30 and second layer or top layer 50 may be formed from respective sheets or strips of medical grade adhesive tape . however , other materials may be satisfactorily used to form first layer 30 and second layer 50 . examples of such materials include but are not limited to medical grade foam , medical grade film and / or relatively thin , flexible sheets or strips of plastic . various types of medical grade adhesive tapes may be satisfactorily used to form first layer 30 and second layer 50 . examples of such adhesive tapes includes durapore ™ surgical tapes available from 3m corporation . however , a wide variety of other medical grade adhesive tapes may be satisfactorily used . a wide variety of woven fabrics , non - woven fabrics , urethane foam and polyethylene films may also be satisfactorily used to form either first layer 30 and / or second layer 50 . other types of skin - friendly materials may also be satisfactorily used . for many applications first layer 30 and second layer 50 may preferably be formed from breathable materials . for some applications material used to form second layer 50 may be stronger than material used to form first layer 30 . second layer 50 and particularly flap or tongue 70 may be formed from nonstretchable material . material selections will depend upon intended use of the resulting holding device , desired length of time that the holding device will be in active use and cost associated with various materials . base 30 preferably includes first surface 31 and second surface 32 . top layer 50 may also include first surface 51 and second surface 52 . first surface 31 of base 30 and first surface 51 of top layer 50 may be covered with various types of medical adhesive material . see fig2 and 3 . first release liner 40 may be disposed on first surface 31 of base 30 to protect associated adhesive material prior to placement of base 30 on a patient &# 39 ; s skin or a surface adjacent to a patient . for some applications , a second release liner 60 may be disposed between portions of base 30 and top layer 50 . see fig3 . tongue or flap 70 may be formed from top layer 50 using various manufacturing techniques . second release liner 60 may be used to protect base 30 during the formation of tongue or flap 70 . for example , release liner 60 may be used when a rotary die kiss cutting process is used to form tongue 70 in second layer 50 . release liner 60 may prevent potential damage to adjacent portions of base 30 during cutting of tongue 70 . for some applications , tongue or flap 70 may have a generally elongated configuration defined in part by longitudinal edges 72 and 74 which extend generally parallel with each other from attached portion 76 . flap or tongue 70 may include a generally arcuate or curved end 78 disposed opposite from attached portion 76 . tongue 70 may be formed in top layer 50 by cutting edges 72 , 74 and end 78 . attached portion 76 connects tongue 70 with top layer 50 and allows movement of tongue 70 relative to base 30 . attached portion 76 is indicated by dotted lines in fig1 and 3 for purposes of illustrating various features of the present invention . for some applications attached portion 76 may function similar to a hinge or flexible connection which allows rotation or lifting of tongue 70 relative to base 30 and placing tongue 70 over an appliance . a flap or tongue may be formed in top layer 50 with a wide variety of configurations . the present invention is not limited to the configuration of flap 70 . also , flap 70 may be cut from a second layer of material and attached to base 30 ( not expressly shown ) without any other portions of the second layer of material being placed on or bonded with base 30 . various bonding techniques such as sonic welding or heat sealing may be used to secure portion 76 of flap 70 to second surface 32 of base 30 . for some applications , strip 80 may be placed on top layer 50 prior to forming tongue or flap 70 . strip 80 may be formed from paper or plastic film . during formation or cutting of tongue 70 , segment 80 a will be separated from strip 80 . segment or tab 80 a disposed adjacent to end 78 provides a convenient location for grasping tongue 70 . segment or tab 80 a may be particularly beneficial when trying to manipulate flap 70 while wearing gloves . various types of advertising information and / or operating instructions may be printed on strip 80 . strip 80 and segment 80 a may be used to identify end 78 of tongue 70 to assist in moving or lifting tongue 70 relative to base 30 . the portion of base 30 immediately adjacent to tongue 70 may be described as an attachment location for releasably securing an appliance with base 30 . for the embodiments such as shown in fig3 and 6 , the associated attachment location has been designated as 32 a . for some applications tongue 70 and attachment location 32 a may be approximately centered relative to second surface 32 of base 30 . the material used to form base 30 and particularly attachment location 32 a along with adhesive material placed on first surface 51 of tongue 70 are preferably selected to allow multiple opening and closing of tongue 70 relative to base 30 . since attachment location 32 a is generally protected from contact with a patient &# 39 ; s skin and associated skin oils , tongue 70 may be engaged and disengaged multiple time with base 30 . adhesive material disposed on first surface 51 will generally prevent undesired movement of an attached appliance relative to base 30 and / or tongue 70 . however , for some applications portions of the adhesive material on surface 51 may be removed ( if desired ) to prevent the adhesive material from contacting an associated appliance . various color combinations of materials may be used to form first layer 30 and second layer 50 . also , the adhesives placed on first layer 31 and first layer 51 may have different colors to indicate characteristics of the associated adhesive . for example , the adhesive used on first layer 31 may be compatible with attachment to a person &# 39 ; s skin or may be compatible with attachment to clothing worn by a person . each type of adhesive material may have a different color to indicate a respective type of use . adhesive material placed on first surface 51 of tongue 70 may be selected for compatibility with attachment location 32 a . for embodiments such as shown in fig4 and 6 , securing device 120 may have a generally elongated , rectangular configuration with generally rounded corners 22 . securing device 120 may include some of the same features and benefits as previously described with respect to securing device 20 . securing device 120 may be formed with first layer or base layer 30 and release liner 40 as previously described with respect to device 20 . however , second layer or top layer 150 of securing device 120 may be formed from material satisfactory for machining tongue 70 using kiss cutting techniques . therefore , securing device 120 does not include second release liner 60 as previously described with respect to securing device 20 . second layer or top layer 150 preferably includes first surface 151 and second surface 152 . first surface 151 of top layer 150 may be covered with a wide variety of medical adhesive materials . for some applications the same adhesive material may be used on first surfaces 31 and 151 . see fig6 . respective strips 180 of paper or plastic film may be disposed between top layer 150 and base 30 at approximately desired locations for end 78 of each tongue 70 . strip 180 may be formed from the same material as release liner 40 or any other suitable paper or plastic film . the materials used to form top layer 150 are preferably compatible with die rotary die kiss cutting cutting tongue 70 without damage to base 30 . one example of such material includes 3m durapore . for some applications strip 180 may be disposed between top layer 150 and base 30 prior to forming tongue or flap 70 . as a result during the formation or cutting of tongue 70 , segment 180 a of strip 180 will be separated from strip 180 . segment or tab 180 a disposed adjacent to end 78 provides a convenient surface for grasping tongue 70 . segment or tab 180 a may be particularly beneficial when trying to manipulate flap 70 while wearing gloves . various types of advertising information and / or operating instructions may be printed on strip 180 . strip 180 and segment 180 a may be used to identify end 78 of tongue 70 to assist in moving or lifting tongue 70 relative to base 30 . materials used to form second layer or top layer 150 may be relatively translucent such that operating instructions and / or advertising material printed on strip 180 may be read by a person using associated securing device 120 . as a result of forming tab or segment 180 a , tongue 70 may be manipulated without engaging adhesive material disposed on other portions of first surface 151 . securing devices 20 and 120 may be formed using various manufacturing techniques and procedures incorporating teachings of the present invention . one process associated with securing device 20 may include forming an elongated strip or blank with multiple layers of material ( not expressly shown ) defined in part by a first layer of release liner material , a second layer of material satisfactory for forming base 30 , a third layer of release liner material and a fourth layer of material satisfactory for forming top layer 50 . respective strips 80 of paper or plastic film may be placed on the fourth layer of material ( second surface 52 of layer 50 ) at locations corresponding approximately with desired locations for end 78 of each tongue 70 . one process associated with securing device 120 may include forming an elongated strip or blank with multiple layers of material ( not expressly shown ) defined in part by a first layer of release liner material , a second layer of material satisfactory for forming base 30 , intermittent strips 180 disposed on the second layer of material ( second surface 31 of base 30 ) and a third layer of material satisfactory for forming top layer 150 . the first , second and third layers of material may extend generally longitudinally relative to each other . strips 180 may be placed laterally between the second layer of material and the third layer of material at locations corresponding approximately with desired locations for end 78 of each tongue 70 . preprinted instructions and / or advertising may be placed on one or more of the respective material rolls . the position of the instructions or advertising on each material layer may be selected to correspond with each securing device formed therefrom . also , rolls of material with different colors may be used . for example , different colors may be used to indicate different types of uses for the resulting securing device . each strip or blank of multiple layers of material may be formed by a wide variety of manufacturing techniques such as feeding material from respective rolls of release liner and medical grade adhesive tape in sequential order to form the desired strip . various types of cutting and / or stamping procedures may be used to form devices 20 and 120 from associated blanks . for example , rotary die kiss cutting techniques ( such as kiss cutting ) may be used to cut device 120 from the respective strip of multiple layers of material and to cut tongue 70 in top layer 150 without damage to base 30 . adhesive material on first surface 51 and first surface 151 is preferably compatible with the material used to form second surface 32 of associated base 30 . for some applications , portions of first surface 51 and first surface 151 may not be covered with adhesive material to avoid undesired contact between the adhesive material and the associated appliance when respective tongue 70 releasably secures the appliance to associated base 30 . various methods and techniques incorporating teachings of the present invention may be used to releasably secure an appliance with a patient using securing devices 20 or 120 . for example , release liner portions 40 a and 40 b may be removed from first surface 31 of base 30 . forming liner 40 with segments 40 a and 40 b facilitates wearing gloves while applying device 20 or 120 to a patient &# 39 ; s skin . base 30 may then be placed at a desired location on a patient &# 39 ; s skin or on a surface adjacent to the patient . for securing device 20 , segment or tab 80 a provides a convenient location to grasp and lift tongue 70 relative to base 30 . release liner 60 may then be removed from first surface 51 . see fig3 . an appliance such as a catheter tube or an electrical wire may be placed on attachment location 32 a and releasably secured thereto by engaging end 78 and adjacent portions of first surface 51 of tongue 70 with attachment location 32 a . for securing device 120 , segment or tab 180 a provides a convenient location to grasp or lift tongue 70 relative to base 30 . as previously noted , securing device 120 does not include release liner 60 . see fig6 . an appliance such as a catheter tube or an electrical wire may be placed on attachment location 32 a and releasably secured thereto by engaging adjacent portions of first surface 51 of tongue 70 with attachment location 32 a . segment or tab 180 a also provides a convenient location to grasp or lift tongue 70 to release an associated appliance . segment or tab 180 a facilitates multiple opening and closing of securing device 120 . fig7 and 8 are schematic drawings showing various steps associated with using securing device 120 to releasably engage tubular structure 24 at a desired location on arm 26 of a patient . for some applications tubular structure 24 may be a catheter . after release liner 40 has been removed from base 30 , first surface 31 of securing device 120 may be applied at the desired location on arm 26 . segment or tab 180 a may be lifted from top layer or second layer 150 to lift tongue 70 and expose attachment location 32 a . a portion of tubular structure 24 may be placed on attachment location 32 a . see fig7 . when tubular structure 24 is in the desired location , tab 180 a may be used to releasably engage portions of first surface 151 of flap 150 with tubular structure 24 and attachment location 32 a . fig9 and 10 show alternative embodiments of the present invention . for the embodiment shown in fig9 , securing device 120 a includes a pair of flaps or tongues 170 a and 170 b formed in second surface or top layer 150 . flaps 170 a and 170 b may be disposed generally parallel with each other . flaps 170 a and 170 b may be used to releasably secure a single appliance with respective attachment locations 32 a ( not expressly shown ). for the embodiment shown in fig1 , securing device 120 b includes tongues 170 c and 170 d formed in second layer or top layer 150 . tongues 170 c and 170 d may be disposed generally in series and aligned with each other along the length of top layer 150 . securing device 120 b allows attaching multiple appliances such as two respective tubular structures 24 beneath respective tongues 170 c and 170 d ( not expressly shown ). although the present invention and its advantages have been described in detail , it should be understood that various changes , substitutions and alternations can be made herein without departing from the spirit and scope of the invention as defined by the following claims .
apparatus and method to secure an appliance to a person is provided . the apparatus may have a base that attaches to a selected portion of a person &# 39 ; s skin or other desired surface . a tongue may extend from the base and wrap around the appliance . at least a portion of the tongue may be alternately engaged with and disengaged from the tongue to accommodate securing and releasing the associated apparatus .