1. Field of the Invention
This invention relates to a tube securing device for affixing medical tubing to the skin of a patient and, more particularly to a device for securing a thoracostomy tube to the skin of a patient.
2. Description of Prior Art
During the placement of larger medical tubes such as thoracostomy tubes, endotracheal tubes, and nasogastric tubes, it is important to secure the tube in position. It is particularly important that the tube remain stable and without movement in the longitudinal direction. Currently, these tubes are most commonly secured by wrapping tape around the tube and taping to the skin, or by suturing the tubing to the patient's skin. The difficulty occurs when wrapping tape or suture materials around a smooth tube. When a wet tubing is pulled on, the tape and suture material can slip or come undone allowing movement of the tubing and the resulting inability to secure the tube. Furthermore, it is cumbersome to remove tape or suture material from the tube when repositioning the tube without moving in a longitudinal direction.
Many devices have been described for securing endotracheal tubes and nasogastric tubes in position with respect to some external reference point on the skin of a patient. Representative of such tube holders are U.S. Pat. Nos. 4,449,527; 5,060,645; 5,069,206; and European Patent EP356683 A. Such devices use complex locking mechanisms and often rely on tape or sutures to secure the tubing to the device. Moreover, these devices frequently include several parts and are, therefore, not unitary. They are often bulky and include a significant area of the device which lies on the face or mouth for stabilization. Such devices often provide reduction in horizontal movement at the expense of ease in placement. While such tube holders may be preferable in endotracheal tubes, which are utilized in a long term chronic setting, no simple device, unitary is currently available for securing a thoracostomy tube to the patient's body. The convention is to use a suture tie material attached to the skin incision around the tube to secure it. No device is currently available that can attach to the suture tie material and thereby secure the tubing.
The foregoing limitations in prior art tube holders with respect to securing or anchoring a thoracostomy tube in position so as to prevent vertical or longitudinal motion suggests a different approach to holder design is appropriate. What is truly required is a unitary device which can be made inexpensively and can be placed quickly around a thoracostomy tube in either an emergency or elective setting. Further, it would also be desirable if such a tube holding device provided means for facile removal from the tubing without injuring or moving the tubing.