This application claims priority to U.K. Provisional Application Nos. 1809756.8, 1813969.1, and 1902774.7 respectively filed on Jun. 14, 2018, Aug. 28, 2018, and Mar. 1, 2019; the disclosures of which are hereby incorporated by reference in their entirety.
Embodiments of the present disclosure relate to apparatuses, systems, and methods for the monitoring of body loading and body position for treatment of pressure ulcers.
Pressure ulcers, which are also known as pressure sores, bedsores, or decubitus ulcers, are injuries to skin and underlying tissue resulting from prolonged pressure on the skin, soft tissue, muscle, or bone above capillary filling pressure (approximately 32 mmHg). Pressure ulcers may typically develop on skin that covers bony areas, such as heels, ankles, hips, shoulder blades, spine, elbows, back of the head, and tailbone. Persons whose mobility is limited due to age or medical conditions are at an increased risk of developing pressure ulcers because of their inability to change positions while sitting or lying down. Management and treatment of pressure ulcers include repositioning of the injured limb or body part and using support surfaces, such as a mattress, cushion, or the like.
One type of pressure ulcer that develops on a foot is known as a diabetic foot ulcer (DFU), which tends to occur with higher frequency and intensity in the diabetic population. Management and treatment of diabetic foot ulcers requires offloading the wound by using cushioned footwear, such as a support boot, cast, shoe, etc. While offloading can be effective, because many offloading devices are removable, it has been found that patient non-compliance with the offloading devices plays a large role in the delayed healing of diabetic foot ulcers.
However, prior art approaches and systems provide no or little information regarding patients' lifestyle and non-compliance or compliance with the offloading devices and support surfaces. Gaining insight into patients' lifestyle can be important for prevention and healing of pressure ulcers. However, because of these limitations, prevention and healing of patients' pressure ulcers using prior art approaches and systems may be delayed or, worse yet, the condition could worsen leading to prolonged discomfort, hospitalization, or even surgery.
Embodiments of the present disclosure will now be described hereinafter, by way of example only, with reference to the accompanying drawings in which:
An activity monitoring device can be a wearable component usable for monitoring diabetic foot ulcers. The activity monitoring device can include a sensor or number of sensors, including an accelerometer (such as, a 3 axis accelerometer), gyroscope, magnetometer, barometric pressure (barometer), light (for example, usable for identification of day/night cycles, initiation like removal from opaque packaging or opaque release handle/label, failure of adhesion such as with sensor pointing at tissue and lit up if the activity monitoring device falls off, or data transmission), or temperature. The one or more sensors can be mounted on a single or multi-layer board (for example, FR4 board) or other substrate (for example, polyimide). Multiple types of sensors (or elements within sensors) can be combined to use as an inertial measurement unit (INU) (for example, 6-axis for 2 sensors or 9-axis for 3 sensors), even if one sensor (such as, an accelerometer) may be alone in actively reading (for example, powered up) for some or all of the time. In some implementations, the use of an accelerometer, gyroscope, and magnetometer as a 9-axis INU can be utilized initially to identify datum positions and angles, and then shut down one or more elements or components (such as, power hungry components) for some or all of the time.
The activity monitoring device can be worn just below the knee and may be towards the inside of the knee. The activity monitoring device can be encapsulated or otherwise encased in housing. The activity monitoring device can be attached using an adhesive, a film adhesive, or via a garment. The activity monitoring device or one or more sensors with the activity monitoring device can include a portable energy source, such as a battery. The removal of unrequired sensors can be facilitated in some implementations to make use of the finite energy budget available or minimise the risk of noise from external sources on both signal and software.
The activity monitoring device can be applied to different surfaces for monitoring the different surfaces, and individual activity monitoring devices can thus be used to monitor different parts of a user activity monitoring system. For example, one activity monitoring device can monitor a patient while another activity monitoring device can monitor an offloading device (for example, offloading boots, insoles, crutches, or other mobility aids), such as that may be used by a patient with a foot ulcer (for example, a diabetic foot ulcer). The
A housing of the activity monitoring device can have one or more of the following features. The housing can have a thinned out region to allow the user to press a button within the housing while providing protection to avoid an unintentional operation of the button. This region can be in the form of a triangular cut-out and formed within the top-part of the housing to avoid a separate button. Other parts of the housing can designed to be stiffer than this button area. The area can be shaped and sized to accommodate the pad of a thumb. A wide range of button designs can be used. The thinned out region can also allow a light source to shine through, and the light level shining through can be tailored by selecting the thickness of the housing or by selecting a transparency and color of the housing. There can be on the inside of the housing which allow a circuit board to be positioned or supported. For instance, circumferential constraints or 4 pins at 90 degrees spacing can fix a rotation and lateral alignment of the circuit board with respect to the housing, while a ledge fixes the height of the circuit board with respect to the top surface. This can facilitate, for example, the circuit board being in a correct orientation and at a correct height to provide interaction with the button and also aligns the light source in the thinned out area. Within the top molding, parts of the lid can be deliberately made to be stiff by using a thicker material thickness, and these thicker areas can be cored out in order ensures that the part is moldable, avoid sinkage, and maintain the stiffness of these areas while reducing the overall weight. The bottom molding can have a largely flat surface with a small radius of curvature on the outside to allow the part to be attached to the human body while avoiding clothes to be caught under the edge and ripping the part off. In addition, the bottom surface can have a small recess to allow for the attachment of a double-sided adhesive tape to attach the tracker to a person. The top molding can be shaped in a rounded and smooth manner to avoid any point where the activity monitoring device may catch with clothes or another object and may also to give the activity monitoring device a smaller visual footprint. The housing can be made by stereolithography (SLA) or polyjet from photopolymer 3D printing material with a Shore hardness of 73-77 on scale A, or by 3D printing from an engineering resin with a Shore hardness of 80 A. The housing can include an elastomer, a thermoplastic elastomer, or be constructed by injection molding. The molded parts can be made from liquid silicone rubber in white. An adhesive (for example, one for attaching plastics and elastomeric materials) can be used to glue the two moldings together, and a wide range of other adhesives (for example, cyanoacrylates, silicones, epoxies, hydrogels, hydrocolloids, sealant systems) or other techniques (for example use of double-sided adhesive tapes, ultrasonic welding, staking etc.) can be used. The top and bottom housings can be designed to have a very small gap between them in the assembled state in order to allow for the adhesive thickness but also to allow for a circuit board to be slightly clamped in the assembled housing (to prevent “rattling” of the circuit board within the housing and unintended button presses). The intention can be that a slight pressure is applied between the top and bottom housings while the adhesive is setting. When assembled, the features in the top and bottom housing can form a convoluted path to assist with ingress protection. Features in the side walls of both moldings can allow the parts to be mechanically held together or grooves for adhesive. Pressure or light sensors or other components can be removed from the activity monitoring device to reduce power consumption.
The housing can be sealed, flexible, and have a known Shore hardness. The housing can have a mechanical structure and design features that provide for a shouldered keyway alignment of elements of the activity monitoring device. The housing can include areas designed for support of the circuit board. The housing can have a flexible surface above the circuit board, and a pin designed to provide force onto a button above the board. The housing can include thin areas for viewing of a light emitting diode (LED) enclosed within the housing. The housing can include case work that touches components of the activity monitoring device (for example, the printed circuit board assembly). Portions of the housing can be made clear for visible or ultraviolet (UV) light and to enhance visualization of the LED encased in the case work of the activity monitoring device when the LED is activated. The case work or housing can have a hard base and a soft top, or a soft base and hard top. The housing can be adapted to seal both sides of the housing with an adhesive material. The housing can be sealed or constructed so that, upon unsealing or deconstruction of the housing (for example, by separation of two portions of the housing) or tampering with the housing, one or more components positioned in the housing are destroyed or cease properly functioning. For instance, one component in the housing (such as a circuit board or a component attached to the circuit board) can be attached to a first portion of the housing and another component in the housing can be attached to a second portion of the housing, so upon separation of the first portion and the second portion, the one component and the another component can be separated causing the one component or the another component to cease to function properly (such as by breaking an electrical connection between the one component and the another component or by breaking an electrical on the one component or the another component that breaks a functionality). The housing can be adhered to the patient of an orthopedic device by using an adhesive film. Alternatively a glue such as a super glue for use on tissue could be used to bond the housing to an adhesive film. The adhesive film may be an IV3000 dressing, such as Opsite Flexigrid dressing or any other adhesive film dressing already used in wound care. The adhesive can be a medical or healthcare field grade adhesive. Alternatively the adhesive can be any adhesive film that is tolerable on human skin. The adhesive on the film can be acrylic or silicone gel.
The activity monitoring device can be adhered to, sewn into, placed within etc. clothing, such as a knee brace, a knee strap, a garter, or a snug-fitting tube of fabric that is worn over a portion of a limb. The activity monitoring device could be retained in place by inserting in the device in a pocket at the knee, in a pocket in some suitable garment, including trousers, knee braces etc. The activity monitoring device could be secured to a user or an orthopedic device using a strap—such as similar to a watch strap or belt could be used, or using a clip—for example, similar to a money clip.
The activity monitoring device can be retained in the lacing of a shoe or other garment. The activity monitoring device can be integrated into a shoe. The activity monitoring device can be given a color that promotes discretion or blending in of the activity monitoring device, such as by matching the color of the device to the skin tone. The activity monitoring device can be given a color to allow the product to standout in an emergency. The form factor of the activity monitoring device can be adapted such that the activity monitoring device can be worn and can be protruding from the skin. As such, the activity monitoring device can be given a form that avoids shapes that can be likely to snag on clothing. The activity monitoring device can have a low profile. For example, the sides of the activity monitoring device can be arranged so that they do not have a significant overhang. The sides of the activity monitoring device can be profiled, for example, as a dome, or truncated cone. The activity monitoring device can be designed to allow a low profile design, rather than a stacked design.
Chemical agents can be included in the housing material to aid with reducing friction across the housing surface. For example EPDM (ethylene propylene diene monomer rubber) can be attached to a leg or to an offloading device. The activity monitoring device can be attached to items such as boots, crutches, or a carrier. The activity monitoring device can be attached to a mobility aid. The activity monitoring device can attach to something tubular. The activity monitoring device can be attached to a carrier with a hook-and-loop fastening strap. The activity monitoring device can be attached using a zip tie or other fastener that requires no tool to secure the activity monitoring device with the fastener. The activity monitoring device can be attached by a screw. The activity monitoring device could be attached to orthopedic devices, such as external fixators, for example an Ilizarov apparatus. The activity monitoring device can be applied to a dressing, such as a wound dressing.
In order to move from a disposable to a non-disposable activity monitoring device, the housing might not have an adhesive film underneath. Due to the shedding of the skin's epithelial cells non-circumferential adhesive dressings typically have a limited wear time. Rather, in some embodiments, the activity monitoring device can use a dressing secured at its perimeter that can allow the dressing to be removed and reapplied, using the same sensor and housing. For example, the activity monitoring device can be attached using an adhesive film dressing with a hole cut out that is slightly smaller than the size of the housing. A circle or any suitable profile corresponding to a reduced version of the profile of the housing can be used. The film can tent to retain the edges of the housing, alternatively the film could be slit to have fronds, etc.
Activities of a user may be desirably monitored by an activity monitoring device for a variety of reasons including wound prevention and monitoring. In one example, the activities of a user can be monitored when the user may be prone to or already have a pressure ulcer. Information gathered by the activity monitoring device about the activities of the user can be helpful for assisting with prevention or treatment of the pressure ulcer. In addition, information gathered by the activity monitoring device about the activities can be useful for checking compliance with a treatment regimen.
Embodiments disclosed herein relate at least to apparatuses, systems, and methods for the monitoring of body loading and body position for treatment of pressure ulcers. Loading can refer to transferring or placing at least a threshold amount of force on a body part. Placing such threshold amount of force on the body part causes the body part to support weight. For example, loading of a foot can refer to transferring or placing at least a portion of the body weight (or body weight in combination with external weight) on the foot such that the foot is supporting at least such portion of the body weight. At least such portion of the body weight can serve as a threshold for determining that the foot has been loaded.
Some embodiments relate to wound monitoring or therapy for a human or animal body. Therefore, any reference to a wound herein can refer to a wound on a human or animal body, and any reference to a body herein can refer to a human or animal body. The disclosed technology embodiments may relate to preventing or minimizing damage to physiological tissue or living tissue, or to the treatment of damaged tissue (for example, a wound as described herein).
As used herein the expression “wound” may include an injury to living tissue may be caused by a cut, blow, or other impact, typically one in which the skin is cut or broken. A wound may be a chronic or acute injury. Acute wounds occur as a result of surgery or trauma. They move through the stages of healing within a predicted timeframe. Chronic wounds typically begin as acute wounds. The acute wound can become a chronic wound when it does not follow the healing stages resulting in a lengthened recovery. It is believed that the transition from acute to chronic wound can be due to a patient being immuno-compromised.
Chronic wounds may include for example: venous ulcers (such as those that occur in the legs), which account for the majority of chronic wounds and mostly affect the elderly, diabetic ulcers (for example, foot or ankle ulcers), peripheral arterial disease, pressure ulcers, or epidermolysis bullosa (EB).
Examples of other wounds include, but are not limited to, abdominal wounds or other large or incisional wounds, either as a result of surgery, trauma, sterniotomies, fasciotomies, or other conditions, dehisced wounds, acute wounds, chronic wounds, subacute and dehisced wounds, traumatic wounds, flaps and skin grafts, lacerations, abrasions, contusions, bums, diabetic ulcers, pressure ulcers, stoma, surgical wounds, trauma and venous ulcers or the like.
Wounds may also include a deep tissue injury. Deep tissue injury is a term proposed by the National Pressure Ulcer Advisory Panel (NPUAP) to describe a unique form of pressure ulcers. These ulcers have been described by clinicians for many years with terms such as purple pressure ulcers, ulcers that are likely to deteriorate and bruises on bony prominences.
Wound may also include tissue at risk of becoming a wound as discussed herein. For example, tissue at risk may include tissue over a bony protuberance (at risk of deep tissue injury/insult) or pre-surgical tissue (for example, knee tissue) that may has the potential to be cut (for example, for joint replacement/surgical alteration/reconstruction).
Some embodiments relate to methods of monitoring or treating a wound with the technology disclosed herein in conjunction with one or more of the following: advanced footwear, turning a patient, offloading (such as, offloading diabetic foot ulcers), treatment of infection, systemix, antimicrobial, antibiotics, surgery, removal of tissue, affecting blood flow, physiotherapy, exercise, bathing, nutrition, hydration, nerve stimulation, ultrasound, electrostimulation, oxygen therapy, microwave therapy, active agents ozone, antibiotics, antimicrobials, or the like.
A wound may be treated using topical pressure (such as, with negative or positive pressure therapy) or traditional advanced wound care, which is not aided by the use of applied pressure (may also be referred to as non-pressure therapy).
The use of an orthopedic device, such as a contact cast or walking boot, that offloads weight from a body part can be important for healing or preventing injury, such as a pressure ulcer, to the body part. The orthopedic device may be provided by caregiver to a patient with particular instructions to use the orthopedic device in a manner to heal or prevent injury.
The body part 10 can be a leg of a user that includes a knee 12 and a foot 14. As illustrated, in some embodiments, the activity monitoring device 20 can be supported by the body part 10 at a position between the knee 12 and the foot 14, such as proximate to the foot 14. In other embodiments, the activity monitoring device 20 can be supported by another part of the body part 12. The activity monitoring device 20 can monitor and record activities (for instance, walking, jumping, sitting, laying down, running, squatting, or standing) of the body part 10, such as from a position, movement, or orientation of the activity monitoring device 20 or one or more other sensors of the activity monitoring device 20. The activity monitoring device 20 can, for example, be used for loading monitoring of loading of the foot 14. In certain implementations, multiple body parts can be monitored by the activity monitoring device 20, and different sensors can be used for monitoring different body parts.
The body part 10 is shown wearing and partly covered by an orthopedic device 30. The orthopedic device 30 can support the body part 10 and reduce a pressure on the foot 14 when the user may be standing or engaging in other activities. A compliance monitoring device 32 can be attached to the orthopedic device 30. The compliance monitoring device 32 can be the same as or different from the activity monitoring device 20 and supported by the orthopedic device 30 using a strap, adhesive, or other coupling mechanism. The compliance monitoring device 32 can be attached to an inner surface of the orthopedic device 30 such that the compliance monitoring device 32 is disposed between the orthopedic device 30 and the skin of the patient. The compliance monitoring device 32 can be attached to an outer surface of the orthopedic device 30 such that a portion of the orthopedic device 30 is disposed between the compliance monitoring device 32 and the skin of the patient. Although not shown in
Although not illustrated in
The activity monitoring device 20 and the data processing device 40 can together configure a communication channel with one another to permit transfer of recorded activities or other data from the activity monitoring device 20 and the data processing device 40 or transfer of one or more commands from the data processing device 40 to the activity monitoring device 20, among other possibilities. The data processing device 40 can, for example, be a smart phone or a tablet computer.
The activity monitoring device 20 can at least partly or may be fully covered by conductive material, dielectric material, or the like (for instance, a polymer or that may approximate a conductance or capacitance of a human finger). The data processing device 40 can include a touch-sensitive display that detects the conductive or dielectric material on the activity monitoring device 20 to determine contact between the activity monitoring device 20 and the display of the data processing device 40.
As illustrated in
The controller 202 can control operations of one or more other components of the activity monitoring device 20 according at least to instructions stored in the memory device 204. The controller 202 can, for instance, control monitoring of loading of the body part 10 with a weight of the body or positioning of the body part 10 and record data indicative of loading of the body part 10 or positioning of the body part 10 to the memory device 204.
The user interface 206 can include one or more output elements, such as indicators (for example, light emitting diodes) or speakers, that provide user outputs to a user. The one or more output elements can convey status information to the user like whether the activity monitoring device 20 is successfully functioning or has successfully configured communication with the data processing device 40. The user interface 206 can further include one or more input elements, such as buttons, switches, dials, or touch screens, for receiving user inputs for configuring the activity monitoring device 20. In some embodiments, the user interface 206 may have no more than one user input element, such as a button, for receiving user inputs to activate and deactivate the activity monitoring device 20 or performing one or more other functions.
The one or more sensors 210 can be used to detect and monitor a motion of the activity monitoring device 20. The one or more sensors 210 can be used to detect and monitor activities of the user of the activity monitoring device 20 that include, for instance, a loading or positioning of the body part 10. The one or more sensors 210 can include one or more accelerometers, gyroscopes, magnetometers, pressure sensors, impedance sensors, thermistors, or optical sensors, among other types of sensors. The one or more sensors 210 can be positioned proximate to the body part 10 or may be remote from the body part 10 yet usable to monitor characteristics of the body part 10.
The communication interface 212 can be used to communicate with the data processing device 40, such as via radio waves and according to a Bluetooth™ protocol like Bluetooth™ Low Energy or another protocol. The communication interface 212 can, for example, transmit device usage data like alarms, monitored loading or positioning, or changes to a monitoring or therapy program performed by the activity monitoring device 20 to the data processing device 40. The communication interface 212 can be used to receive data, including commands, from the data processing device 40.
Turning to the data processing device 40, the controller 222 of the data processing device 40 can control operations of one or more other components of the data processing device 40 according at least to instructions stored in the memory device 224. The controller 222 can, for instance, configure and control communication with the activity monitoring device 20, as well as process data received from the activity monitoring device 20 or send commands to the activity monitoring device 20. The data processing device 40 can executed one or more applications to assist with communicating with the activity monitoring device 20.
The user interface 226 of the data processing device 40 can include one or more elements that receive user inputs or provide user outputs to a user. The one or more elements of the user interface 226 that receive user inputs can include buttons, switches, dials, touch screens, or the like, and the one or more elements that provide user outputs can include indicators, screens, speakers, or the like.
The one or more sensors 230 of the data processing device 40 can be used to monitor an environment around the data processing device 40. The one or more sensors 230 can include one or more accelerometers, gyroscopes, magnetometers, pressure sensors, impedance sensors, thermistors, or optical sensors, among other types of sensors.
The communication interface 232 of the data processing device 40 can be used to communicate with the activity monitoring device 20, such as via radio waves and according to a Bluetooth™ protocol like Bluetooth™ Low Energy or another protocol. The communication interface 232 can, for example, receive device usage data like alarms, monitored loading or positioning, or changes to a monitoring or therapy program performed by the activity monitoring device 20 or transmit data like commands
The PCBA 300 can include one or more of the components of the activity monitoring device 120A such as the controller 202, the memory device 204, the user interface 206, the power source 208, the sensor(s) 210, and the communication interface 212. In some embodiments, one or more of the components of the activity monitoring device 120A can be mounted to a portion of the activity monitoring device 120A other than the PCBA 300, such as the housing 400A. As shown in
As discussed in more detail herein, the housing 400A can be arranged such that a targeted or intended compression of the housing 400A within a particular vicinity of the microswitch 302 activates the microswitch 302. The housing 400A can include features that cause the push button 304 to be pressed when a targeted compression is applied to the housing 400A in the vicinity of the microswitch 302. The housing 400A can be arranged such that an untargeted or unintentional compression of the housing 400A outside a particular vicinity of the microswitch 302 does not activate the microswitch 302. The housing 400A can be arranged such that the housing 400A shields the PCBA 300 from compressive forces that are applied to the housing 400A.
With continued reference to
Referring back to the rendering of the cap portion 402A shown in the assembly view of
The housing 400A can be arranged so that a compressive force applied to the landing pad 426A activates the microswitch 302 when the compressive force is applied substantially parallel to a longitudinal axis 10 of the activity monitoring device 120A and not when compressive force is applied substantially non-parallel to the longitudinal axis 10. For example, the raised rim 418A, the inner rim 406A, and the outer sidewall 408A can be arranged to form a support structure that distributes a compressive load away from the microswitch 302 when the compressive load is applied in a region of the housing 400A other than the landing pad 426A or in a direction other than substantially parallel to the longitudinal axis 10 of the housing 400A. The raised rim 418A, the inner rim 406A, and the outer sidewall 408A can form a thickened outer wall to resist global compression of the activity monitoring device 120A. In some embodiments, the raised rim 418A provides a stiff, hoop-like structure that transmits force to the base portion 404A through the junction of the inner rim 406A and the outer sidewall 408A, thereby bypassing transmission of the compressive load to the push button 304 of the microswitch 302. In this way, the housing 400A can be adapted to prevent the microswitch 302 from being activated by someone or something leaning on the activity monitoring device 120A.
The sensor(s) 210 can have a default or desired orientation at which the sensor(s) 210 operate. Operation of the sensor(s) 210 in the default or desired orientation may desirably, for instance, reduce a computational burden of processing data output by the sensor(s) 210 because the data may be detected relative to a default orientation, such as with respect to gravity. To facilitate the orientation and operation of the sensor(s) 210 in the default or desired orientation, the sensor(s) 210 may be positioned on the PCBA 300 at a particular orientation so that the sensor(s) 210 can be positioned with respect to the housing 400A in a certain orientation. The housing 400A can, in turn, be designed or indicated to be oriented on a user at a given orientation so that the sensor(s) 210 may be oriented during operation in the default or desired orientation. In one example, the orientation of a face of the landing pad 426A may be used to identify the default or desired orientation of the sensor(s) 210 when the cap portion 402A and the base portion 404A are coupled together and enclose the sensor(s) 210. The face of the landing pad 426A may, for instance, be initially positioned on a user to align with a direction of gravity so that the sensor(s) 210 are positioned in the default or desired orientation. Additionally or alternatively, a label placed on the housing 400A can be used to determine the default or desired orientation for the sensor(s) 210 when the sensor(s) 210 may be enclosed in the housing 400A.
For example, as shown in
The orientation of the cup-shaped and dish-shaped portions 402J, 404J of the housing can be reversed relative to the configuration in
Assembly and Attachment of Activity Monitoring Device
The activity monitoring device 120M may be assembled with a power source 228M, such as a battery. The activity monitoring device 120M can be sealed to enclose the components within the housing 400M. The housing 400M can be covered with a film to mitigate against contact with the housing material.
The activity monitoring device 120M may include the dressing 150M to secure the activity monitoring device 120M to a body part or an orthopedic device. In some embodiments, the housing 400M and the dressing 150M may be pre-assembled by the manufacturer with the housing 400M adhered to the dressing 150M. In other embodiments, the housing 400M and the dressing 150M may be provided separately by the manufacturer and configured to be adhered to one another by a user. The dressing 150M can include a frame delivery layer 152M, a film layer 154M, and a release handle 156M. The release handle 156M may include or be provided with tape, such as surgical tape, which can be usable for a clinician to write information. The housing 400M may be attached to the dressing 150M in a variety of ways as discussed herein. The frame delivery layer 152M may be an upper carrier layer of the film layer 154M. The frame delivery layer 152M may be removed to expose or reveal a non-tacky upper surface of the film layer 154M. The film layer 154M may be dimensioned to cover an outer diameter of the housing 400M or a body part 110 of a patient or other object. The film layer 154M can larger than the housing 400M. The dimensions of the film layer 154 may vary. In certain embodiments, a width or length of the film layer 154 may range from 5 cm to 20 cm, such as 6 cm to 15 cm or 10 cm to 12 cm. The film layer 154M can have a width or length that is 1.25, 1.5, 1.75, 2, 2.5, or 3 times or more than a diameter or length of the housing 400M in some implementations.
The features shown in
As shown in
Once the adhesive 470P may be applied, a cover portion can be placed on top of the base portion 404P and lightly pressed into place to enclose components. The pressure applied may be sufficient to eliminate air bubbles, as well as to minimize a distance between the base portion 404P and the cover portion that is bridged by the adhesive 470P. For instance, in some implementations, a pressure of 10N may be applied. Excess of the adhesive 470P may be wiped away using a spatula or another appropriate instrument. The adhesive 470P can, for instance, be an instant adhesive that has a low viscosity (for example, Loctite 431) and may be usable to bond plastics and elastomeric materials with relatively fast fixturing. The adhesive can air cure for one to a few minutes. A primer, such as Loctite 770 or 7239 may further be used in some implementations.
The wrapping 480 may be a circle of that is dimensioned to cover the housing 400Q. For example, the wrapping material 480 may be a circle of approximately 5 cm in diameter. The wrapping material 480 may be a film, such as a retention strip used with wound dressings, and may first be applied to the outer surface of a cap portion of the housing 400Q. The wrapping material 480 may be wrapped around the housing 400Q to cover all surfaces exposed to the environment.
The wrapping 480 may be covered by a first carrier layer and a second carrier layer, which may be made of paper. The wrapping 480, including both the first and second carrier layers, may be placed on a work surface. The first carrier layer may be removed from the wrapping 480 to expose the tacky or adhesive surface of the wrapping 480. With the exposed tacky surface facing upwards, the housing 400Q may be placed centrally on the wrapping 480. The second carrier layer may then be removed to wrap the wrapping material 480 around the housing 400Q.
In
In one example, the dressing 150R may have a 6 cm by 7 cm film layer 154R with full spread A8 adhesive on the lower surface of the film layer 154. The base portion 404R with the adhesive 470R applied may be placed on the upper surface of the film layer 154R. The base portion 404R may be placed centrally on the upper surface of the film layer 154R. Light pressure may be applied to the housing 400R against the upper surface of the film layer 154R to evenly distribute the adhesive 470R. As shown in
With the housing 400R adequately secured to the dressing 150R, the dressing 150R can be secured to a body part of a patient or another object, such as an orthopedic device. In some embodiments, such as described with respect to
In another example, the dressing 150R may have a 10 cm by 12 cm film layer 154R with full spread A8 adhesive on the lower surface of the film layer 154R. The housing 400R may be attached to the dressing 150R and secured to a patient or another surface using a process similar to the process described with respect to
As shown in
To manufacture the dressing 150S shown in
A contact layer 160S, which may be made of silicone, may be provided that include an adhesive spread layer on one or both sides thereof The contact layer 160S may be covered with a first carrier layer or a second carrier layer on one or both sides. The first carrier layer can be removed to expose a tacky first surface of the contact layer 160S. The tacky first surface may be an adhesive spread layer covering one side of the contact layer 160S. The adhesive spread layer of the contact layer 160S may be centrally applied to the adhesive spread layer 158S. Pressure may be applied to secure the contact layer 160S to the adhesive spread layer 158S. The contact layer 160S may be perforated or moisture vapor permeable.
The second carrier layer of the contact layer 160S can be removed to expose the second surface of the contact layer 160S. The release handle 156S, which may have been previously removed as discussed above, can be reapplied to cover the contact layer 160S and the adhesive spread layer 158S of the film layer 154S. Thus, the contact layer 160S is surrounded by the adhesive spread layer 158S. The housing 400S may be attached to the dressing 150S by substantially the same or a similar process as described with respect to
A re-usable or re-sealable adhesive can be used under the housing 400S and a single-use adhesive around an edge of the dressing 150S in some embodiments. The single-use adhesive may function both to provide an attachment force and serve as a tamper-evident attachment to a user. In yet other implementations, other tamper evident mechanisms such as shearing layers, stress-apparent printing, or the like may be used additionally or alternatively.
As shown in
The frame delivery layer may be an upper carrier layer of the film layer 154S. The release handle 156S may be a lower carrier layer of the film layer 154S, the adhesive spread layer 1585 or the contact layer (not shown). The film layer 1545 and the two of the release handle 156S may be cut into similar strips or shapes.
In another example, to manufacture the dressing 150S shown in
The release handle 1565 may be removed to expose the adhesive spread layer 1585, which may be a tacky lower surface like a K5 adhesive layer. With the film layer 1545 and the contact layer 160S aligned, the adhesive spread layer 1585 of may be placed onto the contact layer 160S. The second carrier layer of the contact layer 160S can be removed to expose an adhesive layer.
The release handle 156S may be perforated or folded. One of the release handles 156S can be perforated and folded and may be applied to the contact layer 160S or the adhesive layer of the contact layer 160S. The other of the release handle 156S may be applied to the contact layer 160S or the adhesive layer of the contact layer 160S. The release handle 156S may be applied so that there is an overlap between the two release handles 156S. The overlap between the two frame delivery handles may be around or at least 2.5 cm.
The housing 400S may be attached to the dressing 150S by substantially the same or a similar process as described with respect to
The release handles 156S can be removed to expose the tacky surface of the contact layer 160S and film layer 154S, which can be adhered to a body part 110 of a patient or other object.
In addition to the cap portion 402T having an inner surface 410T with a raised boss 422T that extends from a recessed well 424T that circumferentially surrounds the raised boss 422T, however, the recessed well 424T may include an additional recess 425T that is recessed from the recessed well 424T. The additional recess 425T can advantageously, in certain embodiments, increase a transparency of the cap portion 402T at the additional recess 425T so that the additional recess 425T passes light emitted by a light mounted the PCBA 300 through the cap portion 402T to an outside of the cap portion 402T. The additional recess 425T can moreover control a delineation or definition of light that is viewable from the outside of the cap portion 402T.
The base portion 404T can include a bottom outer surface 435T, a lower outer side surface 436T, a middle outer surface 437T, a upper outer side surface 438T, and a top outer surface 439T. The lower outer side surface 436T and the upper outer side surface 438T can respectively be angled at ∠A and ∠B relative to the top outer surface 439T. ∠A can be the same as or different from ∠B. ∠A or ∠B can, for example, be an angle within a range from 0° to 70°, such as an angle of 2°, 3°, 5°, 7°, or 10°. The corresponding parts of the cap portion 402T that are be positioned proximate to the lower outer side surface 436T and the upper outer side surface 438T when attached to the base portion 404T can be angled to match ∠A and ∠B and facilitate a fit between the cap portion 402T and the base portion 404T. The angling of the lower outer side surface 436T and the upper outer side surface 438T relative to the top outer surface 439T can desirably, in certain embodiments, increase a surface area of the bottom outer surface 435T that may be usable for attaching the base portion 404T, such as to a dressing as described herein.
The base portion 404T can be flared, flanged, or winged at the bottom outer surface 435T in some implementations. The flare, flange, or wing can facilitate use of a layer for securing the base portion 404T where the layer has a hole through which the flare, flange, or wing may not pass but through which a remainder of the base portion 404T may pass. The layer can be part of or attachable to a dressing.
The base portion 404T can have one or more surfaces with a surface roughness greater than other surfaces of the base portion 404T to facilitate and enhance the attachment of an adhesive to the surfaces with the greater surface roughness. Additionally or alternatively, the base portion 404T can have one or more textured surfaces with textures that facilitate and enhance the attachment of an adhesive to the textured surfaces.
The bottom outer surface 435T of the base portion 404T can include one or more channels (not shown) in some implementations. The one or more channels can allow air or fluid to flow and may help with presentation of a buildup of moisture under the bottom outer surface 435T. The one or more channels may reduce a lateral rigidity of the base portion 404T to improve a damping, Young's modulus, or a lateral shear modulus for the base portion 404T.
The activity monitoring device 120U may include the dressing 150U to secure the activity monitoring device 120U to a body part or an orthopedic device. In some embodiments, the housing 400U and the dressing 150U may be pre-assembled by the manufacturer with the housing 400U adhered to the dressing 150U. In other embodiments, the housing 400U and the dressing 150U may be provided separately by the manufacturer and configured to be adhered to one another by a user.
The dressing 150U may include a frame delivery layer 152U, an adhesive spread layer 158U, a contact layer 160U, a film layer 154U, and a release handle 156U. The release handle 156U may include or be provided with tape, such as surgical tape, which can be usable for a clinician to write information. The frame delivery layer 152U may be an upper carrier layer of the film layer 154U.
The dressing 150U may include a spacer layer 164U for breathability by providing an air gap between the patient's skin (or another surface) and the housing 400U. The air gap may allow fluid vapour to escape. The contact layer 160U may be adhesive to aid the adherence of the spacer layer 164U to the housing 400U. The contact layer 160U may be perforated or moisture vapor permeable, which may be advantageous for breathability.
The film layer 154U may be dimensioned to cover an outer diameter of the housing 400U or a body part 110 of a patient or other object. The film layer 154U can larger than the housing 400U. The dimensions of the film layer 154U may vary. The housing 400U may be attached to the dressing 150U in a variety of ways as discussed herein.
The activity monitoring device 120U may include a shaped film dressing 162U. The shaped film dressing 162U may be used to secure the housing 400U to the dressing 150U. The shaped film dressing 162U may be made of an adhesive film. The adhesive film may be an IV3000 dressing, such as Opsite Flexigrid dressing or another adhesive film dressing used in wound care. The adhesive can be a medical or healthcare field grade adhesive. Alternatively, the adhesive can be an adhesive film that is tolerable on human skin.
The adhesive on the film can be acrylic or silicone gel. The use of the shaped film dressing 162U can enable coupling without use of an adhesive spread layer of the contact layer to adhere to adhesive spread layer of the dressing 150U. The contact layer 160U may be adhesive to aid the retention of the spacer layer 164U. The contact layer 160U may be made of silicone.
As shown in
The features shown in
The activity monitoring device 120V may include the dressing 150V to secure the activity monitoring device 120V to a body part or an orthopedic device. The dressing 150V may include an adhesive spread layer 158V, a contact layer 160V, and one or more release handles 156V. The dressing 150V may include a spacer layer 164V for breathability by providing an air gap between the patient's skin (or another surface) and the housing 400V. The air gap may allow fluid vapour to escape. The contact layer 160V may be adhesive to aid the adherence of the spacer layer 164V to the housing 400V. The contact layer 160V may be perforated or moisture vapor permeable, which may be advantageous for breathability.
The housing 400V may be attached to the dressing 150V in a variety of ways as discussed herein. The activity monitoring device 120V may include a shaped film dressing 162V. The shaped film dressing 162V may be used to secure the housing 400U or the dressing 150V to the patient's skin or another surface. The shaped film dressing 162V may also be used to secure the housing 400U to the dressing 150V. The shaped film dressing 162V may be made of an adhesive film. The adhesive film may be an IV3000 dressing, such as Opsite Flexigrid dressing or another adhesive film dressing already used in wound care. The adhesive can be a medical or healthcare field grade adhesive. The adhesive can be an adhesive film that is tolerable on human skin. The adhesive on the film can be acrylic or silicone gel. The use of the shaped film dressing 162V can enable coupling without use of an adhesive spread layer of the contact layer to adhere to adhesive spread layer of the dressing 150V. The contact layer 160V may be adhesive to aid the retention of the spacer layer 164V. The contact layer 160U may be made of silicone.
As shown in
With continued reference to
As shown in
The ADL may be constructed so as to advantageously horizontally wick fluid, such as wound exudate, as it is absorbed upward through the layers of the dressing 550D. The ADL may comprise cellulose in the range of 40-160 gsm (or about 40 to about 160 gsm), for example 80 (or about 80) gsm. The ADL may be constructed from a material which resists compression. The ADL material, in an uncompressed state, may be 0.5 mm to 3 mm thick, or approximately 0.5 mm to approximately 3 mm thick, and in some embodiments may be 1.2 mm thick, or approximately 1.2 mm thick, in an uncompressed state. The ADL material may comprise a plurality of loosely packed fibers, which may be arranged in a substantially horizontal fibrous network.
In some aspects, the ADL material may consist of a mix of two fiber types. One may be a flat fiber which may be 20 μm to 50 μm in width, or approximately 20 μm to approximately 50 μm in width, and may comprise a cellulosic based material. The other fiber may be a two component fiber that has an inner core that is 8 μm to 10 μm in diameter, or approximately is 8 μm to approximately 10 μm in diameter, and an outer layer with a thickness of 1 μm to 2 μm, or approximately 1 μm to approximately 2 μm. The two component fiber may be a mix of a polyethylene (PE) type material, and polyethylene terephthalate (PET). In some embodiments the inner core of the two component fiber may be PET and the outer layer may be PE. The PE/PET fibers may have a smooth surface morphology, while the cellulosic fibers may have a relatively rougher surface morphology. In some embodiments the ADL material may comprise about 60% to about 90% cellulosic fibers, for example approximately 75% cellulosic fibers, and may comprise about 10% to about 40% PE/PET fibers, for example approximately 25% PE/PET fibers.
In some aspects, a majority of the fiber volume of the ADL may extend horizontally (that is, parallel to the plane of the top and bottom surfaces of the material), or substantially or generally horizontally. In some variants, 80%-90% (or approximately 80% to approximately 90%) or more of the fiber volume of the ADL may extend horizontally, or substantially or generally horizontally. In another variant, a majority, 80%-90% (or approximately 80% to approximately 90%) of the fibers or more, or even all or substantially all of the fibers, span a distance perpendicular to the thickness of the ADL material (a horizontal or lateral distance) that is greater than the thickness of the ADL material. In some embodiments, the horizontal or lateral distance spanned by such fibers is 2 times (or about 2 times) or more, 3 times (or about 3 times) or more, 4 times (or about 4 times) or more, 5 times (or about 5 times) or more, or 10 times (or about 10 times) or more the thickness of the ADL material. The orientation of such fibers may promote lateral wicking of fluid through the ADL material. This may more evenly distribute fluid such as wound exudate throughout the ADL material.
In some aspects, the fluid handling layer 170 can be or include a spacer or transmission layer. The spacer or transmission material can be preferably formed of a material having a three dimensional structure, and may have a top layer and a bottom layer comprising a knit pattern. For example, a knitted or woven spacer fabric (for example Baltex 7970 weft knitted polyester) or a non-woven fabric could be used. The top and bottom fabric layers may comprise polyester, such as 84/144 textured polyester or a flat denier polyester. Other materials and other linear mass densities of fiber could of course be used. In some aspects, the top and bottom fabric layers may be the same pattern and the same material, and in other aspects they may be different patterns and/or different materials. The top fabric layer may have more filaments in a yarn used to form it than the number of filaments making up the yarn used to form the bottom fabric layer, in order to control moisture flow across the transmission layer. Particularly, by having a filament count greater in the top layer, that is to say, the top layer is made from a yarn having more filaments than the yarn used in the bottom layer, liquid tends to be wicked along the top layer more than the bottom layer.
In some aspects, the spacer or transmission layer can have a majority of the filaments, by volume, extending vertically (that is, perpendicular to the plane of the top and bottom layers), or substantially or generally vertically. In some aspects, 80%-90% (or approximately 80% to approximately 90%) of the filaments or more, by volume, may extend vertically, or substantially or generally vertically. In another variant, all or substantially all of the filaments, by volume, may extend vertically, or substantially or generally vertically. In some aspects, a majority, 80%-90% (or approximately 80% to approximately 90%) of the filaments or more, or even all or substantially all of the filaments, extend upward from the bottom fabric layer and/or downward from the top fabric layer, and in some aspects, such filaments extend over a length more than half the distance between the top and bottom fabric layers. In some aspects, a majority, 80%-90% (or approximately 80% to approximately 90%) of the filaments or more, or even all or substantially all of the filaments, span a distance that is greater in a direction perpendicular to the top and bottom fabric layers (a vertical direction) than in a direction parallel to the top and bottom fabric layers (a horizontal direction). The orientation of such filaments may promote vertical wicking of fluid through the spacer layer. Such filaments may also keep the top and bottom layers spaced apart when the dressing 550D is exposed to compressive forces or negative pressure.
In the illustrated embodiment of
The housing 600E can be attached to the outer surface of the film layer 154E such that the film layer 154E is sandwiched between the housing 600E and the masking layer 190. In some aspects, placing the housing 600E on top of a foam-containing dressing 550E can reduce the likelihood of the housing 600E being knocked off of the dressing 550E by an impact to the housing 600E. As shown in
Turning back to
As discussed, the housing 600E can be adhered to the dressing 550E using an adhesive (e.g., an ultraviolet-curable adhesive, an ostomy adhesive, a hydrocolloid adhesive), as described herein. In some variants, an ultraviolet-curable adhesive is applied to the bottom surface of the housing 600E which is then placed on the outer surface of the film layer 154E to form an assembly. The assembly can be placed onto a curing shelf 500 (shown in
An activity-monitoring device for positioning on a body of a user or on an orthopedic device is disclosed. The activity-monitoring device can include: a housing including a cap portion and a base portion, wherein the cap portion includes an inner rim that extends from an upper wall of the cap portion, a recessed portion disposed on a base-facing surface of the upper wall, a boss extending from the recessed portion, wherein the base portion includes an outer sidewall that extends from a cap-facing surface of the base portion, the inner rim and the outer sidewall can connect with one another to form an enclosed space therebetween, a thickness of the upper wall at the recessed portion being thinner than a thickness of the upper wall outside of the recessed portion; a circuit board assembly positioned in the cap portion, wherein the circuit board assembly includes a controller and a button, the button can be pressed by the boss to activate the controller; and a power source positioned in the cap portion and configured to power the controller.
The activity-monitoring device of the preceding paragraph can include one or more of the following features: The activity-monitoring device can further include a sensor, which is a gyroscope, a magnetometer, an accelerometer, a barometer, a light sensor, and a temperature sensor. The sensor can detect a movement of the housing. The controller can monitor the movement of the housing using the sensor. The controller can store the movement of the housing to a memory device and output the movement of the housing to an electronic device via a communication interface. The activity-monitoring device can further include a light source disposed on the circuit board assembly, the light source being arranged to illuminate through the recessed portion when the light source is activated. The cap portion can include one or more pins for aligning the circuit board assembly with the cap portion. The activity-monitoring device can include a dressing including an upper surface and a lower surface, wherein the base portion is configured to be adhered to the upper surface. The activity-monitoring device can include an orthopedic device, wherein the base portion is configured to be adhered to the orthopedic device.
Any value of a threshold, limit, duration, etc. provided herein is not intended to be absolute and, thereby, can be approximate. In addition, any threshold, limit, duration, etc. provided herein can be fixed or varied either automatically or by a user. Furthermore, as is used herein relative terminology such as exceeds, greater than, less than, etc. in relation to a reference value is intended to also encompass being equal to the reference value. For example, exceeding a reference value that is positive can encompass being equal to or greater than the reference value. In addition, as is used herein relative terminology such as exceeds, greater than, less than, etc. in relation to a reference value is intended to also encompass an inverse of the disclosed relationship, such as below, less than, greater than, etc. in relations to the reference value. Moreover, although blocks of the various processes may be described in terms of determining whether a value meets or does not meet a particular threshold, the blocks can be similarly understood, for example, in terms of a value (i) being below or above a threshold or (ii) satisfying or not satisfying a threshold.
Features, materials, characteristics, or groups described in conjunction with a particular aspect, embodiment, or example are to be understood to be applicable to any other aspect, embodiment or example described herein unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features or steps are mutually exclusive. The protection is not restricted to the details of any foregoing embodiments. The protection extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of protection. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. For example, while the housing has been shown to be mounted on an outer surface of the dressing, in some variants the housing and/or the electronics of the activity-monitoring device can be encapsulated in the dressing. Furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein may be made. Those skilled in the art will appreciate that in some embodiments, the actual steps taken in the processes illustrated or disclosed may differ from those shown in the figures. Depending on the embodiment, certain of the steps described above may be removed, others may be added. For example, the actual steps or order of steps taken in the disclosed processes may differ from those shown in the figure. Depending on the embodiment, certain of the steps described above may be removed, others may be added. For instance, the various components illustrated in the figures may be implemented as software or firmware on a processor, controller, ASIC, FPGA, or dedicated hardware. Hardware components, such as controllers, processors, ASICs, FPGAs, and the like, can include logic circuitry. Furthermore, the features and attributes of the specific embodiments disclosed above may be combined in different ways to form additional embodiments, all of which fall within the scope of the present disclosure.
Although the present disclosure includes certain embodiments, examples and applications, it will be understood by those skilled in the art that the present disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments or uses and obvious modifications and equivalents thereof, including embodiments which do not provide all of the features and advantages set forth herein. Accordingly, the scope of the present disclosure is not intended to be limited by the specific disclosures of preferred embodiments herein, and may be defined by claims as presented herein or as presented in the future.
Conditional language, such as “can,” “could,” “might,” or “may,” unless specifically stated otherwise, or otherwise understood within the context as used, is generally intended to convey that certain embodiments include, while other embodiments do not include, certain features, elements, or steps. Thus, such conditional language is not generally intended to imply that features, elements, or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without user input or prompting, whether these features, elements, or steps are included or are to be performed in any particular embodiment. The terms “comprising,” “including,” “having,” and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and so forth. Also, the term “or” is used in its inclusive sense (and not in its exclusive sense) so that when used, for example, to connect a list of elements, the term “or” means one, some, or all of the elements in the list. Further, the term “each,” as used herein, in addition to having its ordinary meaning, can mean any subset of a set of elements to which the term “each” is applied.
Conjunctive language such as the phrase “at least one of X, Y, and Z,” unless specifically stated otherwise, is otherwise understood with the context as used in general to convey that an item, term, etc. may be either X, Y, or Z. Thus, such conjunctive language is not generally intended to imply that certain embodiments require the presence of at least one of X, at least one of Y, and at least one of Z.
Language of degree used herein, such as the terms “approximately,” “about,” “generally,” and “substantially” as used herein represent a value, amount, or characteristic close to the stated value, amount, or characteristic that still performs a desired function or achieves a desired result. For example, the terms “approximately”, “about”, “generally,” and “substantially” may refer to an amount that is within less than 10% of, within less than 5% of, within less than 1% of, within less than 0.1% of, and within less than 0.01% of the stated amount. As another example, in certain embodiments, the terms “generally parallel” and “substantially parallel” refer to a value, amount, or characteristic that departs from exactly parallel by less than or equal to 15 degrees, 10 degrees, 5 degrees, 3 degrees, 1 degree, or 0.1 degree.
The scope of the present disclosure is not intended to be limited by the specific disclosures of preferred embodiments in this section or elsewhere in this specification, and may be defined by claims as presented in this section or elsewhere in this specification or as presented in the future. The language of the claims is to be interpreted broadly based on the language employed in the claims and not limited to the examples described in the present specification or during the prosecution of the application, which examples are to be construed as non-exclusive.
Number | Date | Country | Kind |
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1809756.8 | Jun 2018 | GB | national |
1813969.1 | Aug 2018 | GB | national |
1902774.7 | Mar 2019 | GB | national |
Filing Document | Filing Date | Country | Kind |
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PCT/EP2019/065684 | 6/14/2019 | WO | 00 |