A chin binder

156

A merican

Journal

of

Surgery

Charache-A

SUMMARY I. An improved direct bIood transfusion apparatus is presented. 2. It has a four-way air-tight valve with straight passages of Iarge caliber (.22 inch). 3. It aIIows rapid transfer of bIood from donor to recipient with minimum trauma to red bIood ceIIs. 4. It furnishes cIean, warm saIine for donor or recipient. 5. It provides a method of rapidIy cIeaning the syringe. 6. Adapters are presented that fit any

Chin

Binder

surface needIe,

JULY,1935

of the arm and any standard and hoId the needIes in the veins.

I wish to express my appreciation to Dr. C. E_ coIledge, p ro f essor of Mechanica Engineering, Georgia SchooI of TechnoIogy, for his assistance in designing the valve, and to Mr. WiIIiam Cross and Mr. Thomas Keith, Instructors in the same department, for making the models. This apparatus has been in use since December, 1931. More than 700 transfusions have been given by the internes on a11the services. I wish to thank them for vaIuabIe suggestions.

A CHIN BINDER HERMAN

CHARACHE,

M.D.

Clinical Assistant in Surgery, CumberIandHospital BROOKLYN,

E

VERY one admires a neat dressing, especiaIIy one that hoIds unti1 the subsequent visit to the doctor. This

FIG. I. Chin binder showing adjustabIe feature.

is particuIarIy true in major Iesions about the chin, where it is often required to extend the dressing in rotary fashion about the head or to apply a Barton’s bandage. The constant movement of the mouth during speech and mastication, and the movement of the head during

N. Y.

sIeep wiI1 Ioosen the bandage; and the next time the patient sees the doctor, Iayers of gauze wiI1 hang over the patient’s eyes or ears. This is even further exaggerated when the doctor orders the patient to keep the dressing wet, not mentioning the discomfort the patient has when the soIution is running down his neck. ShouId there be free drainage from the wound, if the patient does not come for a dressing for severa days, the appearance of the dressing is not very pIeasant, to say the least. The most unfortunate patients are the ones with cancer of the tongue with metastasis to the submenta1 region, with uIceration, necrosis and fIstuIa formation, resuIting in continuous drainage. Such dressing shouId be changed every day, if soon not twice a day, for the drainage saturates the dressing, emanating a most

N1.n

StKlrs

Var..

XXIN,

No.

I

Charache-A

of‘ensive odor. The cIinics, however, are usually open onIy every other day, and veq iew patients can change their own dressings. The peopIe about the patient ma)- run away from him, but he cannot run au-a\- from himseIf. The chin binder described here wouId eliminate these conditions, and wouId make the patient as we11 as the people about him It would heIp the doctor much happier. to dress such wounds with comparative couId easily change ease. Th e patient the dressings severa times a day. It wouId also eIiminate the dressing over the head, which is \-ery cumbersome. He couId speak and eat with ease, and have free movement of the mandibIe, avoiding a constricting bandage about his face and head, and making him Iess conspicuous in public. The chin binder consists of rubberized cloth suspended Iike a hammock by two pieces of eIastic, which fit about the patient’s ears Iike eyegIasses. The eIastic bands are adjustable to any size desired to fit ever!- patient, and couId be reguIated should a great dear of gauze be appIied to the chin. ShouId wet dressings be necessary in cases of inflammatory Iesions, as in infections of the submenta1 region, the rubber \vouId pre\-ent the soIution from

Chin Binder

An,rrkxn

Jwmrl

ot Surpr~

v

lj-

evaporating and wouId aIso prevent Ieakage to the patient’s neck. The binder is very simpIe and shouId be inexpensive.

FIG.

2.

Chin

binder

in place.

It couId be washed and boiIed, over and over again.

and used