WO2008003111A1

WO2008003111A1 - Device for sealing openings

Info

Publication number: WO2008003111A1
Application number: PCT/AT2007/000331
Authority: WO
Inventors: Thomas Wild; Ewald Unger
Original assignee: Medizinische Universität Wien
Priority date: 2006-07-04
Filing date: 2007-07-03
Publication date: 2008-01-10
Also published as: AT503904A1; AT503904B1

Abstract

A device to seal openings in an intestinal wall towards the abdominal cavity and to delimit septic areas has a tube-shaped element (2), the rim of which is intended to encompass the opening in the intestinal wall and which has suction openings (6) which can be connected to a suction connection(4) or to a low pressure source.

Description

Device for sealing openings

The invention relates to a device for sealing openings of a wall of the intestine against the abdominal cavity and for separating septic areas.

Methods for promoting wound healing have already become known, which are referred to as vacuum therapy and use a vacuum-assisted wound closure or a vacuum seal as a non-invasive active therapy for promoting wound healing. Such methods rely on the exercise of a defined controlled vacuum on the wound surface. Such a method is primarily intended to have a positive effect on local perfusion and granulation tissue proliferation in the wound. At the same time extravascular interstitial fluid can be aspirated with such a method.

In the treatment of abscesses or fistulas in the intestinal area, an infection usually leads to the formation of the abscess. The spread of purulent inflammation is usually in the direction of the outer skin, occasionally a spontaneous breakthrough is observed, with a fistula developing at this site. Although spontaneous healing of such fistulas is theoretically possible, experience has shown that this is a recurrent event with variable incidence of abscesses and fistulization. Inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, can be the cause of such fistulas. Breakthroughs in the intestinal wall usually cause secretions from the fistula can penetrate into the abdomen and leads to sepsis here. A cure or therapeutic treatment of such large areas is naturally very complicated and difficult. The invention now aims to provide a device of the type mentioned above, with which the healing can be generally accelerated and at the same time the possibility is created in the case of breakthroughs, which were triggered for example by intestinal obstructions, to create an artificial exit at which septic and aseptic areas can be clearly separated.

For the treatment of such openings or wounds, the device according to the invention consists in a particularly advantageous manner in that a tubular element is provided, which has for the encompassing of the opening of the intestinal wall certain elastic edge suction openings and with a suction port or a vacuum source is connectable. The fact that a tubular element is provided, the possibility is provided to attach a kind of chimney over the wound, wherein the fact that the edge of this tubular member has suction openings and is connectable to a suction or a vacuum source, the possibility is created, the Edge of this tubular element sealingly applied to the edge of the opening, so that a separation of septic and aseptic areas succeed. At the same time, the opening formed in this way allows the immediate action on the septic and usually infectious wound, at the same time an artificial exit can be created. The separation of the abdominal space from the septic area formed by the sucked-in rim of the tubular element allows the secretion exiting the fistula to be adequately suctioned, whereby the external wound area itself can be subjected to therapeutic treatment independently of the treatment of the wound itself.

Advantageously, to form an improved seal and differentiation of the septic areas of aseptic areas, the design is such that the tubular element is designed as a bellows, wherein to maintain a tight connection of the front side of the tubular element with advantage the formation is made such that the bellows in the axial direction of the bellows extending channels or at least one chamber which is connected to the suction ports and to the suction port (are).

In order to supply the outer wound area in a suitable manner, the embodiment is developed in a particularly advantageous manner such that the outer wall of the tubular element is surrounded by a sponge-like or foamed jacket whose pores are in communication with a further suction connection. Such a wound foam, which is designed, for example, as a collagen wound dressing, makes it possible to further improve the seal and to reliably prevent secretions from entering the abdomen from the fistula. Due to the fact that a further suction connection is arranged here, vacuum can also be applied to the wound foam and in this way, if necessary, secretions are sucked off, such a foam can be used to simultaneously introduce healing-promoting active ingredients for the abdomen. A particularly good distribution of the vacuum on the wound foam can be achieved in that the further suction connection for the sponge-like or foamed sheath is designed as a concentric, unrestricted ring distributor as the tubular element.

A particularly simple application of the required vacuum and, if necessary, the respectively required pressure can be achieved by arranging the suction connections on or near the end face of the tubular element facing away from the suction openings outside a cover foil extending essentially radially. The substantially radially extending rectangular cover film can be attached, for example, to the abdominal wall and held by applying the adjustable negative pressure in the particular desired position. The entire device is sensibly designed as a disposable device to eliminate the risk of microbial contamination. If necessary, it should also be changed during the therapy, in which case the wound foam should be exchangeable according to the wound care and wound size.

In order to adjust the respectively suitable pressures in the respectively separate regions, namely the abdominal cavity or the region of the foam and the end face of the tubular element to be suctioned against the intestinal wall, the design is advantageously developed such that the two suction connections can be adjusted separately or in combination with adjustable pressure control devices , in particular pressure reducer, are connectable to a Hauptsauganschluss, wherein preferably the Hauptsauganschluss via a water trap or a siphon with the suction ports of the device are connectable. Such a siphon protects the pressure distributor or the corresponding pressure control devices against contamination, wherein the negative pressure for the suction on the intestinal wall, for example, can be applied slightly higher than the negative pressure in the abdominal area. The underpressure in the abdominal cavity is usually maintained at about 125 mm Hg, whereby not only is a particularly secure closure between the septic area and the pressure selected for the end wall suction openings smaller than the pressure applied to the spongy or foamed mantle Abdominal cavity is achieved.

Compared with the previously known vacuum therapy, in which the negative pressure was exerted only on the wound itself, it is possible with the device according to the invention to develop forms of therapy in which the actual wound area or the opening to be treated is available as an artificial intestinal outlet and the surrounding areas can be treated effectively separated from the septic wound therapy of the wound site (fistula), whereupon, after appropriate limitation of the subsequently to be treated in the body Intestinal wall the definitive healing can be started with simultaneous use of the natural source.

The invention will be explained in more detail with reference to an embodiment of the device according to the invention schematically illustrated in the drawing. In this Fig.l show a cross section through the device according to the invention and Figure 2 is a perspective view of the device according to Fig.l from above the side.

FIG. 1 shows the device 1 according to the invention, which has a tubular element 2. The tubular element 2 is designed as a bellows and has a cavity 3, which is connected to a suction port 4. The lower end face 5 of the tubular element 2 in this case has suction openings 6 on the circumference, which can be sucked to the edge of an opening of a bowel wall.

Concentric with the tubular element 2, a sponge-like or foamed material is provided as a jacket 12. This wound foam 12 is connected to a further suction connection 7. On the side facing away from the end face 5 of the tubular element, a cover 8 is provided.

By means of the suction connections 4 and 7, a negative pressure can now be intentionally applied, whereby a sealing pressing of the tubular element onto a wall of the intestine succeeds on one side via the suction openings 6, at the same time forming a chimney-like channel 9 which provides an artificial outlet for the intestine formed. With 10 in this case a closure lid is referred to, which covers the septic area.

The suction connection 7 opens into a vacuum distributor 11, via which the negative pressure is evenly distributed in the wound foam 12. After removal of the lid 10, access to the septic area is made possible, whereas in the radial direction outside of the enveloping circle of the suction holes 6 an aseptic area is formed, whereby via the wound foam 12 corresponding active substances can be introduced for faster healing of this area.

2, the wound foam 12, the lower end wall 5, the cover 10 and the two suction ports 4 and 7 can be seen, wherein the cover film is again denoted by 8 and may have a substantially rectangular outline. The shape of the cover and in particular the size thereof is chosen as a function of the respective location at which the device is to be used. Underneath the end wall 5 of the tubular element is the intestine with the intestinal fistula, whereby a corresponding delimitation of the septic area from the aseptic area is achieved by the edge of the end face 5.

Claims

Claims:

1. A device for sealing openings of a wall of the intestine against the abdominal cavity and for the separation of septic areas, characterized in that a tubular element (2) is provided, which has for embracing the opening of the intestinal wall certain edge suction openings (6) and with a suction port ( 4) or a vacuum source is connectable.

2. Device according to claim 1, characterized in that the tubular element (2) is designed as a bellows.

3. Device according to claim 1 or 2, characterized in that the bellows in the axial direction of the bellows extending channels or at least one chamber (9) which is connected to the suction ports (6) and to the suction port (4) are (are).

4. Device according to claim 1, 2 or 3, characterized in that the outer wall of the tubular element (2) is surrounded by a spongy or foamed jacket (12) whose pores are in communication with a further suction port (7).

5. Device according to one of claims 1 to 4, characterized in that the suction ports (4,7) at or near the suction openings (6) facing away from the end face (5) of the tubular element (2) outside of a substantially radially extending cover (8) are arranged.

6. Device according to one of claims 1 to 5, characterized in that the further suction connection (7) for the sponge-like or foamed jacket (12) as the tubular element (2) is formed concentrically unripe ring distributor.

7. Device according to one of claims 1 to 6, characterized in that the two suction ports (4,7) via separately or coupled adjustable pressure control devices, in particular pressure reducer, are connectable to a Hauptsauganschluss.

8. Device according to one of claims 1 to 7, characterized in that the Hauptsauganschluss via a water trap or a siphon with the suction ports (4,7) of the device are connectable.

9. Device according to one of claims 1 to 8, characterized in that the pressure for the end wall-side suction openings (6) is selected to be less than the pressure applied to the spongy or foamed jacket (12).