Swelling associated with trauma or certain pathologies (e.g. lymphedema) may cause various medical complications. For example, swelling can cause discomfort and pain, may limit range of motion, or otherwise negatively impact patient quality of life. Swelling may also limit the ability of a medical provider to medically image, view, access underlying tissue, or may otherwise interfere in the treatment of a patient, and thus may pose an impediment to the healing and recovery of the patient. In certain circumstances, swelling may lead to even more severe consequences, such as, e.g., atrophy of surrounding muscle tissue.
It would be advantageous to provide a durable, reusable treatment system that could be easily applied to a tissue site and which could be washed (or otherwise sterilized) between uses, and which could reliably and repeatedly be operated to provide decompression therapy to increase blood perfusion and lymphatic flow at a tissue site to reduce swelling.
According to one implementation of the present disclosure, an apparatus for applying a lifting force to a tissue site of a patient includes an occlusive layer, a decompression layer, and a connector. The occlusive layer is configured to be sealed to a patient around the tissue site to define a substantially air-tight chamber. The decompression layer is disposed within the chamber defined by the occlusive layer at a location proximate the tissue site. The decompression layer includes a compressible fabric defining one or more channels therethrough. The connector is provided along the occlusive layer and is configured to fluidly couple the chamber to a vacuum source. Upon operation of the vacuum source, the decompression layer is configured to compress in a direction away from the tissue site.
According to some embodiments, the occlusive layer extends at least 360° around an extremity (or other anatomical structure) defining the tissue site upon being sealed to a patient, and the decompression layer compresses in a radially outwards direction during operation of the vacuum source. In other embodiments, the occlusive layer extends less than 360° around an extremity (or other anatomical structure) defining the tissue site upon being sealed to a patient, and the decompression layer compresses in a upwards direction during operation of the vacuum source.
In some embodiments, the decompression layer is formed from a macro-mesh material (e.g., a macro-mesh fabric). The macro-mesh material optionally includes an upper layer, a lower layer, and a plurality of filaments extending between and connecting the upper layer and the lower layer. The filaments are optionally flexible, such that a distance between the upper layer and the lower layer prior to operation of the vacuum source is greater than a distance between the upper layer and the lower layer during operation of the vacuum source
In various embodiments, the upper layer extends substantially continuously relative to the lower layer. The upper layer has at least one of a higher stiffness and a higher density than the lower layer.
The macro-mesh material further optionally includes a first intermediate layer disposed between the upper layer and the lower layer. The first intermediate layer has at least one of a higher stiffness and a higher density than the lower layer. In some embodiments the first intermediate layer is formed from the same material as the upper layer. A plurality of filaments extend between the first intermediate layer and at least one of the lower layer and the upper layer.
The macro-mesh material further optionally includes a second intermediate layer disposed between the upper layer and the first intermediate layer. The second intermediate layer has at least one of a lower stiffness and a lower density than the first intermediate layer.
In other embodiments, the macro-mesh material further optionally includes a second intermediate layer disposed between the lower layer and the first intermediate layer. The second intermediate layer has at least one of a lower stiffness and a lower density than the first intermediate layer. In various embodiments, the second intermediate layer is formed from the same material as the lower layer.
A center of mass of the decompression layer may be located at a height along the decompression layer that is closer to the upper surface of the decompression layer than to the lower surface of the decompression layer.
An optional interface layer is located below the lower surface of the decompression layer. The interface layer contacts the skin surrounding the tissue site upon sealing of the occlusive layer to the patient. The interface layer may comprise a non-woven breathable fabric. The interface layer may be a discrete structure provided separately from the decompression layer. The interface layer is optionally selectively releasably attached to at least one of the decompression layer and the occlusive layer. In some embodiments, the interface layer is attached to the decompression layer along a lower surface thereof.
In some embodiments, the occlusive layer and decompression layer are attached to one another to define an annular structure comprising at least a first open end. The annular structure is sized for attachment to one of a knee, ankle, leg, arm or hand of a patient. In some embodiments, the annular structure optionally defines a sleeve-like structure that further comprises a second open end.
According to one implementation of the present disclosure, an apparatus for increasing at least one of blood perfusion and lymphatic flow at a tissue site includes a circumferentially extending occlusive layer, a decompression layer, and a connector. The occlusive layer is configured to be sealed to a patient around the tissue site to define a substantially air-tight chamber. The decompression layer has a lower surface configured to be disposed proximate a tissue site within the chamber defined by the occlusive layer. The connector is configured to fluidly couple the chamber to a vacuum source. Upon operation of the vacuum source, the decompression layer is configured to compress in a direction away from the tissue site.
The occlusive layer optionally includes one of a boot-like or hand-like configuration. A shape and size of the decompression layer may be similar to the occlusive layer configuration. Alternatively, a size of the decompression layer is smaller than a size of the occlusive layer, such that the decompression layer is concentric relative to the occlusive layer. In some embodiments, the occlusive layer includes at least one of a zipper and a gusset.
In some embodiments, the decompression layer includes a first mesh layer vertically offset from a second mesh layer by a flexible layer. The first mesh layer is positioned opposite the occlusive layer and the second mesh layer is positioned opposite the tissue site. The second mesh layer may move radially outwards towards the first mesh layer during operation of the vacuum source. The first mesh layer may having a higher density than the second mesh layer.
According to one implementation of the present disclosure, a method for providing decompression therapy includes attaching a dressing proximate intact skin extending over a treatment site. The dressing includes an occlusive layer configured to define a substantially air-tight chamber between the skin of the patient and a lower surface of the occlusive layer, and a compressible decompression layer including a plurality of fluid channels extending therethrough. An air displacement device fluidly coupled to the chamber is operated to evacuate air from the chamber. The evacuation of air from the chamber causes the decompression layer to compress in a direction away from the tissue site. The compression of the decompression layer in a direction away from the tissue site is configured to pull the intact skin in a direction outward relative to the treatment site.
The decompression layer optionally includes a first mesh layer facing the occlusive layer and a second mesh layer facing the treatment site. The second layer is configured to move relative to the first layer in a direction opposite the treatment site upon the evacuation of air from the chamber. In some embodiments, first layer has at least one of a greater density and a greater stiffness than the second layer.
An optional interface layer may be attached proximate the intact skin extending over the treatment site. In some embodiments, the occlusive layer and decompression layer are attached to the skin of the patient after attaching the interface layer to the patient. The occlusive layer may be attached to the patient after attaching the decompression layer to the patient.
The treatment site is optionally a location corresponding to at least one of a broken bone in a limb, a sprained tissue and a strained tissue. The evacuation of air from the chamber reduces swelling at the treatment site from a first degree of swelling to a second degree of swelling. In some embodiments, the treatment site undergoes surgical treatment following the reduction of swelling at the treatment site from the first degree of swelling to a degree of swelling that is equal to, or less than, the second degree of swelling. The reduction of swelling from the first degree of swelling to the second degree of swelling occurs from 3 to 7 days following an initial operation of the air displacement device to evacuate air from the chamber.
Before turning to the figures, which illustrate certain exemplary embodiments in detail, it should be understood that the present disclosure is not limited to the details or methodology set forth in the description or illustrated in the figures. It should also be understood that the terminology used herein is for the purpose of description only and should not be regarded as limiting.
Referring generally to the FIGURES, a decompression therapy treatment system for applying a vacuum to intact skin extending over, or surrounding, different types of treatment tissue sites (such as, e.g., bone tissue, adipose tissue, muscle tissue, neural tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendons, ligaments, etc.) is described according to various embodiments. The application of vacuum to intact skin provided by the treatment system imparts a pulling (e.g., lifting) force to the intact skin, which decompresses the treatment tissue site and thereby increases the perfusion of blood and other fluids (e.g. lymphatic flow) at the treatment tissue site.
The decompression of the treatment tissue site resulting from the operation of the treatment system may advantageously be used to reduce swelling at a tissue site. The treatment system is configured for use in both medical and non-medical settings, and may be used to treat swelling occurring as a result of a variety of different conditions. For example, the treatment system may be used in a home setting by a patient to treat swelling resulting from an injury, over-exertion, an underlying medical condition (e.g., lymphedema), etc.
In yet other embodiments, the treatment system may also be used in a medical setting, such as, e.g., to reduce swelling during pre- and/or post-operative care of a patient. For example, reducing swelling at a treatment site (e.g., caused by a broken bone, edema, tissue sprain, tissue strain, etc.) prior to surgery may advantageously facilitate access to underlying tissue at a target surgical site, reduce surgery time and/or improve the outcome of surgical treatment. Use of a treatment system according to any of the embodiments described herein prior to surgical treatment may advantageously decrease the time needed to reduce swelling at the target surgical site to an acceptable degree of swelling as compared to the time that would be required to reduce swelling using conventional methods of treating swelling. For example, use of the treatment system may reduce swelling to an acceptable degree within 3 to 7 days of initiation of treatment using the treatment system.
In addition to the use of the treatment system to reduce swelling, the decompression therapy provided by the treatment system may advantageously also be used in the treatment of a variety of other medical conditions or ailments. As one non-limiting example, the treatment system may be used for the acute treatment of pain and/or inflammation (occurring, e.g., as a result of a sprain or other stress at a tissue site). In yet other situations, the treatment system may be used to increase blood perfusion and/or lymphatic flow at a treatment tissue site to minimize the effects of over-exertion (e.g., following athletic training or other intense activity).
Referring to
As illustrated by the treatment system 10 embodiment of
In addition to the use of the treatment system 10 as a standalone decompression therapy device, in various embodiments the treatment system 10 may be used in conjunction with (and may optionally be integrated into) one or more additional treatment systems. For example, although the treatment system 10 has been described as being used to impart a pulling force onto intact skin surrounding a treatment tissue site, in some embodiments, the treatment system 10 may be used to impart a pulling force onto a wound. In some such embodiments, the treatment system 10 is optionally applied atop (or integrated into) a wound dressing of a negative pressure wound therapy system (“NPWT” system). In yet other embodiments, the treatment system 10 may be used with a variety of other treatment systems, such as, e.g., a heat treatment system, systems configured to treat fractured bones, etc.
Dressing
Referring to
During operation of the treatment system 10, the evacuation of air from the treatment chamber occurring upon initiation of the air displacement device 200 causes the occlusive layer 110 and decompression layer 120 to be drawn towards the intact skin surrounding the treatment tissue site. Once the vacuum applied by the air displacement device 200 has removed most of the air from the treatment chamber, the continued application of negative pressure to the treatment chamber causes the compressible decompression layer 120 to collapse (e.g., compress) in on itself. This sustained application of negative pressure to the treatment chamber and collapse of the decompression layer 120 causes the intact skin at the treatment tissue site to be pulled outwardly (such as shown by the arrows of
A. Occlusive Layer
The occlusive layer 110 is configured to be sealed to the skin of a patient to envelop (e.g., surround, extend over, cover, etc.) the treatment tissue site. In some embodiments, such as, e.g., where the occlusive layer 110 is defined by a sleeve-like, boot-like, or other annular structure and/or by a sheet-like or tape-like structure configured to be wrapped about an anatomical structure, the occlusive layer 110 extends by approximately 360° (i.e. circumscribes) or more than 360° (i.e. the occlusive layer 110 wraps around upon itself) about a limb, extremity or other anatomical structure of the patient. In other embodiments (such as, e.g., during treatment of a knee, shoulder, elbow, etc.) the occlusive layer 110 is optionally defined by a sheet-like structure that extends less than 360° (e.g., less than 180°) around an anatomical structure of the patient.
Upon operation of the air displacement device 200, the sealed attachment between the occlusive layer 110 and the skin of the patient forms a sealed decompression treatment chamber via which negative pressure is transmitted to the treatment tissue site. An opening 111 is optionally defined through the occlusive layer 110, via which the treatment chamber is fluidly coupled to the air displacement device 200 of the treatment system 10. Alternatively, the treatment chamber is fluidly coupled to the vacuum source via a connector interposed between the skin of the patient and a lower surface of the occlusive layer 110.
The occlusive layer 110 may be formed from a variety of materials that are capable of maintaining a desired vacuum within the treatment chamber during use of the treatment system 10. The occlusive layer 110 is optionally formed from a material having a high MVTR, to allow moisture (e.g. perspiration) to be evaporated from the treatment tissue site during use of the treatment system 10. The material selected for the occlusive layer 110 is advantageously also sufficiently strong and resilient to allow the occlusive layer 110 to withstand extended periods of use of the treatment system 10. In embodiments in which the occlusive layer 110 is reusable, the material forming the occlusive layer 110 is optionally also sufficiently durable to allow the occlusive layer 110 to be cleaned (e.g. washed) between uses.
As shown in
Non-limiting examples of materials that may be used for the occlusive layer 110 include: polyurethane film (e.g., ESTANE 5714F), other polymer films such as, but not limited to poly alkoxyalkyl acrylates and methacrylates (e.g., such as those described in Great Britain Patent Application No. 1280631A filed Nov. 22, 2002, the entire disclosure of which is incorporated by reference herein), laminated fabrics (e.g., polyurethane laminated fabric, expanded polytetrafluoroethylene laminated fabric, etc.), polymer-coated fabrics, fabrics made from various synthetic fibers, etc.
B. Decompression Layer
The decompression layer 120 (e.g., manifolding layer, macro-mesh layer, compressible layer, collapsible layer, etc.) is configured to impart a pulling, or lifting, force onto the skin at the treatment tissue site. The decompression layer 120 is formed from a material including (or defining) a plurality of flow channels (e.g. pathways, passageways, pores, etc.) therethrough. The flow channels of the decompression layer 120 allow for a sustained transmission (e.g., manifolding) of negative pressure to the treatment tissue site during operation of the treatment system 10. Some or all of the flow channels are optionally interconnected to improve the distribution of fluids (e.g. air) provided to or removed from the treatment tissue site. The decompression layer 120 is formed from a compressible material having a stiffness sufficient to provide airflow through the flow channels at negative pressures up to at least approximately 150 mmHg.
Referring to
The direction (i.e. outward/inwards; upwards/downwards; away from/towards the tissue site; in a radial direction; in a vertical direction, etc.) in which the decompression layer 120 collapses (e.g., compresses) varies depending on the construction of the decompression layer 120. The collapse of a decompression layer 120 comprising a single layer, and formed from a material having a uniform density, in response to a vacuum is representatively illustrated in
The collapse of a decompression layer 120 comprising an outer portion (i.e. a portion of the decompression layer 120 adjacent the outwardly-facing surface 125 that faces away from the tissue site) formed from a stiff material and an inner portion (i.e. a portion of the decompression layer 120 adjacent the tissue-facing surface 127) formed from a softer material in response to a vacuum is representatively illustrated in
Given the impact of the parallel plate effect on lymphatic flow and blood perfusion at a tissue site, the decompression layer 120 is advantageously constructed such that the center of stiffness of the decompression layer 120 is located closer to the outwardly-facing surface 125 than the tissue-facing surface 127 of the decompression layer 120). The decompression layer 120 is also advantageously constructed from a material that is sufficiently flexible to allow the decompression layer 120 to be secured to a patient and to allow for a range of motion of the body part to which the dressing 100 is attached during use of the treatment system 10.
The decompression layer 120 is advantageously also formed having sufficient structural integrity and resilience to withstand repeated applications of negative pressure thereto over the course of operation of the treatment system 10 (e.g., for periods of up to, or greater than, one week). To facilitate the reuse of the treatment system 10 with the same, or other, patients, the decompression layer 120 is additionally optionally constructed having a durability that allows the decompression layer 120 to be washed in-between uses.
Referring to
The upper layer 121 and lower layer 123 defining the macro-mesh material forming the decompression layer 120 may be defined by a variety of different materials. To provide the decompression layer 120 with a desired degree of resilience and durability, one or both of the upper layer 121 and the lower layer 123 are formed from a textile material. The textile may be defined by a variety of different woven or non-woven patterns, weights, densities, fibers, stiffnesses, etc., depending on the desired properties of the decompression layer 120. According to various embodiments, one or both of the upper layer 121 and the lower layer 123 are formed from a polymer or nylon material (e.g., a polymer or nylon mesh).
To provide the decompression layer 120 with the desired offset center of stiffness (i.e., a center of stiffness that is located closer to the outwardly-facing surface 125 of the decompression layer 120), the upper layer 121 is formed from a different material, has a different construction, or otherwise varies from the lower layer 123. For example, the upper layer 121 is formed from a material having a greater stiffness than the material used for the lower layer 123. The materials selected for the upper layer 121 and/or lower layer 123 may optionally include a coating (e.g., an anti-microbial coating, a hydrophobic coating, etc.), to provide the decompression layer 120 with additional desired features.
The intermediate layer 122 may be formed from a variety of different materials. As shown in
The effects of varying various properties of the dual-layered decompression layer 120 arrangement of
In general, a decompression layer 120 comprising a macro-mesh configuration such as, e.g., representatively illustrated by the embodiment of
For example, as shown in the table of
As illustrated by a comparison of the performance of the decompression layer 120 examples of
As illustrated by the table of
As illustrated by
As a result of the interrupted upper layer 121 configuration of the decompression layer 120 embodiment of
The degree of pulling force imparted onto the skin by the decompression layer 120 may be further augmented by constructing the decompression layer 120 to maximize the distance of the center of stiffness from the tissue-facing surface 127 of the decompression layer 120. As described with reference to
As representatively illustrated by the embodiments of
C. Interface Layer
An optional interface layer 130 (i.e. skin contact layer) is disposed adjacent the skin of the patient upon the attachment of the dressing 100 to the patient. The interface layer 130 may be incorporated into the dressing 100 for a variety of reasons, and may be defined by a variety of different features. For example, the interface layer 130 may be configured to: decrease discomfort and irritation during use of the treatment system 10; provide cooling; wick liquid away from the skin; function as an antimicrobial barrier; create friction between the decompression layer 120 and the skin to enhance the lifting force imparted onto the skin by the decompression layer 120, etc.
The materials forming the interface layer 130 may be selected based on the desired features of the interface layer 130. In general, the optional interface layer 130 is constructed from a light-weight, thin material that does not impede flow between the skin and the decompression layer 120, and which does not irritate the skin. As shown in
The interface layer 130 may be integrated into the dressing 100 according to a variety of arrangements. In some embodiments the interface layer 130 is provided entirely separate and detached from the decompression layer 120. In some such embodiments, the interface layer 130 may be provided as a sock or sleeve that is slid onto and around a treatment tissue site (e.g., a leg or arm of the patient). Once positioned in the desired location, the decompression layer 120 and occlusive layer 110 components of the dressing 100 are attached to the patient. Such a decoupled arrangement may advantageously allow a user to verify that the interface layer 130 lies taut and smoothly along the skin prior to attaching the remaining components of the dressing 100, thus minimizing the risk of pinching resulting from wrinkling along the interface layer 130 during use of the treatment system 10.
Alternatively, the interface layer 130 is partially, or entirely, attached along the tissue-facing surface 127 of the decompression layer 120, such as, e.g., illustrated by the embodiment of
D. Seal Member
A seal member of the dressing 100 is used to provide a sealing (e.g., fluid-tight) attachment between the occlusive layer 110 and an underlying surface (e.g., skin, a section of the occlusive layer 110 that has been wrapped around the patient, an optional interface layer 130, etc.) that enables a vacuum to be created and maintained within the treatment chamber surrounding the tissue treatment site. Advantageously, the seal member is structured to be sufficiently robust to continuously, or intermittently, maintain a desired negative pressure within the treatment chamber over the duration of use of the treatment system 10. The seal member is advantageously self-adhering and is able to provide a fluid-tight attachment to a variety of different surfaces, including, e.g., skin, the optionally included interface layer 130, the decompression layer 120, the occlusive layer 110, etc. In embodiments in which the seal member is reusable, the seal member is advantageously sterilizeable. Alternatively, the seal member may be replaceable (e.g., removable), such that a new seal member may be used with each subsequent use of the treatment system 10.
The seal member may be defined by a variety of, and combination of, various sealing structures. As shown in
In various embodiments, the sealing attachment provided by the seal member may be reinforced and/or concealed by a hook-and-pile fastener, cohesive bandage, cast protector, or other structure that is positioned atop the dressing 100 following the attachment of the dressing 100 to a patient.
Dressing Configurations
The size, shape and configuration of the dressing 100 may vary depending on a variety of factors, including, e.g., the treatment tissue site being treated, the patient being treated, the duration of the treatment being provided, etc. Additional features of the dressing 100 that may be varied depending on the desired use of the treatment system 10 include, e.g., the degree of tailoring of the dressing 100 to a particular treatment site, the extent to which the dressing 100 is attached to a patient, the incorporation of features facilitating the attachment of the dressing 100 to a patient, the degree of integration of the components of the dressing 100, etc.
As illustrated in
In some embodiments, the annular dressing 100 is defined by a sleeve-like structure having a generally tubular shape that extends between a first open end and a second open end. In other embodiments the sleeve-like annular dressing 100 extends between a first open end and a second open end, and is shaped, sized and contoured for attachment around a specific extremity of a patient. For example, referring to
In embodiments in which the dressing 100 is defined by an annularly extending structure having one open end or two open ends, and which is configured to encircle or otherwise circumscribe a portion of the patient, the dressing 100 may be formed from materials that allow the dressing 100 to stretch during application of the dressing 100 around a patient. Alternatively, or additionally, the dressing 100 optionally includes one or more features configured to facilitate the application of the dressing 100 around the patient. For example, as illustrated in
As an alternative to (or in addition to) constricting the dressing 100 from materials that provide for a degree of stretch and/or the inclusion of a slit such as representatively illustrated in
According to other embodiments, the dressing 100 may alternatively be defined by a flexible, sheet-like structure. The sheet-like dressing 100 may be provided in a range of shapes and sizes. As representatively illustrated by the embodiment of
As illustrated in
According to yet other embodiments, the dressing 100 may be provided as a flexible tape that can be wound around a treatment tissue site, or which may be attached as one or more strips atop a treatment tissue site. Such a tape-like dressing 100 arrangement may provide a user with the ability to customize the attachment of the treatment system 10 to a variety of different treatment sites and to a variety of different patients. In some embodiments, an adhesive is optionally provided along an outer periphery of the tape-like structure to facilitate the attachment of the dressing 100 to the patient. In such embodiments, the application of the tape-like structure such that adjacent segments of the tape (e.g. adjacent winding or adjacent strips) overlap may allow the dressing 100 to be attached to a patient without requiring any additional sealing of the dressing 100 to the patient. Alternatively, an additional sealing layer (such as, e.g., the occlusive layer 110) may be attached to a patient to surround the tape-like dressing 100 that has been applied to the patient.
The various to dressing 100 configurations and features described above may apply to all of, or only some of, the components of the dressing 100. For example, as representatively illustrated by the embodiment of
As utilized herein, the terms “approximately,” “about,” “substantially”, and similar terms are intended to have a broad meaning in harmony with the common and accepted usage by those of ordinary skill in the art to which the subject matter of this disclosure pertains. It should be understood by those of skill in the art who review this disclosure that these terms are intended to allow a description of certain features described and claimed without restricting the scope of these features to the precise numerical ranges provided. Accordingly, these terms should be interpreted as indicating that insubstantial or inconsequential modifications or alterations of the subject matter described and claimed are considered to be within the scope of the disclosure as recited in the appended claims.
It should be noted that the term “exemplary” and variations thereof, as used herein to describe various embodiments, are intended to indicate that such embodiments are possible examples, representations, or illustrations of possible embodiments (and such terms are not intended to connote that such embodiments are necessarily extraordinary or superlative examples).
The term “coupled” and variations thereof, as used herein, means the joining of two members directly or indirectly to one another. Such joining may be stationary (e.g., permanent or fixed) or moveable (e.g., removable or releasable). Such joining may be achieved with the two members coupled directly to each other, with the two members coupled to each other using a separate intervening member and any additional intermediate members coupled with one another, or with the two members coupled to each other using an intervening member that is integrally formed as a single unitary body with one of the two members. If “coupled” or variations thereof are modified by an additional term (e.g., directly coupled), the generic definition of “coupled” provided above is modified by the plain language meaning of the additional term (e.g., “directly coupled” means the joining of two members without any separate intervening member), resulting in a narrower definition than the generic definition of “coupled” provided above. Such coupling may be mechanical, electrical, or fluidic.
The term “or,” as used herein, is used in its inclusive sense (and not in its exclusive sense) so that when used to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Conjunctive language such as the phrase “at least one of X, Y, and Z,” unless specifically stated otherwise, is understood to convey that an element may be either X, Y, Z; X and Y; X and Z; Y and Z; or X, Y, and Z (i.e., any combination of X, Y, and Z). Thus, such conjunctive language is not generally intended to imply that certain embodiments require at least one of X, at least one of Y, and at least one of Z to each be present, unless otherwise indicated.
References herein to the positions of elements (e.g., “top,” “bottom,” “above,” “below”) are merely used to describe the orientation of various elements in the FIGURES. It should be noted that the orientation of various elements may differ according to other exemplary embodiments, and that such variations are intended to be encompassed by the present disclosure.
This application claims the benefit of priority to the U.S. Provisional Application No. 62/929,215, filed on Nov. 1, 2019, the complete disclosure of which is hereby incorporated herein by reference in its entirety.
| Number | Name | Date | Kind |
|---|---|---|---|
| 1355846 | Rannells | Oct 1920 | A |
| 2547758 | Keeling | Apr 1951 | A |
| 2632443 | Lesher | Mar 1953 | A |
| 2682873 | Evans et al. | Jul 1954 | A |
| 2910763 | Lauterbach | Nov 1959 | A |
| 2969057 | Simmons | Jan 1961 | A |
| 3066672 | Crosby, Jr. et al. | Dec 1962 | A |
| 3367332 | Groves | Feb 1968 | A |
| 3520300 | Flower, Jr. | Jul 1970 | A |
| 3568675 | Harvey | Mar 1971 | A |
| 3648692 | Wheeler | Mar 1972 | A |
| 3682180 | McFarlane | Aug 1972 | A |
| 3826254 | Mellor | Jul 1974 | A |
| 4001953 | Fugere et al. | Jan 1977 | A |
| 4080970 | Miller | Mar 1978 | A |
| 4096853 | Weigand | Jun 1978 | A |
| 4139004 | Gonzalez, Jr. | Feb 1979 | A |
| 4165748 | Johnson | Aug 1979 | A |
| 4184510 | Murry et al. | Jan 1980 | A |
| 4233969 | Lock et al. | Nov 1980 | A |
| 4245630 | Lloyd et al. | Jan 1981 | A |
| 4256109 | Nichols | Mar 1981 | A |
| 4261363 | Russo | Apr 1981 | A |
| 4275721 | Olson | Jun 1981 | A |
| 4284079 | Adair | Aug 1981 | A |
| 4297995 | Golub | Nov 1981 | A |
| 4333468 | Geist | Jun 1982 | A |
| 4373519 | Errede et al. | Feb 1983 | A |
| 4382441 | Svedman | May 1983 | A |
| 4392853 | Muto | Jul 1983 | A |
| 4392858 | George et al. | Jul 1983 | A |
| 4419097 | Rowland | Dec 1983 | A |
| 4465485 | Kashmer et al. | Aug 1984 | A |
| 4475909 | Eisenberg | Oct 1984 | A |
| 4480638 | Schmid | Nov 1984 | A |
| 4525166 | Leclerc | Jun 1985 | A |
| 4525374 | Vaillancourt | Jun 1985 | A |
| 4540412 | Van Overloop | Sep 1985 | A |
| 4543100 | Brodsky | Sep 1985 | A |
| 4548202 | Duncan | Oct 1985 | A |
| 4551139 | Plaas et al. | Nov 1985 | A |
| 4569348 | Hasslinger | Feb 1986 | A |
| 4605399 | Weston et al. | Aug 1986 | A |
| 4608041 | Nielsen | Aug 1986 | A |
| 4640688 | Hauser | Feb 1987 | A |
| 4655754 | Richmond et al. | Apr 1987 | A |
| 4664662 | Webster | May 1987 | A |
| 4710165 | McNeil et al. | Dec 1987 | A |
| 4733659 | Edenbaum et al. | Mar 1988 | A |
| 4743232 | Kruger | May 1988 | A |
| 4758220 | Sundblom et al. | Jul 1988 | A |
| 4787888 | Fox | Nov 1988 | A |
| 4826494 | Richmond et al. | May 1989 | A |
| 4838883 | Matsuura | Jun 1989 | A |
| 4840187 | Brazier | Jun 1989 | A |
| 4863449 | Therriault et al. | Sep 1989 | A |
| 4872450 | Austad | Oct 1989 | A |
| 4878901 | Sachse | Nov 1989 | A |
| 4897081 | Poirier et al. | Jan 1990 | A |
| 4906233 | Moriuchi et al. | Mar 1990 | A |
| 4906240 | Reed et al. | Mar 1990 | A |
| 4919654 | Kalt | Apr 1990 | A |
| 4941882 | Ward et al. | Jul 1990 | A |
| 4953565 | Tachibana et al. | Sep 1990 | A |
| 4969880 | Zamierowski | Nov 1990 | A |
| 4985019 | Michelson | Jan 1991 | A |
| 5037397 | Kalt et al. | Aug 1991 | A |
| 5086170 | Luheshi et al. | Feb 1992 | A |
| 5092858 | Benson et al. | Mar 1992 | A |
| 5100396 | Zamierowski | Mar 1992 | A |
| 5134994 | Say | Aug 1992 | A |
| 5149331 | Ferdman et al. | Sep 1992 | A |
| 5167613 | Karami et al. | Dec 1992 | A |
| 5176663 | Svedman et al. | Jan 1993 | A |
| 5215522 | Page et al. | Jun 1993 | A |
| 5232453 | Plass et al. | Aug 1993 | A |
| 5261893 | Zamierowski | Nov 1993 | A |
| 5278100 | Doan et al. | Jan 1994 | A |
| 5279550 | Habib et al. | Jan 1994 | A |
| 5298015 | Komatsuzaki et al. | Mar 1994 | A |
| 5342376 | Ruff | Aug 1994 | A |
| 5344415 | DeBusk et al. | Sep 1994 | A |
| 5358494 | Svedman | Oct 1994 | A |
| 5437622 | Carion | Aug 1995 | A |
| 5437651 | Todd et al. | Aug 1995 | A |
| 5527293 | Zamierowski | Jun 1996 | A |
| 5549584 | Gross | Aug 1996 | A |
| 5556375 | Ewall | Sep 1996 | A |
| 5607388 | Ewall | Mar 1997 | A |
| 5625896 | LaBarbera et al. | May 1997 | A |
| 5636643 | Argenta et al. | Jun 1997 | A |
| 5645081 | Argenta et al. | Jul 1997 | A |
| 5910125 | Cummings | Jun 1999 | A |
| 6056713 | Hayashi | May 2000 | A |
| 6071267 | Zamierowski | Jun 2000 | A |
| 6135116 | Vogel et al. | Oct 2000 | A |
| 6241747 | Ruff | Jun 2001 | B1 |
| 6287316 | Agarwal et al. | Sep 2001 | B1 |
| 6345623 | Heaton et al. | Feb 2002 | B1 |
| 6488643 | Tumey et al. | Dec 2002 | B1 |
| 6493568 | Bell et al. | Dec 2002 | B1 |
| 6553998 | Heaton et al. | Apr 2003 | B2 |
| 6814079 | Heaton et al. | Nov 2004 | B2 |
| 7846141 | Weston | Dec 2010 | B2 |
| 8062273 | Weston | Nov 2011 | B2 |
| 8216198 | Heagle et al. | Jul 2012 | B2 |
| 8251979 | Malhi | Aug 2012 | B2 |
| 8257327 | Blott et al. | Sep 2012 | B2 |
| 8398614 | Blott et al. | Mar 2013 | B2 |
| 8449509 | Weston | May 2013 | B2 |
| 8529548 | Blott et al. | Sep 2013 | B2 |
| 8535296 | Blott et al. | Sep 2013 | B2 |
| 8551060 | Schuessler et al. | Oct 2013 | B2 |
| 8568386 | Malhi | Oct 2013 | B2 |
| 8679081 | Heagle et al. | Mar 2014 | B2 |
| 8834451 | Blott et al. | Sep 2014 | B2 |
| 8926592 | Blott et al. | Jan 2015 | B2 |
| 9017302 | Vitaris et al. | Apr 2015 | B2 |
| 9198801 | Weston | Dec 2015 | B2 |
| 9211365 | Weston | Dec 2015 | B2 |
| 9289542 | Blott et al. | Mar 2016 | B2 |
| 20020077661 | Saadat | Jun 2002 | A1 |
| 20020115951 | Norstrem et al. | Aug 2002 | A1 |
| 20020120185 | Johnson | Aug 2002 | A1 |
| 20020143286 | Tumey | Oct 2002 | A1 |
| 20050203452 | Weston et al. | Sep 2005 | A1 |
| 20080167593 | Fleischmann | Jul 2008 | A1 |
| 20090299257 | Long et al. | Dec 2009 | A1 |
| 20100159192 | Cotton | Jun 2010 | A1 |
| 20120046582 | Hopman et al. | Feb 2012 | A1 |
| 20140163491 | Schuessler et al. | Jun 2014 | A1 |
| 20140276288 | Randolph | Sep 2014 | A1 |
| 20150032035 | Banwell | Jan 2015 | A1 |
| 20150057624 | Simmons et al. | Feb 2015 | A1 |
| 20150080788 | Blott et al. | Mar 2015 | A1 |
| 20160262942 | Riesinger | Sep 2016 | A1 |
| 20190117466 | Kazala, Jr. et al. | Apr 2019 | A1 |
| Number | Date | Country |
|---|---|---|
| 550575 | Mar 1986 | AU |
| 745271 | Mar 2002 | AU |
| 755496 | Dec 2002 | AU |
| 2005436 | Jun 1990 | CA |
| 3060484 | Dec 2018 | CA |
| 26 40 413 | Mar 1978 | DE |
| 43 06 478 | Sep 1994 | DE |
| 29 504 378 | Sep 1995 | DE |
| 102005049466 | Apr 2007 | DE |
| 102011054619 | Apr 2013 | DE |
| 0100148 | Feb 1984 | EP |
| 0117632 | Sep 1984 | EP |
| 0161865 | Nov 1985 | EP |
| 0358302 | Mar 1990 | EP |
| 1018967 | Jul 2000 | EP |
| 3473218 | Apr 2019 | EP |
| 692578 | Jun 1953 | GB |
| 2 195 255 | Apr 1988 | GB |
| 2 197 789 | Jun 1988 | GB |
| 2 220 357 | Jan 1990 | GB |
| 2 235 877 | Mar 1991 | GB |
| 2 329 127 | Mar 1999 | GB |
| 2 333 965 | Aug 1999 | GB |
| 4129536 | Aug 2008 | JP |
| 71559 | Apr 2002 | SG |
| 8002182 | Oct 1980 | WO |
| 8704626 | Aug 1987 | WO |
| 90010424 | Sep 1990 | WO |
| 93009727 | May 1993 | WO |
| 94020041 | Sep 1994 | WO |
| 9605873 | Feb 1996 | WO |
| 9718007 | May 1997 | WO |
| 9913793 | Mar 1999 | WO |
| WO-2005052235 | Jun 2005 | WO |
| 2016188968 | Dec 2016 | WO |
| 2018152127 | Aug 2018 | WO |
| WO-2018229008 | Dec 2018 | WO |
| Entry |
|---|
| Louis C. Argenta, MD and Michael J. Morykwas, PHD; Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Clinical Experience; Annals of Plastic Surgery; vol. 38, No. 6, Jun. 1997; pp. 563-576. |
| Susan Mendez-Eatmen, RN; “When wounds Won't Heal” RN Jan. 1998, vol. 61 (1); Medical Economics Company, Inc., Montvale, NJ, USA; pp. 20-24. |
| James H. Blackburn II, MD et al.: Negative-Pressure Dressings as a Bolster for Skin Grafts; Annals of Plastic Surgery, vol. 40, No. 5, May 1998, pp. 453-457; Lippincott Williams & Wilkins, Inc., Philidelphia, PA, USA. |
| John Masters; “Reliable, Inexpensive and Simple Suction Dressings”; Letter to the Editor, British Journal of Plastic Surgery, 1998, vol. 51 (3), p. 267; Elsevier Science/The British Association of Plastic Surgeons, UK. |
| S.E. Greer, et al. “The Use of Subatmospheric Pressure Dressing Therapy to Close Lymphocutaneous Fistulas of the Groin” British Journal of Plastic Surgery (2000), 53, pp. 484-487. |
| George V. Letsou, MD., et al; “Stimulation of Adenylate Cyclase Activity in Cultured Endothelial Cells Subjected to Cyclic Stretch”; Journal of Cardiovascular Surgery, 31, 1990, pp. 634-639. |
| Orringer, Jay, et al; “Management of Wounds in Patients with Complex Enterocutaneous Fistulas”; Surgery, Gynecology & Obstetrics, Jul. 1987, vol. 165, pp. 79-80. |
| International Search Report for PCT International Application PCT/GB95/01983; Nov. 23, 1995. |
| PCT International Search Report for PCT International Application PCT/GB98/02713; Jan. 8, 1999. |
| PCT Written Opinion; PCT International Application PCT/GB98/02713; Jun. 8, 1999. |
| PCT International Examination and Search Report, PCT International Application PCT/GB96/02802; Jan. 15, 1998 & Apr. 29, 1997. |
| PCT Written Opinion, PCT International Application PCT/GB96/02802; Sep. 3, 1997. |
| Dattilo, Philip P., Jr., et al; “Medical Textiles: Application of an Absorbable Barbed Bi-directional Surgical Suture”; Journal of Textile and Apparel, Technology and Management, vol. 2, Issue 2, Spring 2002, pp. 1-5. |
| Kostyuchenok, B.M., et al.; “Vacuum Treatment in the Surgical Management of Purulent Wounds”; Vestnik Khirurgi, Sep. 1986, pp. 18-21 and 6 page English translation thereof. |
| Davydov, Yu. A., et al; “Vacuum Therapy in the Treatment of Purulent Lactation Mastitis”; Vestnik Khirurgi, May 14, 1986, pp. 66-70, and 9 page English translation thereof. |
| Yusupov. Yu.N., et al; “Active Wound Drainage”, Vestnki Khirurgi, vol. 138, Issue 4, 1987, and 7 page English translation thereof. |
| Davydov, Yu.A., et al; “Bacteriological and Cytological Assessment of Vacuum Therapy for Purulent Wounds”; Vestnik Khirugi, Oct. 1988, pp. 48-52, and 8 page English translation thereof. |
| Davydov, Yu.A., et al; “Concepts for the Clinical-Biological Management of the Wound Process in the Treatment of Purulent Wounds by Means of Vacuum Therapy”; Vestnik Khirurgi, Jul. 7, 1980, pp. 132-136, and 8 page English translation thereof. |
| Chariker, Mark E., M.D., et al; “Effective Management of incisional and cutaneous fistulae with closed suction wound drainage”; Contemporary Surgery, vol. 34, Jun. 1989, pp. 59-63. |
| Egnell Minor, Instruction Book, First Edition, 300 7502, Feb. 1975, pp. 24. |
| Egnell Minor: Addition to the Users Manual Concerning Overflow Protection—Concerns all Egnell Pumps, Feb. 3, 1983, pp. 2. |
| Svedman, P.: “Irrigation Treatment of Leg Ulcers”, The Lancet, Sep. 3, 1983, pp. 532-534. |
| Chinn, Steven D. et al.: “Closed Wound Suction Drainage”, The Journal of Foot Surgery, vol. 24, No. 1, 1985, pp. 76-81. |
| Arnljots, Björn et al.: “Irrigation Treatment in Split-Thickness Skin Grafting of Intractable Leg Ulcers”, Scand J. Plast Reconstr. Surg., No. 19, 1985, pp. 211-213. |
| Svedman, P.: “A Dressing Allowing Continuous Treatment of a Biosurface”, IRCS Medical Science: Biomedical Technology, Clinical Medicine, Surgery and Transplantation, vol. 7, 1979, p. 221. |
| Svedman, P. et al: “A Dressing System Providing Fluid Supply and Suction Drainage Used for Continuous of Intermittent Irrigation”, Annals of Plastic Surgery, vol. 17, No. 2, Aug. 1986, pp. 125-133. |
| N.A. Bagautdinov, “Variant of External Vacuum Aspiration in the Treatment of Purulent Diseases of Soft Tissues,” Current Problems in Modern Clinical Surgery: Interdepartmental Collection, edited by V. Ye Volkov et al. (Chuvashia State University, Cheboksary, U.S.S.R. 1986); pp. 94-96 (copy and certified translation). |
| K.F. Jeter, T.E. Tintle, and M. Chariker, “Managing Draining Wounds and Fistulae: New and Established Methods,” Chronic Wound Care, edited by D. Krasner (Health Management Publications, Inc., King of Prussia, PA 1990), pp. 240-246. |
| G. Živadinovi?, V. ? uki?, Ž. Maksimovi?, ?. Radak, and P. Peška, “Vacuum Therapy in the Treatment of Peripheral Blood Vessels,” Timok Medical Journal 11 (1986), pp. 161-164 (copy and certified translation). |
| F.E. Johnson, “An Improved Technique for Skin Graft Placement Using a Suction Drain,” Surgery, Gynecology, and Obstetrics 159 (1984), pp. 584-585. |
| A.A. Safronov, Dissertation Abstract, Vacuum Therapy of Trophic Ulcers of the Lower Leg with Simultaneous Autoplasty of the Skin (Central Scientific Research Institute of Traumatology and Orthopedics, Moscow, U.S.S.R. 1967) (copy and certified translation). |
| M. Schein, R. Saadia, J.R. Jamieson, and G.A.G. Decker, “The ‘Sandwich Technique’ in the Management of the Open Abdomen,” British Journal of Surgery 73 (1986), pp. 369-370. |
| D.E. Tribble, An Improved Sump Drain-Irrigation Device of Simple Construction, Archives of Surgery 105 (1972) pp. 511-513. |
| M.J. Morykwas, L.C. Argenta, E.I. Shelton-Brown, and W. McGuirt, “Vacuum-Assisted Closure: A New Method for Wound Control and Treatment: Animal Studies and Basic Foundation,” Annals of Plastic Surgery 38 (1997), pp. 553-562 (Morykwas I). |
| C.E. Tennants, “The Use of Hypermia in the Postoperative Treatment of Lesions of the Extremities and Thorax,” Journal of the American Medical Association 64 (1915), pp. 1548-1549. |
| Selections from W. Meyer and V. Schmieden, Bier's Hyperemic Treatment in Surgery, Medicine, and the Specialties: A Manual of Its Practical Application, (W.B. Saunders Co., Philadelphia, PA 1909), pp. 17-25, 44-64, 90-96, 167-170, and 210-211. |
| V.A. Solovev et al., Guidelines, The Method of Treatment of Immature External Fistulas in the Upper Gastrointestinal Tract, editor-in-chief Prov. V.I. Parahonyak (S.M. Kirov Gorky State Medical Institute, Gorky, U.S.S.R. 1987) (“Solovev Guidelines”). |
| V.A. Kuznetsov & N.a. Bagautdinov, “Vacuum and Vacuum-Sorption Treatment of Open Septic Wounds,” in II All-Union Conference on Wounds and Wound Infections: Presentation Abstracts, edited by B.M. Kostyuchenok et al. (Moscow, U.S.S.R. Oct. 28-29, 1986) pp. 91-92 (“Bagautdinov II”). |
| V.A. Solovev, Dissertation Abstract, Treatment and Prevention of Suture Failures after Gastric Resection (S.M. Kirov Gorky State Medical Institute, Gorky, U.S.S.R. 1988) (“Solovev Abstract”). |
| V.A.C. ® Therapy Clinical Guidelines: A Reference Source for Clinicians; Jul. 2007. |
| International Search Report and Written Opinion for Corresponding Application No. PCT/IB2020/060158, mailed Feb. 11, 2021. |
| International Search Report and Written Opinion for related application PCT/IB2020/060151, mailed Feb. 4, 2021. |
| Chinese Office Action for related application 2020800809607, dated May 31, 2023. |
| Office Action for related U.S. Appl. No. 17/772,479, dated Jun. 7, 2023. |
| Office Action for related U.S. Appl. No. 17/772,479, dated Dec. 15, 2023. |
| Japanese Office Action for related application 2022-524956, dated May 7, 2024. |
| Office Action for related U.S. Appl. No. 17/772,479, dated Jun. 21, 2024. |
| Japanese Office Action for related application 2022-524956, dated Oct. 8, 2024. |
| Number | Date | Country | |
|---|---|---|---|
| 20210128340 A1 | May 2021 | US |
| Number | Date | Country | |
|---|---|---|---|
| 62929215 | Nov 2019 | US |