Not applicable.
The invention relates generally to the field of wound treatment, and more particularly, to a device for treating wounds with negative pressure and/or therapeutic agents.
Many wounds can be treated by the application of negative pressure. The method of such treatment has been practiced for many years. The benefits of such treatment can include: reduction of edema; reduction of wound exudate; reduction of wound size; and stimulation of formation of granulation tissue. Existing devices and appliances for the provision of negative pressure wound therapy are complex. Such devices typically encompass a porous insert such as foam or gauze that is placed into the wound; a tube connecting the insert to a source of suction; a flexible cover draped over these components and sealed to the skin around the wound; an electrically powered suction pump; controls to operate the pump and monitor the system; containers to collect wound fluids; filters to process the materials removed from the wound; and safety systems to prevent harm to the patient and to block the escape of biological materials into the outside environment. These devices are expensive, labor intensive, and restrictive of patient mobility. The many components, particularly the seals around the insert and the tube, tend to leak. Therefore, suction must be applied either continuously or frequently.
Continuous suction is typically achieved by a vacuum pump powered by an electric motor. Such systems require complex means to measure, monitor, and control the operation of the pump to ensure the safety of the patient. In addition, many negative pressure devices are contraindicated in the presence of necrotic tissue, invasive infection, active bleeding, and exposed blood vessels. They require the use of a porous insert (sponge, foam, gauze, mesh, etc.) in the wound. The insert may present two problems: growth of tissue into the insert, and the harboring of infectious and/or undesirable materials in the insert. Wound tissue can grow into and around such inserts, thereby causing adverse results to the healing process. Moreover, such inserts can retain wound fluid and microorganisms, and therefore can become contaminated and/or infected, presenting an adverse effect to the healing process. In addition, the high cost of these devices may deter or delay their use on patients.
Existing negative pressure treatment devices are labor intensive since they require the user to assemble, fit, and customize a number of components. First, the user must prepare, trim, and size an insert of foam, gauze, mesh, or other material that will be placed in the wound. Next, the user must position a tube in the insert, and then cover the tube and insert with a material that is intended to create a leakproof seal. In practice, and as mentioned above, such compositions tend to leak, requiring the frequent application of suction in order to establish and re-establish negative pressure within the space about the wound. In addition, currently available negative pressure devices and systems block the view of the wound, making monitoring and diagnosis more difficult. Therefore, an improved device for applying negative pressure to wounds is needed.
In one aspect, the present invention is summarized as a device for wound treatment, comprising a chamber that includes an inner surface and defines a treatment space, the chamber being made of a flexible, impermeable material. The device further includes a plurality of structures configured to exert mechanical stress on a wound and configured to create pathways through which negative pressure can be distributed and maintained in the treatment space, the plurality of structures intruding from the inner surface of the chamber into the treatment space. The device further includes a tube having a first end connected to the chamber, the tube being in fluid communication with the treatment space so as to enable at least one selected from the group of applying negative pressure to the treatment space and applying a therapeutic agent.
In some embodiments, the plurality of structures and the chamber are part of a single ply of material. In addition, in some embodiments, each of the structures in the plurality of structures is semi-rigid.
In some embodiments, the device includes a wedge-shaped manual pump, and the treatment space is in fluid communication with the wedge-shaped manual pump. The wedge-shaped manual pump may include a spring that biases the wedge-shaped manual pump to an uncompressed position.
The foregoing and other objects and advantages of the invention will appear in the detailed description that follows. In the description, reference is made to the accompanying drawings that illustrate a preferred embodiment of the invention.
The invention may be understood by reference to the following description taken in conjunction with the accompanying figures, in which like reference numerals identify like elements. It should be understood that figures represent an example of the present invention and components are not necessarily shown to be proportional to one another. The terms “chamber wall” or “wall” mean any part of the chamber device that forms or encloses the chamber treatment space. The term “overview” means a view from the inside of the chamber treatment space looking toward the interior surface of the chamber wall.
a is a side sectional view of the raised ridges of
b is a side sectional view of the raised ridges of
a is a side sectional view of the fold in the chamber wall of
While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown by way of example in the drawings and are described below in detail. It should be understood, however, that the description of specific embodiments is not intended to limit the invention to the particular forms disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the appended claims.
While the present invention may be embodied in any of several different forms, the present invention is described here with the understanding that the present disclosure is to be considered as setting forth an exemplification of the present invention that is not intended to limit the invention to the specific embodiment(s) illustrated.
The present invention is directed to providing a simple, safe, disposable, and cost-effective device that is easy to install and operate, that allows freedom of motion to the patient, and that overcomes, or at least reduces the effects of, one or more of the problems set forth above. The present invention does not require the use of a porous insert. The one-piece construction of the device eliminates virtually all leaks, therefore preserving and maintaining negative pressure within the wound without the need for constant or frequent regeneration of negative pressure. In addition, the structure of the device is configured to promote wound healing and to create pathways through which negative pressure can be distributed and maintained in the treatment space. The indications for the present invention may be expanded beyond the limitations imposed on current devices. The cost-effectiveness of the present invention may lead to the provision of negative pressure wound therapy on a more widespread basis and earlier in the timeline of wound care.
One aspect of the present invention is seen in a wound treatment device including a chamber defining a treatment space around the wound. The flexible adhesive base of the chamber forms a water-tight and gas-tight seal. A tube communicates from the treatment space to a source of suction. The suction source also serves as a receptacle for materials removed from the chamber. All components preferably are inexpensive, lightweight, and disposable.
Referring first to
A tube 32 is attached to the chamber 22 preferably at a location spaced above the base 26 and communicates with the treatment space 24. The tube 32 is constructed to maintain its shape without collapsing and to permit the passage of wound fluids and wound debris. The tube 32 may be permanently fixed to the chamber 22, or a fitting 25 may be provided to allow the attachment and removal of the tube 32 or any other device that can deliver material or therapies to, or remove material from, the treatment space 24. The tube 32 may terminate at a wall of the chamber 22, or it may extend through the wall a distance and terminate within the treatment space 24, where it may communicate with such space, with channels formed on the inner surface of the chamber wall, or with folds formed in the chamber wall. The tube 32 is sealed to the chamber 22 in such a manner as to prevent the escape of liquid or gas from the treatment space 24 to the outside environment. A distal end of the tube 32 terminates at a suction device 34. The suction device 34 may be a pump, although other types of devices may be used as discussed below. A fitting 33 may be provided to permit the detachment and reattachment of a suction device 34 to the tube 32.
Turning to
Turning now to
Referring to
The engineered structures 40 interface with the wound surface during use of the device 20. One purpose of these structures is to ensure that negative pressure established within the chamber space 24 is evenly distributed and maintained throughout such space. As negative pressure is established within the tube that leads to the source of suction, the chamber will lie tighter against the wound tissue. The device 20 includes the engineered surfaces 40 in order to define pathways to establish, distribute, and maintain negative pressure across the wound surface and prevent complete contact between the inner surfaces of the chamber and the wound tissue. Without such structures, the chamber wall would make complete contact with the wound surface. As a result, there would be no space within which negative pressure could be established, distributed, and maintained. Therefore, the engineered structures are preferably semi-rigid. The term “semi-rigid” should be understood as meaning that deformation only occurs at a microscopic level under operating negative pressures in the range of 0.5-2 psi. Alternatively, the engineered structures may be somewhat flexible depending on the spacing between the structures. In addition, the structures are engineered to reduce the extent to which wound tissue can enter the space between the structures, so that a sufficient amount of open space is maintained.
An additional purpose of these structures is to serve as a form of stimulation to the wound to produce beneficial results, including without limitation the formation of granulation tissue and an increase of micromechanical forces. Such mechanical forces provide stimulation to a portion of the wound tissue, which has been suggested as a contributing factor to the effectiveness of negative pressure wound therapy. From the above discussion and the figures, it should be understood that the flexible chamber is movable over a range of positions. The range of positions includes a first position, such as the position shown in
The chamber wall can be formed of any appropriate medical grade material that has the following characteristics: flexibility, conformability, gas impermeability, liquid impermeability, the ability to be formed, tooled, and engineered, and the ability to retain the shape, function, and effectiveness of raised structures under desired ranges of negative pressure. In addition, the material is preferably hypo-allergenic and provided to a medical facility in a sterile condition. For example, the chamber device may be made of a flexible, conformable material such as polyurethane, although other similar materials may also be used. The chamber is preferably designed to provide sufficient material to lie against the surface of the wound tissue without special sizing, trimming, or other customizing operations. The chamber may be made from a single ply of material, or may be constructed of multiple layers of material in and on which the structures are engineered. It should be understood that a single ply chamber may be made of multiple sheets of material during manufacturing, but is provided to a medical facility in a state in which the multiple sheets are bonded or otherwise connected to one another. For example, individual three dimensional shapes may be adhered or bonded to the inner surface of the chamber wall during manufacturing to provide the engineered structures. A single ply chamber could also be formed from a single sheet of material that defines both the chamber walls and the engineered structures. Alternatively, a multiple layer chamber is provided to a medical facility in a state in which layers of material are stacked to form the chamber. For example, the layer facing the interior treatment space of the chamber could be a layer containing engineered structures that is bonded onto a generally flat layer of material (or multiple sheets of generally flat layers) by a medical practitioner.
The engineered structures can be made by techniques familiar to those in the art, such as embossing, stamping, molding, forming, or bonding. If the structures are created by embossing their shape into the material, the embossed structures may be left in a concave state relative to the outside of the chamber as shown in
The raised structures on the inner surfaces of the chamber wall can be configured and distributed in a number of patterns. For example,
The distribution and maintenance of negative pressure within the chamber device and at all points on the wound may be enhanced by providing defined channel spaces as pathways among the raised engineered structures for the distribution of negative pressure. However, defined channel spaces are not required for providing fluid pathways within the treatment space.
The distribution and maintenance of negative pressure with the chamber device and at all points on the wound can also be enhanced by the use of folds in the chamber wall to create additional channel space for the distribution of negative pressure. When negative pressure is established within the chamber, the material will tend to fold along the pre-formed location.
As shown in
Suction for the wound treatment device is provided by a suction device 34, which may be a pump that is connected and disconnected to the chamber device by appropriate connectors. Although the wound chamber can be used with a motor driven pump, it is also effective with a hand-powered device actuated by the caregiver or patient. The hand-powered device may be a squeeze bulb that provides suction by means of the energy stored in the material of its construction. Alternatively, the suction device may be powered by springs that are compressed by the user. The springs can be selected to produce the clinically desired level of negative pressure. The amount of suction provided by these suction devices is therefore dependent on the level of force generated by squeezed material or the springs. Unlike a motor driven suction pump, the hand powered device preferably cannot produce a high level of suction that may cause an adverse effect to wound healing.
Referring to
For the previous suction devices, once suction has been established, fluid may flow from the wound to the suction device, where it may be collected and stored for eventual disposal. Alternatively, a separate fluid collector, such as the fluid collector 60 in
The present invention can be engineered to operate at various levels of negative pressure, in accordance with clinical procedures. Historically, the commonly accepted range of negative pressure is between 0.5 and 2 psi. The device of the present invention operates efficiently in this range. The chamber material conforms to the shape of the wound, and the embossed projections maintain their shape and functionality. However, the chamber can be engineered to operate at higher levels of negative pressure. In addition, if a hand-powered suction device is used, the operating pressure of the device may be higher than the commonly accepted range; that is, the device may operate at a pressure close to 0 psi before suction ceases.
The effectiveness of the raised structures in distributing and maintaining negative pressure within the chamber and across the wound surface has been demonstrated in a test model. A wound was created in a sample of animal cadaver tissue. A pressure sensor was installed in the tissue at the center of the wound. A wound chamber device with raised engineered structures on the interior chamber wall was sealed to the skin around the wound. A tube from the chamber device was connected to a source of suction capable of delivering a range of negative pressure. The amount of negative pressure measured at the suction source was compared to the measurement at the center of the wound, in order to determine the effectiveness of the device with respect to the distribution of negative pressure to the wound. The following values were obtained:
The raised structures were observed to maintain their shape with no deformation, thereby preserving their functionality.
The operation of the invention may be illustrated by the following case. A patient with a full-thickness skin wound was treated with a wound chamber negative pressure device connected to a hand-powered suction pump. The interior surface of the chamber contained embossed raised structures. The area around the wound was treated with normal skin disinfectants. The backing from the adhesive base of the chamber was removed, and the chamber was sealed to the normal skin around the wound. The tube was connected to a modified squeeze bulb with an inlet port for fluid, and an exhaust port through which air can be expelled from the bulb. By squeezing the bulb down to its flattest configuration, a negative pressure of 2 pounds per square inch was established and maintained within the chamber. After the first twenty-four hours of treatment, the squeeze bulb had expanded to approximately half of its normal size. The bulb was compressed again to its fully flattened configuration. The bulb remained in such configuration for an additional twelve hours, at which point the chamber was removed. The wound showed healthy granulation tissue and progressed to heal rapidly and with minimal scarring. The device produced no adverse effects on the wound or the surrounding skin.
The present invention eliminates many of the drawbacks to existing negative pressure wound therapy systems. For example, the device of the present invention is preferably simplified and lightweight. In some embodiments of the invention, the patient is not restricted to a source of electricity or a battery pack. The system can be worn with ease, so that the patient's mobility is not otherwise compromised. In addition, the wound interface appliance can be applied quickly without the need for custom fitting and construction. The device preferably does not leak due to the smooth adhesive base, eliminating the need for constant suction from an electric pump with sophisticated controls and safety measure. There is no porous wound insert that can potentially cause tissue in-growth and harbor infectious material. Instead, the inner surfaces of the chamber are generally non-porous and non-adherent to prevent any interaction with the wound tissue. Further still, the suction pump preferably has built-in safety limitations on force of suction, duration of operation, and overfilling of the collector for wound fluid.
The particular embodiments disclosed above are illustrative only, as the invention may be modified and practiced in different but equivalent manners apparent to those skilled in the art having the benefit of the teachings herein. Furthermore, no limitations are intended to the details of construction or design herein shown, other than as described in the claims below. It is therefore evident that the particular embodiments disclosed above may be altered or modified and all such variations are considered within the scope and spirit of the invention. Accordingly, the protection sought herein is as set forth in the claims below.
This application is a continuation of U.S. patent application Ser. No. 12/601,394 filed on Nov. 23, 2009, which is a 371 of PCT International Application No. PCT/US2008/064897 filed May 27, 2008, which claims the benefit of U.S. Provisional Patent Application 60/931,559 filed May 24, 2007, each of which is incorporated herein by reference.
Number | Date | Country | |
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Parent | 12601394 | Sep 2010 | US |
Child | 14092004 | US |