Patent Application
20200306094
This disclosure is in the field of wound treatment and concerns a wound dressing device, assembly and method.
Chronic wounds and skin ulcers are a serious medical condition and effective wound treatment approaches is a recognized medical need.
U.S. Pat. No. 9,180,142 discloses a wound treatment procedure by which blood is coagulated and the so-formed blood clot is applied onto a wound with a dressing material.
The present disclosure concerns wound treatment through the use of a blood clot. Specifically provided by this disclosure is a wound dressing device and assembly (e.g. in the form of a kit-of-parts for use in the currently disclosed wound treatment) for forming a blood clot, a method for preparing a blood clot-comprising wound dressing, and a method for dressing the wound therewith.
The blood clot that is formed and used according to this disclosure is typically formed from blood of the same subject whose wound is to be dressed by the teaching of this disclosure, withdrawn from the subject in any manner acceptable in medical practice for blood withdrawal. However, the use of blood from a different source, e.g. blood obtained from a blood bank, is also contemplated in accordance with this disclosure.
Three aspects are provided by this disclosure: one concerns a wound dressing device; the other concerns an assembly, e.g. in the form of a kit-of-parts, which comprises said device as one of its components; and the third concerns a method of wound dressing and a use wherein said device is a key component.
All three aspects center around the formation of a blood clot, in situ, onto a wound, as part of the wound dressing procedure. In other words, the blood, still in liquid state, is brought into contact with the wound and is induced to clot while at least partially in contact with the wound to be dressed therewith. All three aspects are encompassed in the following description by the term “wound dressing procedure”.
The method comprises fixing a device of the kind disclosed herein, on top of the wound, the device defining with the wound an enclosed space which serves as a mold (cast) for clotting blood on top of the wound. This space will be referred to herein as a “mold space”.
The device comprises a cavity or depression surrounded by lips configured for attachment to skin in a fluid tight manner. The cavity or depression may have walls that may be generally concave, polygonal or any other suitable shape. In some embodiments, the cavity is shallow, namely, it has a depth relatively smaller than the overall area confined by the walls.
The lips typically define narrow flat surfaces that when brought into contact with the skin, should be relatively level and smooth to permit fluid tight attachment to the skin. By an embodiment of this disclosure, the lips may carry an adhesive that will ensure fluid tight attachment to the skin.
In addition, in some embodiments, the adhesive may be applied onto the skin or onto the lips, prior to attachment. At times, according to this embodiment, at least a portion of the lips may have a rough surface onto which the adhesive is applied prior to fixation onto the skin. It is also possible, by other embodiments of this disclosure, to fit a two-sided adhesive strip onto the lips or the skin to be used as means for attachment. By still another embodiment, the attachment may be by means of an adhesive tape fitted over the device's lips and the surrounding skin portions for tight association throughout the blood clot formation process.
By other embodiments, the attachment of the lips to the skin may be by forming a vacuum within the mold space, by forcing the device (and hence the lips) against the skin by hand, by the use of an elastic band, adhesive tape or other means for tight forcing of the device against the skin.
The wound's surface area confined between the lips may have different shapes and sizes to suit wounds of different shapes and sizes. Thus, the wound dressing procedure may also involve selection of a device of the proper shape and size to permit the lips to be placed on skin portions surrounding the wound's boundaries. In some embodiments, the device is flexible or pliable to permit its shaping and/or stretching to a desired shape and wound surface area to be confined between the lips.
The device may also comprises a closure that is removably attached to the lips and seals the cavity until use. The closure may be useful for maintaining sterility of the cavity and for holding elements, such as a coagulant initiator and/or scaffold matrix within the cavity. The closure may, for example, be a film made of plastic, foil, a combination thereof, etc. that is pealed from the opening of the cavity (the lips) prior to fixation onto the skin.
according to the wound dressing procedure disclosed herein, once the lips are firmly fixed to skin portions surrounding the wound, a mold space is formed, which, as noted above, is defined between the surface of the wound and the cavity's walls. Blood, typically whole blood, can then be introduced into the mold space and permitted to clot within the mold space to form a blood clot over the wound. The blood clot is maintained over the wound for a time period. This time period may vary and is typically several hours, several days or several weeks, e.g. 1 day, 2-6 days, 1 week, 2-4 weeks, and at times even longer, as well as for any period of time in-between than that indicated. In some embodiments, the blood clot may be maintained over the wound for the entire healing process of several weeks to several month. In some embodiments the wound treatment comprises periodical refreshing procedures that comprises removal of an existing blood clot from the wound and then forming a new blood clot on the wound in a manner as described above. The time period between a blood clot formation over a wound and the performance of a refreshing procedure may be, for example, 1 day, 2-6 days, 1 week, 2-4 weeks, etc., as well as for any period of time in-between than that indicated. The entire wound healing procedure may involve several consecutive refreshing procedures.
The device's walls may be made from a variety of materials. Typically, in order to permit monitoring the blood introduction and the clot formation, the walls or parts thereof are transparent.
Introduction of the blood involves, by one embodiment, piercing the wall with a needle and then injecting blood into the mold space through the needle. Optionally, this introduction is preceded by a second piercing of the wall on an adjacent or different location, to thereby form a vent aperture to permit release of excess pressure during blood introduction. By other embodiments, the walls may comprise a venting valve which, a priori, is sealed and opened before the blood introduction and/or a port for introducing the blood into the mold space.
By one embodiment, the device is removed after the blood clot is formed. To facilitate easy removal, e.g. without severing the integrity of the formed blood clot, the walls are preferably made of or coated with a material to which a blood clot does not adhere. By another embodiment, the device or part thereof remains in situ after the blood clot is formed and serves as part of the wound dressing.
In the case where the device is removed after clot formation, a dressing material, for example, gauze, plaster or bandage, may be fitted over the blood clot to protect and secure the blood clot in place. The wound dressing procedure, by some embodiments, may make use of a scaffold matrix combined with and brought into contact with the blood prior to its clotting, so as to become integrated with the thus formed blood clot. The scaffold matrix supports the clot and assists in maintaining the clot's structural integrity. The scaffold matrix may, by one embodiment, be an independent element fitted onto the wound, prior to said fixing of the device onto the skin; by another embodiment, the scaffold matrix may be comprised within the cavity, e.g. a priori comprised therein or introduced into the cavity before fixing the device onto the wound. The scaffold matrix may, for example, be a 2-dimensional or 3-dimensional matrix, may be a porous material, may have a netlike structure; may be made of a polymeric material such as plastic, may be made out of natural or synthetic fibers or made out of a woven or non-woven cloth, e.g. gauze.
In order to ensure controlled coagulation, the blood may be contacted with one or combination of coagulation initiators, namely, one or more substances (synthetic or naturally occurring) that promotes/activates blood coagulation. In some embodiments, the coagulation initiator is kaolin. When using a coagulation initiator, coagulation of blood may involve, for example, mixing the blood with kaolin shortly before introduction into the mold space. Alternatively, the coagulation initiator may a priori be present within the cavity; for example, attached to the walls or incorporated into a scaffold matrix, placed within or a priori comprised within the cavity or further, separately introduced into the mold space (e.g. by injection) before or after introduction of the blood. In addition or alternatively, the coagulation initiator may be incorporated into a scaffold matrix that is fitted onto the wound, prior to fixing of the device over the found.
In some embodiments, the coagulation initiator is independently stored, e.g. as a powder, granulate or liquid in a separate container and subsequently mixed with the blood upon introduction into the mold space or applied onto the scaffold matrix prior to or after introducing the blood. By still another alternative, the coagulation initiator may be applied directly onto the wound as a first step in the wound treatment procedure.
The wound dressing assembly or kit of this disclosure comprises a clotting mold device of the kind specified above. In addition, according to some embodiments, the assembly or kit may comprise other elements or devices required for the in situ formation of the blood clot on the wound, e.g. a syringe for introducing blood into the cavity. The assembly or kit may comprise also a dressing material for applying over the blood clot formed over the wound.
In order to better understand the subject matter that is disclosed herein and to exemplify how it may be carried out in practice, embodiments will now be described, by way of non-limiting example only, with reference to the accompanying drawings, in which:
The invention will now be illustrated with reference to embodiments shown in the annexed Figures. It should be noted that these Figures are pictures from a test trial on skin without a wound, to demonstrate the wound dressing procedure of this disclosure.
The device 100 shown in
Also shown in
Turning now to
In some other embodiments, the blood is pre-mixed with a coagulation initiator, such as Kaolin, that is provided in a separate container (not shown), or the coagulation initiator is introduced into the mold space separately, either before, during or after the blood introduction.
As can also be seen in
The device is then allowed to remain attached to the skin with the blood held within the mold space for a time at least until the blood has clotted. Such time may range from several days, to one or more weeks, The device can be secured to the skin by use of an adhesive strip 130, as seen in
After a period of time, a blood clot is formed and the walls of the device can then be cut away, as seen in
| Number | Date | Country | Kind |
|---|---|---|---|
| 254644 | Sep 2017 | IL | national |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/IL2018/051049 | 9/17/2018 | WO | 00 |
