Patent Application
20160256665
All publications and patent applications mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.
The apparatuses and methods described herein relate to three-dimensional support products, including adhesive support devices such as adhesive medical devices, formed of a sheet of rigid or semi-rigid material into a 3D shape to which an adhesive material is attached, as well as methods of making and using these apparatuses.
Support products including medical devices and household consumer products can be used for many purposes. For example, adhesive medical devices are used to treat various medical and non-medical conditions or to supplement the use of other medical and consumer devices. These adhesive devices include, but are not limited to, adhesive bandages, ostomy devices, catheter stabilization devices, finger splints, nasal strips, wound therapy devices, ECG leads and drug delivery patches.
Many adhesive products including medical devices that are made through web converting manufacturing methods, are generally flat or planar (mostly two dimensional). For example, adhesive medical bandages may not have significant thickness, though they consist of multiple layers of materials, and typically are mostly flat. There is a need for adhesive products including medical devices that are three dimensional, which will enable a large number of new uses for such devices, uses that are not possible to achieve with traditional flat, planar devices. These new uses may include but are not limited to stabilization of other medical devices, wound care, treatment of burns, ostomy devices, application of antibiotic or antifungals, stabilization of joints, and treatment of other skin and nail conditions.
Fabrication of layered devices, and particularly layered medical device by continuous processes, such as web converting, work well for flat structures (layers), but may not be used to create devices with three-dimensional structures. Instead, such three dimensional (3D) structures must be separately placed/positioned, which may be expensive and time consuming, limiting rate of production and increasing manufacturing costs and cost of goods. Thus, there is also a need for automated processes or methods for manufacture of layered devices including 3D structures.
Described herein are specific variations of support devices, accessories for support devices, methods of using support devices and kits including support devices. In particular, described herein are adhesive support devices configured as adhesive medical devices. Examples of such medical devices may include bandages carrying (e.g., pre-applied) liquid, gel, or paste medicines, bandages forming a protected chamber over a wound when applied to the patient, and the like. The adhesive medical devices described herein may be used for various medical, non-medical and consumer health applications, including OTC (over-the-counter) products that treat medical, non-medical or cosmetic conditions and/or promote wellness or other tangible or intangible benefit. The term “medical” does not exclude devices and therapies that do not treat diagnosed medical conditions. These adhesive medical devices are thus intended to treat any health condition. Further, adhesive medical devices may be worn by a subject to enhance or supplement some body function, to treat a medical condition or facilitate the use of another medical device. Other adhesive devices described herein may be purely ornamental or designed to provide amusement (e.g., toys) or be used for fashion or aesthetic purposes. In still other cases, adhesive products may be used to hang other items (e.g., serve as hooks) or manage cords, or serve other household purposes. As described in more detail below, an adhesive device may be secured to any part of the user's body, and may attached to the skin of any part of the body, including the face.
The adhesive devices described herein may be completely flexible, partially flexible, partially rigid, or completely rigid. For example, the devices described herein may include an adhesive region (e.g., configured as a holdfast region) that is at least partially flexible and may also include another region that serves a medical or non-medical purpose or function. In other embodiments, the adhesive devices described herein may have a flexible portion (such as a holdfast) and another portion or region which is more rigid, which may help provide the intended function of the adhesive device. In other embodiments, a rigid layer may extend over all or substantially all, of the adhesive device to provide structure to the device including the holdfast region. This rigid layer may enable the device to support other devices (such as holding a tube, catheter or other medical product or to support or hang other items (thereby serving as a hook or fastener).
In general, an adhesive support devices described herein may be secured in communication with a subject's skin. The adhesive region (e.g., holdfast) may comprise a biocompatible adhesive and a flexible substrate configured to conform to the subject's skin. Materials for the holdfast may be chosen to attach the device to the skin or other body part and/or to serve an intended therapeutic or non-therapeutic function.
As used herein, rigid or semi-rigid structures, and particular 3D structures forming the cover, protective cap, barrier cap, protective cover, vacuum cap, or other formed plastic component may use similar materials and thickness, share similar geometries, and utilize similar manufacturing processes including in line forming using rotary dies or step and repeat forming processes. Any description of a material, geometry, etc. for one rigid or semi-rigid 3D structure may be used for any other rigid or semi-rigid 3D structure described herein. For example, draft angles, relative thicknesses or sequential forming processes described for a barrier cap may be applicable for the vacuum cap or securement doors (including living hinges), etc.
As used herein, rigid or semi-rigid structures, and particular 3D structures forming the cover, protective cap, barrier cap, protective cover, vacuum cap, or other formed plastic component, etc. described herein, may have a material and/or structural stiffness that is above a predetermined threshold. For example, in some variations a rigid or semi-rigid structure is formed of a material having an elastic modulus that is relatively high, so that the material resists deformation (e.g., a rod or sheet of material resists deformation). For example, a material forming a 3D structure to be included in any of the apparatuses (including systems and devices) described as a stiff or rigid material and may be a material that has an elastic modulus (e.g., Young's modulus) value in a range of greater than about 0.4 GPa, e.g., from 0.4 to 200 GPa, such as from 0.8 to 200 GPa, for example from 1.0 to 200 GPa, etc. Semi-rigid materials may have an elastic modulus (e.g., Young's modulus) of between about 0.04 and about 4 GPa, for example. Material having a range of Young's modulus such as 0.5 GPa to 100 GPa, 0.9 GPa to 100 GPa, etc., may also be preferred.
A 3D structure as described herein may also be rigid or semi-rigid based on the structural stiffness. Stiffness is understood to refer to resistance to deformation in response to applied force, and may be described in terms of force per unit length (e.g., newtons per meter or pounds per inch). Stiffness, particularly of three-dimensional structures may be described a deflections in a particular dimension (e.g., degree of freedom); for simplicity, stiffness (rigidity) may refer to stiffness in the direction(s) opposing crushing forces, of the 3D structure when applied to a subject. As described herein, structural elements may be formed into the 3D structure to increase the rigidity (stiffness) of the material, including ridges, ribs, and the like, which may buttress and support the structure, increasing its relative rigidity.
As examples, 3D structures may use materials with tensile strength of 70-80 N/mm2, notched impact strength of 60-80 Kj/m2, thermal coefficient of expansion 65×10−6, maximum continuous use temperature of 125° C., and density 1.20 g/cm3. In other cases, materials may have a tensile strength of 0.20-0.40 N/mm2, thermal coefficient of expansion 100-220×10−6, maximum continuous use temperature of 65° C. and density 0.944-0.965 g/cm3. In other cases, tensile strength may be approximately 9500 psi, flexural modulus of approximately 345,000 psi and a coefficient of linear thermal expansion of 3.8 in/in/° F.×10−5 though these values may be increased or decreased by +/−30% depending on the exact material chosen.
The adhesive devices described herein may be composed of layers. Layered devices (which may also be referred to as layered adhesive devices or layered adhesive medical devices) may be completely or partially flexible, as previously mentioned. For example, a layered device may include a pad and medicament and an adhesive holdfast layer that secures the adhesive device in communication with the skin. The adhesive holdfast layer may itself include a flexible substrate that includes a biocompatible adhesive.
Any of the devices described herein may also include an anatomic guide, such as a ring, a conical alignment guide, a tactile alignment guide, or a visual alignment guide, which enables or facilitates placement of the device on or around an anatomic site on the subject's body.
In some variations, the device may further include a support frame. The support frame may be removable and/or removably attached to another portion of the device including the adhesive substrate, the adhesive layer or another portion of the device including rigid portions of the device that may be made from plastic. For example, the support frame may support the device, including the holdfast region of the device, and be completely or partially removable after the device has been applied to the subject. In some variations, the support frame remains on the device after application. The support frame may serve to make application of the device easier or to prevent the holdfast from unintentionally attaching to itself, to another portion of the device or to the subject. As mentioned, any of these devices may also include a support frame. In some variations, the support frame is a support frame layer.
Also described herein are methods of treating a subject that include the steps of removing a protective cover or liner from a layered adhesive holdfast of an adhesive device and placing the layered device in communication with the subject's skin.
Also described are methods of fabricating a layered medical device, including the steps of forming an adhesive layer comprising a biocompatible adhesive and forming a rigid three dimensional layer, cutting the rigid three dimensional layer (including laser cutting) and accurately attaching this rigid layer to the layered device.
The adhesive devices described herein may be fabricated by batch or continuous fabrication methods, and may include the use of web converting to enable the production of very large volumes of product at low cost.
The layered devices described herein may be contrasted with previously described adhesive devices that were made by other methods that required more assembly time, required “pick-and-place” assembly of injection molded parts, or were not able to be produced at low cost.
An adhesive device may be adapted to be removably secured in communication with a subject's skin and configured to provide a medicament (which may be a liquid, semi-liquid, paste, ointment, gel, liquid matrix, liquid/solid mix, solid, fluid or semi-fluid) to a subject's skin or nails for a sustained duration to provide a benefit to the subject. Medicaments may include various OTC and prescription medications, antibiotics, antifungals or other active ingredients. Adhesive devices that deliver antibiotics may be beneficial in preventing bacterial infection, promoting healing or reducing scar formation. Adhesive devices that deliver antifungals may be used to treat toenail fungus or other fungal skin conditions. Other adhesive devices described herein deliver medicaments that may deliver tar (for example to treat psoriasis), petroleum jelly, moisturizers, oils, extracts, minerals or vitamins to the skin or nails (e.g., to make them stronger, healthier or to improve appearance), and may include other active ingredients as described herein. The medicament may comprise an odorant, such as a fragrance. In some versions, the active agent comprises menthol, eucalyptus oil, and/or phenol. Such devices may be applicability in treating humans and in some cases may have veterinary applications for the treatment of cats, dogs, horses, alpacas and the like.
In some cases, a protective cap is removably attached to the holdfast (and more specifically at least partly attached to the adhesive layer of the holdfast) which serves to protect and/or seal a medicament prior to use by the subject. This protective cap is generally a rigid or semi-rigid three dimensional structure that has been optimized for the purpose of protecting the medicament. As such the protective cap provides a physical barrier that may prevent or minimize migration or movement of the medicament off the pad, especially during storage and transport. This protective cap may serve to reduce evaporation of components of the medicament, thereby maintaining the medicament in a more preferred liquid or fluid state. In other cases, the protective cap may have one or more holes, which may enable evaporation thereby hardening or making more solid the medicament on the pad of the adhesive medical device. The protective cap (or cover, barrier cap, protective cover, vacuum cap, etc.) may also include a selectively compressible region that can be activated by applying force (e.g., from a hand or finger) to deform the region. Such elements may be bistable, so that deformation of this activatable region may be achieved by applying force above some threshold to “snap” the structure from a first configuration to a second configuration. Bistable sub-structures may be useful for protecting, then delivering upon user activation, a medicament as illustrated and described below.
In some cases, a barrier cap is removably attached to the holdfast (and more specifically at least partly attached to the adhesive layer of the holdfast) and serves to protect the wound or other treatment site of the subject. This barrier cap is generally a rigid or semi-rigid three dimensional structure that has been optimized for the purpose of protecting a wound. The barrier cap may also contain a medicament and/or gauze or foam or another hemostatic agent.
In some devices, the shape of the adhesive holdfast may be optimized to comfortably fit an anatomic body site, such as parts of the face, hands, wrists, fingers, legs, ankles, toes, toe or finger nails, ostomy sites, breast, ear, earlobe, arm, chest, thorax, pelvis and the like. In some cases, the adhesive holdfast is designed to be sufficiently flexible to enable comfortable movement of the user, especially when the adhesive device is located on or close to a joint. In other cases, the device may be used to stabilize a joint or prevent motion of a joint.
In other cases, the adhesive device is designed to help support the function of another body part or another medical device, including intravenous (IV) catheters, peripherally inserted central catheters (PICC) or central venous catheters (CVC), urinary catheters, other types of catheters, endotracheal tubes, nasogastic/orogastric tubes, activity monitors as a few examples. For example, an adhesive medical device that comprises an adhesive holdfast that surrounds and securely and releaseably attaches to a portion of an IV catheter may provide stabilization of the IV catheter, preventing its motion which is a can cause pain or injury to the vein. A similar design can used to stabilize urinary catheters or PICC/CVC lines, in which an adhesive holdfast is attached to a more rigid, plastic structure on the adhesive medical device which removeably attaches to and secures an indwelling catheter. In other cases, the adhesive medical device may be useful in the management of stoma sites. For example, ostomy devices with integrated, rigid or semi-rigid rings that are fixed on an adhesive substrate (such as a hydrocolloid) may find use. In this case, the ostomy device (or ostomy “wafer”) may be attached to an ostomy or urostomy bag.
Additionally, adhesive devices are described in which the patient is treated with negative pressure wound therapy, in which an adhesive holdfast creates a seal against the subject's skin and a chamber provides negative pressure to the subject's wound to promote more rapid healing. The negative pressure within the chamber may be created by one or more of several means including patient actuation of a small vacuum chamber or by an external bulb or similar device that creates negative pressure and is attached to a tube. A negative pressure wound therapy device and methods of manufacturing and using said device are described and illustrated herein. The device may include a wound dressing, a plastic cover including an integrated adapter, tubing, and a vacuum source.
As mentioned, an adhesive holdfast may include a flexible adhesive substrate, and/or a protective cover or liner (configured to be removed, for example, by peeling off to expose the adhesive of the adhesive layer). The device may also include a tab or handle configured to be grasped by a subject applying the device. In some variations, this tab or handle is formed from a region of the layered adhesive holdfast.
The various components of the device may be made of any appropriate materials, as described in greater detail below. For example, various components of the device (e.g., protective or barrier cap regions) may be made of medical grade plastic, such as Acrylonitrile Butadiene Styrene (ABS), polypropylene, polyethylene, polycarbonate, polyurethane or polyetheretherketone. The adhesive holdfast may include an adhesive substrate made of silicone, polyurethane or polyethylene. Examples of biocompatible adhesive on the adhesive holdfast may include hydrocolloids, hydrogels or acrylics.
Also described herein are methods of making any of the adhesive support devices described herein. For example, described herein are methods of making an adhesive support device having a three-dimensional shape, the method comprising: placing a planar sheet of material between a first tool and a second tool, wherein the sheet of material extends in a first plane and wherein the material has an elastic modulus of greater than 0.4 GPa; stamping the planar sheet of material between the first tool and the second tool to deform a portion of the material so that it forms a cavity portion extending out of the first plane that is surrounded by a base region extending in the first plane; and securing an adhesive substrate to at least a portion of the base region.
Any of the methods of making an adhesive support device having a three-dimensional shape may include: placing a planar sheet of material between a first tool and a second tool, wherein the sheet of material extends in a first plane and wherein the material has an elastic modulus of greater than 0.4 GPa; stamping the planar sheet of material between the first tool and the second tool to deform a portion of the material so that it forms a cavity portion extending out of the first plane, wherein a wall of the cavity portion comprises one or more ridges increasing the rigidity of the cavity portion; and securing an adhesive substrate to a base region extending in the first plane wherein the base region is a portion of the planar sheet peripheral to the cavity portion.
For example, a method of making an adhesive support device having a three-dimensional shape, the method comprising: placing a planar sheet of material between a first tool and a second tool, wherein the sheet of material extends in a first plane, wherein the material has an initial thickness, and wherein the material has an elastic modulus of greater than 0.4 GPa; stamping the planar sheet of material between the first tool and the second tool to deform a portion of the material so that it forms a cavity portion extending out of the first plane that is surrounded by a base region extending in the first plane, wherein a ratio of a maximum length of the cavity portion in the first plane to a maximum depth of the cavity portion out of first plane is greater than 2:1, further wherein a wall thickness of the cavity portion is less than the initial thickness while the thickness of the base region is approximately the same as the initial thickness; and securing an adhesive substrate to at least a portion of the base region.
Securing an adhesive substrate to at least a portion of the base region may comprise securing the adhesive substrate so that the adhesive substrate is covered on a face opposite from the base region by a liner.
Because of the manner in which the devices described herein are fabricated, e.g., by stamping, pressing, cold pressing, etc. an initially flat piece of rigid or semi-rigid material into a 3D shape, any of the structures described may have structural features that are characteristic of this formation process; these features may have functional benefits. For example, a wall thickness of the cavity portion may generally be less than an initial thickness of the planar sheet of material, while the thickness of the base region may be approximately the same as the initial thickness. Similarly, a ratio of a maximum length of the cavity portion in the first plane to a maximum depth of the cavity portion out of first plane may be greater than 2:1 (e.g., the depth may be much less than the length).
In general, a wall of the cavity portion may comprise one or more ridges increasing the rigidity of the cavity portion.
The angles of all walls of the cavity portion relative to adjacent portions of the base region extending in the first plane may be greater than 90° and less than 180°. This angle (e.g., non-normal) wall, may be useful for cutting, particularly when cutting the device from above (perpendicular to the plane of the base region). For example, the method of forming may include laser cutting one or more walls of the cavity portion using a laser that is oriented perpendicular to the first plane. In general, the method may include cutting around the base region to release the adhesive support device from the planar sheet of material.
Multiple stamping/forming steps may be performed as part of the formation. For example, the method may include stamping the planar sheet of material between a third tool and a fourth tool to further deform the cavity portion so that it extends further out of the first plane.
As mentioned above, in general, the method of forming any of these device may be performed with the tool at room temperature (e.g., “cold” stamping).
Stamping the planar sheet of material between the first tool and the second tool may comprise compressing the planar sheet of material between complementary sides of a die, wherein the first tool forms an upper side of the die and the second tool forms lower side of the die.
In any of the variations described herein, any of the stamped projections formed in the material may then be flattened (e.g., flattening the cavity region) which may increase support and reduce the device profile.
Stamping a material (having the appropriate Young's modulus) may comprise forming a cavity region having a lattice pattern extending in parallel to the first plane; the lattice may enhance stiffness. The material may have a Young's modulus of great than 0.4 GPa, greater than 0.5 GPa, greater than 0.6 GPa, greater than 0.7 GPa, greater than 0.8 GPa, greater than 0.9 GPa, greater than 1.0 GPa, between 0.4 GPa and 100 GPa, between 0.4 GPa and 80 GPa , etc. Exemplary materials that may be used generally include a polycarbonate material (having a Young's modulus/modulus of elasticity of between about 2.0-2.6 GPa), a polyethylene material (having a Young's modulus/modulus of elasticity of between about 0.11-1 GPa, e.g., approximately 0.11 to 0.45 GPa for low density polyethylene, about 0.7-1.0 GPa for high-density polyethylene), or a polyethylene terephthalate material (having a Young's modulus/modulus of elasticity of between about 2-2.7 GPa). In general, the Young's modulus can be used to predict the elongation or compression of an object as long as the stress is less than the yield strength of the material.
In general, placing comprises placing the planar sheet between projecting surfaces of the first and second tool that have only rounded edges. This may also result in device having projecting regions (e.g., cavity regions, hub regions, etc.) having rounded edges on all projecting surfaces.
Stamping the planar sheet of material between the first tool and the second tool to deform the material may comprise stamping an elongate hinge region in the material, and further comprising forming a living hinge by folding the material along the elongate hinge region.
In forming the devices, one or more regions may be cut (e.g., die cut, laser cut, etc.). For example the methods may include die cutting one or more openings through the material.
The material of the initial sheet may comprise a polycarbonate, a polyethylene, or polyethylene terephthalate.
For example, described herein are adhesive support devices having a three-dimensional shape, the device comprising: a body portion comprising a sheet of material, the material having an elastic modulus of greater than 0.4 GPa, wherein the sheet has been deformed from a flat plane to form: a base region extending in the flat plane, the base region having a first thickness; and a cavity region having a thickness that is less than the first thickness, the cavity region at least partially surrounded by the base region, wherein the cavity region extends out of the flat plane at an angle that is greater than 90° relative to an adjacent base region; and an adhesive substrate portion coupled to at least a portion of the base region, wherein the adhesive substrate comprises a liner on a face opposite from the base region.
An adhesive support device having a three-dimensional shape may include: a body portion comprising a sheet of material, the material having an elastic modulus of greater than 0.4 GPa, wherein the sheet has been deformed from a flat plane to form: a base region extending in the flat plane, the base region having a first thickness; and a cavity region having a thickness that is less than the first thickness, the cavity region at least partially surrounded by the base region, wherein the cavity region extends out of the flat plane, wherein a volume of material in any section of a continuous portion of the base region bounded by an arbitrary shape projected from a plane that is parallel to the flat plane is approximately equal to a volume of material in any section of a continuous portion of the cavity region bounded by the arbitrary shape projected from the plane that is parallel to the flat pane; and an adhesive substrate portion coupled to at least a portion of the base region.
An adhesive support device having a three-dimensional shape may include: a body portion comprising a sheet of material, the material having an elastic modulus of greater than 0.4 GPa, wherein the sheet has been deformed from a flat plane to form: a base region extending in the flat plane, the base region having a first thickness, a cavity region at least partially surrounded by the base region, wherein the cavity region extends out of the flat plane, and one or more ridges in a wall of the cavity region increasing the rigidity of the cavity portion, wherein the volume of material in any section of a continuous portion of the base region bounded by a shape projected from a plane that is parallel to the flat plane is approximately equal to the volume of material in any section of a continuous portion of the cavity region bounded by the shape projected from the plane that is parallel to the flat pane; and an adhesive substrate portion coupled to at least a portion of the base region, wherein the adhesive substrate comprises a liner on a face opposite from the base region.
In general, because of the manner in which the devices described herein are formed (e.g., by cold pressing) any of these device may include different regions, such as the base region and the cavity region (or hub region), and the volume of material in any section of a continuous portion of the base region bounded by a shape projected from a plane that is parallel to the flat plane is approximately equal to the volume of material in any section of a continuous portion of the cavity region bounded by the shape projected from the plane that is parallel to the flat pane. This is illustrated in
As mentioned, any of these devices may include one or more ridges in a wall of the cavity region increasing the rigidity of the cavity region. The devices may include one or more cut-out sections on a wall of the cavity region, wherein the wall is angled greater than 90° relative to an adjacent base region.
A ratio of a maximum length of the cavity portion in the flat plane to a maximum depth of the cavity portion perpendicular to the flat plane is greater than 1:1 (e.g., 2:1, 3:1, 4:1, etc.). The angle of all walls of the cavity portion relative to the first plane are greater than 90° and less than 180° relative to an adjacent base region. The base region may form a lip of greater than 0.5 mm around the cavity portion. The cavity region may comprise a lattice pattern extending in parallel to the first plane to enhance stiffness. As mentioned, in general, all projecting surfaces of the cavity region have rounded edges.
Any of these devices may include an elongate hinge region in the material, forming a living hinge by folding the material along the elongate hinge region.
In general, the cavity (or hub) region may extend up from the base region by between about 1 mm and about 50 mm.
Any 3D structure may be formed of any appropriate thin layer (sheet) or material having the requisite Young's modulus as described herein. For example, the material may comprise a polycarbonate, a polyethylene, a polyethylene terephthalate, etc.
An example of a device as described herein configured as a medical device is an intraosseus needle securement device stamped from a sheet of material into a three-dimensional shape. In this example, the device may include: a body portion comprising a sheet of material having an elastic modulus of greater than 0.4 GPa, wherein the sheet has been stamped from a flat plane to form: a base region extending in the flat plane, the base region having a first thickness, and a hub region surrounded by the base region, the hub region having a maximum wall thickness that is equal to or less than the first thickness, wherein the hub region extends from the flat plane at an angle that is greater than 90° relative to an adjacent base region, the hub region having an opening configured to secure an intraosseus needle, and a plurality of ridges in the hub region extending from the base region towards the opening and configured to increase stability of the hub relative to the base region; and an adhesive substrate coupled to the base region and configured to secure the device to a patient's skin.
For example, an intraosseus needle securement device stamped from a sheet of material into a three-dimensional shape may include: a body portion comprising a sheet of material having an elastic modulus of greater than 0.4 GPa, wherein the sheet has been stamped from a flat plane to form: a base region extending in the flat plane, the base region having a first thickness, and a hub region surrounded by the base region, the hub region having a maximum wall thickness that is equal to or less than the first thickness, wherein each wall of the hub region extend up from the flat plane at an angle that is greater than 90° relative to a nearest portion of the base region, the hub region having a central opening configured to secure an intraosseus needle, and a plurality of ridges in the hub region extending up toward the opening and configured to increase stability of the hub relative to the base region; and an adhesive substrate coupled to the base region and configured to secure the device to a patient's skin.
As mentioned above, the base region comprises a raised pattern extending in parallel to the first plane to enhance stiffness. The hub region may comprise a generally cylindrical shape (e.g., a cylinder with an outer wall that slopes or tapers slightly inward (forming a flattened cone or bullet shape, for example).
In general, the device described are adhesive devices. These devices may generally include a flat (planar) region having a back side to which the adhesive material is attached. The opposite (e.g., front) side of the device typically includes a three-dimensional structure stamped from a planar sheet of material so that the 3D structure extends out from the front side.
As mentioned above, the volume of material in any section of a continuous portion of the base region bounded by a shape projected from a plane that is parallel to the flat plane is approximately equal to the volume of material in any section of a continuous portion of the hub region bounded by the shape projected from the plane that is parallel to the flat pane.
The ratio of a maximum length of the hub portion in the flat plane to a maximum depth of the hub portion perpendicular to the flat plane is greater than 1:1.
The base region may form a lip of greater than 0.5 mm adjacent to the hub portion.
All surfaces of the hub region projecting from the flat plane may have rounded edges. The hub region may extend up from the base region by between about 1 mm and about 50 mm.
In general, the hub region may be continuous with the base region, or it may be separated from the base region by one or more intermediate regions.
As mentioned above, the material forming the base and hub region (from the initially planar sheet) may comprise a polycarbonate, a polyethylene, or polyethylene terephthalate.
FIB. 26B illustrates the top view of an intraosseous access device being stabilized by an adhesive medical device.
Described herein are devices and household products, including adhesive medical devices having a three-dimensional structure configured to be adhesively secured to a patient or other object. Although this disclosure describes various different structures, any of which may be referred to as an adhesive device, any of these devices or variations of devices may incorporate any of the features or elements described in any of the other device or variations of devices. Features and elements illustrated and described for the various figures and exemplary embodiments described herein may, unless the context indicates otherwise, be applied to any of the embodiments described.
For example, any of the devices described herein may be layered adhesive devices that include a three-dimensional structure extending from an adhesive base (or substrate) that may be attached to a patient or other surface. The three-dimensional structure may generally be formed of a lightweight, relatively durable material. In any of the embodiments described herein, the structure may be formed by a press, e.g., as part of a web converting process. The 3D structure or component may be formed from an initially planar material (e.g., a thin polymeric material) that is pressed (e.g., cold pressed, hot pressed, stamped, etc.) one or more times (sequentially) during fabrication and concurrent assembly. Thus, the resulting structure may include features that reflect this forming technique, such as the thickness, dimensions, orientation, vertical wall angle, and the like, as described in greater detail below. For example, the 3D structures may include an outer edge having a wall thickness that is greater than the thickness of any of the more radially inward walls. This outer edge wall thickness may also provide improved stability and strength.
The structures described herein may also include one or more cutting, and particularly laser cutting, steps to be formed. As described in greater detail below, a laser cutter may be used and mounted above the manufacturing line to cut materials, including the 3D structures formed by the pressing/stamping techniques described above, including making cut outs. Thus, in general, when laser cutting is performed, the walls to be cut may all have outwardly sloping walls, so that the laser cutter will be able to project its beam on the wall to be cut. A vertically oriented laser cutter may typically emit a beam that is parallel to the vertical wall, hence for precise cutting, the wall should be sloping. For example, the walls to be cut may be sloping relative to a direction that is perpendicular from a base region, at an angle of (relative to an outer ‘flat’ base region) greater than 90° and less than 180° (e.g., greater than 91°, 92°, 93°, 94°, 95°, 96°, 97°, 98°, 99°, 100°, 101°, 102°, 103°, 104°, 105°, 110°, 115°, etc.).
An adhesive device is one variation of a medical device in which an adhesive holdfast region is used to secure the device in communication with a body part of the subject such as the skin. The devices and methods described herein are not limited to the particular embodiments described. Variations of the particular embodiments described may be made and still fall within the scope of the disclosure. Examples and particular embodiments described are not intended to be limiting.
Layered devices are of particular interest, and are described more fully below. Layered adhesive medical devices may include two or more layers. For example, a layered medical device may include an adhesive holdfast layer (which itself is made from a single or multiple layers) and a functional component (which may include a three dimensional rigid or semi-rigid structure). These various layers may be composed of separate layers, and these layers may be separated by other layers, or they may be adjacent. The adhesive holdfast layer may be itself formed of layers (optionally: a substrate layer, a protective covering layer (or liner), an adhesive layer, etc.), and thus may be referred to as a layered adhesive holdfast. Similarly, the functional component may be formed of multiple layers including layer(s) that may be rigid and be comprised of thin plastic, for example. In some variations, the layered adhesive holdfast and the functional component may have one or more layers. For example, the liner layer and protective cap may be the same layer.
As used herein, a “layer” may be generally planar geometry (e.g., flat), although it may have a thickness, which may be uniform or non-uniform in section.
The following descriptions including various design parameters or goals, and methods and devices which fit the design parameters or goals. The devices and methods described herein (and recited by any claims) are not limited to any particular theory of operation.
In general, the adhesive medical devices described herein include a holdfast region (or layer) and at least one functional layer that provides a therapeutic or non-therapeutic function. As will be apparent from the figures, many of these devices may be removable and insertable by a user without special tools. In some variations, a subject may use an applicator to apply the device (e.g., to help align it). Adhesive medical devices may also be packaged in various ways, including pouches or boxes that may be designed to create a seal around each device or around more than one device. In some cases, the packaging will be airtight to prevent evaporation of any parts of the device (including the medicament). In other cases, the packaging may not be airtight or may be partly or completely permeable to air or gaseous components.
It may also be beneficial for a subject to wear an adhesive device over an extended period of time (several minutes to an hour to several hours, for approximately 4, 6, 8 or 12 hours, a day or more than one day, several days or a week). Some devices may be reused while others are single use and disposable. A user may be required to wear the device (or multiple new devices) over the course of days, week, months or years depending on the condition being treated.
Described below are variations of adhesive devices that may be comfortably worn by the subject. In some variations, a grip (e.g., a tab, handle, strap, or other additional interface region) may be included to help secure the device to the subject's face or body, and may additionally or alternatively be helpful in positioning or manipulating (e.g., gripping) the device, particularly when it is being applied. This additional interface region may be formed of the same material as the adhesive holdfast region, or it may be a separate region, as described in more detail below.
Other materials of interest include any materials that can serve as filters. This filter may be part of the device. Any suitable filtering material known to those skilled in the art may be used. Such materials include, but are not limited to, activated carbon charcoal filters, hollow-fiber filters, and the like.
The adhesive devices described herein generally include an adhesive holdfast for securing the device in communication with a subject's body or in communication with another surface such as a wall or furniture. The adhesive holdfast may include one or more adhesive surfaces that are suitable for use against a subject's body (e.g., skin, mucous membranes, wounds). Thus, the adhesive holdfast may include a biocompatible adhesive. The adhesive holdfast may facilitate the positioning and securing of the device in a desired location with respect to the subject's body. In some cases, the adhesive device may be removable and worn again, depending on the choice of adhesive layer (which may include silicone for example).
The adhesive holdfast may be flexible so that it conforms to the surface of the subject's skin, which may be relatively irregularly shaped and may include hair, wounds and the like. In some variations, the adhesive holdfast is made of a material that permits the passage of water vapor, liquid water, sweat and/or oil, which may enhance comfort. In other variations, the adhesive holdfast (and the entire device) may be completely, mostly or somewhat occlusive, or impermeable to these substances, in order to provide a moist healing environment for the wound. A fully occlusive material may help promote transport of the medicament into the skin. Any commonly used occlusive wound materials may be used as a component of the adhesive medical device. The adhesive holdfast may also include a texture or patterned relief surface (either on the later directly touching the skin or any other layer including the adhesive substrate) to enhance bonding to the subject's skin.
The adhesive holdfast may be made of layers. Thus, the adhesive holdfast may be referred to as a layered holdfast (or layered adhesive holdfast). For example, the adhesive holdfast may include a substrate (also known as adhesive substrate) layer to which a biocompatible adhesive is applied. The substrate is typically a substantially flat (predominantly 2-sided) material that is flexible. An adhesive may be present on at least one surface of the substrate. In some variations, the substrate layer is itself adhesive without needing an additional adhesive. An additional protective cover or liner may also be removably attached to the adhesive of the adhesive layer. The protective cover or liner may allow the device (and particularly the adhesive holdfast) to be manipulated without inadvertently sticking the device to the fingers or other parts of the body and it may also prevent contamination of the adhesive. The liner may be a removable paper or other film that can be peeled off or otherwise removed to expose the adhesive. In some variations, the adhesive of the adhesive holdfast is activatable. For example, the adhesive may become ‘sticky’ only after exposure to an activator (e.g., water, air, light, etc.) or may increase its “stickiness” after application (for example after exposure to heat from the subject's body or skin). In some variations, an adhesive could be applied to the skin in a liquid form first, than the device is applied. In other variations, the skin of the subject is prepped through normal or vigorous cleaning which may involve the use of solvents or other cleaning substances or fluids. In some variations, a protective cover is not used. As already mentioned, in some variations, the substrate and adhesive are a single layer, so that the substrate comprises an adhesive material, or a material that can be activated to become adhesive.
The adhesive holdfast may comprise any appropriate material. For example, the adhesive substrate may be a biocompatible material such as silicone, fabric, cloth, polyethylene, or polyethylene foam. Other appropriate biocompatible materials (that may be part of the holdfast or any part of the device) may include some of the materials previously described, such as biocompatible polymers and/or elastomers. Suitable biocompatible polymers may include materials such as: a homopolymer and copolymers of vinyl acetate (such as ethylene vinyl acetate copolymer and polyvinylchloride copolymers), a homopolymer and copolymers of acrylates (such as polypropylene, polymethylmethacrylate, polyethylmethacrylate, polymethacrylate, ethylene glycol dimethacrylate, ethylene dimethacrylate and hydroxymethyl methacrylate, and the like), polyvinylpyrrolidone, 2-pyrrolidone, polyacrylonitrile butadiene, polyamides, fluoropolymers (such as polytetrafluoroethylene and polyvinyl fluoride), a homopolymer and copolymers of styrene acrylonitrile, cellulose acetate, a homopolymer and copolymers of acrylonitrile butadiene styrene, polymethylpentene, polysulfones polyimides, polyisobutylene, polymethylstyrene and other similar compounds known to those skilled in the art. Structurally, the substrate may be a film, foil, woven, non-woven, foam, or tissue material (e.g., poluelofin non-woven materials, polyurethane woven materials, polyethylene foams, polyurethane foams, polyurethane film, etc.). In some cases, a pad maybe attached to the any portion of the adhesive holdfast and may be made from woven or non-woven materials, gauze, foam (open or close cell) or other material that may provide hemostasis. In some cases, the pad also comprises a medicament that can promote clotting, healing or repair, or provide other medical or non-medical benefit.
In variations in which an adhesive is applied to the substrate, the adhesive may comprise a medical grade adhesive such as a hydrocolloid or an acrylic. Medical grade adhesives may include foamed adhesives, acrylic co-polymer adhesives, porous acrylics, synthetic rubber-based adhesives, silicone adhesive formulations (e.g., silicone gel adhesive), and absorbent hydrocolloids and hydrogels.
In some variations, the adhesive is a structural adhesive. For example, the adhesive may adhere based on van der Walls forces. Patents no. U.S. Pat. No. 7,011,723, U.S. Pat. No. 6,872,439, U.S. Pat. No. 6,737,160, and U.S. Pat. No. 7,175,723 describe setal-like structures whose shape and dimension provide adhesive force. These patents are herein incorporated by reference in their entirety.
The removable liner layer may be made of any appropriate matter that may be released from the adhesive. For example, the liner material may comprise craft paper. In some variations, the liner material comprises polyethylene film, or polyethylene coated paper (e.g. kraft paper) or any plastic or other material described herein. In some cases, different types of liner material may be used in the same device. For example, one liner material may be used as part of a protective cap and another liner material may be used to protect other parts of the adhesive layer (i.e. not in the area of the protective cap. In general, any of the materials commonly used in the manufacture of bandages (particularly disposable bandages such as Band-Aids™), ostomy kits, and wound care products may be used in any or all components of devices described herein.
The following materials may be used in any part of the adhesive devices (including the protective and barrier caps or any other 3D form component) described herein: fabric, cloth, latex, polyethylene, polypropylene, polystyrene, polyvinyl chloride, polyvinylidene chloride, polyvinyl acetate, polyacrylate, styrene-butadiene copolymer, chlorinated polyethylene, polyvinylidene fluoride, ethylene-vinyl acetate copolymer, ethylene-vinyl acetate-vinyl chloride-acrylate copolymer, ethylene-vinyl acetate-acrylate copolymer, ethylene-vinyl acetate-vinyl chloride copolymer, nylon, acrylonitrile-butadiene copolymer, polyacrylonitrile, polyvinyl chloride, polychloroprene, polybutadiene, thermoplastic polyimide, polyacetal, polyphenylene sulfide, polycarbonate, thermoplastic polyurethane, thermoplastic resins, thermosetting resins, natural rubbers, synthetic rubbers (such as a chloroprene rubber, styrene butadiene rubber, nitrile-butadiene rubber, and ethylene-propylene-diene terpolymer copolymer, silicone rubbers, fluoride rubbers, and acrylic rubbers), elastomers (such as a soft urethane, water-blown polyurethane), sodium polyacrylate, paper batteries, and thermosetting resins (such as a hard urethane, phenolic resins, and a melamine resins), and injection moldable materials such as polyether block amide (e.g., PEBAX®), and the like.
An adhesive layer (or an adhesive holdfast layer) may be formed using any appropriate method, particularly those described herein. For example, an adhesive layer may be formed by cutting (stamping, punching, die cutting, laser cutting, etc.) the adhesive substrate, biocompatible adhesive, and protective cover into the desired shape. Multiple steps may be used to form the adhesive layer. For example, the adhesive layer may be formed by cutting (or otherwise forming) the outer perimeter, then by cutting (or otherwise forming) an inner opening. Any of these steps may be combined, as appropriate.
It is not necessary that the entire adhesive holdfast region include an adhesive, although many of the substantially flat holdfast regions described in the figures may have a biocompatible adhesive over much of the skin-contacting surface (although it may be covered by a protective cover that can be at least partially removed later). In some variations only a subset of the holdfast region (including the outer layer) includes an adhesive. For example, the region beneath the tabs or grips may not include an adhesive. In some variations, the adhesive medical devices described herein are adapted to fit different users having a diversity of sizes and shapes. In other cases, there is an adhesive layer on both sides of the adhesive substrate. For example, the side of the device that is attached to patient's skin may have adhesive on part or all of its skin-contacting surface, and there may be adhesive applied to part or all of the other side of the holdfast or device to attach various 3D plastic pieces (or other components as described herein).
The adhesive devices may be formed by sequentially layering onto a backing layer (or liner) that protects one side of double-sided adhesive (forming the adhesive holdfast), and cutting out (e.g., die-cutting) one or more openings through this adhesive holdfast substrate.
In some versions, the device includes a medicament. As used herein, a medicament includes any substance that may be applied or delivered to the subject by the device. A medicament may provide a health benefit, including treating a certain health condition. In some versions, the medicament may be an active agent that comprises a drug. In other versions, the active agent is not a drug and does not serve a medicinal purpose. For example, the active agent may only provide fragrance. In some cases, the active agent may be embedded or impregnated in the device or components of the device. In some cases the active agent is a coating. A medicament may comprise any compound that is in some way useful or desirable for the subject. For example, the active agent may be any odorant, including: menthol, phenol, eucalyptus, tea tree oil, or any agent that provides a fragrance. Alternatively, a medicament may comprise a drug with beneficial effects, such as beneficial vasculature effects. For example, a medicament may comprise a drug that affects the blood vessels (oxymetazoline or any other vasoactive compound), nasopharynx, airways or lungs (albuterol, steroids, or other bronchoconstriction or bronchodilation compounds). A medicament may comprise, for example, an antibiotic or a steroid. Other medicaments may be topical anesthetics (which may be helpful to numb an area prior to a medical or surgical intervention), and imiquimod and fluorouracil for various skin conditions including cancer. The above list of active agents is not meant to be limiting.
Any medicament, whether therapeutic or non-therapeutic, may be used. The medicament can take the form of an ointment, balm, cream, salve, liquid, paste, gel, solid, or near solid. Agents that change from solid to liquid (or change from a more viscous liquid to a less viscous liquid) when applied to the subject or when exposed to higher temperatures may find use. The medicaments may have medicinal benefit and may be prescription, non-prescription or OTC (over the counter).
A medicament may be placed in or on any portion of the device. Furthermore, the location of the medicament within the device may specifically guide the delivery of the active agent. For example, in versions of the device, the holdfast comprises a medicament (e.g., coated, embedded or otherwise part of the holdfast). In another example, a medicament may be included as a powder or releasable coating. Thus, a medicament may be on an internal or external surface of the device (e.g., pad, holdfast, cap, etc.) or embedded within or on any surface of the device. A separate drug-containing region may also be included in the device. In some cases, a flux enhancer may be used. As an example, for veterinary use, a fragrance such as bitter apple may be applied or deposited to any portion of the subject devices. Such a fragrance may deter the animal from removing or chewing on the device.
In some embodiments, one or more components of the device are impregnated with, contain or are coated with one or more compounds that may be inhaled during use. The presence of airflow, heat or other conditions may facilitate the release of the compound into the air or surrounding tissues. The compound may be herbal (such as menthol or lavender), chemical or pharmaceutical (such as an antihistamine or anti-asthma drug) in nature. Depending on the compound, the user might experience a pleasant aroma (which may soothe or promote sleep or activity) or medical benefits, such as nasal decongestion or asthma relief. The compound may be inhaled during all or at least a portion of the time the user is wearing the device.
Active ingredients that may find use include: isotretinoin, alclometasone, doxycycline, erythromycin, iodoquinol, hydrocortisone, imiquimod, alefacept, sodium sulfacetamide, sulfur, tretinoin, muprirocin, clindamycin, benzoyl peroxide, fluocinolone, fluorouracil, clocortolone, clobetasol, fluticasone, prednicarbate, adapalene, calcipotriene, minocycline, pimecrolimus, mometasone, sertaconazole, famciclovir, azelaic acid, urea, terbinafine, lidocaine, acetate, ciclopirox, metronidazole, minocycline, naftifine, oxiconazole, finasteride, tacrolimus, tretinoin, itraconazole, diclofenac, tazarotene, desoximetasone, fluocinolone, hydroquinone (including 2 and 4%), valacyclovir, doxepin cetirizine, salicylic acid, silver sulfadiazine, zinc oxide, silver nitrate, aloe vera, benzalkonium chloride, dyclonine, LMX or other topical anesthetic, steroids, Aldera, Efudex, phenol, tar (to treat psoriasis), petroleum jelly, Vicks VaporRub, moisturizers, oils, extracts, minerals or vitamins and combinations of more than one of the above compounds. Other medicaments and inactive ingredients include persea gratissima oil (avocado), ethylhexyl Palmitate, vitis vinifera seed oil, helianthus annuus seed oil (sunflower), isopropyl palmitate, lecithin, sesamum indicum seed oil (sesame), capric/caprylic stearic triglyceride, aleurites moluccana (kukui nut) seed oil, tocotrienol, alcohol, glyceryl stearate, oleic acid, vitamin C, tocopherol, BHT, methylparaben, benzyl alcohol, benzyl salicylate, geraniol, hexylcinnamal, hydroxyisohexyl 3 cyclohexene carboxaldehyde, butylphenyl methypropional, onion extract, limonene, linalool, terbinafine, butenafine, amorolfine, and tonalftate.
Other compounds that may be used include other antiobiotic and antimicrobials including bacitracin, polymixin B, neomycin and various double or triple combinations of various antimicrobials including Neosporin. These include but are not limited to: bacitracin ointment containing, in each gram, 500 units of bacitracin, bacitracin zinc ointment containing, in each gram, 500 units of bacitracin zinc, chlortetracycline hydrochloride ointment containing, in each gram, 30 milligrams of chlortetracycline hydrochloride, neomycin sulfate ointment containing, in each gram, 3.5 milligrams of neomycin in a suitable water soluble or oleaginous ointment base, neomycin sulfate cream containing, in each gram, 3.5 milligrams of neomycin, tetracycline hydrochloride ointment containing, in each gram, 30 milligrams of tetracycline hydrochloride.
Alternatively, combinations of antibiotic active ingredients may include. (1) bacitracin-neomycin sulfate ointment containing, in each gram, 500 units of bacitracin and 3.5 milligrams of neomycin in a suitable ointment base. (2) bacitracin-neomycin sulfate-polymyxin B sulfate ointment containing, in each gram, in a suitable ointment base the following: (i) 500 units of bacitracin, 3.5 milligrams of neomycin, and 5,000 units of polymyxin B; or (ii) 400 units of bacitracin, 3.5 milligrams of neomycin, and 5,000 units of polymyxin B; (3) bacitracin zinc-neomycin sulfate ointment containing, in each gram, 500 units of bacitracin and 3.5 milligrams of neomycin in a suitable ointment base. (4) bacitracin zinc-neomycin sulfate-polymyxin B sulfate ointment containing, in each gram, in a suitable ointment base the following: (i) 400 units of bacitracin, 3 milligrams of neomycin, and 8,000 units of polymyxin B; or (ii) 400 units of bacitracin, 3.5 milligrams of neomycin, and 5,000 units of polymyxin B; or (iii) 500 units of bacitracin, 3.5 milligrams of neomycin, and 5,000 units of polymyxin B; or (iv) 500 units of bacitracin, 3.5 milligrams of neomycin, and 10,000 units of polymyxin B; (5) bacitracin zinc-polymyxin B sulfate ointment containing, in each gram, 500 units of bacitracin and 10,000 units of polymyxin B in a suitable ointment base. (6) bacitracin zinc-polymyxin B sulfate topical powder containing, in each gram, 500 units of bacitracin and 10,000 units of polymyxin B in a suitable (7) neomycin sulfate-polymyxin B sulfate ointment containing, in each gram, 3.5 milligrams of neomycin and 5,000 units of polymyxin B in a suitable water miscible base. (8) neomycin sulfate-polymyxin B sulfate cream containing, in each gram, 3.5 milligrams of neomycin and 10,000 units of polymyxin B in a suitable vehicle. (9) oxytetracycline hydrochloride-polymyxin B sulfate ointment containing, in each gram, 30 milligrams of oxytetracycline and 10,000 units of polymyxin B in a suitable ointment base.
Additionally, combinations of first aid antibiotic active ingredients and local anesthetic active ingredients may be used: (1) bacitracin ointment containing, in each gram, 500 units of bacitracin and any amine or “caine”-type local anesthetic active ingredient in a suitable ointment base. (2) bacitracin-neomycin sulfate-polymyxin B sulfate ointment containing, in each gram, in a suitable ointment base the following: (i) 500 units of bacitracin, 3.5 milligrams of neomycin, 5,000 units of polymyxin B, and any amine or “caine”-type local anesthetic active ingredient; or (ii) 400 units of bacitracin, 3.5 milligrams of neomycin, 5,000 units of polymyxin B, and any single generally recognized as safe and effective amine or “caine”-type local anesthetic active ingredient. (3) bacitracin zinc-neomycin sulfate-polymyxin B sulfate ointment containing, in each gram, in a suitable ointment base the following: (i) 400 units of bacitracin, 3 milligrams of neomycin, 8,000 units of polymyxin B, and any amine or “caine”-type local anesthetic active ingredient; or (ii) 400 units of bacitracin, 3.5 milligrams of neomycin, 5,000 units of polymyxin B, and any amine or “caine”-type local anesthetic active ingredient; or (iii) 500 units of bacitracin, 3.5 milligrams of neomycin, 5,000 units of polymyxin B, and any amine or “caine”-type local anesthetic active ingredient; or (iv) 500 units of bacitracin, 3.5 milligrams of neomycin, 10,000 units of polymyxin B, and any single amine or “caine”-type local anesthetic active ingredient; (4) bacitracin zinc-polymyxin B sulfate ointment containing, in each gram, 500 units of bacitracin, 10,000 units of polymyxin B, and any amine or “caine”-type local anesthetic active ingredient in a suitable ointment base. (6) neomycin sulfate-polymyxin B sulfate cream containing, in each gram, 3.5 milligrams of neomycin, 10,000 units of polymyxin B, and any amine or “caine”-type local anesthetic active ingredient in a suitable vehicle.
Antifungals that may be used include: clioquinol (including 3 percent formulations), haloprogin (including 1 percent formulations), miconazole nitrate (including 2 percent formulations), povidone-iodine (including 10 percent formulations), clotrimazole (including 1 percent formulations) and tolnaftate (including 1 percent formulations). Additionally, undecylenic acid, calcium undecylenate, copper undecylenate, and zinc undecylenate may be used individually or in any ratio that provides a total undecylenate concentration of 10 to 25 percent.
Acne medications may also be used including: benzoyl peroxide (including 2.5 to 10 percent formulations), resorcinol (including 2 percent formulations), resorcinol monoacetate (including 3 percent formulations which may be combined with sulfur), salicylic acid (including 0.5 to 2 percent formulations-which may also be used for the treatment of warts), sulfur, (including 3 to 10 percent formulations), and sulfur (including 3 to 8 percent formulations which may be combined with resorcinol or resorcinol monoacetate.)
The volume of medicament in each device may be approximately 0.1 ml, 0.2 ml, 0.3 ml, 0.4 ml, 0.5 ml, 0.6 ml, 0.7 ml, 0.8 ml, 0.9 ml, 1.0 ml, 1.1 ml, 1.2 ml, 1.3 ml, 1.4 ml, 1.5 ml, 1.6 ml, 1.7 ml, 1.8 ml, 1.9 ml, 2.0 ml, 2.1 ml, 2.2 ml, 2.3 ml, 2.4 ml, 2.5 ml, 2.6 ml, 2.7 ml, 2.8 ml, 2.9 ml, 3.0 ml, 3.1 ml, 3.2 ml, 3.3 ml, 3.4 ml, 3.5 ml, 3.6 ml, 3.7 ml, 3.8 ml, 3.9 ml, 4.0 ml, 4.1 ml, 4.2 ml, 4.3 ml, 4.4 ml, 4.5 ml, 4.6 ml, 4.7 ml, 4.8 ml, 4.9 ml, or 5.0 ml.
The viscosity of the medicament may vary from 1 cps to 200,000 cps. Generally medium to higher viscosity medicaments may find use include those with viscosities between 25,000-35,000 cps, between 35,000-45,000 cps, between 45,000-55,000 cps, between 55,000-65,000 cps, between 65,000-75,000 cps, between 75,000-85,000 cps, between 85,000-95,000 cps, between 95,000-105,000 cps, between 105,000-120,000 cps, between 120,000-135,000 cps, between 135,000-150,000 cps and above 150,000 cps in some cases.
A medicament (such as an ointment or the like) may have the tendency to seep or wick through a gauze, pad, or other substrate that it contacts, especially if the ointment has a relatively low viscosity. This effect may be worsened if the substrate has holes within it. Ointment that is too viscous may have a tendency to stick to the protective cap. In some cases, a hydrophobic or hydrophilic pad is used. In some cases, a portion of the device (e.g., a pad) may be treated or covered so as to prevent absorption or wicking of materials. In some cases, paraffin wax or similar materials may be used as a layer under the medicament, under the pad, under the adhesive, etc.
Exemplary materials that may be used for use any portion of the adhesive devices described herein include: metals, plastics, rubbers, ceramics, wood, chrome, or combinations thereof. Other materials may include acrylics, latex, polyethylene, polypropylene, polystyrene, polyvinyl chloride, polyvinylidene chloride, polyvinyl acetate, polyacrylate, styrene-butadiene copolymer, chlorinated polyethylene, polyvinylidene fluoride, ethylene-vinyl acetate copolymer, ethylene-vinyl acetate-vinyl chloride-acrylate copolymer, ethylene-vinyl acetate-acrylate copolymer, ethylene-vinyl acetate-vinyl chloride copolymer, nylon, acrylonitrile-butadiene copolymer, polyacrylonitrile, polyvinyl chloride, polychloroprene, polybutadiene, thermoplastic polyimide, polyacetal, polyphenylene sulfide, polycarbonate, thermoplastic polyurethane, thermoplastic resins, thermosetting resins, natural rubbers, synthetic rubbers (such as a chloroprene rubber, styrene butadiene rubber, nitrile-butadiene rubber, and ethylene-propylene-diene terpolymer copolymer, silicone rubbers, fluoride rubbers, and acrylic rubbers), elastomers (such as a soft urethane, water-blown polyurethane), sodium polyacrylate, thermochromatic plastic, and thermosetting resins (such as a hard urethane, phenolic resins, and a melamine resins).
Biocompatible materials may be used, particularly for those portions of the device which may contact a user. In addition to some of the materials described above, biocompatible materials may also include a biocompatible polymer and/or elastomer. Suitable biocompatible polymers may include materials such as: a homopolymer and copolymers of vinyl acetate (such as ethylene vinyl acetate copolymer and polyvinylchloride copolymers), a homopolymer and copolymers of acrylates (such as polypropylene, polymethylmethacrylate, polyethylmethacrylate, polymethacrylate, ethylene glycol dimethacrylate, ethylene dimethacrylate and hydroxymethyl methacrylate, and the like), polyvinylpyrrolidone, 2-pyrrolidone, polyacrylonitrile butadiene, polyamides, fluoropolymers (such as polytetrafluoroethylene and polyvinyl fluoride), a homopolymer and copolymers of styrene acrylonitrile, cellulose acetate, a homopolymer and copolymers of acrylonitrile butadiene styrene, polymethylpentene, polysulfones polyimides, polyisobutylene, polymethylstyrene and other similar compounds known to those skilled in the art. Teflon, Mylar, PFA, LDPE, Hytrel, HDPE and polyester may also find use in any components of the devices. Materials that are biocompatible and/or sterilizable may also be preferred, for example, medical grade plastics such as Acrylonitrile Butadiene Styrene (ABS), latex, polypropylene, polycarbonate, and polyetheretherketone. The forgoing materials are intended as illustrations only. In general, the materials used for any of the adhesive devices described herein may be appropriate for in-line fabrication, for example, using a web conversion technique. For example, the materials used to form the various layers (adhesive substrate, adhesive, 3D rigid/semi-rigid structure, etc.) may be an appropriate material selected from those described above. Further, the dimensions (e.g., thickness) of such materials may be within an appropriate range to accommodate this fabrication technique. Examples of such materials and fabrication techniques are provided herein. For example, an exemplary class of adhesive devices described herein includes negative pressure wound therapy systems
Traditional negative pressure wound therapy often requires vacuum sources that are bulky, complex, and/or expensive. There is a need for devices that are more portable, simpler and less expensive. Currently available devices are generally manufactured with a hybrid method, involving some steps that are performed by machine, and other steps that are performed by hand. The instant invention may utilize a manufacturing method such as web converting that can be fully or partially automated, can be easily scaled and is cost-effective. Web converting can involve die cutting, island placement, heat seal packaging, printing, conveying, inspecting, and rejecting parts not within set tolerances. With respect to negative pressure wound therapy systems, the instant invention may use a web converting method in order to co-manufacture the absorbent pad/dressing and the vacuum interface (e.g., plastic cap hat attaches to the vacuum tubing) simultaneously. Rather than using slower and relatively expensive “pick and place” processes, web converting enables the invention to be manufactured with less human labor and less cost and increased speed.
Negative pressure wound therapy devices enable controlled application of negative pressure to a wound. A dressing that is sealed against the skin surrounding the wound is placed on the user and connected to a vacuum pump which pulls negative pressure. The pressure draws out fluid from the wound and increases blood flow to the area, facilitating healing and minimizing scar tissue. Large wounds, chronic wounds, pressure sores and diabetic ulcers may all benefit from negative pressure therapy.
The wound dressing is typically placed directly on the wound. It may be a flexible material to shape to the contours of the wound area, or it may be a more rigid material in order to better support a seal for negative pressure. The wound dressing may be impermeable to fluids, or may be absorbent. It may contain an absorbable matrix. In some embodiments, the wound dressing may contain, or work in communication with, another absorbent material, such as open cell or polyurethane foam, medical gauze or fabric pad. In some embodiments, the wound dressing may contain a layer designed to evenly distribute pressure over the wound. This layer may contain one or more materials that in some way deform under negative pressure, such as open cell foam, medical gauze, sponges, other matrix-like materials, etc. In some embodiments, an airlock layer may additionally be added to the wound dressing. In some embodiments, a hydrophilic layer that interacts with any fluid to form a gel may be used. In some embodiments, a moisture wicking material may be used. The wound dressing may additionally contain an adhesive for the purposes of adhering to patient skin around the wound and may be made out of hydrocolloid. The pad can be cut to size, or can be different size and shapes according to the type of wound. Saline or antibiotics or growth factors may be dispensed into the wound or dressing. Any of the parts of the device described herein may be impregnated with antibiotics or other medicines.
Turning to the figures, additional exemplary devices, systems and methods of manufacturing and using them are described. For example,
In
In
In
The angle α seen in
In general, in any of the 3D structures (e.g., caps, cover, protective cap, barrier cap, protective cover, vacuum cap, etc.) described herein all of the walls may have angle with respect to the perpendicular direction relative to the base plane of the structure. For example, all of the walls of the 3D structure may be at an angle of between about 58 degrees and 88 degrees relative to the plane formed by the outer (peripheral) baser region of the structure. As mentioned above, this outer base region may have a larger wall thickness compared to all of the walls forming the 3D structure (e.g., projecting up from this base region).
The height of the protective cap 106 in
The ratio of the maximum length of the protective cap/barrier cap (measured on the inside at the base of the protective cap/barrier cap in a direction that is parallel to the adhesive holdfast in the figures) to the height of the protective cap/barrier cap is generally greater than 1:1, more specifically greater than 2:1, or greater than 3:1, though in some cases where the protective/barrier cap is much longer than wide, this ratio my be less than 1:1 or less than 1:2. The maximum length of the protective/barrier cap is defined as the maximum distance between any two points measured at the base of the inside of the protective/barrier cap. In other words, this is the maximum internal distance or dimension measured at the base of the protective/barrier cap. This definition applies to any shape of the protective/barrier cap (or any other 3D component in an other device described herein) whether it is circular, oval, triangular, square, rectangular, or other polygonal shape or non-polygonal shape.
The ratio of the minimum length of the protective cap/barrier cap (measured on the inside at the base of the protective cap/barrier cap in a direction that is parallel to the adhesive holdfast in the figures) to the height of the protective cap/barrier cap is generally greater than 1:1, more specifically greater than 2:1, or greater than 3:1. The minimum length of the protective/barrier cap is defined as the minimum distance between any two points measured at the base of the inside of the protective/barrier cap. In other words, this is the minimum internal distance or dimension measured at the base of the protective/barrier cap. This definition applies to any shape of the protective/barrier cap whether it is circular, oval, triangular, square, rectangular, or other polygonal shape or non-polygonal shape. In some variations, because of limitations of in-line forming during the web converting process, the height of the protective cap/barrier cap may be limited by the length, width and/or circumference of the base of the protective cap/barrier cap. In some variations, the ratio of the height of the protective cap/barrier cap relative to the area of the opening (surface area) may be less than about 0.50 (e.g., less than about 0.45, less than about 0.4, less than about 0.35, less than about 0.30, less than about 0.25, less than about 0.2). In some variations, e.g., depending on the shape of the opening, it may be more accurate to describe the height in terms of the total distance of the perimeter (or circumference) of the opening. The terms perimeter or circumference both mean the total linear distance measured along the inside of a closed curve measured at the base of the protective cap/barrier cap. As defined herein, the terms perimeter and circumference may apply to any closed curve and need not be limited to circular shapes. For example, the maximum height of the protective cap/barrier cap may be a function of the length of the perimeter of the opening formed. Further, the height of the cap/cover may be within about 95%, within about 90%, within about 85%, within about 80%, within about 75%, within about 70%, within about 65%, within about 60%, within about 55%, within about 50%, within about 45%, within about 40%, within about 35%, within about 30%, within about 25%, within about 20%, within about 15%, within about 10%, within about 5% etc. of the length of the perimeter of the opening.
The thickness of the protective cap or barrier cap in these and other embodiments may be uniform, mostly uniform, somewhat variable or variable, which may be defined by the manufacturing methods used and relative tolerances that are possible. The thickness of this protective cap/barrier cap and/or liner may be less than about 0.01mm, between about 0.01mm and about 0.1 mm, between about 0.1mm and about 0.2mm, between about 0.2mm and about 0.3 mm, between about 0.3 mm and about 0.4 mm, between about 0.4 mm and about 0.5 mm, between about 0.5 mm and about 0.6 mm, between about 0.6 mm and about 0.7 mm, between about 0.7 mm and about 0.8 mm, between about 0.8 mm and about 0.9 mm, between about 0.9 mm and about 1.0 mm, between about 1.0 mm and about 1.1 mm, between about 1.1mm and about 1.2mm, between about 1.2mm and about 1.3 mm, between about 1.3 mm and about 1.4 mm, between about 1.4 mm and about 1.5 mm, between about 1.5 mm and about 1.6 mm, between about 1.6 mm and about 1.7 mm, between about 1.7 mm and about 1.8 mm, between about 1.8 mm and about 1.9 mm, between about 1.9 mm and about 2.0 mm, between about 2.0 mm and about 2.1 mm, between about 2.1 mm and about 2.2 mm, between about 2.2 mm and about 2.3 mm, between about 2.3 mm and about 2.4 mm, between about 2.4 mm and about 2.5 mm, between about 2.5 mm and about 2.6 mm, between about 2.6 mm and about 2.7 mm, between about 2.7 mm and about 2.8 mm, between about 2.8 mm and about 2.9 mm, between about 2.9 mm and about 3.0 mm.
Thickness of plastic sheets to be formed during web converting into protective caps, barrier caps, or any other plastic or formed component in another device described herein may be measured in inches or mm (e.g., 1 inch is approximately 25.4 mm). For example, plastic sheets made of any material described herein (including polycarbonate, polyethylene, acrylics or polyethylene terephthalate in many cases) may be 0.0025″ (0.0635 mm), 0.005″ (0.127 mm) or 0.01″ (0.254 mm) or 0.015″ (0.381 mm) or 0.02″ (0.508 mm) or 0.03″ (0.763 mm) or 0.04″ (1.016 mm) or 0.05″ (1.27 mm) or other thicknesses. As further examples, barrier caps may have thicknesses of 0.005″ (0.127 mm) or 0.01″ (0.254 mm), protective caps (including those that “snap” or have bistable configurations, may have thicknesses of 0.005″ (0.127 mm) or 0.01″ (0.254 mm), negative pressure therapy device plastic caps may have thicknesses of 0.01″ (0.254 mm) or 0.015″ (0.381 mm), ostomy wafers may have flared cone thicknesses of 0.02″ (0.508 mm), intraosseous access securement devices may have plastic hub thicknesses of 0.02″ (0.508 mm), and surgical wound protector barrier caps may have thicknesses of 0.01″ (0.254 mm). As described previously, the thickness of any or all of these plastic components may be variable.
Regions of the protective cap and barrier cap may have thickness that is different from other regions of the protective cap and barrier cap, especially at regions of curvature or where regions have been stretched during the forming process. For example, the walls of the protective cap or barrier cap (that extend away from the generally planar adhesive substrate) may be thinner or thicker than the rest of the protective cap/barrier cap. As one example, by being thinner than the rest of the protective cap/barrier cap, this portion of the device may be more transparent than the rest of the protective cap/barrier cap, enabling the user to see the pad and/or medicament on the pad. These walls may be primarily linear as seen in
The protective caps and barrier caps seen in
The protective cap/barrier cap may be made from a variety of materials that are conducive to injection molding or in-line forming during a web converting process. These materials include but are not limited to polycarbonate and polyethylene (including high density polyethylene). The protective cap/barrier cap may be any color and may be transparent, opaque or variably opaque. Choice of color and opacity of the protective cap/barrier cap may be important to protect the medicament from light or other elements which may affect the quality or longevity of the medicament. The choice of color may be cosmetic in nature. For example, the protective or barrier cap can be any color such as blue, red, green, yellow or the like and various shading or gradations in coloring are possible for cosmetic and non-cosmetic reasons. For example, novel adhesive bandages that have a blue barrier cap may be produced, which may appeal to children of fashion-conscious adults. In some cases, the material used in the cap (such as some plastics) may partially or completely block ultraviolet light, which may help with wound healing, scar prevention or may help prevent discoloration of the wound/skin as it heals. Writing or other marking may be provided on the protective cap/barrier cap or any other part of the adhesive device including the adhesive substrate or liner. Laser cutting, die cutting or other cutting method may be used to cut the protective cap/barrier cap or any other part of the adhesive device, providing novel features or cosmetic benefits. In some cases, the protective or barrier cap may be shaped into a functional or whimsical shape, such as child-friendly shapes or the shapes of various cartoon characters, bugs, sporting goods, or other shapes that may appeal to children or adults. The protective or barrier cap may be made from thermochromatic materials that change color with heat. Importantly, the edges of the protective cap/barrier are not sharp and are not likely to cut or otherwise harm a user.
In
In some embodiments, such as those shown in
As shown in
As shown in
In some embodiments, the negative pressure wound device (including any and all components such as the tubing or bulb or other fluid collection means) may be held or attached to the patient's body (such as their leg or foot) through the use of an attachment means such as tape, gauze, Velcro, strap or the like.
The plastic cap 532 generally has a leak-proof seal to the adhesive substrate 530. It also may contain a port or adapter to connect to the vacuum source. This connection to the vacuum source may be through a press fit seal, or other means of connection that is commonly known in the art. The plastic cap or plastic cover may also contain one or more other ports—a port to remove waste exudate into a waste receptacle or reservoir, a port to add water, saline, antibiotic or other fluid to the wound area, and/or a viewing area or port that provides a visual indication of the progress of the wound healing.
This cap may be cone shaped and may be manufactured smaller or larger to be sized for specific wound sizes or common wound locations. For example, it may be sized particularly for a common spot for diabetic ulcers on the foot or there may be child or adult sizes. The plastic cap generally is located on top of the hole within the adhesive substrate (or holdfast), allowing the fluid transmission of negative pressure to the wound.
The cap may be raised and/or have a hollow space within it. The height and shape of the plastic cap may be limited by the manufacturing process used (i.e. forming during web converting). The cap may be made out of any variety of common plastics, such as ABS, PC/ABS, PVC, polypropylene, polyethylene, polycarbonate, or others, or could contain, be impregnated with, be adhered to, be coated with, or be manufactured out of any variety of biologically compatible materials, such as PEG, PLA, PGA, PLGA, hydrogels, etc. The plastic cap 532 may additionally contain a hub for the purposes of aspirating wound exudate and other liquids from the wound. An additional tube and suction source may be applied in order to remove this exudate from underneath the occlusive dressing and drain it into a waste container. Leak prevention mechanisms may be designed into any of the parts described in this invention. Less than 10 mL of exudate is expected per day for many patients with diabetic ulcers, though in some cases, this may be significantly more, especially for other disease states.
As described previously, the device contains tubing between the plastic cap and the vacuum source, which may be made from any medical grade, biocompatible material. The tubing may additionally lock or seal onto the source of the vacuum via a Luer lock or similar standard sealing system, or it may press fit into an inlet sized to make a seal at that connection. The tubing material is generally non reactive to and/or compatible with normal medical device sterilization.
An additional adapter or locking mechanism may be added to the tubing, in order to separate the tubing portion in two parts: a reusable section with in which the tubing connects to the vacuum source, and a disposable section that attaches to the wound dressing/absorbent pad and is attached to the plastic cap as described previously. This additional adapter could be any quick release adapter/locking mechanism such that the disposable wound dressing section could be taken off, thrown away, and the wound dressing replaced and reconnected to the vacuum source. The adapter material can undergo normal medical device sterilization.
The device shown in
This therapy can be utilized continuously over a period of a few minutes to a few days, or can be used intermittently throughout therapy for wound healing. The vacuum source may pull a pressure between −40 and −150 mm Hg, but may be optimized to −75 and −125 mm Hg. Consistent pressure may be maintained until the patient interrupts it, it may be variable, or it may slowly return to zero, thus triggering the patient to reset it. In some embodiments, the device may make use of valves or other viable methods of pressure modulation in order to reduce or increase the amount of negative pressure delivered to the wound. The device may be configured to provide any suitable or desired level of negative pressure at any suitable or desired frequency.
In some embodiments, the device may be configured such that air can only flow through the device or parts of the device in one direction, in order to maximize efficiency of the vacuum applied. This could be designed by using one way valves or other methods.
The construction and geometry of the vacuum cap may be similar to that of the protective cap and barrier cap that were previously described. This includes the angle α and the various dimensional attributes that were previously described for protective and barrier caps. In some embodiments, as shown in
In
Alternate embodiments of tubing attachment means is shown in
Additionally, another embodiment of an IV stabilization device is seen in
In the example shown in
The ridges of this nasal strip may assume any shape including straight, mostly straight, wavy, curvy, or the like.
The subject nasal devices are attached to the exterior of the nasal passages as shown in
Lateral sections 875 and 875′ in
In general the preformed shapes of the nasal strips described herein are particularly significant. As discussed above, the elongate body of the nasal device may be relatively rigid. In addition, any of these devices may also include additional textures or structural (e.g., stiffening) elements. For example,
Ample contact between the base of the flared cone 955 is important as it provides necessary rigidity and securement to the device.
Finally,
Described herein are adhesive securement devices for use with a PICC that is formed of a (a “PICC adhesive securement device”) that include one or more guides for individually holding /securing multiple lines of the PICC. These adhesive PICC line guide devices may also include a lock, clasp, or holder that may be integrally formed from the body of the device and may hold the one or more lines of the PICC in place.
For example, a PICC line guide device with a clamp may include a base that is formed to include a plurality of projections (e.g., posts, channels, rims, etc.) forming a guide, and also includes an arm (e.g., clasp arm) configured to bend over and secure one or more lines (or two or more lines) of the PICC against the base. The base and/or arm may also include an adhesive material. For example, adhesive material on the base may secure the device to the patient, while adhesive material on the arm (or in some variations on the opposite side of the base) may secure the one or more lines of the PICC against the base, within the guide formed by the projections. A PICC line guide device may also be adapted so that any anchor (e.g., wings) on the PICC attach to the base. The PICC anchor may engage one or more projections extending from the base; these anchor-interfacing projections may be separate from, or may be the same as, the guide projections for separating, securing and/or guiding one or more of the lines of the PICC. An anchor may also be secured by the arm.
Any of the devices (including the PICC-securing devices described) may include a liner or release liner coving the adhesive material, and configured to be manually removed.
In some devices described herein, an alignment guide may be present. For example, an alignment guide may comprise a visual alignment guide that a subject can look at to align the device (e.g., in a mirror). For example, the device may be marked by a shape, a text, or a color, to help align the device with a location on the body include the ear canal or ostomy site. In some variations, at least a region of the device may be transparent or opaque. In some variations, the alignment guide is a tactile alignment guide. A tactile alignment guide may be felt by the subject. For example, the alignment guide may be a ring, ridge, bump, post, or the like. An alignment guide may be a cone or conical region.
In some variations, the device may further include a support frame. The support frame may be removable and/or removably attached to another portion of the device including the adhesive substrate, the adhesive layer or another portion of the device including rigid portions of the device that may be made from plastic. For example, the support frame may support the device, including the holdfast region of the device, and be completely or partially removable after the device has been applied to the subject. In some variations, the support frame remains on the device after application. The support frame may serve to make application of the device easier or to prevent the holdfast from unintentionally attaching to itself, to another portion of the device or to the subject. As mentioned, any of these devices may also include a support frame. In some variations, the support frame is a support frame layer.
Methods of Making/Manufacturing adhesive devices
Different manufacturing methods including web converting may be used to make the adhesive devices described herein. Multiple layers may be laminated together using heat, pressure or adhesives either alone or in combination. Methods may include cutting, laser cutting, die cutting, jet cutting, or the like. In some variations, thermoforming or cold forming may be used either as part of a continuous process or as part of a multi-step process. In some variations, casting, molding or injection molding may be used. In some variations, silicone or thermoplastic urethane may be used in any or all parts of the subject devices. Mesh may be used in any or all parts of the device, serving as a filter or other role. For example, the mesh may be formed of nylon or other fibrous materials. In some variations, it may be beneficial to use materials that are relatively stiff. Exemplary meshes may include: molded polypropylene plastic mesh (e.g., 0.0140″ thickness), precision woven nylon mesh (31.2 openings per inch×31.2 openings per inch), precision woven nylon mesh (80×80), precision woven polypropylene mesh (69×69), filter mesh, precision woven nylon mesh (198×198), PTFE diamond mesh, precision woven polyester mesh (109×109), precision woven polyester mesh (45.7×45.7).
Portions of the adhesive medical devices may be assembled or joined together using adhesive (e.g., by using the adhesive substrate region of the adhesive holdfast), by compression, laminating, by welding, by heat staking, heat sealing, gluing, or press fitting. Ultrasonic or laser welding may also be used. The adhesive or layers of adhesive may cut before, after or during the process of combining them through the aforementioned processes. In some cases, the unneeded portions of adhesive or adhesive layers may be cut against (kiss cut) the liner they are cast on or a process liner. After cutting the liners may be removed carrying the unneeded portions of adhesive or adhesive layers with them.
The devices described herein may be continuously fabricated, batch fabricated, or fabricated by hand. In particular, the layered devices described herein may be fabricated by sequentially adding and processing multiple layers to form the final device and then packaging the final device. A layer may be pre-processed by cutting, trimming, forming, stamping etc., or otherwise modifying it. Processing may be performed by layering strips or sheets corresponding to the different layers, and cutting or stamping the devices out of the strips or sheets after they have been at least partially assembled. The various operations may be combined into single tools or in multiple tools and aligned or registered to one another using a closed loop system and/or PID controller in and automated, semi-automated or manual system. The adhesive holdfast layer may be formed by, for example, cutting a continuous strip of shapes. A three dimensional portion of the device (such as the barrier cap, protective or fixator) may be thermoformed or cold formed and then cut and accurately placed or transferred on the moving web. A three dimensional portion of the device may be formed and connected to the device in-line as part of a continuous process or formed in a separate process and then attached in a subsequent process. A three dimensional portion of the device may be delivered in a continuous roll of material or individually (e,g, in a bowl feeder) and picked and placed onto a moving roll.
Three dimensional forming, and particularly forming in combination with or as part of web processing may be used in fabrication of the apparatuses described herein. For example, a film of polymeric (e.g., plastic) material may be stamped, pressed, pushed, vacuum formed or otherwise deformed or molded as a step in the web processing of the device. In some variations the formed portion may include a metallic material (e.g., aluminum) that can be deformed with the material and also operate as a barrier for water and oxygen. Forming may be done without any heat applied (i.e. cold forming) or with heat applied (i.e. thermoforming). Heat may be applied in various ways including, heating the material which is to be formed before it reaches the forming tool, heating the forming tool or both pre-heating the material and the forming tool. Annealing may also be done after forming to give the finished shape the desired physical properties.
In some variations the formed material may be used to form three-dimensional shapes, e.g., a cover, protective cap, barrier cap, protective cover, vacuum cap, etc., and may be web processed along with the other layers, in particular the layer(s) forming the adhesive holdfast and any backing layer(s). In one example, the apparatus may be formed by a continuous process in which a web (sheet) of plastic material from which the cover or cap (e.g. protective cap) is to be formed is cold-formed by stamping to form a chamber or cavity having a desired dimension. After forming chambers on the sheet, it may be combined (while aligned) with an adhesive layer. In some variations, the adhesive layer may be at least partially cut (e.g. by stamping or the like) to remove internal regions. The adhesive layer may also be pre-applied to a backing layer on one side. In some variations the adhesive layer forming the holdfast region (including an adhesive and adhesive substrate) may be formed as a preliminary web that is then sequentially or simultaneously combined with other webs, including a formed web forming a cap or cover.
In one variation of a method for forming an adhesive bandage having a medicament may be performed by a combined cold forming or thermoforming and web processing technique. For example, the adhesive substrate may be combined with the adhesive to form a first web. An additional web forming the pad to which a medicament may be applied (including applied during the fabrication process), pre-applied, or the like, may be cut and placed onto the adhesive side of the first web. A layer of plastic material that is initially flat may then be cold-formed to form the cover/chambers and placed (e.g. rolled) over the pad and medicament. In some cases, heated dies are used to form the plastic sheets. In some cases, the medicament may be applied or deposited into the protective cap or barrier cap or other chamber formed during the manufacturing process. This medicament can be deposited on to/into a cap/chamber/blister when the web that is receiving the medicament is facing upward or downward. The combined webs may then be finally cut to form bandages as shown in
In some variations, a cold-forming or thermoforming technique may be used in combination with the web processing in which individual layers (webs) are cut before placement and/or after placement against other webs. The placement maybe accurate to within a tolerance of less than about 1.0 mm, less than about 0.1 mm, less than about 0.05 mm, less than about 0.01 mm, less than about 0.005 mm, less than about 0.001 mm.
Another example of a continuous fabrication process including cold forming or thermoforming may be used to form a bandage including a protective region (cap) such as those shown in
Next, the holdfast (or any or all of its components) may be kiss-cut and any extra waste material may be separated and rewound for subsequent disposal. The cut pattern is generally optimized to minimize wastage of materials. A punch or other tool may be used to create holes in the holdfast or liner or both. Alternatively, a laser may be used to create a hole or to etch a feature or writing onto the device. Slit cutting (using a rotary cutting tool for example) and spreading of the web (using spreading rollers) may then be completed. Spreading can happen in the cross-web direction and in machine direction, which may be helpful in minimizing use or wastage of incoming material. The adhesive device may be transferred to new liner if desired. The liner may be folded or slit to ease in the removal of the device.
Precise cutting and island placing of fabric (such as the pad of a BAND-AID) or other material may then be completed, accomplished though the use of a servo-controlled process. A nip roller may be used at this point to press the pad onto the adhesive holdfast. Next the plastic sheet may be formed, through the use of cold forming or thermoforming. This may occur using a rotary die tool, with male and female components. In some cases, vacuum and or heat may be utilized to enable the forming process. In other cases, vacuum and heat are not required. A step-and-repeat process (during the forming process) may be utilized. A step-and-repeat process can permit the utilization of a standard die set (i.e. not rotary) which may allow for tighter tolerances. In other cases, a step-and-repeat process is not used, which may increase the speed of production and number of units that can be produced in a given time period. In some cases, sequential molds with identical, similar, different or variable shapes may find use. An annealing step may be added after forming. A step and repeat process, where a moving web is stopped and then indexed, may also be used in conjunction with a continuous web converting process. Where the step and repeat portion of the web is fed into an accumulator or multiple rollers or pulleys that index closer and further from one another as the step and repeat web is fed in. The web may then be fed or pulled from the accumulator at a steady continuous rate.
In general, 0.1-0.3 mm PET and polycarbonate are preferred materials for inline forming operations to make the devices described herein, although other materials listed herein may also be used.
The difficulty in forming certain 3D features will vary significantly from device to device. Some important parameters to consider include the relative depth of a given feature compared to its surrounding base of material (which may include width, length, circumference and perimeter of the base which has already been discussed herein). This may be referred to as the “depth of draw” and this has been discussed previously in depth in the sections related to the protective and barrier cap. For example, it is preferred that the “aspect ratio” which is defined as the ratio of width (either short width or long width) to height (defined as the highest deflection from the base) shall generally not exceed 1:2. Certain exceptions are possible by increase the complexity of the forming operation. Other parameters to consider include edge sharpness and material thickness.
Some products may require alignment of multiple cut features in the product at different locations (also know as registration). Registration capabilities with currently available equipment at high speeds is typically +/−0.030 which means that the position of the formed plastic components may vary in position by that amount during manufacturing. Challenges with registration may be minimized by building all of the cut features into the same tool.
Regarding packaging, packaging may be done inline with cold seal pouch film to minimize cost. Tabs or other three dimensional features (including those made from formed plastic) may potentially become flattened during packaging as cold sealing is typically done by running the product and material between two rollers, one steel and the other rubber. One solution is to provide relief on of these rollers of other tools to accommodate a 3D part being passed through the line, to minimize the potential for damage to the product.
In some cases, a medicament is dispensed or injected into the cavity or depression formed during the earlier described forming process. The depression may be downward facing so that the liquid/fluid ointment is held in place by gravity. Next, the formed plastic piece may be cut using a cutting tool, die or laser. The formed plastic piece can then be accurately placed on the moving web. A vision system may be used to aid in alignment or to identify processing defects. Adhesives may be used to securely fix the plastic formed piece to the holdfast, although in other cases, heat sealing or other bonding methods may find use.
At this point, the individual “final product” may be cut (via die cutting or the like) using controlled cutting techniques under the control of a vision system. Additional inspection/machine vision testing may be completed to ensure quality of the product, including confirming the accurate placement of the pad, pad size, patch (or holdfast) size and any other feature such as the location and size/height of the formed plastic piece. Defective pieces may be removed from the line automatically or manually. The vision system may also provide registration feedback to the cut-out die station or other parts of the manufacturing system. A bullnose may also be used to remove any air prior to packaging. Final inspection of the part (visual or otherwise) or testing of an individual part may or may not be required.
The device can then be placed into the packaging and the packing sealed and cut into individual packaging. Various heat settings, pressure settings or dwell time of sealing may be modified to ensure a good seal. A slit cutting tool may be helpful to create multiple lanes of packaged product. A take away conveyor with reject gate or compressed air may be used to remove defective product. Next, cartoning and case packing may be completed. Any and all parts of this process may be interchanged with any other part. Other parts of the process may be deleted or not used if not appropriate. Some parts of the process may be repeated one or more times. The process may be broken into multiple steps which may be performed at different times or on different pieces of equipment.
Regarding packaging, any appropriate packaging technique may be used. As an example, cold sealing or heat sealing may find use. Foil or film packaging or other pouching may be used, which may help prevent evaporation of the medicament. Specialized packing such as a flat bed reciprocating packager may find use.
Converter speeds may achieve 30 feet/minute and packaging speeds may achieve 40 feet/minute. In some cases, the fabricating of the product and the packaging operation may be separate processes. In other cases, they may be connected, part of a seamless single operation or manufacturing line.
Returning to the figures,
In
Multiple ribs may be included to reinforce the cap's thin cross-section and provide stiffness and maintain the shape while forming. Additional ribs may be located adjacent to large features, terminating at the living hinge to ensure only the desired bending area is bent during folding. The top and bottom features are stamped or formed from a single sheet in one more forming steps (in the same station or across multiple stations). The snap features can be pre-cut or laser-cut post-forming.
In
On the bottom securement door 3254, several formed features capture the base of the PICC anchor preventing it from moving up/down or side to side. The PICC bifurcation area (defined above) where two or more tubes emanate from the PICC anchor is held in place by one or more projections 3252 and 3240 that are formed from either the top securement door 3238, the bottom securement door 3254 or both. These projections help prevent movement of the PICC anchor, especially in the distal direction (away from the insertion site). Further, abutment 3239 also prevents this distal movement of the PICC anchor. The wing of the PICC anchor may also fit into a recess that is preferably formed into the bottom securement door, again to help prevent the PICC from bring pulled out distally.
The top securement door 3238 exerts continuous downward pressure and keeps the PICC anchor from being displaced out of the device. The proximal end of the cap 3230 also constrains the wing from being pulled in the direction of the insertion site. Ribs or ridges can be placed in one or several locations on the top securement door 3238 and bottom securement door 3254 including next to large formed features such as 3242 or on or near large flat surfaces to maintain flatness (and reduce warping of formed parts).
Snap 3256 and cutout 3234 are present in the securement device and hold the top and bottom halves together in the closed position. One or more snaps or cutouts may be on the top anchor or the bottom anchor door or both. Closure of the device is facilitated by formed corrugations 3232 which the user's fingers press down on to engage the snap. These corrugations may also increase the rigidity of the snap area, providing structural support for the entire device.
Any of the device described herein may include one or more features, including structural features (e.g., creases, patterned wrinkles and/or raised patterns) to help prevent warping and allow the surface to lay flat. In general, particularly when forming flat sheets of material into the 3D structures described herein by pressing or stamping, flat sheets have a tendency to warp during the pressing/forming process, depending on material properties, material thickness, mold configuration, temperature of dies, number of dies and their sequence, depth of draw, etc. During die pressing, the die may not be able to maintain a flat shape because the die may only deform the plastic within an elastic range. The material may spring back or return to a warped shape after the die is released as the residual stresses in the adjacent formed features start “pulling on” the flat area. This warping phenomena is illustrated in
In some variations, otherwise flat surfaces (e.g., horizontal surfaces) may therefore be patterned to prevent or limit the warping. In general, a raised pattern may be formed in the horizontal regions (e.g., base regions), as illustrated in
In addition to the cross-sectional shape of the raised projections, the overall pattern of raised projections (e.g., ribs), may be configured to increase or decrease the stiffness. For example, a square lattice pattern as shown in 33B may provide stiffness in two general directions, but may allow warping in the diagonal directions (relative to the squares in the pattern) whereas triangular patterns (such as seen in
In some variations, these raised projections may be compressed or flattened during the fabrication technique to reduce the profile and/or modify the physical properties such as stiffness, of these otherwise flat regions. For example, after forming the projecting regions, they may be stamped flat or pressed (at an angle). This is illustrated in
In some variations, ribs or ridges may be positioned around the sides of some or all of the large features being formed. For example, ribs or ridges may be approximately 1 mm wide, approximately 2 mm wide, approximately 3 mm wide, or approximately 4 mm wide to support the sides of large features. As mentioned above, shallow projections on the flat surfaces (e.g., interconnecting patterns) may be used (e.g., approximately 2 mm wide/1.5 mm tall ribs) to add rigidity. At the base of isolated tall and thin features a fillet radius of between about 0.2 mm to 0.8 mm may be used, more ideally between 0.3 mm and 0.6 mm and most ideally between 0.4 mm and 0.5 mm should be added to the base to help material flow.
To facilitate forming, a radius of 0.25-0.75 mm, more ideally from 0.35-0.65 mm and most ideally between 0.45 and 0.5 mmm on horizontal edges is adequate for features 3 to 6 mm thick. For shallower features it may be beneficial to reduce the gap locally between the dies, reduce the fillet radius to 0.15-0.35 mm, more ideally from 0.2 mm-0.3 mm and most ideally to approximately 0.25 mm and possibly design bend angles to be 5 to 10 degrees sharper than seen on the features to compensate for the material springing back. Shallow features generally require sharper bends to form.
Forming with Progressive Dies:
Any of the structures described herein may be formed by the stamping techniques described herein. In particular, any of these devices may be formed by a plurality of repeated stamping steps (e.g. progressive, overlapping stamping) which may help shape and form the devices. For example, a relative taller feature may be formed using a series of forming steps with different dies or the same die that progressively forms the feature into its final shape. This may include one step, two steps, three steps or four steps or more all of which may happen on single tool or single station of the press or across two or more tools or stations. This is illustrated in
In practice, the multiple stamping steps may be built into a single die/tool with several spring loaded and/or static forming features that engage the material at the same time with various spring coefficients or at different times during the forming process. This may be done with forming features in one or both sides of the tool that form material and then are removed as following forming features are engaged. In some variations the forming features may be male or female molds, male/male, or female/female, and may be on the same tool.
In some variations, the forming techniques described herein may extend the structures being formed out of the plane of the material (e.g., in the z direction) without substantially changing the size of the plane. Alternatively, the size of the plane (in x,y) may be changed as the height of the projecting structures(s) is changed.
For example, in
Alternatively,
In operation, any of these structures may be formed in rapid succession (e.g., stamp or pressing steps) or they may be formed with a delay between steps. The stamps may include an alignment guide to help align them between stamps/pressing steps; in some variations the previously stamped shape may be used as an alignment guide. In some variations a pressed alignment guide shape may be formed during an earlier step to be used for alignment during a later step.
Any of the variations described herein may include a living hinge. For example,
Other alternative means of creating a living hinge mechanism include creating numerous parallel cuts that soften the material, thereby enabling bending or using multiple parallel half depth cuts, again with the goal of enabling bending of the plastic. In addition, the top and bottom piece can be formed in two sheets then stacked on top of each other then glued together at the hinge location. This provides a hinge that has the tendency to close instead of staying open.
As shown in
In a separate embodiment, shown in
In
The device shown in
Conditions that may be treated with the subject device include but are not limited to cuts, wounds, pressure ulcers, diabetic ulcers, burns, abrasions, surgical incisions, acne, psoriasis, allergic reactions, pain (including muscle pain, back pain and headache), cosmetic issues including wrinkles, nail fungus, skin fungus and other conditions. The devices may be used to treat humans or animals.
As previously mentioned, any of the layered adhesive devices described herein may be used to treat a variety of medical or non-medical conditions. A subject may apply the device to his or her skin. For example, the devices may be first removed from clean or sterile packaging. The devices described herein may be sized (e.g., child/adult, small, medium, large, etc.), or one-size-fits-all. Placement of an adhesive medical device may be done in front of a mirror or can occur without looking at a mirror, depending on the anatomic part of the body on which the device is being placed. A device having an adhesive holdfast with a protective cover may be prepared for application by first removing the protective cover, and then aligning the device (or alignment guide in some cases) with the body part or part of the skin being treated. The device may then be applied by pushing the adhesive holdfast against the skin or other body part to secure the device in communication with the body. In some cases, it gauze or other tape may be applied on top of the device and/or surrounding anatomic structures. After use, the device may be removed by peeling the adhesive holdfast away from the body/skin.
With regard to devices that provide negative pressure wound therapy, there may be several steps followed: 1. Applying a wound dressing/absorbent material to the wound itself, with or without saline and/or antibiotics (Examples of this include cutting a polyurethane foam to the size of the wound and placing it onto the wound, putting it in direct contact with the wound surface). 2. Applying the plastic cap and integrated dressing on the user's skin (on top of the wound). The initial absorbent material, plastic cap, and the area immediately surrounding the wound are now covered with an adhesive, fluid-and-air-tight cover film, such that a wound space is formed between cover film and wound base. The film adheres to the intact skin surrounding the patient's wound and closes the wound space around the edges of the plastic cap in a gas tight manner. 3. Connecting the vacuum source via the adapter or directly to the open end of exposed tubing stemming from the plastic cap. 4. Turning on, pumping, or otherwise activating the vacuum source. Initiating the negative pressure source generates a negative pressure in the wound space, i.e. in the space formed between the wound base and the plastic cap/double backed adhesive/hydrocolloid sealed top. 5. Turning off or otherwise inactivating the vacuum source. 6. Unlocking or otherwise removing the reusable vacuum pump and affiliated tubing section from the rest of the device. 7. Removing and replacing the disposable hydrocolloid/cap/adhesive/tubing/ports section. 8. Reconnecting the two sections to each other, and reengaging the vacuum.
When a feature or element is herein referred to as being “on” another feature or element, it can be directly on the other feature or element or intervening features and/or elements may also be present. In contrast, when a feature or element is referred to as being “directly on” another feature or element, there are no intervening features or elements present. It will also be understood that, when a feature or element is referred to as being “connected”, “attached” or “coupled” to another feature or element, it can be directly connected, attached or coupled to the other feature or element or intervening features or elements may be present. In contrast, when a feature or element is referred to as being “directly connected”, “directly attached” or “directly coupled” to another feature or element, there are no intervening features or elements present. Although described or shown with respect to one embodiment, the features and elements so described or shown can apply to other embodiments. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed “adjacent” another feature may have portions that overlap or underlie the adjacent feature.
Terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. For example, as used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items and may be abbreviated as “/”.
Spatially relative terms, such as “under”, “below”, “lower”, “over”, “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms “upwardly”, “downwardly”, “vertical”, “horizontal” and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.
Although the terms “first” and “second” may be used herein to describe various features/elements, these features/elements should not be limited by these terms, unless the context indicates otherwise. These terms may be used to distinguish one feature/element from another feature/element. Thus, a first feature/element discussed below could be termed a second feature/element, and similarly, a second feature/element discussed below could be termed a first feature/element without departing from the teachings of the present invention.
As used herein in the specification and claims, including as used in the examples and unless otherwise expressly specified, all numbers may be read as if prefaced by the word “about” or “approximately,” even if the term does not expressly appear. The phrase “about” or “approximately” may be used when describing magnitude and/or position to indicate that the value and/or position described is within a reasonable expected range of values and/or positions. For example, a numeric value may have a value that is +/−0.1% of the stated value (or range of values), +/−1% of the stated value (or range of values), +/−2% of the stated value (or range of values), +/−5% of the stated value (or range of values), +/−10% of the stated value (or range of values), etc. Any numerical range recited herein is intended to include all sub-ranges subsumed therein.
Although various illustrative embodiments are described above, any of a number of changes may be made to various embodiments without departing from the scope of the invention as described by the claims. For example, the order in which various described method steps are performed may often be changed in alternative embodiments, and in other alternative embodiments one or more method steps may be skipped altogether. Optional features of various device and system embodiments may be included in some embodiments and not in others. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be interpreted to limit the scope of the invention as it is set forth in the claims.
The examples and illustrations included herein show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. As mentioned, other embodiments may be utilized and derived there from, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term “invention” merely for convenience and without intending to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is, in fact, disclosed. Thus, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. Combinations of the above embodiments, and other embodiments not specifically described herein, will be apparent to those of skill in the art upon reviewing the above description.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2191/DEL/2014 | Aug 2014 | IN | national |
| PCT/US2014/052750 | Aug 2014 | US | national |
This patent application claims priority to the following provisional patent applications: U.S. provisional patent No. 61/893,095, filed on Oct. 18, 2013, and titled “ADHESIVE MEDICAL DEVICES”; U.S. provisional patent No. 61/927,943, filed on Jan. 15, 2014, and titled “ADHESIVE MEDICAL DEVICES”; U.S. provisional patent No. 62/026,453, titled “ADHESIVE DEVICES”, and filed on Jul. 18, 2014; and Indian provisional patent application 2191/DELNP/2014, filed on Aug. 1, 2014, and titled “ADHESIVE DEVICES”. This patent also claims priority to the PCT application filed 26 Aug. 2014, as International Application No. PCT/US2014/052750. Each of these patent applications is herein incorporated by reference in its entirety.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/US14/61189 | 10/17/2014 | WO | 00 |
| Number | Date | Country | |
|---|---|---|---|
| 61893095 | Oct 2013 | US | |
| 61927943 | Jan 2014 | US | |
| 62026453 | Jul 2014 | US |
