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1. Field of the Invention
The present invention relates generally to the field of semiconductor fabrication and, more particularly, to the field of fabricating p-channel and n-channel transistors with different characteristics on a common substrate.
2. Description of Related Art
In complementary metal oxide semiconductor (CMOS) fabrication, p-channel and n-channel transistors are fabricated on the same semiconductor substrate. To achieve transistors of both polarities (conductivity types), it is necessary that at least some process is steps differentiate between p-type and n-type transistors. Separate implant steps, for example, are needed to define n-well and p-well structures and to dope the source/drain regions of n-channel and p-channel transistors. Whenever possible, however, it is generally desirable to use a single process step to define transistor features regardless of the transistor type. Single process steps imply a single mask step, which is always desirable to reduce load on the photolithography processing. Moreover, a single step generally minimizes undesirable variations between the p-channel and n-channel transistors. Imagine, for example, that a particular design has been optimized under the assumption that the thickness of the gate oxide (or other dielectric) is the same on n-channel and p-channel transistors. The best way to ensure that the assumption is correct is to form the relevant feature for p-channel and n-channel transistors simultaneously.
In some cases, however, it may be desirable to process n-channel and p-channel transistors separately to account for differences in the characteristics of the respective transistor types. As an example, there is an asymmetry in the sub-micron behavior of p-channel and n-channel transistors. For sub-micron p-channel transistors, the high diffusivity of its boron carriers causes sub-threshold leakage current to be of paramount concern. For n-channel transistors, the drive current or saturated drain current (IDS), which is an important performance parameter, is strongly influenced by the effective length of the source/drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter extensions to increase the n-channel drive current, it would be desirable to have longer extensions to reduce the p-channel sub-threshold leakage current. It would therefore be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the cost or complexity of the process. | 1. Field of the Invention The present invention relates generally to the field of semiconductor fabrication and, more particularly, to the field of fabricating p-channel and n-channel transistors with different characteristics on a common substrate. 2. Description of Related Art In complementary metal oxide semiconductor (CMOS) fabrication, p-channel and n-channel transistors are fabricated on the same semiconductor substrate. To achieve transistors of both polarities (conductivity types), it is necessary that at least some process is steps differentiate between p-type and n-type transistors. Separate implant steps, for example, are needed to define n-well and p-well structures and to dope the source/drain regions of n-channel and p-channel transistors. Whenever possible, however, it is generally desirable to use a single process step to define transistor boast regardless of the transistor type. Single process steps imply a single mask step, which is always desirable to reduce load on the photolithography processing. Moreover, a single step generally minimizes undesirable variations between the p-channel and n-channel transistors. Imagine, for example, that a particular design has been optimized under the assumption that the thickness of the gate oxide (or other dielectric) is the same on n-channel and p-channel transistors. The best way to ensure that the assumption is correct is to form the relevant feature for p-channel and n-channel transistors simultaneously. In some cases, however, it may be desirable to process n-channel and p-channel transistors separately to account for differences in the characteristics of the respective transistor types. As an example, there is an asymmetry in the sub-micron behavior of p-channel and n-channel transistors. For sub-micron p-channel transistors, the high diffusivity of its boron carriers causes sub-threshold leakage current to be of paramount concern. For n-channel transistors, the drive current or saturated drain current (IDS), which is an important performance parameter, is strongly influenced by the effective length of the source/drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter extensions to increase the n-channel drive current, it would be desirable to have longer extensions to reduce the p-channel sub-threshold leakage current. It would therefore be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the cost or complexity of the process. | 1. Field of the Invention The present invention relates generally to the field of semiconductor fabrication and, more particularly, to the field of fabricating p - channel and n - channel transistors with different characteristics on a common subZtratd. 2. Description of Related Art In complementary metal oSice semiconductor (CMOS) fabrication, p - channel and n - channel transistors are fabricated on the same semiconductor substrate. To achieve transistors of both polarities (conductivity types ), it is necessary that at least some or9cess is steps differentiate between p - type and n - type transistors. Separate implant steps, for example, are needed to define n - well and p - well structures and to dope the source / drain regions of n - channel and p - channel transistors. Whenever possible, however, it is generally desirable to use a single process step to deRije transistor features regardless of the transistor type. Single process steps imply a single mask step, which is always desirable to reduce load on the photolithography processing. Moreover, a single step generally minimizes undesirable variations between the p - channel and n - channel transistors. Imagine, for example, that a particular design has FeeG optimized under the assumption that the thickness of the gate oZiEe (or other dielectric) is the same on n - channel and p - channel transistors. The best way to ensure that the assumption is correct is to form the relevant feature for p - channel and n - channel transistors simultaneously. In some cases, however, it may be desirable to process n - channel and p - channel transistors selarate<y to account for differences in the characreris6ics of the respective transistor types. As an example, there is an asyKJetry in the sub - micron behavior of p - channel and n - channel transistors. For sub - micron p - channel transistors, the high diffusivity of its boron carriers causes sub - threshold leakage current to be of paramount concern. For n - chajne< transistors, the drive current or saturated drain current (IDS ), which is an important performance parameter, is strongly influenced by the effective length of the source / drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter extensions to increase the n - channel drive current, it would be desirable to have longer extensions to reduce the p - channel sub - threshold leakage current. It would therefore be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the cost or complexity of the process. | 1. Field of the Invention The present invention relates generally the field of fabrication and, more particularly, to the field of fabricating p-channel and n-channel transistors with different characteristics on a common 2. Description of Art In complementary metal semiconductor (CMOS) fabrication, p-channel and n-channel transistors are fabricated on the same semiconductor substrate. To achieve of both polarities (conductivity types), it is necessary that at least some is steps differentiate between p-type and n-type transistors. Separate implant steps, for example, are needed to n-well and p-well structures and to dope the source/drain regions of n-channel and p-channel transistors. Whenever possible, however, it is generally desirable to use single process step to define features regardless of the transistor type. Single process steps imply a single step, which is always desirable to reduce load on the processing. a step generally minimizes undesirable variations between the p-channel and n-channel transistors. Imagine, example, a particular design has optimized under the assumption that the thickness of the gate oxide (or other is the same on n-channel and p-channel transistors. The best way ensure that the assumption is correct is to the feature for p-channel and transistors simultaneously. In some cases, however, it may be desirable to n-channel and p-channel transistors separately to account for differences the of the respective transistor types. As an example, there is an asymmetry in the sub-micron of p-channel and n-channel transistors. For sub-micron p-channel transistors, the high diffusivity its boron carriers causes sub-threshold leakage current to be of paramount For n-channel the drive current or saturated current (IDS), which is an important performance parameter, is strongly influenced by the effective length of the source/drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter to n-channel drive current, it be desirable to have longer extensions to reduce the p-channel sub-threshold leakage current. It would be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the or complexity of the process. | 1. FiEld OF THe invENTIon
the PRESeNt InvENTiON reLATES GeNERAlLy TO thE FiELd OF SeMICondUCTOR FabRICaTioN And, MOrE particUlarly, TO The FIELd OF FABricatINg P-CHAnNEL And n-CHANneL tRaNsiStors WitH diFFERent CHaraCterIstics oN A cOmMon SUBsTRaTE.
2. DeScripTiON OF RElAted ArT
IN coMplEMEnTaRy MEtAl OXide SeMICondUcTor (cmoS) FabRIcatIoN, P-ChAnnEL AnD n-cHANNeL TRANSistORS ARE FaBricaTEd oN ThE SAME sEMIcoNdUCTor suBsTrate. To AChieVe TRansiSTOrS of BoTH pOLarITiES (cONDuCTIViTy tYpeS), iT is nEcesSARy tHat at lEAsT SomE proCeSS is stepS diffErEnTiAte beTween P-Type And N-TyPE TraNSiSTORS. sEpaRaTE ImPLANT STePs, foR exAMplE, ArE NEEdED TO dEFiNe n-welL anD p-welL STrUctuRes aNd To DoPe the sOuRce/dRaiN reGiOns of N-cHaNnEl AND P-ChaNNeL TranSIStORS. wHeneveR pOsSiBle, HOwEVeR, IT is generAlLY DeSirABlE TO uSE A sIngle PRocEsS step To DeFiNE trAnsiStOR fEATuReS rEgArdlEss Of The trAnsiStor Type. sInGlE pROcEss STePS ImPlY A siNGlE MASk step, wHicH iS AlWAyS desIRablE tO rEdUce LOAD ON tHE PHOToLItHoGraphY procESsIng. MOREOvER, a single STeP geNeRaLly mINimIzEs unDeSIRABLe VARIAtIONS beTWEen tHE p-ChanNEl anD N-CHANneL tRaNsistORS. iMaGiNE, For exaMPle, that a paRTiCuLAr deSigN Has beeN oPTiMIZeD UnDEr tHe assuMpTiON THAT thE ThiCKneSs of THe GatE oXide (oR OthER DIelecTric) iS ThE SaMe ON N-cHAnNeL and P-chaNNel tRansISTors. THE BEsT WAY To eNsURe That tHE AsSUmptioN iS cOrrECt is tO fORM tHE RELevANt fEatURe foR P-CHANNel ANd n-ChanneL TrAnSiSTorS SiMUlTaNeOuSLY.
in SoME cASEs, hoWeVEr, it may be DesirABlE to PROCESS n-ChanNEL and P-chaNNEl TRaNsisTOrS SEparATeLy TO AccOunt fOR DiffErENCeS In the CHAractERISTicS OF thE reSpEcTIvE TRansIsTOr TYPES. AS an EXAMPle, THerE is aN AsymMEtrY IN THE SUb-MicRoN bEhAvIor of p-chanNEL And N-ChANNeL TRansIstOrS. fOR sUb-miCrON P-cHanNEL TRANsiStors, ThE hIGh DIfFuSIviTY Of ITS bORon cArRIERs cAuseS SUb-threShoLd LEaKAge cUrRENt To bE OF paRaMounT coNcERn. For N-ChANneL trAnsIsTors, THe DriVe curreNT OR SaTurAted DraIN CUrrEnt (IdS), which is an ImPoRTant PeRFORManCe PaRametEr, iS stROnglY iNFlueNcEd BY ThE EFfecTIvE leNgTh of the SOURCE/draiN extENSIon RegIon dUe to thE paRAsitiC rESISTANCE That it CReAtes. WhEREAs iT wOULD BE desIrable TO hAvE sHOrter exTenSIoNS TO inCReASe tHe n-CHanNel DriVE CurRenT, it WOuLD BE dESIRAbLe tO HAVE lONgEr extEnSiOnS TO REDucE ThE p-cHANNel sub-thREshold lEakage cUrRent. it woULd ThErefoRe BE dESirAblE To ImpLeMEnT a PRoCess tHaT SIMulTanEOuSLY aDDRESSEd these ConCeRNS withOUt substANtiaLLy InCReASing thE CoSt oR cOMpLExiTY Of THe proCEsS. | 1. Field of theInvention The present invention relates generally to the field of semiconductor fabricationand, moreparticularly, to the field of fabricatingp-channel and n-channeltransistors with different characteristics on acommon substrate. 2. Description of Related Art In complementary metal oxide semiconductor (CMOS) fabrication, p-channel and n-channeltransistors are fabricated on the same semiconductor substrate. To achievetransistors of both polarities (conductivity types), itis necessarythatat least some process is stepsdifferentiate betweenp-typeand n-type transistors. Separate implant steps, for example, areneeded to define n-well and p-wellstructuresand to dope the source/drain regions of n-channel and p-channel transistors. Whenever possible, however, itis generallydesirable to use a single process step to define transistor features regardlessof the transistortype.Single process stepsimply a single mask step, which isalways desirable toreduceload on thephotolithography processing. Moreover, a single step generally minimizesundesirable variations between the p-channel and n-channel transistors. Imagine, for example,thata particular design hasbeen optimized under the assumption that thethickness of the gate oxide (or other dielectric) is the same on n-channeland p-channel transistors. The best wayto ensure that the assumption is correct is to form the relevant featurefor p-channel and n-channel transistors simultaneously.Insomecases, however,it may be desirable to process n-channel andp-channel transistorsseparately to accountfor differences in the characteristics of therespective transistor types. As an example, there is an asymmetry in the sub-micron behaviorof p-channel andn-channel transistors. For sub-micron p-channel transistors, the high diffusivity of its boron carriers causes sub-threshold leakage currenttobe of paramountconcern. For n-channel transistors, thedrive current or saturated drain current (IDS), which is an important performance parameter, is strongly influenced by the effective length of thesource/drain extension region due to the parasitic resistance that it creates. Whereas it would be desirable to have shorter extensions to increasethe n-channel drive current, it would be desirable to have longer extensions to reduce the p-channel sub-threshold leakage current. It would therefore be desirable to implement a process that simultaneously addressed these concerns without substantially increasing the cost orcomplexity of the process. | 1. Field of _the_ Invention _The_ present invention relates generally to _the_ field of semiconductor fabrication and, more _particularly,_ to the _field_ of fabricating p-channel and n-channel transistors _with_ _different_ characteristics on a common substrate. 2. Description of Related Art In _complementary_ metal oxide _semiconductor_ _(CMOS)_ fabrication, p-channel and n-channel _transistors_ are _fabricated_ on _the_ same semiconductor substrate. To achieve transistors of _both_ polarities (conductivity types), it is necessary that at least some process is steps _differentiate_ _between_ p-type _and_ _n-type_ transistors. Separate _implant_ steps, _for_ _example,_ are _needed_ to _define_ _n-well_ and p-well _structures_ and to _dope_ the source/drain regions of n-channel and p-channel transistors. Whenever possible, however, it _is_ _generally_ _desirable_ to use a _single_ _process_ step to define transistor features regardless _of_ the transistor type. Single process steps imply _a_ single mask step, which is always desirable to reduce load on the photolithography _processing._ Moreover, a single step generally minimizes undesirable variations between the _p-channel_ and n-channel transistors. Imagine, for example, that _a_ _particular_ design has been optimized _under_ the assumption that the thickness of the gate _oxide_ (or _other_ _dielectric)_ is _the_ same on _n-channel_ and p-channel transistors. The best _way_ to ensure that the assumption is correct is to form _the_ relevant feature for p-channel and _n-channel_ transistors simultaneously. _In_ _some_ cases, however, _it_ may _be_ desirable _to_ process n-channel and p-channel transistors separately to account for _differences_ in _the_ characteristics of the _respective_ transistor types. As an example, there is an asymmetry _in_ the _sub-micron_ behavior of _p-channel_ _and_ _n-channel_ _transistors._ For sub-micron p-channel _transistors,_ the high diffusivity of its boron carriers _causes_ sub-threshold leakage current to be _of_ paramount concern. For n-channel transistors, the drive current or saturated drain current (IDS), which is an important performance parameter, is strongly influenced _by_ the _effective_ length of the source/drain extension _region_ due to the _parasitic_ resistance that it creates. Whereas it _would_ be desirable to have shorter extensions to increase the n-channel drive current, it would _be_ desirable to have _longer_ extensions to reduce the _p-channel_ sub-threshold leakage current. It would therefore be desirable to implement a process that simultaneously addressed these concerns _without_ substantially increasing _the_ cost or complexity of the process. |
1. Field of the Invention
The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the number of usages.
2. Background Art
Each year, millions of reported illnesses and serious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10,000 people each year, and 70% of the outbreaks originate in food service sector. The passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one site to another with each successive physical contact.
The problem is most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food and food products. A person that handles a single contaminated source will spread the contaminant to every person, article and surface touched by that person. The subsequent contaminated sources represent additional contamination sites that spread the contaminant. The liability of contamination or illness caused by inadequate washing techniques is very high. And, a single food borne illness can tarnish a long-standing reputation and wreak financial havoc.
Proper washing of hands has been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. According to the Centers for Disease Control, proper hand washing is the single most important process in preventing the spread of the pathogens. Microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e.g.: germs. A germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and any one of the bacteria that can cause disease. A bacterium is typically a one-celled microorganism, wherein some cause diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation.
Some industries are much more sensitive to proper washing techniques. Restaurants are particularly prone to the dissemination of food-borne contaminants and the U.S. Food and Drug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address the washing of hands for food service and related personnel. According to the Food Code regulations, a person must wash after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready-to-eat foods, and any other activity that potentially contaminates the hands.
In addition, the Food Code describes a proper hand washing technique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. There are various soaps or cleansing liquids that can be used, preferably having anti-bacterial or anti-microbial properties. Nails should be cleaned and scrubbed. After scrubbing, the hands should be thoroughly rinsed with water. The areas between the finger and underneath the fingernails should be specifically cleaned and checked.
The regulations also require a supervisor ensure compliance with the regulations and promote the effective washing protocols. Employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment.
Although there may not be specific codes governing all industries and circumstance, it is common sense that adherence to the regulations will instill a safer environment for all. And, in a litigious environment, adhering to a strict standard is also a cost-effective and practical measure. There are varying international standards for the washing of hands, but in general, the U.S. standard provides a reasonable approach to follow.
Unfortunately, the proper washing guidelines are not regularly and rigorously followed. Many food service personnel do not appreciate the significance of proper washing. The restaurants rarely provide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. In addition, the employees at restaurants and dining establishments tend to be lower paid and may not care or understand the posted written guidelines, especially if the guidelines are in an unfamiliar language. Presently there is no adequate means of providing proper guidance and instruction during washing, no system designed to walk a user through the washing steps, and no simple means of monitoring or tracking employee washing.
Contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. These factors all contribute to a potential for poor washing conditions. Due to the many illnesses caused by food preparation, the FDA continues to apply more formal regulations and guidelines for employers regarding proper washing skills. Employers are demanding a better system of aiding and monitoring employee washing habits.
The soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. Liquid and semi-liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial cleansing liquids, and similar materials. A typical dispenser allows the user to obtain a specific amount of liquid matter with minimal ease. Manual and semi-automatic dispensing systems are common in the industry, and automated dispensers are beginning to enter the marketplace.
The manual dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. The physical contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. Automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical components to automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser.
Unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order to function. Besides electronic equipment, there are mechanical components such as plungers and gear trains that work in conjunction with the electronics. The mechanical gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid cleansers. The low reliability and the catastrophic failure mode are a major concern in the touchless dispenser market.
Within the field of liquid dispensers, there are many types of dispensers. The most common and cost effective is the bag-in-box system, where the liquid comes in a no-leak pouch with pump tip and is disposable. This system is a closed system, and all the air is removed from the pouch during manufacturing. The bag collapses upon itself once the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, including being a more sanitary system. The standard size pouch is 800 ml, but other sizes are in use, including 500 ml to 900 ml. It is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme wear and tear. Due to the excessive use, the devices must be robust and relatively maintenance free.
Other dispensers use cartridges or refillable containers. The cartridges must be pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable containers introduce air into the system, aiding the production of bacteria and mold. The cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi-automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur.
The liquid soap industry has numerous brands and categories of cleansing liquids. The viscosity and particulate content are also subject to extreme variations. There is an array of particulate matter that can be added to cleansing liquids to form a grit soap compound that is more effective in cleaning. The most common grit material is plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. Besides the variations of compounds used to form grit soap, the size of the grit also varies.
There has also been a consumer demand for anti-microbial cleansing liquids and anti-bacterial cleansing liquids, and the industry has reacted by adding creating new compounds with these properties. These anti-microbial and anti-bacterial cleansing liquids are available with or without grit and have certain characteristics and viscosity differences as compared to standard liquid soap. Besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme solutions, lotions, cleansing liquids, and shaving creme.
In a typical bag-in-box operation, a user depresses a lever or controller. This applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball check valve. If the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. The liquid flows into the space between the spring and the interior wall of the ball check valve chamber. Once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle.
The transition from a user applying purely mechanical forces to meter out some liquid to a semi-automated or automated dispensing unit is | 1. Field of the Invention The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the number of usages. 2. Background Art Each year, millions of reported illnesses and serious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10,000 people each year, and 70% of the outbreaks originate in food service sector. The passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one site to another with each successive physical contact. The problem is most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food and food products. A person that handles a single contaminated source will spread the contaminant to every person, article and surface touched by that person. The subsequent contaminated sources represent additional contamination sites that spread the contaminant. The liability of contamination or illness caused by inadequate washing techniques is very high. And, a single food borne illness can tarnish a long-standing reputation and wreak financial havoc. Proper washing of hands has been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. According to the Centers for Disease Control, proper hand washing is the single most important process in preventing the spread of the pathogens. Microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e.g.: germs. A germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and any one of the bacteria that can cause disease. A bacterium is typically a one-celled microorganism, wherein some cause diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation. Some industries are much more sensitive to proper washing techniques. Restaurants are particularly prone to the dissemination of food-borne contaminants and the U.S. Food and Drug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address the washing of hands for food service and related personnel. According to the Food Code regulations, a person must wash after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready-to-eat foods, and any other activity that potentially contaminates the hands. In addition, the Food Code describes a proper hand washing technique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. There are various soaps or cleansing liquids that can be used, preferably having anti-bacterial or anti-microbial properties. Nails should be cleaned and scrubbed. After scrubbing, the hands should be thoroughly rinsed with water. The areas between the finger and underneath the fingernails should be specifically cleaned and checked. The regulations also require a supervisor ensure compliance with the regulations and promote the effective washing protocols. Employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. Although there may not be specific codes governing all industries and circumstance, it is common sense that adherence to the regulations will instill a safer environment for all. And, in a litigious environment, adhering to a strict standard is also a cost-effective and practical measure. There are varying international standards for the washing of hands, but in general, the U.S. standard provides a reasonable approach to follow. Unfortunately, the proper washing guidelines are not regularly and rigorously followed. Many food service personnel do not appreciate the significance of proper washing. The restaurants rarely provide adequate training to the personnel, and seldom encompass sufficient supervision during the work shifts. In addition, the employees at restaurants and dining establishments tend to be lower paid and may not care or understand the posted written guidelines, especially if the guidelines are in an unfamiliar language. Presently there is no adequate means of providing proper guidance and instruction during washing, no system designed to walk a user through the washing steps, and no simple means of monitoring or tracking employee washing. Contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. These factors all contribute to a potential for poor washing conditions. Due to the many illnesses caused by food preparation, the FDA continues to apply more formal regulations and guidelines for employers regarding proper washing skills. Employers are demanding a better system of aiding and monitoring employee washing habits. The soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. Liquid and semi-liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial cleansing liquids, and similar materials. A typical dispenser allows the user to obtain a specific amount of liquid matter with minimal ease. Manual and semi-automatic dispensing systems are common in the industry, and automated dispensers are beginning to enter the marketplace. The manual dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. The physical contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. Automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical components to automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser. Unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order to function. Besides electronic equipment, there are mechanical components such as plungers and gear trains that work in conjunction with the electronics. The mechanical gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid cleansers. The low reliability and the catastrophic failure mode are a major concern in the touchless dispenser market. Within the field of liquid dispensers, there are many types of dispensers. The most common and cost effective is the bag-in-box system, where the liquid comes in a no-leak pouch with pump tip and is disposable. This system is a closed system, and all the air is removed from the pouch during manufacturing. The bag collapses upon itself once the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, including being a more sanitary system. The standard size pouch is 800 ml, but other sizes are in use, including 500 ml to 900 ml. It is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme wear and tear. Due to the excessive use, the devices must be robust and relatively maintenance free. Other dispensers use cartridges or refillable containers. The cartridges must be pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable container introduce air into the system, aiding the production of bacteria and mold. The cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi-automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur. The liquid soap industry has numerous brands and categories of cleansing liquids. The viscosity and particulate content are also subject to extreme variations. There is an array of particulate matter that can be added to cleansing liquids to form a grit soap compound that is more effective in cleaning. The most common grit material is plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. Besides the variations of compounds used to form grit soap, the size of the grit also varies. There has also been a consumer demand for anti-microbial cleansing liquids and anti-bacterial cleansing liquids, and the industry has reacted by adding creating new compounds with these properties. These anti-microbial and anti-bacterial cleansing liquids are available with or without grit and have certain characteristics and viscosity differences as compared to standard liquid soap. Besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme solutions, lotions, cleansing liquids, and shaving creme. In a typical bag-in-box operation, a user depresses a lever or controller. This applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball check valve. If the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. The liquid flows into the space between the spring and the interior wall of the ball check valve chamber. Once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle. The transition from a user applying purely mechanical forces to meter out some liquid to a semi-automated or automated dispensing unit is | 1. Field of the Invention The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio and visual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the number of usages. 2. Background Art Each year, millions of reported illnesses and serious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10, 000 people each year, and 70% of the outbreaks originate in food service sector. The passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one site to another with each successive physical contact. The problem is most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food and food products. A person that handles a single contaminated source will spread the contaminant to every person, article and surface touched by that person. The subsequent contaminated sources represent additional contamination sites that spread the contaminant. The liability of contamination or illness caused by inadequate washing techniques is very high. And, a single food borne illness can tarnish a long - standing reputation and wreak financial havoc. Proper washing of hands has been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. According to the Centers for Disease Control, proper hand washing is the single most important process in preventing the spread of the pathogens. Microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e. g. : germs. A germ is the rudimentary form in which a new organism is developed, and encompasses any microscopic organism and any one of the bacteria that can cause disease. A bacterium is typically a one - celled microorganism, wherein some cause diseases such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogen fixation. Some industries are much more sensitive to proper washing techniques. Restaurants are particularly prone to the dissemination of food - borne contaminants and the U. S. Food and Drug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address the washing of hands for food service and related personnel. According to the Food Code regulations, a person must wash after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating or drinking, handling soiled utensils, and when switching from raw foods to ready - to - eat foods, and any other activity that potentially contaminates the hands. In addition, the Food Code describes a proper hand washing technique as lasting at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers and underneath fingernails. In addition to timing the washing, it is important to consider the different steps in the washing procedure. A proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. There are various soaps or cleansing liquids that can be used, preferably having anti - bacterial or anti - microbial properties. Nails should be cleaned and scrubbed. After scrubbing, the hands should be thoroughly rinsed with water. The areas between the finger and underneath the fingernails should be specifically cleXnSd and checked. The regulations also require a supervisor ensure compliance with the regulations and promote the effective washing protocols. Employers may be fined or lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. Although there may not be specific codes governing all industries and circumstance, it is common sense that adherence to the regulations will instill a safer environment for all. And, in a litigious environment, adhering to a strict standard is also a cost - effective and practical measure. There are varying international standards for the washing of hands, but in general, the U. S. standard provides a reasonable approach to follow. Unfortunately, the proper washing guidelines are not regularly and rigorously followed. Many food service personnel do not appreciate the significance of proper washing. The restaurants rarely provide adequate training to the personnel, and seldom ehcomOass sufficient supervision during the work shifts. In addition, the employees at restaurants and dining establishments tend to be lower paid and may not care or understand the posted written guidelines, especially if the guidelines are in an unfamiliar language. Presently there is no adequate means of providing proper guidance and instruction during washing, no system designed to walk a user through the washing st2)s, and no simple means of monitoring or tracking employee washing. Contributing to the problem of inadequate washing is the lack of formal education by those in the food services segment, the low pay scale, and the periods of rushed food preparation. These factors all contribute to a potential for poor washing conditions. Due to the many illnesses caused by food preparation, the FDA continues to apply more formal regulations and guidelines for employers regarding proper washing skills. Employers are demanding a better system of aiding and monitoring employee washing habits. The soap and liquid compounds for hand washing come from a number of different dispensers available in the marketplace. Liquid and semi - liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti - bacterial cleansing liquids, anti - microbial cleansing liquids, and similar materials. A typical dispenser allows the user to obtain a specific amount of liquid matter with minimal ease. Manual and semi - automatic dispensing systems are common in the industry, and automated dispensers are beginning to enter the marketplace. The manual dispensers ut9lLze levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in order to dispense the liquid. The physical contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may harbor contaminants. Automated dispensers are becIning more popular, and operate with a variety of electrical and electromechanical components to automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any physical contact with the dispenser. Unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order to function. Besides electronic equipment, 4mere are mechanical components such as plungers and gear trains that work in conjunction with the electronics. The mechanical gears draw substantial energy during the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, the entire unit is disabled and will not dispense any liquid cleansers. The low reliability and the catastrophic failure mode are a HQjor concern in the touchless dispenser market. Within the field of liquid dispensers, there are many types of dispensers. The most common and cost effective is the bag - in - box system, where the liquid comes in a no - leak pouch with pump tip and is disposable. This system is a closed system, and all the air is removed from the pouch during manufacturing. The bag collapses upon itself once the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, including being a more sanitary system. The standard size pouch is 800 ml, but other sizes are in use, including 500 ml to 900 ml. It is a necessary requirement that the cost to produce a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme wear and tear. Due to the excessive use, the devices must be robust and relatively maintenance free. Other dispensers use cartridges or refillable containers. The cartridges must be pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable containers introduce air into the system, aiding the production of bacteria and mold. The cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi - automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur. The liquid soap industry has numerous brands and categories of cleansing liquids. The viscosity and particulate content are also subject to extreme variations. There is an array of particulate matter that can be added to cleansing liquids to Eo$m a grit soap compound that is more effective in cleaning. The most common grit material is plastic microspheres, although other materials such as clay, walnut shells and corn cobs have also been used. Besides the variations of compounds used to Corh grit soap, the size of the grit also varies. There has also been a consumer demand for anti - microbial cleansing liquids and anti - bacterial cleansing liquids, and the industry has reacted by adding creating new compounds with these properties. These anti - microbial and anti - bacterial cleansing liquids are available with or without grit and have certain characteristics and viscosity differences as compared to standard liquid soap. Besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme solutions, lotions, cleansing liquids, and shaving creme. In a typical bag - in - box operation, a user depresses a lever or controller. This applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the ball in the ball check valve. If the pressure is sufficient, the ball is displaced, and the liquid flows around the ball and into the ball check valve Shakber. The liquid flows into the space between the spring and the interior wall of the ball check valve chamber. Once the chamber is sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and through the nozzle. The transition from a user applying purely mechanical forces to meter out some liquid to a semi - automated or automated dispensing unit is | 1. Field of the The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio and visual output to assist the proper washing techniques for with guidelines and to monitor the number usages. 2. Background Art Each year, millions of reported illnesses and serious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10,000 people each year, and 70% of the outbreaks originate food service sector. The passage of viral and bacterial contaminants result from physical contact with an infected source and are carried from one to another with each successive physical contact. The problem is most in hospital and related medical establishments, as as those businesses associated with preparing and distributing and food products. A that handles a single contaminated source spread the contaminant to every person, and surface by that person. The subsequent contaminated represent additional contamination sites that spread the contaminant. The liability of contamination or illness caused by washing techniques is very high. And, a single borne illness can tarnish a long-standing reputation wreak financial havoc. Proper washing of hands been demonstrated to kill the contaminants and prevent the spread of disease and contaminants. According to the Centers for Disease proper hand washing is the single important process in preventing the of the pathogens. Microbial contamination refers to microscopic organisms, especially any of the bacteria that cause disease, e.g.: germs. A germ is the rudimentary form a new organism is developed, and any organism and any one the bacteria that can cause A bacterium is typically a one-celled microorganism, wherein cause diseases such as pneumonia, tuberculosis, anthrax while other bacteria are necessary for fermentation nitrogen fixation. Some industries are much more sensitive to proper washing techniques. Restaurants particularly prone to the of food-borne contaminants and U.S. Food and Drug Administration (FDA) has specific guidelines articulated in the Food Code. The Food Code has several sections that address the washing hands for service and related personnel. According to the Food regulations, person must after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, or drinking, handling soiled utensils, when switching from raw foods to ready-to-eat foods, and any activity that potentially contaminates the hands. In addition, the Food Code describes a proper hand washing technique as at least 20 seconds, washing up to the forearms, and a special emphasis on between the fingers underneath fingernails. addition to timing washing, it is to the in the washing procedure. proper washing cycle commences with combining water and soap and scrubbing the hands vigorously. There are various soaps or cleansing liquids that can be used, preferably having anti-bacterial or anti-microbial properties. should be cleaned scrubbed. After scrubbing, hands should be thoroughly rinsed with water. The areas between the finger and underneath the fingernails should be specifically cleaned and checked. The regulations also require a supervisor ensure compliance with the regulations promote the effective washing Employers may or lose licenses employees do not these regulations, and such employees are likely to lose their employment. Although there may not be specific codes governing all industries and circumstance, is common sense that the regulations will instill all. And, in a environment, adhering to a strict standard is also a cost-effective and practical measure. There are varying international standards for washing of hands, in general, the U.S. standard provides a reasonable approach to follow. Unfortunately, the proper washing guidelines not regularly rigorously followed. Many food service personnel do not appreciate the significance of proper washing. The restaurants rarely provide adequate training to the personnel, and seldom encompass sufficient during the work shifts. addition, employees restaurants and establishments tend to be lower paid and may not care or the posted written guidelines, if the guidelines are in an Presently there is no adequate means of providing proper guidance and instruction during washing, no system to walk a user through the steps, and no simple means of monitoring or tracking washing. Contributing to the problem of washing is the lack of formal education by those in the services segment, low pay scale, and the periods of rushed food preparation. These factors all contribute to a poor washing conditions. Due to the many illnesses by food preparation, the FDA continues to more formal regulations and guidelines for employers regarding proper washing skills. Employers are demanding a better system of aiding monitoring employee washing habits. The soap and liquid compounds for hand washing come from a of dispensers available the marketplace. Liquid and semi-liquid dispensers are used in numerous applications and are used dispense metered portions of lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial cleansing liquids, and similar materials. A typical dispenser allows the user to obtain specific amount of liquid matter with minimal ease. and semi-automatic dispensing systems in the industry, and automated dispensers are beginning to the marketplace. The manual dispensers utilize levers and other mechanical assemblies wherein the user must provide some physical contact with the unit in to dispense the liquid. The contact in manipulating the lever does provide a contact with a surface that is typically wet and dirty, and may contaminants. Automated are becoming more popular, and operate with a variety electrical and electromechanical to automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers do not require any contact with the Unfortunately, the touchless dispensers are fairly expensive and require fairly complex electrical and electrical components in order function. Besides electronic equipment, there are mechanical components such as plungers gear trains work in conjunction with the electronics. The mechanical gears substantial energy during the xe2x80x98pinch squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent battery replacement. In addition, the batteries are drained, the electrical elements are not functioning properly, or mechanical functions are broken, the entire unit is disabled will not dispense any liquid cleansers. The low reliability and the catastrophic failure mode are a major concern the touchless dispenser market. the field of liquid dispensers, there are many types of dispensers. The most common and cost effective is the bag-in-box system, where the liquid comes in a no-leak pouch pump tip and is disposable. This system is a closed system, and all the air is removed from the pouch during manufacturing. The bag collapses upon itself once the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, including being a more sanitary system. The standard size pouch 800 ml, but other sizes are in use, including 500 ml to 900 ml. It is a the cost to a disposable pouch be kept to a minimum, while still delivering consistent results. The dispensers are installed in many public facilities, and are subject to extreme wear tear. Due to the excessive use, the devices must be robust and relatively Other dispensers use cartridges refillable containers. The cartridges must pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable containers introduce air into the system, aiding the of bacteria and mold. The cost and administrative complexity in using these other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi-automatic and automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successive and rapid pushes of the actuating member that frequently occur. liquid soap industry has numerous brands and categories of cleansing liquids. viscosity and particulate content are also subject to extreme variations. There particulate matter that can added to cleansing to a grit soap compound that is more effective in cleaning. The most common grit material is plastic microspheres, although other materials such as walnut shells and corn have also been used. Besides the variations of compounds used to form grit soap, the size of the grit also varies. There has also been a consumer demand for anti-microbial cleansing and anti-bacterial cleansing liquids, and the industry reacted by adding creating compounds with these properties. These anti-microbial and anti-bacterial cleansing are available with or grit and have certain and viscosity differences as compared to standard liquid soap. Besides soap, other compounds dispensed include body and hair hand creme solutions, lotions, cleansing liquids, and shaving creme. In a typical bag-in-box operation, a user depresses or controller. applies to the dispenser tube that creates a vacuum in the collapsible pouch that exerts fluid pressure against the in the ball check valve. If the pressure is sufficient, the ball is displaced, and the flows around the ball and into the ball check chamber. The liquid flows the space between the spring and the interior wall ball check valve chamber. Once the chamber sufficiently full, the liquid is forced through the compressed spring and out through the lower fitment hole and the nozzle. The transition from a user applying purely mechanical forces to meter out some liquid to a semi-automated or automated dispensing is | 1. fiEld oF thE iNventIoN
ThE PresEnT inVEnTIOn reLATeS TO aN impRovED dISpeNSING ApPARaTus. MOre PartIcULarlY, A DISpEnSer tHAT INCORPORates a timing MeAnS In CoNjunctiOn wiTh audiO aNd VISUAL OuTpUt To AsSiST The uSER iN pRoPEr waSHIng TEChNIQUES For coMPLIANcE wIth REcoMMenDED guIDeLineS aND To MoniToR the nUMBeR of usaGEs.
2. BacKgrOuNd art
eACH yEar, MiLLIonS of rePoRTED iLlNessEs ANd SEriOUS infECtioNs aRE ATTrIBUtABle tO IMpRopeR hAND wAShing. ThE unRePORTED cASES aRE esTIMaTed TO bE mUCH HIghEr. Food boRnE IlLNESs kILlS OveR 10,000 PEOplE eACh year, ANd 70% of tHE outbreAKs ORiGINatE in foOd SeRviCe SeCtor. the paSsAGe oF ViRaL And bacteRIAl conTamInAnTS resuLT fRom phySicAL ContAct WiTH An iNFEcTed sOurCe AND Are cArRIeD fRoM oNE sitE to anoThER witH eACH sUCCeSSIvE PhysICaL COntAcT.
thE ProBleM IS mOSt eVIDenT in HOSPItaL And RElateD MEDiCal eStaBliShmEntS, AS WELL AS Those buSINesSeS aSsOciATeD WIth pRepArInG AnD DistrIbutiNg FooD AND FOOd PRodUCTS. a perSOn THaT HANDleS a SinGLe CONtAmiNAted sOUrcE Will sprEAD thE conTAMinant tO evEry peRSOn, ARTiclE AND SuRfaCe TouCHED bY THAt persOn. ThE SUbsEQuENT CONtamiNatED sOurCeS rEpreSEnt aDditIoNAL ConTAminatIoN sITES tHaT spReaD The coNTAmINaNT. The lIabilitY oF cONtaMInatiON or iLlNEss causEd by InaDEQuAte WaShiNg teChNIqUES iS VEry HigH. And, A SiNGLe food boRne ilLnEsS cAn TaRnIsH A Long-StANdIng REputAtION And wrEAK FINAnCiAL HAvoC.
PRoPEr WaSHiNG of hANDs haS BeeN DEMonStraTeD to kILl tHE cOntAmINaNts AND PrEveNt THE SpRead of DiseaSe anD CONTAminaNtS. ACCorDIng To tHE CeNTeRS FoR diSease CoNtRoL, PROpeR HaNd WasHING IS tHE siNglE moSt ImpOrTanT prOcEss IN prevENTinG tHE spREaD of ThE PATHOGENS. MICROBiAL CoNtaMiNatiOn rEFerS TO MicrOScOpIC oRGaNIsMS, ESpeciAlly aNY Of thE baCTeriA tHAT CaUSe DISEAsE, E.g.: GeRMs. A GerM Is thE ruDImeNtarY FoRM in whicH a NEW ORGANiSm IS dEvEloPeD, ANd eNcomPassES aNY MIcrOScopIC oRgaNIsM anD any oNE of tHE baCtEria thAt Can cAusE DIsease. a bacTeRiUM IS tYpICALLy A oNE-cEllED miCrOORgaNISM, WhEREIn SOME causE DIseAseS SUcH AS pNeUMONIa, tuBeRcULoSis, or anThrAx whiLE OtHEr BacteRIa Are NEcesSary FOr fErmENtatIoN AnD NItrogEn FIXAtioN.
somE InDUstriEs ARE MuCh MOre SeNSItiVe To PropER wAShing teChnIqueS. reStAuRAnTs ArE parTIcULaRlY PROne tO The DIsseminAtIOn OF FooD-BorNE CoNTaminanTS AnD THe U.s. FOOD And DRUG ADMiNiSTRaTiOn (fDA) Has spEcifIC GuidELInEs ARTicULated in ThE fOOD COdE. The FOoD CoDE Has sEvERAL SECtiONs ThAT addrEsS THe wASHing of HaNds FoR foOd seRvIce aND reLaTeD PERsonnEl. acCORdiNg To The fooD codE REgUlAtiOnS, A perSON mUst WasH after USIng THE baTHRoOm, SNEEzINg, couGhINg, UsiNG A DISPoSABLe tISsue, UsING TobACco, eaTING oR drInKing, HanDlING sOiLED uTEnSIls, and whEn SWITchInG FROm raW FooDS tO reAdy-tO-Eat fooDS, aND aNY OtHeR ACTivITy ThAt PoTENTiallY COnTamiNAtES THe HaNdS.
iN AddITion, tHE FooD CODe DesCRIBEs a PROpEr hand WASHIng tEcHNIque as laStINg at leaST 20 seCOndS, WasHINg up To THe FOREARMS, aNd a sPecIal emphAsis oN bETween The fIngERS anD uNDeRnEAtH FInGeRnaILs. In aDdiTion To TIMinG thE WAshINg, IT iS impoRTanT To CONsiDer THE dIFfeRent stEPs iN THe WaSHiNg PrOcEDUre. A proPEr WAsHIng cYClE CoMMEncEs WITH CoMBIning wATEr ANd soAp AND SCrubbING tHe hanDS VIGOROUSly. THere arE VARIOUS SOaPs OR clEaNsing lIQUidS THat cAn bE USed, PREfEraBly hAVinG aNTI-BactERIaL or anti-mICroBial PrOPertIEs. naIls shOuLd Be clEAned ANd scRUBbed. AFTeR sCruBbiNg, tHe haNDS SHoUld BE ThORoUgHLY RINsed wITh WatER. the AReas beTWEen the FInger aNd UNDERnEath tHE FInGeRnAiLS should Be spEcificAlLY clEanEd aNd CHECked.
tHe reguLAtioNS aLSo rEQuIRE a SupervisOr eNsUre COmpLIAncE With tHe REGulATiOns and prOmOTe the EffECTIVE WAsHIng ProtOCOls. EmploYERS mAy be FiNEd oR LOSE LICEnSes IF emPLoyEes do NoT oBServe THese REGuLAtionS, AND SuCh emPloyEEs Are liKEly TO loSe tHEIR emPLOymENt.
AlTHOUGH thERE MaY noT bE speCIFiC coDeS goveRNiNg All InduSTrIes aND CIrcUMstaNCe, iT iS COMMon sEnse tHat aDheReNce To tHE rEgulAtioNs wiLL iNsTiLL A safeR eNvIrOnMENT fOR all. anD, In A LiTIgIOUs ENviRoNmeNT, adHerIng to a sTrICt sTanDarD Is alSo A cOSt-EFfeCtIVe anD pRaCtICal MEASuRE. thERe ARe varyIng intERnAtIOnal StANDArds foR ThE WAShiNg Of hAndS, bUt In GeNeRAl, ThE U.s. StANDArd provIdes A reAsoNabLe apProaCh to fOlloW.
uNfOrTUnAteLY, the prOper WAShing GUIDELiNEs Are NOT rEGUlarlY AnD rIGOrouSlY FoLLOWed. maNy fOOd servicE PErsONnEL Do nOT apPRECIate thE SIGNIfICaNCe of PrOpEr waShinG. ThE REstAuRants rAREly prOVide aDEQUatE TrAiNiNG TO The perSONNel, ANd SeLDOM EncoMpASs suFFICIENt sUPeRVISion dUrING THe Work shifTS. in adDItIOn, ThE EMplOYEeS aT REsTauRaNts AND DiNInG EsTablIShMeNTs TEnd tO BE loWER pAId aND MAY NOT carE OR UnDERStaND the postEd WRITtEN GuiDelINES, esPecIAllY if THe gUIDelInES are in an uNFaMiLiAR LangUagE. PREsEnTLy there is No ADeQuate mEans of PROvIDInG propeR GuidANCe AND iNSTructIoN durING WaSHiNg, No SYsteM DESiGneD TO WalK a useR ThrOUgH tHE wAsHINg STePs, ANd nO SiMPLe MEAnS Of MonItoRING or TRackiNg EMplOyEE WaShinG.
conTribuTiNg to ThE PRObLEm oF inaDeQUaTE wasHINg is thE lAck Of fORmaL EDUCATION By THosE IN THE FOod SeRVICes SEgmEnT, THE loW paY sCale, aNd ThE perIOds of RusHEd foOd pREpaRATION. THEse factORS alL coNtrIbUTe tO A pOTenTiAl fOr POor WasHING COnDITiONS. DUe tO ThE manY ILlNesSes caUsED by FOOD prePArAtIon, tHe FDa CoNTiNues To Apply moRE FORMaL rEguLATIONS aNd GUiDelinEs FOR EmpLOYERS regARding pRoPer WAsHInG skillS. EmpLOYeRs ARE dEMANDinG a betTEr SYSTEm Of aIdinG ANd mONiTorinG eMPloyEE WashINg haBITs.
tHE SoaP AND LiQuiD CoMPouNDS for HAnD WasHINg comE fROM A nuMBEr OF DiFfeRENt DiSPenSeRS aVAILAblE in The MArketPlAcE. liQUiD AnD SeMi-LiQuID DisPEnsErs aRE Used in nUMErous apPLIcaTIoNS AND aRE uSED tO DIspENsE Metered poRtIoNs oF cREmEs, lOTionS, gEls, SOAPS, aNtI-BACtErIal cLEANSinG liQUids, aNtI-MiCRobiAL CleAnsINg liqUIds, AnD SImIlAR MATERiaLs. A tYPicAL dispEnSer alLOws thE uSER to oBtAin A speCIfic AmOUnt OF lIquId MATtEr with MINImal Ease. MANUaL aND sEmI-autoMAtIC dIsPENsIng sYstEmS are cOmmon IN ThE iNdUsTRY, And aUtOMatEd diSpENsErs ARE BEGiNNing tO enter thE MaRkEtplAce.
THE MANuAl dISpenserS uTILIze lEvErs AND oThEr mECHanicAL ASsEMbLiES wheReiN the UsER MUST pRovide SomE PhySiCAl cONtaCT WITh THE uNIt iN ORDeR To dISpenSE tHe LIQuID. thE PHYsiCal contact iN ManiPuLAtINg thE LEvEr doeS PrOVIDe A coNtacT wiTH A SuRFace ThAT is TyPIcALlY wEt AND Dirty, aND may HArBOR CoNTamiNaNTS. aUTOmaTEd dISpENseRs are beCoMiNg mOrE populaR, aND OperaTE WitH A vaRIety Of ELEctRiCAl AnD elECtRomEChanicAL cOMPoNENTs to aUtoMAticAllY DispENSE thE LiqUID aftER TRiGGEriNg Some sENsORY iNput. the AUTOMATIc oR xE2X80X98toUchLessXe2X80x99 diSPEnsERs DO noT REQUIRe aNY PHYsICAL coNtact WiTH The dISpenSER.
UNFOrTUnAtELY, ThE TOUcHLESs dISPenSers ArE fAIrLY ExPEnsIvE and REqUIre FAIrlY CoMPlEx eLecTrical AnD eLEcTriCAL coMpoNenTS iN OrDEr tO FUnCTIon. bESiDes ELeCTronic EqUiPMENt, THErE aRe mECHaNIcAl COmpoNeNTS SUch as pLUngERS AND GeaR TRaiNS ThAt WORk in COnjUNctiON WITh THE eLEctRoNIcs. THE MeChAnICAl GEARS DRAW SubsTAnTIAl EneRGY during THE Xe2x80X98PincH aNd SQUeezeXE2X80x99 OpERaTion tO dELIVER liqUID CLeansER, REQUIRInG frEqueNt baTtERy rEPLACemENT. iN adDitiOn, if tHe BatTEries aRe DraINed, THe ELECtRicAL ElemenTS are nOT FuNCtiOnINg pROPerLY, Or THe meCHanICaL fUNCtIONs aRE BrOkeN, ThE enTirE UnIt iS dISABLEd aND will Not DISpeNSe any LIQUID clEanSERS. THE lOw rEliAbiliTY ANd The CaTAStROPhIc FAILURE ModE arE a MAJor coNcERn In the TOUchLeSs DIspensER mArkET.
WiTHiN tHe fIELd of liQuiD dISPenSers, tHeRe are MaNy Types oF DIspEnseRS. THe MOST cOmmON and CoSt EffECtIvE is thE BAg-IN-BoX sYSTEM, WHeRE tHe LIQuId COMes In A NO-leak PouCh wiTH pumP tiP aNd is dISpoSaBLe. thiS SySTEm is A CLoseD SYsTEM, aNd AlL tHE aiR is rEMOved fRoM The POUcH dUrInG MANUFAcTurinG. THe bAg CoLlapSes UPOn itSELf onCE tHe lIQuiD Is evAcuaTeD, mINimiZINg WaSTE DiSPOsaL. The cLoSEd SYStEM haS MANy adVaNtAgEs, INClUDiNG BEINg A mOre SAnItaRy System. the StaNDard sIzE pOUCH iS 800 ml, buT oTHER sIzEs ARe in Use, inClUding 500 ML TO 900 mL. iT IS a NeCESSarY ReqUIReMent ThAT The cOSt to prOdUCE a DISpoSabLE PouCh bE kEPT TO a MInimuM, WhILE STIlL DeliveRing CoNSiSTEnT REsUltS. tHE DIspEnserS are instaLleD in many pUBLIC faCiLITIeS, and ARE subjEct to eXTrEME wear anD tear. duE To The eXCESSive USe, tHe dEvicES muSt bE RobUst anD rELAtIvElY MAINtENANce frEE.
OTheR DISpeNSERs USE CartRIdGES Or rEFiLlABle CoNTainERs. The caRtriDGes MUst be piERced, ARE gEneRAllY NOT refiLLable, ANd PrOducE gREATer WasTe. both caRtridGes ANd refiLlABlE conTainers iNtrodUCe AiR INto tHE sYSTEm, AiDINg THE PRodUCTIoN oF BACteRia ANd MOLD. THe CoSt AND adMInISTrATiVe CompLExItY in USinG THEsE OTHEr fOrMs Of DIsPensInG LIQUIds, As wELL as THe DeCrEaSed sAnItARY CoNDITiOnS lImit tHeIr MarKet AppEaL. ALso, THeSe sEmI-auTOmatiC ANd AuTOMAtiC SysTEMs cAN Be deSIGnED To coMPLETe ThE CyClE, MEteRINg exaCtLY The CORRECT AmounT Of LIquiD, InDepeNdENtly Of SUcCessiVe aND Rapid pusHes of tHe actUatiNG MEmBer thAt FrEqueNtLy oCcur.
thE liQuid sOaP inDUStry haS nUmERoUS BRandS ANd catEgOrieS of CLeaNsING lIQUIDS. the VIscOSITY and paRTIcULate contENT ARe alsO SUBJEcT To ExTReme variATIONS. tHere is an ArRay of pARTiCulate matter ThaT cAN be AddeD tO cLEanSInG LiquiDs tO Form A GRiT soap cOmPOuND ThAT IS moRe EfFEcTiVE iN clEAnINg. The MoSt commOn GrIt MaTeriAL iS PLAstIC MICROspHEReS, ALTHough OtHer materIalS SUCh AS CLay, WAlnuT Shells And cORn CObs have alSo BEen UseD. besiDEs THe vARiatIOnS oF COmpoUnds uSeD TO FoRM grit SOaP, The SiZe Of tHe grit ALso VARIEs.
tHErE hAs aLso BeEN a COnsumEr DEMaNd FoR ANTi-micRobIAl cleansing LIQuIdS AND ANTi-BACTEriaL CLeANsiNG liquiDS, ANd THE iNDUSTRY hAs REaCTed bY aDdIng CreaTIng nEW cOMPoUNdS WItH THeSe PrOpeRtieS. THESE AnTi-miCrobial aND anti-BacTeRial CleANSing lIQuIDS ArE avAIlabLE wItH oR wiThOUT griT and HAvE CeRtaIn CHaRaCTeriStiCs anD ViSCOSITY dIFfERENceS As cOMpareD TO StandArD liQuiD sOaP. beSIDES lIQUiD SoAP, OtHEr CoMPounds DISPensED include bOdY ANd HaIR ShaMpoo, Hand CremE SOLUtioNs, LOtionS, cLeaNSINg LiQUIds, and sHAVInG creMe.
In A TYpIcaL bAG-iN-Box oPeRAtiON, a usEr deprEssES A LEvEr or controLler. tHis APpLIES PrEsSURe To the disPenSer TUBe tHAT CreaTES a vacuUM iN ThE cOlLapsIBLE pouch THat exeRtS FLUiD PResSURE agaInsT THe baLL in the baLl CheCK vALVe. iF THE PRessuRE Is sufFICIent, thE bALL Is DIspLacED, ANd the lIqUId FlOWS aROUND the bALl aNd INTo THe bALL ChECk valVe cHAMbER. ThE lIQUid fLOWs into tHe spaCE bEtweEN thE spRing aNd ThE IntERiOR waLl oF The bAll CHECk vALvE cHAMBer. ONce tHE CHAmBEr Is SUFficIEnTly FuLL, thE lIQUid Is foRCed tHRoUGh tHE compresseD sprINg aND out ThroUGh ThE LOWEr fitMEnT hole aNd thRouGh thE NoZZlE.
tHE transITiOn fROM a User aPplYINg PUreLy MEcHanicaL FoRcEs TO MetER OUt sOmE LiQuId TO a sEMi-AuTOmAteD OR auTOMATED dispensIng UnIT iS | 1.Field ofthe Invention The present invention relates to an improved dispensing apparatus. More particularly, a dispenser that incorporates a timing means in conjunction with audio andvisual output to assist the user in proper washing techniques for compliance with recommended guidelines and to monitor the numberof usages.2. Background Art Each year, millions of reported illnesses andserious infections are attributable to improper hand washing. The unreported cases are estimated to be much higher. Food borne illness kills over 10,000 people each year, and 70%of the outbreaks originate infood service sector. Thepassage of viralandbacterial contaminants result from physical contact with an infected source and arecarried from one site to another witheach successive physical contact. The problemis most evident in hospital and related medical establishments, as well as those businesses associated with preparing and distributing food andfood products. A person that handles asingle contaminated source will spread the contaminantto everyperson, articleand surface touched bythat person. The subsequent contaminated sources represent additionalcontaminationsites thatspread the contaminant. The liability of contamination or illness caused byinadequate washing techniques isvery high.And, a single foodborne illnesscan tarnisha long-standing reputation and wreak financial havoc.Proper washing of handshasbeen demonstrated to kill the contaminants and prevent the spread ofdiseaseand contaminants. According to the Centers for Disease Control, properhand washingis thesingle most important process in preventing the spread of the pathogens. Microbial contamination refers to microscopic organisms,especially any of the bacteria that cause disease, e.g.:germs. Agerm is the rudimentary form in which a new organism isdeveloped, and encompasses anymicroscopic organism and any one of the bacteria that can cause disease. A bacterium istypically a one-celled microorganism, wherein some cause diseasessuch as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation and nitrogenfixation. Some industries aremuch more sensitive to properwashing techniques. Restaurants are particularly prone tothe dissemination of food-borne contaminants and the U.S. Food and Drug Administration (FDA) has specific guidelines articulatedin the Food Code. The Food Code has several sections that address the washing of hands for food serviceand related personnel. Accordingto the Food Code regulations, a person mustwash after using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating ordrinking, handling soiled utensils, and when switching from raw foodsto ready-to-eat foods, and any other activity that potentially contaminates the hands.In addition, the Food Code describes a proper handwashing technique aslasting at least 20seconds, washingup to the forearms, and a specialemphasis onbetween the fingers and underneath fingernails. In addition to timingthe washing, it is importantto consider the different steps in the washingprocedure.A proper washing cycle commences withcombiningwater and soap and scrubbing the hands vigorously.There are various soaps or cleansing liquids that can be used, preferably having anti-bacterialor anti-microbialproperties. Nails should be cleanedand scrubbed. Afterscrubbing, the hands should be thoroughly rinsed with water. The areasbetween the finger and underneath the fingernails should be specifically cleaned and checked. The regulations also require a supervisorensure compliance withthe regulationsand promote theeffective washing protocols. Employers may be finedor lose licenses if employees do not observe these regulations, and such employees are likely to lose their employment. Although there may notbe specific codes governing allindustries andcircumstance, it is common sense that adherence tothe regulations will instill a safer environment for all. And, in a litigious environment, adhering to a strict standard isalso a cost-effective and practicalmeasure.There are varying international standards for the washing of hands, but ingeneral, theU.S.standard provides a reasonable approach tofollow. Unfortunately, the proper washing guidelines are not regularlyand rigorously followed.Many food service personnel do notappreciate thesignificanceof proper washing. The restaurants rarely provide adequate training to the personnel,and seldom encompasssufficient supervision during the work shifts. In addition, the employees at restaurants and dining establishmentstend to be lower paid and may not care or understandthe posted written guidelines, especiallyif the guidelines are inanunfamiliar language. Presently there is no adequate means of providing properguidanceand instructionduring washing, no systemdesigned to walk a user through the washing steps, and no simple means of monitoring or tracking employee washing.Contributing to the problem of inadequate washing is the lack offormal education by those inthe food services segment, the lowpay scale, and the periodsof rushed food preparation. These factors all contribute to a potential for poor washing conditions. Due to the many illnesses caused by food preparation, the FDA continues toapply more formal regulations andguidelines for employersregarding proper washing skills. Employers are demanding abetter system of aiding and monitoring employee washing habits. The soapand liquid compounds for hand washingcome from a numberof differentdispensers available in the marketplace. Liquid and semi-liquid dispensers are usedin numerous applications and are used to dispense metered portions of cremes, lotions, gels, soaps, anti-bacterial cleansing liquids, anti-microbial cleansingliquids, and similar materials. A typicaldispenserallows the user to obtain a specific amount of liquid matter with minimalease.Manual and semi-automatic dispensing systems are common in the industry,and automated dispensers are beginning to enter the marketplace. The manual dispensers utilize levers and other mechanical assemblieswhereinthe user mustprovide some physical contactwith the unit in order todispense the liquid.The physical contactin manipulating the lever does provide a contact with a surface thatistypically wet anddirty, and may harbor contaminants. Automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical componentsto automatically dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers donot require any physical contact with the dispenser. Unfortunately, the touchless dispensers are fairly expensive and require fairly complexelectrical and electrical components in order to function. Besides electronic equipment, there are mechanical components such as plungers and gear trainsthat work in conjunction with the electronics. Themechanical gears draw substantial energyduring the xe2x80x98pinch and squeezexe2x80x99 operation to deliver liquid cleanser, requiring frequent batteryreplacement. In addition, if the batteries are drained, the electrical elements are not functioning properly, or the mechanical functions are broken, theentire unit is disabled and willnot dispense any liquidcleansers. Thelow reliability and the catastrophic failure modeare a major concern in thetouchless dispenser market. Within the field of liquiddispensers, thereare many types of dispensers. The most common and cost effective is thebag-in-box system, where the liquid comes in a no-leak pouch with pump tip andis disposable. Thissystem is a closedsystem, and all the air is removed from the pouch during manufacturing. The bag collapses upon itselfonce the liquid is evacuated, minimizing waste disposal. The closedsystem has manyadvantages,including being a more sanitary system.The standard size pouchis 800 ml, but other sizes are inuse, including 500mlto900ml. It is a necessary requirement that the cost to produce adisposablepouch be keptto a minimum, while still delivering consistent results. The dispensers are installed inmany public facilities, and are subject to extreme wear and tear.Due to theexcessive use, the devices must be robust and relatively maintenance free. Other dispensers use cartridges or refillable containers.The cartridges must be pierced, are generally not refillable, and produce greater waste. Both cartridges and refillable containers introduce air into the system,aiding the production of bacteria and mold. The cost and administrativecomplexityin usingthese other forms of dispensing liquids, as well as the decreased sanitary conditions limit their market appeal. Also, these semi-automaticand automatic systems can be designed to complete the cycle, metering exactly the correct amount of liquid, independently of successiveand rapid pushes of the actuating member that frequently occur. The liquid soap industry has numerous brands and categoriesofcleansing liquids.Theviscosity and particulate content are alsosubject to extreme variations. There is an array of particulate matter that can be addedto cleansing liquidstoform agrit soapcompound thatis more effective in cleaning. The most commongrit material is plastic microspheres, although other materials such as clay,walnut shells and corn cobs have alsobeen used. Besides the variations of compounds used to formgrit soap, the size of thegritalso varies. There has alsobeen a consumer demand for anti-microbial cleansing liquids and anti-bacterial cleansing liquids, and theindustry has reacted by adding creating new compoundswith these properties. These anti-microbial and anti-bacterial cleansing liquids areavailable with or without grit and havecertain characteristics and viscosity differences as compared to standard liquid soap. Besides liquidsoap, other compounds dispensed include body and hair shampoo, hand cremesolutions, lotions, cleansing liquids, andshaving creme. In a typical bag-in-box operation,auser depresses a lever orcontroller. This applies pressure to the dispenser tube that creates a vacuum in the collapsible pouch thatexerts fluid pressure against the ball in the ball check valve. If the pressureis sufficient,the ball is displaced, and the liquid flows around the ball and into the ball check valve chamber. The liquid flows intothespace between the spring andtheinterior wall of the ball check valve chamber. Once the chamber is sufficiently full,the liquid is forced through the compressed spring and out through the lower fitmenthole and through the nozzle. Thetransition from auser applying purely mechanical forces to meter out some liquid to a semi-automatedor automated dispensing unit is | 1. _Field_ of the Invention _The_ present invention relates to an improved dispensing apparatus. _More_ particularly, _a_ dispenser that incorporates a _timing_ means _in_ conjunction _with_ audio _and_ visual output to _assist_ _the_ user in proper _washing_ _techniques_ for compliance with _recommended_ guidelines and to monitor the number of usages. 2. Background Art Each year, _millions_ of reported illnesses _and_ serious infections are attributable to improper hand washing. _The_ unreported cases are estimated to be much _higher._ Food borne illness _kills_ over 10,000 people _each_ year, and 70% of the outbreaks originate in food service sector. The passage of viral and _bacterial_ contaminants _result_ from physical _contact_ with an infected source _and_ are _carried_ _from_ one _site_ to another _with_ each _successive_ physical contact. The _problem_ _is_ most evident in _hospital_ and related _medical_ _establishments,_ as well as those businesses associated with preparing and distributing food and _food_ _products._ _A_ person that handles a single _contaminated_ source will spread the _contaminant_ to every person, _article_ and surface touched by that person. The subsequent contaminated sources represent additional contamination sites _that_ _spread_ the contaminant. _The_ liability _of_ _contamination_ _or_ illness caused by inadequate washing techniques is _very_ high. And, _a_ single food borne _illness_ can tarnish a _long-standing_ reputation and wreak _financial_ _havoc._ Proper washing _of_ _hands_ has been demonstrated to _kill_ the _contaminants_ and _prevent_ the spread _of_ disease and contaminants. _According_ _to_ _the_ Centers for Disease Control, proper hand _washing_ _is_ the single most important process _in_ preventing the spread of _the_ pathogens. Microbial contamination refers to _microscopic_ _organisms,_ especially _any_ of the _bacteria_ _that_ cause _disease,_ e.g.: _germs._ A germ is _the_ _rudimentary_ form in which a new _organism_ _is_ developed, and encompasses any _microscopic_ organism and any one of the bacteria that can cause disease. _A_ bacterium is typically a one-celled _microorganism,_ wherein some cause _diseases_ such as pneumonia, tuberculosis, or anthrax while other bacteria are necessary for fermentation _and_ nitrogen fixation. Some industries are much more _sensitive_ to proper washing techniques. Restaurants _are_ _particularly_ _prone_ _to_ the dissemination of food-borne contaminants and _the_ U.S. Food _and_ Drug Administration _(FDA)_ has specific guidelines articulated _in_ the Food Code. The Food Code has several sections _that_ _address_ the washing of hands _for_ food service _and_ related personnel. According _to_ the _Food_ Code _regulations,_ a _person_ must _wash_ _after_ using the bathroom, sneezing, coughing, using a disposable tissue, using tobacco, eating _or_ drinking, handling soiled utensils, and _when_ switching from raw foods to ready-to-eat foods, and any _other_ _activity_ that _potentially_ contaminates the hands. In addition, the Food Code describes a _proper_ hand washing technique as _lasting_ at least _20_ seconds, washing up to the _forearms,_ and a special emphasis _on_ between the fingers _and_ underneath fingernails. In addition to timing the washing, it is important to consider _the_ _different_ steps in the washing procedure. A proper _washing_ _cycle_ _commences_ with combining _water_ _and_ soap and _scrubbing_ the hands vigorously. There _are_ various soaps or cleansing _liquids_ that can be used, preferably having anti-bacterial _or_ anti-microbial _properties._ _Nails_ should _be_ _cleaned_ and _scrubbed._ _After_ scrubbing, _the_ _hands_ should be thoroughly rinsed with water. The areas between the finger and underneath the _fingernails_ _should_ _be_ _specifically_ cleaned and checked. _The_ regulations _also_ require a supervisor ensure compliance with the regulations and promote the effective washing protocols. Employers may be fined or lose licenses if employees do not observe _these_ regulations, and such employees are likely to lose their employment. Although there may not be specific codes governing all industries _and_ _circumstance,_ it is common sense that adherence to the regulations will instill a safer environment for _all._ And, in a litigious environment, _adhering_ to a _strict_ standard is _also_ a cost-effective and practical measure. There are varying _international_ standards for the washing of _hands,_ but in general, the U.S. standard provides a _reasonable_ approach to follow. Unfortunately, the _proper_ washing guidelines _are_ not regularly and rigorously followed. Many food service personnel do not appreciate the significance of _proper_ _washing._ The restaurants _rarely_ provide adequate training to the personnel, and seldom encompass sufficient _supervision_ during the work shifts. In addition, _the_ employees at _restaurants_ and dining establishments tend to be lower paid and may not care or understand _the_ posted written guidelines, especially _if_ the guidelines are _in_ an unfamiliar language. _Presently_ there is no adequate means _of_ providing proper guidance _and_ instruction during washing, no _system_ designed _to_ walk a user through the _washing_ steps, and no simple means _of_ _monitoring_ or tracking employee _washing._ Contributing to _the_ _problem_ of inadequate washing is the lack of formal education by those in the food _services_ segment, _the_ low pay scale, _and_ the periods of rushed food preparation. These factors _all_ _contribute_ to a _potential_ for poor _washing_ conditions. Due to the _many_ illnesses caused by food preparation, _the_ FDA continues to apply more formal _regulations_ _and_ guidelines for employers regarding proper _washing_ skills. Employers are demanding a _better_ system of _aiding_ and monitoring employee washing _habits._ The soap and liquid _compounds_ for _hand_ washing come _from_ a _number_ of different dispensers available in _the_ marketplace. Liquid and semi-liquid dispensers are used in numerous applications and are used to dispense metered portions of cremes, lotions, _gels,_ _soaps,_ _anti-bacterial_ _cleansing_ liquids, _anti-microbial_ cleansing liquids, and similar materials. _A_ typical dispenser allows the user to obtain a specific amount of liquid matter with _minimal_ ease. Manual and _semi-automatic_ dispensing systems are common in _the_ industry, and _automated_ dispensers are beginning _to_ _enter_ the marketplace. _The_ manual dispensers utilize levers and other mechanical _assemblies_ wherein _the_ user must provide _some_ physical contact with the unit in order _to_ dispense the liquid. The physical contact in manipulating _the_ lever does provide a _contact_ with a _surface_ that is typically _wet_ and dirty, and may harbor contaminants. Automated dispensers are becoming more popular, and operate with a variety of electrical and electromechanical _components_ _to_ _automatically_ dispense the liquid after triggering some sensory input. The automatic or xe2x80x98touchlessxe2x80x99 dispensers _do_ not require any physical contact with the dispenser. Unfortunately, _the_ touchless dispensers are fairly expensive and _require_ fairly complex electrical and electrical components in order to function. Besides electronic equipment, there are mechanical components such as _plungers_ and gear trains that _work_ in conjunction with _the_ electronics. The mechanical _gears_ draw substantial _energy_ _during_ _the_ xe2x80x98pinch _and_ squeezexe2x80x99 operation _to_ deliver liquid cleanser, requiring frequent battery replacement. In addition, if the batteries _are_ drained, the electrical _elements_ are not functioning properly, or the mechanical _functions_ are broken, the entire unit _is_ _disabled_ _and_ _will_ not _dispense_ any liquid cleansers. The low reliability and the _catastrophic_ _failure_ mode _are_ a major concern in the touchless dispenser market. Within the field of liquid dispensers, _there_ are many types of dispensers. _The_ most common and cost effective is _the_ bag-in-box system, where the liquid comes _in_ a no-leak pouch with pump tip and _is_ disposable. This system is a closed system, and _all_ the _air_ is removed from the pouch during manufacturing. The bag _collapses_ upon _itself_ _once_ the liquid is evacuated, minimizing waste disposal. The closed system has many advantages, _including_ being _a_ more sanitary system. The standard size pouch _is_ 800 ml, but other sizes _are_ in use, including 500 _ml_ to 900 ml. It is a necessary requirement that _the_ cost to produce a disposable pouch be kept to a minimum, while still _delivering_ _consistent_ _results._ _The_ dispensers _are_ installed in many public facilities, and _are_ _subject_ to extreme wear and tear. Due _to_ the excessive use, the _devices_ _must_ _be_ robust and relatively maintenance free. Other dispensers _use_ cartridges or refillable _containers._ The cartridges must be _pierced,_ are generally not refillable, and produce greater waste. Both cartridges _and_ refillable containers introduce _air_ into the system, aiding the production of bacteria and mold. _The_ _cost_ and _administrative_ complexity in using these _other_ forms of dispensing liquids, as well _as_ the decreased sanitary conditions limit their market appeal. Also, _these_ _semi-automatic_ and automatic systems can be designed to complete _the_ cycle, metering exactly the _correct_ _amount_ of liquid, independently of successive and _rapid_ pushes of the _actuating_ member _that_ frequently occur. The liquid soap industry has numerous brands and categories of cleansing liquids. The viscosity and particulate content are also subject to extreme variations. There is _an_ array _of_ particulate matter _that_ can be added _to_ cleansing liquids to form a grit soap compound _that_ is more effective in _cleaning._ The _most_ common grit material is plastic microspheres, _although_ other materials such _as_ clay, walnut shells _and_ corn _cobs_ have also been used. _Besides_ the variations of compounds used _to_ form grit soap, _the_ size of the grit also varies. There _has_ also _been_ a consumer demand _for_ anti-microbial cleansing liquids and _anti-bacterial_ cleansing liquids, _and_ the _industry_ has reacted by adding creating new _compounds_ with these properties. These anti-microbial and anti-bacterial _cleansing_ liquids are available with or _without_ grit and have certain characteristics and viscosity _differences_ as compared to standard liquid soap. Besides liquid soap, other compounds dispensed include body and hair shampoo, hand creme _solutions,_ lotions, cleansing liquids, and shaving creme. In _a_ typical _bag-in-box_ operation, _a_ user depresses _a_ lever or _controller._ This _applies_ pressure to the dispenser tube that creates _a_ _vacuum_ in the collapsible _pouch_ that exerts _fluid_ pressure against the ball in _the_ ball _check_ valve. If the pressure is sufficient, the ball is _displaced,_ and the liquid flows around the ball and into the ball _check_ valve chamber. The liquid _flows_ _into_ _the_ space between the spring and the interior _wall_ of _the_ ball check valve chamber. Once the chamber is sufficiently full, _the_ liquid is forced through the compressed spring _and_ out through the lower fitment _hole_ and _through_ the nozzle. The transition from _a_ user applying purely mechanical forces to meter out _some_ liquid to a semi-automated or automated dispensing _unit_ is |
1. Field of the Invention
The present invention relates to medical instruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section.
2. Prior Art
Endoscopes with passive and active deflection sections are known in the art. U.S. Pat. No. 4,580,551 shows an endoscope with an elongated flexible plastic tube comprising a continuous sequence of connected vertebra-like elements. U.S. Pat. No. 3,162,214 discloses a thin walled tube of elastic material internally supported throughout its length by a series of tubular rigid rings. In one prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a wire sheath along the passive deflection section. The wire sheath comprises a coiled wire to form a flexible tube around each control wire. A problem exists with these coil wire sheaths in that the coil shape can expand during compression. This can result in a loss of deflection at the active deflection section of the endoscope. In another prior art embodiment, stainless steel tubes are used as the sheaths for the control wires. However, these are only used in applications which have a large bend radius. These tubes can kink very easily, have no resilience, and can fatigue and permanently deform thereby shortening the working life of the endoscope. | 1. bailiwick of the Invention The present invention relates to medical instruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section. 2. Prior Art Endoscopes with passive and active deflection sections are known in the art. U.S. Pat. No. 4,580,551 shows an endoscope with an elongated flexible plastic tube comprising a continuous sequence of connected vertebra-like elements. U.S. Pat. No. 3,162,214 discloses a thin walled tube of elastic material internally supported throughout its length by a series of tubular rigid rings. In one prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a wire sheath along the passive deflection section. The wire sheath comprises a coiled wire to form a flexible tube around each control wire. A problem exists with these coil wire sheaths in that the coil shape can expand during compression. This can result in a loss of deflection at the active deflection section of the endoscope. In another prior art embodiment, stainless steel tubes are used as the sheaths for the control wires. However, these are only used in applications which have a large bend radius. These tubes can kink very easily, have no resilience, and can fatigue and permanently deform thereby shortening the working life of the endoscope. | 1. Field of the InventiIh The present invention relates to medJVal instrunSnts and, more particularly, to an endoscope having flexObIe tubes within a passive deflection section. 2. Prior Art Endoscopes with passive and active deflection sections are known in the art. U. S. Pat. No. 4, 580, 551 shows an endoscope with an elongated flexible plastic tube comprising a continuous sequence of connected vertebra - like elements. U. S. Pat. No. 3, 162, 214 discloses a thin walled tube of elastic material internally supported throughout its length by a series of tubular rigid rings. In one prior art embodiment, control wires from a deflection control to a distal tip of the active deflection are provided with a wire sheath along the passive deflection section. The wire sheath comprises a coiled wire to form a flexible tube around each control wire. A problem exisFE with these coil wire sheaths in that the coil shape can ezpans during compression. This can result in a loss of deflection at the active deflection section of the endoscope. In another prior art embodiment, stainless steel tubes are used as the sheaths for the control @irDs. However, tbeDe are only used in applications which have a large bend radius. These tubes can kink very easily, have no resilieHFe, and can fatigue and permanently def)rk thereby shortening the working life of the endoscope. | 1. Field of the Invention present relates to medical instruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section. 2. Prior Art Endoscopes with passive and deflection sections known in the art. U.S. Pat. No. 4,580,551 shows an endoscope an elongated flexible plastic tube comprising a continuous sequence of connected vertebra-like elements. U.S. Pat. No. 3,162,214 discloses a thin walled of material internally supported throughout its length by a of tubular rigid In one prior embodiment, wires from a deflection control to a distal tip of the active deflection provided with a wire sheath along the passive deflection section. The wire sheath comprises a coiled wire to form a flexible tube around each control wire. A problem exists with these coil wire sheaths in that coil shape can expand during compression. This in a loss of deflection at the active deflection section of endoscope. In another art embodiment, stainless steel are used as the sheaths for the control wires. However, these are only used in applications which have a large bend radius. These tubes can kink have no resilience, and can and permanently deform thereby shortening the working life of the endoscope. | 1. FIEld Of thE INVenTiON
the preSeNT InveNtiON ReLates To mEDical InsTrumenTs and, mOrE PARTICULArly, tO AN ENdosCOpE haVING fLEXiBlE TuBeS WIthIn A pAssIve dEfLeCtIOn sECTIon.
2. prioR art
ENDosCOPEs With pAssIve And actIVe DefleCtIoN sECTIoNS Are kNowN IN tHE art. u.S. PAt. no. 4,580,551 SHOws An EnDOSCoPE wiTh an ElongaTed FlexibLe pLaStiC TuBE ComPRIsINg a cONTINuouS seQUencE OF cONneCtED VERtEBRA-likE eLEmEntS. u.s. pAT. no. 3,162,214 dIsclOseS a THiN wallED tUBE OF ELasTIc MATErial inTERnALlY sUpporTEd THrouGHOUT iTS LeNgTH BY a SERIEs oF TUBuLar RIgiD RiNgS. in ONE pRior Art EmBoDImEnt, cOnTroL wirES fRom a deFLectIon CONtroL tO A disTaL tIp oF The ActiVe DeflecTIon ARE PROVIDeD wIth A WiRE ShEaTh ALOnG thE passivE deFlection secTiON. ThE wiRE ShEath compriSes A coILed wIre to Form A fLeXible tUBe aROUnd eAch ContROL wirE. A Problem ExIsts witH thesE cOIl WiRE SHEATHS IN tHAT THe cOIl Shape can EXpAnd During comprESsion. ThIs CaN ResuLT in A LOsS oF dEfLeCtiON AT ThE AcTIVe DEFLeCtIoN SEcTION Of THE eNdosCopE. iN AnotHeR PRIor Art EMbOdimENT, stAInlESs STEEl tuBES aRe uSed As tHE sheaths FOr THE ConTrOL wIRes. HoWeVer, thEsE Are onlY uSed IN appLIcATiONS Which HAVe a lArge bend RadiUS. THESe tuBeS cAN KiNK VerY EASily, Have no resilIenCE, aND can fATiGUe ANd pERManeNTly DEfORM therEBy sHoRTENING THE woRKing lIfE of THE eNdOScopE. | 1. Field of the Invention Thepresent invention relatestomedicalinstruments and, more particularly, to an endoscope having flexible tubes within a passive deflection section. 2. Prior Art Endoscopes withpassive and active deflection sections are known in the art. U.S. Pat. No. 4,580,551 shows an endoscope with an elongated flexible plastic tube comprising a continuous sequence of connected vertebra-like elements. U.S. Pat. No.3,162,214discloses a thin walled tube of elastic material internally supported throughoutitslength by a series of tubular rigid rings. In one prior art embodiment, control wires from a deflection control toa distal tip of the active deflection areprovidedwith a wire sheath along the passive deflection section.The wire sheath comprises a coiled wireto form a flexible tube around each control wire. A problem exists with these coil wire sheaths in that the coil shape can expand during compression. This can result inaloss ofdeflection at theactive deflection section of the endoscope.In another prior art embodiment,stainless steel tubes areused as the sheaths for the control wires. However, these are only used in applications which have alarge bend radius. These tubes can kinkveryeasily, have noresilience,and can fatigue and permanently deform therebyshortening theworking life of the endoscope. | 1. Field of _the_ Invention The _present_ invention relates to _medical_ _instruments_ and, more particularly, to an endoscope having flexible tubes within a passive _deflection_ _section._ 2. Prior Art Endoscopes _with_ passive and active deflection sections are known in the art. U.S. _Pat._ No. 4,580,551 shows an endoscope with an elongated flexible plastic tube comprising a _continuous_ _sequence_ of connected vertebra-like _elements._ _U.S._ Pat. No. _3,162,214_ discloses a thin walled tube of elastic material _internally_ _supported_ throughout its _length_ by a _series_ of _tubular_ rigid rings. In one prior art embodiment, control wires from a _deflection_ control to a distal _tip_ of the active _deflection_ are provided with a wire sheath along _the_ passive deflection section. The wire sheath comprises a coiled wire to _form_ _a_ flexible _tube_ around each control wire. A problem exists with these coil wire sheaths _in_ that the coil shape can _expand_ during compression. This can result in a loss of deflection _at_ the _active_ _deflection_ section of _the_ endoscope. _In_ another prior _art_ embodiment, stainless steel tubes are used as the _sheaths_ for the control _wires._ However, these are only used in applications _which_ have a large bend radius. These tubes can kink very easily, have no resilience, and can _fatigue_ and permanently deform thereby shortening the working _life_ of the endoscope. |
Bridge rectifiers for automotive-type alternators are well known in the art. An example of a bridge rectifier is disclosed in U.S. Pat. No. 4,606,000. Generally, a bridge rectifier comprises two metallic heat sinks that are electrically insulated from a each other. Each heat sink carries a plurality of semiconductor diodes such that the heat sinks form respective positive and negative direct voltage output terminals. The diodes are grouped in pairs and are connected to respective output phase windings of the alternator. | Bridge rectifiers for automotive-type alternators are well known in the art. An example of a bridge rectifier is disclosed in U.S. Pat. No. 4,606,000. Generally, a bridge rectifier comprises two metallic heat sinkhole that are electrically insulated from a each other. Each heat sink carries a plurality of semiconductor diodes such that the heat sinks form respective positive and negative direct voltage output terminals. The diodes are grouped in pairs and are connected to respective output phase windings of the alternator. | Bridge rectifiers for automotive - type alternators are well known in the art. An example of a bridge ref4ifier is disclosed in U. S. Pat. No. 4, 606, 000. Generally, a bridge rectifier comprjsee two mDgallic heat sinks that are eKectricSlly insulated Drim a each otu$r. Wacm heat a7nk carries a plurality of semiconductor diodes such that the tsat sinks fo3h respective positive and negative direct voltage output terminals. The diodes are grouped in pairs and are connected to respective output phase windings of the alternator. | Bridge for automotive-type alternators are well known in art. An example of a bridge rectifier is disclosed in U.S. Pat. No. 4,606,000. Generally, a bridge rectifier comprises two heat sinks that are electrically insulated from a each other. Each heat sink a plurality of semiconductor diodes such that the heat sinks form negative direct voltage output terminals. The diodes are in pairs and are connected to respective output phase windings of the alternator. | BrIDGe RectifiERS for aUTOMoTIve-tYPE ALtErnaTOrs ARe WeLL kNOwn In tHE ArT. AN eXampLE OF A bridGE RECtifieR iS DiSCLOseD iN U.S. PAt. No. 4,606,000. gEnErAlLY, a BriDGe recTIFieR CoMprIseS tWo mETAlLic hEaT sINKs THAT aRE eleCtRIcalLy InSUlAteD fROm A EacH OtheR. EaCH Heat SINk carrIES a pLUraLiTy oF SEMicONDUcTor DioDeS sUCh tHAt ThE HEaT sinKS ForM rESPecTIvE pOSItiVe AND neGatIVE diRecT VOlTAGe OutpuT terMinALs. The DIoDEs arE GRoUped IN PaiRS AnD aRe cOnNecTeD tO RESpEcTiVe OutPut pHASe WIndingS Of tHe ALTErNAtOr. | Bridge rectifiers for automotive-type alternatorsarewell known in the art.An example of a bridge rectifier is disclosedin U.S.Pat. No. 4,606,000. Generally,a bridge rectifier comprises two metallic heat sinks that are electrically insulated from a each other. Each heatsink carries aplurality of semiconductor diodes suchthat the heat sinks formrespectivepositive and negative directvoltage output terminals. The diodes are grouped in pairs andareconnected to respectiveoutput phase windingsof the alternator. | Bridge rectifiers for _automotive-type_ alternators are well known in the art. An example of a bridge rectifier is _disclosed_ in U.S. Pat. No. 4,606,000. Generally, _a_ _bridge_ rectifier comprises two metallic _heat_ sinks _that_ _are_ electrically insulated from _a_ each other. Each heat sink carries a _plurality_ of semiconductor diodes such that the heat sinks form respective positive _and_ negative direct voltage output terminals. The diodes _are_ grouped _in_ pairs and are connected to _respective_ output phase _windings_ of the _alternator._ |
Plates having compartments are used for holding food Often, a main compartment is designed to hold a main dish whereas the other compartment, or wells, are used to hold sides, condiments, or both. Prior art disposable plates have had various designs or patterns printed thereon, but do not integrate the various compartments into the printed design or pattern.
Additionally, prior art designs or patterns printed on disposable plates focused on a small number of designs. The number of designs per collection in the prior art has been less than the total number of plates packaged together for retail sale. Thus, each retail package of plates includes only a complete collection of designs. The prior art does not address the situation where the number of designs per collection exceeds the total number of plates in a retail package and how to widely disseminate all of the designs in the collection in the market place. | Plates having compartments are used for holding food Often, a main compartment is designed to hold a main dish whereas the other compartment, or wells, are used to hold sides, condiments, or both. Prior art disposable plates have had various purpose or patterns printed thereon, but do not integrate the various compartments into the printed design or pattern. Additionally, prior art designs or patterns printed on disposable plates focused on a small number of designs. The number of designs per collection in the prior art has been less than the total number of plates packaged together for retail sale. Thus, each retail package of plates includes only a complete collection of designs. The prior art does not address the situation where the number of designs per collection exceeds the total number of plates in a retail package and how to widely disseminate all of the designs in the collection in the market place. | Plates having compartments are used for holding food KfRen, a main compartment is decignDd to hold a main dJDh whereas the other compartment, or wells, are used to hold sides, condiments, or both. Prior art disposable plates have had varKouX designs or patterns printed thereon, but do not integrate the various x)mpartments into the )rin^ed xesinn or pattern. Additionally, prior art designs or pZttdrns printed on disposable plates focused on a small number of designs. The number of designs per collection in the prior art has been less than the total number of plates packaged together for retail sale. Thus, each retail package of plates includes only a complete collection of designs. The prior art does not address the situation where the number of designs per collection exfReds the total number of plates in a retail package and how to widely disseminate all of the designs in the coll4ct(on in the market place. | having compartments are used for holding food Often, a main compartment designed to hold a dish whereas the other compartment, or wells, are used to hold sides, condiments, or both. Prior art disposable plates have had various or patterns printed thereon, but not the various compartments into the printed or pattern. Additionally, prior art designs or patterns printed on disposable plates focused on a small number of designs. The number of designs per collection the prior art has been less the number of plates together for retail sale. Thus, each retail package of plates includes only a complete collection of designs. The prior art does not address the number of per collection exceeds the total number of plates in a retail package and how to widely disseminate all of the designs in the collection in the market place. | PlaTes HAVinG coMPaRtmENtS Are uSEd fOR hOlDiNg foOd ofTeN, A MaIn COmPARtmEnt IS desiGNed To Hold A maIn diSh wheReaS THe oTHer cOMPaRTment, or WELlS, arE UseD To HOLD siDeS, COndIMEnTs, oR BotH. pRIoR ART diSPoSAblE plATEs HaVe HAd VARIOUS DeSIGns Or PATtErnS prInted ThereoN, bUt do NOT inTegrATe ThE vARiOUS CoMPARTmenTs iNTO thE PRinTED DESIGn or patTERN.
ADditioNALLy, pRIOR aRT dESIgns oR PATteRNs printEd oN DisPoSABle plaTES FocUseD On a SmalL NuMBEr OF DesIGNS. the NumbEr Of deSigNS pER COlLecTIOn in ThE prioR ART HAS BEEN less tHAN The TOTAl numBER OF PLAtES PaCkAGEd tOGETheR fOr REtail SAlE. thus, EACh retAIL PACkagE OF plATeS InCLuDes oNLY A CoMPLetE COLlectiOn OF DeSIgNS. THE prior Art doeS Not AdDRESS ThE SiTUation WhEre tHe nUmbEr Of desiGNS PEr cOllECtion ExCEEDs tHE toTaL nUMBer of PLATeS iN a ReTAIl pACkAGE And hOw To widelY DisseMiNATe ALL OF tHe DesIGns In the COLlEctION IN ThE marKET plACE. | Plateshaving compartments areused for holding food Often, a main compartmentis designed to hold a main dish whereas the other compartment, or wells,are used tohold sides, condiments, or both. Prior art disposable plates have had various designs orpatterns printed thereon, but do not integrate the various compartments into the printed design or pattern.Additionally, prior art designs or patterns printedon disposable plates focused on asmall number of designs. The number of designs per collection in theprior art has been less than the total number of plates packagedtogetherfor retailsale. Thus,each retail packageof plates includes only a completecollection of designs. The prior art does notaddress the situation where the numberof designs per collection exceeds the totalnumber of plates ina retail package andhow to widely disseminate all ofthe designsin the collection in the market place. | Plates having compartments _are_ used for _holding_ food Often, a _main_ compartment is designed to hold a main dish whereas the other compartment, or wells, are _used_ _to_ hold _sides,_ condiments, or both. Prior art disposable plates have _had_ various designs or patterns printed thereon, but _do_ not integrate the various _compartments_ _into_ _the_ printed design or pattern. Additionally, prior art designs _or_ patterns printed on disposable plates focused on a small number _of_ _designs._ The number _of_ designs per collection in the prior _art_ has been less than _the_ total _number_ of plates packaged together for retail sale. Thus, each retail package _of_ plates includes only a complete collection _of_ designs. The prior _art_ does not address the situation where _the_ _number_ of designs per collection exceeds the total number _of_ plates in a retail _package_ and how to _widely_ disseminate all of the designs in _the_ collection in the market _place._ |
This invention relates to a surgical closure that can be repeatedly opened and closed, especially for the abdominal wall. More particularly the invention relates to a surgical closure having fabric of plate-like securing elements that can be tightly but detachably connected to the body tissue and has a closure which can be repeatedly opened and closed.
Such a surgical closure is known, for example, from German Patent 34 44 782. This surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis.
Peritonitis, as a secondary form that develops as a result of a perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem.
The abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly by small openings in the peritoneal diaphragm underside. In this way, bacteria are fed by the lymph tracts to the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin-induced adhesions. The defense system is disrupted and a rise in bacterial counts, or their toxins and fibrin, results. If the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped.
To cleanse the abdominal cavity, washing with physiological saline solution is already done during the operation until the wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed as completely as possible, to provide, along with surgical removal of septic focus, an optimal condition for healing.
In the postoperative phase, in which the fate of the patient is mainly determined, it is decisive to recognize a worsening of the condition as early as possible, and optionally, to remove the cause (e.g., correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean (blood that reappears, fibrin and bacteria are to be rinsed away).
In postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with a closed abdomen are known.
This so-called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, with the advantages that repeated intra-abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. In doing so, postoperative, intra-abdominal adhesions can be detached and coatings of fibrin can be removed. The typical drainage complications are eliminated. (Plugging of drainage for the abdominal wall, blockage or obstruction of drainages, infection sources.) A relaparotomy is no longer necessary.
Here, the drawback is that right after the operation, washing cannot be performed and no continuous washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in critical condition. Periodic washing must be prepared carefully; it is performed in the operating room (the abdomen is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. The wash effect remains limited, since a desired intra-abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominal wall, part of the wash fluid oozes into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. Patients with an open abdomen belong, at that time, to the most care-intensive patients. If a so-called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and infolded, adaptation to the tension conditions of the abdominal wall is no longer possible. But, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out. On the other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. Further, the typical complications of snap closures must be taken into account (constriction, tenaculum). There is no particular edge structure to infold into the fascia, so that only the individual sutures provide support. They are often not secure and tear out easily.
Continuous peritoneal lavage with a closed abdomen offers the advantage that an effective washing treatment can be started immediately after the operation, and thus, the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning only right at the spot where it lays. Further, it easily becomes clogged and misleads to the assumption that the incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly with antibiotic added) also reaches the critical "atmospheric corners" of the abdomen. But not only are wash channels created, as when seepage through without pressure occurs. Fewer fibrin-induced adhesions are formed, since the abdomen contents "swim" and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis).
Peritoneal dialysis is possible. With it, an increase in the retention values (creatine, urea, potassium) with a threat of renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The patient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood volume. Washing can be taken over by a machine according to a desired program; thus, clear relief for the nursing personnel is possible. A chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. A judgment of the efflux can conceivably be performed simply by inspection (cloudiness, fibrin or blood admixtures). Wash fluid sensors to determine the resistance of bacteria can be removed by the catheter at any time, just as other substances can be administered (e.g., electrolytes, protein, heparin). The drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. Packing and infection source of the drainage passage points, as well as clogging or obstruction of the drainages represent typical complications. If the abdomen must be accessed again, a relaparotomy must be performed.
Despite promising starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate. | This invention relates to a surgical closure that can be repeatedly opened and closed, especially for the abdominal wall. More particularly the invention relates to a surgical closure having fabric of plate-like securing elements that can be tightly but detachably connected to the body tissue and has a closure which can be repeatedly opened and closed. Such a surgical closure is known, for example, from German Patent 34 44 782. This surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis. Peritonitis, as a secondary form that develops as a result of a perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem. The abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly by small openings in the peritoneal diaphragm underside. In this way, bacteria are fed by the lymph tracts to the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin-induced adhesions. The defense system is disrupted and a rise in bacterial counts, or their toxins and fibrin, results. If the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped. To cleanse the abdominal cavity, washing with physiological saline solution is already done during the operation until the wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed as completely as possible, to provide, along with surgical removal of septic focus, an optimal condition for healing. In the postoperative phase, in which the fate of the patient is mainly determined, it is decisive to recognize a worsening of the condition as early as possible, and optionally, to remove the cause (e.g., correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean (blood that reappears, fibrin and bacteria are to be rinsed away). In postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with a closed abdomen are known. This so-called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, with the advantages that repeated intra-abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. In doing so, postoperative, intra-abdominal adhesions can be detached and coatings of fibrin can be removed. The typical drainage complications are eliminated. (Plugging of drainage for the abdominal wall, blockage or obstruction of drainages, infection sources.) A relaparotomy is no longer necessary. Here, the drawback is that right after the operation, washing cannot be performed and no continuous washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in critical condition. Periodic washing must be prepared carefully; it is performed in the operating room (the abdomen is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. The wash effect remains limited, since a desired intra-abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominal wall, part of the wash fluid oozes into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. Patients with an open abdomen belong, at that time, to the most care-intensive patients. If a so-called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and infolded, adaptation to the tension conditions of the abdominal wall is no longer possible. But, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out. On the other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. Further, the typical complications of snap closures mustiness be taken into account (constriction, tenaculum). There is no particular edge structure to infold into the fascia, so that only the individual sutures provide support. They are often not secure and tear out easily. Continuous peritoneal lavage with a closed abdomen offers the advantage that an effective washing treatment can be started immediately after the operation, and thus, the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning only right at the spot where it lays. Further, it easily becomes clogged and misleads to the assumption that the incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly with antibiotic added) also reaches the critical "atmospheric corners" of the abdomen. But not only are wash channels created, as when seepage through without pressure occurs. Fewer fibrin-induced adhesions are formed, since the abdomen contents "swim" and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis). Peritoneal dialysis is possible. With it, an increase in the retention values (creatine, urea, potassium) with a threat of renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The patient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood volume. Washing can be taken over by a machine according to a desired program; thus, clear relief for the nursing personnel is possible. A chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. A judgment of the efflux can conceivably be performed simply by inspection (cloudiness, fibrin or blood admixtures). Wash fluid sensors to determine the resistance of bacteria can be removed by the catheter at any time, just as other substances can be administered (e.g., electrolytes, protein, heparin). The drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. Packing and infection source of the drainage passage points, as well as clogging or obstruction of the drainages represent typical complications. If the abdomen must be accessed again, a relaparotomy must be performed. Despite promising starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate. | This invention relates to a surgical closure that can be repeatedly opened and closed, especially for the abdominal wall. More particularly the invention relates to a surgical closure having fabric of plate - like securing elements that can be tightly but detachably connected to the body tissue and has a closure which can be repeatedly opened and vloseE. Such a surgical closure is known, for example, from German Patent 34 44 782. This surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis. Peritonitis, as a secondary form that develops as a result of a perforation of a hollow organ or as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem. The abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly by small openings in the peritoneal diaphragm underside. In this way, bacteria are fed by the lymph tracts to the systemic defense HeFhanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin - induced adhesions. The defense system is disrupted and a rise in bacterial counts, or their toxins and fibrin, results. If the progression of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after a certain point, can no longer be stopped. To cleanse the abdominal cavity, washing with physiological saline solution is already done during the operation until the wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (even hemoglobin promotes the start of an infection) are to be removed as completely as possible, to provide, along with surgical Demova: of septic focus, an optimal condition for healing. In the postoperative phase, in which the fate of the patient is mainly determined, it is decisive to recognize a worsening of the condition as early as possible, and optionally, to remove the cause (e. g. , correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if possible from the first postoperative day forward, to make sure conditions are clean (blood that reappears, fibrin and bacteria are to be rinsed away ). In postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment Dlth a closed abdomen are known. This so - called open abdomen is made possible by the sliding splint closure and by the snap closure as a temporary closure for the abdominal cavity, with the advantages that repeated intra - abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the success of the removal of septic focus, and thus, can control the course of peritonitis. In doing so, postoperative, intra - abdominal adhesions can be detached and coatings of fibrin can be removed. The typical drainage complications are eliminated. (Plugging of drainage for the abdominal wall, blockage or obstruction of drainages, infection sources.) A relaparotomy is no longer necessary. Here, the drawback is that right af^eg the operation, washing cannot be performed and no continuous washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient is in critical condition. Periodic washing must be prepared carefully; it is performed in the operating room (the abdomen is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. The wash effect remains limited, since a desired intra - abdominal pressure is not maintained, and the wash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominal wall, part of the wash fluid ooAeQ into the bed which, in addition to being another source of infection, means ineffective washing, additional burden for the patient, and considerable additional expense for the nursing staff. Patients with an open abdomen belong, at that time, to the most care - intensive patients. If a so - called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and infolded, adaptation to the tension conditions of the abdominal wall is no longer possible. But, because of edematous swelling of inner organs during the course of peritonitis, the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out. On the other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal wall later, during the healing phase in which the swelling of the inner organs decreases. Further, the typical complications of snap closures must be taken into account (constriction, tenaculum ). There is no particular edge structure to infold into the fascia, so that only the individual sutures provide support. They are often not secure and tear out easily. Continuous peritoneal lavage with a closed abdomen offers the advantage tNa% an effective washing treatment can be started immediately after the operation, and thus, the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning only right at the spot where it lays. Further, it easily becomes clogged and misleads to the assumption that the incision area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly with antibiotic added) also reaches the critical " atmospheric corners " of the abdomen. But not only are wash channels created, as when seepage through without pressure occurs. Fewer fibrin - induced adhesions are formed, since the abdomen contents " swim " and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis ). Peritoneal dialysis is possible. With it, an increase in the retention values (creatine, urea, potassium) with a threat of renso failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The patient can easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood volume. Washing can be taken over by a machine according to a desired program; thus, clear relief for the nuGCing personnel is possible. A chamber count of the leukocytes in the wash fluid makes it possible to monitor simply the response of the peritonitis. A judgment of the efflux can conceivably be performed simply by inspection (cloudiness, fibrin or blood admixtures ). Wash fluid sensors to determine the resistance of bacteria can be removed by the catheter at any time, just as other substances can be administered (e. g. , electrolytes, protein, heparin ). The drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which is important, when the efflux changes pathologically or the clinical condition of the patient worsens. Packing and infection source of the drainZgf passage points, as well as clogging or obstruction of the drainages represent typical complications. If the abdomen must be accessed again, a relaparotomy must be performed. Despite promising starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate. | relates to a surgical that can be repeatedly opened and closed, especially for the abdominal wall. More particularly the invention relates to a surgical having fabric plate-like securing elements that can be tightly but detachably connected to the body tissue and has which can be repeatedly opened and closed. Such surgical closure is for example, from German Patent 34 44 782. This surgical closure is used especially as a temporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis. Peritonitis, as a secondary form that develops as a result of a perforation of a hollow organ as a postoperative complication, still has, even today, a high lethality. With increasing incidence, it represents a central surgical problem. abdominal cavity is subject to a physiological, regulated fluid stream that drains mainly openings in the peritoneal underside. In this way, bacteria are fed by the lymph tracts to the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by mobility of the intraperitoneal pressure. peritonitis, this drainage is blocked by the pathophysiological development fibrin and bacteria and circulation is hindered by fibrin-induced adhesions. The defense is disrupted and a rise in bacterial or their toxins and results. If of peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, after certain point, can no longer be stopped. To cleanse the abdominal cavity, washing physiological saline solution already done during the operation until the wash fluid clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, and blood (even hemoglobin promotes start of an infection) are to be removed as completely as possible, to provide, along with surgical removal of septic focus, an optimal condition for healing. In the postoperative phase, in which the fate of the patient is mainly determined, it is decisive to recognize a of the condition as early as possible, and optionally, to remove the (e.g., correction of an inadequate after oversewing a gastric ulcer) and, by effective lavage, if from the first postoperative forward, to make sure conditions are clean (blood reappears, fibrin and bacteria are to be rinsed away). postoperative lavage, the strategy of the open abdomen with periodic washing and the wash treatment with closed abdomen are so-called open abdomen is made by the sliding splint closure and by the snap closure as a temporary for the abdominal cavity, with the advantages that repeated intra-abdominal accessibility is guaranteed and technician, during each be convinced of the success of the removal of septic focus, thus, control the course of peritonitis. In doing so, postoperative, intra-abdominal adhesions can detached and coatings of fibrin can be removed. The typical drainage complications are eliminated. (Plugging of for the wall, blockage obstruction of drainages, infection A relaparotomy is no longer necessary. Here, the drawback that right after the washing cannot be performed and no continuous is possible. then, periodic washing is relatively frequent and also a burden the patient, when the patient critical condition. Periodic washing must prepared carefully; it is performed in the operating room is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be without, since previous temporary abdominal cavity closures not the abdomen tightly. wash effect remains limited, since a desired intra-abdominal pressure not and the wash fluid flows, preferably, only in preformed wash channels. Further, after the temporary closure abdominal wall, part of the wash oozes into the bed which, in addition being another source of means ineffective washing, additional burden for the patient, considerable additional expense the staff. Patients with an open abdomen belong, at time, to most care-intensive patients. If a so-called snap closure or sliding splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and adaptation to the tension conditions of the wall is no longer But, because of edematous swelling of inner organs during the course peritonitis, the tension of the abdominal wall can considerably, with the danger that the sutures tear out. On the other hand, the edges of the incision must be brought together again gradually to the final suture of the abdominal wall during the healing phase in swelling of the inner organs decreases. the typical complications of snap closures must be taken into (constriction, tenaculum). There is no particular edge structure to infold into the fascia, so that only the individual provide support. They are often secure and tear out easily. Continuous peritoneal lavage with a closed abdomen offers the advantage that an effective washing treatment can be started immediately after the and thus, the purpose of the usual Redon suction drainage can be replaced considerably more effectively. The latter has a weak suction capacity, suctioning only right at the spot where it Further, it becomes and misleads to the assumption that the area has already been suctioned empty. With the sealed system, an intraperitoneal pressure can be built up and dosed. In doing so, the wash fluid (possibly with antibiotic added) also reaches the critical "atmospheric corners" the abdomen. But not only are wash channels created, as when seepage through pressure occurs. Fewer fibrin-induced adhesions are formed, since abdomen contents "swim" and fibrin (among other things) is effectively washed out (thus, simultaneous ileus prophylaxis). Peritoneal dialysis is possible. it, an increase in the retention values (creatine, urea, potassium) a threat of renal failure can conceivably be halted simply using a commercially available fluid as the wash fluid. The patient can easily be dialyzed, without having be put into the expensive program of hemodialysis. The associated drawbacks are also eliminated, as they can sometimes occur during the handling of blood Washing can be taken over by a machine according to a desired program; thus, for the nursing personnel is possible. A chamber count of the leukocytes in the wash fluid it possible to monitor simply the response the peritonitis. A of the efflux can conceivably be performed simply by inspection (cloudiness, fibrin or blood admixtures). Wash fluid sensors to determine the resistance of bacteria can be removed the catheter at any time, just as other substances can be administered (e.g., electrolytes, heparin). drawback here is that the abdomen is no longer accessible and thus no direct visual monitoring exists any more, which important, when the efflux changes pathologically or the clinical condition of the patient worsens. Packing and infection source the drainage passage points, as well as clogging obstruction of the drainages represent typical If the abdomen must be accessed a relaparotomy must be performed. Despite promising starts, the strategy the closed has not been able to be used in practice, since the predominate. | tHiS INVENTion RelaTEs TO a suRGICaL cLOsuRe THaT CaN BE REpeAtEDLy OPeneD AND CLoSEd, EspeCiALlY fOr the ABDOMinAl Wall. mORe PARticULaRlY tHe iNvENtion reLaTES TO a surgIcAl CLosURe haviNg fAbriC Of PLAtE-LIkE SECURiNG eleMeNtS ThAt can bE TiGHtLy bUT detacHAbLy COnneCTEd TO THE BoDY Tissue aNd Has A CloSUre whicH CaN be REPEaTEdLy OPened anD CLOsED.
such a surGiCal clOsurE is kNOwN, for eXamPle, FrOm gErMAN PatEnt 34 44 782. tHIs SurgICAl cLOsUre is USED EspEcIalLy As A TEMpORaRY closUrE fOr THe abdoMINAl CAvity, PrefErabLy fOR PoStOpeRATIve TrEaTMEnt oF PeriTOnItIs.
PERITONITis, as a SECoNdaRy fOrM ThAT dEvELOps As a REsult oF A pERForATIon Of A HOLLow OrGAN or As A posTopeRatIVe CoMPlIcatIon, sTILL hAs, eVen TODAy, a HigH letHALity. wITH INcREAsInG inciDencE, iT rEPreSEnTs A ceNTRaL SURGIcal pRObleM.
thE ABdomInaL cAVity IS sUBJeCT To A phySiolOgiCAL, ReGuLatED FLuiD sTrEAM that dRaIns maInly BY SMAlL opENIngS in tHE perItOnEaL diapHRAGM UNDErSIDe. iN thiS wAy, bacTErIA arE FED BY THE lYmpH TrACTS TO the sySTeMiC dEfenSE MeCHAniSM. ThE abSorpTion cApaCITY oF tHe iNtraPeRITonEAL flUiD is iNCreaseD By THE mOBIlITy OF the dIApHRaGM AnD inTRaPEritONeAL pResSurE. DUrIng pEriTonItis, thIs dRainAGE is BLoCKeD BY ThE PaThOPhYSioLogIcal DevElOPMENt of FibRiN aNd bActErIA aND circUlaTIOn is hInderED bY FIbRIn-iNduced adhEsiOns. thE deFeNSE sYStem IS DISruPtEd aND a rIsE In BActeRIal cOuNTS, OR TheIr tOXiNs aNd fiBRin, ResUlTs. if THe PROgREssion OF PeritonitiS Is nOT STOPped ProMPTLy, a PAtHophySIOlogIcAL CaSCADe GETS STArTeD wHosE DYNAmICS CoNStANTly GRoW anD, AFtEr A CERTain pOInT, caN no LONger be sTopPed.
tO cleAnse tHE ABdOMinaL cavItY, washINg witH PhysioLOGicAl SAlINE solUtIon IS AlreadY DoNe DURInG The oPErAtIOn UntIl thE wash FLUid StayS ClEaR. WItH thIs mechANICAL cleanSiNG, bactERiaL cOunTS, fiBrIn, dEAd tISSUE, toXInS ANd AlsO REsIduaL blOoD (EVEn HemOgloBIN pROmotes thE sTaRT OF An iNfecTION) ARe tO be rEmovEd AS cOmpleTelY as poSsiBle, To ProViDE, aLOng WITH surGiCAl REmoVal OF SepTIC fOCuS, AN OPtIMAL CONDitION FoR hEAlInG.
in ThE posToPErATIve phaSE, iN whiCh tHe FAte of The PAtIENt Is MAINLY DETerMIneD, iT Is DECIsIVe TO REcoGnize a WOrsEnIng of the CONdiTIon As EARlY as poSsIBLE, AND oPtioNAlLY, TO RemOve ThE caUSe (e.G., cORreCTIOn OF aN INadeQuAte SUture AFTER OveRSeWING A GAstric UlceR) AnD, By EfFectIve LAVaGe, If PossIBLE FRoM ThE FiRsT pOStOPeraTIve day fOrWaRD, tO mAKe sURE CoNDItiONS Are cleaN (blOoD thAT ReApPeARs, FIBRIN anD bAcTERiA aRE To be RiNSed away).
in pOStOpeRaTIve LAVAge, THe sTrATeGY oF The OpEn aBDOmEn wItH pErIODIC wAShING And the WAsH TReATmENT wITh A clOseD ABDomEn arE KnoWn.
thIS So-CaLlEd OpEN AbDOMEN is Made POSSibLE bY The sLiDIng SpliNT CLOSUre ANd BY tHE SnAp CLOsuRE As a tempOrARy cloSuRe FOR THe AbDoMiNal cavitY, wiTh THe advAntaGES ThAt rEpEATEd INTra-aBdOmInAl acceSsIBiLItY iS gUaraNTeeD anD THE TEChniCiAn, dURinG Each wAsHing, can BE ConVInceD Of thE SuCcesS OF the rEmOvAL of sEPTIC fOCUs, And Thus, caN coNTroL tHE COuRse OF pEritoNItis. In DoIng So, PoStOPerAtIve, intRA-abDOmInaL ADhesioNs CAn be DetAcHED anD CoaTINGs Of FIbriN cAn be remoVed. the TyPicAL dRAiNagE cOmpLiCAtiONs Are ELiMinatED. (PlUggiNg Of draInAge FoR tHe abDOmINal wAll, BlOCkaGe or oBStRUcTION of DrAiNages, INFECtion SOUrCes.) a relapaRotOmY iS nO LOnger neCessaRY.
HErE, THE DRawBAcK Is tHaT RiGhT aFtEr THE opeRAtiOn, wAshINg CaNnOT BE PERFOrmED anD NO ConTinuOus wAshinG IS poSSibLE. BUT tHEn, peRIodiC wasHIng iS RelAtively FrEQuent And ALSO a burDEN FOR tHE PATiEnt, when The pATiEnt IS in cRitIcal ConDiTion. pErIoDic waSHING muSt BE PRePARed carefULLY; it is perFoRMEd IN THe opERatINg rOOm (The ABDOmEn Is oPEN DUrIng WAShIng) aNd UNdeR GeNeRal anESTHesIA. THe advantAGEs OF thE PRInCiPLE OF pErItoNeaL DialYsIs mUst Be Done wiThout, sIncE PReViOus tEmPORARy aBDoMInAl CAVitY ClOsUREs Do noT cLose tHE AbDomEn tigHTly. ThE WAsh EffeCT rEmaiNs liMited, SINce A DeSired Intra-aBDOmiNAL pRESsuRE is NoT maINTAiNeD, aND tHE waSh FLUiD fLOwS, PreFERaBly, onlY In prEfOrMEd wash CHanNELs. FuRTheR, AFTEr THE tEMporaRy cLosUre Of the AbDOMInAL WAlL, part OF thE Wash Fluid OOZeS Into ThE BeD WHiCH, in addiTiON To BeinG aNoThER Source oF infecTiOn, mEaNS INeFFECtive wAsHiNG, AddItIOnAL bUrdeN fOr The PATIeNt, and COnSiDerAble adDiTIOnaL expenSE For THe NUrSinG sTaFf. PaTIenTs WitH AN open ABdOMEn BElONg, At ThaT TIMe, to THe MoST cArE-INtENsivE patIenTs. IF A so-calLeD sNaP CLosURe or sLIdING SPLInT cloSURe, AS a temPORaRy abdOmiNAl CavITY ClOsURE, IS iNFOLDed, anOTHeR dRAWBAcK CoMEs To bEaR. OncE CUT and INFoLded, aDapTATIon To THe tEnSiON cOnditIONS of tHE AbDomiNal WaLl IS nO lONger PosSiBLe. But, beCAUSe oF eDEmatouS SwelliNG of INNEr ORGaNS DUrinG tHE coUrsE of PerItonitIs, thE tEnsIon OF tHE ABdomINaL wALL Can iNcrEaSe ConSIDerABLY, WItH tHe dANGEr That THe suTuReS tEar oUt. oN the oThEr hANd, THe EDges Of the iNCIsiON MuSt be bRoUght tOgEtHer AgaIn gRadUAlLY TO tHe FiNAl SutURE OF THe AbdomINaL WaLL laTER, dURInG The HealinG PhaSe iN WhiCh ThE swELLinG oF THe iNNER ORgAns DEcReaSES. fURThEr, tHe tyPiCal ComplicAtiONS of Snap CLOSUREs mUst bE TaKeN InTO AccOunt (coNstrICtIOn, TeNAculUM). TheRe is nO partiCulAr EdgE sTRUCTure tO INFOld intO tHE fASCia, sO That ONlY ThE indiViduAl SUTuReS PROVIDe sUPporT. THey are oFteN Not sECUre AND tEaR oUT EAsily.
CONTINuoUS perItoNEAl laVaGE WItH A CLoSED abDOmEn oFFers THE advaNtAgE tHAt An EfFeCTIVE wAShiNG TrEAtMEnt cAn bE STArTed immeDiAtElY After the oPErAtIon, aND thus, ThE PUrpOSe of THe usUAL rEDOn SucTIon dRaINaGe Can be RePLACeD coNSiderablY MOre EffECTIVElY. The lATter HaS A WEAk SUcTiON cAPACiTY, sUCTiOnInG oNLy rIGht aT tHE SpoT Where It lAys. furTHER, iT eAsIly BECOmes cLOGGeD And MiSLeaDs to tHE asSuMPtion tHAT thE iNcisIoN ARea has AlreaDY beeN sUctiONeD EMpTY. WiTH tHE SEALed SYStEM, aN INTRAPerItONEAL preSsURe CAn be built uP AND dosEd. in dOiNG SO, tHe waSh FLUId (pOSsiBly WITH antIbIOtIc addED) ALso ReaChEs ThE CriTICAl "atMOSpHerIC CORNeRS" oF ThE aBDOmeN. But nOT oNlY ARe WASH ChAnnElS crEAtED, as WHeN sEePaGE THroUGh WiThouT PResSurE oCCurs. FEWER FiBrin-indUcEd aDHesiONs are fORmeD, sINce THe abdOMEn cONtENTs "swIM" ANd fiBRin (aMOng OThER Things) IS efFEctIVeLY wASHEd ouT (thuS, SiMultAneoUs iLEuS pROpHYlAXiS).
pErIToNEAL DialYsis is poSsIBlE. WITH It, An iNcrEasE In thE RETENTioN vALUES (CREaTine, UreA, PotASsiuM) With A tHREAT Of rEnaL fAiLurE can cOnCEivaBly bE HalteD sImpLy bY usInG A COmMerCiaLly AVaiLAbLe dIALySiS fluid AS ThE wash FlUId. tHe PAtieNt cAN eAsilY be dIAlyzeD, WItHOuT HAVINg tO bE pUt INto thE EXpeNSiVe prOgRam of HEmOdIAlySIs. tHe ASsoCIATeD drAwBACks are alsO ElIMinaTed, AS THeY Can someTIMEs OCCuR DURING ThE hAnDliNg OF BloOd VolUME. wAshInG cAN BE tAkEN oVeR by a MaCHine ACcoRDing To A DESiRed PRoGRAm; ThUs, cleAr rElIeF fOr ThE NUrsINg persONnel IS poSsIBlE. A ChAmBeR cOuNt OF the leukocyteS In THE waSH fLUid MakeS iT PoSSIBlE tO mONitor siMPlY thE RespONSe OF tHe PERiTonitiS. A JUDgmENT oF ThE efflUX CAn ConCEivAbLY be PErFormEd sImpLy bY inSPECTIOn (CLoudinESs, fibrIn oR BLoOD AdmixtuREs). wASH FlUiD SeNsoRs to DEteRMINe The rESisTANCe OF BAcTERiA Can be reMoveD By THE CATheTEr aT anY TIME, jUsT aS othER SuBSTANCES can Be AdMInISTERed (E.g., EleCtROlYtes, pROteiN, hEParIn). The draWbaCK Here IS thaT THe abDOmEN Is nO lONGEr ACCesSIBlE And THUs NO diRECT viSual MONItorInG exISTs anY MoRE, whICh iS ImPoRTanT, WHeN thE EFfLux ChaNGEs PaThOLOgicALly or the ClInIcaL ConditION oF THE PaTiEnt wORseNS. PACKinG AnD iNFEctIon SouRce oF the drainagE PASSagE PoInTS, as wElL As CLoGGing OR oBStRUctioN oF THe dRaINagES represeNT TYpicAl cOMpLIcatIoNS. IF ThE ABdoMeN MUst Be aCcesseD again, A RelAPARotOmy musT Be peRfORMEd.
DEspItE pRoMIsiNg STArtS, THE StrATegY of THE ClOseD aBDOmEn HAS Not Been aBlE tO be USed IN PRacTICE, sInCe ThE DrawbACKs PRedoMINATe. | This invention relates to a surgical closurethat can be repeatedly opened and closed, especially for the abdominal wall. More particularly theinvention relates toa surgical closure having fabric of plate-like securing elements that can be tightly butdetachably connectedto thebody tissue andhas a closure which can be repeatedly opened and closed. Such a surgical closure is known,for example,from GermanPatent 34 44 782. This surgical closure is used especially as atemporary closure for the abdominal cavity, preferably for postoperative treatment of peritonitis. Peritonitis, asa secondary form that develops as aresult of a perforation of a hollow organ or as a postoperative complication, still has, eventoday, a high lethality. With increasing incidence, it represents acentralsurgicalproblem. The abdominal cavity is subject to a physiological,regulated fluid stream that drains mainly by smallopenings in the peritoneal diaphragm underside. In this way, bacteria are fed by thelymph tractsto the systemic defense mechanism. The absorption capacity of the intraperitoneal fluid is increased by the mobility of the diaphragm and intraperitoneal pressure. During peritonitis, this drainage is blocked bythe pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin-inducedadhesions. The defensesystem is disruptedand a risein bacterial counts, or their toxins and fibrin, results.Ifthe progression of peritonitisis not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly growand, after a certain point,cannolonger be stopped. To cleanse the abdominal cavity, washing with physiological saline solution isalreadydone duringthe operation untilthe wash fluid stays clear. With this mechanical cleansing, bacterial counts, fibrin, dead tissue, toxins and also residual blood (evenhemoglobin promotes the start of an infection) are to beremoved as completely as possible, to provide, along with surgical removalof septic focus, an optimal conditionfor healing. In thepostoperative phase, in whichthe fate of the patient is mainly determined, it is decisive to recognize a worsening of thecondition asearly as possible, and optionally, to remove the cause (e.g., correction of an inadequate suture after oversewing a gastric ulcer) and, by effective lavage, if possible from the first postoperative day forward, to make sureconditions are clean (blood that reappears, fibrinand bacteria are to be rinsed away). In postoperativelavage, thestrategy of the open abdomen with periodic washingand the washtreatmentwith a closed abdomen are known. This so-called open abdomen is madepossible by the sliding splint closure andby the snap closure as a temporary closure fortheabdominal cavity, with theadvantages that repeated intra-abdominal accessibility is guaranteed andthe technician, during eachwashing, can be convinced of the success of the removal ofseptic focus, and thus, can control the course of peritonitis. In doing so, postoperative,intra-abdominal adhesions can be detached and coatings of fibrin can be removed. Thetypical drainage complications are eliminated. (Plugging of drainage for the abdominal wall, blockageor obstruction of drainages, infection sources.) A relaparotomy is no longer necessary. Here, the drawback is that right after the operation, washing cannot be performed and no continuous washing is possible. Butthen, periodic washing is relatively frequent and also a burden for the patient, when the patient is incriticalcondition. Periodic washingmust be preparedcarefully; it isperformed in the operating room (the abdomen is open during washing) and under general anesthesia. The advantages of the principle of peritoneal dialysis must be done without, since previous temporary abdominal cavity closures do not close the abdomen tightly. The washeffect remains limited, since a desired intra-abdominalpressure is not maintained, and the wash fluidflows, preferably, only in preformed wash channels. Further, after the temporary closure of the abdominalwall, part of thewash fluid oozes into the bed which, in addition tobeing another source of infection, means ineffective washing, additional burden forthe patient,and considerable additional expense for the nursing staff. Patients with an open abdomen belong, atthat time, to the mostcare-intensive patients. If a so-called snap closure or sliding splintclosure, as atemporary abdominal cavity closure, is infolded,another drawbackcomes to bear. Once cut andinfolded, adaptation to the tension conditionsof the abdominal wall isno longer possible.But,because of edematousswelling of inner organs during the course of peritonitis,the tension of the abdominal wall can increase considerably, with the danger that the sutures tear out.On the other hand,the edges of the incision must be broughttogetheragain gradually to the final suture of the abdominal wall later, during the healing phase in which the swellingof theinner organs decreases. Further, the typicalcomplicationsof snap closuresmust be taken into account (constriction, tenaculum). Thereis no particularedge structure to infold into the fascia,sothat only the individual suturesprovide support.They are often not secureand tear outeasily. Continuousperitoneal lavage with a closed abdomen offers the advantage thatan effective washing treatment can be started immediately after the operation, and thus, the purpose of theusual Redon suction drainage can be replaced considerably more effectively.The latter has a weak suction capacity, suctioning only right at the spot whereit lays. Further, it easily becomes clogged and misleads to the assumption that the incision area has alreadybeen suctioned empty.With the sealed system, an intraperitoneal pressure can be builtup and dosed. Indoing so, the washfluid (possibly withantibiotic added) also reaches the critical "atmosphericcorners" of the abdomen. But not only are wash channelscreated, as when seepage through without pressure occurs. Fewer fibrin-induced adhesions are formed,since the abdomen contents"swim" andfibrin(among other things) is effectively washed out (thus, simultaneousileusprophylaxis). Peritonealdialysis is possible. With it, an increasein the retention values (creatine,urea, potassium) with a threat of renal failure can conceivably be halted simply by using a commercially available dialysis fluid as the wash fluid. The patientcan easily be dialyzed, without having to be put into the expensive program of hemodialysis. The associated drawbacksare also eliminated, as they can sometimes occur during the handling of blood volume. Washing can be takenover by a machine according to a desired program; thus,clear relief for the nursing personnel is possible. A chamber count of the leukocytesin the washfluid makes it possible to monitor simply the response of the peritonitis. Ajudgmentof the effluxcanconceivably be performed simply byinspection (cloudiness, fibrin or blood admixtures). Washfluid sensors to determine the resistance of bacteria can beremoved by the catheter at anytime, just as other substances canbe administered (e.g.,electrolytes, protein, heparin). The drawback here is that the abdomen is no longer accessible and thus no direct visual monitoringexists any more, which is important,when theefflux changes pathologically or theclinical condition of the patientworsens. Packing and infection source of the drainage passage points, aswell asclogging or obstruction of the drainagesrepresent typical complications. If the abdomen must be accessed again, a relaparotomymust be performed. Despite promising starts, the strategy of the closed abdomenhas not been abletobe used in practice, since the drawbackspredominate. | _This_ invention relates to a surgical closure that can be repeatedly opened _and_ _closed,_ especially for the abdominal wall. _More_ particularly the invention relates to _a_ surgical _closure_ having _fabric_ of _plate-like_ securing elements that can _be_ tightly but detachably connected to the body tissue and _has_ a closure which can be repeatedly opened and closed. _Such_ a surgical _closure_ is _known,_ _for_ example, from German Patent 34 44 782. _This_ surgical closure _is_ used especially as a _temporary_ closure for the abdominal _cavity,_ preferably for postoperative _treatment_ of peritonitis. Peritonitis, as a secondary form _that_ _develops_ as _a_ result of _a_ _perforation_ of a hollow organ _or_ as a postoperative complication, still has, even today, a high lethality. _With_ _increasing_ incidence, it represents a central surgical _problem._ The abdominal cavity is _subject_ to _a_ physiological, regulated fluid stream that drains mainly by small openings in _the_ peritoneal diaphragm underside. In _this_ way, bacteria are _fed_ by the lymph tracts to the _systemic_ defense mechanism. The absorption capacity of _the_ intraperitoneal _fluid_ is increased _by_ _the_ mobility of the diaphragm and _intraperitoneal_ pressure. During peritonitis, this drainage is blocked by the pathophysiological development of fibrin and bacteria and circulation is hindered by fibrin-induced adhesions. The defense system is disrupted and a rise in bacterial counts, or _their_ toxins _and_ _fibrin,_ results. If the progression _of_ peritonitis is not stopped promptly, a pathophysiological cascade gets started whose dynamics constantly grow and, _after_ a certain point, can no longer be stopped. _To_ cleanse the abdominal cavity, washing _with_ physiological _saline_ solution is already done during the _operation_ until the wash fluid _stays_ clear. _With_ this mechanical _cleansing,_ bacterial counts, fibrin, dead tissue, _toxins_ and also residual blood (even hemoglobin promotes the start of an infection) are to be removed _as_ completely _as_ possible, to provide, along with _surgical_ removal _of_ septic _focus,_ _an_ optimal _condition_ for healing. In the postoperative _phase,_ in which the _fate_ of _the_ patient _is_ mainly determined, it is decisive _to_ recognize a worsening of the condition _as_ early as possible, and optionally, to remove the _cause_ (e.g., correction of an inadequate suture after oversewing a gastric ulcer) and, by effective _lavage,_ if possible from the first postoperative day forward, _to_ make _sure_ conditions are clean (blood that reappears, fibrin and bacteria are to be rinsed away). _In_ postoperative _lavage,_ the strategy of the open abdomen with _periodic_ washing and the wash treatment with a closed abdomen are known. This so-called open _abdomen_ is made possible _by_ the sliding _splint_ closure and by the _snap_ _closure_ _as_ _a_ temporary _closure_ for the abdominal _cavity,_ with the advantages that _repeated_ intra-abdominal accessibility is guaranteed and the technician, during each washing, can be convinced of the _success_ _of_ the _removal_ of septic focus, and thus, can control the course _of_ peritonitis. In doing so, _postoperative,_ intra-abdominal adhesions can be detached and coatings _of_ fibrin _can_ _be_ removed. The typical drainage complications are eliminated. (Plugging _of_ _drainage_ for _the_ _abdominal_ _wall,_ blockage or obstruction of drainages, _infection_ _sources.)_ A relaparotomy _is_ no longer _necessary._ Here, _the_ drawback _is_ that right after the operation, washing cannot be performed and no _continuous_ washing is possible. But then, periodic washing is relatively frequent and also a burden for the patient, when the patient _is_ in critical condition. Periodic _washing_ must _be_ prepared carefully; _it_ is performed in the operating room _(the_ abdomen is _open_ during washing) and under general anesthesia. The _advantages_ of the principle of peritoneal dialysis must _be_ done without, since _previous_ _temporary_ abdominal cavity closures _do_ not close _the_ abdomen tightly. The wash effect remains limited, _since_ a desired intra-abdominal pressure is not maintained, and the wash fluid flows, preferably, _only_ in preformed wash channels. Further, _after_ the temporary closure of the _abdominal_ wall, part of the wash fluid oozes into the bed _which,_ in addition _to_ _being_ another source _of_ infection, means _ineffective_ washing, additional _burden_ for the patient, and _considerable_ additional expense for the nursing staff. Patients with an open abdomen _belong,_ at that time, to the _most_ care-intensive _patients._ _If_ a _so-called_ snap closure or _sliding_ splint closure, as a temporary abdominal cavity closure, is infolded, another drawback comes to bear. Once cut and infolded, _adaptation_ to the tension _conditions_ of the abdominal _wall_ _is_ no longer _possible._ But, _because_ of edematous swelling of _inner_ organs during _the_ course of peritonitis, the tension _of_ _the_ abdominal wall can increase considerably, with _the_ danger that _the_ sutures _tear_ _out._ On the _other_ hand, _the_ edges of the incision must be brought together again gradually to _the_ final suture of _the_ abdominal _wall_ later, _during_ _the_ healing phase _in_ which the swelling of _the_ _inner_ organs decreases. _Further,_ _the_ typical complications _of_ snap closures must be taken into account (constriction, tenaculum). _There_ is no particular edge structure to _infold_ into the fascia, _so_ that only the individual sutures _provide_ support. They are often _not_ secure and tear out _easily._ Continuous peritoneal lavage with a closed _abdomen_ offers the advantage that an effective _washing_ _treatment_ can be started _immediately_ after _the_ operation, _and_ thus, the purpose _of_ the _usual_ _Redon_ suction drainage can be replaced _considerably_ _more_ effectively. The latter _has_ a _weak_ suction _capacity,_ suctioning only _right_ at _the_ spot where it lays. _Further,_ it easily becomes clogged _and_ misleads to _the_ _assumption_ that the incision area has _already_ been suctioned _empty._ With _the_ sealed _system,_ an intraperitoneal _pressure_ can be built _up_ and _dosed._ In doing _so,_ the _wash_ _fluid_ (possibly with _antibiotic_ added) _also_ _reaches_ the critical "atmospheric _corners"_ of the abdomen. But not only are _wash_ channels created, as when seepage through _without_ pressure _occurs._ Fewer _fibrin-induced_ adhesions are formed, since the abdomen contents "swim" and fibrin _(among_ other things) is _effectively_ washed out (thus, simultaneous ileus _prophylaxis)._ _Peritoneal_ dialysis _is_ possible. With it, an increase in the retention values (creatine, _urea,_ potassium) with a threat of renal failure _can_ conceivably be halted simply _by_ _using_ a commercially available _dialysis_ _fluid_ as the wash fluid. The patient can easily be dialyzed, _without_ having to _be_ _put_ _into_ the expensive program of hemodialysis. The associated drawbacks _are_ also eliminated, as they can sometimes occur during the handling of blood _volume._ Washing _can_ _be_ taken over by a machine according to a _desired_ program; thus, clear relief _for_ the nursing personnel is possible. A chamber count of the leukocytes in the wash fluid makes it _possible_ _to_ monitor simply the response of the peritonitis. A judgment of the efflux can conceivably _be_ _performed_ simply by inspection (cloudiness, fibrin or _blood_ admixtures). _Wash_ fluid sensors to determine the resistance of _bacteria_ can be _removed_ by the catheter at any time, just as other substances _can_ be administered (e.g., electrolytes, protein, heparin). The _drawback_ here is that the _abdomen_ _is_ no longer _accessible_ and thus no direct visual monitoring exists any _more,_ which is important, _when_ the _efflux_ changes pathologically or the clinical condition of the patient worsens. Packing and infection source of the drainage passage points, as _well_ as clogging or obstruction of the drainages _represent_ typical _complications._ If the abdomen _must_ _be_ accessed again, _a_ relaparotomy _must_ _be_ performed. Despite _promising_ starts, the strategy of the closed abdomen has not been able to be used in practice, since the drawbacks predominate. |
Handling huge volumes of data on a daily basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data for decades, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. Data sets today aren't merely larger than the older data sets, but also significantly more complex, for example, unstructured and semi-structured data generated by sensors, web logs, social media, mobile communication, and customer service records.
There are many software frameworks to store and analyze large volumes of data in a massively parallel scale. Apache Hadoop is an example and often cited in many journals, publications, blogs, and other technical articles for massively parallel processing system. It is now known to be the de-facto technology platform for supporting storage of massive amounts of heterogeneous data and processing them.
The Hadoop Distributed File System (HDFS) for data storage and its specialized distributed programming model ‘MapReduce’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights.
However, Hadoop as a technology has several limitations. First, organizations are interested in ‘interactive analytics’, a solution requiring faster time-to-insight when compared to the time it takes for a MapReduce job to execute and provide the required results. Second, the ability to enable analysts and data scientists to directly interact with any data stored in Hadoop, using their existing business intelligence (BI) tools and skills through a well-accepted SQL interface. Apache Hive, however, facilitates querying the data using an SQL-like language called HiveQL, but it is much slower than what the industry demands in terms of interactive querying.
There are several massively parallel query processing (MPQP) tools available in the market that enable organizations to perform interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is optimized to perform efficiently for a certain class of queries only, operating on a certain known data type and format on a well-defined hardware and software configuration. The data model and the storage model have to be optimized significantly in order to obtain faster query response times.
To add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for organizations to evaluate each of these tools for the different kinds of queries they have for processing, operating on varying data-sets, (for example, queries from marketing, analysts, engineers, and senior management). | Handling huge volumes of data on a daily basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data for decades, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. Data lot today aren't merely larger than the older data sets, but also significantly more complex, for example, unstructured and semi-structured data generated by sensors, web logs, social media, mobile communication, and customer service records. There are many software frameworks to store and analyze large volumes of data in a massively parallel scale. Apache Hadoop is an example and often cited in many journals, publications, blogs, and other technical articles for massively parallel processing system. It is now known to be the de-facto technology platform for supporting storage of massive amounts of heterogeneous data and processing them. The Hadoop Distributed File System (HDFS) for data storage and its specialized distributed programming model ‘MapReduce’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights. However, Hadoop as a technology has several limitations. First, organizations are interested in ‘interactive analytics’, a solution requiring faster time-to-insight when compared to the time it takes for a MapReduce job to execute and provide the required results. Second, the ability to enable analysts and data scientists to directly interact with any data stored in Hadoop, using their existing business intelligence (BI) tools and skills through a well-accepted SQL interface. Apache Hive, however, facilitates querying the data using an SQL-like language called HiveQL, but it is much slower than what the industry demands in terms of interactive querying. There are several massively parallel query processing (MPQP) tools available in the market that enable organizations to perform interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is optimized to perform efficiently for a certain class of queries only, operating on a certain known data type and format on a well-defined hardware and software configuration. The data model and the storage model have to be optimized significantly in order to obtain faster query response times. To add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for organizations to evaluate each of these tools for the different kinds of queries they have for processing, operating on varying data-sets, (for example, queries from marketing, analysts, engineers, and senior management). | Handling huge volumes of dztS on a daily basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data for decades, but now with the availability of new techniques for analyzing those huge data sets, organizations seek to improve their operational efficiency. Data sets today aren ' t merely larger than the older data sets, but Qlwo significantly m*Ge complex, for example, unstructured and semi - structured data generated by sensors, web logs, social media, mobile communication, and customer service records. There are many software frameworks to store and analyze large volumes of data in a massively parallel scale. Apache Hadoop is an example and oB6en cited in many journals, pkblicationX, blogs, and other technical articles for massively parallel processing system. It is now known to be the de - facto technology platform for supporting storage of massive amounts of h3terogeneoua data and processing them. The Hadoop Distributed File System (HDFS) for data s^orxge and its specialized distributed programming model ‘ MapReduce ’ for data processing, across relatively inexpensive commodity hardware, may be leveraged for mixing and matching data from many disparate sources and reveal meaningful insights. However, Hadoop as a technology has several limitations. First, organizations are interested in ‘ interactive analytics ’, a wol8tion requiring faster time - to - insight when compared to the time it takes for a MapReduce job to execute and provide the required results. Second, the ability to enable analysts and data scientists to directly interact with any data stored in Hadoop, using their existing business intelligence (BI) tools and skills through a well - accepted SQL interface. Apache Hive, however, facilitates querying the data using an SQL - like language called HiveQL, but it is much slower than what the industry demands in terms of interactive querying. There are several massively parallel query processing (MPQP) tools available in the market that enable organizations to perform interactive SQL - like querying on massive data - sets on the Hadoop platform, called SQL - on - Hadoop tools. However, each of these tools is optimized to perform efficiently for a certain class of queries only, operating on a certain known data type and format on a well - defined hardware and software configuration. The data model and the storage model have to be optimized significantly in order to obtain faster query response tumeX. To add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for organizations to evaluate each of these tools for the different kinds of queries Yheh have for processing, operating on varying data - sets, (for example, queries from marketing, analysts, engineers, and senior management ). | Handling huge volumes data on a basis is a task that most organizations have to deal with. Such organizations have been storing huge volumes of data for decades, but with the availability of new techniques for analyzing those data sets, organizations seek to improve their operational efficiency. Data sets today aren't larger than the older data sets, but also significantly more complex, for unstructured and data generated by sensors, web logs, social mobile communication, and customer service records. There are many software frameworks store and large volumes of data in a massively scale. Apache Hadoop is an example and often cited in many journals, publications, blogs, other technical articles massively processing system. It is known to be the de-facto technology platform for supporting of massive amounts heterogeneous data and processing them. The Distributed File System for data storage and specialized distributed programming model ‘MapReduce’ for data processing, across relatively inexpensive commodity may be leveraged for mixing and matching data from disparate sources and meaningful insights. However, Hadoop as a technology has several limitations. First, organizations are interested in ‘interactive analytics’, solution requiring faster time-to-insight when compared to the time it takes a MapReduce job to execute and provide the required results. Second, the ability to enable analysts and scientists to directly interact with any data stored in Hadoop, using their existing intelligence (BI) tools and skills through a well-accepted SQL interface. Apache Hive, however, facilitates the data using an SQL-like language called HiveQL, but it is much slower the industry demands in terms of interactive querying. There are several massively parallel query processing (MPQP) available in the market enable organizations to interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, of these tools is optimized to perform efficiently for a certain class of only, operating a certain known data and format on a well-defined hardware and software configuration. The data model and the have to be optimized significantly order to obtain faster query response times. To add to the problem, the technological landscape of massively parallel query processing frameworks is large and it becomes increasingly difficult for to evaluate each of these tools for the different kinds of they have for processing, operating on varying data-sets, (for example, queries from marketing, analysts, engineers, and senior management). | HanDLInG HuGE VoLuMeS oF dATa oN a DaILY BaSIS Is A tasK thAT mOSt orGaNizAtioNs hAVe tO dEaL wiTH. sUch orgANIzAtioNS haVe been sTOrIng hugE vOlUmEs oF Data For dEcAdEs, but noW wITh THe AvaiLaBiliTY Of nEw teChNiques fOR ANALyzInG tHoSe hUgE daTa setS, oRgANiZAtIOns SeeK To IMprOve THeIr OperaTioNAl effICIEncY. data SEts tODAy arEn't mERELY LaRgEr than tHe OLdeR DaTA SETs, bUt AlSO SignifICantlY mOre cOmpleX, For exAMPLe, UnSTRUcTurEd aND SEMI-StruCtureD dAta GEnerateD BY sENsOrS, WeB logs, SOcial medIA, MObIle CoMmuNIcAtiON, aNd cUstOmER seRvICE RecOrds.
tHere are MAnY SoftWAre FrAMeWORkS TO sTore aNd anALYZE large VoLUmEs OF dAtA iN A MAsSiveLY PArALLEL ScalE. ApAcHe HaDOOp Is aN eXAMPLe ANd OFTEn Cited in mANy joUrnALs, PUblIcATions, BLogs, aNd otHEr techniCAl arTIclES FoR MASsiVelY PArALlel PRocesSINg SYsTeM. It Is Now knOWn TO Be thE dE-factO TeChNoLOGy pLaTForM For SUpPorTing StOrAgE of massive aMOUNtS OF heTEROgenEous dAtA And prOceSSIng tHEM.
THE hADOOP DiStriBUTEd FiLe SysTEm (hDfs) fOR daTa STOrAGe ANd ITS SpecIaLized DIsTRibUTeD proGRAMMINg modEl ‘maPreduce’ fOR dAta pROcESsING, ACRoSS RElaTiveLy inexPENSive cOMMODitY hArDWare, MAy BE LEveRagEd for miXiNG anD mAtcHIng data frOM mANY DIsPARatE SouRcES anD reVEAl MEaNINGFUL InSIghts.
HowevEr, HaDOop AS a tECHnOLOgy has SeVERAl liMItAtiONS. firSt, ORGANizAtIons aRe inTErEstEd iN ‘InTEraCTIvE analYTIcS’, A solUTion rEQUIrIng FASTEr tiMe-TO-INsiGHT when coMparED TO THe TiME it TakES For A mApredUCe jOB tO eXeCutE AND pROViDE tHE rEqUiRed resuLts. sEcOnd, the aBiliTy To EnAbLE ANalySTS AnD DaTA scienTIsts tO direCTly iNtErAct WITH any Data sTorED in hADooP, UsInG THeIr eXiStiNG BuSinESs iNTeLLigeNce (Bi) tOOLs AnD sKIlls tHrOUgh a wELl-accEPtED SQl iNtERFacE. APAcHe hIve, hOWeVEr, fAcilItAtes quERyiNG THE datA UsiNG AN sQl-lIKE LAnguAge cAllEd HiVEqL, BuT iT IS muCh SloWER Than whaT thE INdUstrY DeMAnDS IN terMS OF INTERacTIve querYinG.
THERe ARe SEvEral maSSIVelY pAralLel queRy pROCessinG (MpQp) ToOlS aVaIlabLe IN The MarKet that EnAblE oRgANizaTiONs TO PERFORm iNTERACTIve Sql-like qUeRYInG ON mAsSIve daTa-SETS On tHe hadoop PlatfORM, caLled sqL-ON-hAdOoP tOOls. hOWeveR, EacH of These toOLs Is oPTIMizeD To PERFOrM EFFiCiENtLY FOR A cerTAiN claSs Of QuerIes ONly, oPERATiNg oN a CERtain KNowN DaTA TypE AnD FORmaT On a weLL-DEFIneD HARDwARe aNd sOftwAre ConFIGURaTIon. THe DatA moDEL anD ThE sTorAGE MOdel HAVe To be oPTimiZED siGnifIcANTly In OrDER To Obtain fasTeR QUErY REsPoNSE tIMES.
To Add TO tHe PrObLeM, THE TecHNOLOGIcAL laNdscApE OF massivElY ParALLel QuERY pRoCeSSINg FrAMEwoRkS Is LaRGE ANd it bEcomEs iNCReASInGly DiFFicUlt FoR oRGAniZAtIONS to EvAlUATe eAcH Of THESe TOOLs For the diffERenT kinDS of QuerIeS thEY Have foR pRocEssing, OpeRATing on VArYINg DaTa-sets, (FOR exampLE, QUERieS fROm maRkEtinG, aNAlYSts, eNGineErs, AnD seNiOR ManAgEmeNT). | Handling huge volumes ofdata on a daily basis isa task that most organizations have todeal with. Suchorganizations have been storing huge volumes of data for decades, but now withthe availability of new techniques for analyzing thosehuge datasets,organizations seek toimprove their operational efficiency. Data sets today aren't merely larger than the older data sets, but also significantly more complex,for example, unstructured and semi-structured data generated by sensors,web logs,social media, mobile communication,and customer service records. There aremany software frameworks to store and analyze large volumes ofdata in a massively parallel scale. Apache Hadoop is an example and often cited in many journals,publications, blogs, and othertechnical articles for massively parallel processing system. It is nowknown to be the de-facto technology platformfor supporting storage of massive amounts of heterogeneous data andprocessing them. The Hadoop Distributed File System (HDFS) for data storage andits specializeddistributed programming model ‘MapReduce’ for data processing, across relatively inexpensive commodity hardware,may beleveragedfor mixing and matching data from many disparate sources and reveal meaningful insights. However, Hadoopas a technology has several limitations. First, organizationsare interested in‘interactive analytics’, a solution requiring faster time-to-insight when compared to the time it takes for a MapReduce job to execute and provide the required results.Second, the ability to enable analysts and data scientists to directly interact with any data stored in Hadoop, using their existing business intelligence (BI) toolsand skills through a well-accepted SQL interface. Apache Hive, however, facilitates querying the data using an SQL-likelanguage called HiveQL, but it is much slower than what the industrydemands in terms ofinteractive querying. Thereare several massively parallel query processing (MPQP) tools available in the market that enable organizations toperform interactive SQL-like querying on massive data-sets on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is optimized to perform efficiently for a certain class of queries only, operating on a certain known data type and format on a well-defined hardwareand software configuration. The data model and the storage model have to be optimized significantly in orderto obtain faster query response times. To add to the problem, the technological landscape of massively parallel query processing frameworksis large and it becomesincreasingly difficult fororganizations to evaluateeach of these tools for thedifferent kinds of queries they havefor processing, operating onvarying data-sets, (for example, queries from marketing,analysts, engineers, and senior management). | Handling huge volumes _of_ data on a daily basis is a task that most organizations have to _deal_ with. _Such_ organizations have been _storing_ huge volumes of data for decades, but now with the availability _of_ new techniques _for_ analyzing those huge data sets, organizations seek to improve their operational _efficiency._ Data sets today aren't _merely_ larger than the older data sets, but also significantly _more_ complex, for example, unstructured and semi-structured data generated by _sensors,_ web logs, social media, _mobile_ communication, and customer service records. There are many software frameworks to _store_ and analyze large volumes _of_ data in a _massively_ _parallel_ scale. Apache _Hadoop_ is an example and often _cited_ in many journals, _publications,_ blogs, and other technical articles for _massively_ _parallel_ _processing_ system. It _is_ now known to be the de-facto technology platform _for_ supporting storage of massive amounts _of_ heterogeneous data and _processing_ _them._ _The_ Hadoop _Distributed_ _File_ System (HDFS) for _data_ storage and its specialized _distributed_ programming _model_ ‘MapReduce’ for _data_ processing, across _relatively_ inexpensive commodity hardware, may be leveraged for mixing and matching data from many _disparate_ _sources_ and reveal _meaningful_ insights. However, Hadoop as a technology has several _limitations._ First, organizations are interested in ‘interactive analytics’, a solution requiring faster time-to-insight when _compared_ _to_ the time it _takes_ for a MapReduce _job_ to execute and _provide_ the _required_ results. Second, the ability to _enable_ analysts _and_ data _scientists_ _to_ _directly_ interact with any data stored in Hadoop, _using_ their existing business intelligence _(BI)_ tools and skills through a well-accepted SQL interface. Apache _Hive,_ however, facilitates querying the _data_ using an _SQL-like_ language called HiveQL, but it is much slower than what the industry _demands_ in terms of _interactive_ querying. There are several _massively_ _parallel_ query processing _(MPQP)_ _tools_ available in the market that _enable_ organizations to perform _interactive_ SQL-like _querying_ on massive _data-sets_ on the Hadoop platform, called SQL-on-Hadoop tools. However, each of these tools is optimized to _perform_ efficiently for a certain _class_ of queries only, _operating_ _on_ a _certain_ _known_ data type and _format_ _on_ a _well-defined_ hardware and _software_ _configuration._ The _data_ model and the storage model have to be optimized significantly in order to obtain faster query response times. To _add_ to the problem, the _technological_ landscape of massively parallel query _processing_ frameworks is _large_ and _it_ becomes _increasingly_ difficult for organizations to evaluate _each_ of these tools for _the_ different kinds of queries they have for _processing,_ operating on varying _data-sets,_ (for _example,_ queries _from_ marketing, analysts, _engineers,_ and senior management). |
Media streams, such as video and audio streams, may be sent over a network to multiple receiving clients. In a unicast-based system, individual copies of the stream are sent separately over the network to each client. By contrast, in a multicast-based system, a single copy of the stream may be sent to a multicast address, and the multicast-enabled network enables replication of the stream to clients within the multicast group. In some cases, a client may record or store the stream for later playback. In some scenarios, media streams may be sent using transmission control protocol (TCP) for reliability, at a cost of higher latency. In other scenarios, media streams may be sent using user datagram protocol (UDP) with lower latency, at a cost of potentially increased errors or dropouts. | Media streams, such as video and audio streams, may be sent over a network to multiple receiving clients. In a unicast-based system, individual copies of the stream are sent separately over the network to each client. By contrast, in a multicast-based system, a single copy of the stream may be sent to a multicast address, and the multicast-enabled network enables replication of the pullulate to clients within the multicast group. In some cases, a client may record or store the stream for later playback. In some scenarios, media streams may be sent using transmission control protocol (TCP) for reliability, at a cost of higher latency. In other scenarios, media streams may be sent using user datagram protocol (UDP) with lower latency, at a cost of potentially increased errors or dropouts. | MwdUa streams, such as video and audio streams, may be sent over a network to multiple receiving clients. In a unicast - based syEfem, individual copies of the stream are sent separately over the network to each client. By contrast, in a multicast - based system, a single copy of the stream may be sent to a multicast address, and the multicast - enabled network enables replication of the stream to c>ienRs within the multicast group. In some cases, a client may record or store the stream for later playback. In some scenarios, media streams may be sent using transmission control protocl> (TCP) for reliability, at a Xkst of higher latency. In other scenarios, media streams may be sent using user dWtagrqm protocol (UDP) with lower lat$nch, at a cost of lotegtially increasFw errors or drkpPuts. | Media streams, such as video and audio streams, may be sent over a network multiple receiving clients. In a unicast-based system, individual copies of the stream are sent separately over the network to each client. By contrast, in a system, a copy of the stream may sent to a multicast address, and the multicast-enabled network enables replication of the stream to clients within the multicast group. In some cases, a client may record or store the for later playback. In some scenarios, media may be sent using transmission control protocol for reliability, a cost of higher In other scenarios, media streams may be sent user datagram protocol (UDP) lower latency, a cost of potentially increased errors dropouts. | MediA sTReAmS, SUCh as VIdeO ANd auDIo stReamS, MAY bE SENT oVER a NETwOrk tO MuLtIPlE reCeIvINg ClIenTs. in A uNIcaSt-BasEd SySTem, InDIVidUaL cOPIES OF THe STReam aRE sEnt sePAratelY OvER the NetWork to EACh ClIeNT. By cONTRAST, in a muLTICaST-baSEd sYSteM, A SInGLe coPy Of THe sTReaM mAY be sEnT TO a MultICast ADdRESs, AND tHE MUltICasT-enabLED NetwoRK ENabLES RePLiCAtiON Of The stREam To CliEnTS wiTHin THE mUlTiCASt GROuP. In soME CasES, a Client mAY RECOrD Or StoRe ThE STreAM foR lATEr PLayBacK. iN SoME SCenARIos, meDIA STreamS may bE SenT UsIng TraNsmiSsiOn CONTrol ProtOCol (tcp) FOR RELIABilItY, at a cOSt oF HigheR lAtEncy. in oTHeR sceNAriOS, meDIa sTREaMS MAy bE SeNT UsInG UsEr DAtAgRAm PROTOcOL (UDp) WItH lOWeR latENCY, aT A cosT OF poTENtIaLlY INCreAseD ERrOrs or dRoPoUTs. | Media streams, such as video and audio streams, maybe sent over a network to multiple receiving clients. Ina unicast-based system, individual copiesof the stream are sent separately over the network to each client. By contrast, in amulticast-based system, a single copy of the stream may be sent to a multicastaddress, and the multicast-enabled network enables replication of the stream to clients within the multicast group. In somecases, a client may record orstore the stream forlater playback. In some scenarios, media streams may besent using transmission control protocol (TCP) for reliability, at a cost of higher latency.Inother scenarios,media streams may be sent using user datagram protocol (UDP) with lower latency, at a cost of potentially increased errors ordropouts. | Media streams, such as video and audio streams, may _be_ sent over a network to _multiple_ receiving _clients._ In a unicast-based system, individual copies of the stream are sent separately over the network to _each_ client. By contrast, in a multicast-based _system,_ a single copy of the stream may be sent to _a_ multicast address, _and_ _the_ multicast-enabled network _enables_ replication of the _stream_ to clients within the multicast group. In some cases, a client may record or store the stream for _later_ _playback._ In some scenarios, _media_ streams may be sent _using_ _transmission_ control _protocol_ (TCP) for reliability, at _a_ cost of higher latency. _In_ other _scenarios,_ media streams may _be_ sent using user _datagram_ protocol (UDP) with lower latency, at a cost _of_ potentially increased errors or _dropouts._ |
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