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WO2008011774A1 - Multi-function adhesive negative-pressure drainage device - Google Patents

Multi-function adhesive negative-pressure drainage device Download PDF

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Publication number
WO2008011774A1
WO2008011774A1 PCT/CN2007/001055 CN2007001055W WO2008011774A1 WO 2008011774 A1 WO2008011774 A1 WO 2008011774A1 CN 2007001055 W CN2007001055 W CN 2007001055W WO 2008011774 A1 WO2008011774 A1 WO 2008011774A1
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WO
WIPO (PCT)
Prior art keywords
isolation cover
wound
cover body
branch pipe
negative pressure
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/CN2007/001055
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French (fr)
Chinese (zh)
Inventor
Shaoquan Chen
Weiqiang Zhang
Lie Wang
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Individual
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Individual
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Publication date
Application filed by Individual filed Critical Individual
Publication of WO2008011774A1 publication Critical patent/WO2008011774A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/90Negative pressure wound therapy devices, i.e. devices for applying suction to a wound to promote healing, e.g. including a vacuum dressing
    • A61M1/92Negative pressure wound therapy devices, i.e. devices for applying suction to a wound to promote healing, e.g. including a vacuum dressing with liquid supply means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/90Negative pressure wound therapy devices, i.e. devices for applying suction to a wound to promote healing, e.g. including a vacuum dressing
    • A61M1/96Suction control thereof
    • A61M1/964Suction control thereof having venting means on or near the dressing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/84Drainage tubes; Aspiration tips
    • A61M1/85Drainage tubes; Aspiration tips with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants

Definitions

  • the invention relates to a glue type multifunctional negative pressure drainer. Background technique
  • the object of the present invention is to provide a multi-functional negative pressure drainage device which can not only realize active drainage treatment of a patient's wound cavity, but also can quickly and effectively control the wound to achieve timely anti-inflammatory treatment, and is easy to operate. Safe and reliable.
  • the adhesive type multifunctional negative pressure drainage device of the invention comprises an isolation cover body for being buckled on the wound, wherein the isolation cover body is provided with a wound anti-inflammatory liquid supply branch pipe A and a waste liquid suctioning which can extend into the wound cavity
  • the bottom side of the isolation cover body is provided with a glue layer for contacting the surface of the human skin, wherein the upper side of the isolation cover body is provided with an operation port, and the operation port is provided with Seals.
  • the medical staff can open the seal first, and adjust the placement of the anti-inflammatory liquid supply branch pipe A and the waste liquid suction branch pipe B through the opening, and then seal the seal.
  • the invention not only has convenient use, good sealing performance, but also is safe and reliable.
  • Fig. 1 is a front elevational view showing a stick type multi-function negative pressure drafter according to a first embodiment of the present invention.
  • Fig. 2 is a front elevational view showing the isolator body of the stick-type multi-function negative pressure drafter according to the first embodiment of the present invention.
  • Fig. 3 is a schematic view showing the construction of a pipe of a pasting type multifunctional negative pressure drainer according to a first embodiment of the present invention.
  • Fig. 4 is a cross-sectional view showing a sticking type multi-function negative pressure flow diverter according to a first embodiment of the present invention.
  • Fig. 1 is a front elevational view showing a stick type multi-function negative pressure drafter according to a first embodiment of the present invention.
  • Fig. 2 is a front elevational view showing the isolator body of the stick-type multi-function negative pressure drafter according to the first embodiment of the present invention.
  • Fig. 3 is a schematic view showing the construction of a pipe of a
  • FIG. 5 is a view showing the operation state of the adhesive type multi-function negative pressure flow diverter according to the first embodiment of the present invention.
  • Fig. 6 is a view showing the working state of the adhesive type multi-function negative pressure flow diverter according to the second embodiment of the present invention.
  • the present invention includes an isolation cover 1 for fastening to a wound.
  • the isolation cover 1 is provided with a wound anti-inflammatory liquid supply branch A and a waste suction branch pipe which can be inserted into the wound cavity. B.
  • the anti-inflammatory liquid enters the wound cavity from the anti-inflammatory liquid supply branch pipe A, and the wound is cleaned, and then the waste liquid is sucked out from the waste liquid to the branch pipe B.
  • the bottom side of the isolation cover 1 is provided with a bonding layer 2 for contacting the surface of the human skin. After the isolation cover is bonded to the surface of the human skin through the adhesive layer, the isolation cover and the wound cavity form a closed space, and the outside air Isolation to prevent dust and bacteria from entering the interior of the wound cavity. At the same time, it is more important to effectively protect the normal skin tissue around the wound and control the flow of waste.
  • the upper side of the isolation cover body is provided with an operation port 7, and the operation port is provided with a sealing member 3.
  • the isolation cover body is further provided with a vent pipe C.
  • the outer end portion of the waste liquid suction branch pipe B is provided with an atmosphere bypass control valve 4.
  • the atmospheric bypass control valve 4 disposed on the outer end of the waste suction branch pipe B can be immediately opened, and the pressure inside and outside the drain can be quickly balanced. Reduce the pain of the patient.
  • the sealing member 3 is a sealing film adhered to the operation port, so that the drainage device and the wound cavity form a closed space to isolate the air.
  • the isolation cover body is provided with a positioning duct 6, and the wound anti-inflammatory liquid supply branch pipe A, the waste liquid suction branch pipe B and the vent pipe C are jointly inserted into the isolation cover body through the positioning pipe 6.
  • the wound anti-inflammatory liquid supply branch pipe A, the waste liquid suction branch pipe B and the vent pipe C are connected into a combined pipe body.
  • the isolation cover is provided with at least two sets of combined tubes, 12 and 13, respectively.
  • the embodiment of the invention has the characteristics of safety, hygiene, simple operation and remarkable curative effect, and obviously shortens the treatment period, greatly reduces the suffering of the patient, saves the medical expenses of the patient, reduces the workload of the medical staff, and has a large Promote application value.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • Otolaryngology (AREA)
  • External Artificial Organs (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

A multi-function adhesive negative-pressure drainage device comprises an isolation cover (1) which covres on a wound (8). The isolation cover (1) is provided with a sub-tube A for supplying antipyrotic to the wound and a sub-tube B for suctioning the waste fluid, both of which can be inserted into the wound lumen (10). An adhesive layer (2) for contacting with the skin surface of a human body is disposed on one side of the isolation cover (1). An operation opening (7) is provided in the upper side of the isolation cover (1), and a sealing element (3) is disposed on the operation opening (7).

Description

粘贴式多功能负压引流器 技术领域  Paste type multifunctional negative pressure drainer

本发明涉及一种粘贴式多功能负压引流器。 背景技术  The invention relates to a glue type multifunctional negative pressure drainer. Background technique

目前, 对于病患的创伤以及外科手术之后所遗留的伤口, 需要进行引流处理以及 局部消炎治疗, 常规的做法包括被动引流和主动引流, 对于炎症严重者, 局部加用消 炎液冲洗。 这些常规做法存在以下缺点: 一、 引流物、 冲洗管的胶布不够牢靠, 容易 脱落; 二、 引流物、 冲洗管的缝合定位虽牢固, 但缝线的牵扯、 切割对皮肤存在明显 的伤害; 三、仅依靠覆盖在创口上的纱布及胶布来隔离创腔与外部空气, 在长时间的 治疗过程中, 空气中的灰尘、 细菌容易侵入创腔内部, 从而加剧炎症; 四、 开放式的 被动或主动引流使创口周部的皮肤暴露、浸渍于引流液中, 导致损害; 五、填塞式被 动或主动引流使创腔难以闭合, 愈合缓慢。 因此, 需要进一步改进。 发明内容  At present, drainage treatment and local anti-inflammatory treatment are required for the trauma of the patient and the wound left after the surgery. Conventional methods include passive drainage and active drainage. For patients with severe inflammation, local disinfection with an anti-inflammatory solution is applied. These conventional practices have the following disadvantages: 1. The tape of the drainage material and the irrigation tube is not strong enough to be easily detached; 2. The suture and the irrigation tube are firmly positioned, but the suture and cutting of the suture have obvious damage to the skin; Only rely on gauze and tape covering the wound to isolate the wound cavity and the outside air. During long-term treatment, dust and bacteria in the air easily invade the inside of the wound cavity, thereby accelerating inflammation. 4. Open passive or Active drainage causes the skin around the wound to be exposed and immersed in the drainage fluid, causing damage. 5. The passive or active drainage of the wound makes the wound cavity difficult to close and heal slowly. Therefore, further improvements are needed. Summary of the invention

本发明的目的是要提供一种粘贴式多功能负压引流器,它不仅能够实现对患者的 创腔进行主动引流处理, 同时可迅速有效的控制创面达到及时消炎治疗的作用,而且 操作简便, 安全可靠。 本发明的粘贴式多功能负压引流器,包括用以扣置于创口上的隔离罩体, 所述的 隔离罩体上设置有可伸入创腔的创口消炎供液支管 A和废液吸出支管 B, 所述的隔离 罩体底侧面设置有用于与人体皮肤表面相接触的胶接层, 其特征在于:所述的隔离罩 体的上侧面设置有操作口, 所述的操作口上设有密封件。  The object of the present invention is to provide a multi-functional negative pressure drainage device which can not only realize active drainage treatment of a patient's wound cavity, but also can quickly and effectively control the wound to achieve timely anti-inflammatory treatment, and is easy to operate. Safe and reliable. The adhesive type multifunctional negative pressure drainage device of the invention comprises an isolation cover body for being buckled on the wound, wherein the isolation cover body is provided with a wound anti-inflammatory liquid supply branch pipe A and a waste liquid suctioning which can extend into the wound cavity The bottom side of the isolation cover body is provided with a glue layer for contacting the surface of the human skin, wherein the upper side of the isolation cover body is provided with an operation port, and the operation port is provided with Seals.

工作时, 医务人员可先打开密封件,通过开口对消炎供液支管 A和废液吸出支管 B进行操作调节安放后, 再封上密封件。  During work, the medical staff can open the seal first, and adjust the placement of the anti-inflammatory liquid supply branch pipe A and the waste liquid suction branch pipe B through the opening, and then seal the seal.

本发明不仅使用方便, 密封性好, 而且安全可靠。 附图说明  The invention not only has convenient use, good sealing performance, but also is safe and reliable. DRAWINGS

下面结合附图和实施例对本发明进一步说明。  The invention will now be further described with reference to the drawings and embodiments.

图 1是本发明的实施例一的粘贴式多功能负压引流器的主视图。 图 2是本发明的实施例一的粘贴式多功能负压引流器的隔离罩体的主视图。 图 3是本发明的实施例一的粘贴式多功能负压引流器的管路构造示意图。 图 4是本发明的实施例一的粘贴式多功能负压引流器的剖视图。 图 5是本发明的实施例一的粘贴式多功能负压引流器的工作状态示意图。 图 6是本发明的实施例二的粘贴式多功能负压引流器的工作状态示意图。 BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a front elevational view showing a stick type multi-function negative pressure drafter according to a first embodiment of the present invention. Fig. 2 is a front elevational view showing the isolator body of the stick-type multi-function negative pressure drafter according to the first embodiment of the present invention. Fig. 3 is a schematic view showing the construction of a pipe of a pasting type multifunctional negative pressure drainer according to a first embodiment of the present invention. Fig. 4 is a cross-sectional view showing a sticking type multi-function negative pressure flow diverter according to a first embodiment of the present invention. Fig. 5 is a view showing the operation state of the adhesive type multi-function negative pressure flow diverter according to the first embodiment of the present invention. Fig. 6 is a view showing the working state of the adhesive type multi-function negative pressure flow diverter according to the second embodiment of the present invention.

图中 1.隔离罩体, 2. 胶接层, 3.密封胶片, 4. 大气旁通控制簡, 5.阀门, 6.定 位导管, 7.操作口, 8.创腔位置口, 9.皮肤, 10.创腔, 11.肉体, 12.—套组合管体, 13.另一套组合管体。 具体实施方式 请参考附图所示, 本发明包括用以扣置于创口上的隔离罩体 1, 隔离罩体 1上设 置有可伸入创腔的创口消炎供液支管 A和废液吸出支管 B。消炎液从消炎供液支管 A 进入创腔,对伤口进行清洗,然后废液从废液吸出支管 B排出。隔离罩体 1底侧面设 置有用于与人体皮肤表面相接触的胶接层 2, 当隔离罩体通过胶接层与人体皮肤表面 粘合之后, 隔离罩体与创腔构成封闭空间, 与外部空气隔离, 以防止空气中的灰尘、 细菌侵入创腔内部。 同时更主要的是起到有效保护创面周围正常皮肤组织,控制废液 的到处流散。为了便于医务人员的操作观察和创面定位, 所述的隔离罩体的上侧面设 置有操作口 7, 所述的操作口上设有密封件 3。  Figure 1. Isolation cover, 2. Bonding layer, 3. Sealing film, 4. Atmospheric bypass control, 5. Valve, 6. Positioning catheter, 7. Operating port, 8. Infector position, 9. Skin, 10. wound cavity, 11. flesh, 12. - set of combined tube, 13. another set of combined tube. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT Referring to the drawings, the present invention includes an isolation cover 1 for fastening to a wound. The isolation cover 1 is provided with a wound anti-inflammatory liquid supply branch A and a waste suction branch pipe which can be inserted into the wound cavity. B. The anti-inflammatory liquid enters the wound cavity from the anti-inflammatory liquid supply branch pipe A, and the wound is cleaned, and then the waste liquid is sucked out from the waste liquid to the branch pipe B. The bottom side of the isolation cover 1 is provided with a bonding layer 2 for contacting the surface of the human skin. After the isolation cover is bonded to the surface of the human skin through the adhesive layer, the isolation cover and the wound cavity form a closed space, and the outside air Isolation to prevent dust and bacteria from entering the interior of the wound cavity. At the same time, it is more important to effectively protect the normal skin tissue around the wound and control the flow of waste. In order to facilitate the operation observation and wound positioning of the medical staff, the upper side of the isolation cover body is provided with an operation port 7, and the operation port is provided with a sealing member 3.

为了有利于平衡气压, 所述的隔离罩体上还设有通气管 C。 为了避免由于负压过 大,且通气管 C也无法起到平衡引流器内外气压的情况发生,所述的废液吸出支管 B的 外端部上设置有大气旁通控制阀 4。 当引流器内的负压过大, 对创口产生很大压迫感 时, 可立即打开设置于废液吸出支管 B的外端部上的大气旁通控制阀 4, 能迅速平衡引 流器内外气压, 减少病患的痛楚。 所述的密封件 3为粘贴于操作口上的密封胶片, 使 得引流器和创腔形成一个密闭空间, 以隔绝空气。 为了有利于安装定位, 所述的隔离罩体上设置有定位导管 6, 所述的创口消炎供 液支管 A、 废液吸出支管 B和通气管 C共同经过定位导管 6伸入隔离罩体内。 为了有利于实际操作, 所述的创口消炎供液支管 A、 废液吸出支管 B和通气管 C 连接成组合管体。  In order to facilitate the balance of the air pressure, the isolation cover body is further provided with a vent pipe C. In order to avoid the occurrence of a situation in which the vent pipe C is not able to balance the pressure inside and outside the damper due to excessive negative pressure, the outer end portion of the waste liquid suction branch pipe B is provided with an atmosphere bypass control valve 4. When the negative pressure in the drain is too large and a large pressure is generated on the wound, the atmospheric bypass control valve 4 disposed on the outer end of the waste suction branch pipe B can be immediately opened, and the pressure inside and outside the drain can be quickly balanced. Reduce the pain of the patient. The sealing member 3 is a sealing film adhered to the operation port, so that the drainage device and the wound cavity form a closed space to isolate the air. In order to facilitate the installation and positioning, the isolation cover body is provided with a positioning duct 6, and the wound anti-inflammatory liquid supply branch pipe A, the waste liquid suction branch pipe B and the vent pipe C are jointly inserted into the isolation cover body through the positioning pipe 6. In order to facilitate the actual operation, the wound anti-inflammatory liquid supply branch pipe A, the waste liquid suction branch pipe B and the vent pipe C are connected into a combined pipe body.

为了有利于对同一创口下的多处地方进行引流处理治疗,所述的隔离罩体上设置 有至少两套的组合管体, 分别为 12和 13。  In order to facilitate the drainage treatment of a plurality of places under the same wound, the isolation cover is provided with at least two sets of combined tubes, 12 and 13, respectively.

本发明实施例具有安全卫生、操作简便、疗效显著等特点,明显缩短了治疗周期, 极大地减轻了病患的痛苦, 节省了患者的医疗费用, 减少了医护人员的工作量, 具有 较大的推广应用价值。  The embodiment of the invention has the characteristics of safety, hygiene, simple operation and remarkable curative effect, and obviously shortens the treatment period, greatly reduces the suffering of the patient, saves the medical expenses of the patient, reduces the workload of the medical staff, and has a large Promote application value.

Claims

权利要求书 Claim 1.一种粘贴式多功能负压引流器,包括用以扣置于创口上的隔离罩体,所述 的隔离罩体上设置有可伸入创腔的创口消炎供液支管 A和废液吸出支管 B,所述 的隔离罩体底侧面设置有用于与人体皮肤表面相接触的胶接层,其特征在于:所 述的隔离罩体的上侧面设置有操作口, 所述的操作口上设有密封件。  A sticking type multifunctional negative pressure drainer comprising an isolation cover body fastened to a wound, wherein the isolation cover body is provided with a wound anti-inflammatory liquid supply branch pipe A and a waste liquid which can extend into the wound cavity Absorbing the branch pipe B, the bottom side of the isolation cover body is provided with a glue layer for contacting the skin surface of the human body, wherein the upper side of the isolation cover body is provided with an operation port, and the operation port is provided There are seals. 2.根据权利要求 1所述的粘贴式多功能负压引流器,其特征在于:所述的隔 离罩体上还设有通气管 C, 所述的废液吸出支管 B的外端部上设置有大气旁通控 制阀, 所述的密封件为粘贴于操作口上的密封胶片。 2 . The adhesive multi-function negative pressure drainage device according to claim 1 , wherein the isolation cover body further comprises a vent pipe C, and the waste liquid suction branch pipe B is disposed on an outer end portion. There is an atmosphere bypass control valve, and the sealing member is a sealing film attached to the operation port. 3.根据权利要求 1或 2所述的粘贴式多功能负压引流器,其特征在于:所述 的隔离罩体上设置有定位导管, 所述的创口消炎供液支管 A、废液吸出支管 B和 通气管 C共同经过定位导管伸入隔离罩体内。  The adhesive multi-function negative pressure drainage device according to claim 1 or 2, wherein the isolation cover body is provided with a positioning catheter, the wound anti-inflammatory liquid supply branch pipe A, and the waste liquid suction pipe branch. B and vent tube C together extend through the positioning catheter into the isolation enclosure. 4.根据权利要求 1或 2所述的粘贴式多功能负压引流器,其特征在于:所述 的创口消炎供液支管 A、 废液吸出支管 B和通气管 C连接成组合管体。 The adhesive type multi-function negative pressure drainage device according to claim 1 or 2, wherein the wound anti-inflammatory liquid supply branch pipe A, the waste liquid suction branch pipe B and the vent pipe C are connected into a combined pipe body. 5.根据权利要求 4所述的粘贴式多功能负压引流器,其特征在于:所述的隔 离罩体上设置有至少两套的组合管体。  The adhesive multi-functional negative pressure drainage device according to claim 4, wherein the isolation cover body is provided with at least two sets of combined tubular bodies.
PCT/CN2007/001055 2006-07-20 2007-03-30 Multi-function adhesive negative-pressure drainage device Ceased WO2008011774A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN200610045569.5 2006-07-20
CNB2006100455695A CN100484579C (en) 2006-07-20 2006-07-20 Adhered multifunctional negative pressure drainage device

Publications (1)

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WO2008011774A1 true WO2008011774A1 (en) 2008-01-31

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WO (1) WO2008011774A1 (en)

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WO2013034374A1 (en) * 2011-09-08 2013-03-14 Paul Hartmann Ag Connection device for use in negative pressure wound therapy
US9033942B2 (en) 2008-03-07 2015-05-19 Smith & Nephew, Inc. Wound dressing port and associated wound dressing
US9050398B2 (en) 2010-12-22 2015-06-09 Smith & Nephew, Inc. Apparatuses and methods for negative pressure wound therapy
US9227000B2 (en) 2006-09-28 2016-01-05 Smith & Nephew, Inc. Portable wound therapy system
US9327065B2 (en) 2009-12-22 2016-05-03 Smith & Nephew, Inc. Apparatuses and methods for negative pressure wound therapy
USD804014S1 (en) 2010-12-22 2017-11-28 Smith & Nephew, Inc. Suction adapter
US10406036B2 (en) 2009-06-18 2019-09-10 Smith & Nephew, Inc. Apparatus for vacuum bridging and/or exudate collection
USRE48117E1 (en) 2010-05-07 2020-07-28 Smith & Nephew, Inc. Apparatuses and methods for negative pressure wound therapy
US11819386B2 (en) 2018-07-12 2023-11-21 T.J.Smith And Nephew, Limited Apparatuses and methods for negative pressure wound therapy
CN117462321A (en) * 2023-11-17 2024-01-30 吉林大学 An intestinal fluid return device with anti-infection function
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US12016993B2 (en) 2020-01-15 2024-06-25 T.J.Smith And Nephew, Limited Fluidic connectors for negative pressure wound therapy
US12533459B2 (en) 2020-01-15 2026-01-27 T.J.Smith And Nephew, Limited Fluidic connectors for negative pressure wound therapy
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