WO2013113332A1

WO2013113332A1 - Stiffenable retention device

Info

Publication number: WO2013113332A1
Application number: PCT/EP2012/000498
Authority: WO
Inventors: Ulrich Pfeiffer; Matthias FÄHLE; Sebastian Kisban; Anna-Luisa UHLITZ; Stephan Regh; Tobias THOMAMÜLLER; Reinhold Knoll
Original assignee: Up-Med Gmbh
Priority date: 2012-02-03
Filing date: 2012-02-03
Publication date: 2013-08-08

Abstract

The invention relates to a stiffenable retention device (10), wherein the retention device has a flexible sleeve (20) comprising an external side (22) and an interior (21) as well as at least one layered filler material (30) arranged in the interior (21) of the sleeve (20), the filler material (30) having at least two layers (31) which are stacked one on top of the other and consist of a plurality of partial surfaces (32) that can be moved towards each other, each partial surface (32) being connected to at least one adjacent partial surface (32) within a layer (31). The invention also relates to the use of a stiffenable retention device (10) as well as to a system (100) for attaching a body part of a patient.

Description

Stiffenable retention device

The invention relates to a stiffenable retention device, the use of a stiffening retention device for fixing a body part, the use of a stiffenable retention device for intermittent patient support, a system for fixing a body part of a patient and a system for intermittent patient positioning. In the field of traumatology, it is often necessary, for example in fractures, joint or ligament injuries or large soft tissue traumata, to stabilize and fix a affected limb of a human or animal patient or even the entire patient for a certain period in its position (retention ). A distinction must be made between short-term retention and long-term retention.

The short-term retention serves, for example, to prevent further injuries, which may occur, for example, after an accident during transport to the clinic or within a clinic from station to station. A short-term retention can also be used during an operation. In this case, the short-term retention can include the fixation of a single body part as well as the entire patient. Thus, especially in suspected spinal injuries or unconsciousness of a patient to be transported, it is often necessary to stabilize the entire patient in his position.

In contrast, long-term retention serves to support the body or a part of the body during convalescence. A long-term retention of a body part is particularly necessary if the supporting apparatus of the body has been injured in such a way that its healing takes some time, while the affected body part is not full is resilient or unable to move within its natural limits without being injured or being further harmed. Also, in the case of long-term retention, it is to be prevented that pain is caused by voluntary or involuntary movements or a disturbance of the healing process occurs. For example, it should be prevented that repositioned fractured or dislocated bones or joints can move out of the correct anatomical position. Also, in the case of ruptures of the tendons, ligaments or muscles, it is at least to some degree desirable to stabilize the affected body part in its correct, defined position so that healing can take place without undesirable shortening or stretching of the affected tissue.

In the prior art, various retention agents are known, for example, gypsum or Kunststoffeast, invasively mounted so-called "external fixator", orthoses or vacuum rails or mattresses. All of these variants have more or less serious disadvantages, which lead either to a short-term retention to cumbersome handling and / or poor storage of the patient, or in the area of long-term retention to incomplete support and / or occurrence of unwanted side effects. Thus, for example, the use of gypsum or plastic brine as a means of long-term retention has the disadvantage that it often does not come to the entire time of retention to a complete stabilization of the body part. In particular, this is mostly due to the fact that the muscles of the body part to be stabilized or fixed regress very rapidly. As a result, the volume of the body part to be rescued decreases, but not the volume imaged by the plaster or cast. The retention dressing sits so far loose after a certain time and can no longer adequately fix the body part accordingly. Another danger of poor retention is favoring the formation of a compartmental syndrome. A dressing change is so far indicated in case of incorrect fit of the Association in any case, but correspondingly expensive. As a further disadvantageous consequence, there may be insufficient hygiene in the area of the skin enclosed by the dressing. In addition, a bandage made of gypsum or Kunststoffeast in the fixed state usually leaves no position correction too. There is thus the risk of pressure points in all degrees of severity. As with unwanted loosening, the existing dressing must be removed and re-applied in this case. For a short-term retention, for example, to stabilize the position of a patient at an accident site before the patient is transported, a retention by plaster or Kunststoffeast is already not suitable, because it takes too long until the dressing is sufficiently hard enough to the patient sufficient to fix for a transport. For the same reason, use of gypsum or plastic ester as a preventive aid during an operation is ruled out. In addition, the application of such a dressing outside a correspondingly clean room, such as at an accident site, cumbersome and associated with risks of inclusion of unwanted foreign bodies. Also, under certain environmental conditions, such as freezing temperatures, the handling of wet plaster bandages only extremely limited possible. Kunststoffeast also requires at least a humidification in order to start the curing process can.

A correspondingly invasive "external fixator" or similar invasive medical stabilization methods (Kirschner wire or the like) are not suitable per se for first aid at the accident site, in particular for transporting the patient. Also for a long-term retention of a body part are the considerably unpleasant and risky effects that an invasive, d. H. that is, operating, attaching the fixator to a patient means to pay attention to and weigh carefully against the expected benefits. In practice, "external fixation" and similar stabilization aids are used so far mostly only in very complicated fractures or the like.

So-called orthoses usually have the disadvantage that they do not readily fit the individual body shape of the respective patient. There is therefore a great danger of pressure points to the development of pressure ulcers. They must therefore be either made specifically, which takes some time, or provided with a padding, which may affect the stabilizing effect. As in the case of retention using plaster or Kunststoffeast, it can also lead to a loosening of the orthosis by dwindling muscle volume. To counter this, for example, DE 103 03 327 A1 provides an orthosis for the long-term retention of a body part. This consists of a support shell arrangement in which a shaped cushion is arranged for adaptation to the body part. The molded cushion consists of a gas-tight envelope, which can be evacuated via a valve device, and a shaped body filling. The shaped body filling consists of a multiplicity of shaped bodies, for example polystyrene balls, so that the shaped cushion can conform to the body part to be supported. When the gas-tight envelope of the molding pad is evacuated after the molding pad has been applied to the body part, the molding pad retains the imaged shape of the body part. It then surrounds the body part like a plaster and supports it. However, a disadvantage of such a support device is that, on the one hand, the shaped bodies in the elastic shell of gravity always accumulate at the lower end of the shell. However, this complicates the optimal application to a body part. Furthermore, the evacuated sheath is stiff enough only to a limited extent to ensure adequate retention of the body part even under load. In this respect, an additional support shell arrangement is always necessary in order, for example, to sufficiently stabilize a leg in such a way that it can support the body weight of the patient without renewed injury to the part of the body in convalescence. WO 01/30280 A1 and WO 2004/004608 A1, see WO 01/30280 A1 and WO 2004/004608 A1 so-called vacuum mattresses, vacuum vests or vacuum rails as rescue or short-term fixation of an injured person, in particular for supporting and stabilizing an injured person or an injured body part. Transport facilities. Such rescue and / or transport facilities are used, for example, in the field of mountain rescue, but also in other accident situations. They have a flexible element comprising a shell made of an airtight plastic film and a filling of a plastic granules, for example of foamed polystyrene beads. After molding on a body part to be placed quietly, the plastic film can be evacuated by means of a suction pump. The result is a dense packing of the filled granules, which leads to a stiffening of the flexible element. This thus forms a substantially rigid shell or cuff around the body part to be fixed. Also a corresponding edition for the entire patient can on these Way be formed. The problem with such vacuum rails or vacuum mattresses, however, may be that for a sufficient fixation of a complete patient in an emergency, a very large volume must be present or that the vacuum rail must be supported by means of an external frame in order to achieve the required rigidity. Depending on the distribution of the styrofoam balls, usual thicknesses of such systems are therefore usually between approximately 3 and 15 cm and often additionally require external solid rails of approximately 5 cm in thickness. The system has a certain pack size and a corresponding transport weight. The use of an externally mounted, stabilizing rail system is also time consuming and the rail system can be unwieldy. Also, an additional rail system is associated with an increased transport weight of the device. In addition, with a very large volume of the vacuum system, a correspondingly powerful vacuum pump may be required in order to achieve sufficient rigidity within a reasonable time.

Another disadvantage of such transport systems is that corresponding vacuum systems can be used almost exclusively in horizontal application. In the unevacitated state, the airtight casings are usually only loosely filled with corresponding filler particles, such as plastic pellets, in order to ensure good formability. However, these loosely-arranged particles always fall downwards in the unevacitated state, following gravity, making it difficult to properly distribute the stiffening material for use other than horizontal use. Although the already mentioned WO 01/30280 A1 and WO 2004/004608 A1 provide corresponding chamber systems in order to counteract this problem. Within the individual chambers of these systems, however, there remains the problem of uneven distribution of the filling material in non-horizontal use. There is also the problem of the high pack size and thickness of the corresponding vacuum mattresses, as well as the problem of possibly insufficient rigidity, if no additional support rails are used.

The object of the present invention is therefore to provide an improved retention device. In particular, an improved retention device with reversible stiffening is to be provided, which at the same time allows optimal conditioning and adaptability to the body part to be fixed and / or the patient. The re- tentionsvorrichtung should be as easy as possible, easy to transport and inexpensive to implement and easy to handle. In particular, the retention device should be usable for both short-term and long-term retention. It is a further object of the invention to provide an improved system for securing a body part of a patient, as well as an improved system for intermittent patient positioning.

The object is solved by the appended, independent claims. Advantageous developments are defined in the subclaims.

In a particularly simple further embodiment, the object is achieved by a reversibly stiffenable retention device, wherein the retention device consists of a flexible, airtight envelope with an outer side and an inner space and at least one, arranged in the interior of the shell, layered filling material. However, such a retention device is preferably neither a blood pressure measuring device nor part of a blood pressure measuring device. The layer-shaped filling material of such a retention device preferably consists of a stack of flexible paper sheets, which can move in the non-stiffened state against each other and form a frictionally connected layer composite in the stiffened state. Particularly in the case of such a particularly simple embodiment of the retention device according to the invention, in which the layered filling material consists exclusively of paper layers not divided into partial surfaces, the retention device according to the invention preferably has no components which can be used for the determination of hemodynamic parameters.

In particular, the object is achieved by a stiffenable retention device, wherein the retention device has a flexible shell with an outer side and an inner space and at least one arranged in the interior of the shell, layered filling material, wherein the filler has at least two stacked layers, which consists of a Variety of mutually movable sub-surfaces, each sub-surface is connected to at least one adjacent sub-surfaces within a layer. Two surfaces, in particular two partial surfaces of a layer, are considered to be movable relative to one another when both surfaces or partial surfaces are movable, whereby the spatial orientation and / or arrangement which the surfaces have relative to one another can be changed.

A first great advantage of the solution according to the invention is that the layers of the filling material arranged in the casing consist of a multiplicity of mutually movable partial surfaces. Namely, such partial surface layers can particularly well mold the three-dimensional shape of a body part, for example, when wound or laid around a body part. Each partial surface is applied to a corresponding section of the body part to be molded. As a consequence of the mobility of the partial surfaces against each other, adjacent partial surfaces can be arranged in different spatial orientations. At the same time, the layer can be obtained as such if the adjacent partial surfaces are connected to one another within a layer. The coherent layer of the filling material can thus optimally invest in the body part. However, it requires no bending process of the entire layer surface (and thus not the application of a correspondingly large bending force) to follow the three-dimensional shape of the body part when applying the layer, so that the body part is molded largely contour exactly, but it must be align only the individual faces in corresponding relation to each other. Overall, the rigidity of a single layer consisting of (several) partial surfaces is significantly reduced, while the partial surfaces themselves continue to exhibit the rigidity of the corresponding layer material.

At the same time, another advantage of the invention lies in the fact that, in the retention device according to the invention, at least two such layers are stacked in the flexible sheath. For stiffening and thus for fixing a surrounding body part or an entire patient, in the case of such a retention device according to the invention, the layers contour-matched to the body part can then be pressed onto one another. In this case, the envelope may for example be made airtight, so that the pressing together of the layers by the application of a negative pressure can be achieved. As a result, the frictional force between the abutting surfaces of the adjacent layers increases such that a frictional connection occurs between the layers. The layers thus pressed together can then act as a layer composite. In this case, the thickness-dependent area moment of inertia and thus the stiffness of the filling material increases such that it essentially no longer measures according to the thickness of the individual layers, but now according to the total thickness of the layer stack of layers pressed together and bonded together in a non-positive manner. The corresponding pressure to press the layers together is exerted by the atmospheric pressure applied to the outside of the envelope, which is higher than the pressure inside the envelope when the negative pressure is applied.

It can be seen that the stiffening of the retention device can be reversible with great advantage. In this respect, in a particularly preferred embodiment, it may be a reversibly stiffenable retention device.

It can be seen further that it makes sense if the casing has a connection piece, for example an air inlet and / or outlet, which can be connected to a vacuum pump. It is advantageous if the arranged in the shell, stacked layers in the unstiffened state of the retention device to a certain extent, which is preferably predetermined by the dimensions of the interior of the shell, against each other can move. This is the case, for example, if the same pressure conditions prevail both on the outside and in the interior of the shell and the volume of the interior of the shell is slightly larger than the volume occupied by the filler material. Due to the flexibility of the airtight sheath, the sheath can also be optimally adapted to the contour of a body part or an entire patient to be shaped. If such a shell with the layers of filler contained therein is placed around a body part, in this way each of the layers can assume an optimal position with their partial surfaces, without being affected by contact with a layer adjacent thereto and the frictional force acting thereon under tension or tension To get compressive stress and to be prevented from the necessary movement. The flexible sheath and the filling material arranged in it can in this way shape the body part contour-accurate.

The inventive design of the layers of the filling material in the form of interconnected partial surfaces offers the one hand the advantage that the individual layers have a very low overall rigidity and thus can optimally adapt to the shape of a body part to be stabilized or fixed. At the same time, however, they can also be stacked on top of one another in such a way that they can form a layer composite of relatively high rigidity if they are connected to one another in a force-fitting manner, for example by means of a normal force acting on them. It can thus be achieved in the unstiffened state optimal Anformung to be stabilized or fixed body part and at the same time in the stiffened state optimal fixation.

It is also particularly favorable if the layers of the filling material have recesses which subdivide the layers into the partial surfaces, wherein the recesses preferably form the edges, in particular the shaping edges, of the partial surfaces. In this respect, the recesses can, for example, be regarded as holes which are or are introduced into the layers of filling material which initially consist of continuous material. The recesses may for example be formed as simple cuts in a continuous material surface. The partial surfaces of the layers of the filling material according to the invention can therefore arise from an initially continuous material layer by holes, punches, cuts or similar recesses are introduced into this original layer. The introduction of the recesses can be done for example by means of laser beam cutting, water jet cutting, micro perforating, punching or a combination of such methods.

Such a subdivision of the layers into partial surfaces with the aid of these recesses has the great advantage that individual sections of the layers can be tension-relieved or relieved of pressure as required. This is particularly beneficial when the retention device is applied to a body part having a spherical, cylindrical or conical shape. If a stack of several layers is placed around such a mold, usually not all of the layers stacked on top of one another have the same curvature. tion radius. Rather, the radius of curvature of the layers depends on whether, because of their position in the layer stack, they are arranged closer to or further away from the body part to be shaped. The same applies of course to individual layer sections which follow different three-dimensional curvature geometries of the body part to be shaped. However, the frictional forces acting between adjacent layers may cause a layer or layer portion having a larger radius of curvature to be tensioned by contact with an adjacent layer having a smaller radius of curvature, while a layer or layer portion, the or has a smaller radius of curvature than its adjacent layer, can be pressure loaded. However, such tensile or compressive loading may counteract the bending force that is applied or has been applied to conform the layer to the surface of the body shape being molded. As a result, it may come to fundamentally less desirable deformation to kinking. Such deformations or even buckling can not only adversely affect the dimensional stability of the layer composite in the stiffened state, but also, for example, lead to pressure or friction points on the body part to be supported.

This can be counteracted advantageously with the aid of the recesses according to the invention. If a layer stack according to the invention is applied to a body part with a retention device according to the invention, then, as explained above, it usually assumes a more or less complex three-dimensional geometry. Within such a three-dimensional geometry, both tensile-stressed and pressure-loaded layers or layer sections can be stacked on top of one another. With the aid of the recesses introduced into the layers according to the invention, these layers or layer sections can be relieved of pressure or strain independently of each other. In this case, a strain relief by an elongation of the recesses and the corresponding layers, a pressure relief by shortening of the recesses and the corresponding layers or layer sections take place. Overall, the expansion behavior within the layers of the filling material can be made approximately isotropic in this way. At the same time, the frictional force between corresponding adjacent partial surfaces of adjacent layers remains large enough to produce an effective composite layer. Overall, it is advantageous if the friction between the layers supporting surface portion of the stacked layers at least a surface portion of about 50% or more, preferably about 80% or more of the total surface of the layer makes. That is, in a preferred embodiment, it may be beneficial if at least about 50%, preferably at least about 80% of the total surface area of each layer is in frictional contact with an adjacent layer of the layer stack.

It is also conceivable that the loading forms within a layer of the filling material can be designed to be directed in this way by introducing a geometry of recesses adapted to a body part into the layers. This is particularly advantageous when the etentionsvorrichtung is to be applied to a body part having different bending radii, for example. An upper arm with a well-developed biceps or the transition region between the shoulders and neck / neck of a patient. This may also be favorable if the retention device is intended to fix, for example, a joint in an angled state or to transport a patient in a specific posture. If the recesses are introduced in a corresponding pattern, then it is possible, based on the design of the pattern of the partial surfaces and recesses, to make the modulus of elasticity of the corresponding layers or the retention device different depending on the direction. Overall, an optimal compromise between adaptability to the anatomical conditions in the non-evacuated state and the stiffness in the evacuated state can thereby be achieved.

It can be seen that, in the non-stiffened state, a retention device according to the invention can initially be applied exactly to a body part or the body shape of a patient to be transported or stored can be optimally adapted. In this case, the individual layers of the filling material, with their partial surfaces stacked on top of one another, conform exactly to the contour of the patient's body or contour and shape this three-dimensional geometry accordingly, without the formation of kinks or other air pockets. Subsequently, a negative pressure is applied to the airtight shell of the retention device to non-positively connect the layers of the containing filler material and in this way to the retention device stiffen, so the subdivided layers maintain the previously assumed three-dimensional shape. The retention device lies in the sequence both in the stiffened and in the unstiffened state exactly contour on the corresponding body part or on the patient.

In a further preferred embodiment, it is provided that the partial surfaces are connected to one another via connecting elements. Such connecting elements can serve to keep the partial surfaces of the layers in contact with one another, but movable relative to one another in the unassembled state. The surface of the connecting elements is preferably small in relation to the partial surfaces. Adjacent subareas are insofar only selectively interconnected. In the case of larger recesses and a connection through a small bridge is conceivable. Moving the faces against each other requires so far only the pivoting about the fasteners. For example, multiple adjacent faces, similar to, say, the links of a mailing shirt, can be oriented without problems in different directions relative to each other without interfering with each other, blocking, or being subjected to an unfavorable tensile or compressive force. The fasteners thus ensure, on the one hand, a cohesion of the partial surfaces of the individual layers and thus the stackability of the layers without these falling apart, but on the other hand also optimal mobility of the partial surfaces against each other with little effort.

It can be seen that it is advantageous if the connecting elements are formed integrally with the partial surfaces. For example, it is conceivable that the connecting elements are made of the same material as the partial surfaces of the layers and that the recesses, which are introduced in the layers of the filling material, are designed such that they limit both the partial surfaces and the connecting elements. The connecting elements may for example be fine webs, which are formed between the partial surfaces. Of course, it is also conceivable that the connecting elements are made of a different material than the partial surfaces and, for example, are materially connected to the partial surfaces. For example, partial surfaces can be applied to a carrier network. However, it is favorable if the layers in the region of the connecting elements have a smaller thickness than in the area of the partial surfaces. It may be particularly advantageous if the layers in the region of the connecting elements can break more rapidly due to this smaller thickness than in the area of the partial surfaces. In particular, as soon as the layers of the filling material come under tensile and / or compressive stress during application of the retention device, the connecting elements can act as predetermined breaking points or "predetermined crack locations." As a consequence, the partial surfaces of the individual layers can shift more freely relative to one another On the one hand there is the advantage that the composite of the layers stacked on top of one another can adapt even better to the individual anatomy.Also, even better tension or pressure relief can be achieved when the device is stiffened.On the other hand, this also has the advantage that multiple use of the device can be achieved Namely, such a retention device is preferably designed as a disposable item, for example, this prevents unhygienic multiple uses of a corresponding article ng from the most cost-effective, easy to procure and easy to process materials, such as paper as filler, is made. The different thicknesses of the respective layers in the region of the partial surfaces on the one hand and in the region of the connecting elements on the other hand can be produced, for example, by introducing the recesses, for example by means of laser beam cutting, water jet cutting, microperforating, punching or a combination of such processes. Ideally, the planar shape of the layers or of the paper is not impaired by the structuring with the aid of the recesses. It is conceivable, for example, that when the recesses are introduced with the aid of a laser beam, the paper is thinned, for example by increasing the cutting speed or reducing the power in the region of the desired connecting elements. In a further advantageous embodiment, it is provided that the layers of the filling material are stacked one above the other in such a way that the sub-areas adjacent to one another are not stacked congruently one above the other. In this way It can be ensured that there is always a total area-wide composite of frictionally connected layers. In particular, it can be effectively avoided that holes form in the layer composite if partial surfaces of layers stacked on top of each other come to rest precisely over one another in such a way that the recesses between the partial surfaces also form as continuous recesses in the layer composite.

In a further preferred embodiment it can be provided that the layers of the filling material have a structured surface. This is particularly advantageous for further improving the adhesion between the layers. It is conceivable, for example, that the individual layers of the layers are provided with a golfball-like structure. The structuring can be carried out both on one side and on both sides on both surfaces of a layer. For example, it is conceivable that a first surface of each layer is provided with corresponding elevations, while the opposite surface of the layer is embossed. If two such layers are adjacent to each other in such a way that in each case one surface with elevations and one surface with embossings lie opposite one another, then the frictional connection arising when the vacuum is applied can be intensified by a positive connection between the elevations and embossings of the adjacent layers. Of course, this can also be achieved by other geometries in which structures are present on the surface of the layers, which can engage correspondingly in adjacent structures of adjacent layers. It is also possible to envisage surface geometries with inter-engaging structures, as well as structures in general, which overall lead to an increase in the roughness of the surface and thus to an increase in the frictional force between adjacent layers.

According to a further embodiment, it is favorable if at least one further filling material is arranged in the casing. Such a further filling material, like the surface structuring described above, can serve to further reinforce the frictional connection between the layers. By way of example, these may be particles which can fit into the embossing of the surface applied by the structuring or else intercalate into the fiber mesh of the paper present per se. There are Particle dimensions preferred, which are similar to the dimensions of the cavities of the embossing or of the paper fiber braid, so that the particles indeed get caught in the embossing or in the fiber braid, but can not completely submerge. The thus entangled particles lead to an increase in the surface roughness and can favor the positive connection between adjacent layers. As a consequence, the achieved frictional connection is increased when the negative pressure is applied. Overall, the stiffness during the evacuated state compared to the flexibility in the non-evacuated state can still be increased. It can be seen that it is favorable in a further embodiment if the further filling material is an intercalatable powder or fluid between the layers of the layer material. Such a powder is preferably formed with a granular structure.

It can be seen, moreover, that it also makes sense if the envelope is preferably made of an incompressible material. Particularly preferred is a material that is insensitive to the vacuum to be applied. At the same time, the material should be as stiff as possible in order to be able to adapt as well as possible to the corresponding shape to be contoured.

In a preferred embodiment, the filling material is preferably paper or a paper-like material. It may also be a coated paper to positively influence the frictional forces between adjacent stacked layers. For example, synthetic fiber paper, plastic films, silicified paper, waxed paper or coated paper can be used. In either case, the low frictional force between the layers of the filler in the unevacuated state causes the conformability of the shape to result from the low modulus of elasticity of the individual layers. The stiffness in the non-evacuated state results mainly in the stiffness of the individual layers. In the evacuated state, however, determines the stiffness of the paper stack or stack of paper-like material formed from the total thickness of the layer composite formed by the frictional force between the layers. In addition to many other positive qualities, paper offers the advantage of being a relatively inexpensive, readily available, easily and safely processed, environmentally friendly raw material. In addition, with an embodiment of the filling material in the form of paper layers, on the one hand, a low rigidity of the individual layers, but on the other hand, a very high rigidity of a layer composite can be realized even with few layers stacked one above the other. In this respect, low stiffness in the non-evacuated and high rigidity in the evacuated state can be achieved.

It can be seen that it is advantageous in a further preferred embodiment, when the retention device in the stiffened state has at least 100 times greater, preferably at least 1000 times greater, bending stiffness than in the unadjusted state. It is also conceivable that the flexural rigidity in the stiffened state is even at least 10,000 times or more, more preferably at least 100,000 times higher than in the non-stiffened state. The relatively low bending stiffness in the unadjusted state is mainly determined by the bending stiffness of the individual layers. The high bending stiffness in the stiffened state then results from the formation of the frictional layer composite,. In particular, when using paper or a paper-like material formed a particularly advantageous, large ratio between a low bending stiffness in the unobstructed and a high bending stiffness in the stiffened state can be achieved. In a further preferred embodiment, it is provided that the filling material 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 -30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, 91-100, 101-1 10.1 1 1 -120, 121 -130, 131-140, 141 -1 50, 1 51 -1 60, 1 61 -1 70, 1 71 -180, 181 -190, 191-200, 201-220, 221-240, 241-260, 261-280, 281-300, 301-320, 321-340, 341-360, 361-380, 381-400, 401-420, 421-440, 441-460, 461-480, 481-500, 501-550, 551-600 or more layers , preferably 10 to 500 layers, more preferably 20 to 200 layers, most preferably 40 to 100 layers. The number of layers is also dependent on the respective layer thickness of the individual layers. With a layer composite having a corresponding number of layers, a good stiffening of the retention device can be achieved. At the same time, however, the total thickness of the retention device is acceptable and the retention device is easy to handle and in particular in the case of use as Handling means or securing means in the intermittent patient storage to handle well.

In this connection, it is also advantageous if the layers of the filling material have a thickness less than or equal to about 3 mm, preferably from about 0.01 mm to about 0.5 mm, particularly preferably from about 0.05 to about 0.2 mm exhibit. Depending on the type and geometry of the filling material, the thickness of the individual layers of the filling material can be adapted to the stiffness desired in the stiffened state, wherein the thickness of the individual layers can influence the total thickness and the number of layers which can be used particularly advantageously.

The sheath in which the filling material is arranged is preferably foil-shaped, particularly preferably made of a plastic, very particularly preferably of a thermoplastic material, most preferably for example of thermoplastic polyurethane (TPU), polyethylene (PE), fluoropolymers or the like. In this case, composite films made of several different materials can be used, for example, metal coatings are conceivable for particularly thin polymer films. It is also advantageous if the shell is fluid-tight, preferably airtight. In this case, the wall of the shell preferably has a thickness of less than or equal to 1 mm, preferably less than or equal to 500 μιτι, very particularly preferably less than or equal to 250 pm. The thinner the shell is formed, the less stiff and stable are kinks that may form in the shell. As a result, such kinks can exert less disturbing influences on the function of the retention device. It is also conceivable that the shell consists of two cohesively connected layers of different thickness, between which the filling material is arranged. The thinner of the two layers can then represent in use, for example, the side of the shell, which rests against the body part to be molded and should be as flexible as possible in order to promote good moldability. The thicker of the two layers can be the outside of the envelope, which should be as stable as possible and insensitive to external influences. In a particularly preferred embodiment, for example, the outer layer may have a thickness of about 250 pm while the inner layer has a thickness of about 100 pm. It is favorable, although the shell out an incompressible material. In addition, the sheath may have an area serving as an overlapping area. This overlapping area is particularly helpful in order to be able to place the retention device around a body part without any gaps. The overlap area may either contain filler or be free of filler.

Overall, thus, the thickness of the retention device in a range between 1 and 40mm move, such as when you should be used to stabilize a limb of a patient. Of course, embodiments with a thickness of a few centimeters, but preferably less than or equal to about 40 mm can be realized. Such somewhat thicker retention devices provide sufficient stability for transporting a patient. In any case, however, it can be seen that a retention device according to the invention is extremely space-saving. The retention device according to the invention can be transported in this way, for example in the folded state particularly space-saving and easy, which is advantageous for example for a rescue operation in difficult terrain. It is also conceivable that, if used for long-term retention, it can be placed under normal clothing, which can significantly improve patient and wear comfort. According to another embodiment, it is preferred that the filler material at atmospheric pressure is a thickness of about 1 mm to about 40 mm, preferably about 1 mm to about 30 mm, more preferably from about 2 mm to about 1 5 mm, most preferably about 3 mm to 9 mm. The respective individual optimum thickness of the filling material also depends on the individual intended use of the retention device. Overall, it is advantageous if this thickness does not change substantially during stiffening of the device. This is especially the case when the layered filling material used is substantially incompressible. Ideally, the volume in vacuum does not change at all relative to the volume at atmospheric pressure. As a result of the application of a negative pressure to the shell containing the filler material, the total thickness of the filler material also changes only to an extremely small extent. This measure is determined by the volume of air present in the envelope. It is preferred if the change in thickness upon application of the negative pressure, ie in the case of guiding the device to the stiffened state, less than about 75%, preferably less than about 50%, more preferably less than about 25%, of the thickness in the unstiffened state. Thus, it is also advantageous if the pressure applied in the stiffened state in the shell at least a negative pressure of 250 mbar, preferably more than 500 mbar, more preferably more than or equal to 750 mbar, most preferably more than or equal to 850 mbar compared to the the outside of the shell is adjacent atmospheric pressure. The total thickness of the retention device in the stiffened state advantageously differs only in the air volume, which is present in the non-rigid state in addition to the filling material in the flexible, airtight envelope. It can be seen that the change in thickness of the device between the stiffened and unstiffened state when using a corresponding filling material, for example paper, is almost negligible.

It can be seen further that it is favorable if the filling material already fills the interior of the casing as far as possible in the unstiffened state. In this case, the volume of air contained in the shell is just large enough that the layers of filler material can move sufficiently against each other to optimally shape the body part or the contour of the patient. In this case, the sheath is preferably dimensioned such that the filling material does not abut the boundary of the sheath while it adapts to the body part or the patient contour, so that the risk of kinking due to such abutment is avoided as far as possible. At the same time, however, the volume of the shell is small enough to have as little influence as possible on the total thickness of the retention device. In this case, air is preferably only at the locations in the preferably flexibly formed casing, on which a volume is spanned by the filling material in the casing. In this respect, one recognizes the advantage of a further preferred embodiment in which the circumference and the shape of the layers of the filling material correspond to the circumference and the shape of the interior of the envelope. The layers of such a filler fill the interior of the shell almost optimally and the additional volume of air contained is relatively low, namely typically less than about 50%; preferably less than about 30% of the volume of the filler material. As a consequence, the application of a corresponding negative pressure with a relatively small vacuum pump is also possible in such a case. Such a vacuum pump is easy to transport and can also be difficult Conditions, for example in the application of mountain rescue, are used at accident sites.

In a further preferred embodiment it is provided that the retention device is mat-shaped. Such a mat-shaped retention device is particularly good at a body part can be applied. For example, it can be wrapped around an arm and / or around a leg. A mat-shaped embodiment of the retention device is also advantageous if the retention device is to be used, for example, for the intermittent storage of a patient during transport. For example, the patient can then simply be placed on the mat-shaped retention device. The mat-shaped retention device then adapts in its shape to the bearing surface of the patient, if appropriate using a molding aid. If the retention device then stiffened it keeps the patient in the previously occupied position or position stable. If the patient lies approximately on his back, he can be transported, for example with the help of a retention device according to the invention in a lying position without bending or twisting of the spine.

In a further preferred embodiment, it is provided that such a mat-shaped retention device is characterized in that it has an abutment surface, which in the applied state is in contact with the surface of a body or body part and whose shape is the shape of the lateral surface of the body or body part is adjusted. This is particularly advantageous for use of the retention device as a fixation of a body part for long-term fixation. Thus, for example, the retention device may have a trapezoidal shape, for example the shape of a cone-stump lateral surface. Such a trapezoid-like mat is particularly easy to apply to a body part with a conical basic shape, such as a lower leg or upper arm, which often have a smaller circumference in the region of the ankle or elbow joint than in the region of the knee or shoulder joint. A corresponding trapezoidal mat can be optimally applied to such a conical body part, without causing large overlaps. Various other shapes and contours of the retention device according to the invention are of course also conceivable. Thus, the mat-shaped retention device, the shape of a So- ckenschnittmusters, for example, with an opening, or have a hood, and special patterns for the thorax stabilization are conceivable. For the stabilization and fixation of joints it is also conceivable that more complex cuff forms are composed of several individual cuffs. It is both conceivable that the individual sleeves are flow-connected to each other and can be evacuated together, as well as that a plurality of independently stiffenable sleeves are connected to a holder with each other.

In a further embodiment variant, the layers of the filling material may be provided with a partial adhesive coating. For example, it is conceivable that predetermined regions of the filling material are coated with an acrylate adhesive or a first component of a two-component, fast-curing adhesive. Also UV-curable substances or other cohesive bonding methods, which can be activated, for example, by the presence or absence of, for example, oxygen or water, are conceivable. When a vacuum is applied, the second component necessary for triggering the gluing process or a corresponding moisture to activate the acrylate adhesive could then be released. For example, the sheath may have a moisture reservoir sealed with a membrane, wherein the membrane can be broken or torn by a targeted buckling upon application of the vacuum. The moisture released in the process can activate the cyanoacrylate adhesive and lead to sticking and thus additional stiffening of the layers of the filling material. In this way, for example, at certain points of the retention device particularly rigid areas can be predefined, such as in the form of support ribs or the like.

In a further preferred embodiment it is provided that the retention device has at least one pressure sensor element. Such a pressure sensor element may, for example, be a gel pad in which a pressure sensor is embedded. It is also conceivable that the gel pad has a hose connection to a pressure sensor arranged outside the retention device. In this case, a pressure change acting on the gel pad can be forwarded via the hose connection to the pressure sensor in accordance with the principle of the communicating tubes. Other versions Of course, forms of the pressure sensor element are also conceivable. The additional use of electrodes for impedance measurement or other other measuring devices is conceivable. It is conceivable both that the retention device has a single pressure sensor element as well as a plurality of pressure sensors. Each pressure sensor element can be adapted in its shape and size to the respective conditions. It is also conceivable that a plurality of pressure sensor elements are arranged along the surface of the retention device. The presence of such pressure sensor elements is particularly advantageous for controlling an optimal system pressure. This can be useful, for example, if the patient himself can not provide any feedback as to whether a corresponding retention device is fixed enough or too tight, for example, if the patient is unconscious. Especially with long-term retention, it is also important that the system pressure is optimal over a longer period of time. Thus, the formation of pressure points or pressure ulcer syndrome may occur at too high or unfavorable pressure conditions. In rare cases, it can also lead to the formation of a compartment syndrome. Both should be avoided in any case. In addition, in the case of long-term retention, unwanted loosening of the retention device can be achieved by reducing the muscle mass of the unloaded muscles of the retarded limb. A corresponding pressure sensor element of the retention device can thereby determine both an increase in pressure, for example due to swelling of muscles in the case of a compartment syndrome that forms, as well as a reduction in pressure when the retention device is looser due to muscle wasting. As soon as the pressure sensor element registers such a pressure change, an alarm can be issued. In addition, the retention device according to the invention can be adapted in this case to the corresponding pressure conditions. For this purpose, for example, the stiffening of the device can be temporarily eliminated by ventilating the airtight, flexible sheath. Then, the position of the retention device is corrected so that it rests again at optimum pressure before the envelope is evacuated again and thus the device is stiffened. In this respect, unwanted side effects of retention can be counteracted simply and effectively, while at the same time optimally stabilizing or fixing the corresponding body part. In a further preferred embodiment, it is provided that the retention device has a Anformhilfe. This may be, for example, an inflatable air cushion or the like. Such Anformhilfe is useful when using the retention device for intermittent storage of a patient during transport. Thus, it is conceivable, for example, that the retention device consists of a first or lower layer in the form of a collapsible, inflatable air cushion and a second layer in the form of the flexible, air-impermeable envelope in which the filling material is attached. These two layers can form a common mat which can be spread under a patient. For optimal impression of the body contour of the patient and for fixation then, for example, the lower air cushion layer can be inflated while the patient lies on the upper, second layer. The flexible sheath of the second layer forming retention device, in which the layered filling material is arranged, it follows simply the contour of the patient stored on her. The retention device thus conforms to the contour of the bearing surface of the patient, but without exerting pressure on them. If the corresponding impression by the flexible shell completely or achieved in the desired stage, the flexible, air-impermeable envelope is covered with a corresponding negative pressure and stiffened in this way. It can be seen that the air cushion layer arranged under the flexible shell acts as an optimal molding aid. Such an application aid can also be designed, for example, in the form of an air cushion sleeve which can be slipped over the retention device if the retention device serves, for example, for fixing an arm or leg. In this case, it is also conceivable that the Anformhilfe also serves as a protective coating. It can, for example, absorb and mitigate impacts, impacts or similar actions whose force would otherwise be passed on undamped to the injured body part to be fixed by the stiffened retention device.

In yet another embodiment, it is provided that the retention device has a pressure regulating device. These may be, for example, fluid pads or chambers, which are arranged between the retention device and the body part to be surrounded. These can be particularly helpful for thrombosis prophylaxis and for the reduction of swelling after accidents. Through a speaking control unit, such fluid cushion or chambers can regularly, for example. From distal to proximal, filled with fluid, such as air. This leads to a short increase in pressure in the corresponding part of the body surrounded by the retention device. As a consequence, an impulse-wave, local increase in tissue pressure can promote venous return to the heart, which reduces swelling and reduces the risk of thrombosis, especially in the elderly. A peristaltic pumping function can be generated, for example, by attaching a plurality of separately adjustable fluid chambers. These fluid chambers can be pumped in alternation and emptied again. The emptying can be done both by simply pumping off the fluid or by applying a mechanical external load.

The configuration of a retention device according to the invention with such a pressure regulating device can furthermore be advantageously used for decubitus prophylaxis. In this case, for example, caused by the own body weight local pressure points are temporarily relieved by rhythmic filling of fluid chambers. Here, too, the capillary pressure can be varied or increased and the tissue supply can be restored and maintained by a peristaltic pump function independent of the pressure relief. The device can be attached to limbs or to the trunk.

In a further embodiment, it is conceivable that the fluid chambers of the pressure regulating device are also used to control the temperature of the underlying body regions.

In a further embodiment it is provided that the retention device has a fixing aid. Such a fixation aid can serve, for example, to be able to optimally position the retention device on the body part when it is not yet stiffened. This is particularly advantageous when the retention device must not be mounted in horizontal but in vertical position on a body part. In addition, such a fixation aid, of course, also advantageous to secure the retention device on the body part long term. For example, it is conceivable that the fixing aid is a Velcro strip or buckle attached to the outside of a mat-shaped retention device. Also holding shells or straps that are wrapped around the retention device after stiffening are conceivable.

In a particularly advantageous embodiment it is provided that the fixing aid has one or more Zugbandvorrichtungen. Such Zugbandvorrichtungen can be coupled, for example, with a pressure sensor element. The pressure sensor element is expediently arranged at least partially on the inside of the retention device.

Furthermore, it is conceivable that the Zugbandvorrichtung has a band which consists of relatively movable sections. For example, it is again conceivable that the drawstring device has the basic shape of a rectangular band which can be placed around the retention device according to the invention. Other basic shapes are of course conceivable, such as the shape of a lateral surface, a truncated cone or a closed annular band. The subsections may, for example, be substantially rectangular strips arranged parallel to one another. The strip-shaped sections can be juxtaposed to give the rectangular base. Preferably, at least three such strips are present. It is conceivable that the strip-shaped sections each have a long and a short side, wherein the long side of the sections can be aligned either parallel to the long side or parallel to the short side of the body. Each of these sections can then be equipped, for example, with its own regulation device, as described below. However, it is also conceivable that the sections are regulated by a common regulation device, such as by being connected or coupled by a rope-shaped element of a power transmission device. The sections of the drawstring device may also form a spiral band that wraps around the body part. It is also conceivable that the sections have a different shape, for example. The shape of triangles or other polygons. Due to their relatively given mobility, the sections can optimally invest in the surface of the flexible, airtight shell of the retention device or a protective sheath disposed above.

It can also be seen that it is expedient if the subsections are connected to one another. They can move relative to each other, similar to a joint. This supports the optimal adaptation of the drawstring device to the outer contour of the retention device. The subsections can cover the surface of the retention device, in particular the outside of the flexible, airtight sheath in this way over the entire contact surface of the Zugbandvorrichtung away, without causing the occurrence of wrinkles or non-contact air spaces. This in turn has a favorable effect on a uniform force transmission from the Zugbandvorrichtung on the retention device.

The connection of the subsections with one another takes place, as with the layers of the filling material of the retention device according to the invention, preferably with the aid of connecting elements. In the simplest case, this may be strips arranged between the sections and made of the same material from which the sections are also formed. For example, it is conceivable that the drawstring device per se, as already shown above, is formed from a large strip of material in a rectangular shape. The material is preferably flexible but not elastic, hence anelastic. In these strips of material can then be incorporated at certain intervals parallel rows of slots. These rows of slots divide the rectangular body of the Zugbandvorrichtung in the sections of the invention. The connecting elements can then be formed by remaining material webs arranged between the slots. The connecting elements are preferably flexible in the sequence, but anelastic. It is also conceivable that the drawstring device is a material strip made of a non-stretchable fabric. This strip of material can be divided by the targeted removal of warp threads of the fabric into partial surfaces. At the tissue sites, on where the warp threads have been removed, an isotropic, flexible connection of the partial surfaces by the weft threads of the fabric can result in consequence.

Such a Zugbandvorrichtung may for example also have a hydraulic, pneumatic see or mechanical regulation device.

Mechanical regulation means non-hydraulic and nonpneumatic regulation. Such mechanical regulation may consist, for example, in a shortening of the circumference of the drawstring device caused by mechanical contraction of the drawstring device. In this way, the pressure which the tension band device exerts on the retention device and thus also indirectly on a body part surrounded by the retention device can be increased. A corresponding reduction of the applied pressure can be achieved by loosening - by enlarging the inner circumference - the Zugbandvorrichtung.

A mechanical regulation device can be realized in different ways. For example, it is conceivable that it is a regulation device which acts in the manner of an iris diaphragm. In this case, the Zugbandvorrichtung may for example consist of several partial surfaces which are mutually displaceable such that the inner circumference of the Zugbandvorrichtung is changeable.

It is also conceivable that the regulation device has at least one carrier device, at least one dynamic element and / or at least one force transmission device. The regulating device is then preferably a transmission device which has all three of these elements, ie, a carrier device, a dynamic element and a power transmission device. However, variants are also conceivable in which only one or two of the three elements are realized. A carrier device may be a stable or flexible plate or a fabric reinforcement. On or on the support device - if present - the dynamic element and / or the power transmission device can be mounted. The dynamic element is preferably an element that provides a force that is transmitted from the power transmission device to the Zugbandvorrichtung and a contraction or relaxation of the Zugbandvorrichtung, thus causing a reduction or increase in the inner circumference of the Zugbandvorrichtung. In a preferred embodiment, the dynamic element is a motor.

The power transmission device is preferably an element that transmits the force applied thereto in a reduction or enlargement of the inner circumference of the Zugbandvorrichtung. For example, it is conceivable that the power transmission device includes a cable or a ring belt, which is steered via one or more guide elements.

In a first variant of the regulation device, which is particularly easy to realize technically, the force can be exerted by the mere action of the hand on the force transmission device. For example, it is conceivable that the support device may be reinforced holes which are formed in opposite ends of a fabric band forming the drawstring device. The transmission element can then be a rope or rope-like element guided through the holes, at the ends of which the pulling-belt device contracts in a manner similar to the principle of a corset. The holes act accordingly not only as a support device, but also as guide elements for the power transmission device. Of course, it is also conceivable that in place of holes pulleys, hooks, eyes o. The like. Be used as guide elements.

In a more preferred embodiment, the regulation device comprises a motor as a dynamic element. This motor may for example be mounted on the carrier device. It may be a carrier plate whose shape corresponds more or less exactly to the contour of the body part. In further embodiments that can be combined with the abovementioned embodiments, the regulation device can act on the tension belt device in different directions with a force that leads to a change in the effective inner circumference of the tension belt device. The effective inner circumference of the Zugbandvorrichtung corresponds with the outer periphery of the attached to the body part retention device. The force exerted on the Zugbandvorrichtung can act on the one hand in the circumferential direction of the Zugbandvorrichtung, for example, when the Zugbandvorrichtung is placed around a body part, such as an arm or a leg around. However, it can also be aligned perpendicular to the layers of the filling material of the retention device.

Thus, it is conceivable, for example, that the regulation device has a cable pull or a cable-like element as a force transmission element whose effective length can be shortened or extended with the aid of the dynamic element, for example by the dynamic element being able to wholly or partially wind up the force transmission element. The Zugbandvorrichtung can be designed as a band with two ends, which can be drawn by the winding of the power transmission device to each other, thereby reducing the inner circumference of the Zugbandvorrichtung.

The Zugbandvorrichtung can also be designed for example in the form of a closed ring. The effective inner circumference of the Zugbandvorrichtung can be formed on the one hand by the Zugbandvorrichtung and on the other hand by the regulation device, for example by the carrier device of the regulation device. The regulation device can then be designed so that it pushes the Zugbandvorrichtung outward, for example, so radially to the axial direction of a body part, around which the Zugbandvorrichtung is applied over the retention device. In this way, the proportion that the Zugbandvorrichtung takes over the carrier device of the regulation device on the effective inner circumference is reduced. As a consequence, the entire effective inner circumference also decreases. In any case, the dynamic element may be a motor with a rotatable shaft.

In a first variant, this wave can cause a change in the effective length of an element of the power transmission device. For example, it may be used as a cable drum or rope-like element, and hereinafter the use of the term "cable drum" always means and includes a cable drum-like element, which is particularly advantageous when the power transmission device is or has a rope-shaped element Winding on or unwinding from the shaft can be shortened or lengthened The shortening, ie the winding onto the shaft, causes it to pull on the rope-shaped element Such a rope-shaped element of a power transmission device can be fastened with one end to the tensioning belt device and with the other end on the shaft of the motor acting as a cable drum, ie the dynamic element The drawstring device can then, as described above, have the shape of a band whose two ends face each other when the tensioning device surrounds a retention device In this case, the rope-shaped force transmission element can connect the two ends to one another in a zigzag shape, for example. As guide elements for such a power transmission device deflecting elements in the form of simple holes, but also rollers, hooks, eyes or the like may be formed at both ends, through which the rope-shaped transmission element is guided. The shortening of the transmission element by winding on the cable drum, i. Thus, on the spindle of the dynamic element, then causes the two ends of the Zugbandvorrichtung be drawn towards each other and that reduces as a result, the inner circumference of the Zugbandvorrichtung.

In a further variant, the shaft can cause an eccentric deflection of the Zugbandvorrichtung. The shaft of the engine designed as a dynamic element can be used as a drive for an eccentric. Such an eccentric is preferably mounted on the shaft so that its center of gravity can rotate about the axis of the shaft. For example, it is conceivable that the dynamic element, ie the motor, is mounted on a carrier plate. The eccentric may then have, for example, an off-axis and a near-axis end. About the eccentric can the Zugbandvorrichtung, which is then preferably a closed annular band, are guided. In a rotation about the axis of the shaft then the off-axis end of the eccentric can be alternately in a small and a long distance to the support plate. Serves the off-axis end of the eccentric at the same time as a guide element for the Zugbandvorrichtung, the Zugbandvorrichtung is deflected by the eccentric to the outside, when the off-axis end is located at a great distance from the support plate. In this case, the proportion which the Zugbandvorrichtung occupies the effective inner circumference in relation to the support plate of the regulation device, can be reduced. This in turn leads to a total reduction in the effective inner circumference. It can be seen that it is favorable if the regulation device is arranged between the tension band device and the retention device.

It is also conceivable that the drawstring device is a band wrapped around the retention device. The tape can have two long sides and two short ends. The short ends of the band can face each other. Between the two short ends of the band, the support plate of the regulation device can be arranged. The ends of the band can slide at least a little way over a support plate of the regulation device. The cable-shaped element of the power transmission device can then be fastened with its one end at a certain distance from the first end of the band of the Zugbandvorrichtung and with its second end at a certain distance from the second end of the band of the Zugbandvorrichtung. The dynamic element can then be designed so that it pushes the middle part of the rope-shaped element to the outside, for example with a hydraulic, pneumatic or a simple mechanical plunger. The two ends of the rope-shaped element are drawn towards each other and cause the result that also move the two ends of the Zugbandvorrichtung each other. As a result, in turn, the effective inner circumference of the Zugbandvorrichtung be shortened. In a further preferred embodiment it is provided that the retention device has a protective padding. Such a protective padding, for example, as described above, already be formed by the Anformhilfe, if it is is about an air cushion, which is arranged as a cushion below the retention device. In addition, it may also be a casing, which is attached after stiffening the retention device, for example on the outside of the retention device. It is also conceivable that a foam or other padding is attached to the flexible, airtight envelope on the facing away from the body part to be fixed side, which absorbs shocks that are exerted on the fixation, and damps. Such protective padding is particularly advantageous in the case of long-term retention, for example when the patient moves with a suitably fixed extremity over a longer period of time in his everyday environment. In this case, an overlapping area of different ends of the sheath may occur when the sheath is wrapped around a body part to be fixed. In this overlapping area, it is expedient if there is no padding or if padding is present only at one of the overlapping ends. The overlapping area can either be equipped with filling material or be free of filling material.

In a further aspect, the invention relates to the use of a retention device according to the invention for fixing a body part. In this case, the retention device according to the invention can be used both for long-term retention, for example after the fracture of an extremity bone, after joint injuries or after ligament injuries, and for instabilities, for example in the case of spinal injuries. It is particularly advantageous in this context that with the aid of the retention device according to the invention over the entire period of necessary retention optimal fixation of the body part can be achieved. For example, it is conceivable that a retention device for such a use is mat-shaped. After the repositioning of a fractured bone, such a retention device can simply be wrapped around the body part to be fixed, for example an arm or a leg. Once it has reached a perfect fit, it is stiffened by means of a vacuum pump. It is conceivable that the retention device, in particular the airtight, flexible sheath of the retention device has a connection piece for connection to a vacuum pump. The vacuum pump can thus be separated from the retention device. the. This is particularly advantageous if the patient is to wear the retention device over a longer period of, for example, several weeks without permanently carrying the vacuum pump with him. In particular, in this way it can also be prevented that the patient regulates the strength of the retention independently and at will.

In any case, at the beginning of the treatment, the retention device can then be optimally adapted to the currently available circumference of the corresponding body part. If deviations in the system pressure occur during retention, for example as a result of muscle wasting due to less stress on the corresponding muscles, then the appropriate strength of the retention can be maintained by a simple readjustment of the retention device. It is only necessary to briefly aerate the airtight flexible envelope in which the filler is present, then nachzupositionieren the retention device accordingly and re-stiffen the retention device. This readjustment can, for example, be carried out as part of regular medical check-ups.

It may be useful if the retention device, as described above, has corresponding pressure sensors which indicate whether the corresponding pressure exerted by the retention device on the body part to be fixed is located in the optimum, desired range.

It can be seen that it is particularly advantageous when using the retention device for fixing a body part when the retention device has at least one fixation aid. This may be, for example, a Velcro tape attached to the outside of the flexible sleeve of the retention device. Such a fixing aid helps in particular to attach the retention device in the unstiffened state in the correct position orientation and circumferential strength on the body part to be fixed. Such a fixing aid may also be tethers or a drawstring device, as described above. Such a Zugbandvorrichtung may for example also be coupled to a pressure sensor element. In this way, the force applied by a fixation aid or a drawstring device of a fixation is applied to the retention device, are automatically adjusted to the pressure exerted by the retention device on the body part pressure.

In a further embodiment, it is also advantageous if the retention device used has a protective coating, as described above. Such a protective sheath can either already be present on the outside of the retention device, for example by coating one side of the flexible, air-impermeable sheath with a foam, foam rubber or similar coating. It is also conceivable that during the fixation of a body part over a longer period of time first the retention device is attached and then a windable or tubular protective cover is placed over the retention device, for example in the form of a stocking, an arm protector, a shoe or the like. Such a protective sheath is preferably made of a shock-absorbing material.

In a further aspect, the invention relates to the use of a retention device according to the invention for intermittent patient positioning. Such an intermittent, ie temporary or transitional, patient positioning, in which the position of the patient should not be changed as possible, is desirable in various areas. For example, it is necessary after accidents, for example, if there is a suspicion of a spinal injury and the patient is indeed not to be moved, but still needs to be transported in order to get from the scene of the accident to the appropriate supply station. Another temporary situation in which body movements should be avoided is, for example, the situation in the operating theater. Here it is often necessary to store the patient in a special position, but this can not hold independently, for example, due to anesthesia or general weakness. In addition, the autonomous active attitude of such a position entails the risk of voluntary or involuntary movement, for example due to muscle twitching or the like. Here, too, a corresponding retention device for stabilizing the position of the patient over a certain short-term period is desirable. A preferred retention device for such use has, for example, two layers, a lower layer which takes the form of a Air or fluid cushion is formed and an upper layer, which is the flexible, air-impermeable envelope, which has the layer-shaped filling materials is. In particular, when the lower layer is an inflatable air cushion, the entire retention device can be made very flat. Overall, this is, for example, a very compact roll-up or collapsible mat. This mat can preferably be connected to a vacuum pump.

It can be seen that it is furthermore advantageous if the retention device used has at least one molding aid as described above. This Anformhilfe can be formed for example by the lower air cushion layer. Thus, for example, it is conceivable that the retention device is transported in the folded state to an accident site, then rolled out there and spread under the transportable, injured patient, so that the flexible, airtight envelope containing the filling materials, in contact with the patient stands, while the Anformhilfe, which is designed as an air cushion or inflatable air cushion, between the flexible, airtight envelope and the ground on which the patient is located, is arranged. Next, the dressing aid may then be inflated, pushing the flexible, airtight sheath against the patient's body. As the patient sinks into the inflatable air cushion of the dressing aid, the flexible, air-impermeable sheath with the filler forms the body shape of the patient. Next, when the flexible, air-impermeable sheath is placed under negative pressure, that is to say when the retention device is stiffened, the patient is held in exactly the position in which he has sunk into the air cushion. The advantage that is given when the retention device used has at least one fixing aid, as described above, is further recognized. If the patient has sunk into the air cushion as desired and the flexible, air-impermeable sheath with the filling material has been correspondingly stiffened, then it is favorable if the patient can be correspondingly fixed on the base thus formed so as not to roll down during transport. It is also conceivable that the retention device used, in particular the flexible, airtight shell of the retention device, and the Anformhilfe are formed integrally or flow connected to each other. Thus, it is conceivable that the air from the retention device, in particular the volume of air from the flexible, air-impermeable sheath during stiffening of the retention device in the Anformhilfe, in particular in the inflatable air cushion is pumped.

In a further aspect, the invention relates to a system for fixing a body part of a patient with a retention device according to the invention and a control unit. It is conceivable, for example, that the retention device according to the invention can be attached to the body part of the patient to be fixed and remains there for the entire time in the fixation, while the control unit, which requires only for attachment, in particular for controlled stiffening of the retention device is left in a clinic or doctor's office. The retention device of such a system according to the invention is preferably a retention device according to the invention, as described above. The control unit of a system according to the invention for fixing a body part of a patient can, for example, be equipped with a computer unit and a corresponding device for stiffening the retention device. In this case, for example, the computer unit can on the one hand control the controlled air inlet or air outlet from the flexible, air-impermeable envelope and, on the other hand, record parameters such as the pressure with which the retention device is applied to the body part to be fixed.

It can be seen that it makes sense if the control unit has a vacuum pump. Such a vacuum pump can then be used to pump out the air from the flexible, air-impermeable sheath of the retention device and in this way to stiffen the retention device. It is useful if the patient can only influence the control unit, in particular the vacuum pump, under controlled conditions. It is conceivable that for certain injuries, after appropriate guidance, an independent pressure regulation by the patient, depending on the feeling, can take place, as well as that with other fixations of a Body part exclusively a doctor or medical assistant under the direction of a doctor regulates the pressure that the retention device exerts on the part of the body to be fixed.

It can be seen in this context that it also makes sense if the retention device has a connection device for detachably connecting the retention device to the control unit, preferably to the vacuum pump of the control unit. Such a connection device may for example be an air inlet or outlet which is attached with a valve to the flexible, air-impermeable sheath in the retention device. In this case, a connection piece for connecting to the vacuum pump may be present. Such an embodiment of the retention device supports the two-part design of the system with a first part, which remains for fixing the body part in the patient and a second part, which remains for setting the retention device and regulating the strength with which the retention device on the body part, remains at the doctor namely the control unit. With the aid of the connecting device, the retention device can then be connected to the control unit when the patient is in the clinic or in practice. The doctor can then control the seat and the pressure exerted by the retention device on the body part pressure and adjust or readjust accordingly. It can be seen that it is also advantageous if the retention device of the system according to the invention for fixing a body part of a patient has at least one pressure sensor element. Such a pressure sensor element can for example be coupled to the control unit. It is also conceivable that a corresponding connection is guided by the connecting device which is also used for coupling to the vacuum pump of the control unit. It is also conceivable that the pressure sensor element is equipped with a chip that records the recording of the pressure curve - which is particularly useful from a forensic point of view - over the entire period of fixation of the body part and can transmit, for example by transponder signal to a read-out unit. In this way, a graph-like monitoring of the pressure prevailing between the stiffened retention device and the body part is possible. This allows the early detection of the formation of a compartment syndrome. In this case, it can be counteracted immediately before it causes lasting damage Also, a signal can be automatically transmitted in this way, for example, if the fixation of the body part is no longer sufficiently strong, that is, if, for example, the retention device no longer sits firmly enough on the body part, because the muscles of the body part to be fixed are, for example, receded to have. Also, it can be responded to corresponding stresses that are exerted on the body part, for example, when the body part to be fixed in the course of rehabilitation gradually get used to stress again.

In a further embodiment, it makes sense if the retention device of the system according to the invention has a protective padding. Such a protective padding may, for example, be a suitably tubular or windable protective cover, for example a foam or foam rubber jacket or a bubble wrap, which is wrapped around the retention device, which in a stiffened condition bears against the body part of the patient. It is also conceivable that the protective padding is an already prefabricated shoe, sleeve or other, which in turn is equipped with inflatable air cushions or fluid pads, for example, and can be easily slipped over the retention device. Such protective padding prevents shocks, impacts or other forces from the outside can act on the body part to be fixed. In particular, it is prevented that such shocks, shocks or other undamped transmitted via the stiffened retention device on the body part located in convalescence and can cause pain or renewed damage there.

In another aspect, the invention relates to a system for intermittent patient storage with a retention device according to the invention, at least one Anformhilfe and a control unit. It is particularly advantageous if the retention device and the Anformhilfe form a common support device. Such a support device made of a retention device and an Anformhilfe can for example be a mat having a first layer in the form of the Anformhilfe and a second layer in the form of the retention device. The retention device is here again according to the invention, a flexible, air-impermeable envelope, in which, as already described above, a layered filling material is arranged. The dressing aid can be For example, be an inflatable air chamber system. It is conceivable that the retention device, in particular the flexible, air-impermeable casing, is flow-connected to the air chamber system of the molding aid. However, it is also conceivable that the retention device and the Anformhi lfe represent two physically separate components.

Depending on the desired field of application, the support device can be designed as flat and light as possible or as a disposable item. It is also conceivable that the Anformhilfe is reusable, while the retention device is designed as a removable disposable article.

Thus, it is conceivable that the system for emergency care and patient transport in Unfal lbereich should be used, such as traffic accidents or in mountain rescue, that the support device is a flexible and lightweight mat with low structural dimensions. Such a mat consists for example of a very flat retention device made of flexible, air-impermeable sleeve with a corresponding layer material, which has a thickness of not more than a few centimeters, eg. about less than or equal to 4 cm to about less than or equal to 1 cm and a flat collapsible Anformhilfe that is integrally connected to the retention device. Such an embodiment is preferably an inflatable chamber. In this case, the weight of this inflatable chamber can also be very low, for example, it is a chamber of flexible material, such as in an air mattress or the like. The control unit can be very easily and space-saving in such a system. It can also be seen here that it makes sense if the control unit has a vacuum pump. Due to the small volume of air in the retention device, however, only one vacuum pump with very low power and accordingly with the smallest possible size and low weight is necessary for stiffening the retention device. Such a system can be transported quickly and easily without great transport costs to a corresponding accident location. In order to be able to retrieve or transport an injured patient with the aid of such a system according to the invention for intermittent patient storage, it is only necessary to dispose of the support device which consists of the retention device and the attachment device. form aid exists to spread among the patient. For this, the patient usually has to be moved in only a very small amount and over very short distances. In the best case, even only a slight lifting of the patient is sufficient. If the patient then lies on this support device, then the dressing aid can be inflated with the aid of the control unit, in particular the pump of the control unit which can also be used as a vacuum pump. It will be appreciated that it is beneficial if the molding aid of the system has at least one inflatable chamber as described above. During the inflation of this chamber, the patient lying on the support device and thus on the chamber remains in the position in which he first came to lie on the support device and thereby sinks in this position into the air bed formed by the impression aid. In this case, the retention device shapes the body contour of the patient accordingly. As far as the retention device has then been stiffened by means of the control unit, the patient is in the position in which he has come to rest on the support device, fixed and held stable.

It can be seen that it is furthermore advantageous if the system according to the invention for intermittent patient storage has at least one fixing aid. If the patient is then correspondingly fixed in position in the support device, then it is particularly helpful for transporting the patient if he can not fall down or roll down from this support device. For this he can be secured with appropriate fixation aids, such as tethers or Velcro. It is also conceivable that the fixing aid is a draw-band device, as described above. After the stabilization of the position, the patient can be transported without major movements, which could put the patient in appropriate danger in the case of suspected back, spinal or skull injuries or cause him corresponding pain. In particular, for a smooth transport of the device or the system, it is also useful if the retention device and / or the Anformhilfe a connection device for releasably connecting the retention device with the control unit, preferably with the vacuum pump of the control unit comprises. This allows the retention device and the dressing aid to be transported separately from the vacuum pump and the control unit. For example, it is possible to carry out the transport of the patient without disturbing hose connections to which, if appropriate, corresponding devices hang.

In a further embodiment, however, it is also conceivable that the vacuum pump of the control unit is a very small vacuum pump, for example a valve pump that can be integrated into a valve or even a manual pump, and that the control unit is a very simple control unit which can be opened or closed by the control unit automatic valve can be operated. Such a control unit with a valve vacuum pump may be formed, for example, on the Anformhilfe of the system. Overall, the system for intermittent patient storage therefore consist of a single mat having as the first layer, the retention device comprising the flexible sheath with the filling material and as a second layer the Anformhilfe on which a corresponding valve is arranged. Such a mat is flexible, has a low weight and can be folded very small. The very low weight and the very low overall height are due in particular to the design of the retention device with the flexible, layer-shaped filling material, preferably a filling material made of paper. With such a filler, a correspondingly good stiffening while good formability and correspondingly low overall height can be achieved.

Another embodiment of the system for intermittent patient storage can be used, for example, stationary in an operating room. Here, the retention device may preferably be formed separately from the Anformhilfe the system. For example, it is particularly advantageous here if the retention device is designed as a disposable item. For example, it is conceivable that the Anformhilfe in turn represents an inflatable or hydraulically adjustable chamber, such as a waterbed. This molding aid can then be covered with a corresponding retention device onto which the patient to be operated on can lie. The patient is then in particular with the most even pressure distribution on this system. In this way, especially in elderly patients, especially sensitive patients, and / or prolonged operations to prevent decubitus symptoms. Even pressure points are accordingly avoidable. In contrast to the above-described use of the system for intermittent patient positioning in a change of location, it is less on the low height, low weight and ease of transport, but rather on an optimal storage of the patient while maintaining optimal hygiene. However, optimal hygiene is best ensured with sterile surgical instruments that are only used once. Such disposable items are a continuous cost factor in corresponding hospitals and should accordingly be as cost-effective as possible. This is the case in particular of the retention device according to the invention. An embodiment of paper in a suitably flexible, airtight envelope represents a very cost-effective, reliable embodiment of such a retention device. If the layers of the filling material are, as described above, equipped with connecting elements which represent predetermined breaking points, the reusability of the retention device can be effectively prevented ,

When using the retention device in the surgical area, it is also expedient to make the sheath of the retention device ESD-safe.

When using a fluid bed as Anformhilfe for example, a heated fluid bed can be realized, which prevents the cooling of the patient during the operation, if possible. This may also be useful after or during recovery of a patient in an accident.

To better control the optimal support of the patient or the victim on a corresponding support device of a system for intermittent patient storage, it may also be useful here that the retention device has at least one pressure sensor element, as provided in a further embodiment. Also in the embodiment as a support device for an operating room, it is advantageous if the system for intermittent patient storage has at least one fixation aid. In particular, a fully anaesthetized patient is no longer able to control whether he is stuck on a possibly even inclined corresponding pad, or whether he may slip or roll down. It makes sense to fix the patient on the appropriate edition.

Finally, it is favorable if the system for intermittent patient support has at least one transport device. Such a transport device may for example be designed so that it optimally receives the Anformhilfe and retention device, which form the support device. In the simplest case, these are transport rods, which can be introduced on the support device, and with which the support device is portable. For example, it is conceivable that loops are present on the support device through which telescopic rods can be inserted. Of course, however, other transport devices are conceivable. For example, transport racks with corresponding castors or rollable hospital beds and operating tables.

Further features and characteristics of the invention can be taken from the following description of specific embodiments and with reference to the drawings. Show it:

Fig. 1: A schematic view of a retention device according to the invention;

Fig. 2a: A cross-section along the line X - X of the embodiment of Figure 1 in non-stiffened state;

FIG. 2b shows a cross section along the line X-X of FIG. 1 in the stiffened state; FIG.

2c shows a cross section through a further exemplary embodiment of a retention device;

3a shows a detailed view of two layers of the stiffening device according to the invention in cross section;

Fig. 3b: Another cross-sectional view of another embodiment of two

Layers of the retention device according to the invention;

4a shows a schematic view of a subdivided layer of the filling material of a retention device according to the invention;

Fig. 4b: Detail view of Fig. 4a;

Fig. 5a: Another schematic view of a subdivided into partial areas

Layer of the filling material of a retention device according to the invention; An enlarged detail of Fig. 5a;

A further schematic view of a subdivided layer of a retention device according to the invention;

An enlarged detail of Fig. 6a;

A further exemplary embodiment for a schematic view of a subdivided layer of a filling material according to the invention of a retention device according to the invention;

A detailed view of partial surfaces and recesses and connecting webs of a layer of a filling material according to the invention of a retention device according to the invention;

A cross section along the line Y-Y of Fig. 8a;

a retention device according to the invention, which is applied to a limb for fixing the same;

another embodiment of a retention device according to the invention, which is applied to a body part;

a schematic view of a retention device according to the invention, which fixes a body part;

a further schematic view of a retention device according to the invention for fixing a body part;

Yet another schematic view of a retention device according to the invention for fixing a body part;

FIG. 14b shows the path change s of the circumference of the retention device over time in synchronism with the pressure profile shown in FIG. 14a; FIG. a schematic embodiment of a retention device according to the invention for intermittent patient positioning;

a side view of an embodiment of a retention device according to the invention for intermittent patient positioning;

a further schematic view of a retention device according to the invention for intermittent patient positioning; FIG. 18 shows a schematic section of a draw-band device of a retention device according to the invention; FIG.

Fig. 19a: another embodiment of a Zugbandvorrichtung;

Fig. 19b: The Zugbandvorrichtung of Fig. 19a in a schematic to a bicepsförmiges

Body part applied condition;

Fig. 20: another embodiment of a Zugbandvorrichtung;

Fig. 21: A cross-section through a regulation device of a device according to the invention

Zugbandvorrichtung of Figure 20 along the line Z- Z;

FIG. 22: a side view of a compression device according to the invention. FIG

Blood pressure measuring device with a mechanical regulation device;

FIG. 23 shows a further exemplary embodiment of a retention device according to the invention with a tension band device and a mechanical regulation device; FIG.

FIG. 24 shows a further exemplary embodiment of a retention device according to the invention with a tension band device and a mechanical regulation device; FIG.

Fig. 25 A schematic representation of the operation of a pressure regulating device for a retention device.

FIG. 1 shows a retention device 10 according to the invention. The retention device 10 consists of a flexible, preferably airtight envelope 20 with an air inlet or outlet 24. The envelope 20 has an outside 22 and an interior 21. In the interior 21, a filling material 30 is arranged. It can be seen in Fig. 1 that the illustrated embodiment is a retention device 10 having a substantially rectangular basic shape. The retention device 10 is mat-shaped and can be wrapped in this way particularly easily around a body part, as shown for example in Figures 9, 10, 1 1, 12, 13, 23 and 24. Of course, however, other embodiments are conceivable in which the retention device 10, for example, the basic shape of a truncated cone surface or other shapes, which are adapted to the respective body part to be encompassed. It can be seen further in Fig. 1 that the filling material 30 fills the interior 21 of the shell 20 in large parts. With respect to the rectangular basic shape of the mat-shaped retention device 10 is so far the width B of the filling material 30 is just so much larger than the width b of the inner space 21 of the shell 20, that abutment of the filling material at one end of the shell during bending of the retention device during use is prevented. The same applies to the length S of the filling material 30 and the length s of the interior 21 of the flexible, air-impermeable sheath 20. The filling material 30 is a stacked layer 31 of paper or a paper-like material. However, other layered, stackable materials are also conceivable. The layers 31 have a preferred thickness of less than 60 μιη. They are, for example, at least about 0.01 mm and at most about 3 mm thick. All values in between are imaginable and possible. Corresponding to the above already stated corresponds to the width B of a layer 31 of the filling material 30 of the width b of the inner space 21 of the shell 20 and the length S of such a layer 31 of the length s of the inner space 21st Also in the case of other geometries of the shell 20, the outer dimension of the layers 31 and the contour of the layers 31 with a corresponding tolerance range for a movement of the Füllmate- rials 30 in the shell 20 corresponds to the inner dimension and the contour of the interior 21 of the shell 20th

It can be seen in Fig. 2a, which shows a cross section along the line X - X of Fig. 1 that the layers 31 of the filling material 30 are loosely stacked in the unadjusted state. A certain volume of air 25 is present in the airtight, flexible envelope 20, so that corresponding air-filled intermediate spaces 26 are formed or present between the individual layers 31. Furthermore, it can be seen in FIG. 2 a that the layers 31 of the filling material 30 almost completely fill the interior 21 of the casing 20, and that the air volume 25 is relatively small in relation to the volume occupied by the filling material 30.

If the air is now pumped out of the flexible sheath 20 through the air outlet 24, for example by means of a vacuum pump as shown in FIGS. 11, 12 and 13, the atmospheric pressure applied to the outside 22 of the, preferably airtight and flexible, sheath 20 is compressed External pressure, the shell 20 and arranged in the shell 20 layers 31 of the filling material 30 together, so that a layer composite of frictionally interconnected layers 31 of the filling material 30 is formed. In this case, the pressure difference between the voltage applied to the outside 22 and in the interior 21 prevailing pressure of at least 250 mbar, preferably more, for example 750 or even 850 mbar. Even lower or higher pressure differences are vorstellabr. The frictional connection between the layers 31 stacked one above the other is created by frictional forces acting between the layers 31 of the filling material 30. The frictional force between the layers 31 increases approximately proportionally to the standing on the layers 31 normal force. While the individual layers 31 are decisive for the rigidity and elasticity of the filling material 30 and thus for the rigidity and elasticity of the retention device 10 prior to the production of the adhesion, these properties are dimensioned after the occurrence of the frictional connection, as shown in FIG - Total thickness of the stack of interconnected layers 31st

The frictional forces between the individual layers 31 can be enhanced if, as in the exemplary embodiment illustrated in FIG. 2c, another filling material 40 is present in the airtight envelope 20 of the retention device 10 according to the invention. It can be seen in FIG. 2 c that the further filling material 40 is granular particles, which are arranged in the intermediate spaces 26 between the individual layers 31. The spaces 26 are also air-filled in the unstiffened state. If the air is now pumped out of the flexible sheath 20 through the air outlet 24, the particulate parts of the second filling material 40 reinforce the frictional force which acts between the individual layers 31 of the filling material 30.

A further reinforcement of the frictional force or of the frictional connection between the individual layers 31 of the layer-shaped filling material 30 can, for example, be effected by a corresponding surface design of the layers 31. Thus, it can be seen in FIG. 3 a that the one side surface 31 1 of such a layer 31 is provided with elevations 313, while the other, opposite side surface 312 of the layer 31 has an embossment 314. As can be seen in FIG. 3 a, the elevations 313 in the first layer 31 can interact positively with the embossings 314 of the adjacent layer 31 and in this way reinforce the frictional force between the layers 31 of the layered filling material 30. The elevations 313 can intervene on the one hand form-fitting in the embossments 314. On the other hand, however, the frictional force is already amplified even if the elevations 313, as shown in the area marked C, Asked to find a simple stop on the edge of such an embossment 314. Preferably, many embossments 314 and elevations 313 are randomly distributed on the layer 31, so that in each position a portion embossments 314 and elevations 313 is interlocked. It is also conceivable that in the layers 31, as can be seen in FIG. 3 b, only imprints 31 5 are introduced into which the particles of the second filling material 40 can dip. In this case, the embossings 315 are preferably formed so that the particles 40 do not completely dip into the embossings 315 but protrude beyond them and thus likewise favor a positive connection between two adjacent layers 31, which can reinforce the frictional force between the layers 31 of the filling material 30.

FIG. 4 a shows a schematic design of a single layer 31 of the filling material 30 of the retention device 10 according to the invention. It can be seen that this layer 31 consist of a plurality of partial surfaces 32 with a square basic shape. The partial surfaces 32 are delimited on all four sides by recesses 34, which are introduced into the layer 31. By way of example, these recesses 34 can be introduced into the layer 31 by laser cutting, cutting or punching. It can be seen that 32 connecting elements 33 are formed between the individual partial surfaces. These arise through short distances between the recesses 34. The recesses 34 in the example shown in Fig. 4a are particularly simple. It is merely a slot-shaped straight recesses, which are, for example, by a punching particularly easy to introduce. In Fig. 4b it can be seen that the connecting elements 33 in relation to the partial surfaces 32 have a very small area. The connecting elements 33 are therefore web-shaped in the illustrated embodiment. The connecting elements 33 can be bent very easily in this way, whereby the part surfaces can move very well against each other.

5a shows a further embodiment variant for the design of the layers by partial surfaces 32. The partial surfaces 32 shown here have a triangular basic shape and are formed by inserting star-shaped recesses 34, each having three beams, into the layers 31 in that in each case three star-shaped recesses 34 form a hexagon, wherein in this hexagon a fourth star centered shaped recess 34 is arranged. This creates a hexagonal grid with trigonal base elements. Here again, bar-shaped connecting elements 33 are formed between the individual partial surfaces 32, which stop during the introduction of the recesses 34 between adjacent recesses 34. Again, it can be seen in the detail enlargement in Fig. 5b that the surface of the connecting elements 33 in relation to the surface of the partial surfaces 32 is very small.

The exemplary embodiment illustrated in FIG. 6 a for a layer subdivided into sub-areas 32

31 of the filling material 30 and the detail enlargement of this pattern of the layer 31 according to the invention shown in FIG. 6b has hexagonal partial surfaces 32, which in turn are interconnected by connecting elements 33. The partial surfaces 32 are arranged honeycomb-like

Finally, FIG. 7 shows yet another exemplary embodiment of a layer 31 of the filling material 30 according to the invention consisting of partial surfaces 32. The partial surfaces 32 likewise have a hexagonal symmetry here. However, the corresponding partial surfaces 32 have a first longitudinal axis and a second, shorter, perpendicular to the longitudinal axis transverse axis. The expansion behavior of such a layer 31 is different in this way in the longitudinal direction of the layer than in the transverse direction running perpendicular thereto. In this way, the retention device 10 can be particularly well on eg biconical shaped body parts, such as create an upper arm with a well-developed biceps. Also, the retention device 10 may well follow the geometry of slightly angled joints in this manner. One recognizes in Fig. 8a, an enlarged detail of such example, in Fig. 7 geometry shown by partial surfaces 33, recesses 34 and web-shaped connecting elements 33, a layer 31 of the filling material according to the invention 30. Again, it can be seen that the surface of the connecting elements 33rd as well as the surface of the faces 32 is bounded by the recesses 34. The connecting elements 33 are formed integrally with the partial surfaces 32, i. the faces

32 and the connecting elements 33 consist of a continuous common piece of material. However, the area of the connecting elements 33 in relation to the area Surface of the surfaces 32 extremely low. 8b, which shows a section along the line Y-Y of FIG. 8a, that the layer 31 is thinner in the region of the connecting elements 33 than in the region of the partial surfaces 32. The thickness d 'is shown in FIG. The connecting element 33 acts in this way as a predetermined breaking point or "Sollrissstelle" between the adjacent part surfaces 32. Such geometry of the surface can, for example. With the aid of laser beam cutting on the Surface of the layer 32 can be achieved by guiding the laser beam more rapidly over the surface of the layer 31 in the region of the connecting elements 33 than in the region of the recesses to be formed. As a result, the connecting element 33 with the smaller thickness d 'remains In this way, they not only act as predetermined breaking points but are also much lighter to bend, as the much thicker faces 32 of the layer 31st They act in this way as joints between the faces 32nd

It can be seen in FIG. 9 that the flexible sheath 20 of the retention device 10 according to the invention is wound around a body part K, in the example shown an elbow of an arm. Fixing elements 70 serve as fixation elements 70 in the example shown. Tethering straps 70 may be formed with a hook-and-loop fastener, a buckle or a drawstring device according to FIGS. 18 to 22 described below. It will be appreciated that it is a particularly great advantage of the invention that the flexible, air-tight envelope 20 has an extremely small thickness both in the un-stiffened and in the stiffened state. In this way it is possible, for example, to fix an arm or a leg, which is normally covered by a more or less wide piece of clothing, without it being absolutely necessary to avoid particularly long-sleeved clothing. In addition, the casing 20 according to the invention with the filling material 30 arranged therein has a very low weight. For applying the retention device 10, as shown in FIG. 9, first the flexible, airtight sleeve 20 is folded around the body part K to be fixed. Then, for example, the two fixing elements 70 can be closed, so that the retention device per se is located at the correct position with respect to the body part K and can not slip. Next, the desired angle at which the arm or elbow should be fixed, as shown in Figure 9, before evacuating and thus stiffening the airtight, flexible sleeve over the air outlet 24. Another advantage of the retention device 10 according to the invention can be seen in FIG. Here, the sheath 20 is placed around the neck of a patient as a type of cervical collar. As described above, both the flexible, airtight envelope 20 and the filling material 30 arranged in it adjust exactly to the anatomical conditions of the respective patient. In particular, at the places where the neck brace or airtight, flexible sheath 20 rests on the shoulders, sternum and chin, it comes to a precise accurate impression of the body shape of the patient. For this purpose, the flexible, airtight sheath 20 can initially be loosely wrapped around the neck area of the patient and then, before evacuation, fixedly attached to the flexible, air-tight sheath 20 by two fixing aids 70, which are for example Velcro straps or buckles are closed, so that first a correct and comfortable for the patient seat of the retention device 10 can be controlled and secured before evacuation. Finally, only the flexible, airtight envelope 20 is evacuated via the air outlet 24 and thus stiffened. The retention device 10 adapted in this way optimally to the anatomical conditions of the patient ensures in this way, on the one hand, a firm stabilization of the cervical spine, but at the same time avoids undesired pressure points, in particular in the region of the sternum and the chin. In a particularly favorable embodiment variant of the retention device 10 shown in FIG. 10, at least one pressure sensor element is additionally arranged between the retention device 10 and the neck of the patient. In this way, possible impairments of the venous return or a carotid sinus syndrome can be prevented by too close contact of the retention device.

FIGS. 11 and 12 each show a cross-section through a body part K to be fixed, around which a retention device 10 according to the invention is applied. In each case, the flexible, air-impermeable envelope 20 with the filling material 30 contained therein is applied in a form-fitting manner to the circumference U of the body part K. Figures 1 1 and 12 each show a cross section in the region of the fixing element 70 and 70 '. In FIG. 11, the fixing element 70 'is a fluid-padded sleeve, for example an inflatable air cushion sleeve. In FIG. 12, the fixing element 70 is, for example, a draw-band device 70 'with a drawstring 70 ", as is more closely characterized in FIGS.

The formation of the fixing element 70 as fluid-padded or air-cushioned sleeve has the additional advantage that the sleeve-shaped fixing element 70 simultaneously acts as a protective coating. Namely, while the retention device 10 fixed in the stiffened state, the body part K and holds optimally in position, there is also the risk that it passes on them acting shocks, shocks or other effects from the outside unattenuated to the enclosed body part K. However, depending on the nature and severity of the injuries that the fixation requires, it can be extremely painful and detrimental to the patient. It is therefore advantageous if the fixing element 70 at the same time represents a protective casing, which absorbs shock acting from the outside, shocks or the like, so that they can not be transmitted directly to the body part K.

It can be seen both in FIG. 11 and in FIG. 12 that the fixing or retention device 10 is coupled to a control unit 90. In FIG. 11, the control unit 90 controls two pumps 91, 92, wherein the first pump 91 is connected to the flexible, airtight envelope via the air inlet or outlet 24 and the second pump 92 is connected to the fixing collar via another Fluid inlet and outlet 25 is connected. It is conceivable that the shell 20 and formed as an air sleeve fixing member 70 are also connected to each other, or that air from the flexible, airtight envelope 20 by means of the first pump 91 out and with the help of the second pump 92 in the air sleeve-shaped fixing element 70 can be pumped directly into it. In this case, evacuation of the sheath 20 is directly accompanied by inflation of the air sleeve. Volume differences between the pumped out of the shell 20 and the pumped into the air sleeve air volume can also be compensated by appropriate control valves. In the example shown in FIG. 12, on the one hand the control unit 90 is likewise connected to a pump 91 which, via an air inlet or outlet 24, supplies the flexible, evacuate or aerate with air and in this way can cause the stiffening or loosening of the sleeve 70 '. At the same time, the controller 90 is connected to a regulator 71 which regulates the effective inner circumference of the fixation aid 70. This can be, for example, a regulation device 71, as described in greater detail in FIGS. 18 to 22.

FIG. 13 shows a further exemplary embodiment of a retention device 10 according to the invention, which is shown in cross-section and is wrapped around a body part K. It can be seen in particular that a plurality of pressure sensor elements 80 are arranged between the flexible, airtight envelope 20 of the retention device and the body part. These pressure sensor elements are used in particular for detecting the pressure conditions during application and stiffening of the retention device 10 and over a certain period of time t. In this case, with the aid of the pressure sensor elements 80, it can in particular be recognized in good time whether a compartment syndrome can develop and / or whether a readjustment of the system rigidity of the retention device 10 becomes necessary.

FIG. 14 shows, by way of example, the pressure profile which can be ascertained with the aid of the pressure sensor elements 80 when a compartment syndrome develops. FIG. 14 a shows the pressure p recorded by the pressure sensor elements, while FIG. 14 b shows a shortening of the fixation aid, that is to say a distance k around which the inner circumference of the fixation aid is shortened, this shortening resulting in a defined pressure increase effected by the retention device 10 on the encompassed body part K applied pressure. It can be seen in particular that the shortening, namely the distance k, by which the inner circumference of the fixing aid 70 is shortened, is the same in all four measuring times t1, t2, t3, t4. In this case, the fixation aid is first pulled together at four different measurement times t1, t2, t3 and t4 at controlled intervals and then directly released back to the desired circumference U. An evolving compartment syndrome can be recognized by the fact that at time t1 and t2, in the graph of FIG. 14A, a correspondingly constant pressure change dp, namely an increase in pressure, occurs simultaneously with the reduction in the inner circumference of the fixation aid. At time t3 and time t4 an incipient compartment syndrome is detectable. Here The pressure change dp on the one hand fluctuates by a much greater amount than in the case of the measurements t1 and t2 occupied with identical changes in circumference. At the same time, the output pressure level as a whole has also increased, which can be seen from the higher initial pressure level at time t3 and t4. If such a pressure curve is recorded, this can be an indication that a compartment syndrome develops below the retention device 10, to which it is necessary to react immediately.

FIGS. 15a, 15b and 15c show a retention device 10 according to the invention, which is used for intermittent patient positioning. In this case, the retention device 10 according to the invention forms the upper layer of a support device. The support device consists of the retention device 10 and an Anformhilfe 50. The retention device 10 in turn has a flexible, airtight envelope 20, which is filled with a filling material 30 as described above. The Anformhilfe 50 is an inflatable, collapsible air cushion. The retention device 10 according to the invention is therefore designed in the form of a mat in the example shown. When using the retention device 10 according to the invention for intermittent patient storage, a body K of a patient initially lying on a solid substrate is first placed on the mat-shaped retention device 10, as can be seen in FIG. 15a. In a next step, the Anformhilfe 50 is inflated so far, for example, with a small pump that the body K of the patient, without changing its position, can sink into the Anformhilfe 50 ie in the formed air cushion. It can be seen in FIG. 15b that the flexible, airtight envelope 20 as well as the contained filling material 30 molds the rear contour R of the body K, with which it sinks into the air cushion of the molding device 50. After evacuation of the flexible, air-impermeable sheath 20, the retention device 10 then retains exactly the shape that has formed, as can be seen in FIG. 15b. After evacuation, ie after stiffening, then, as can be seen in FIG. 1c, the molding aid 50 can be removed as desired. The body K of the patient is then fixed according to its rear contour R and stabilized in position. The patient can then be transported without there being any movement of the spine, for example. FIG. 16 shows a schematic representation of a system 100 for intermittent patient storage with a retention device 10 according to the invention of a dressing aid 50 and a control unit 90. The flexible and reversibly stiffenable retention device 10 according to the invention is again designed as a first layer of a mat which consists of a flexible, air-impermeable envelope 20, in which the layer-shaped filling material 30 is arranged. As the second layer of the mat, the application aid 50 is formed, which in turn is an inflatable air cushion. Both the flexible, air-impermeable envelope 20 and the Anformhilfe 50 are connected via air inlets and outlets 24, 25 'to the control unit 90. The control unit 90 includes in particular a small vacuum pump. It can be seen that it is particularly advantageous if the air inlets or outlets 24, 25 'are detachably connected to the control device 90. For transporting such a system for intermittent patient support 100, the mat, for example, which consists of flexible, airtight envelope 20 filled with filling material 30 and the dressing aid 50, can be tightly folded or rolled, independently of the control unit 90. The mat is then unrolled, positioned under the patient, as shown in FIGS. 15 a, 15 b and 15 c, and connected to the control unit 90 only at the corresponding site of use, for example an accident site. For transporting the patient, the control unit 90 can then be decoupled again, which considerably facilitates transport.

The system for intermittent patient support 100 shown in FIG. 7 in turn shows the retention device 10 according to the invention in the form of a mat, which consists of the flexible, air-impermeable envelope 20 with the filling material 30 and the dressing aid 50 arranged therein. In addition, the system 100 here still has fixing aids 70 and a transport device 95. The transport device 95 is a particularly simple embodiment, namely simply two carrying aids. Such carrying aids can be about telescopic poles or the like and are therefore also very good and easy to transport. It is also conceivable that the transport device 95 is a hospital bed or an operating couch. It can be seen that the flexible, air-impermeable sheath 20 of the retention device 10 can either be firmly connected to the air cushion-shaped Anformhilfe 50 or that they can rest loosely on the Anformhilfe 50. The latter is especially true then advantageous if the flexible, air-impermeable sheath 20 is a disposable item to be used, for example, in the operating room.

In FIG. 18 it can be seen that the draw-band device 70 'consists of a substantially rectangular basic body 701. This has two opposite longitudinal sides 702 and two short sides 703. In the applied state, the short sides 703 face each other. In this case, the one short side 703 is formed at the first end 72 of the main body 701, while the second short side 703 is formed at the second end 73 of the main body 701.

It can further be seen in FIG. 18 that the main body 701 of the tension band device 70 'consists of three partial surfaces 704 which extend in the longitudinal direction L of the tension band device 70'. The partial surfaces 704 are interconnected by means of connecting elements. In the present example of FIG. 18, both the partial surfaces 704 and the connecting elements are formed in that two rows of recesses extending parallel to one another are introduced into the main body 701 of the tensioning belt device 70 '. The recesses run in the example shown, due to the tensile load after adaptation to the body part K slightly oblique to the longitudinal direction L of the drawstring device 70 '. In the load-free state, the recesses are preferably arranged transversely to the longitudinal direction L. However, it is also conceivable that they run transversely or parallel or at any angle to the longitudinal direction L. It can be seen that the partial surfaces 704 are separated from each other by the rows of recesses. When the connecting elements are webs of the material of the body, which remain between the individual recesses and thus connect the sub-surfaces 704 integrally with each other.

The first end 72 and the second end 73 of the main body 701 of the Zugbandvorrichtung 70 'by means of a regulating device 71 are interconnected. The connection is made by means of a power transmission device 101, in the present example, a cable, which winds around a plurality of deflection elements 102. The deflection elements 102 of the illustrated example are rollers which are formed both at the first end 72 and at the second end 73 of the Zugbandvorrichtung 70 '. The power transmission device 101, namely the cable of the cable, winds in a zigzag between the roller-shaped deflecting elements 102 of the first end 72 and the second end 73 back and forth. In addition, one end of the power transmission device 101 is wound around a coupling member 103 in the form of a cable drum connected to a motor 104. By rotating the motor 104, the power transmission device 101 can be shortened or lengthened. It is useful if the other end of the power transmission device 101 is fixed to a mounting 106. A shortening of the power transmission device 101 then leads to contraction of the Zugbandvorrichtung 70 ', while an extension of the power transmission device 101 leads to an increase in the inner circumference of the Zugbandvorrichtung 70'. If the inner circumference of the Zugbandvorrichtung 70 'while smaller than the circumference U of the body part K, so the Zugbandvorrichtung 70' exerts a corresponding pressure on the body part K from. It can also be seen in FIG. 18 that the motor 104 of the regulation device 71 is mounted on a support 105 which is formed on the second end of the draw-band device 70 '. On the support 105 and the deflecting elements 102, the second end 73 of the Zugbandvorrichtung 70 'are formed. Also at the first end 72 of the Zugbandvorrichtung 70 'is a carrier 105 is formed.

It can be seen further in FIG. 18 that a guide element 107 is formed on the carrier 105. The guide element 107 serves to guide the power transmission device 101 from the coupling element 103 to the first deflection element 102, which is formed on the opposite first end 72 of the Zugbandvorrichtung 70 '. In an alternative embodiment, as shown for example in FIG. 20, a force sensor 107 'may be present instead of the guide element 107. A combination solution of guide element 107 and force sensor 107' is also possible.

FIGS. 19a and 19b show further embodiments of a draw-band device 70 '. 19a shows the tension band device 70 'in the state not applied to a body part K, while FIG. 19b shows the tension band device 70' in the state applied to a bicep-shaped body part K, for example. This results in a curvature of the Zugbandvorrichtung 70 ', which can be seen in Fig. 19b vertically down from above, whereby the curvature appears flat in the presentation. The main body 701 here consists of a fabric material of preferably anelastic longitudinal threads 704 ', which are trapped with transverse threads Q and thus mutually movably connected to each other. Only a few longitudinal threads 704 'and some transverse threads Q are shown by way of example in FIGS. 19a and 19b for illustration purposes. The fabric is preferably formed anelastisch at least in the longitudinal direction L of the drawstring 70 '. The longitudinal threads 704 'extend parallel to the longitudinal direction L of the Zugbandvorrichtung 70'. In this case, the longitudinal direction L in the state applied to a body part runs in its circumferential direction. The longitudinal threads 704 'can also be regarded as partial surfaces of the main body 701. The longitudinal threads 704 'can be displaced parallel to each other in the longitudinal direction L, for example when the drawstring device 70', as shown in Fig. 19b, is to be applied to a biceps-shaped body part. This can lead to a slight bending of the transverse threads Q, which follow the movement of the anelastic longitudinal threads 704 '.

On the short side 703 of the first end 72 and in the embodiment of Figures 19a and 19b in each case three carriers 105 are arranged on which deflecting elements 102 are formed. It can be seen that each carrier consists of a first section 105a and a second section 105b. The first section 105a is connected to the main body 701, while the second section 105b carries the deflecting element 102. The edge 105c of the second portion 105b is obliquely formed in the illustrated embodiments, so that the carriers 105 can be moved relative to each other without interfering with each other. This is particularly advantageous if the carriers 105 are arranged in the state applied to the body part K at an angle α to each other.

The latter is particularly advantageous in the embodiment illustrated in FIG. 19b in the state applied to a biceps-shaped body part. The bevelled edges 105c prevent the carriers 105 of the outer partial surfaces 704 from colliding with the carrier 105 of the inner partial surface 704, thus interfering with one another.

FIG. 20 shows a further exemplary embodiment of a flexible tension band device 70 'according to the invention. Again, the main body 701 of the Zugbandvorrichtung 70 'of several partial surfaces 704, which are movable relative to each other. At its second end 73, in turn, the carrier 105 is arranged, on which a motor 104 is arranged centrally as a dynamic element with a cable drum-shaped coupling element 103 which belongs to a regulation device 71. The regulation device 71 furthermore comprises a number of deflecting elements 102, which are arranged on the carrier 105 or on the opposite carriers 105 'of the first end 72 of the Zugbandvorrichtung 70'. In addition, on the carrier 105 of the second end 73 of the Zugbandvorrichtung 70 ', a force sensor 107' is arranged, which guides the power transmission device 101 of the coupling element 103 to the first deflecting element 102 and at the same time the force applied to the power transmission device 101, measures. Based on the measured force can be determined with what pressure the Zugbandvorrichtung 70 'is contracted and according to which pressure by the Zugbandvorrichtung 70' on the Zugbandvorrichtung 70 'surrounded body part K is exercised.

It can also be seen in FIG. 20 that the end region of the main body 701 is configured at the first end 72 such that the partial surfaces 704 which run parallel to one another in the longitudinal direction L of the main body 701 are separated from one another by recesses 7041. However, the partial surfaces 704 are connected to one another with the aid of a linking device 7042. By means of the linking device 7042, the recesses 7041 are prevented from diverge during the application of the tension band device 70 'to such an extent that the functionality of the device is thereby impaired. The linking device 7042 consists of a linking element 7043, which is, for example, a rope. The linking element 7043 is fastened to an upper attachment 7044 and a lower attachment 7045 to a respective partial surface 704 of the base body 701 of the Zugbandvorrichtung 70 '. In this case, each linking device 7042 connects two sub-surfaces 704 arranged adjacent to one another. The linking element 7043 is guided back and forth in zigzag fashion over the recess 7041. Deflection points 7046 are respectively formed on the partial surfaces 704 for this purpose. In the present example, the deflection points 7046 are deflection rollers, but eyelets, deflection rollers, deflection pins, hooks, or the like are also conceivable like. It can be seen that the upper attachment 7044 is preferably formed in the region of the carrier 105. This leads to a particularly stable mounting option. In addition, it can be seen that each partial surface 704 is provided with its own carrier 105.

FIG. 21 shows a cross-section through the draw-band device 70 'according to the invention in the mounted state, which leads through the line Z-Z of FIG. It can be seen that the carrier 105 is rigid but preformed and the main body 701 is flexible. As a result, the body part K and the carrier 105 and the base body 701 can be adapted to one another. It can be seen that the motor 104 is arranged in the mounted state on the carrier 105 such that it does not affect a change or adaptation of the inner circumference of the Zugbandvorrichtung 70 'to the corresponding body part K. The same applies to the deflection elements 102. FIG. 22 also shows a cross section through a flexible tension band device 70 'according to the invention. It can be seen schematically how the carriers 105, 105 'are attached to the base body 701 and are opposite each other in the connection area. On the support 105, the motor 103 is also mounted. Both on the support 105 and on the support 105 'is in each case a deflecting element 102 can be seen in cross section. Around the deflecting elements 102, the power transmission device 101 winds - in the example illustrated a cable pull - which regulates the gap between the second end 73 and the first end 72. A shortening of the power transmission device 1 01 leads directly to a reduction in the gap width, while an extension of the power transmission device 101 leads to an increase in the gap width, consequently leads to a shortening of the power transmission device 101 to exert pressure by the Zugbandvorrichtung 70 'on the of the Zugbandvorrichtung 70' surrounded body part K.

It can also be seen in FIG. 22 that a cover 1051, which surround the deflection elements 102, is formed on the carrier 105 or carrier 105 '. The covers 1051 provide in this way effective protection of the deflectors 102 and bound to the deflecting elements 102 power transmission device 101 is.

FIG. 23 shows a further exemplary embodiment of a retention device 10 according to the invention with a tension band device 70 ', in which the regulation device 71 is arranged on the inside of the tension band device 70'. The carrier device 71 1 consists of a flexible, round plate. On the plate of the carrier device 71 1, a motor with a coupling device 7121 is mounted as a dynamic element 712. The coupling device 7121 in the example shown is a lift rod, which is connected via a transfer point 7133 with the power transmission device 713. This power transmission device 713 is a belt ring which engages around the tension band 70 "of the tension band device 70. It can be seen that the lifter piston-shaped coupling device 7121 outwardly transmits the power transmission device 713 via the transmission point 7133 in the direction R radially to the axial direction of the body part K. As a result, the inner circumference I of the drawstring device 70 'can be reduced. In a further variant (not shown), instead of the belt ring, the drawstring 70 "of the drawstring device 70' itself can be operated via the coupling device as well as the power transmission device. Tensioner be tense.

In a further embodiment variant shown in FIG. 24, the regulation device 71 is likewise arranged on the inside of the tension band device 70 '. Here, too, the regulation device 71 can apply a force to the tension band device 70 'in a direction R extending radially with respect to the axial direction of the body part K. The regulation device 71 here also has a carrier device 71 1 in the form of a round, flexible plate. On this is in turn mounted as a dynamic element, a motor with serving as a coupling device 7121 shaft. Mounted on the spindle 7121 as the force transmission device 713 is an eccentric which is pivotable in the direction of rotation V about the wave-shaped coupling device 7121 of the dynamic element 712. The eccentric has an off-axis end 7131 and a proximal end 7132. The off-axis end 7131 serves as a transfer point 7133 and makes contact with the drawstring 70 "drawstring device 70. The drawstring device 70 'in the illustrated example is a closed annular belt which extends around the eccentric .. Upon pivoting of the eccentric about undulating coupling device 7121 of the dynamic element 712 is the transfer point 7133 alternately at a small distance close to the body part K and at a greater distance away from the body part K. In doing so, it deflects the tension band device 70 'outward in the position away from the body part K, thereby applying a force in the radial direction r to the tension band device 70'. This causes an overall reduction of the inner circumference I of the Zugbandvorrichtung 70 '.

Finally, FIGS. 25a to 25g show a schematic sequence of cyclic pressure exertion by a pressure regulating device 900. The pressure regulating device 900 comprises a plurality of fluid chambers 901 which are arranged between the body part K to be fixed and the sheath 20 of the retention device 10. By sequentially filling the chambers 901 with fluid, a pressure can be exerted on the internal body part K. In this case, a pressure wave runs along the axial direction P of the body part K.

The invention is of course not limited to the above exemplary embodiments, but may be varied or modified in many ways.

All of these features may be essential to the invention, either individually or in combination.

List of Symbols α angle Q transverse thread

B, b width R contour

C section area r direction d, d 'thickness S, s length

dp pressure change t time

k distance t1, t2, t3, t4 time of measurement

1 inner circumference U circumference

Body (part) V Rotation direction

L longitudinal direction X line

P pressure Y line

P direction z line

10 Retention device 20 sheath

100 System 21 Interior

22 outside

101 Power transmission device 24 Air inlet / outlet

102 deflecting element 25 air volume

103 coupling element 25 'air outlet

104 Engine 26 Gap

105 carriers

105 'carrier 30 filling material

105a section 31 layer

105b section 31 1 side surface

105c edge 312 side surface

1051 cover 31 3 elevations

106 Fastening 314 embossing

107 guide element 31 5 embossing

107 'force sensor 32 partial area

33 connecting element 4 recess 71 regulation device

71 1 carrier device

0 filling material 712 dynamic element

7121 coupling device

50 Anformhilfe 713 power transmission device

7131 off-axis end

70 Fixing element 7132 near the axle

70 'Tieback device 7133 Transfer point

70 "drawstring 72 end

701 main body 73 end

702 long side

703 short side 80 Pressure sensor element

704 partial area

704 'longitudinal thread 90 control unit

7041 recess 91 pump

7042 linking device 92 pump

7043 linking element 95 transport device

7044 attachment

7045 Fastening 900 pressure regulating device

7046 Deflection point 901 Fluid chamber

Claims

claims

1 . Stiffenable retention device (10) wherein the retention device has a flexible sheath (20) with an outer side (22) and an inner space (21) and at least one in the inner space (21) of the sheath (20) arranged, layered filling material (30), characterized in that the filling material (30) comprises at least two layers (31) stacked one above the other and consisting of a plurality of mutually movable partial surfaces (32), each partial surface (32) having at least one adjacent partial surface (32) within a layer (31). connected is.

2. Retention device according to claim 1, characterized in that the retention device (10) is reversibly stiffenable.

3. Retention device according to one of claims 1 or 2, characterized in that the layers (31) of the filling material (30) recesses (34) which divide the layers (31) in the partial surfaces (32), wherein the recesses (34 ) preferably the edges, in particular the shaping edges, the part surfaces (32) form.

4. Retention device according to one of claims 1 to 3, characterized in that the filler material (30) is preferably paper or a paper-like material formed.

5. Retention device according to one of claims 1 to 4, characterized in that the retention device (10) in the stiffened state has at least 100 times greater, preferably at least 1000 times greater, more preferably at least 10,000 times greater bending stiffness than in the unstiffened state.

6. Retention device according to one of claims 1 to 4, characterized in that the filling material (30) 2, 3, 4, 5, 6,

7,

8th,

9

10, 1 1, 12, 13, 14, 15, 16, 17, 18, 19, 20-30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, 91-100, 101-110,111-120, 121-130, 131-140, 141-150, 151-160, 161-170, 171-180, 181-190, 191-200, 201-220, 221-240, 241-260, 261-280, 281-300, 301-320, 321-340, 341- 360, 361-380, 381-400, 401-420, 421-440, 441-460, 461-480, 481-500, 501-550, 551 to 600 or more layers (31), preferably 10 to 500 layers ( 31), more preferably 20 to 200 layers (31), most preferably 40 to 100 layers (31).

Retention device according to one of claims 1 to 6, characterized in that the layers (31) of the filling material (30) have a thickness (d) less than or equal to about 3 mm, preferably from about 0.01 mm to about 0.5 mm, especially preferably about 0.05 to about 0.2 mm.

Retention device according to one of claims 1 to 7, characterized in that the filling material (30) at atmospheric pressure has a thickness of about 1 mm to about 40 mm, preferably about 1 mm to about 30 mm, particularly preferably from about 2 mm to about 15 mm, most preferably about 3 mm to 9 mm

Retention device according to one of claims 1 to 8, characterized in that in the stiffened state in the interior of the shell (20) applied pressure of at least about 250 mbar, preferably more than 500 mbar, more preferably more than 750 mbar, most preferably more than 850 mbar is less than the pressure applied to the outside of the shell (20) atmospheric pressure.

Retention device according to one of claims 1 to 9, characterized in that the sleeve film-like, more preferably made of a plastic, most preferably of a thermoplastic material, most preferably for example of thermoplastic polyurethane (TPU), polyethylene (PE), fluoropolymers or the like is formed.

1 1. Retention device according to one of claims 1 to 10, characterized in that the sheath is fluid-tight, preferably airtight.

12. Retention device according to one of claims 1 to 1 1, characterized in that the circumference and the shape of the layers (31) of the filling material (30) corresponds to the circumference and the shape of the interior (21) of the shell (20).

13. Retention device according to one of claims 1 to 1 1, characterized in that the partial surfaces (32) via connecting elements (33) are interconnected.

14. Retention device according to claim 13, characterized in that the connecting elements (33) are formed integrally with the partial surfaces (32).

1 5. Retention device according to claim 13 or 14, characterized in that the layers (31) in the region of the connecting elements (33) have a smaller thickness (d ') than in the region of the partial surfaces (32).

1 6. Retention device according to one of claims 1 to 13, characterized in that the layers (31) of the filling material (30) are stacked one above the other, that the partial surfaces (32) adjacent superimposed layers (31) are non-congruent one above the other.

1 7. Retention device according to one of claims 1 to 16, characterized in that the layers (31) of the filling material (30) have a structured surface.

1 8. Retention device according to one of claims 1 to 1 7, characterized in that in the sheath (20) at least one further filling material (40) is arranged.

19. Retention device according to claim 18, characterized in that the further filling material (40) is an intercalatable powder or fluid between the layers (31) of the filling material (30).

20. Retention device according to one of claims 1 to 19, characterized in that the retention device (10) is mat-shaped.

21. Retention device according to one of claims 1 to 20, characterized in that the retention device (10) has at least one pressure sensor element (80, 30).

22. Retention device according to one of claims 1 to 21, characterized in that the retention device (10) has a Anformhilfe (50).

23. Retention device according to one of claims 1 to 22, characterized in that the retention device (10) has a fixing aid (70, 70 ').

24. Retention device according to claim 23, characterized in that the fixing aid (70) has one or more Zugbandvorrichtungen (70 ').

25. Retention device according to one of claims 1 to 24, characterized in that the retention device (10) has a protective padding.

26. Use of a retention device (10) according to any one of claims 1 to 25 for fixing a body part.

27. Use according to claim 26, characterized in that the retention device (10) has at least one fixing aid (70, 70 ').

28. Use according to one of claims 26 or 27, characterized in that the retention device (10) has a protective coating.

29. Use of a retention device (10) according to any one of claims 1 to 25 for intermittent patient positioning.

30. Use according to claim 29, characterized in that the retention device (10) has at least one Anformhilfe (50).

31. Use according to one of claims 29 or 30, characterized in that the retention device (10) has at least one fixing aid (70, 70 ').

32. System (100) for fixing a body part of a patient with a retention device (10) according to one of claims 1 to 25 and a control unit (90).

33. System according to claim 32, characterized in that the control unit (90) comprises a vacuum pump (91, 92).

34. System according to one of claims 32 or 33, characterized in that the retention device (10) has a connection device for releasably connecting the retention device (10) to the control unit (90), preferably to the vacuum pump (91, 92) of the control unit (90 ), having.

35. System according to one of claims 32 to 34, characterized in that the retention device (10) has at least one pressure sensor element (80, 30).

36. System according to one of claims 32 to 34, characterized in that the retention device (10) has a protective padding.

37. System (100) for intermittent patient positioning with a retention device (10) according to any one of claims 1 to 25, at least one Anformhilfe (50) and a control unit (90).

38. System according to claim 37, characterized in that the Anformhilfe (50) has at least one inflatable chamber.

39. System according to claim 37 or 38, characterized in that the control unit (90) comprises a vacuum pump (91, 92).

40. System according to one of claims 37 to 39, characterized in that the retention device (10) and / or the Anformhilfe (50) has a connection device for releasably connecting the retention device (10) with the control unit (90), preferably with the Vacuum pump (91, 92) of the control unit (90).

41. System according to claim 37 to 40, characterized in that the retention device (10) has at least one pressure sensor element (80, 30).

42. System according to one of claims 37 to 40, characterized in that the retention device (10) and the Anformhilfe (50) form a support device.

43. System according to one of claims 37 to 42, characterized in that the system (100) has at least one fixing aid (70, 70 ').

44. System according to one of claims 37 to 43, characterized in that the system (100) has at least one transport device (95).