Patent Application
20200306422
The present disclosure relates generally to a wound therapy system, and more particularly to a wound therapy system configured to estimate the volume of a wound.
Negative pressure wound therapy (NPWT) is a type of wound therapy that involves applying a negative pressure to a wound site to promote wound healing. Some wound treatment systems apply negative pressure to a wound using a pneumatic pump to generate the negative pressure and flow required. Recent advancements in wound healing with NPWT involve applying topical fluids to wounds to work in combination with NPWT. However, it can be difficult to determine the appropriate volume of instillation fluid to deliver to the wound. Additionally, it can be difficult to accurately monitor and track healing progression over time.
One implementation of the present disclosure is a wound therapy system, according to some embodiments. In some embodiments, the wound therapy system includes a negative pressure circuit, a pump, a pressure sensor, and a controller. In some embodiments, the negative pressure circuit is configured to apply negative pressure to a wound. In some embodiments, the pump is fluidly coupled to the negative pressure circuit and configured to produce a negative pressure at the wound or within the negative pressure circuit. In some embodiments, the pressure sensor is configured to measure the negative pressure within the negative pressure circuit or at the wound. In some embodiments, the controller is configured to perform a testing procedure including a first drawdown period, a leak rate determination period, a vent period, and a second drawdown period. In some embodiments, the controller is configured to receive one or more pressure measurements of the pressure sensor over the leak rate determination period to determine a leak rate parameter. In some embodiments, the controller is configured to monitor an amount of elapsed time over the second drawdown period to determine a drawdown parameter. In some embodiments, the controller is configured to estimate a volume of the wound based on the leak rate parameter and the drawdown parameter.
In some embodiments, the first drawdown period of the testing procedure includes operating the pump to achieve a predetermined negative pressure within the negative pressure circuit.
In some embodiments, the leak rate determination period of the testing procedure includes maintaining the predetermined negative pressure for a predetermined time duration and receiving pressure measurements from the pressure sensor during the predetermined time duration.
In some embodiments, the leak rate parameter is a change in pressure of the negative pressure circuit over the leak rate determination period.
In some embodiments, the leak rate parameter is a change of pressure with respect to time over at least a portion of the leak rate determination period.
In some embodiments, the vent period of the testing procedure includes opening a valve of the negative pressure circuit to allow the negative pressure circuit to return to atmospheric pressure.
In some embodiments, the second drawdown period of the testing procedure includes operating the pump to produce a negative pressure within the negative pressure circuit at a predetermined rate.
In some embodiments, the drawdown parameter is an amount of time the pump operates at the predetermined rate to achieve a predetermined pressure value within the negative pressure circuit.
In some embodiments, the controller is further configured to estimate the volume of the wound by inputting the drawdown parameter and the leak rate parameter into a model that relates the volume of the wound to the drawdown parameter and the leak rate parameter.
In some embodiments, the model is determined by performing the testing procedure for known values of the volume of the wound, and determining the model based on the known values of the volume of the wound, and the leak rate parameters and drawdown parameters associated with each of the known values of the volume of the wound.
Another implementation of the present disclosure is a method for determining volume of a wound, according to some embodiments. In some embodiments, the method includes providing a negative pressure circuit configured to apply negative pressure to a wound. In some embodiments, the method includes providing a pump fluidly coupled to the negative pressure circuit and configured to produce a negative pressure at the wound or within the negative pressure circuit. In some embodiments, the method includes providing a pressure sensor configured to measure the negative pressure within the negative pressure circuit or at the wound. In some embodiments, the method includes performing a testing procedure for a known value of the volume of the wound. In some embodiments, the testing procedure includes performing a first drawdown over a first drawdown period, performing a leak rate determination over a leak rate determination period, venting the negative pressure circuit, and performing a second drawdown over a second drawdown period. In some embodiments, the method includes receiving one or more pressure measurements of the pressure sensor over the leak rate determination period to determine a leak rate parameter. In some embodiments, the method includes monitoring an amount of elapsed time over the second drawdown period to determine a drawdown parameter. In some embodiments, the method includes generating a model based on the known value of the volume of the wound, the leak rate parameter, and the drawdown parameter. In some embodiments, the model relates the volume of the wound to the leak rate parameter and the drawdown parameter. In some embodiments, the method includes re-performing the steps of performing the testing procedure, receiving the one or more pressure measurements, and monitoring the amount of elapsed time to determine a leak rate parameter and a drawdown parameter for an unknown value of the volume of the wound. In some embodiments, the method further includes estimating the unknown value of the volume of the wound by inputting the leak rate parameter and the drawdown parameter associated with the unknown value of the volume of the wound to the model.
In some embodiments, the first drawdown includes operating the pump to achieve a predetermined negative pressure within the negative pressure circuit. In some embodiments, the leak rate determination includes maintaining the predetermined negative pressure for a predetermined time duration and receiving pressure measurements from the pressure sensor during the predetermined time duration.
In some embodiments, the leak rate parameter is a change in pressure of the negative pressure circuit over the leak rate determination period.
In some embodiments, the leak rate parameter is a rate of change of pressure of the negative pressure circuit with respect to time over at least a portion of the leak rate determination period.
In some embodiments, venting the negative pressure circuit includes opening a valve of the negative pressure circuit to allow the negative pressure circuit to return to atmospheric pressure.
In some embodiments, the second drawdown includes operating the pump to produce a negative pressure within the negative pressure circuit at a predetermined drawdown rate.
In some embodiments, the drawdown parameter is an amount of time the pump operates at the predetermined drawdown rate to achieve a predetermined pressure value within the negative pressure circuit.
In some embodiments, the model is determined by performing the testing procedure for multiple known values of the volume of the wound to determine multiple values of the leak rate parameter and the drawdown parameter. In some embodiments, the model is determined by performing a regression on the values of the volume of the wound and the values of the leak rate parameter and the drawdown parameter.
In some embodiments, the model is a lookup table that relates the leak rate parameter and the drawdown parameter to the volume of the wound.
Another implementation of the present disclosure is a wound therapy device, according to some embodiments. In some embodiments, the wound therapy device includes a pump fluidly coupled to a negative pressure circuit. In some embodiments, the pump is configured to produce a negative pressure at a wound or within the negative pressure circuit. In some embodiments, the negative pressure circuit is configured to apply negative pressure to the wound. In some embodiments, the wound therapy device includes a pressure sensor configured to measure the negative pressure within a negative pressure circuit or at the wound, and a controller. In some embodiments, the controller is configured to operate the pump to produce a negative pressure within the negative pressure circuit, receive one or more pressure measurements of the pressure sensor over a predetermined time period, determine a leakage rate based on the one or more received pressure measurements of the pressure sensor over the predetermined time period, vent the negative pressure circuit to atmospheric pressure, and operate the pump to decrease the pressure within the negative pressure circuit at a predetermined rate. In some embodiments, the controller is configured to monitor an amount of elapsed time that the pump operates at the predetermined rate until a predetermined pressure is achieved within the negative pressure circuit. In some embodiments, the controller is configured to estimate a volume of the wound based on the leakage rate and the amount of elapsed time.
Those skilled in the art will appreciate that the summary is illustrative only and is not intended to be in any way limiting. Other aspects, inventive features, and advantages of the devices and/or processes described herein, as defined solely by the claims, will become apparent in the detailed description set forth herein and taken in conjunction with the accompanying drawings.
Referring generally to the FIGURES, a wound therapy system with fluid instillation and removal and components thereof are shown, according to various exemplary embodiments. The wound therapy system may include a therapy device and a wound dressing. The therapy device may include an instillation fluid canister, a removed fluid canister, a valve, a pneumatic pump, an instillation pump, and a controller. The wound dressing can be applied to a patient's skin surrounding a wound. The therapy device can be configured to deliver instillation fluid to the wound and provide negative pressure wound therapy (NPWT) by maintaining the wound at negative pressure. Components of the wound therapy device, the wound dressing, and/or the wound form a negative pressure circuit.
The controller can estimate the volume of the wound based on the leakage rate of the wound dressing and an amount of time it takes the pneumatic pump to achieve a predetermined negative pressure. The controller can cause the therapy device to perform a testing procedure (e.g., a pressure testing procedure) to determine the leakage rate of the wound dressing and the amount of time it takes the pneumatic pump to achieve the predetermined negative pressure. The leakage rate of the wound dressing and the amount of time it takes the pneumatic pump to achieve the predetermined negative pressure at the wound are the observed parameters. For example, the controller can apply the observed parameters as inputs to a model that defines a relationship between the observed parameters and the volume of the negative pressure circuit and/or the volume of the wound. The model may include a polynomial approximation model, a neural network model, or any other model that relates the observed parameters to the volume of the negative pressure circuit and/or the volume of the wound. In some embodiments, the model is a pre-existing model stored in the controller by the manufacturer of the therapy device. In other embodiments, the controller can generate the model on-site by performing a training procedure.
The training procedure may be the same as the pressure testing procedure with the exception that the therapy device is connected to a training circuit having a known volume. For example, the wound dressing can be applied to a test device having a known volume rather than to a patient's skin surrounding a wound. The controller can perform the training procedure on various training circuits having various known volumes and may observe the parameters (i.e., the leakage rate and the amount of time to achieve the predetermined negative pressure) of each training circuit. Each of the known volumes may result in different observed parameters. The controller can then associate the known volume of each training circuit with the corresponding parameters. In some embodiments, the controller uses the observed parameters and the known volume of the training circuits to generate the model that defines a relationship between the observed parameters and the volume of the training circuit. The model can then be stored in the therapy device and used to estimate the volume of a wound, as previously described.
In some embodiments, the controller is configured to execute the pressure testing procedure, observe the parameters, and estimate the wound volume at a plurality of times during wound treatment. The controller can then determine healing progression based on changes in the wound volume during wound treatment. In some embodiments, the controller is configured to determine a volume of instillation fluid to deliver to the wound based on the estimated wound volume. The volume of instillation fluid to deliver may be a predetermined percentage of the volume of the wound (e.g., 20%, 50%, 80%, etc.). The controller can then operate the instillation pump to deliver the determined volume of instillation fluid to the wound. These and other features of the wound therapy system are described in detail below.
Referring now to
Therapy device 102 can be configured to provide negative pressure wound therapy by reducing the pressure at wound 114. Therapy device 102 can draw a vacuum at wound 114 (relative to atmospheric pressure) by removing wound exudate, air, and other fluids from wound 114. Wound exudate may include fluid that filters from a patient's circulatory system into lesions or areas of inflammation. For example, wound exudate may include water and dissolved solutes such as blood, plasma proteins, white blood cells, platelets, and red blood cells. Other fluids removed from wound 114 may include instillation fluid 105 previously delivered to wound 114. Instillation fluid 105 can include, for example, a cleansing fluid, a prescribed fluid, a medicated fluid, an antibiotic fluid, or any other type of fluid which can be delivered to wound 114 during wound treatment. Instillation fluid 105 may be held in an instillation fluid canister 104 and controllably dispensed to wound 114 via instillation fluid tubing 108. In some embodiments, instillation fluid canister 104 is detachable from therapy device 102 to allow canister 106 to be refilled and replaced as needed.
The fluids 107 removed from wound 114 pass through removed fluid tubing 110 and are collected in removed fluid canister 106. Removed fluid canister 106 may be a component of therapy device 102 configured to collect wound exudate and other fluids 107 removed from wound 114. In some embodiments, removed fluid canister 106 is detachable from therapy device 102 to allow canister 106 to be emptied and replaced as needed. A lower portion of canister 106 may be filled with wound exudate and other fluids 107 removed from wound 114, whereas an upper portion of canister 106 may be filled with air. Therapy device 102 can be configured to draw a vacuum within canister 106 by pumping air out of canister 106. The reduced pressure within canister 106 can be translated to wound dressing 112 and wound 114 via tubing 110 such that wound dressing 112 and wound 114 are maintained at the same pressure as canister 106.
Referring particularly to
Similarly, instillation pump 122 can be fluidly coupled to instillation fluid canister 104 via tubing 109 and fluidly coupled to wound dressing 112 via tubing 108. Instillation pump 122 can be operated to deliver instillation fluid 105 to wound dressing 112 and wound 114 by pumping instillation fluid 105 through tubing 109 and tubing 108, as shown in
Filter 128 can be positioned between removed fluid canister 106 and pneumatic pump 120 (e.g., along conduit 136) such that the air pumped out of canister 106 passes through filter 128. Filter 128 can be configured to prevent liquid or solid particles from entering conduit 136 and reaching pneumatic pump 120. Filter 128 may include, for example, a bacterial filter that is hydrophobic and/or lipophilic such that aqueous and/or oily liquids will bead on the surface of filter 128. Pneumatic pump 120 can be configured to provide sufficient airflow through filter 128 that the pressure drop across filter 128 is not substantial (e.g., such that the pressure drop will not substantially interfere with the application of negative pressure to wound 114 from therapy device 102).
In some embodiments, therapy device 102 operates a valve 132 to controllably vent the negative pressure circuit, as shown in
In some embodiments, therapy device 102 vents the negative pressure circuit via an orifice 158, as shown in
In some embodiments, therapy device 102 includes a variety of sensors. For example, therapy device 102 is shown to include a pressure sensor 130 configured to measure the pressure within canister 106 and/or the pressure at wound dressing 112 or wound 114. In some embodiments, therapy device 102 includes a pressure sensor 113 configured to measure the pressure within tubing 111. Tubing 111 may be connected to wound dressing 112 and may be dedicated to measuring the pressure at wound dressing 112 or wound 114 without having a secondary function such as channeling installation fluid 105 or wound exudate. In various embodiments, tubing 108, 110, and 111 may be physically separate tubes or separate lumens within a single tube that connects therapy device 102 to wound dressing 112. Accordingly, tubing 110 may be described as a negative pressure lumen that functions apply negative pressure wound dressing 112 or wound 114, whereas tubing 111 may be described as a sensing lumen configured to sense the pressure at wound dressing 112 or wound 114. Pressure sensors 130 and 113 can be located within therapy device 102, positioned at any location along tubing 108, 110, and 111, or located at wound dressing 112 in various embodiments. Pressure measurements recorded by pressure sensors 130 and/or 113 can be communicated to controller 118. Controller 118 use the pressure measurements as inputs to various pressure testing operations and control operations performed by controller 118 (described in greater detail with reference to
Controller 118 can be configured to operate pneumatic pump 120, instillation pump 122, valve 132, and/or other controllable components of therapy device 102. In some embodiments, controller 118 performs a pressure testing procedure by applying a pressure stimulus to the negative pressure circuit. For example, controller 118 may instruct valve 132 to close and operate pneumatic pump 120 to establish negative pressure within the negative pressure circuit. Once the negative pressure has been established, controller 118 may deactivate pneumatic pump 120. Controller 118 may cause valve 132 to open for a predetermined amount of time and then close after the predetermined amount of time has elapsed. Controller 118 may observe a dynamic pressure response of the negative pressure circuit to the pressure stimulus using pressure measurements recorded by pressure sensors 130 and/or 113. The dynamic pressure response may be characterized by a variety of parameters including, for example, a drawdown time parameter αtime and a leak rate parameter αleak.
Controller 118 can estimate volume 160 of wound 114 based on the observed dynamic pressure response. For example, controller 118 can apply the observed parameters as inputs to a model that defines a relationship between the observed parameters and the volume of the negative pressure circuit and/or volume 160 of wound 114. The model may include a polynomial approximation model, a neural network model, or any other model that relates the observed parameters to the volume of the negative pressure circuit and/or volume 160 of wound 114. In some embodiments, the model is a pre-existing model stored in controller 118 by the manufacturer of therapy device 102. In other embodiments, controller 118 can generate the model on-site by performing a training procedure.
The training procedure may be the same as the pressure testing procedure with the exception that therapy device 102 is connected to a training circuit having a known volume. For example, wound dressing 112 can be applied to a test device having a known volume rather than to a patient's skin 116 surrounding wound 114. Controller 118 can apply the pressure stimulus to various training circuits having various known volumes and may observe the dynamic pressure response of each training circuit. Each of the known volumes may result in a different dynamic pressure response to the pressure stimulus. Controller 118 can then associate the known volume of each training circuit with the corresponding dynamic pressure response. In some embodiments, controller 118 uses the dynamic pressure responses of the training circuits to generate the model that defines a relationship between the observed parameters of the dynamic pressure response (e.g., depth of purge, rebound, delta, leak rate, etc.) and the volume of the training circuit. The model can then be stored in controller 118 and used to estimate the volume of a wound 114, as previously described. In some embodiments, controller 118 determines one or more sets of values of the drawdown time parameter αtime and the leak rate parameter αleak, where each set of the drawdown time parameter αtime and the leak rate parameter αtime corresponds to a known volume 160. In some embodiments, controller 118 uses the one or more sets of values to generate the model.
In some embodiments, controller 118 is configured to execute the pressure testing procedure, observe the dynamic pressure response, and estimate volume 160 of wound 114 at a plurality of times during wound treatment. Controller 118 can then determine healing progression based on changes in volume 160 of wound 114 during wound treatment. In some embodiments, controller 118 is configured to determine a volume of instillation fluid 105 to deliver to wound 114 based on the estimated value of volume 160. The volume of instillation fluid 105 to deliver may be a predetermined percentage of volume 160 of wound 114 (e.g., 20%, 50%, 80%, etc.). Controller 118 can then operate instillation pump 122 to deliver the determined volume of instillation fluid 105 to wound 114. These and other features of controller 118 are described in greater detail with reference to
In some embodiments, therapy device 102 includes a user interface 126. User interface 126 may include one or more buttons, dials, sliders, keys, or other input devices configured to receive input from a user. User interface 126 may also include one or more display devices (e.g., LEDs, LCD displays, etc.), speakers, tactile feedback devices, or other output devices configured to provide information to a user. In some embodiments, the pressure measurements recorded by pressure sensors 130 and/or 113 are presented to a user via user interface 126. User interface 126 can also display alerts generated by controller 118. For example, controller 118 can generate a “no canister” alert if canister 106 is not detected.
In some embodiments, therapy device 102 includes a data communications interface 124 (e.g., a USB port, a wireless transceiver, etc.) configured to receive and transmit data. Communications interface 124 may include wired or wireless communications interfaces (e.g., jacks, antennas, transmitters, receivers, transceivers, wire terminals, etc.) for conducting data communications external systems or devices. In various embodiments, the communications may be direct (e.g., local wired or wireless communications) or via a communications network (e.g., a WAN, the Internet, a cellular network, etc.). For example, communications interface 124 can include a USB port or an Ethernet card and port for sending and receiving data via an Ethernet-based communications link or network. In another example, communications interface 124 can include a Wi-Fi transceiver for communicating via a wireless communications network or cellular or mobile phone communications transceivers.
Referring now to
Referring now to
Memory 144 may include one or more devices (e.g., memory units, memory devices, storage devices, etc.) for storing data and/or computer code for completing and/or facilitating the various processes described in the present disclosure. Memory 144 may include random access memory (RAM), read-only memory (ROM), hard drive storage, temporary storage, non-volatile memory, flash memory, optical memory, or any other suitable memory for storing software objects and/or computer instructions. Memory 144 may include database components, object code components, script components, or any other type of information structure for supporting the various activities and information structures described in the present disclosure. Memory 144 may be communicably connected to processor 142 via processing circuit 140 and may include computer code for executing (e.g., by processor 142) one or more processes described herein. When processor 142 executes instructions stored in memory 144, processor 142 generally configures controller 118 (and more particularly processing circuit 140) to complete such activities.
Controller 118 is shown to include a pump controller 146 and a valve controller 150. Pump controller 146 can be configured to operate pumps 120 and 122 by generating and providing control signals to pumps 120-122. The control signals provided to pumps 120-122 can cause pumps 120-122 to activate, deactivate, or achieve a variable capacity or speed (e.g., operate at half speed, operate at full speed, etc.). Similarly, valve controller 150 can be configured to operate valve 132 by generating and providing control signals to valve 132. The control signals provided to valve 132 can cause valve 132 to open, close, or achieve a specified intermediate position (e.g., one-third open, half open, etc.). In some embodiments, pump controller 146 and valve controller 150 are used by other components of controller 118 (e.g., testing procedure controller 148, wound volume estimator 156, etc.) to operate pumps 120-122 and valve 132 when carrying out the processes described herein.
In some embodiments, pump controller 146 uses input from a canister sensor configured to detect whether removed fluid canister 106 is present. Pump controller 146 can be configured to activate pneumatic pump 120 only when removed fluid canister 106 is present. For example, pump controller 146 can check whether canister 106 is present and can activate pneumatic pump 120 in response to a determination that canister 106 is present. However, if canister 106 is not present, pump controller 146 may prevent pneumatic pump 120 from activating. Similarly, pump controller 146 can be configured to activate instillation pump 122 only when instillation fluid canister 104 is present. For example, pump controller 146 can check whether canister 104 is present and can activate instillation pump 122 in response to a determination that canister 104 is present. However, if canister 104 is not present, pump controller 146 may prevent instillation pump 122 from activating.
Controller 118 is shown to include a pressure monitor 152. Pressure monitor 152 can be configured to monitor the pressure within removed fluid canister 106 and/or the pressure within wound dressing 112 or wound 114 using feedback from pressure sensors 130 and/or 113. For example, pressure sensors 130 and/or 113 may provide pressure measurements to pressure monitor 152. Pressure monitor 152 can use the pressure measurements to determine the pressure within canister 106 and/or the pressure within wound dressing 112 or wound 114 in real-time. Pressure monitor 152 can provide the pressure value to model generator 154, pump controller 146, testing procedure controller 148, and/or valve controller 150 for use as an input to control processes performed by such components.
Referring now to
Referring particularly to
Graph 600 includes series 602 which shows the relationship between negative pressure (the Y-axis) and time (the X-axis) over the testing procedure, according to some embodiments. In some embodiments, the testing procedure includes a first drawdown period 604, a leak rate determination period 606, a vent period 608, and a second drawdown period 610. In some embodiments, first drawdown period 604 occurs between time t0 and time t1. In some embodiments, leak rate determination period 606 occurs between time t1 and time t2. In some embodiments, vent period 608 occurs between time t2 and time t3. In some embodiments, second drawdown period 610 occurs between time t3 and time t4.
During first drawdown period 604, controller 118 can send a control signal to valve 132 to transition valve 132 into a closed configuration such that air cannot pass through conduit 138 to vent 134. In some embodiments, testing procedure controller 148 sends a command to valve controller 150 to transition valve 132 into a closed configuration for first drawdown period 604. In some embodiments, after valve 132 has been transitioned into the closed configuration, testing procedure controller 148 sends control signals to pump controller 146 to draw down (e.g., create a negative pressure) at wound 114. In some embodiments, testing procedures controller 148 sends information to pump controller 146 regarding a drawdown rate
Pump controller 146 is configured to send control signals to pneumatic pump 120 to draw down pressure (e.g., create negative pressure) at wound 114 according to the drawdown rate. In some embodiments, pump controller 146 is configured to operate pneumatic pump 120 to drawdown according to one or more predetermined drawdown rates. In some embodiments, testing procedure controller 148 is configured to send a command to pump controller 146 to cause pneumatic pump 120 to drawdown at a maximum rate for first drawdown period 604. In some embodiments, testing procedure controller 148 sends values of a manipulated variable u to pump controller 146 to cause pneumatic pump 120 to drawdown according to a predetermined drawdown rate. For example, testing procedure controller 148 may send pump controller 146 a binary value of manipulated variable u (e.g., u=1 or u=0). For example, testing procedure controller 148 may send pump controller 146 a value u1=1 of the manipulated variable to pump controller 146 which indicates that pump controller 146 should cause pneumatic pump 120 to drawdown at a first predetermined drawdown rate. Likewise, testing procedure controller 148 may send pump controller 146 a value u2=1 of the manipulated variable to pump controller 146 which indicates that pump controller 146 should cause pneumatic pump 120 to drawdown at a second predetermined drawdown rate which is greater than the first predetermined drawdown rate. Testing procedure controller 148 may send pump controller 146 a 1×d vector of values of the manipulated variable u such as:
{right arrow over (u)}=[u
1
u
2
. . . u
d]
where u1 is a binary value of the manipulated variable u indicating whether or not pump controller 146 should cause pneumatic pump 120 to drawdown at a first drawdown rate, u2 is another binary value of the manipulated variable u indicating whether or not pump controller 146 should cause pneumatic pump 120 to drawdown at a second drawdown rate, etc., and ud is a dth binary value of the manipulated variable u indicating whether or not pump controller 146 should cause pneumatic pump 120 to drawdown at a dth drawdown rate. For example, if d=4, and pump controller 146 can cause pneumatic pump 120 to drawdown according to four predetermined drawdown rates, vector {right arrow over (u)} may have the form:
{right arrow over (u)}=[0001]
such that u1=0, u2=0, u3=0, and u4=1 which indicates that pump controller 146 should cause pneumatic pump 120 to drawdown according to the fourth drawdown rate (i.e., u4=1). In some embodiments, the dth drawdown rate (e.g., in this case, the fourth), is the fastest drawdown rate, while the first drawdown rate is the slowest drawdown rate. In some embodiments, testing procedure controller 148 sends pump controller 146 a command to cause pneumatic pump 120 to drawdown at the fastest drawdown rate for first drawdown period 604 (e.g., ud=1). Testing procedure controller 148 can also use the variable drawdown rate of pneumatic pump for second drawdown period 610. In some embodiments, the drawdown time parameter αtime is determined across second drawdown period 610. In some embodiments, if the drawdown rate of pneumatic pump 120 across second drawdown period 610 is fast, the volume estimation of wound 114 is less accurate, but is estimated faster. Likewise, if the drawdown rate of pneumatic pump 120 across second drawdown period 610 is slow, the volume estimation of wound 114 is more accurate, but takes a longer time to estimate. In some embodiments, model generator 154 is configured to determine a model fwound for various predetermined drawdown rates of second drawdown period 610, as described in greater detail below.
In some embodiments, testing procedure controller 148 uses a setpoint value r as a target value of negative pressure for first drawdown period 604. For example, as shown in
In some embodiments, testing procedure controller 148 receives measured pressure values of the pressure p at wound 114 via pressure monitor 152 and pressure sensors 130/113. In some embodiments, testing procedure controller 148 receives values of the pressure p at wound 114 as values of a performance variable y. In some embodiments, testing procedure controller 148 is configured to perform feedback control (e.g., PID control, PI control, etc.) to determine values of the manipulated variable u. In some embodiments, testing procedure controller 148 monitors the values of the performance variable y in real time until the value of the performance variable y is substantially equal to the setpoint value r (e.g., p1). In some embodiments, once the value of the performance variable y is substantially equal to the value of the setpoint r (e.g. p =p1), testing procedure controller 148 sends a value of the manipulated variable u to pump controller 146 to cause pneumatic pump 120 to cease the drawdown. For example, testing procedure controller 148 may initially send pump controller 146 a value of the manipulated variable u such as u=1 until y=r. In some embodiments, once y=r, testing procedure controller 148 sends pump controller 146 a value of the manipulated variable u such as u=0 so that pump controller 146 causes pneumatic pump 120 to stop drawing down pressure p. In some embodiments, once y=r (or once y is within an acceptable range r±rx where rx indicates an allowable deviation of y from r), testing procedure controller 148 sends a command to pump controller 146 to cease drawing down negative pressure at wound 114.
After first drawdown period has been completed (at t1 as shown in graph 600), leak rate determination period 606 begins, according to some embodiments. Leak rate determination period 606 is used to determine slope 612 which indicates a rate of leakage of the dressing application (e.g., wound dressing 112, connectors 162-166) of wound 114. In some embodiments, slope 612 is the leak rate parameter αleak.
During leak rate determination period 606, testing procedure controller 148 causes valve controller 150 to maintain valve 132 in the closed configuration for a predetermined period of time Δtleak, according to some embodiments. Testing procedure controller 148 monitors pressure changes over leak rate determination period 606 to determine the leak rate parameter αleak for the specific wound application. As shown in graph 600, the negative pressure decreases from p1 to p2 from time t=t1 to time t=t2. In some embodiments, testing procedure controller 148 monitors change in pressure (e.g., a decrease) over leak rate determination period. For example, testing procedure controller 148 can determine a drop in pressure, p1-p2, over leak rate determination period 606 as the leak rate parameter αleak. In some embodiments, leak rate determination period 606 has a predetermined time duration, Δtleak=t2−t1. In some embodiments, testing procedure controller 148 measures pressure p1 at time t1 and pressure p2 at time t2. In some embodiments, the leak rate parameter αleak=p1−p2 over the predetermined time duration Δtleak of leak rate determination period 606.
Leak rate determination period 606 includes testing procedure controller 148 receiving and storing values of the performance variable y (e.g., negative pressure) over the predetermined time period Δtleak, according to some embodiments. In some embodiments, testing procedure controller 148 receives values of the performance variable y over the predetermined time period Δtleak where Δtleak=t2−t1. For example, testing procedure controller 148 may receive values of the performance variable y at a sampling rate fsample over Δtleak. In some embodiments, the sampling rate is the number of samples of the performance variable y received from pressure sensors 130, 113 in a second, such as
For example, if testing procedure controller 148 is configured to monitor and record values of the performance variable y from pressure sensors 130, 113 over a ten second interval (i.e., Δtleak=t2−t1=10 seconds), and
then the number of samples of the performance variable y over leak rate determination period 606 is fsample·Δtleak=60 Hz·10 sec=600 samples. In some embodiments, the samples are measured by pressure sensors 130/113, and testing procedure controller 148 records the samples of the performance variable y in a vector, such as: {right arrow over (S)}=[S1 S2 . . . Sw] where S1 is the first recorded value of the performance variable y during leak rate determination period 606, S2 is the second recorded value of the performance variable y during leak rate determination period 606, etc., Sw is the wth recorded value of the performance variable y during leak rate determination period 606, and w is the number of samples of the performance variable y over leak rate determination period 606 (e.g., w=fsample·(t2 −t1)).
In some embodiments, testing procedure controller 148 also stores a vector of time values associated with the vector {right arrow over (S)}. For example, testing procedure controller 148 may store a time vector {right arrow over (t)}=[tS
For example, if fsample=60 Hz, and tS
In some embodiments, testing procedure controller 148 is configured to determine slope 612 (i.e., the leak rate parameter αleak) based on the vector {right arrow over (S)} of samples of the negative pressure at wound 114, and the time vector {right arrow over (t)} associated with {right arrow over (S)}. In some embodiments, testing procedures controller 148 determines slope 612 (i.e., slope m) between consecutive sampling values (e.g., S2 and S1, S3 and S2, S4 and S3, etc.). For example, if testing procedure controller 148 records 5 sampled values (i.e., w=5) over leak rate determination period 606 such that {right arrow over (S)}=[S1 S2 S3 S4 S5] and {right arrow over (t)}=[tS
In some embodiments, testing procedure controller can determine w−1 values of m and store the values in a slope vector such as:
{right arrow over (m)}=[m1 m2 . . . m(w−1)]
where each value of m is determined between consecutively occurring values of S and corresponding/associated values of t at which the samples were recorded.
Testing procedure controller 148 can determine the leak rate parameter αleak based on {right arrow over (t)}, {right arrow over (S)}, and {right arrow over (m)}. In some embodiments, testing procedure controller 148 determines an average of the values of {right arrow over (m)} as αleak. For example, testing procedure controller 148 can determine:
according to some embodiments. Testing procedure controller 148 also determines a standard deviation associated with the leak rate parameter αleak:
according to some embodiments.
In some embodiments, testing procedure controller 148 selects the maximum or minimum value of in as αleak. For example, testing procedure controller 148 may determine αleak as:
αleak=max({right arrow over (m)})
or:
αleak=min({right arrow over (m)})
according to some embodiments.
In some embodiments, testing procedure controller 148 uses the initial and final values of {right arrow over (t)} and {right arrow over (S)} to determine an overall slope m over the entirety of leak rate determination period 606 as the leak rate parameter αleak. Testing procedure controller 148 determines:
according to some embodiments.
In some embodiments, Δtleak (e.g., time between t2 and t1) of leak rate determination period 606 is a predetermined time period. For example Δtleak may be 10 seconds, 30 seconds, 5 minutes, etc., according to some embodiments. If Δtleak is a predetermined time period, testing procedure controller 148 can determine the leak rate parameter αleak as the change in pressure (e.g., p2−p1) over the predetermined time period. For example, αleak=p2−p1 assuming Δtleak is a predetermined value. Leak rate determination period 606 is used to determine αleak which characterizes a seal quality at wound 114 and quantifies a leak rate at wound 114. In some embodiments, αleak characterizes an ability of wound 114 to hold a negative pressure. For example, if αleak is very low, this indicates that wound 114 is well sealed and can hold a negative pressure well (e.g., without any leaks) since the pressure drop across leak rate determination period is negligible or slope 612 is a near-zero value. Similarly, if αleak is very high, this indicates that wound 114 is not well sealed and may not hold a negative pressure as well (e.g., identified by a large pressure drop across leak rate determination period 606 or a negative slope 612 with a large magnitude), according to some embodiments.
In some embodiments, after leak rate determination period 606 is completed, testing procedure controller 148 stores the values of αleak, {right arrow over (m)}, {right arrow over (t)}, and {right arrow over (S)} collected/determined over leak rate determination period 606 and proceeds to vent period 608. During vent period 608, testing procedure controller 148 sends a command to valve controller 150 to transition valve 132 into the open configuration to allow wound 114 to return to atmospheric pressure, according to some embodiments. In some embodiments, testing procedure controller 148 causes valve controller 150 to maintain valve 132 in the open configuration for a predetermined amount of time such that the pressure p within wound 114 can return to atmospheric pressure (e.g., 0 mmHg negative pressure). In some embodiments, testing procedure controller 148 monitors the real time value of the performance variable y received from pressure sensors 130/113 via pressure monitor 152 and causes valve controller 150 to maintain valve 132 in the open configuration until the received pressure measurements from pressure sensors 130/113 are substantially equal to atmospheric pressure, as shown at t3.
After wound 114 has returned to atmospheric pressure, testing procedure controller 148 proceeds to second drawdown period 610, according to some embodiments. In some embodiments, second drawdown period 610 is performed to determine the drawdown time parameter αtime. The drawdown time parameter αtime is an amount of time required to achieve a desired negative pressure value (e.g., p1). In some embodiments, the drawdown time parameter αtime is time interval 614. Time interval 614 as shown in
Testing procedure controller 148 can determine the drawdown time parameter αtime by sending a command (e.g., a value of the manipulated variable u) to pump controller 146 to cause pneumatic pump 120 to drawdown at a rate of
Testing procedure controller 148 can receive the pressure measurements from pressure monitor 152 and/or pressure sensors 130/113 and determine an amount of time that pneumatic pump 120 operates to achieve a desired pressure (e.g., p1) as αtime. In some embodiments, testing procedure controller 148 can send a command to pump controller 146 to cause pneumatic pump 120 to drawdown according to various drawdown rates
In some embodiments, faster drawdown rates allow αtime to be determined quicker but the model determined using αtime (described in greater detail below with reference to model generator 154) is less accurate. In some embodiments, slower drawdown rates allow αtime to be used to generate a more accurate model, but require longer drawdown time (e.g., time interval 614) to determine αtime.
In some embodiments, testing procedure controller 148 is configured to send a command to valve controller 150 to transition valve 132 into the closed configuration to initiate second drawdown period 610. In some embodiments, after valve 132 has been transitioned into the closed configuration, testing procedure controller 148 sends a command to pump controller 146 to initiate a second drawdown. In some embodiments, testing procedure controller 148 sends a value of the manipulated variable u to pump controller 146 to cause pneumatic pump 120 to drawdown the negative pressure at wound 114. In some embodiments, testing procedure controller 148 sends a command (e.g., a value of the manipulated variable u) to pump controller 146 to cause pneumatic pump 120 to drawdown according to a predetermined drawdown operation. In some embodiments, the predetermined drawdown operation includes increasing the voltage supplied to pneumatic pump 120 if pneumatic pump 120 cannot achieve the desired negative pressure (e.g., p1) given the current voltage. In some embodiments, the voltage increases of pneumatic pump 120 are performed at predetermined/known time intervals.
Similar to first drawdown period 604, testing procedure controller 148 can send values of the manipulated variable u to pump controller 146 to cause pneumatic pump 120 to drawdown at a variety of drawdown rates for second drawdown period 610. In some embodiments, faster drawdown rates result in a less accurate estimation of the drawdown time parameter αtime but can advantageously be used to estimate the drawdown time parameter αtime faster. Likewise, slower drawdown rates advantageously result in a more accurate estimation of the drawdown time parameter αtime but require a longer amount of time to estimate the drawdown time parameter αtime, according to some embodiments.
During second drawdown period 610, testing procedure controller 148 monitors the value of the performance variable y received from pressure sensors 130, 113 via pressure monitor 152 and compares the value of the performance variable y to the desired/setpoint value r. In some embodiments, the desired/setpoint value r is a negative pressure value at wound 114 that pneumatic pump 120 is trying to achieve (e.g., a target pressure value). For example, the setpoint value r may be p1. In some embodiments, the setpoint value r is greater than or less than p1. In this way, the target pressure value of second drawdown period 610 may be the same, or greater than, or less than the target pressure value of first drawdown period 604.
Testing procedure controller 148 continues monitoring the value of the performance variable y and monitoring an amount of elapsed time since the beginning (e.g., t3) of second drawdown period 610, according to some embodiments. In some embodiments, testing procedure controller 148 includes a timer configured to reset at the beginning of second drawdown period 610 (e.g., at t3) or to store a time at which second drawdown period 610 begins (e.g., store the value of t3). In some embodiments, the timer resets or records the time value immediately after valve 132 has transitioned into the closed configuration and once pneumatic pump 120 has begun drawing down pressure at wound 114.
In some embodiments, once the value of the performance variable y is substantially equal to the setpoint r (e.g., equal to, within a negligible amount, etc.), the timer of testing procedure controller 148 records time t4. In some embodiments, testing procedure controller 148 monitors the amount of time (i.e., t4−t3) required to achieve the desired negative pressure value (e.g., r, p1). In some embodiments, testing procedure controller 148 monitors the elapsed time to drawdown to p1 or r. In some embodiments, the amount of elapsed time Δtdrawdown=t4−t3. In some embodiments, the amount of elapsed time At drawdown is the drawdown time parameter αtime.
Testing procedure controller 148 can perform the testing procedure as described in greater detail above to determine values of the leak rate parameter αleak and the drawdown time parameter αtime for a known volume of wound 114 and/or a known training circuit volume. For example, testing procedure controller 148 can perform the testing procedure multiple times for a variety of several training circuits having known volumes (e.g., 50 cc, 100 cc, 200 cc, 300 cc, etc.). In some embodiments, testing procedure controller 148 is configured to perform the testing procedure several times for each of the training circuits having known volumes. In some embodiments, the resulting values of the leak rate parameter αleak and the drawdown time parameter αtime are averaged for each of the training circuits to mitigate an amount of random error. For example, the testing procedure may be performed 10 times for a training circuit having the known volume of 50 cc and the leak rate parameter αleak and the drawdown time parameter αtime can be averaged to reduce random error. In some embodiments, the testing procedure is performed for various NPWT systems having different pneumatic pumps 120, therapy pressures, training circuit volumes, etc. In some embodiments, model generator 154 is configured to generate a model for each of multiple training circuits using any of the methods and techniques described in greater detail below.
In some embodiments, the training circuit volume includes known volume values of the various pipes, canisters, tubes, etc., which pneumatic pump 120 is configured to draw down. In some embodiments, the training circuit volume includes a known volume of wound 114, Vwound. In some embodiments, the training circuit volume is:
V
training
=V
system
+V
wound
where Vsystem is the known volume of various tubes, pipes, canisters, etc., which pneumatic pump 120 is configured to produce a negative pressure within (e.g., conduit 136, removed fluid canister 106, tubing 110, wound dressing 112, and/or wound 114), and Vwound is a known volume of wound 114.
In some embodiments, the testing procedure can be performed multiple times for a variety of values of Vwound. For example, the testing procedure can be performed by controller 118 for a value of Vwound=50 cc, Vwound=100 c, Vwound=125 cc, etc. In some embodiments, the testing procedure is performed multiple times for each value of Vwound to determine average parameter values associated with the particular value of Vwound. In some embodiments, Vsystem is held constant while the testing procedure is repeated for various values of Vwound. In this way, changes in the overall volume of the training circuit, Vtraining are due to changes in Vwound. The testing procedure can also be performed multiple times for each value of Vwound having multiple leak rates. In some embodiments, testing procedure controller 148 is configured to provide model generator 154 with the leak rate parameter αleak and the drawdown time parameter αtime for each combination of leak rate and Vwound resulting from performing the testing procedure.
In some embodiments, controller 118 performs the testing procedure for various systems having different values of Vsystem. In some embodiments, controller 118 performs the testing procedure multiple times for various values of Vwound for each of the various systems. In some embodiments, model generator 154 is configured to generate a model for each of the various systems using any of the methods and techniques described in greater detail below. For example, model generator 154 can generate a model for various training circuits which may be used during NPWT.
In some embodiments, model generator 154 is configured to determine a model to relate the recorded/determined parameters (i.e., αleak and αtime) to Vwound for the known values of Vwound. This model can then be used during NPWT to determine the volume of an unknown wound 114. Model generator 154 can be configured to perform a multi-variable regression (e.g., perform a multi-variable polynomial curve fit, perform a multi-variable linear regression), use a neural network, or create a matrix/table to create a model that relates the parameters to known values of Vwound. In some embodiments, model generator 154 creates a model for a variety of values of Vsystem. For example, model generator 154 can create a table for each of a variety of typical values of Vsystem which correspond to various NPWT circuits that may be used during NPWT.
Referring again to
In some embodiments, model generator 154 records the values of the parameters of the dynamic pressure response (i.e., the leak rate parameter αleak and the drawdown time parameter αtime) for each known volume and associates those values with the known volume. The values of the parameters and the known volume form a set of training data which can be used to construct the model. The values of the parameters form a set of model input training data, whereas the known volumes form a set of model output training data. Model generator 154 can use any of a variety of model generation techniques to construct a model (i.e., a mathematical model) that relates the values of the parameters to the corresponding volume in the set of training data.
In some embodiments, model generator 154 creates a n by m matrix A (i.e., a model) for each typical value of Vsystem (i.e., typical negative pressure wound therapy systems). In some embodiments, the matrix A relates the leak rate parameter values αleak and the drawdown time parameter values αdrawdown to the known wound volume values Vwound associated with the parameters. In some embodiments, the matrix A has the form:
where each column represents volumes of wound 114 corresponding to a different value of the drawdown time parameter αtime, each row represents different volumes of wound 114 corresponding to a different leak rate parameter αleak, and each element of the matrix represents a volume of Vwound which corresponds to the particular combination of αtime and αleak. In some embodiments, model generator 154 is configured to receive various data sets where each data set includes a value of Vwound for which the particular test was performed, and the values of αtime and αleak that resulted from the test. In some embodiments, model generator 154 is configured to receive data sets from each iteration of the test and create matrix A based on the data sets. In some embodiments, matrix A is created (e.g., sorted, arranged, generated, constructed, etc.) such that the values of αtime (e.g., associated with the columns of matrix A) increase from left to right, and such that the values of αleak (e.g., associated with the rows of matrix A) increase from top to bottom of matrix A.
In some embodiments, model generator 154 also generates vectors which correspond to the rows and columns of matrix A. In some embodiments, the vectors are row and column vectors of the drawdown time parameters αtime and the leak rate parameters αleak which were determined through testing for the associated volume values. For example, the vector of the drawdown time parameters αtime may be referred to as vector C and have the form:
C=[aαtime,1 αtime,2 . . . αtime,m]
according to some embodiments. Likewise, the vectors of the leak rate parameters αleak may be referred to as vector B and have the form:
B=[aαleak,1 αleak,2 . . . αleak,n]T
according to some embodiments.
In some embodiments, model generator 154 creates a table 900 as shown in
In some embodiments, model generator 154 performs a multi-variable regression based on the values of Vwound and the corresponding αtime and αleak parameters. In some embodiments, model generator 154 performs a multi-variable linear regression to determine the equation:
V
wound
=C
1αtime+C2αleak+C3
where C1, C2, and C3 are constants determined by model generator 154 by performing the multi-variable linear regression.
In some embodiments, model generator 154 performs a multi-variable non-linear regression to determine the equation:
V
wound
=f
1(αtime)+f2(αleak)
where f1 is a non-linear function of αtime determined by performing the non-linear multi variable regression, and f2 is a non-linear function of αleak determined by performing the non-linear multi variable regression. In some embodiments, any of the above equations have the general form:
V
wound
=f
wound(αtime, αleak)
where fwound is a function (e.g., linear, non-linear, etc.) relating αleak and αtime to Vwound. In some embodiments, fwound is determined by performing a multi-variable regression on the various values of Vwound and the associated values of αtime and αleak corresponding to each of the Vwound values.
In some embodiments, model generator 154 creates fwound using a polynomial approximation model to relate the values of the parameters to the corresponding volume. To generate a polynomial approximation model, model generator 154 can perform a curve fitting process such as polynomial regression using any of a variety of regression techniques. Examples of regression techniques which can be used by model generator 154 include least squares, ordinary least squares, linear least squares, partial least squares, total least squares, generalized least squares, weighted least squares non-linear least squares, non-negative least squares, iteratively reweighted least squares, ridge regression, least absolute deviations, Bayesian linear regression, Bayesian multivariate linear regression, etc.
In some embodiments, fwound is generated by model generator 154 using a neural network. To generate a neural network model, model generator 154 can perform a machine learning process. Examples of machine learning techniques which can be used by model generator 154 include decision tree learning, association rule learning, artificial neural networks, deep learning, inductive logic programming, support vector machines, clustering, Bayesian networks, reinforcement learning, representation learning, similarity and metric learning, sparse dictionary learning, genetic algorithms, rule-based machine learning, etc.
Referring still to
In some embodiments, wound volume estimator 156 uses table 900 to determine the unknown value Vwound based on the determined parameters αtime and αleak resulting from performing the testing procedure on wound 114 with an unknown volume. In some embodiments, wound volume estimator 156 first checks through the values of side header 904 to determine if any of the values of αleak in side header 904 are substantially equal to the value of αleak determined from performing the testing procedure on wound 114 with the unknown value of Vwound. For example, if wound volume estimator 156 determines that αleak is substantially equal to αleak,2 of side header 904, wound volume estimator 156 determines that the value of Vwound is one of the values of V in the row corresponding to αleak,2. Next, wound volume estimator 156 can compare the various values of αtime in the top header 902 to the value of αtime determined from performing the testing procedure on wound 114. For example, if wound volume estimator 156 determines that αtime is substantially equal to αtime,5, and αleak is substantially equal to αleak,2,wound volume estimator 156 can determine that the volume of wound 114 is substantially equal to V2,5.
In some embodiments, if wound volume estimator 156 determines that αleak and/or αtime do not correspond to values of side header 904 and top header 902, respectively, wound volume estimator 156 can perform an interpolation or an extrapolation to determine the volume of wound 114. In some embodiments, wound volume estimator 156 uses any of the values of table 900 in a multi-variable linear interpolation (or extrapolation) to determine the volume of wound 114. In some embodiments, wound volume estimator 156 performs a non-linear interpolation to determine the volume of wound 114.
Wound volume estimator 156 can be similarly configured to determine the volume of wound 114 using matrix A and vectors B and C. For example, wound volume estimator 156 can compare the value of αtime to values of the elements of vector C to determine a column value of matrix A, and compare the value of αleak to values of the elements of vector B to determine a row value of matrix A. For example, if αtime is equal to the fifth element of vector C and αleak is equal to the tenth element of vector C, wound volume estimator 156 can select A(10,5) or V10,5as Vwound for wound 114. Likewise, wound volume estimator 156 can be configured to interpolate or extrapolate values of matrix A to determine values of Vwound that are associated with a value of αtime and/or αleak not included in vector B and vector C. In some embodiments, wound volume estimator 156 is configured to use a linear multi-variable interpolation technique or a non-linear interpolation technique.
In some embodiments, wound volume estimator 156 is configured to use any of the linear regression equations (e.g., Vwound=C1αtime+C2αleak+C3), the non-linear regression equation (e.g., Vwound=f1(αtime)+f2(αleak)), or any of the mathematical models (e.g., generally referred to as Vwound=fwound(αtime, αleak)) determined using any of the methods described in greater detail above (e.g., generated using a machine learning algorithm, using a polynomial curve-fit, using a linear regression, etc.) using the data received from testing procedure controller 148 for the known volumes. For example, wound volume estimator 156 can input the determined values of αleak and αtime (e.g., the parameters resulting from performing the testing procedure on a wound 114 with an unknown volume) into fwound to determine the volume Vwound of wound 114. In some embodiments, wound volume estimator 156 is configured to select an appropriate model (e.g., an appropriate table 900, an appropriate matrix A, an appropriate fwound) based on a volume (e.g., Vsystem) of circuit which pneumatic pump 120 is configured to drawdown. For example, wound volume estimator 156 can select an appropriate fwound model generated from a testing procedure for a system having a similar volume from a database of various fwound models.
Advantageously, using both αtime and αleak to determine Vwound reduces inaccuracies or deviations in αtime due to air leaking into inner volume 160 of wound 114, according to some embodiments. For example, a wound application for a wound having volume Vwound with a high leak rate (e.g., a high value of αleak ) may have a higher value of αtime when compared to a wound with the same volume Vwound but a lower leak rate (e.g., a lower value of αleak ). By taking both αtime and αleak into account, model generator 154 and wound volume estimator 156 can account for the degree of leakage for the particular wound and accurately determine Vwound, regardless of high or low leakage rates (e.g., high or low values of αleak).
Referring now to
In graph 1000, line 1002 represents the estimated volume of wound 114 as a function of time, whereas line 1004 represents the calculated volume of instillation fluid 105 to deliver to wound 114 over time. At time t1, the estimated volume of wound 114 is V4. The estimated wound volume V4 at time t1 can be multiplied by the fluid instillation factor F (e.g., F=0.8) to calculate the volume of instillation fluid 105 V3 to deliver to wound 114 at time t1 (i.e., V4*F=V3). As wound 114 heals, the estimated volume of wound 114 decreases and reaches a value of V2 at time t2. The estimated wound volume V2 at time t2 can be multiplied by the fluid instillation factor F to calculate the volume of instillation fluid 105 V1 to deliver to wound 114 at time t2 (i.e., V2*F=V1).
Controller 118 can then operate a pump to deliver the calculated volume of instillation fluid 105 to wound 114 (step 1104). Step 1104 can include operating instillation pump 122 to draw instillation fluid 105 from instillation fluid canister 104 and deliver instillation fluid 105 to wound 114 via tubing 109 and 108. In some embodiments, the calculated volume of instillation fluid 105 is also used to control the operation of pneumatic pump 120. For example, controller 118 can operate pneumatic pump 120 to remove the volume of instillation fluid 105 from wound 114 via tubing 110. The amount of time that pneumatic pump 120 operates may be a function of the volume of instillation fluid 105 that was delivered to wound 114.
Referring now to
Process 1200 includes providing a negative pressure circuit (NPC) with a known volume Vsystem for a known wound volume Vwound (step 1202), according to some embodiments. In some embodiments, providing the NPC circuit for the known wound includes setting up a NPC circuit by providing wound dressing 112 to patient's skin 116 over wound 114. In some embodiments, Vwound is a known volume of wound 114. For example, step 1202 may include configuring NPWT system 100 (e.g., having a known Vsystem) to perform NPWT for a test wound (e.g., wound 114 with a known volume Vwound). In some embodiments, step 1202 includes setting up NPWT system 100 and starting therapy device 102.
Process 1200 includes operating a pump to draw down negative pressure at wound 114 to achieve p1 at the known wound volume Vwound (step 1204), according to some embodiments. in some embodiments, step 1204 is first drawdown period 604. In some embodiments, the pump is pneumatic pump 120. In some embodiments, step 1204 includes any of the functionality, techniques, steps, etc., of first drawdown period 604. In some embodiments, step 1204 is performed by testing procedure controller 148. In some embodiments, p1 is 200 mmHg. In some embodiments, step 1204 is performed by testing procedure controller 148 and pump controller 146. Pneumatic pump 120 is configured to produce a negative pressure at wound 114, according to some embodiments. In some embodiments, step 1204 includes testing procedure controller 148 monitoring pressure measurements at wound 114 via pressure sensors 130, 113, and continuing to cause pneumatic pump 120 to drawdown the negative pressure until the measured/monitored pressure is substantially equal to p1. In some embodiments, step 1204 is also performed by valve controller. In some embodiments, step 1204 includes valve controller 150 sending a control signal to valve 132 to transition valve 132 into a closed configuration such pneumatic pump 120 can drawdown a negative pressure at wound 114.
Process 1200 includes recording pressure values of the known volume Vwound for a predetermined time period Δtleak (step 1206), according to some embodiments. In some embodiments, step 1206 is leak rate determination period 606. In some embodiments, controller 118 is configured to perform step 1206. In some embodiments, step 1206 is performed by testing procedure controller 148. For example, testing procedure controller 148 can be configured to receive pressure measurements from pressure sensors 130/113 over time period Δtleak (e.g., t2−t1 as shown in
Process 1200 includes venting wound 114 to atmospheric pressure (step 1208), according to some embodiments. In some embodiments, step 1208 is performed after step 1210. In some embodiments, step 1208 and step 1210 are performed simultaneously. In some embodiments, step 1208 is performed by testing procedure controller 148 and valve controller 150. For example, step 1208 may include testing procedure controller 148 sending a command to valve controller 150 to transition valve 132 into the open configuration such that wound 114 can return to atmospheric pressure. In some embodiments, step 1208 is performed by testing procedure controller, valve controller 150, and valve 132. In some embodiments, step 1208 is vent period 608.
Process 1200 includes determining the leak rate parameter αleak for Vwound based on the pressure values of wound 114 recorded during step 1206 (step 1210), according to some embodiments. In some embodiments, step 1210 is performed by testing procedure controller 148. In some embodiments, αleak is a difference between an initial pressure value and a final pressure value of time interval Δtleak. In some embodiments, αleak is slope 612. In some embodiments,
Process 1200 includes repeating steps 1202-1210 (step 1212), according to some embodiments. In some embodiments, controller 118 and/or NPWT system 100 repeat steps 1202-1210 X number of times to determine an average value of αleak to minimize random error. In some embodiments, step 1212 is optional.
Process 1200 includes operating the pump (e.g., pneumatic pump 120) to draw down negative pressure at wound 114 to achieve p1 (step 1214), according to some embodiments. In some embodiments, step 1214 is second drawdown period 610. In some embodiments, step 1214 is performed by testing procedure controller 148, pump controller 146, and pneumatic pump 120. In some embodiments, the pressure is drawn down to pressure p1. In some embodiments, the pressure is drawn down to a pressure greater than or less than pressure p1.
Process 1200 includes recording a time duration Δtdrawdown to achieve p1 for wound 114 as αttime (step 1216), according to some embodiments. In some embodiments, time duration Δtdrawdown is time interval 614. In some embodiments, αtime is the amount of time that pneumatic pump 120 must operate to achieve pressure p1. In some embodiments, step 1216 is performed by testing procedure controller 148.
Process 1200 includes repeating steps 1214-1216 Y number of times to determine an average value of αtime (step 1218), according to some embodiments. In some embodiments, steps 1214-1216 are repeated in order to reduce an amount of random error in αtime. In some embodiments, step 1218 is optional.
Process 1200 includes recording the leak rate parameter αleak and the drawdown time parameter αtime associated with the value of Vwound in a dataset (step 1220), according to some embodiments. In some embodiments, step 1220 is performed by testing procedure controller 148. In some embodiments, step 1220 includes generating a matrix N=[αtime αleak Vwound] and providing matrix N to model generator 154. In some embodiments, the matrix N is stored, and additional performances of steps 1202-1220 define additional rows for the matrix N.
Process 1200 includes repeating steps 1202-1220 for various values of Vwound, αleak, and αtime (step 1222), according to some embodiments. In some embodiments, each additional iteration of steps 1202-1220 results in an additional row of the matrix N. In some embodiments, steps 1202-1220 are performed until a sufficient amount of test data is recorded in matrix N. In some embodiments, steps 1202-1220 are performed for various values of Vwound which are typical, and for various leakages αleak that may be encountered during implementation of NPWT.
Process 1200 includes generating a model (e.g., fwound) relating Vwound to αleak and αtime for a current value of Vsystem (step 1224) based on the recorded datasets (e.g., matrix N), according to some embodiments. In some embodiments, step 1224 is performed by model generator 154. In some embodiments, step 1224 includes providing the recorded datasets (e.g., matrix N) to model generator 154. In some embodiments, the generated model is matrix A, table 900, fwound, etc. In some embodiments, step 1224 includes performing any of a regression, a curve fitting technique, a machine learning algorithm, etc., to determine fwound. In some embodiments, step 1224 includes arranging, sorting, etc., matrix N to generate matrix A or table 900. In some embodiments, a model is generated for each of multiple values of Vsystem. In some embodiments, step 1224 includes providing the generated model to wound volume estimator 156.
Process 1200 includes repeating steps 1202-1224 for various values of Vsystem (step 1226) to determine models that relate αleak and αtime to Vwound for each of the various values of Vsystem, according to some embodiments. In some embodiments, step 1226 includes performing steps 1204-1224 for various NPWT systems. In some embodiments, step 1226 is performed by controller 118 and a test technician (e.g., step 1202 may include replacing a current NPWT system with a different system having a different Vsystem).
Referring now to
Process 1300 includes performing steps 1202-1210 of process 1200 to determine the leak rate parameter αleak for an unknown value of Vwound (step 1302), according to some embodiments. In some embodiments, step 1302 is performed by controller 118.
Process 1300 includes performing steps 1214-1216 to determine the drawdown time parameter αtime (step 1304) for the unknown value of Vwound (step 1304), according to some embodiments. In some embodiments, step 1304 is performed by controller 118.
Process 1300 includes inputting αleak and αtime to the model generated by model generator 154 in process 1200 (step 1306), according to some embodiments. In some embodiments, step 1306 includes inputting αleak and αtime into fwound for a present NPWT system having Vsystem to determine Vwound. In some embodiments, step 1306 is performed by wound volume estimator 156. In some embodiments, step 1306 includes looking up a value of Vwound in table 900 and/or matrix A based on αleak and αtime. In some embodiments, step 1306 includes interpolating or extrapolating to determine the value of Vwound if αleak does not match any of the values of side header 904 and/or vector B, or if αtime does not match any of the values of top header 902 and/or vector C.
Process 1300 includes determining an instillation fluid volume based on the determine Vwound of step 1306 (step 1308), according to some embodiments. In some embodiments, step 1308 is performed by controller 118. In some embodiments, step 1308 is step 1101 of process 1100.
Referring now to
Process 1400 initiates with startup of therapy device 102 (step 1402), according to some embodiments. In some embodiments, after therapy device 102 has started, process 1200 proceeds to step 1404. At step 1404, controller 118 can receive a command from a user to transition therapy device 102 into fill assist mode, manual volume move, or automatic volume determination mode. In some embodiments, the command is received via user interface 126. If the user sends a command to transition therapy device 102 into the fill assist mode, therapy device 102 transitions into the fill assist mode, and process 1400 proceeds to step 1420, according to some embodiments. If the user sends a command to transition therapy device 102 into the manual volume entry mode, process 1400 proceeds to step 1426, according to some embodiments. If the user sends a command to transition therapy device 102 into an automatic volume detection mode, process 1400 proceeds to step 1406, according to some embodiments.
Process 1400 includes performing the testing procedure to determine the leak rate parameter αleak and the drawdown time parameter αtime (step 1406), according to some embodiments. In some embodiments, the testing procedure is the testing procedure described in greater detail above with reference to
Process 1400 includes estimating Vwound based on the leak rate parameter αleak and the drawdown time parameter αtime (step 1408), according to some embodiments. In some embodiments, step 1408 is performed by wound volume estimator 156 using the model generated by model generator 154. In some embodiments, the model fwound, or table 900, or matrix A (and vectors B and C) are preloaded into memory 144 of controller 118 for a variety of values of Vsystem. In some embodiments, step 1408 is step 1306 of process 1300. In some embodiments, step 1408 includes inputting the leak rate parameter αleak and the drawdown time parameter αtime into the model (as generated by model generator 154, described in greater detail above) to determine Vwound.
Process 1400 includes displaying the value of Vwound determined in step 1408 via user interface 126 (step 1410), according to some embodiments. In some embodiments, the value of Vwound is displayed via user interface 126 in response to completing step 1408. In some embodiments, the value of Vwound is displayed via user interface 126 in addition to a confirmation from the user to accept or reject the value of Vwound.
Process 1400 includes determining (e.g., receiving an input) whether the user has accepted the value of Vwound as determined in step 1408 (step 1412), according to some embodiments. In some embodiments, a request is displayed via user interface 126 requesting confirmation of the value of Vwound. In some embodiments, controller 118 receives a command from a user (e.g., a yes or a no command) indicating whether the user has accepted the value of Vwound. If controller 118 receives a command from the user indicating that the user has accepted the value of Vwound (YES), process 1400 proceeds to step 1414, according to some embodiments. If controller 118 receives a command from the user indicating that the user has rejected the value of Vwound (NO), process 1400 proceeds to step 1416.
Process 1400 includes setting the value of Vwound equal to the instillation volume (step 1414), according to some embodiments. In some embodiments, step 1414 is performed by controller 118. In some embodiments, step 1414 includes determining the instillation volume (e.g., a volume of instillation fluid 105 to be provided to wound 114) based on the value of Vwound. In some embodiments, step 1414 includes performing process 1100. In some embodiments, process 1400 ends (step 1428) in response to completing step 1414.
If controller 118 receives a command via user interface 126 that the user has rejected the value of Vwound (NO, step 1412), process 1400 proceeds to step 1416, according to some embodiments. In some embodiments, step 1416 includes requesting an input from the user via user interface 126 whether the automatic volume estimation (i.e., steps 1406-1410) should be performed again. In some embodiments, if controller 118 receives a command from the user via user interface 126 to re-perform the automatic volume estimation, process 1400 returns to step 1406. If controller 118 receives a command from the user via user interface 126 that indicates the automatic volume estimation should not be performed again, process 1400 proceeds to step 1418, according to some embodiments.
Process 1400 includes requesting an input from a user whether or not to transition into the fill assist mode (step 1418), according to some embodiments. In some embodiments, step 1418 includes providing a request to the user via user interface 126. In some embodiments, if controller 118 receives a command from the user via user interface 126 to perform the fill assist (YES, step 1418), process 1400 proceeds to step 1420. In some embodiments, if controller 118 receives a command from the user via user interface 126 that a fill assist operation should not be performed (NO, step 1418), process 1400 proceeds to step 1424.
Process 1400 includes performing a fill assist operation (step 1420), according to some embodiments. In some embodiments, the fill assist operation is performed by controller 118 and instillation pump 122. In some embodiments, the fill assist operation includes allowing a user to manually indicate an amount of instillation fluid 105 that should be provided to wound 114 by manually operating instillation pump 122. Controller 118 can be configured to measure a quantity of instillation fluid 105 added to wound 114 by instillation pump 122 during the fill assist operation (as controlled by the user), and can determine Vwound based on the quantity of instillation fluid added to wound 114 during the fill assist operation (step 1422). In some embodiments, in response to completing the fill assist operation, process 1400 proceeds to step 1428.
If controller 118 receives a command via user interface 126 that the fill assist operation should not be performed (step 1418, NO), process 1400 proceeds to step 1424, according to some embodiments. At step 1424, controller 118 receives a manual volume entry via user interface 126, according to some embodiments. In some embodiments, in response to receiving the manual volume entry via user interface 126, process 1400 proceeds to step 1426. At step 1426, controller 118 sets the manually entered volume (e.g., manually entered Vwound) as the instillation fluid volume. In some embodiments, after the manually entered volume has been set as the instillation fluid volume, process 1400 proceeds to step 1428.
The construction and arrangement of the systems and methods as shown in the various exemplary embodiments are illustrative only. Although only a few embodiments have been described in detail in this disclosure, many modifications are possible (e.g., variations in sizes, dimensions, structures, shapes and proportions of the various elements, values of parameters, mounting arrangements, use of materials, colors, orientations, etc.). For example, the position of elements can be reversed or otherwise varied and the nature or number of discrete elements or positions can be altered or varied. Accordingly, all such modifications are intended to be included within the scope of the present disclosure. The order or sequence of any process or method steps can be varied or re-sequenced according to alternative embodiments. Other substitutions, modifications, changes, and omissions can be made in the design, operating conditions and arrangement of the exemplary embodiments without departing from the scope of the present disclosure.
The present disclosure contemplates methods, systems and program products on any machine-readable media for accomplishing various operations. The embodiments of the present disclosure can be implemented using existing computer processors, or by a special purpose computer processor for an appropriate system, incorporated for this or another purpose, or by a hardwired system. Embodiments within the scope of the present disclosure include program products comprising machine-readable media for carrying or having machine-executable instructions or data structures stored thereon. Such machine-readable media can be any available media that can be accessed by a general purpose or special purpose computer or other machine with a processor. By way of example, such machine-readable media can comprise RAM, ROM, EPROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to carry or store desired program code in the form of machine-executable instructions or data structures and which can be accessed by a general purpose or special purpose computer or other machine with a processor. Combinations of the above are also included within the scope of machine-readable media. Machine-executable instructions include, for example, instructions and data which cause a general purpose computer, special purpose computer, or special purpose processing machines to perform a certain function or group of functions.
Although the figures show a specific order of method steps, the order of the steps may differ from what is depicted. Also two or more steps can be performed concurrently or with partial concurrence. Such variation will depend on the software and hardware systems chosen and on designer choice. All such variations are within the scope of the disclosure. Likewise, software implementations could be accomplished with standard programming techniques with rule based logic and other logic to accomplish the various connection steps, processing steps, comparison steps and decision steps.
