Patent Grant
9662246
Field of the Invention
Embodiments described herein relate to apparatuses, systems, and methods the treatment of wounds, for example using dressings in combination with negative pressure wound therapy.
Description of the Related Art
Prior art dressings for use in negative pressure have been difficult to apply, particularly around curved or non-flat body surfaces. Further, when used, wound exudate may soak into the dressing, which some patients may find aesthetically unpleasing and difficult to address in social situations.
Accordingly, certain embodiments disclosed herein relate to improved wound dressing that exhibit enhanced conformability and aesthetic presentation. Also disclosed are improved methods of use and systems for use of the same, preferably in conjunction with negative pressure wound therapy.
In one embodiment, a wound dressing comprises:
an acquisition distribution layer;
an absorbent layer over the acquisition distribution layer; and
a backing layer above the absorbent layer.
In some embodiments, the wound dressing may further comprise a fluidic connector configured to connect the backing layer to a source of negative pressure. The fluidic connector may be positioned over an opening in the backing layer.
The acquisition distribution layer may be configured to horizontally wick fluid as the fluid is absorbed upward through the wound dressing. In some embodiments, the acquisition distribution layer may comprise a mix of cellulosic fibers and composite fibers, the composite fibers comprising a PET core and a PE outer layer. The acquisition distribution layer may comprise a plurality of fibers, and a majority of the fiber volume may extend horizontally, or substantially or generally horizontally. The acquisition distribution layer may comprise a plurality of fibers, and approximately 80% to approximately 90% of the fiber volume may extend horizontally, or substantially or generally horizontally. The acquisition distribution layer may comprise a plurality of fibers, and all or substantially all of the fiber volume may extend horizontally, or substantially or generally horizontally extending fibers. The acquisition distribution layer may comprise a plurality of fibers, and a majority of the fibers may span a distance perpendicular to the thickness of the acquisition distribution layer that is greater than the thickness of the acquisition distribution layer. The wound dressing may be configured such that a ratio of an amount of fluid wicking laterally across the acquisition distribution layer to an amount of fluid wicking vertically through the acquisition distribution layer when under negative pressure is about 2:1 or more.
In some embodiments, the absorbent layer and acquisition distribution layer may be bonded together by one or more of adhesive, stitching, or heat bonding. The absorbent layer may comprise a fibrous network and superabsorbing particles within the fibrous network. The wound dressing may further comprise a wound contact layer below the acquisition distribution layer. The wound dressing may further comprise a transmission layer between the wound contact layer and the acquisition distribution layer.
The transmission layer may be configured to vertically wick fluid. The transmission layer may comprise a top fabric layer, a bottom fabric layer, and a plurality of filaments extending generally perpendicularly between said top fabric layer and said bottom fabric layer. In some embodiments, a majority of filaments, by volume, may extend vertically, or substantially or generally vertically. In another embodiment, approximately 80% to approximately 90% of the filaments, by volume, may extend vertically, or substantially or generally vertically. In yet another embodiment, all or substantially all of the filaments, by volume, may extend vertically, or substantially or generally vertically. In some embodiments, a majority of filaments may extend upward from the bottom fabric layer and/or downward from the top fabric layer and may extend over a length more than half the distance between the top and bottom fabric layers. A majority of filaments may span a distance that is greater in a direction perpendicular to the top and bottom fabric layers than in a direction parallel to the top and bottom fabric layers. A ratio of an amount of fluid wicking vertically through the transmission layer to an amount of fluid wicking laterally across the transmission layer when under negative pressure may be, in some embodiments, about 2:1 or more.
In some embodiments, the acquisition distribution layer may comprise viscose, polyester, polypropylene, cellulose, polyethylene or a combination of some or all of these materials. The absorbent layer may comprise between 30% and 40% cellulose matrix and 60% and 70% superabsorbing polymers. The absorbent layer may comprise a mix of cellulosic fibers and composite fibers, and the composite fibers may comprise a PET core and a PE outer layer. The absorbent layer may comprise a plurality of layers. The plurality of layers of the absorbent layer may comprise a textured layer configured to laterally spread absorbed fluid, an absorption layer configured to draw fluid upward into an interior of the absorbent layer, a storage layer configured to absorb the fluid, and a liquid distribution layer configured to apply a reverse suction effect to the storage layer. The absorbent layer may further comprise a tissue dispersant layer.
The backing layer may be transparent or translucent, and the wound dressing may further comprise an obscuring layer between the absorbent layer and the backing layer. The wound dressing may comprise one or more viewing windows in the obscuring layer. At least the obscuring layer may be shaped with a narrowed central portion along its length. The obscuring layer may comprise two rows of three viewing windows. The obscuring layer may comprise one row of three viewing windows. The obscuring layer may comprise one row of eight viewing windows. The obscuring layer may comprise two rows of five viewing windows. The obscuring layer may comprise one row of five viewing windows. At least the obscuring layer may be shaped with a narrowed central portion along both its width and its length. The obscuring layer may comprise a 3×3 array of viewing windows. The obscuring layer may comprise a quincunx array of viewing windows. At least the obscuring layer may comprise a six-lobed shape. The absorbent layer and acquisition distribution layer may be substantially the same shape as the obscuring layer. The obscuring layer may further comprise a cross or maltese cross shaped hole over which a fluidic connector for transmitting negative pressure may be connected.
In one embodiment, a wound treatment apparatus for treatment of a wound site comprises:
In some embodiments, the obscuring layer is above or below the backing layer. The obscuring layer may be configured to at least partially visually obscure fluid contained within the absorbent layer. The obscuring layer may comprise at least one viewing window configured to allow a visual determination of the saturation level of the absorbent layer. The at least one viewing window may comprise at least one aperture made through the obscuring layer. The at least one viewing window may comprise at least one uncolored region of the obscuring layer. The viewing window may comprise an array of dots. The array of dots may be distributed in a straight line of dots, the straight line of dots being positioned on a center line along a length of the absorbent layer. The straight line of dots may comprise an array of three dots. The straight line of dots may comprise an array of five dots. The straight line of dots may comprise an array of eight dots. The array of dots may be distributed in two straight lines of dots, the two straight lines of dots positioned to be an equal distance from a center line along a length of the absorbent layer, the two straight lines of dots having an equal number of dots. The two straight lines of dots may comprise an array of three dots. The two straight lines of dots may comprise an array of five dots. The array of dots may be distributed regularly over the obscuring layer to enable assessment of wound exudate spread. The viewing window may be selected from the group consisting of a graphical element or a typographical element. The obscuring layer may comprise an auxiliary compound, wherein the auxiliary compound may comprise activated charcoal configured to absorb odors and configured to color or tint the obscuring layer. The fluidic connector may comprise an obscuring element configured to substantially visually obscure wound exudate.
Some embodiments may further comprise an acquisition distribution layer between the wound contact layer and the absorbent material. The absorbent layer may comprise cellulose fibers and between 40% and 80% (or between about 40% and about 80%) superabsorbent particles. The obscuring layer, in a dry state, may be configured to yield a CIE y value of 0.4 or less and a CIE x value of 0.5 or less on a CIE x, y chromaticity diagram. The obscuring layer, in a dry state, may have a color of Bg, gB, B, pB, bP, P, rP, pPk, RP, O, rO, or yO on a CIE x, y chromaticity diagram. In some embodiments, the wound dressing further comprises an orifice in the backing layer, the orifice configured to communicate negative pressure to the wound site. The obscuring layer may comprise at least one orifice viewing window configured to be positioned adjacent to the orifice in the backing layer, the orifice viewing window configured to allow a visual determination of the saturation level of the absorbent layer adjacent to the orifice. The orifice viewing window may be cross-shaped. The wound dressing may comprise a first length corresponding to a first edge of a wound dressing and a first width corresponding to a second edge of the wound dressing, a first x axis runs along the first width and a first y axis runs along the first length, wherein the first x axis and the first y axis are in a perpendicular alignment. The viewing window may comprise a first arm and a second arm, the first arm of the viewing window define a second length and the second arm defines a second width, a second x axis runs along the second width and a second y axis runs along the second length, wherein the second x axis and the second y axis are in a perpendicular alignment. The second x axis and second y axis of the viewing window is offset from the first x axis and the first y axis of the absorbent layer. The second x axis and second y axis of the viewing window may be aligned with the first x axis and the first y axis of the absorbent layer. The cross-shaped viewing window may comprise flared ends. The fluidic connector may be configured to transmit air. The fluidic connector may comprise a filter, the filter configured to block fluid transport past itself. The fluidic connector may comprise a secondary air leak channel, the secondary air leak channel configured to allow a flow of ambient air to the wound site. The secondary air leak channel may comprise a filter. The fluidic connector may comprise a soft fluidic connector. The soft fluidic connector may comprise a three dimensional fabric. In some embodiments, the three dimensional fabric is configured to transmit therapeutic levels of negative pressure while an external pressure up to 2 kg/cm2 is applied thereto. The soft fluidic connector may be configured to be connected to a tube in fluid communication with the vacuum source. The soft fluidic connector may be configured to be connected directly to the vacuum source. The soft fluidic connector may comprise an enlarged distal end, the enlarged distal end configured to be connected to the wound dressing. The apparatus may further comprise a tube connected to the fluidic connector. The apparatus may further comprise a pump in fluid communication with the fluidic connector. In some embodiments, the absorbent layer comprises two or more lobes. The absorbent layer may further comprise a tissue dispersant layer.
In another embodiment, a wound treatment apparatus for treatment of a wound site comprises:
In some embodiments, the backing layer is transparent or translucent. The backing layer may define a perimeter with a rectangular or a square shape. The wound contact layer may be adhered to the lower surface of the backing layer along the perimeter of the backing layer. The hole in the obscuring layer may have a different diameter than the hole in the absorbent material or the opening in the backing layer. The one or more viewing windows may be arranged in a repeating pattern across the obscuring layer. The one or more viewing windows may have a circular shape. Some embodiments may further comprise an acquisition distribution layer between the wound contact layer and the absorbent material. The absorbent layer may comprise cellulose fibers and between 40% and 80% (or between about 40% and about 80%) superabsorbent particles. The obscuring layer, in a dry state, may be configured to yield a color of Bg, gB, B, pB, bP, P, rP, pPk, RP, O, rO, or yO on the CIE x, y chromaticity diagram.
Some embodiments further comprise a transmission layer between the absorbent material and the wound contact layer. In some embodiments, the apparatus further comprises a hydrophobic filter positioned in or below the port. The absorbent material may have a longitudinal length and a transverse width, wherein the length is greater than the width, and wherein the width of the absorbent material narrows in a central portion along the longitudinal length of the absorbent material. The obscuring layer may have substantially the same perimeter shape as the absorbent material. The apparatus may further comprise a pump
In another embodiment, a wound treatment apparatus for treatment of a wound site comprises:
Some embodiments may further comprise a wound contact layer. The backing layer may be rectangular. In some embodiments, the negative pressure source is a pump. In some embodiments, the wound dressing has a longer axis and a shorter axis, and wherein the waisted portion configured to be on the longer axis. The apparatus may further comprise an obscuring layer configured to at least partly visually obscure fluid within the absorbent layer. The obscuring layer may comprise at least one viewing window configured to allow a visual determination of the saturation level of the absorbent layer. The viewing window may comprise an array of dots. The fluidic connector may be located along a side or corner of the rectangular body. Some embodiments may further comprise an acquisition distribution layer between the wound contact layer and the absorbent material. The absorbent layer may comprise cellulose fibers and 40%-80%(or about 40% to about 80%) superabsorbent particles. The obscuring layer, in a dry state, may be configured to yield a color of Bg, gB, B, pB, bP, P, rP, pPk, RP, O, rO, or yO on the CIE x, y chromaticity diagram. The absorbent layer may further comprise a tissue dispersant layer.
In yet another embodiment, an apparatus for dressing a wound for the application of topical negative pressure at a wound site, comprises:
In some embodiments, the one or more slits comprise one or more concentric arcs.
In another embodiment, a wound treatment apparatus comprises:
In some embodiments, the wound treatment apparatus comprises a pump. The wound dressing may comprise a fluidic connector configured to transmit negative pressure from a pump to the wound dressing for the application of topical negative pressure at a wound site. The wound dressing may also comprise a wound-facing contact layer. The contoured shape may comprise three lobes. The contoured shape may comprise four lobes. The two or more lobes may comprise rounded projections. The apparatus may comprise two or more lobes flared lobes. The contoured shape may be oval-shaped. The contoured shape may comprise six lobes. The apparatus may further comprise an obscuring layer disposed so as to obscure the absorbent layer. The apparatus may further comprise an obscuring layer configured to at least partly visually obscure fluid within the absorbent layer. The obscuring layer may comprise at least one viewing window configured to allow a visual determination of the saturation level of the absorbent layer. The viewing window may comprise an array of dots.
In yet another embodiment, an apparatus for dressing a wound for the application of topical negative pressure at a wound site, comprises:
Some embodiments may further comprise one or more viewing windows in the backing layer. At least the obscuring layer may be shaped with a narrowed central portion along its length. The obscuring layer may comprise a 3×3 array of viewing window or a quincunx array of viewing windows. In some embodiments, at least the obscuring layer may comprise a six-lobed shape. The absorbent layer and acquisition distribution layer may be substantially the same shape as the obscuring layer. The obscuring layer may further comprise a cross or maltese cross shaped hole over which a fluidic connector for transmitting negative pressure may be connected. The apparatus may further comprise a fluidic connector configured to connect the backing layer to a source of negative pressure. The absorbent layer may further comprise a tissue dispersant layer.
In some embodiments, a negative pressure wound therapy kit is provided comprising:
The wound dressing may be any of the dressings described herein. In some embodiments, the kit may further comprise a fluidic connector attached to the wound dressing. The sheet comprising a plurality of sealing strips may comprise an adhesive film and at least one protective layer over an adhesive surface of the adhesive film. The at least one sealing strip may further comprise a carrier layer configured to be releasably attached to a non-adhesive surface of the adhesive film. The carrier layer may comprise at least one tab. The at least one protective layer may comprise a central protective layer and two outer protective layers.
Embodiments disclosed herein relate to apparatuses and methods of treating a wound with reduced pressure, including pump and wound dressing components and apparatuses. The apparatuses and components comprising the wound overlay and packing materials, if any, are sometimes collectively referred to herein as dressings.
It will be appreciated that throughout this specification reference is made to a wound. It is to be understood that the term wound is to be broadly construed and encompasses open and closed wounds in which skin is torn, cut or punctured or where trauma causes a contusion, or any other superficial or other conditions or imperfections on the skin of a patient or otherwise that benefit from reduced pressure treatment. A wound is thus broadly defined as any damaged region of tissue where fluid may or may not be produced. Examples of such wounds include, but are not limited to, abdominal wounds or other large or incisional wounds, either as a result of surgery, trauma, sterniotomies, fasciotomies, or other conditions, dehisced wounds, acute wounds, chronic wounds, subacute and dehisced wounds, traumatic wounds, flaps and skin grafts, lacerations, abrasions, contusions, burns, diabetic ulcers, pressure ulcers, stoma, surgical wounds, trauma and venous ulcers or the like.
It will be understood that embodiments of the present disclosure are generally applicable to use in topical negative pressure (“TNP”) therapy systems. Briefly, negative pressure wound therapy assists in the closure and healing of many forms of “hard to heal” wounds by reducing tissue oedema; encouraging blood flow and granular tissue formation; removing excess exudate and may reduce bacterial load (and thus infection risk). In addition, the therapy allows for less disturbance of a wound leading to more rapid healing. TNP therapy systems may also assist on the healing of surgically closed wounds by removing fluid and by helping to stabilize the tissue in the apposed position of closure. A further beneficial use of TNP therapy can be found in grafts and flaps where removal of excess fluid is important and close proximity of the graft to tissue is required in order to ensure tissue viability.
As is used herein, reduced or negative pressure levels, such as −X mmHg, represent pressure levels that are below standard atmospheric pressure, which corresponds to 760 mmHg (or 1 atm, 29.93 inHg, 101.325 kPa, 14.696 psi, etc.). Accordingly, a negative pressure value of −X mmHg reflects absolute pressure that is X mmHg below 760 mmHg or, in other words, an absolute pressure of (760−X) mmHg. In addition, negative pressure that is “less” or “smaller” than X mmHg corresponds to pressure that is closer to atmospheric pressure (e.g., −40 mmHg is less than −60 mmHg). Negative pressure that is “more” or “greater” than −X mmHg corresponds to pressure that is further from atmospheric pressure (e.g., −80 mmHg is more than −60 mmHg).
The negative pressure range for some embodiments of the present disclosure can be approximately −80 mmHg, or between about −20 mmHg and −200 mmHg. Note that these pressures are relative to normal ambient atmospheric pressure. Thus, −200 mmHg would be about 560 mmHg in practical terms. In some embodiments, the pressure range can be between about −40 mmHg and −150 mmHg. Alternatively a pressure range of up to −75 mmHg, up to −80 mmHg or over −80 mmHg can be used. Also in other embodiments a pressure range of below −75 mmHg can be used. Alternatively, a pressure range of over approximately −100 mmHg, or even 150 mmHg, can be supplied by the negative pressure apparatus. In some embodiments of wound closure devices described here, increased wound contraction can lead to increased tissue expansion in the surrounding wound tissue. This effect may be increased by varying the force applied to the tissue, for example by varying the negative pressure applied to the wound over time, possibly in conjunction with increased tensile forces applied to the wound via embodiments of the wound closure devices. In some embodiments, negative pressure may be varied over time for example using a sinusoidal wave, square wave, and/or in synchronization with one or more patient physiological indices (e.g., heartbeat). Examples of such applications where additional disclosure relating to the preceding may be found include application Ser. No. 11/919,355, titled “Wound treatment apparatus and method,” filed Oct. 26, 2007, published as US 2009/0306609; and U.S. Pat. No. 7,753,894, titled “Wound cleansing apparatus with stress,” issued Jul. 13, 2010. Both applications are hereby incorporated by reference in their entirety.
International Application PCT/GB2012/000587, titled “WOUND DRESSING AND METHOD OF TREATMENT” and filed on Jul. 12, 2012, and published as WO 2013/007973 A2 on Jan. 17, 2013, is an application, hereby incorporated and considered to be part of this specification, that is directed to embodiments, methods of manufacture, and wound dressing components and wound treatment apparatuses that may be used in combination or in addition to the embodiments described herein. Additionally, embodiments of the wound dressings, wound treatment apparatuses and methods described herein may also be used in combination or in addition to those described in U.S. Provisional Application Ser. No. 61/650,904, filed May 23, 2012, titled “APPARATUSES AND METHODS FOR NEGATIVE PRESSURE WOUND THERAPY,” International Application No. PCT/IB2013/001469, filed May 22, 2013, titled “APPARATUSES AND METHODS FOR NEGATIVE PRESSURE WOUND THERAPY,” U.S. Provisional Application Ser. No. 61/678,569, filed Aug. 1, 2012, titled “WOUND DRESSING AND METHOD OF TREATMENT,” U.S. Provisional Application Ser. No. 61/753,374, filed Jan. 16, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” U.S. Provisional Application Ser. No. 61/753,878, filed Jan. 17, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” U.S. Provisional Application Ser. No. 61/785,054, filed Mar. 14, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” and U.S. Provisional Application Ser. No. 61/823,298, filed May 14, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” which are hereby incorporated by reference into this present application in their entireties. Embodiments of the wound dressings, wound treatment apparatuses and methods described herein may also be used in combination or in addition to those described in application Ser. No. 13/092,042, filed Apr. 21, 2011, published as US2011/0282309, titled “WOUND DRESSING AND METHOD OF USE,” and which is hereby incorporated by reference in its entirety, including further details relating to embodiments of wound dressings, the wound dressing components and principles, and the materials used for the wound dressings.
After the skin surrounding the wound site 200 is dry, and with reference now to
With reference now to
Turning to
Treatment of the wound site 200 preferably continues until the wound has reached a desired level of healing. In some embodiments, it may be desirable to replace the dressing 110 after a certain time period has elapsed, or if the dressing is full of wound fluids. During such changes, the pump 150 may be kept, with just the dressing 110 being changed.
As illustrated in
Some embodiments of the wound contact layer 2102 may also act as a carrier for an optional lower and upper adhesive layer (not shown). For example, a lower pressure sensitive adhesive may be provided on the lower surface 2101 of the wound dressing 2100 whilst an upper pressure sensitive adhesive layer may be provided on the upper surface 2103 of the wound contact layer. The pressure sensitive adhesive, which may be a silicone, hot melt, hydrocolloid or acrylic based adhesive or other such adhesives, may be formed on both sides or optionally on a selected one or none of the sides of the wound contact layer. When a lower pressure sensitive adhesive layer is utilized may be helpful to adhere the wound dressing 2100 to the skin around a wound site. In some embodiments, the wound contact layer may comprise perforated polyurethane film. The lower surface of the film may be provided with a silicone pressure sensitive adhesive and the upper surface may be provided with an acrylic pressure sensitive adhesive, which may help the dressing maintain its integrity. In some embodiments, a polyurethane film layer may be provided with an adhesive layer on both its upper surface and lower surface, and all three layers may be perforated together.
A layer 2105 of porous material can be located above the wound contact layer 2102. This porous layer, or transmission layer, 2105 allows transmission of fluid including liquid and gas away from a wound site into upper layers of the wound dressing. In particular, the transmission layer 2105 preferably ensures that an open air channel can be maintained to communicate negative pressure over the wound area even when the absorbent layer has absorbed substantial amounts of exudates. The layer 2105 should preferably remain open under the typical pressures that will be applied during negative pressure wound therapy as described above, so that the whole wound site sees an equalized negative pressure. The layer 2105 may be formed of a material having a three dimensional structure. For example, a knitted or woven spacer fabric (for example Baltex 7970 weft knitted polyester) or a non-woven fabric could be used.
A layer 2110 of absorbent material is provided above the transmission layer 2105. The absorbent material, which comprise a foam or non-woven natural or synthetic material, and which may optionally comprise a super-absorbent material, forms a reservoir for fluid, particularly liquid, removed from the wound site. In some embodiments, the layer 2100 may also aid in drawing fluids towards the backing layer 2140.
With reference to
The material of the absorbent layer 2110 may also prevent liquid collected in the wound dressing 2100 from flowing freely within the dressing, and preferably acts so as to contain any liquid collected within the absorbent layer 2110. The absorbent layer 2110 also helps distribute fluid throughout the layer via a wicking action so that fluid is drawn from the wound site and stored throughout the absorbent layer. This helps prevent agglomeration in areas of the absorbent layer. The capacity of the absorbent material must be sufficient to manage the exudates flow rate of a wound when negative pressure is applied. Since in use the absorbent layer experiences negative pressures the material of the absorbent layer is chosen to absorb liquid under such circumstances. A number of materials exist that are able to absorb liquid when under negative pressure, for example superabsorber material. The absorbent layer 2110 may typically be manufactured from ALLEVYN™ foam, Freudenberg 114-224-4 and/or Chem-Posite™ 11C-450. In some embodiments, the absorbent layer 2110 may comprise a composite comprising superabsorbent powder, fibrous material such as cellulose, and bonding fibers. In a preferred embodiment, the composite is an airlaid, thermally-bonded composite.
An orifice 2145 is preferably provided in the backing layer 2140 to allow a negative pressure to be applied to the dressing 2100. A suction port 2150 is preferably attached or sealed to the top of the backing layer 2140 over an orifice 2145 made into the dressing 2100, and communicates negative pressure through the orifice 2145. A length of tubing 2220 may be coupled at a first end to the suction port 2150 and at a second end to a pump unit (not shown) to allow fluids to be pumped out of the dressing. The port may be adhered and sealed to the backing layer 2140 using an adhesive such as an acrylic, cyanoacrylate, epoxy, UV curable or hot melt adhesive. The port 2150 is formed from a soft polymer, for example a polyethylene, a polyvinyl chloride, a silicone or polyurethane having a hardness of 30 to 90 on the Shore A scale. In some embodiments, the port 2150 may be made from a soft or conformable material, for example using the embodiments described below in
Preferably the absorbent layer 2110 and the obscuring layer 2107 include at least one through hole 2146 located so as to underlie the port 2150. The through hole 2146, while illustrated here as being larger than the hole through the obscuring layer 2107 and backing layer 2140, may in some embodiments be bigger or smaller than either. Of course, the respective holes through these various layers 2107, 2140, and 2110 may be of different sizes with respect to each other. As illustrated in
The aperture or through-hole 2146 is preferably provided in the absorbent layer 2110 and the obscuring layer 2107 beneath the orifice 2145 such that the orifice is connected directly to the transmission layer 2105. This allows the negative pressure applied to the port 2150 to be communicated to the transmission layer 2105 without passing through the absorbent layer 2110. This ensures that the negative pressure applied to the wound site is not inhibited by the absorbent layer as it absorbs wound exudates. In other embodiments, no aperture may be provided in the absorbent layer 2110 and/or the obscuring layer 2107, or alternatively a plurality of apertures underlying the orifice 2145 may be provided.
The backing layer 2140 is preferably gas impermeable, but moisture vapor permeable, and can extend across the width of the wound dressing 2100. The backing layer 2140, which may for example be a polyurethane film (for example, Elastollan SP9109) having a pressure sensitive adhesive on one side, is impermeable to gas and this layer thus operates to cover the wound and to seal a wound cavity over which the wound dressing is placed. In this way an effective chamber is made between the backing layer 2140 and a wound site where a negative pressure can be established. The backing layer 2140 is preferably sealed to the wound contact layer 2102 in a border region 2200 around the circumference of the dressing, ensuring that no air is drawn in through the border area, for example via adhesive or welding techniques. The backing layer 2140 protects the wound from external bacterial contamination (bacterial barrier) and allows liquid from wound exudates to be transferred through the layer and evaporated from the film outer surface. The backing layer 2140 preferably comprises two layers; a polyurethane film and an adhesive pattern spread onto the film. The polyurethane film is preferably moisture vapor permeable and may be manufactured from a material that has an increased water transmission rate when wet.
The absorbent layer 2110 may be of a greater area than the transmission layer 2105, such that the absorbent layer overlaps the edges of the transmission layer 2105, thereby ensuring that the transmission layer does not contact the backing layer 2140. This provides an outer channel 2115 of the absorbent layer 2110 that is in direct contact with the wound contact layer 2102, which aids more rapid absorption of exudates to the absorbent layer. Furthermore, this outer channel 2115 ensures that no liquid is able to pool around the circumference of the wound cavity, which may otherwise seep through the seal around the perimeter of the dressing leading to the formation of leaks.
As shown in
A filter element 2130 that is impermeable to liquids, but permeable to gases is provided to act as a liquid barrier, and to ensure that no liquids are able to escape from the wound dressing. The filter element may also function as a bacterial barrier. Typically the pore size is 0.2 μm. Suitable materials for the filter material of the filter element 2130 include 0.2 micron Gore™ expanded PTFE from the MMT range, PALL Versapore™ 200R, and Donaldson™ TX6628. Larger pore sizes can also be used but these may require a secondary filter layer to ensure full bioburden containment. As wound fluid contains lipids it is preferable, though not essential, to use an oleophobic filter membrane for example 1.0 micron MMT-332 prior to 0.2 micron MMT-323. This prevents the lipids from blocking the hydrophobic filter. The filter element can be attached or sealed to the port and/or the backing layer 2140 over the orifice 2145. For example, the filter element 2130 may be molded into the port 2150, or may be adhered to both the top of the backing layer 2140 and bottom of the port 2150 using an adhesive such as, but not limited to, a UV cured adhesive.
In
With reference now to
In particular for embodiments with a single port 2150 and through hole, it may be preferable for the port 2150 and through hole to be located in an off-center position as illustrated in
In some embodiments, the wound dressing 300 can have a port 304 offset from the center of the dressing as described previously. The port 304 can be a domed port or a soft fluidic connector (described in detail below). Although the port 304 can be placed in a central location on the dressing, it is preferably offset from the center of the dressing to a particular side or edge. As such, the orientation of the port 304, when placed on the body, may thus permit the port 304 to be situated in an elevated position, thereby increasing the amount of time that the dressing 300 may be used before coming into contact with fluids. Although other orientations may be used, and may occur in practice (e.g., when the patient shifts positions), placing the port 304 at a lower position may cause the filter proximate the port (not illustrated here) to become saturated, which may cause the dressing to need changing even though there may still remain some absorptive capacity within the absorbent layer. Preferably, the port 304 has an orifice for the connection of a tube or conduit thereto; this orifice may be angled away from the center of the dressing 300 so as to permit the tube or conduit to extend away from the dressing 300. In some preferred embodiments, the port 304 comprises an orifice that permits the tube or conduit inserted therein to be approximately parallel to the top surface of the backing layer 301.
In various embodiments, the wound dressing 300 can have an absorbent material 302. The absorbent material 302 can be accompanied by the additional components within the wound dressing as described with reference to the wound dressing cross-section in
In some embodiments, the wound dressing 300 can have an absorbent material 302 with a central portion 308. The absorbent material 302 can have a longitudinal length and a transverse width. In some embodiments, the longitudinal length is greater than the transverse width. In some embodiments, the longitudinal length and the transverse width are of equal size. In various embodiments, the absorbent material 302 can have a contoured shape with a substantially rectangular body.
The central portion 308 of the absorbent material 302 may comprise a waisted portion 303. The waisted portion 303 can be defined by the transverse width of the absorbent material 302 narrowing at the central portion 308 of the longitudinal length. For example, in some embodiments, the waisted portion 303 can be a narrow width at the central portion 308 of the absorbent material 302, as illustrated in
The waisted portion 303 can increase the flexibility of the wound dressing and can allow enhanced compatibility of the wound dressing to the patient's body. For example, the narrow central region may allow for improved contact and adhesion of the wound dressing to the skin surface when the wound dressing is used on non-planar surfaces and/or wrapped around an arm or leg. Further, the narrow central portion provides increased compatibility with the patient's body and patient movement.
As in
The wound dressing 400 can be constructed similar to the embodiments of
As illustrated in
The obscuring layer 404 can be positioned at least partially over the absorbent material 402. In some embodiments, the obscuring layer 404 can be positioned adjacent to the backing layer, or can be positioned adjacent to any other dressing layer desired. In some embodiments, the obscuring layer 404 can be adhered to or integrally formed with the backing layer and/or the absorbent material.
As illustrated in
In some embodiments, the obscuring layer 404 can help to reduce the unsightly appearance of a dressing during use, by using materials that impart partial obscuring or masking of the dressing surface. The obscuring layer 404 in one embodiment only partially obscures the dressing, to allow clinicians to access the information they require by observing the spread of exudate across the dressing surface. The partial masking nature of this embodiment of the obscuring layer enables a skilled clinician to perceive a different color caused by exudate, blood, by-products etc. in the dressing allowing for a visual assessment and monitoring of the extent of spread across the dressing. However, since the change in color of the dressing from its clean state to a state containing exudate is only a slight change, the patient is unlikely to notice any aesthetic difference. Reducing or eliminating a visual indicator of wound exudate from a patient's wound is likely to have a positive effect on their health, reducing stress for example.
In some embodiments, the obscuring layer can be formed from a non-woven fabric (for example, polypropylene), and may be thermally bonded using a diamond pattern with 19% bond area. In various embodiments, the obscuring layer can be hydrophobic or hydrophilic. Depending on the application, in some embodiments, a hydrophilic obscuring layer may provide added moisture vapor permeability. In some embodiments, however, hydrophobic obscuring layers may still provide sufficient moisture vapor permeability (i.e., through appropriate material selection, thickness of the obscuring layer), while also permitting better retention of dye or color in the obscuring layer. As such, dye or color may be trapped beneath the obscuring layer. In some embodiments, this may permit the obscuring layer to be colored in lighter colors or in white. In the preferred embodiment, the obscuring layer is hydrophobic. In some embodiments, the obscuring layer material can be sterilizable using ethylene oxide. Other embodiments may be sterilized using gamma irradiation, an electron beam, steam or other alternative sterilization methods. Additionally, in various embodiments the obscuring layer can colored or pigmented, e.g., in medical blue. The obscuring layer may also be constructed from multiple layers, including a colored layer laminated or fused to a stronger uncolored layer. Preferably, the obscuring layer is odorless and exhibits minimal shedding of fibers.
The absorbent layer 402, itself may be colored or tinted in some embodiments, however, so that an obscuring layer is not necessary. The dressing may optionally include a means of partially obscuring the top surface. This could also be achieved using a textile (knitted, woven, or non-woven) layer without openings, provided it still enables fluid evaporation from the absorbent structure. It could also be achieved by printing an obscuring pattern on the top film, or on the top surface of the uppermost pad component, using an appropriate ink or colored pad component (yarn, thread, coating) respectively. Another way of achieving this would be to have a completely opaque top surface, which could be temporarily opened by the clinician for inspection of the dressing state (for example through a window), and closed again without compromising the environment of the wound.
Additionally,
The viewing windows 403 may be cut through the obscuring layer 404 or may be part of an uncolored area of the obscuring layer 404 and therefore may allow visualization of the absorbent material 402. The one or more viewing windows 403 can be arranged in a repeating pattern across the obscuring layer 404 or can be arranged at random across the obscuring layer. Additionally, the one or more viewing windows can be a circular shape or dots. Preferably, the one or more viewing windows 403 are configured so as to permit not only the degree of saturation, but also the progression or spread of fluid toward the fluid port 406, as in some embodiments, dressing performance may be adversely affected when the level of fluid has saturated the fluid proximate the port 406. In some embodiments, a “starburst” array of viewing windows 403 emanating around the port 406 may be suitable to show this progression, although of course other configurations are possible.
In
The viewing windows 403 may take several configurations, as will be discussed in relation to
In some embodiments, the absorbent layer 402 or the obscuring layer 404, in particular the colored portion of the absorbent layer, may comprise (or be colored because of) the presence of an auxiliary compound. The auxiliary compound may in some embodiments be activated charcoal, which can act to absorb odors. The use of antimicrobial, antifungal, anti-inflammatory, and other such therapeutic compounds is also possible. In some embodiments, the color may change as a function of time (e.g., to indicate when the dressing needs to be changed), if the dressing is saturated, or if the dressing has absorbed a certain amount of a harmful substance (e.g., to indicate the presence of infectious agents). In some embodiments, the one or more viewing windows 403 may be monitored electronically, and may be used in conjunction with a computer program or system to alert a patient or physician to the saturation level of the dressing 400.
In other alternatives, instructions may be given to change the wound dressing when the exudate reaches a predetermined distance from the edge of the wound dressing, such as 5 mm from the wound dressing edge or 7 mm from the wound dressing edge, etc. Alternatively a ‘traffic light’ system may be implemented whereby an electronic indicator shows green, amber or red light to indicate the spread of exudate in the wound dressing. Alternatively or additionally, another suitable indicator may be used for indicating the spread of exudate over the dressing.
Embodiments of the wound dressings described herein may be arranged such that each embodiment may have enhanced compatibility with body movement. This can be achieved by using a different shape for different wound types or areas of the body. Wound dressing embodiments can be of any suitable shape or form or size as illustrated in
As noted above, the preceding embodiments illustrated in
The additional sizes and shapes illustrated in
Additionally,
As with
With reference now to
Testing of various weights in various configurations on embodiments of fluidic connectors comprising a 3D fabric was completed. The testing included weights above those believed to be likely to be encountered by a patient, as maximal pressure on a heel for a patient using dressings was found to be 1.3 kg/cm2 in some studies. Preferably, embodiments of the fluidic connectors described herein, especially when comprising 3D fabric, can transmit therapeutic levels of negative pressure (i.e., in an amount sufficient to heal a wound) while a weight is pressed down thereupon. For example, embodiments are preferably able to transmit therapeutic levels of negative pressure while an external pressure applied on the dressing and/or 3D fabric of up to 1 kg/cm2, preferably up to 2 kg/cm2, and even more preferably up to 4 kg/cm2. Certain embodiments, as described below, have been tested as being capable of transmitting therapeutic levels of negative pressure while an external pressure applied on the dressing and/or 3D fabric is above 6 kg/cm2.
In the testing, a 400 ml wound cavity was used, and pressure was measured both at the wound and at the pump. Embodiments of a fluidic connector comprising 3D fabric were tested when laid flat with a weight placed thereupon. Testing indicated that when no pressure was applied to the fluidic connector, the pressure differential between the pressure at the pump and at the cavity was approximately 2 mmHg. Various different weights were applied, ranging between 2 and 12 kg/cm2, in 2 kg increments, and the resulting pressure difference was approximately linear, with the pressure difference at 12 kg/cm2 being calculated at 33 mmHg, while the pressure difference at 2 kg/cm2 being only 16 mmHg. The relation between the pressure difference in mmHg was found to equal approximately 4.5 times the applied load in kg/cm2. Testing also indicated that the relative pressure difference between the pressure at the pump and the pressure at the wound after five minutes was less than 10 mmHg when measured at the pump for loads under 4 kg/cm2, and under 20 mmHg when measured at the wound for loads under 4 kg/cm2.
Testing was also performed with a weight laid on an embodiment of a fluidic connector, while being bent at a 90° angle. Various different weights were applied, ranging between 2 and 12 kg/cm2, in 2 kg increments, and the resulting pressure difference was approximately linear, with the pressure difference at 12 kg/cm2 being calculated at 51 mmHg, while the pressure difference at 2 kg/cm2 being 17 mmHg. The relation between the pressure difference in mmHg was found to equal approximately 8 times the applied load in kg/cm2. Testing also indicated that the relative pressure difference between the pressure at the pump and the pressure at the wound after five minutes was approximately 20 mmHg when measured at the pump for loads under 4 kg/cm2, and under 30 mmHg when measured at the wound for loads under 4 kg/cm2.
Further testing was performed with a weight laid on an embodiment of a fluidic connector, while being bent at a 180° angle (i.e., folded over itself). Various different weights were applied, ranging between 2 and 12 kg/cm2, in 2 kg increments, and the resulting pressure difference was approximately linear, with the pressure difference at 12 kg/cm2 being calculated at 76 mmHg, while the pressure difference at 2 kg/cm2 being 25 mmHg. The relation between the pressure difference in mmHg was found to equal approximately 10.7 times the applied load in kg/cm2. Testing also indicated that the relative pressure difference between the pressure at the pump and the pressure at the wound after five minutes was approximately 20 mmHg when measured at the pump for loads under 4 kg/cm2, and under 30 mmHg when measured at the wound for loads under 4 kg/cm2.
Testing was also performed on different widths and thicknesses of 3D fabric that may be used in embodiments of fluidic connectors described herein. In a particular example, the maximum negative pressure that could be applied using 3D fabric measuring 1, 1.25, 1.5, 1.75, and 2 cm in width was found to be between 85 and 92 mmHg, respectively. Upon application of an applied load of 1 kg/cm2, however, the maximum negative pressure applied for a 1 cm-width embodiment dropped to 75 mmHg, while the 1.25 and 1.5 cm-width embodiments were essentially unchanged, exhibiting pressures between 85 and 90 mmHg. Application of a 1 kg/cm2 weight made the 1 cm-width embodiment maximum negative pressure drop to about 73 mmHg, while the 1.25 cm-width embodiment dropped to about 84 mmHg. The 1.5 cm-width embodiment showed a minimal maximum negative pressure change down to approximately 86 mmHg. As tested, the greatest increases in flow rate (as evidenced by the maximal negative pressures applied) were greatest when increasing the width of the 3D fabric from 1 cm to 1.25 cm, and stabilized above 1.5 cm. Similarly, increasing the width of the 3D fabric (i.e., above 1 cm) was found to slightly reduce the amount of time required to pump a wound cavity down to a target negative pressure.
Further testing with single and double layers of Baltex 3540 3D fabric, either single or double thickness, indicated that while the maximum negative pressure applied using a single thickness fabric dropped from about 88 mmHg with no applied weight to about 73 mmHg with a 2 kg/cm2 weight. However, a double thickness fabric showed minimal change in the maximum amount of negative pressure applied, dropping from 90 mmHg with no weight applied to about 87 mmHg with an applied load of 2 kg/cm2.
Depending on the particular application, using wider and/or thicker 3D fabric may permit improved air flow, together with greater pressure and kink resistance in some context; this may be useful especially if higher absolute negative pressure need to be applied to the wound. However, the greater kink and pressure resistance may need to be balanced with other concerns such as perceived bulk and size of the fluidic connector, aesthetics, and comfort, which may require use of a thinner 3D fabric.
In some embodiments, the proximal end 2411 of the fluidic connector 2410 is configured to be connected to a tube or other conduit that is in fluid communication with a source of negative pressure via the fluid connector body, although some embodiments may provide for the fluidic connector 2410 to be directly connectable to a source of negative pressure without needing a conventional tube. The distal end 2412 of the fluidic connector 2410 may be enlarged, and is configured to be attached and/or adhered to a dressing, for example via an aperture in the backing layer of the dressing and/or in the fluidic connector 2410, so that the fluid connector body is in fluid communication therewith.
In one configuration and as illustrated in
In embodiments of the fluidic connector that are configured to transfer exudate in addition to air, the fluidic connector may be provided with a secondary air leak channel configured to provide a flow of ambient air to the wound site. Preferably, the secondary air leak channel is provided with a filter to prevent contamination of the wound.
Turning now to
In some embodiments, the fluidic connector body may be colored as a result of an auxiliary compound such as activated charcoal. Further, some embodiments may provide for text or images to be printed thereon, for example for instructional or advertising purposes. Such improvements may enhance patient comfort and minimize embarrassment, thereby increasing patient compliance and satisfaction with the device. The obscuring layer in the fluidic connector can have all features described with reference to the obscuring layer of the wound dressing as herein described.
Additionally,
Additionally,
The dressing 2300 can have a rectangular or square shaped backing layer 2302, and in some embodiments, the overall dressing 2300 may measure 190 mm×230 mm, or 145.5 mm×190 mm Preferably, a fluidic connector such as a port 2306 is attached to the dressing 2300, although it will of be recognized that the fluidic connector of
In a preferred embodiment, the dressing 500 illustrated here has a longitudinal length of approximately 400 mm, and a transverse width of approximately 100 mm. The central axis of each arm of the cutout 501 of the orifice viewing window 502 is preferably offset from the longitudinal length and transverse width of the absorbent material, at an angle, for example, a 45° angle, as illustrated. The spacing between each arm of the cutout 501 may be, as illustrated here, 72°, although it will of course be recognized that other angles and configurations are possible. Dashed lines 512 illustrated in
The dressing 3400 may optionally comprise a wound contact layer 3460 for sealing the dressing 3400 to the healthy skin of a patient surrounding a wound area. Certain embodiments of the wound contact layer may comprise three layers: a polyurethane film layer, a lower adhesive layer and an upper adhesive layer. The upper adhesive layer may assist in maintaining the integrity of the dressing 3400, and the lower adhesive layer may be employed for sealing the dressing 3400 to the healthy skin of a patient around a wound site. As described above, in some embodiments with respect to
Some embodiments of the dressing 3400 may comprise an optional spacer or transmission layer 3450. The transmission layer 3450 may comprise a porous material or 3D fabric configured to allow for the passage of fluids therethrough away from the wound site and into the upper layers of the dressing 3400. In particular, the transmission layer 3450 can ensure that an open air channel can be maintained to communicate negative pressure over the wound area even when the absorbent layer 3430 has absorbed substantial amounts of exudates. The transmission layer 3450 should remain open under the typical pressures that will be applied during negative pressure wound therapy as described above, so that the whole wound site sees an equalized negative pressure. An outer perimeter of the transmission layer may be smaller than the outer perimeter of the dressing layer positioned above the transmission layer, for example the ADL 3440 and/or absorbent layer 3430. In some embodiments, the entire outer perimeter of the transmission layer may be spaced inward from the outer perimeter of the overlying layer by 5 mm, or approximately 5 mm, or 2 mm to 8 mm, or approximately 2 mm to approximately 8 mm.
Some embodiments of the transmission layer 3450 may be formed of a material having a three dimensional structure. For example, a knitted or woven spacer fabric (for example Baltex 7970 weft knitted polyester) or a non-woven fabric can be used. In some embodiments, the transmission layer 3450 can have a 3D polyester spacer fabric layer. This layer can have a top layer which is a 84/144 textured polyester, and a bottom layer which can be a 100 denier flat polyester and a third layer formed sandwiched between these two layers which is a region defined by a knitted polyester viscose, cellulose or the like monofilament fiber. In use, this differential between filament counts in the spaced apart layers tends to draw liquid away from the wound bed and into a central region of the dressing 3400 where the absorbent layer 3430 helps lock the liquid away or itself wicks the liquid onwards towards the cover layer 3410 where it can be transpired. Other materials can be utilized, and examples of such materials are described in U.S. Patent Pub. No. 2011/0282309, which are hereby incorporated by reference and made part of this disclosure. However, the transmission layer 3450 may be optional, and for example may be optional in embodiments of the dressing 3400 which comprise the acquisition distribution layer 3440, described below.
Some embodiments may comprise a wicking or acquisition distribution layer (ADL) 3440 to horizontally wick fluid such as wound exudate as it is absorbed upward through the layers of the dressing 3400. Lateral wicking of fluid may allow maximum distribution of the fluid through the absorbent layer 3430 and may enable the absorbent layer 3430 to reach its full holding capacity. This may advantageously increase moisture vapor permeation and efficient delivery of negative pressure to the wound site. Some embodiments of the ADL 3440 may comprise viscose, polyester, polypropylene, cellulose, or a combination of some or all of these, and the material may be needle-punched. Some embodiments of the ADL 3440 may comprise polyethylene in the range of 40-150 grams per square meter (gsm). In some embodiments, the ADL 3440 may have a thickness of 1.2 mm or about 1.2 mm, or may have a thickness in the range of 0.5 mm to 3.0 mm, or about 0.5 mm to about 3.0 mm.
The dressing 3400 may further comprise an absorbent or superabsorbent layer 3430. The absorbent layer can be manufactured from ALLEVYN™ foam, Freudenberg 114-224-4 and/or Chem-Posite™ 11C-450, or any other suitable material. In some embodiments, the absorbent layer 3430 can be a layer of non-woven cellulose fibers having super-absorbent material in the form of dry particles dispersed throughout. Use of the cellulose fibers introduces fast wicking elements which help quickly and evenly distribute liquid taken up by the dressing. The juxtaposition of multiple strand-like fibers leads to strong capillary action in the fibrous pad which helps distribute liquid. In some embodiments, the absorbent layer 3430 may have a thickness of 1.7 mm or about 1.7 mm, or may have a thickness in the range of 0.5 mm to 3.0 mm, or about 0.5 mm to about 3.0 mm.
For example, some embodiments of the absorbent layer 3430 may comprise a layered construction of an upper layer of non-woven cellulose fibers, superabsorbent particles (SAP), and a lower layer of cellulose fibers with 40-80% SAP. In some embodiments, the absorbent layer 3430 may be an air-laid material. Heat fusible fibers can optionally be used to assist in holding the structure of the pad together. Some embodiments may combine cellulose fibers and air-laid materials, and may further comprise up to 60% SAP. Some embodiments may comprise 60% SAP and 40% cellulose. Other embodiments of the absorbent layer may comprise between 60% and 90% (or between about 60% and about 90%) cellulose matrix and between 10% and 40% (or between about 10% and about 40%) superabsorbent particles. For example, the absorbent layer may have about 20% superabsorbent material and about 80% cellulose fibers. It will be appreciated that rather than using super-absorbing particles or in addition to such use, super-absorbing fibers can be utilized according to some embodiments of the present invention. An example of a suitable material is the Product Chem-Posite™ 11 C available from Emerging Technologies Inc (ETi) in the USA.
Super-absorber particles/fibers can be, for example, sodium polyacrylate or carbomethoxycellulose materials or the like or any material capable of absorbing many times its own weight in liquid. In some embodiments, the material can absorb more than five times its own weight of 0.9% W/W saline, etc. In some embodiments, the material can absorb more than 15 times its own weight of 0.9% W/W saline, etc. In some embodiments, the material is capable of absorbing more than 20 times its own weight of 0.9% W/W saline, etc. Preferably, the material is capable of absorbing more than 30 times its own weight of 0.9% W/W saline, etc. The absorbent layer 3430 can have one or more through holes 3431 located so as to underlie the suction port.
Some embodiments of the present disclosure may employ a masking or obscuring layer 3420 to help reduce the unsightly appearance of a dressing 3400 during use due to the absorption of wound exudate. The obscuring layer 3420 may be a colored portion of the absorbent material, or may be a separate layer that covers the absorbent material. The obscuring layer 3420 may be one of a variety of colors such as blue, orange, yellow, green, or any color suitable for masking the presence of wound exudate in the dressing 3400. For example, a blue obscuring layer 3420 may be a shade of blue similar to the shade of blue commonly used for the material of medical gowns, scrubs, and drapes. Some embodiments of the obscuring layer 3420 may comprise polypropylene spunbond material. Further, some embodiments of the obscuring layer 3420 may comprise a hydrophobic additive or coating. Other embodiments may comprise a thin fibrous sheet of 60, 70, or 80 gsm. In some embodiments, the obscuring layer 3420 may have a thickness of 0.045 mm or about 0.045 mm, or may have a thickness in the range of 0.02 mm to 0.5 mm, or about 0.02 mm to about 0.5 mm.
The obscuring layer may comprise at least one viewing window 3422 configured to allow a visual determination of the saturation level of the absorbent layer. The at least one viewing window 3422 may comprise at least one aperture made through the obscuring layer. The at least one viewing window 3422 may comprise at least one uncolored region of the obscuring layer. Some embodiments of the obscuring layer may comprise a plurality of viewing windows or an array of viewing windows, as discussed above with respect to
The masking capabilities of the obscuring layer 3420 should preferably only be partial, to allow clinicians to access the information they require by observing the spread of exudate across the dressing surface. A obscuring layer 3420 may be partial due to material properties allowing wound exudate to slightly alter the appearance of the dressing or due to the presence of at least one viewing window 3422 in a completely obscuring material. The partial masking nature of the obscuring layer 3420 enables a skilled clinician to perceive a different colour caused by exudate, blood, by-products etc. in the dressing allowing for a visual assessment and monitoring of the extent of spread across the dressing. However, since the change in colour of the dressing from its clean state to a state with exudate contained is only a slight change, the patient is unlikely to notice any aesthetic difference. Reducing or eliminating a visual indicator of wound exudate from a patient is likely to have a positive effect on their health, reducing stress for example.
Tests performed upon various dressings with respect to the transmittance properties of the dressing indicate the ability of various samples to mask colour. The ability to mask colour may be calculated, for example, by measuring the reduction in absorption of light radiation at particular wavelengths. The tests utilized a UV-Vis spectrophotometer Jasco with integrating sphere, with a scanning range 340 to 800 nm, bandwidth 5 nm and 1000 nm/sec scanning speed. The data labelled black background represents the extreme of exudate colour (the most colour an exudate might have)—the highest level of radiation absorbed and the least amount of radiation reflected from the sample. The data for white background represents the upper limit for total masking—generally the lowest level of radiation absorbed and the highest level of reflection. Sample 1 was a tinted polymer film placed over a black background, which was judged not to sufficiently mask the black background (representing wound exudate) satisfactorily. Sample 2 was a sheet of 3-dimensional spacer fabric (Baltex 3D) placed over a black background, and was judged to provide adequate masking of the black background. Sample 3 was a sheet of non-woven material dyed green placed over a black background, and provided complete masking of the black background.
Wound exudate may have dark yellow, red and/or brown tones. Therefore, to appropriately mask these colours, an obscuring layer 3420 would preferably shield light wavelengths of below 600 nm.
Measuring the reduction in absorption of light radiation at particular wavelengths may be performed by calculating:
% reduction=(Abackground−Asample placed on background)/(Abackground)×100
where A is the absorption of light radiation at the particular wavelength.
Using this formula, using light at a wavelength of 460 nm, the percentage of absorption reduction was calculated as shown in Table 3 below.
It has been found that materials that reduce light absorption by about 50% or more will provide enough partial or complete masking of wound exudate (as judged by the inventors). Of course a complete masking element would preferably require a means for a clinician to judge the spread of wound exudate in the dressing below the obscuring layer 3420, e.g. the masking element not completely covering the entire dressing. For example, as described above with respect to
It will be understood that the wetting of a masking material (by exudate for example) will also affect the masking performance of the masking element, since hydrophilic materials will allow chromophore-carrying species to travel through them more easily. As such, the absorption reduction rate should also be tested on wet materials.
The above-mentioned Samples 1, 2 and 3 were also tested for their masking properties by measuring CIE L*a*b* values (a known 3-dimensional model for representing colour space). The analysis employed Jasco software using the range 380 to 780 nm, stard observed 2(deg), lightsource D65, colour matching JIS Z8701-1999.
Table 4 below shows the L*a*b* values found when Samples 1, 2 and 3 were respectively placed over a black background. The results for the black background alone and a white background are also shown.
Generally, samples which lead to an increase in L* value will provide a lighter colour tone than the reference surface, which is the main contributor to masking a dark colour. From the values above, apt partial masking materials will yield an L* value above 50, or more aptly above 70.
However, completely opaque masking layers, such as for example a tinted polymeric film, may cover the area to be masked with a darker tone altogether, in which case the measure of L* is not relevant. Once again these values should also be considered on wet material, for the reasons stated above.
In addition to transmittance properties, the color of the obscuring layer 3420 may affect the masking ability of the layer. In liquid permeable embodiments of the obscuring layer, various colors are suitable for masking the usual colors of wound exudate, while other colors may not provide optimal masking of the exudate. For example, with reference to the CIE chromaticity diagram illustrated in
The obscuring layer 3420 can have one or more through holes located so as to underlie the suction port. Some embodiments may have a maltese cross 3421 or other shaped cutout underlying the suction port, wherein the diameter of the maltese cross 3421 is greater than the diameter of the port. This may allow a clinician to easily assess the amount of wound exudate absorbed into the layers beneath the port. The obscuring layer 3420 may have an outer perimeter that is larger than the dressing layer or layers provided beneath it, for example the absorbent layer 3430, ADL 3440 and/or transmission layer 3450. In some embodiments the entire outer perimeter of the obscuring layer 3420 is spaced 1 mm, or approximately 1 mm, or 0.5 mm to 3 mm, or approximately 0.5 to approximately 3 mm, beyond the dressing layer or layers provided beneath it. The larger perimeter of the obscuring layer 3420 may ensure that the underlying layers are adequately covered for visual obscuring of wound exudate.
The dressing 3400 may also comprise a backing layer, or cover layer 3410 extending across the width of the wound dressing. The cover layer 3410 may be gas impermeable but moisture vapor permeable. Some embodiments may employ a polyurethane film (for example, Elastollan SP9109) or any other suitable material. For example, certain embodiments may comprise translucent or transparent 30 gsm EU33 film. The cover layer 3410 may have a pressure sensitive adhesive on the lower side, thereby creating a substantially sealed enclosure over the wound in which negative pressure may be established. The cover layer can protect the wound as a bacterial barrier from external contamination, and may allow liquid from wound exudates to be transferred through the layer and evaporated from the film outer surface.
The cover layer 3410 can have an orifice 3411 located so as to underlie the suction port. The orifice 3411 may allow transmission of negative pressure through the cover layer 3410 to the wound enclosure. The port may be adhered and sealed to the cover film using an adhesive such as an acrylic, cyanoacrylate, epoxy, LTV curable or hot melt adhesive. Some embodiments may have a plurality of orifices for the attachment of multiple ports or other sources of negative pressure or other mechanisms for distributing fluid.
The bottom layer 3540 may comprise an elongate bridge portion 3544, an enlarged (e.g., rounded or circular) sealing portion 3545, and an orifice 3541. In some embodiments a plurality of orifices may be provided in the bottom layer. Some embodiments of the rounded sealing portion 3545 may comprise a layer of adhesive, for example a pressure sensitive adhesive, on the lower surface for use in sealing the port 3500 to a dressing. For example, the port may be sealed to the cover layer 3410 of the dressing in
The top layer 3515 may be substantially the same shape as the bottom layer in that it comprises an elongate bridge 3514 and an enlarged (e.g., rounded or circular) portion 3515. The top layer 3515 and the bottom layer 3545 may be sealed together, for example by heat welding. In some embodiments, the bottom layer 3545 may be substantially flat and the top layer 3515 may be slightly larger than the bottom layer 3545 in order to accommodate the height of the spacer layer 3520 and seal to the bottom layer 3545. In other embodiments, the top layer 3515 and bottom layer 3145 may be substantially the same size, and the layers may be sealed together approximately at the middle of the height of the spacer layer 3520. In some embodiments, the elongate bridge portions 3544, 3514 may have a length of 10 cm (or about 10 cm) or more, more preferably a length of 20 cm (or about 20 cm) or more and in some embodiments, may be about 27 cm long. In some embodiments, the elongate bridge portions may have a width of between 1 cm and 4 cm (or between about 1 cm and about 4 cm), and in one embodiment, is about 2.5 cm wide. The ratio of the length of the elongate bridge portions 3544, 3514 to their widths may in some embodiments exceed 6:1, and may more preferably exceed 8:1 or even 10:1. The diameter of the circular portion 3545, 3515 may be about 3.5 cm in some embodiments.
The bottom and top layers may comprise at least one layer of a flexible film, and in some embodiments may be transparent. Some embodiments of the bottom layer 3540 and top layer 3515 may be polyurethane, and may be liquid impermeable. The top layer may comprise a flexible film having a thickness of 90 gsm, or approximately 90 gsm, or any thickness suitable for making the top film difficult to puncture.
The port 3500 may comprise a spacer layer 3520, such as the 3D fabric discussed above, positioned between the lower layer 3540 and the top layer 3510. The spacer layer 3520 may be made of any suitable material, for example material resistant to collapsing in at least one direction, thereby enabling effective transmission of negative pressure therethrough. Instead of or in addition to the 3D fabric discussed above, some embodiments of the spacer layer 520 may comprise a fabric configured for lateral wicking of fluid, which may comprise viscose, polyester, polypropylene, cellulose, or a combination of some or all of these, and the material may be needle-punched. Some embodiments of the spacer layer 520 may comprise polyethylene in the range of 40-160 grams per square meter (gsm) (or about 40 to about 160 gsm), for example 80 (or about 80) gsm. Such materials may be constructed so as to resist compression under the levels of negative pressure commonly applied during negative pressure therapy.
The spacer layer 3520 may comprise an enlarged (e.g., rounded or circular) portion 3525, and may optionally include a fold 3521. In some embodiments, the elongate bridge portion may have dimensions in the same ranges as the bridge portions of the upper and lower layers described above though slightly smaller, and in one embodiment is about 25.5 cm long and 1.5 cm wide. Similarly, the diameter of the circular portion 3525 may be slightly smaller than the diameters of the enlarged ends 3545, 3515, and in one embodiment is about 2 cm. Some embodiments of the spacer layer 3520 may have adhesive on one or both of its proximal and distal ends (e.g., one or more dabs of adhesive) in order to secure the spacer layer 3520 to the top layer 3510 and/or the bottom layer 3540. Adhesive may also be provided along a portion or the entire length of the spacer layer. In other embodiments, the spacer layer 3520 may be freely movable within the sealed chamber of the top and bottom layers.
The fold 3521 of the spacer fabric may make the end of the port 3500 softer and therefore more comfortable for a patient, and may also help prevent the conduit 3550 from blockage. The fold 3521 may further protect the end of the conduit 3550 from being occluded by the top or bottom layers. The fold 3521 may, in some embodiments, be between 1 cm and 3 cm (or between about 1 cm and about 3 cm) long, and in one embodiment is 2 cm (or about 2 cm) long. The spacer fabric may be folded underneath itself, that is toward the bottom layer 3540, and in other embodiments may be folded upward toward the top layer 3510. Other embodiments of the spacer layer 3520 may contain no fold. A slot or channel 3522 may extend perpendicularly away from the proximal end of the fold 3521, and the conduit 3550 may rest in the slot or channel 3522. In some embodiments the slot 3522 may extend through one layer of the fold, and in others it may extend through both layers of the fold. The slot 3522 may, in some embodiments, be 1 cm (or about 1 cm) long. Some embodiments may instead employ a circular or elliptical hole in the fold 3521. The hole may face proximally so that the conduit 3550 may be inserted into the hole and rest between the folded layers of spacer fabric. In some embodiments, the conduit 3550 may be adhered to the material of the fold 3521, while in other embodiments it may not.
The port 3500 may have a filter element 3530 located adjacent the orifice 3541, and as illustrated is located between the lower layer 3540 and the spacer layer 3520. As illustrated, the filter element 3530 may have a round or disc shape. The filter element 3530 is impermeable to liquids, but permeable to gases. The filter element 3530 can act as a liquid barrier, to substantially prevent or inhibit liquids from escaping from the wound dressing, as well as an odor barrier. The filter element 3530 may also function as a bacterial barrier. In some embodiments, the pore size of the filter element 3530 can be approximately 0.2 μm. Suitable materials for the filter material of the filter element include 0.2 micron Gore™ expanded PTFE from the MMT range, PALL Versapore™ 200R, and Donaldson™ TX6628. The filter element 3530 thus enables gas to be exhausted through the orifice. Liquid, particulates and pathogens however are contained in the dressing. Larger pore sizes can also be used but these may require a secondary filter layer to ensure full bioburden containment. As wound fluid contains lipids it is preferable, though not essential, to use an oleophobic filter membrane for example 1.0 micron MMT-332 prior to 0.2 micron MMT-323. This prevents the lipids from blocking the hydrophobic filter. In some embodiments, the filter element 3530 may be adhered to one or both of top surface of the bottom layer 3540 and the bottom surface of the spacer layer 3520 using an adhesive such as, but not limited to, a UV cured adhesive. In other embodiments, the filter 3530 may be welded to the inside of the spacer layer 3520 and to the top surface of the bottom layer 3540. The filter may also be provided adjacent the orifice on a lower surface of the bottom layer 3540. Other possible details regarding the filter are disclosed in U.S. Patent Pub. No. 2011/0282309 and incorporated by reference herein.
The proximal end of the port 3500 may be connected to the distal end of a conduit 3550. The conduit 3550 may comprise one or more circular ribs 3551. The ribs 3551 may be formed in the conduit 3550 by grooves in a mold during the manufacturing of the conduit. During heat welding of the upper and lower layers 3515, 3545 melted material from those layers may flow around the ribs 3551, advantageously providing a stronger connection between the conduit 3550 and the layers. As a result, it may be more difficult to dislodge the conduit 3550 out from between the layers during use of the port 3500.
The proximal end of the conduit 3550 may be optionally attached to a connector 3560. The connector 3560 may be used to connect the port 3500 to a source of negative pressure, or in some embodiments to an extension conduit which may in turn be connected to a source of negative pressure. The distal end of the conduit 3550, which is inserted into the spacer layer 3520, may be shaped in such a way to reduce the possibility of occlusion.
The dressing 3900 may be connected to a port 3990, such as described above with respect to
The backing layer 3910 (as well as the backing layer of previously described embodiments) may comprise, in some embodiments, EU33 film and may optionally have a pressure-sensitive adhesive provided on a lower surface thereof. For example, the adhesive may be a water dispersible acrylic adhesive, for example K5. The adhesive may be able to be pattern spread, and may be hydrophilic.
The obscuring layer 3920 may be provided to increase patient comfort by masking the presence of wound exudate absorbed by the inner layers of the dressing. The obscuring layer 3920 may have an outer perimeter that is spaced 1 mm, or approximately 1 mm, or 0.5 mm to 3 mm, or approximately 0.5 to approximately 3 mm, beyond the adjacent perimeter edge of the dressing layer or layers provided beneath it, for example the absorbent layer 3930, ADL 3940, and/or transmission layer 3950. The obscuring layer 3920 may be provided with a plurality of viewing windows 3922 which may be used to assess the spread of exudate across the dressing 3900. The cross-shaped opening 3921 may be used as a viewing window to ascertain the level of saturation of the layer or layers underlying an attached port. The width of the cross-shaped opening 3921 may be greater than the width of an attached port to enable such assessment. Some embodiments of the obscuring layer 3920 (including other embodiments of the obscuring layer previously described) may comprise polypropylene spunbond material of suitable colors such as described above, including medical blue. Further, some embodiments of the obscuring layer 3420 may comprise a hydrophobic additive or coating.
The absorbent layer 3930 may be configured to absorb and retain exudate from a patient's wound. The absorbent layer 3930 will preferably be constructed from a material which has good absorbent qualities under negative pressure. In some embodiments (including any of the earlier described embodiments), the absorbent layer may comprise cellulose fibers or air-laid materials. Some embodiments may comprise a cellulose fibers with 40-80% superabsorbent particles (SAP), for example 40%-60% (or about 40% to about 60%) SAP or 60%-80% (or about 60% to about 80%) SAP. Heat fusible fibers can optionally be used to assist in holding the structure of the absorbent pad together. Some embodiments may combine cellulose fibers and air-laid materials, for example as a hybrid bonded airlaid composite in the range of 400-500 gsm (or about 400 to about 500 gsm), for example 460 (or about 460) gsm. The absorbent layer 3930 may include polyacrylate superabsorber powder to increase the absorbent capabilities of the material. Some embodiments of the absorbent layer 3930 comprise a tissue dispersant layer. This may, in some embodiments, be provided along the lower surface of the layer, resulting in an asymmetric construction of the absorbent layer. The tissue dispersant layer may comprise a heat fusible binder to aid in holding the layer structure together. The tissue dispersant layer may provide the advantage of enabling fluid transport. In some embodiments, the tissue dispersant layer may comprise a hot melt adhesive such as ethylene vinyl acetate (EVA), for example applied as a solution to cellulose fibers of the absorbent layer.
The adhesive layer 3970 may bond an upper surface of the acquisition distribution layer 3940 to a lower surface of the absorbent layer 3930. As illustrated, in some embodiments the adhesive layer 3970 may comprise an adhesive web or net. In other embodiments, the adhesive layer 3970 may comprise adhesive tape. Yet other embodiments may employ a hot melt adhesive, such as EVA. For example, EVA powder may be sprinkled over the ADL 3940, which may then be heat bonded to the adhesive layer 3970. In some embodiments the acquisition distribution layer 3940 and the absorbent layer 3930 may be stitched or sewn together, and the adhesive layer 3970 may comprise suitable fibers, strands, or threads. Preferred embodiments of the adhesive layer 3970 are hydrophilic so as not to affect the transport of water and/or water-based solutions between the acquisition distribution layer 3940 and absorbent layer 3930. In some embodiments, the adhesive layer may comprise a fine sprinkle of adhesive powder such that the acquisition distribution layer 3940 and absorbent layer 3930 are not bonded together across the entire upper and lower surfaces, respectively, but may be merely tacked together in a number of locations. However, some embodiments of the dressing may be constructed without the use of an adhesive between the acquisition distribution layer 3940 and absorbent layer 3930.
The acquisition distribution layer (ADL) 3940 may be constructed so as to advantageously horizontally wick fluid, such as wound exudate, as it is absorbed upward through the layers of the dressing 3900. Such lateral wicking of fluid may allow maximum distribution of the fluid through the absorbent layer 3930, enabling the absorbent layer 3930 to reach its full holding capacity. Some embodiments of the ADL 3440 (including any embodiments of the ADL previously described) may comprise cellulose in the range of 40-160 gsm (or about 40 to about 160 gsm), for example 80 (or about 80) gsm. The ADL may be constructed from a material which resists compression under the levels of negative pressure commonly applied during negative pressure therapy.
Some embodiments of the dressing 3900 may optionally comprise a spacer or transmission layer 3950. The transmission layer 3950 may comprise a porous material or 3D fabric configured to allow for the passage of fluids therethrough away from the wound site and into the upper layers of the dressing 3400. In particular, the transmission layer 3450 should remain open under the typical pressures that will be applied during negative pressure wound therapy as described above, so that the whole wound site sees an equalized negative pressure. In some embodiments, the acquisition distribution layer 3940 may be sufficient to maintain even transmission of negative pressure throughout the dressing 3900 and the transmission layer 3950 may be excluded. An outer perimeter of the transmission layer may be spaced 5 mm, or approximately 5 mm, or 2 mm to 8 mm, or approximately 2 mm to approximately 8 mm, inward of the adjacent perimeter edge of the dressing layer positioned above the transmission layer, for example the ADL 3940 or absorbent layer 3930.
The dressing 3900 may optionally comprise a wound contact layer 3960 for sealing the dressing 3900 to the healthy skin of a patient surrounding a wound area. As discussed above with respect to
As illustrated in the side view of
In some embodiments, the ADL material may consist of a mix of two fiber types. One may be a flat fiber which may be 20 μm to 50 μm in width, or approximately 20 jam to approximately 50 μm in width, and may comprise a cellulosic based material. The other fiber may be a two component fiber that has an inner core that is 8 μm to 10 μm in diameter, or approximately is 8 μm to approximately 10 μm in diameter, and an outer layer with a thickness of 1 μm to 2 μm, or approximately 1 μm to approximately 2 μm. The two component fiber may be a mix of a polyethylene (PE) type material, and polyethylene terephthalate (PET). In some embodiments the inner core of the two component fiber may be PET and the outer layer may be PE. The PE/PET fibers may have a smooth surface morphology, while the cellulosic fibers may have a relatively rougher surface morphology. In some embodiments the ADL material may comprise about 60% to about 90% cellulosic fibers, for example approximately 75% cellulosic fibers, and may comprise about 10% to about 40% PE/PET fibers, for example approximately 25% PE/PET fibers.
The bulk of the absorbent material, comprising layers 4220, 4240, and 4250, may have a thickness of 1.7 mm, or approximately 1.7 mm, or may have a thickness in the range of 0.5 mm to 3.0 mm, or about 0.5 mm to about 3.0 mm. The bulk of the absorbent material may comprise a mix of two fiber types arranged in a fibrous network, for example the cellulosic fiber having a width of 20 μm to 50 μm, or approximately 20 μm to approximately 50 μm, and the PE/PET composite fiber, described above with respect to the ADL material. The superabsorbent particles 4230 may be irregularly shaped and varied in size, and may have a diameter of up to 1 mm, or approximately 1 mm. The superabsorbent particles 4230 may comprise a sodium acrylate type material. There may be relatively fewer superabsorbent particles in a portion of the uppermost surface of the bulk of the absorbent material (the surface of layer 4250 opposite the textured layer 4210), for example in an uppermost surface having a thickness of approximately 0.1 mm.
Layer 4220 may be a liquid absorption layer configured to draw liquid upward through the material towards layers 4240 and 4250. Layer 4240 may be a storage layer configured to hold absorbed liquid. Layer 4220 may be a liquid distribution layer configured to apply a “reverse suction” effect to the liquid storage layer 4240 in order to inhibit (or substantially inhibit) absorbed liquid from leaking back down through the lower layers of the absorbent material, a phenomenon which is commonly known as “backwetting.” Superabsorbent particles 4230 may be distributed primarily within the storage layer, may extend partially into the absorption layer 4220 and liquid distribution layer 4250, or may be distributed evenly (or substantially evenly) throughout the layers. The layers 4220, 4240, and 4250 may overlap with a portion of adjacent layers, and may or may not be separable.
Some embodiments of the obscuring material may comprise polypropylene spunbond material. Further, some embodiments of the obscuring material may comprise a hydrophobic additive or coating, for example a hydrophobic wash designed to permeate the fibers of the obscuring material to make the material substantially waterproof while permitting vapor permeability. Other embodiments may comprise a thin fibrous sheet of 60, 70, or 80 gsm. The fibers of the obscuring material may, in one embodiment, comprise layers of polypropylene (PP) fibers having a smooth surface morphology, and the PP fibers may have a thickness of approximately 25 μm. In some embodiments, the obscuring material may have a thickness of 0.045 mm or about 0.045 mm, or may have a thickness in the range of 0.02 mm to 0.5 mm, or about 0.02 mm to about 0.5 mm.
As illustrated in
An example perforation pattern of a perforated cut 4515 is illustrated in
As shown in
The carrier layer 4535 that may be provided on the upper surface of the adhesive film may be configured to releasably attach to the non-adhesive surface of the adhesive film 4545, and may comprise a sheet of paper or film with relatively more rigidity than the adhesive film. Release tabs 4595 may be provided on one or both opposite ends of the carrier layer 4535 for ease of removing the carrier layer 4535 from the adhesive film 4545. As illustrated in
To utilize the sealing strips as described above, one or more sealing strips 4501 may be removed from the sheet 4500 by cutting or tearing along the perforations 4515. The central protective layer 4580 may be removed using the non-adhered portions 4585 of the central protective layer 4580, which serve as handles, for the exposing a central adhesive surface of the adhesive film 4545. The adhesive surface may then be applied to skin and/or a dressing or any desired location, or the adhesive surface may be applied after one or both of the outer protective layers 4570 is removed. The folded handle 4575 of outer protective layers 4570 may be grasped to remove the outer protective layers 4570, exposing the entirety of the lower adhesive surface of the adhesive film 4545. The outer edges of the adhesive surface of the adhesive film 4545 may be placed in a desired location. After sealing the adhesive film 4545, the release tab or tabs 4595 may be used to remove the carrier layer 4535 from the adhesive film 4545. This may be repeated with as many adhesive strips as are needed.
The length 4565 of outer protective layers 4570 (not including the folded portion) may be 85 mm or 110 mm in some embodiments, or approximately 85 mm or approximately 110 mm, or may be in the range of 50 mm to 200 mm, or approximately 500 mm to approximately 200 mm. The length 4555 of the folded portion or handle 4575 of outer protective layer 4570 may be 20 mm plus or minus 5 mm, in some embodiments, or approximately 20 mm plus or minus approximately 5 mm. The distance 4550 from the outer edge of the folded tab 4575 to the outer edge of the central protective layer 4580 may be 20 mm plus or minus 5 mm, in some embodiments, or approximately 20 mm plus or minus approximately 5 mm.
It will be of course appreciated that other dressing configurations are possible other than a narrow central portion configuration, a three-lobed configuration, a four-lobed configuration, including, for example, hexagonal or circular shaped backing layers for use in dressings. As illustrated in
Features, materials, characteristics, or groups described in conjunction with a particular aspect, embodiment, or example are to be understood to be applicable to any other aspect, embodiment or example described herein unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), and/or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features and/or steps are mutually exclusive. The protection is not restricted to the details of any foregoing embodiments. The protection extends to any novel one, or any novel combination, of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or to any novel one, or any novel combination, of the steps of any method or process so disclosed.
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of protection. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. Furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein may be made. Those skilled in the art will appreciate that in some embodiments, the actual steps taken in the processes illustrated and/or disclosed may differ from those shown in the figures. Depending on the embodiment, certain of the steps described above may be removed, others may be added. Furthermore, the features and attributes of the specific embodiments disclosed above may be combined in different ways to form additional embodiments, all of which fall within the scope of the present disclosure.
Although the present disclosure includes certain embodiments, examples and applications, it will be understood by those skilled in the art that the present disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments and/or uses and obvious modifications and equivalents thereof, including embodiments which do not provide all of the features and advantages set forth herein. Accordingly, the scope of the present disclosure is not intended to be limited by the specific disclosures of preferred embodiments herein, and may be defined by claims as presented herein or as presented in the future.
This application is a divisional application of U.S. patent application Ser. No. 14/418,908, filed on Jan. 30, 2015, which is a national stage application of International Patent Application No. PCT/IB2013/002060, filed on Jul. 31, 2013, which claims the benefit of U.S. Provisional Application Ser. No. 61/678,569, filed Aug. 1, 2012, titled “WOUND DRESSING AND METHOD OF TREATMENT,” U.S. Provisional Application Ser. No. 61/753,374, filed Jan. 16, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” U.S. Provisional Application Ser. No. 61/753,878, filed Jan. 17, 2013,titled “WOUND DRESSING AND METHOD OF TREATMENT,” U.S. Provisional Application Ser. No. 61/785,054, filed Mar. 14, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” and U.S. Provisional Application Ser. No. 61/823,298, filed May 14, 2013, titled “WOUND DRESSING AND METHOD OF TREATMENT,” the entireties of each of which are hereby incorporated by reference.
| Number | Name | Date | Kind |
|---|---|---|---|
| 2905174 | Smith | Sep 1959 | A |
| 3687136 | Carmody | Aug 1972 | A |
| 3972328 | Chen | Aug 1976 | A |
| 4093277 | Nolan | Jun 1978 | A |
| 4798603 | Meyer et al. | Jan 1989 | A |
| 4834735 | Alemany et al. | May 1989 | A |
| 4846164 | Martz | Jul 1989 | A |
| 4968181 | Goldman | Nov 1990 | A |
| 4973325 | Sherrod et al. | Nov 1990 | A |
| 4988344 | Reising et al. | Jan 1991 | A |
| 4988345 | Reising | Jan 1991 | A |
| 5000172 | Ward | Mar 1991 | A |
| 5018515 | Gilman | May 1991 | A |
| 5021050 | Iskra | Jun 1991 | A |
| 5037409 | Chen et al. | Aug 1991 | A |
| 5065600 | Byles | Nov 1991 | A |
| 5115801 | Cartmell et al. | May 1992 | A |
| 5124197 | Bernardin et al. | Jun 1992 | A |
| 5149334 | Lahrman et al. | Sep 1992 | A |
| 5151091 | Glaug et al. | Sep 1992 | A |
| 5160328 | Cartmell et al. | Nov 1992 | A |
| 5171391 | Chmielewski et al. | Dec 1992 | A |
| 5175046 | Nguyen | Dec 1992 | A |
| 5197945 | Cole et al. | Mar 1993 | A |
| 5217445 | Young et al. | Jun 1993 | A |
| 5236427 | Hamajima et al. | Aug 1993 | A |
| 5238732 | Krishnan | Aug 1993 | A |
| 5242435 | Murji et al. | Sep 1993 | A |
| 5257982 | Cohen et al. | Nov 1993 | A |
| 5271987 | Iskra | Dec 1993 | A |
| 5281208 | Thompson et al. | Jan 1994 | A |
| 5294478 | Wanek et al. | Mar 1994 | A |
| 5296290 | Brassington | Mar 1994 | A |
| 5314743 | Meirowitz et al. | May 1994 | A |
| 5318554 | Young et al. | Jun 1994 | A |
| 5330456 | Robinson | Jul 1994 | A |
| 5336219 | Krantz | Aug 1994 | A |
| 5342336 | Meirowitz et al. | Aug 1994 | A |
| 5348547 | Payne et al. | Sep 1994 | A |
| 5354261 | Clark et al. | Oct 1994 | A |
| 5356405 | Thompson et al. | Oct 1994 | A |
| 5360420 | Cook et al. | Nov 1994 | A |
| 5364381 | Soga et al. | Nov 1994 | A |
| 5364382 | Latimer et al. | Nov 1994 | A |
| 5366451 | Levesque | Nov 1994 | A |
| 5368909 | Langdon et al. | Nov 1994 | A |
| 5368926 | Thompson et al. | Nov 1994 | A |
| 5374260 | Lemay et al. | Dec 1994 | A |
| 5380294 | Persson | Jan 1995 | A |
| 5382245 | Thompson et al. | Jan 1995 | A |
| 5387208 | Ashton et al. | Feb 1995 | A |
| 5397316 | LaVon et al. | Mar 1995 | A |
| 5401267 | Couture-Dorschner et al. | Mar 1995 | A |
| 5425725 | Tanzer et al. | Jun 1995 | A |
| 5431643 | Ouellette et al. | Jul 1995 | A |
| 5447492 | Cartmell et al. | Sep 1995 | A |
| 5454800 | Hirt et al. | Oct 1995 | A |
| 5456660 | Reich et al. | Oct 1995 | A |
| 5465735 | Patel | Nov 1995 | A |
| 5470326 | Dabi et al. | Nov 1995 | A |
| H1511 | Chappell et al. | Dec 1995 | H |
| 5480377 | Cartmell et al. | Jan 1996 | A |
| 5486167 | Dragoo et al. | Jan 1996 | A |
| 5487736 | Van Phan | Jan 1996 | A |
| 5497788 | Inman et al. | Mar 1996 | A |
| 5500270 | Langdon et al. | Mar 1996 | A |
| 5505719 | Cohen et al. | Apr 1996 | A |
| 5509914 | Osborn, III | Apr 1996 | A |
| 5514120 | Johnston et al. | May 1996 | A |
| 5525407 | Yang | Jun 1996 | A |
| 5536264 | Hsueh et al. | Jul 1996 | A |
| 5538500 | Peterson | Jul 1996 | A |
| H1585 | Ahr | Aug 1996 | H |
| 5545155 | Hseih et al. | Aug 1996 | A |
| 5549584 | Gross | Aug 1996 | A |
| 5549589 | Horney et al. | Aug 1996 | A |
| 5562107 | Lavender et al. | Oct 1996 | A |
| 5562646 | Goldman et al. | Oct 1996 | A |
| 5562650 | Everett et al. | Oct 1996 | A |
| 5579765 | Cox et al. | Dec 1996 | A |
| 5591148 | McFall et al. | Jan 1997 | A |
| 5591149 | Cree et al. | Jan 1997 | A |
| 5603707 | Trombetta et al. | Feb 1997 | A |
| 5603946 | Constantine | Feb 1997 | A |
| 5609588 | DiPalma et al. | Mar 1997 | A |
| 5613960 | Mizutani | Mar 1997 | A |
| 5614283 | Potnis et al. | Mar 1997 | A |
| 5614295 | Quincy, III et al. | Mar 1997 | A |
| 5628736 | Thompson | May 1997 | A |
| 5632731 | Patel | May 1997 | A |
| H1657 | Hammons et al. | Jun 1997 | H |
| 5634915 | Osterdahl | Jun 1997 | A |
| 5637080 | Geng | Jun 1997 | A |
| 5643238 | Baker | Jul 1997 | A |
| 5648142 | Phillips | Jul 1997 | A |
| 5649915 | Chauvette et al. | Jul 1997 | A |
| 5649916 | DiPalma et al. | Jul 1997 | A |
| 5662599 | Reich et al. | Sep 1997 | A |
| 5665082 | Boulanger | Sep 1997 | A |
| 5669895 | Murakami et al. | Sep 1997 | A |
| 5675079 | Gilman et al. | Oct 1997 | A |
| 5700254 | McDowall et al. | Dec 1997 | A |
| 5702356 | Hathman | Dec 1997 | A |
| 5704905 | Jensen et al. | Jan 1998 | A |
| 5713384 | Roach et al. | Feb 1998 | A |
| 5713842 | Kay | Feb 1998 | A |
| 5716703 | Payne | Feb 1998 | A |
| 5728084 | Palumbo et al. | Mar 1998 | A |
| 5728085 | Widlund et al. | Mar 1998 | A |
| 5733273 | Ahr | Mar 1998 | A |
| 5752945 | Mosley et al. | May 1998 | A |
| 5759570 | Arnold | Jun 1998 | A |
| 5762641 | Bewick-Sonntag et al. | Jun 1998 | A |
| 5788684 | Abuto et al. | Aug 1998 | A |
| 5801107 | Everhart et al. | Sep 1998 | A |
| 5810798 | Finch et al. | Sep 1998 | A |
| 5817081 | LaVon et al. | Oct 1998 | A |
| 5827213 | Jensen | Oct 1998 | A |
| 5827254 | Trombetta et al. | Oct 1998 | A |
| 5830202 | Bogdanski et al. | Nov 1998 | A |
| 5837627 | Halabisky et al. | Nov 1998 | A |
| 5840052 | Johns | Nov 1998 | A |
| 5843025 | Shaari | Dec 1998 | A |
| 5843064 | Koczab | Dec 1998 | A |
| 5855572 | Schmidt | Jan 1999 | A |
| 5865822 | Hamajima et al. | Feb 1999 | A |
| 5865824 | Chen et al. | Feb 1999 | A |
| 5873867 | Coles et al. | Feb 1999 | A |
| 5877097 | West et al. | Mar 1999 | A |
| 5891120 | Chmielewski | Apr 1999 | A |
| 5895379 | Litchholt et al. | Apr 1999 | A |
| 5897541 | Uitenbroek et al. | Apr 1999 | A |
| 5916507 | Dabi et al. | Jun 1999 | A |
| 5925026 | Arteman et al. | Jul 1999 | A |
| 5931823 | Stokes et al. | Aug 1999 | A |
| 5938995 | Koltisko, Jr. et al. | Aug 1999 | A |
| 5941863 | Guidotti et al. | Aug 1999 | A |
| 5947945 | Cree et al. | Sep 1999 | A |
| 5951535 | Fujiwara et al. | Sep 1999 | A |
| 5961506 | Guidotti et al. | Oct 1999 | A |
| 5968027 | Cole et al. | Oct 1999 | A |
| 5989478 | Ouellette et al. | Nov 1999 | A |
| 6018092 | Dunshee | Jan 2000 | A |
| 6022610 | Phan et al. | Feb 2000 | A |
| 6037518 | Guidotti et al. | Mar 2000 | A |
| 6040493 | Cooke et al. | Mar 2000 | A |
| 6060638 | Paul et al. | May 2000 | A |
| 6068620 | Chmielewski | May 2000 | A |
| 6075177 | Bahia et al. | Jun 2000 | A |
| 6077526 | Scully et al. | Jun 2000 | A |
| 6096015 | Yeo et al. | Aug 2000 | A |
| 6103953 | Cree et al. | Aug 2000 | A |
| 6103954 | Grondin et al. | Aug 2000 | A |
| 6107539 | Palumbo et al. | Aug 2000 | A |
| 6117523 | Sugahara | Sep 2000 | A |
| 6124520 | Roberts | Sep 2000 | A |
| 6124521 | Roberts | Sep 2000 | A |
| 6127595 | Makoui et al. | Oct 2000 | A |
| 6168849 | Braverman et al. | Jan 2001 | B1 |
| 6191340 | Carlucci et al. | Feb 2001 | B1 |
| 6206865 | Chen et al. | Mar 2001 | B1 |
| 6235966 | Magnusson et al. | May 2001 | B1 |
| 6264776 | DiPalma | Jul 2001 | B1 |
| 6294710 | Schmidt et al. | Sep 2001 | B1 |
| 6297423 | Schoenfeldt et al. | Oct 2001 | B1 |
| 6344036 | Ivansson | Feb 2002 | B1 |
| 6362390 | Carlucci et al. | Mar 2002 | B1 |
| 6369292 | Strack et al. | Apr 2002 | B1 |
| 6372952 | Lash et al. | Apr 2002 | B1 |
| 6403857 | Gross et al. | Jun 2002 | B1 |
| 6461339 | Sugahara | Oct 2002 | B1 |
| 6468295 | Augustine et al. | Oct 2002 | B2 |
| 6497689 | Schmidt et al. | Dec 2002 | B1 |
| 6506175 | Goldstein | Jan 2003 | B1 |
| 6506960 | Young et al. | Jan 2003 | B1 |
| 6521813 | Chihani | Feb 2003 | B1 |
| 6528696 | Ireland | Mar 2003 | B1 |
| 6534149 | Daley et al. | Mar 2003 | B1 |
| 6545194 | Schmidt et al. | Apr 2003 | B1 |
| 6551295 | Schmidt et al. | Apr 2003 | B1 |
| 6552244 | Jacques et al. | Apr 2003 | B1 |
| 6570057 | Schmidt et al. | May 2003 | B1 |
| 6570058 | Fuchs et al. | May 2003 | B1 |
| 6573424 | Raidel et al. | Jun 2003 | B1 |
| 6586653 | Graeme, III et al. | Jul 2003 | B2 |
| 6610898 | Magnusson et al. | Aug 2003 | B1 |
| 6610903 | Latimer et al. | Aug 2003 | B1 |
| 6613028 | Daley et al. | Sep 2003 | B1 |
| 6613953 | Altura | Sep 2003 | B1 |
| 6613955 | Lindsay et al. | Sep 2003 | B1 |
| 6626891 | Ohmstede | Sep 2003 | B2 |
| 6630611 | Malowaniec | Oct 2003 | B1 |
| 6664439 | Arndt et al. | Dec 2003 | B1 |
| 6683229 | Ehrnsperger et al. | Jan 2004 | B1 |
| 6685681 | Lockwood et al. | Feb 2004 | B2 |
| 6706940 | Worthley | Mar 2004 | B2 |
| 6719742 | McCormack et al. | Apr 2004 | B1 |
| 6727403 | Ehrnsperger et al. | Apr 2004 | B1 |
| 6762337 | Boukanov et al. | Jul 2004 | B2 |
| 6764459 | Donaldson | Jul 2004 | B1 |
| 6776769 | Smith | Aug 2004 | B2 |
| 6783837 | Creagan et al. | Aug 2004 | B1 |
| 6787682 | Gilman | Sep 2004 | B2 |
| 6835192 | Guidotti et al. | Dec 2004 | B1 |
| 6838589 | Liedtke et al. | Jan 2005 | B2 |
| 6841715 | Roberts | Jan 2005 | B2 |
| 6960181 | Stevens | Nov 2005 | B2 |
| 6998511 | Worthley | Feb 2006 | B2 |
| 7049478 | Smith et al. | May 2006 | B1 |
| 7112712 | Ancell | Sep 2006 | B1 |
| 7118545 | Boyde | Oct 2006 | B2 |
| 7122023 | Hinoki | Oct 2006 | B1 |
| 7122712 | Lutri et al. | Oct 2006 | B2 |
| 7294751 | Propp et al. | Nov 2007 | B2 |
| 7294752 | Propp | Nov 2007 | B1 |
| 7361184 | Joshi | Apr 2008 | B2 |
| 7381859 | Hunt et al. | Jun 2008 | B2 |
| 7429689 | Chen et al. | Sep 2008 | B2 |
| 7476205 | Erdmann | Jan 2009 | B2 |
| 7511187 | Kelly | Mar 2009 | B2 |
| 7563940 | Kurata | Jul 2009 | B2 |
| 7569742 | Haggstrom et al. | Aug 2009 | B2 |
| 7576256 | Björnberg et al. | Aug 2009 | B2 |
| 7605298 | Bechert et al. | Oct 2009 | B2 |
| 7615036 | Joshi et al. | Nov 2009 | B2 |
| 7622629 | Aail | Nov 2009 | B2 |
| 7676257 | Suryanarayanan et al. | Mar 2010 | B2 |
| 7699823 | Haggstrom et al. | Apr 2010 | B2 |
| 7723561 | Propp | May 2010 | B2 |
| 7749531 | Booher | Jul 2010 | B2 |
| 7775998 | Riesinger | Aug 2010 | B2 |
| 7811269 | Boynton et al. | Oct 2010 | B2 |
| 7838719 | Hilton, Jr. | Nov 2010 | B2 |
| 7838723 | Schmidt et al. | Nov 2010 | B1 |
| 7846141 | Weston | Dec 2010 | B2 |
| 7910791 | Coffey | Mar 2011 | B2 |
| 7922703 | Riesinger | Apr 2011 | B2 |
| 7935066 | Shives et al. | May 2011 | B2 |
| 7964766 | Blott et al. | Jun 2011 | B2 |
| 7988673 | Wright et al. | Aug 2011 | B2 |
| 8021347 | Vitaris et al. | Sep 2011 | B2 |
| 8092436 | Christensen | Jan 2012 | B2 |
| 8147468 | Barta et al. | Apr 2012 | B2 |
| 8152785 | Vitaris | Apr 2012 | B2 |
| 8162907 | Heagle | Apr 2012 | B2 |
| 8168848 | Lockwood et al. | May 2012 | B2 |
| 8188331 | Barta et al. | May 2012 | B2 |
| 8212101 | Propp | Jul 2012 | B2 |
| 8241261 | Randolph et al. | Aug 2012 | B2 |
| 8252971 | Aali et al. | Aug 2012 | B2 |
| 8314283 | Kingsford et al. | Nov 2012 | B2 |
| 8328858 | Barsky et al. | Dec 2012 | B2 |
| 8382731 | Johannison | Feb 2013 | B2 |
| 8403899 | Sherman | Mar 2013 | B2 |
| 8404921 | Lee et al. | Mar 2013 | B2 |
| 8425478 | Olson | Apr 2013 | B2 |
| 8535296 | Blott et al. | Sep 2013 | B2 |
| 8680360 | Greener et al. | Mar 2014 | B2 |
| 8791316 | Greener | Jul 2014 | B2 |
| 8795244 | Randolph et al. | Aug 2014 | B2 |
| 8795247 | Bennett et al. | Aug 2014 | B2 |
| 8801685 | Armstrong et al. | Aug 2014 | B2 |
| 8814842 | Coulthard et al. | Aug 2014 | B2 |
| 8843327 | Vernon-Harcourt et al. | Sep 2014 | B2 |
| 8905985 | Allen et al. | Dec 2014 | B2 |
| 8915895 | Jaeb et al. | Dec 2014 | B2 |
| 8916742 | Smith | Dec 2014 | B2 |
| 9017302 | Vitaris et al. | Apr 2015 | B2 |
| 9220822 | Hartwell et al. | Dec 2015 | B2 |
| 9254353 | Locke et al. | Feb 2016 | B2 |
| 20010000795 | Bolian, II et al. | May 2001 | A1 |
| 20010016985 | Insley et al. | Aug 2001 | A1 |
| 20010018308 | Quick et al. | Aug 2001 | A1 |
| 20010027302 | Glaug et al. | Oct 2001 | A1 |
| 20010027305 | Raidel et al. | Oct 2001 | A1 |
| 20010044610 | Kim et al. | Nov 2001 | A1 |
| 20010051165 | Lenz et al. | Dec 2001 | A1 |
| 20010051178 | Blatchford et al. | Dec 2001 | A1 |
| 20010053904 | Abuto | Dec 2001 | A1 |
| 20020007167 | Dan et al. | Jan 2002 | A1 |
| 20020007169 | Graef et al. | Jan 2002 | A1 |
| 20020019602 | Geng | Feb 2002 | A1 |
| 20020019614 | Woon et al. | Feb 2002 | A1 |
| 20020026166 | Graef et al. | Feb 2002 | A1 |
| 20020034914 | De Leon et al. | Mar 2002 | A1 |
| 20020035352 | Ronnberg et al. | Mar 2002 | A1 |
| 20020035354 | Mirle et al. | Mar 2002 | A1 |
| 20020062113 | Thomas et al. | May 2002 | A1 |
| 20020064639 | Rearick et al. | May 2002 | A1 |
| 20020087136 | Widlund | Jul 2002 | A1 |
| 20020090511 | Smith et al. | Jul 2002 | A1 |
| 20020110672 | Muratore-Pallatino et al. | Aug 2002 | A1 |
| 20020123728 | Graef et al. | Sep 2002 | A1 |
| 20020133132 | Copat et al. | Sep 2002 | A1 |
| 20020150678 | Cramer et al. | Oct 2002 | A1 |
| 20020165509 | Baer et al. | Nov 2002 | A1 |
| 20020169405 | Roberts | Nov 2002 | A1 |
| 20020176964 | Koslow | Nov 2002 | A1 |
| 20020177831 | Daley et al. | Nov 2002 | A1 |
| 20020180092 | Abba et al. | Dec 2002 | A1 |
| 20020183704 | Fields et al. | Dec 2002 | A1 |
| 20030009122 | Veras | Jan 2003 | A1 |
| 20030045707 | West et al. | Mar 2003 | A1 |
| 20030045825 | Etheredge, III | Mar 2003 | A1 |
| 20030050617 | Chen et al. | Mar 2003 | A1 |
| 20030069563 | Johnson | Apr 2003 | A1 |
| 20030070780 | Chen et al. | Apr 2003 | A1 |
| 20030073967 | Wahlstrom et al. | Apr 2003 | A1 |
| 20030088229 | Baker et al. | May 2003 | A1 |
| 20030088231 | Yoshimasa et al. | May 2003 | A1 |
| 20030093044 | Wahlstrom et al. | May 2003 | A1 |
| 20030097101 | Schmidt et al. | May 2003 | A1 |
| 20030097105 | Chen et al. | May 2003 | A1 |
| 20030097113 | Molee | May 2003 | A1 |
| 20030105442 | Johnston et al. | Jun 2003 | A1 |
| 20030114816 | Underhill et al. | Jun 2003 | A1 |
| 20030114818 | Benecke et al. | Jun 2003 | A1 |
| 20030114821 | Underhill et al. | Jun 2003 | A1 |
| 20030120249 | Wulz et al. | Jun 2003 | A1 |
| 20030121588 | Pargass et al. | Jul 2003 | A1 |
| 20030124311 | Cree et al. | Jul 2003 | A1 |
| 20030134559 | Delzer et al. | Jul 2003 | A1 |
| 20030135174 | Benecke et al. | Jul 2003 | A1 |
| 20030135177 | Baker | Jul 2003 | A1 |
| 20030150551 | Baker | Aug 2003 | A1 |
| 20030157857 | Cook et al. | Aug 2003 | A1 |
| 20030171729 | Kaun et al. | Sep 2003 | A1 |
| 20030180341 | Gooch et al. | Sep 2003 | A1 |
| 20030199800 | Levin | Oct 2003 | A1 |
| 20030208175 | Gross et al. | Nov 2003 | A1 |
| 20030212359 | Butler | Nov 2003 | A1 |
| 20030225383 | Glaug et al. | Dec 2003 | A1 |
| 20040019338 | Litvay et al. | Jan 2004 | A1 |
| 20040019339 | Ranganathan et al. | Jan 2004 | A1 |
| 20040019340 | McBride | Jan 2004 | A1 |
| 20040019342 | Nagasuna et al. | Jan 2004 | A1 |
| 20040024375 | Litvay | Feb 2004 | A1 |
| 20040033750 | Everett et al. | Feb 2004 | A1 |
| 20040049146 | Kolte et al. | Mar 2004 | A1 |
| 20040054343 | Barnett et al. | Mar 2004 | A1 |
| 20040054344 | Roettger et al. | Mar 2004 | A1 |
| 20040065420 | Graef et al. | Apr 2004 | A1 |
| 20040078011 | Stevens | Apr 2004 | A1 |
| 20040078016 | Baker | Apr 2004 | A1 |
| 20040087927 | Suzuki | May 2004 | A1 |
| 20040106888 | Lutri et al. | Jun 2004 | A1 |
| 20040111074 | Eliasson | Jun 2004 | A1 |
| 20040127862 | Bubb et al. | Jul 2004 | A1 |
| 20040138602 | Rossen | Jul 2004 | A1 |
| 20040162512 | Liedtke et al. | Aug 2004 | A1 |
| 20040177935 | Hamed et al. | Sep 2004 | A1 |
| 20040181199 | Moberg-Alehammar et al. | Sep 2004 | A1 |
| 20040204696 | Chen | Oct 2004 | A1 |
| 20040230173 | Barge et al. | Nov 2004 | A1 |
| 20040230184 | Babusik et al. | Nov 2004 | A1 |
| 20040243042 | Lipman | Dec 2004 | A1 |
| 20040243080 | Baer | Dec 2004 | A1 |
| 20040243081 | Suzuki et al. | Dec 2004 | A1 |
| 20040253894 | Fell et al. | Dec 2004 | A1 |
| 20040254552 | Mangold | Dec 2004 | A1 |
| 20050008825 | Casey et al. | Jan 2005 | A1 |
| 20050013992 | Azad et al. | Jan 2005 | A1 |
| 20050015036 | Lutri et al. | Jan 2005 | A1 |
| 20050049566 | Vukos et al. | Mar 2005 | A1 |
| 20050079361 | Hamed et al. | Apr 2005 | A1 |
| 20050084641 | Downs | Apr 2005 | A1 |
| 20050096616 | Arora et al. | May 2005 | A1 |
| 20050112979 | Sawyer et al. | May 2005 | A1 |
| 20050119631 | Giloh et al. | Jun 2005 | A1 |
| 20050136773 | Yahiaoui et al. | Jun 2005 | A1 |
| 20050165371 | Giacometti | Jul 2005 | A1 |
| 20050215965 | Schmidt et al. | Sep 2005 | A1 |
| 20050215967 | Toro et al. | Sep 2005 | A1 |
| 20050222547 | Beruda et al. | Oct 2005 | A1 |
| 20050228353 | Thomas | Oct 2005 | A1 |
| 20050261649 | Cohen | Nov 2005 | A1 |
| 20050267429 | Cohen | Dec 2005 | A1 |
| 20060020234 | Chou et al. | Jan 2006 | A1 |
| 20060020250 | Chester et al. | Jan 2006 | A1 |
| 20060058750 | Di Girolamo et al. | Mar 2006 | A1 |
| 20060069366 | Cole | Mar 2006 | A1 |
| 20060069367 | Waksmundzki et al. | Mar 2006 | A1 |
| 20060069375 | Waksmundzki et al. | Mar 2006 | A1 |
| 20060122548 | Abrams | Jun 2006 | A1 |
| 20060122572 | Suarez | Jun 2006 | A1 |
| 20060153904 | Smith et al. | Jul 2006 | A1 |
| 20060161122 | Erdman et al. | Jul 2006 | A1 |
| 20060178650 | Hakannsson et al. | Aug 2006 | A1 |
| 20060184147 | Hamed | Aug 2006 | A1 |
| 20060206047 | Lampe et al. | Sep 2006 | A1 |
| 20060206073 | Crane et al. | Sep 2006 | A1 |
| 20060206074 | Bernal et al. | Sep 2006 | A1 |
| 20060282028 | Howard et al. | Dec 2006 | A1 |
| 20070003604 | Jones et al. | Jan 2007 | A1 |
| 20070073254 | Ponomarenko et al. | Mar 2007 | A1 |
| 20070078467 | Mullen | Apr 2007 | A1 |
| 20070100308 | Miyairi | May 2007 | A1 |
| 20070167096 | Scott | Jul 2007 | A1 |
| 20070167884 | Mangrum et al. | Jul 2007 | A1 |
| 20070224903 | Chakravarty et al. | Sep 2007 | A1 |
| 20070225663 | Watt et al. | Sep 2007 | A1 |
| 20070254550 | Hamed et al. | Nov 2007 | A1 |
| 20070270070 | Hamed | Nov 2007 | A1 |
| 20070282236 | LaGreca | Dec 2007 | A1 |
| 20080004581 | Babusik et al. | Jan 2008 | A1 |
| 20080015532 | Waksmundzki | Jan 2008 | A1 |
| 20080058691 | Sorensen | Mar 2008 | A1 |
| 20080082075 | Morrell-Schwartz | Apr 2008 | A1 |
| 20080090050 | Seyler et al. | Apr 2008 | A1 |
| 20080114317 | Seyler | May 2008 | A1 |
| 20080119586 | Byerly et al. | May 2008 | A1 |
| 20080132821 | Propp et al. | Jun 2008 | A1 |
| 20080147024 | Potts et al. | Jun 2008 | A1 |
| 20080167592 | Greer | Jul 2008 | A1 |
| 20080243100 | Wu et al. | Oct 2008 | A1 |
| 20080255533 | Wu et al. | Oct 2008 | A1 |
| 20080275409 | Kane et al. | Nov 2008 | A1 |
| 20080306456 | Riesinger | Dec 2008 | A1 |
| 20080312621 | Hundorf et al. | Dec 2008 | A1 |
| 20080312622 | Hundorf et al. | Dec 2008 | A1 |
| 20090062760 | Wright et al. | Mar 2009 | A1 |
| 20090076472 | Goldwasser et al. | Mar 2009 | A1 |
| 20090105670 | Bentley | Apr 2009 | A1 |
| 20090112175 | Bissah et al. | Apr 2009 | A1 |
| 20090126103 | Dietrich et al. | May 2009 | A1 |
| 20090204087 | Herfert et al. | Aug 2009 | A1 |
| 20090216168 | Eckstein et al. | Aug 2009 | A1 |
| 20090227935 | Zanella et al. | Sep 2009 | A1 |
| 20090227969 | Jaeb et al. | Sep 2009 | A1 |
| 20090240185 | Jaeb et al. | Sep 2009 | A1 |
| 20090299251 | Buan | Dec 2009 | A1 |
| 20090299255 | Kazala, Jr. et al. | Dec 2009 | A1 |
| 20090326430 | Frederiksen | Dec 2009 | A1 |
| 20100010461 | Herfert et al. | Jan 2010 | A1 |
| 20100030171 | Canada et al. | Feb 2010 | A1 |
| 20100036334 | Heagle et al. | Feb 2010 | A1 |
| 20100036342 | Carlucci et al. | Feb 2010 | A1 |
| 20100048072 | Kauscheke et al. | Feb 2010 | A1 |
| 20100055158 | Vitaris et al. | Mar 2010 | A1 |
| 20100069858 | Olson | Mar 2010 | A1 |
| 20100084074 | McClernon et al. | Apr 2010 | A1 |
| 20100087767 | McNeil | Apr 2010 | A1 |
| 20100106113 | Heinecke | Apr 2010 | A1 |
| 20100106120 | Holm | Apr 2010 | A1 |
| 20100106121 | Holm | Apr 2010 | A1 |
| 20100121298 | Seyler et al. | May 2010 | A1 |
| 20100125234 | Smith | May 2010 | A1 |
| 20100125258 | Coulthard et al. | May 2010 | A1 |
| 20100137775 | Hu et al. | Jun 2010 | A1 |
| 20100137890 | Martinez et al. | Jun 2010 | A1 |
| 20100168695 | Robles et al. | Jul 2010 | A1 |
| 20100174250 | Hu et al. | Jul 2010 | A1 |
| 20100217177 | Cali et al. | Aug 2010 | A1 |
| 20100256545 | Aali et al. | Oct 2010 | A1 |
| 20100256584 | Litvay | Oct 2010 | A1 |
| 20100256586 | Bergstrom et al. | Oct 2010 | A1 |
| 20100262091 | Larsson | Oct 2010 | A1 |
| 20100305526 | Robinson et al. | Dec 2010 | A1 |
| 20100318047 | Ducker et al. | Dec 2010 | A1 |
| 20100318052 | Ha et al. | Dec 2010 | A1 |
| 20100324516 | Braga et al. | Dec 2010 | A1 |
| 20110004172 | Eckstein et al. | Jan 2011 | A1 |
| 20110034892 | Buan | Feb 2011 | A1 |
| 20110052664 | Tennican et al. | Mar 2011 | A1 |
| 20110059329 | Dobrawa et al. | Mar 2011 | A1 |
| 20110060303 | Bissah et al. | Mar 2011 | A1 |
| 20110070391 | Cotton | Mar 2011 | A1 |
| 20110098621 | Fabo et al. | Apr 2011 | A1 |
| 20110125119 | Weismantel et al. | May 2011 | A1 |
| 20110137222 | Masini | Jun 2011 | A1 |
| 20110152813 | Ellingson | Jun 2011 | A1 |
| 20110178375 | Forster | Jul 2011 | A1 |
| 20110183109 | Seyler et al. | Jul 2011 | A1 |
| 20110184364 | Biggs et al. | Jul 2011 | A1 |
| 20110184370 | Seyler et al. | Jul 2011 | A1 |
| 20110208145 | Zhang et al. | Aug 2011 | A1 |
| 20110213286 | Riesinger | Sep 2011 | A1 |
| 20110218509 | Dontas | Sep 2011 | A1 |
| 20110223413 | Herfert et al. | Sep 2011 | A1 |
| 20110238026 | Zhang et al. | Sep 2011 | A1 |
| 20110245788 | Canada | Oct 2011 | A1 |
| 20110247636 | Pollack | Oct 2011 | A1 |
| 20110257572 | Locke et al. | Oct 2011 | A1 |
| 20110257611 | Locke et al. | Oct 2011 | A1 |
| 20110268932 | Catalan et al. | Nov 2011 | A1 |
| 20110282309 | Adie et al. | Nov 2011 | A1 |
| 20120004632 | Zhang et al. | Jan 2012 | A1 |
| 20120045639 | Whitmore et al. | Feb 2012 | A1 |
| 20120053547 | Schroeder et al. | Mar 2012 | A1 |
| 20120065664 | Avitable et al. | Mar 2012 | A1 |
| 20120071848 | Zhang et al. | Mar 2012 | A1 |
| 20120095380 | Gergeley et al. | Apr 2012 | A1 |
| 20120095426 | Visscher et al. | Apr 2012 | A1 |
| 20120101465 | Mcguire, Jr. | Apr 2012 | A1 |
| 20120123311 | Weidemann-Hendrickson et al. | May 2012 | A1 |
| 20120136329 | Carney | May 2012 | A1 |
| 20120143158 | Yang et al. | Jun 2012 | A1 |
| 20120165765 | Barta et al. | Jun 2012 | A1 |
| 20120172778 | Rastegar et al. | Jul 2012 | A1 |
| 20120197229 | Buan | Aug 2012 | A1 |
| 20120203145 | Nilsson | Aug 2012 | A1 |
| 20120203189 | Barta et al. | Aug 2012 | A1 |
| 20120220968 | Confalone et al. | Aug 2012 | A1 |
| 20120232502 | Lowing | Sep 2012 | A1 |
| 20120238932 | Atteia et al. | Sep 2012 | A1 |
| 20120302440 | Theliander et al. | Nov 2012 | A1 |
| 20120308780 | Rottger et al. | Dec 2012 | A1 |
| 20120310186 | Moghe et al. | Dec 2012 | A1 |
| 20120310197 | Thomas | Dec 2012 | A1 |
| 20120330253 | Robinson et al. | Dec 2012 | A1 |
| 20130012902 | Rovaniemi | Jan 2013 | A1 |
| 20130144227 | Locke et al. | Jun 2013 | A1 |
| 20130245583 | Locke et al. | Sep 2013 | A1 |
| 20130310781 | Phillips et al. | Nov 2013 | A1 |
| 20140114268 | Auguste et al. | Apr 2014 | A1 |
| 20150159066 | Hartwell et al. | Jun 2015 | A1 |
| 20150190286 | Allen et al. | Jul 2015 | A1 |
| 20150216733 | Allen et al. | Aug 2015 | A1 |
| Number | Date | Country |
|---|---|---|
| 34 43 101 | May 1986 | DE |
| 40 30 465 | Apr 1992 | DE |
| 90 17 289 | Apr 1992 | DE |
| 198 44 355 | Apr 2000 | DE |
| 0 053 936 | Jun 1982 | EP |
| 0 541 251 | May 1993 | EP |
| 0 549 781 | Sep 1996 | EP |
| 0 748 894 | Dec 1996 | EP |
| 0 599 871 | Apr 1997 | EP |
| 0 768 071 | Apr 1997 | EP |
| 0 875 224 | Nov 1998 | EP |
| 0 941 726 | Sep 1999 | EP |
| 1 013 290 | Jun 2000 | EP |
| 1 048 278 | Nov 2000 | EP |
| 1 066 809 | Jan 2001 | EP |
| 1 139 951 | Oct 2001 | EP |
| 1 312 328 | May 2003 | EP |
| 1 353 001 | Oct 2003 | EP |
| 1 452 156 | Sep 2004 | EP |
| 2 161 011 | Mar 2010 | EP |
| 2 263 627 | Dec 2010 | EP |
| 2 366 721 | Sep 2011 | EP |
| 2 529 767 | Dec 2012 | EP |
| 2 477 674 | Jul 2013 | EP |
| 2 349 154 | Aug 2014 | EP |
| 1163907 | Oct 1958 | FR |
| 2099306 | Dec 1982 | GB |
| 2331937 | Jun 1999 | GB |
| 2 355 228 | Apr 2001 | GB |
| 2 435 422 | Aug 2007 | GB |
| 2 435 423 | Aug 2007 | GB |
| 2 489 947 | Oct 2012 | GB |
| WO 9111161 | Aug 1991 | WO |
| WO 9111162 | Aug 1991 | WO |
| WO 9301778 | Feb 1993 | WO |
| WO 9301779 | Feb 1993 | WO |
| WO 9301780 | Feb 1993 | WO |
| WO 9301781 | Feb 1993 | WO |
| WO 9309745 | May 1993 | WO |
| WO 9311726 | Jun 1993 | WO |
| WO 9423677 | Oct 1994 | WO |
| WO 9504511 | Feb 1995 | WO |
| WO 9513042 | May 1995 | WO |
| WO 9513776 | May 1995 | WO |
| WO 9513779 | May 1995 | WO |
| WO 9514451 | Jun 1995 | WO |
| WO 9516424 | Jun 1995 | WO |
| WO 9607783 | Mar 1996 | WO |
| WO 9621410 | Jul 1996 | WO |
| WO 9711658 | Apr 1997 | WO |
| WO 9714384 | Apr 1997 | WO |
| WO 9820916 | May 1998 | WO |
| WO 9822279 | May 1998 | WO |
| WO 9904830 | Feb 1999 | WO |
| WO 9939671 | Aug 1999 | WO |
| WO 9945876 | Sep 1999 | WO |
| WO 9945878 | Sep 1999 | WO |
| WO 9956687 | Nov 1999 | WO |
| WO 0000016 | Jan 2000 | WO |
| WO 0000127 | Jan 2000 | WO |
| WO 0000129 | Jan 2000 | WO |
| WO 0000130 | Jan 2000 | WO |
| WO 0000131 | Jan 2000 | WO |
| WO 0007653 | Feb 2000 | WO |
| WO 0040190 | Jul 2000 | WO |
| WO 0042957 | Jul 2000 | WO |
| WO 0059438 | Oct 2000 | WO |
| WO 0154743 | Aug 2001 | WO |
| WO 0172251 | Oct 2001 | WO |
| WO 0185248 | Nov 2001 | WO |
| WO 0190465 | Nov 2001 | WO |
| WO 0217840 | Mar 2002 | WO |
| WO 0224132 | Mar 2002 | WO |
| WO 0226180 | Apr 2002 | WO |
| WO 0238096 | May 2002 | WO |
| WO 02076379 | Oct 2002 | WO |
| WO 03073971 | Sep 2003 | WO |
| WO 2004043321 | May 2004 | WO |
| WO 2004073566 | Sep 2004 | WO |
| WO 2004098474 | Nov 2004 | WO |
| WO 2006105305 | Oct 2006 | WO |
| WO 2007035038 | Mar 2007 | WO |
| WO 2007040606 | Apr 2007 | WO |
| WO 2007077214 | Jul 2007 | WO |
| WO 2007077216 | Jul 2007 | WO |
| WO 2007116347 | Oct 2007 | WO |
| WO 2008049277 | May 2008 | WO |
| WO 2008131895 | Nov 2008 | WO |
| WO 2009146441 | Mar 2009 | WO |
| WO 2009126103 | Oct 2009 | WO |
| WO 2009152021 | Dec 2009 | WO |
| WO 2010032951 | Mar 2010 | WO |
| WO 2010048480 | Apr 2010 | WO |
| WO 2010082872 | Jul 2010 | WO |
| WO 2010089448 | Aug 2010 | WO |
| WO 2010139926 | Dec 2010 | WO |
| WO 2011023650 | Mar 2011 | WO |
| WO 2011034789 | Mar 2011 | WO |
| WO 2011058311 | May 2011 | WO |
| WO 2011080427 | Jul 2011 | WO |
| WO 2011112870 | Sep 2011 | WO |
| WO 2011113728 | Sep 2011 | WO |
| WO 2011115908 | Sep 2011 | WO |
| WO 2011128651 | Oct 2011 | WO |
| WO 2011135286 | Nov 2011 | WO |
| WO 2011152368 | Dec 2011 | WO |
| WO 2012009370 | Jan 2012 | WO |
| WO 2012035787 | Mar 2012 | WO |
| WO 2012069793 | May 2012 | WO |
| WO 2012069794 | May 2012 | WO |
| WO 2012074512 | Jun 2012 | WO |
| WO 2012146656 | Nov 2012 | WO |
| WO 2012150235 | Nov 2012 | WO |
| WO 2012168298 | Dec 2012 | WO |
| WO 2013014317 | Jan 2013 | WO |
| WO 2013029652 | Mar 2013 | WO |
| WO 2013060732 | May 2013 | WO |
| WO 2013076450 | May 2013 | WO |
| WO 2013078214 | May 2013 | WO |
| WO 2013090810 | Jun 2013 | WO |
| WO 2013110008 | Jul 2013 | WO |
| WO 2013136181 | Nov 2013 | WO |
| WO 2014020440 | Feb 2014 | WO |
| WO 2014020443 | Feb 2014 | WO |
| WO 2015022340 | Feb 2015 | WO |
| 9605526 | Feb 1997 | ZA |
| Entry |
|---|
| U.S. Appl. No. 14/696,211, filed Apr. 24, 2015, Vitaris et al. |
| International Invitation to Pay Additional Fees, re PCT Application No. PCT/IB2013/002102, mailed Nov. 21, 2013. |
| International Invitation to Pay and Partial Search Report re PCT/IB2013/002060, mailed Nov. 25, 2013. |
| SNAP—Blue Foam Dressing—color brochure (L22162 rev. 130429), 2013. |
| SNAP—Product Overview—Wound Care System, as captured on Wayback Machine on Nov. 17, 2011. |
| “Pico Application” YouTube video https://www.youtube.com/watch?v=yCifiV6RRDw from Jun. 6, 2012. |
| Kendall ULTEC Hydrocolloid Dressing (4″×4″), product ordering page, web page downloaded Jul. 13, 2014. |
| Protz, Kerstin: “Modern Wundauflagen unterstutzen Heilungsprozess”, Wundversorgung: Indikation und Anwendung, Geriatrie Journal, Apr. 2005, pp. 3333-3339, with translation. |
| International Invitation to Pay and Partial Search Report re PCT/IB2011/002943, mailed Nov. 25, 2013. |
| Number | Date | Country | |
|---|---|---|---|
| 20150182677 A1 | Jul 2015 | US |
| Number | Date | Country | |
|---|---|---|---|
| 61823298 | May 2013 | US | |
| 61785054 | Mar 2013 | US | |
| 61753878 | Jan 2013 | US | |
| 61753374 | Jan 2013 | US | |
| 61678569 | Aug 2012 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 14418908 | US | |
| Child | 14658068 | US |
