BR112019007777B1 - COMBINATION OF MEDICAL ARTICLE TO COVER WOUND AND/OR SCAR - Google Patents

Abstract

These are force-modulated tissue bridges and associated applicators, kits and methods. A force modulating tissue bridge may be a medical article for at least partially covering a wound and/or scar. The medical article may include an elastic arch extending over an area, and a middle strut connected to the arch and extending into the area over which the central section extends.

Description

CROSS REFERENCE TO RELATED ORDERS

[0001] This application claims the benefit of Provisional Application in U.S. 62/411,023, filed on October 21, 2016, which is incorporated in its entirety into this document by reference.

FIELD OF INVENTION

[0002] The present invention relates, in general, to medical articles for covering wounds and/or scars and, more particularly, wound closure and/or reducing wound tension.

BACKGROUND

[0003] Traditional wound closure methods typically do not adequately control wound tension, which is well known as a primary stimulus of excess scar formation. Additionally, tension reduction is known to decrease the size, discoloration, and poor appearance of scars when applied during the wound healing period.

[0004] Therefore, there is a need for force modulating tissue bridges that seek to allow wounds to be closed precisely, and additionally seek to provide simultaneous tension reduction in closed wounds and scars in the healing phases.

SUMMARY

[0005] One aspect of this disclosure is the provision of a medical article to at least partially cover a wound and/or scar. The medical article may include a body comprising a central section extending over an area, and flanges extending respectively outwardly from opposite lower sections of the central section. At least the center section of the body may be elastically configured to be deformed from a resting configuration to an extended configuration such that at least the center section may return to the resting configuration in response to being released from the extended configuration. The lower sections are typically further apart in the extended configuration than in the resting configuration. A first of the flanges may have opposing top and bottom surfaces that are each greater than a defined thickness between the top and bottom surfaces of the first flange. The medical article may further include a shim connected to the first flange to move at least partially with the first flange. The wedge may extend into the area over which the center section extends. The shim may have opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the shim. The upper surface of the shim and the lower surface of the first flange may face each other.

[0006] The central section may comprise an arch extending over the area over which the central section extends. The shim can be a first shim. A second of the flanges may have opposing top and bottom surfaces that are each greater than a defined thickness between the top and bottom surfaces of the second flange. The medical article may further comprise a second shim connected to the second flange to move, at least partially, with the second flange. The second shim may extend into the area over which the center section extends. The second shim may have opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the second shim. The upper surface of the second shim and the lower surface of the second flange may face each other.

[0007] The body may be more rigid than at least one of the shims. At least one of the shims may include an extension (e.g., strut) that extends into the area over which the center section extends. At least one of the shims may comprise an outer sheet configured to be secured to a tissue of the patient, and an inner sheet positioned between the outer sheet and the first flange, wherein the inner sheet may be more rigid than the outer sheet. The outer leaf may be larger than the inner leaf. An extension of the outer sheet may extend beyond an outer edge of the inner sheet.

[0008] According to another aspect of this disclosure, a medical article comprises an arch extending over an area, and a middle strut connected to the arch and extending into the area over which the arch extends. Optionally, the middle strut may comprise an outer layer configured to be attached to a patient's tissue, and an inner layer positioned between the outer layer and the arch. Optionally, the inner layer can be stiffer than the outer layer, or vice versa. The middle strut may be a first middle strut. A second middle strut may be connected to the arch and extend into the area over which the arch extends. The first and second middle struts can be positioned oppositely to each other.

[0009] A medical article may optionally additionally comprise or otherwise be associated with at least one removable liner adhered to the shim(s) and/or medium strut(s). A medical article may optionally include one or more features (e.g., a hole, receptacle, space between the body and at least a portion of a wedge and/or a locking portion) configured to interact with an applicator tool.

[0010] Another aspect of this disclosure is the provision of a tool configured to be used to manipulate a medical article. The tool may comprise first and second parts that are separate from each other and each configured to releasably engage a medical article, a reconfigurable link that connects the first and second parts together, and levers (e.g., cables) that engage extend from the proximity of the connection. The linkage and levers may be configured cooperatively so that at least portions of the first and second parts are moved away from each other in response to at least portions of the levers being moved toward each other.

[0011] The first and second parts may be first and second locking parts configured to releasably fasten to the medical article. Each of the locking parts may comprise a rod and one or more protrusions extending outwardly from the rod. The tool optionally may additionally include a support surface that is: positioned between the first and second locking parts, connected to the first and second locking parts by the linkage, and optionally configured to engage the medical article while the first and second locking parts are fitted to the medical article.

[0012] In another aspect of this disclosure, a tool configured to be used to manipulate a medical article may comprise a reconfigurable link that connects first and second bodies together. The first body may comprise a first lever connected to a first part. The second body may comprise a second lever connected to a second part. The first and second parts may be configured to respectively engage (e.g., at least partially receive) opposite first and second ends of a medical article. The reconfigurable link can be configured so that: the first and second bodies are pivotable with respect to each other around the first and second geometric axes, respectively, and the first and second geometric axes are movable towards and away from each other .

[0013] One aspect of this disclosure is the provision of a package having a support comprising a central section and outer sections extending outwardly and downwardly respectively. A medical article may be at least partially supported by support. Shims of the medical article may respectively be close to the outer sections of the support. One or more gaps between the support and the medical article may be configured to receive a portion of a tool configured to be used to manipulate a medical article.

[0014] A liner can be positioned between the support and the medical article. The medical article can be releasably mounted on the lining. At least a portion of the liner may be fixedly mounted to the support. The liner may comprise a tear line to facilitate, at least partially, relative movement between the medical article and the support. The tear line may define, at least partially, a flap in the lining. Such flaps may be respectively associated with shims of the medical article(s).

[0015] One aspect of this disclosure is the provision of a method for at least deforming a medical article from a resting configuration to an extended configuration. Deformation can be understood from reconfiguring a tool while the tool and the medical article are fitted together. The tool and the medical article that are fitted together may be comprised of a first tool part and a first medical article part that are fitted together, and a second tool part and a second medical article part that are fitted between yes. Tool reconfiguration can be understood as moving tool levers toward each other so that the first and second tool parts move away from each other in response to movement of the tool levers toward each other, and the first and second parts of the medical article move away from each other in response to the first and second parts of the tool moving away from each other.

[0016] According to one aspect of this disclosure, a method comprises deforming a medical article from a resting configuration to an extended configuration so that the shims of the medical article are further apart from each other in the extended configuration than in the resting configuration. Each of the shims may comprise an inner portion (e.g., middle strut) extending into an outer portion of the shim so that the inner portions are positioned between the outer portions of the shims. The internal portions may be adhesively mounted to a patient's tissue while the medical device is in its extended configuration. Then, the medical article can reconfigure itself from the extended configuration to an intermediate configuration that is between the resting configuration and the extended configuration. The outer portions of the shims may be adhesively mounted to the fabric while the medical device is in its intermediate configuration. Optionally, adhesive assembly of the outer portions of the shims to the fabric may occur at least partially in response to the automatic/propelled reconfiguration of the medical article.

[0017] The above summary provides some brief examples and is not exhaustive, and the present invention is not limited to the above examples. The above examples, as well as other examples, are further explained in the following detailed description with reference to the attached drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0018] Figures 1A to 1D depict various views of a medical article which may optionally be termed a force modulating tissue bridge, or simply a tissue bridge, and which may be used to cover, at least partially, a wound and/or scar, for example, to help facilitate wound closure and/or reduce wound tension, according to a first embodiment of this disclosure.

[0019] Figure 1E is a pictorial exploded view of the fabric bridge of Figures 1A to 1D, wherein Figure 1E further depicts the exploded fabric bridge away from a schematically depicted section of a release liner and associated adhesive material, in accordance with with the first modality.

[0020] Figures 2A to 2D depict various views of a tool configured to be used to manipulate the medical article or tissue bridge of Figures 1A to 1E, wherein the tool may optionally be referred to as an applicator tool, in accordance with the first modality.

[0021] Figure 2E is a pictorial view of the applicator tool of Figures 2A to 2D mounted on the tissue bridge of Figures 1A to 1E, according to the first embodiment.

[0022] Figure 3A is a pictorial top view of at least a portion of a kit or package comprising the applicator tool of Figures 2A to 2D and several of the tissue bridges of Figures 1A to 1E contained, at least partially, in a tray, according to the first embodiment.

[0023] Figure 3B is a partially exploded view of some of the objects in the packaging of Figure 3A, according to the first embodiment.

[0024] Figure 3C is an isolated top plan view of the tray of Figure 3A, according to the first embodiment.

[0025] Figure 3D is a top plan view of the tray of Figure 3A containing the applicator tool and removable liner, according to the first embodiment.

[0026] Figure 3E is a top plan view of the packaging of Figure 3A, according to the first embodiment.

[0027] Figures 4A to 4F depict a sequence of steps of a method for using the applicator tool to remove a tissue bridge from the tray, according to the first embodiment.

[0028] Figures 4G to 4K depict a sequence of steps of a method for using the applicator tool to apply the tissue bridge to a wound, in accordance with the first embodiment.

[0029] Figures 5A to 5D depict various views of a medical article or fabric bridge having a central removable liner and removable liner mounting lugs attached thereto, in accordance with a second embodiment of this disclosure.

[0030] Figures 6A to 6F depict a sequence of steps of a method for applying the tissue bridge of Figures 5A to 5D to a wound, according to the second embodiment.

[0031] Figure 7 depicts a step of a method for applying the tissue bridge to a wound, according to a third embodiment of this disclosure.

[0032] Figure 8A is an isolated pictorial view of an applicator tool, according to a fourth embodiment of this disclosure.

[0033] Figure 8B is a pictorial view of the applicator tool of Figure 8A mounted on a tissue bridge, according to the fourth embodiment.

[0034] Figure 8C depicts a step of a method for applying the tissue bridge to a wound, according to the fourth embodiment.

[0035] Figure 9A is an isolated pictorial view of an applicator tool, according to a fifth embodiment of this disclosure.

[0036] Figure 9B is a pictorial view of the applicator tool of Figure 9A mounted on a tissue bridge, according to the fifth embodiment.

[0037] Figures 9C and 9D depict a step of a method for applying the tissue bridge to a wound, according to the fifth embodiment.

[0038] Figure 10A is a pictorial view of a fabric bridge, according to a sixth embodiment of this disclosure.

[0039] Figures 10B and 10C depict an applicator tool mounted on the tissue bridge of Figure 10A, according to the sixth embodiment.

[0040] Figures 10D and 10E depict one step of a method for applying the tissue bridge to a wound, according to the sixth embodiment.

[0041] Figure 11A is a pictorial view of a fabric bridge, according to a seventh embodiment of this disclosure.

[0042] Figures 11B and 11C depict an applicator tool mounted on the tissue bridge of Figure 11A, according to the seventh embodiment.

[0043] Figures 11D and 11E depict a step of a method for applying the tissue bridge to a wound, according to the seventh embodiment.

[0044] Figures 12A and 12B depict an applicator tool mounted on a tissue bridge, according to an eighth embodiment.

[0045] Figures 12C and 12D depict one step of a method for applying the tissue bridge to a wound, according to the eighth embodiment.

[0046] Figures 13A and 13B depict a tissue bridge, according to a ninth embodiment.

[0047] Figure 13C is an exploded view of the tissue bridge, according to the ninth embodiment.

[0048] Figure 13D is a cross-sectional view of at least a portion of a kit or package comprising the tissue bridge at least partially contained in a tray, according to the ninth embodiment.

[0049] Figures 13E and 13F depict a sequence of steps of a method for using an applicator tool to remove a tissue bridge from the tray, according to the ninth embodiment.

[0050] Figure 14 is a bottom pictorial view of an applicator tool, according to a tenth embodiment.

[0051] Figure 15 is a top plan view of a tray that contains, at least partially, the applicator tool and a series of tissue bridges, according to the tenth embodiment.

[0052] Figure 16A is a schematic top plan view of an elongated scar or wound in tissue.

[0053] Figure 16B is similar to Figure 16A, except that the scar or wound is covered by a strip.

[0054] Figure 16C is similar to Figure 16B, except that fabric bridges have been mounted on the strip, in accordance with an embodiment of this disclosure.

[0055] Figure 16D is a side elevation view of a first version of the 16C assembly.

[0056] Figure 16E is a side elevation view of a second version of the assembly of Figure 16D, and Figure 16E also depicts a tissue bridge, in accordance with another embodiment of this disclosure.

[0057] Figure 16F is similar to Figure 16E, according to another embodiment of this disclosure.

[0058] Figure 16G is a side elevation view of a fabric bridge, in accordance with an embodiment of this disclosure.

[0059] Figures 17A through 17C depict a tissue bridge, according to an eleventh embodiment.

[0060] Figure 17D is a cross-sectional view taken along line 17D-17D of Figure 17B.

[0061] Figure 17E is an elevational end view of the fabric bridge of the eleventh embodiment.

[0062] Figure 17F is a top pictorial exploded view of the fabric bridge of the eleventh embodiment, wherein Figure 17F further depicts the exploded fabric bridge away from a schematically depicted section of a removable liner and associated adhesive material, of according to the eleventh modality.

[0063] Figure 17G is a pictorial exploded bottom view of selected layers of the tissue bridge of the eleventh embodiment.

[0064] Figures 18A to 18C depict various views of an applicator tool, according to the eleventh embodiment.

[0065] Figure 18D depicts the applicator tool coupled to a fabric bridge of a package that includes a tray and series of fabric bridges, according to the eleventh embodiment.

[0066] Figures 19A to 19F depict a sequence of steps of a method for using the applicator tool to remove a tissue bridge from the tray, in accordance with the eleventh embodiment.

[0067] Figures 19G and 19H depict different confirmations of a removable liner associated with a fabric bridge and tray, according to the eleventh embodiment.

[0068] Figures 19I to 19L depict a sequence of steps of a method for using the applicator tool to apply the tissue bridge to a wound, in accordance with the eleventh embodiment.

[0069] Figure 20A is a top plan view of a fabric bridge of a variation of the eleventh embodiment.

[0070] Figure 20B is an isolated top plan view of a fabric bridge shim of the eleventh embodiment variation.

[0071] Figure 20C is an elevational end view of the tissue bridge of the eleventh embodiment variation.

[0072] Figure 20D is a pictorial top exploded view of the fabric bridge of the variation of the eleventh embodiment, wherein Figure 20D further depicts the fabric bridge exploded away from a section of a removable liner, in accordance with the variation of the eleventh modality.

[0073] Figure 21 depicts a variation of the applicator tool of the eleventh modality.

[0074] Figure 22 depicts another variation of the applicator tool of the eleventh modality.

[0075] Figures 23A to 23C depict an applicator tool, according to a twelfth embodiment.

[0076] Figures 24A to 24C depict an applicator tool, according to a thirteenth embodiment.

[0077] Figures 25A to 25C depict an applicator tool in combination with a tissue bridge, according to a fourteenth embodiment.

[0078] Figures 26A to 26C depict an applicator tool in combination with a tissue bridge, according to a variation of the fourteenth embodiment.

[0079] Figures 27A and 27B depict an applicator tool in combination with a tissue bridge, according to a variation of the fourteenth embodiment.

[0080] Figures 28A and 28B depict an applicator tool in combination with a tissue bridge, according to a variation of the fourteenth embodiment.

[0081] Figures 28D to 28E depict a sequence of steps of a method for using the applicator tool to apply the tissue bridge to a wound, in accordance with the fourteenth embodiment.

[0082] Figures 29A to 29C are top plan views of trays that include mounting features, in accordance with other embodiments of this disclosure.

[0083] Figure 30 depicts a tray that is carrying a series of fabric bridges, and is equipped with fastening straps, according to an embodiment of this disclosure.

[0084] Figure 31 depicts the tray with fabric bridges of Figure 30 mounted on a user's arm, according to an embodiment of this disclosure.

[0085] Figure 32 depicts the fabric bridge tray of Figure 30 with the fastening lugs removed, wherein the tray is exploded away from a mounting base, in accordance with an embodiment of this disclosure.

[0086] Figure 33 depicts a tray that is carrying a series of fabric bridges, and is equipped with fastening straps, according to an embodiment of this disclosure.

[0087] Figure 34 depicts a tray with fabric bridges exploded away from a mounting base equipped with clamps and securing straps, in accordance with an embodiment of this disclosure.

[0088] Figure 35 depicts a tray with fabric bridges exploded away from a mounting base equipped with adhesive material and fastening straps, in accordance with an embodiment of this disclosure.

DETAILED DESCRIPTION

[0089] Numerous embodiments are described below and illustrated in the attached Figures, in which similar numerals refer to similar parts in all views. For convenience of description and ease of understanding, and not for the purpose of limiting the scope of this disclosure or associated inventions, some embodiments may be designated by number. The described embodiments provide examples and should not be construed as limiting the scope of the invention. Other embodiments, and modifications and improvements of the described embodiments, will occur to those skilled in the art and all such other embodiments, modifications and improvements are within the scope of the invention.

[0090] Figures 1A to 1D depict an at least partially elastic (e.g., generally elastic) medical article 20 in its undeformed configuration or at rest (e.g., relaxed state), according to a first embodiment. The medical article 20 may optionally be referred to as a force modulating tissue bridge 20, or simply tissue bridge 20, and throughout this disclosure the tissue bridge may be more generally referred to as a medical item. In the following, first an example of a method for using the tissue bridge 20 is described very briefly, and thereafter the tissue bridge and other aspects of this disclosure are described in greater detail.

[0091] The tissue bridge 20 may be mounted on tissue such as, but without limitation, a surface of a patient's skin, for example, the outer surface of the patient's epidermis. The tissue bridge 20 is typically assembled so that it extends across and at least partially covers a wound and/or scar. In the first embodiment, the tissue bridge 20 generally comprises elastic material, and before the tissue bridge is fitted to the patient, the tissue bridge may generally be elastically deformed from its undeformed or resting configuration to a stretched, deformed, or extended configuration. The tissue bridge 20 can at least begin to be assembled into tissue (e.g., skin tissue), so that a central section of the tissue bridge extends across a wound and/or scar, while the tissue bridge is maintained in its extended configuration. After being at least partially assembled into its extended configuration, the fabric bridge 20 may be left to generally reconfigure itself elastically from its at least partially extended configuration to its resting configuration, which may, for example, reduce tension on the tissue, helping to close the wound, help to inhibit reopening of the wound, and/or inhibit disfigurement of the scar (e.g., enlargement), as will be discussed in greater detail below. In the first embodiment, the fabric bridge 20 comprises material that is, at least generally, elastic, so that the fabric bridge is impelled toward its resting configuration (e.g., relaxed state).

[0092] The fabric bridge 20 of the first embodiment comprises a generally elastic body 22 and one or more multi-layer wedges 24 mounted on the body, although in some examples one or more of the wedges and/or portions thereof may be omitted (for example, a shim may consist of, or essentially consist of, a single layer). The body 22 may generally be styled and/or function generally as a backbone or other suitable structure configured to movably connect two or more of the wedges 24 together. In the embodiment shown in Figures 1A to 1E, the body 22 includes at least two flanges 26 (e.g., feet) that respectively extend obliquely, e.g., outwardly and downwardly, from opposing lower portions of a section. central or arc 28 of the body. Each of the flanges 26 may be flat, or they may be substantially or approximately flat since it may not be critical that the flanges are exactly flat. The flanges 26 can extend divergently from one another, and obliquely from one another. The arch 28 may include a central expansion section 30, and lower sections 32 that respectively extend downwardly from opposite portions of the expansion section. The lower sections 32 of the arch 28 may optionally be configured as and/or termed as bosses 32. The flanges 26 may respectively extend obliquely, for example outwardly and downwardly, from lower portions of the bosses 32 The bosses 32 can provide a smoothly curved transition between the expansion section 30 of the arch 28 and the flanges 26. In the embodiment shown in Figures 1A to 1E, the expansion section 30 of the arch 28 has a relatively low profile and is at least less generally arched in shape, which may be advantageous for an active person who has the tissue bridge 20 mounted to their skin. Alternatively, it is believed that in some situations the arc 28 may be at least more than one flat arc, or the expanding section 30 of the arc may be planar, or the arc or features thereof may be in any other suitable configurations that permit that the tissue bridge 20 operates generally or substantially as described herein.

[0093] Each of the parts of the tissue bridge 20 will typically be constructed of suitable medical grade materials. For example, the body 22 may be an injection molded or mechanically thermoformed unitary article (e.g., one-piece) so that the expansion section 30, bosses 32, and flanges 26 may be formed together as a single article from of a generally injection moldable or conformable elastic material such as, but without limitation, polycarbonate, or any other suitable injection moldable or conformable material. Referring to Figure 1C, each of the expansion section 30, the shoulders 32 and the flanges 26 may be of approximately the same thickness, or alternatively, the thickness of the body 22 may vary along its length. Referring to Figure 1B, the width of the body 22 may, for example, taper along its length so that the expansion section 30 is relatively narrow (e.g., has a narrowed waist) when compared to the shoulder 32 and the flanges. 26, so that the expansion section can be more readily deformed compared to shoulders and flanges. For example, the side edges of the expansion section 30 may be inwardly curved or concave, as shown in Figures 1A, 1B and 1D, or they may have a stepped configuration or other suitable configurations. Alternatively, the side edges of the expansion section 30 may extend generally or substantially straight in a top plan view of the fabric bridge 20, or they may extend in any other suitable manner.

[0094] As shown in Figures 1A-1D, the shims 24 may be separated from each other, and the shims may be fixedly mounted to the flanges 26. Each shim 24 may be or include being a blanket, laminate or other suitable structure comprising one or more layers of material. For example, in the first embodiment, each wedge 24 includes an outer layer or sheet 34 configured to be attached to the fabric (e.g., fur fabric), and an inner layer or sheet 36 positioned between, and fixedly connected to, each of. the outer sheet 34 and the respective flange 26.

[0095] Referring to the exploded view of Figure 1E, the fabric bridge 20 may include inner, middle, and outer adhesive layers 38, 40, 42. The inner adhesive layers 38 may be between and fixedly connect the inner sheets 36 to the flanges 26 , the intermediate adhesive layers 40 may be between and securely connect the outer sheets 34 to the inner sheets, and the outer adhesive layers 42 may be on the outer sides of the outer sheets to secure the fabric bridge 20 to the fabric (e.g., a skin of the patient), as will be discussed in greater detail below.

[0096] The outer and inner sheets 34, 36 may be provided, for example, by die-cutting them from suitable fabrics or larger sheets of material, such as cloth or microporous polymeric sheet cast for the outer sheets 34, and a sheet of polymer or extruded plastic for the inner sheets 36. The outer sheets 34 may be produced from suitable cloth materials, cast materials, films, or other materials of the type from which skin contact layers of bandages or other wound dressings are formed, or any other suitable material. The plastic inner sheets 36 may be produced from suitable materials such as, for example, polyethylene, polyethylene terephthalate, or any other suitable materials. The inner and intermediate adhesive layers 38, 40 may respectively comprise adhesive materials that are compatible with the materials that are connected thereto. The outer adhesive layer 42 (e.g., patient contact adhesive) may be, for example, adhesive material of the type that is typically used as an adhesive base for bandages or other wound dressings. In the first embodiment, the outer adhesive layer 42 may have a lower adhesive strength than the inner and intermediate adhesive layers 38, 40, such as when the tissue bridge 20 is to be removably mounted on tissue (e.g., a patient's skin ).

[0097] In the first embodiment, both the body 22 and the inner sheet 36 have a higher modulus of elasticity (e.g., they are made of stiffer material) than the outer sheet 34. More generally, the body 22 and the inner sheet 36 may be stiffer than outer sheet 34 due to various factors, such as being larger, thicker, comprising material that has a higher modulus of elasticity and/or being constructed to have a clear modulus of elasticity. Similarly, the body 22 may have a higher modulus of elasticity than the shims 24.

[0098] As shown in Figure 1C, the body 22, including its flanges 26, may be thicker than each of the outer and inner sheets 34, 36, and the arc 28 may extend over an area to which portions of the outer and inner sheets can optionally extend. The area over which the arch 28 extends may be referred to as a central area, a treatment area, an area under the arch, and/or the like. The thicknesses of the body 22 and the sheets 34, 36 can be varied, for example, independently as necessary to produce tissue bridges 20 of different sizes and to function optimally in different anatomical areas and with different tissue treatment characteristics.

[0099] As shown in Figures 1A and 1E, at each end of the fabric bridge 20, the flange 26, the outer sheet 34, the inner sheet 36 and the adhesive layers 38, 40, 42 may be at least partially superimposed on each other. others and may have different configurations. For example, and as illustrated schematically in Figure 1E by dashed boundary lines on the outer and inner sheets 34, 36, a congruent portion 44 of each inner sheet may be overlapped and coextensive with the respective flange 26, and a congruent portion 46 of the sheet outer sheet 34 may be overlapped and coextensive with the respective congruent portion of inner sheet 44. As other examples that are also at least partially illustrated schematically by the dashed boundary lines in Figure 1E, inner extensions 48 of the outer and inner sheets 34, 36 may extend congruently with each other to the central area over which the arch 28 extends so that the internal extensions 48 are neither overlapping nor coextensive with the flanges 26. More generally, each shim 24 may include at least at least one extension 48 that extends into the central area over which the arch 28 extends so that the inner extension 48 cannot be overlapped or coextensive with the flanges 26.

[0100] In the first embodiment, the internal extensions 48 can be referred to as middle extensions 48, for example, since they extend towards the center of the area over which the arc 28 extends. As another example and as will be discussed in greater detail below, the inner or middle extensions 48 may be configured so that they at least partially resist longitudinal compression when the fabric bridge 20 in its extended configuration is mounted on fabric (e.g., skin tissue) and then left to generally reconfigure elastically from its extended configuration at least partially to its resting configuration. Accordingly, the inner or middle extensions 48 may be referred to as middle struts 48. In the first embodiment, each middle strut 48 includes the inner extensions 48 of both sheets 34, 36, but one or more layers or sheets of the middle strut 48 may be omitted, so that each middle strut can be formed from one or more layers of material.

[0101] Referring to Figures 1A and 1E, one or more outer extensions 50 of the shims 24 or, more specifically, the outer sheets 34, may extend outwardly so that they are neither overlapping nor coextensive with the flanges 26 or with the middle struts 48. In the example shown in Figure 1B, the outer extensions 50 may extend beyond one or more of the peripheral edges (e.g., the outer end edges and side edges) of the flanges 26.

[0102] In the example shown in Figure 1C, the middle struts 48 may be separated (e.g., at least partially separated) from the arch 28 and extend into the central area over which the arch extends, so that the gaps or receptacles 52 are at least partially defined between the middle struts and the arch. The receptacles 52 may define at least partially, or be at least part of, locking portions configured to interact with corresponding features of an applicator tool that may be used, for example, in mounting the tissue bridge 20 to the tissue (e.g., a patient's skin), where the applicator tool is discussed in greater detail below. For example, the fabric bridge 20 may include one or more locking parts, and the locking parts may respectively comprise receptacles 52. Various differently configured locking parts are within the scope of this disclosure.

[0103] In the first embodiment, the body 22 includes at least two locking parts that additionally comprise holes 56 that extend through the body 22 and are open for receptacles 52. The holes 56 may be defined in the arc 28 or, more specifically , the holes may be positioned in opposite end portions of the expansion section 30. In the example shown in Figure 1B, the holes 56 may be open to the central area over which the arc 28 extends or, more specifically, the holes may be be open for receptacles 52; and the middle struts 48 may extend below the holes.

[0104] As shown in Figures 1A and 1B, each of the holes 56 may be triangular, with a side of the triangle or, more specifically, an edge 58 of the arc 28 defining the triangle, which extends transversely to the length of the arc. The respective locking portion may additionally include the edge 58. The edge 58 may extend parallel, or more generally substantially parallel or approximately parallel, to the boundary between the expansion section 30 and the respective shoulder 32. In other words, the edge may extend perpendicular or, more generally, substantially perpendicular or approximately perpendicular to the geometric axis in the lengthwise or longitudinal direction of the body 22. Furthermore, holes 56, when present, may reduce the area or volume of the outer portions of the expansion section 30 in a manner that increases the deformability of the outer portions of the expansion section.

[0105] Each locking portion may additionally include a portion 60 (Figure 1C) of the lower surface of the arch 28, wherein the surface portion 60 extends outwardly from the edge 58. The locking portions, the receptacles 52, the holes 56 and associated edges 58, and surface portions 60, or the like, may be optional, and other positions and configurations of locking parts, receptacles, holes, or the like, are within the scope of this disclosure.

[0106] In one version of the first embodiment, the shims 24 may be described as including the flanges 26, such that the flanges may be respective layers of the shims, and the flanges may be referred to as base plates 26, or the like. As another example, the first embodiment encompasses fabric bridge configurations 20 in which the base plates 26 are not formed integrally with the arch 28. For example, the base plates 26 may be formed separately from the arch 28 and may be fixedly connected or movably to the arch, such as by means of pivots, joints, or any other suitable resources. Other variations are also within the scope of this disclosure. For example, the base plates 26 may have one or more holes formed in or through them, as discussed in greater detail below. As another example alluded to above, one or more layers of each shim 24 may be omitted. For example, and for each base plate 26, it may be appropriate in some situations to omit the layers between the base plate and outer adhesive layer 42, so that the outer adhesive layer, which is for use in assembling the bridge of tissue 20 on the tissue (e.g., a patient's skin), be mounted directly on the bottom of the base plate. It is also within the scope of the first embodiment for the middle struts 48 to be formed integrally with the arch 28, flanges 26 and/or base plates 26. For example, the middle struts 48 may be extensions of the flanges 26 and/or base plates. 26.

[0107] As alluded to above, Figure 1E depicts the fabric bridge 20 in an exploded configuration. Furthermore, Figure 1E depicts fabric bridge 20 exploded away from a schematically depicted section of a release liner 62 and associated adhesive material 64. As an example, after a fabric bridge 20 is manufactured or as part of the manufacturing process for the fabric bridge, the fabric bridge, or more specifically the outer sheets 34 by means of the outer adhesive layers 42, may be releasably mounted to the upper surface of the release liner 62. Furthermore, the lower surface of a portion of the Removable liner 62 can be fixedly mounted on a support by means of adhesive material 64, as will be discussed in greater detail below. The release liner 62 may be, for example, a sheet of paper or plastic based film coated with a release agent which is fitted against the outer adhesive layers 42 so that the fabric bridge 20 is releasably mounted to the release liner. .

[0108] In accordance with the first embodiment, the fabric bridge 20 may be at least somewhat translucent, and the fabric bridge may optionally include indicative, visible design elements and/or other visual features comprising one or more among color, contrasting colors, decorations, alignment marks, figures, logos, images, characters, words, or any other suitable resources that may be printed matter, or similar, in which the printed matter, or similar, can be embedded or encapsulated on the fabric bridge and visible through one or more outer surfaces of the fabric bridge. For example, one or more of the components or layers of the fabric bridge 20 may be at least generally transparent and/or at least generally translucent, and the printed matter, or the like, may be interior surfaces or exterior of the fabric bridge 20 and viewed by a user of the fabric bridge through at least one of the exterior surfaces of the fabric bridge. For example, printed matter, or the like, may be on a layer or surface of the fabric bridge 20 that is internal to the fabric bridge (e.g., printed matter, or the like, may be positioned or "interleaved" between the various layers of the tissue bridge). Referring to Figure 1E and as an example, the body 22 and the inner sheets 36 may each be at least partially transparent, and the printed matter, or the like, may be on the upper surface of at least one of the outer sheets 34 so that it is visible through the body 22 and the respective inner sheet 36. As another example, the body 22 may be at least partially transparent and the printed matter, or the like, may be on the upper surface of at least one sheet internal 36 so that it is visible through the body 22. Alternatively, it is believed that the printed matter, or the like, may be contained in one or more of the adhesive layers 38, 40, 42 and/or in any other suitable location, with the predetermined portion(s) of the fabric bridge 20 being at least partially transparent and/or translucent to allow printed matter, or the like, to be visible through one or more exterior surfaces of the bridge of fabric.

[0109] Figures 2A to 2D depict an applicator mechanism in the form of an applicator tool 80 that can be used, for example, to manipulate the tissue bridge 20 or other suitable medical article, for example, as part of a method of assembling bridging tissue on tissue (e.g., a patient's skin), according to the first embodiment. For example, the applicator tool 80 may include one or more parts or features that may be separated from each other and may be configured to releasably engage the tissue bridge 20. In the first embodiment, the one or more parts or features of the tool applicator 80 that are configured to engage the tissue bridge 20 may comprise at least one bearing or contact surface 82 and/or one or more locking portions 84. For example, the contact surface 82 may be positioned between the locking portions 84. The applicator tool 80 may additionally include a reconfigurable frame that connects the contact surface 82 and the locking portions 84 together. The applicator tool 80, and the like, can be more generally referred to as a tool. For example, tool 80, or the like, can be used for more purposes than applying a tissue bridge 20.

[0110] The frame may include a reconfigurable link (e.g., one or more links 86A, 86B) that connects the contact surface 82 and the locking portions 84 together, and one or more levers 88A, 88B that extend to up from connections 86A, 86B. The applicator tool 80 may be configured so that when the bearing or contact surface 82 is facing downward, the locking portions 84 extend beneath the link (e.g., link(s) 86A, 86B), and the levers 88A, 88B extend above the connection. The linkages 86A, 86B and the levers 88A, 88B may be configured cooperatively so that at least portions of the locking portions 84 move away from each other, and the contact surface 82 moves toward a line between the locking portions. locking 84, in response to at least portions of the levers 88A, 88B being moved towards each other, as will be discussed in greater detail below.

[0111] Connections 86A, 86B may comprise several connections, for example, a central connection 86A and external connections 86B. Similarly, levers 88A, 88B may comprise several levers, for example, internal levers 88A and external levers 88B. In the example shown in Figures 2A to 2D, the contact surface 82 may be a lower end face of the central link 86A, and the locking portions 84 may include rods 90 extending from lower ends of the outer links 86B and/or or external levers 88B. Each locking portion 84 may additionally include at least one protrusion 92 that extends outwardly from the lower end of the rod 90 in a direction that is transverse to the length of the rod. The protrusions 92 may face away from each other.

[0112] The outer links 86B may extend obliquely, outwardly and downwardly from opposite sides of an upper portion of the central link 86A respectively to upper portions of the rods 90. The inner levers 88A may extend obliquely , outward and upward from opposite sides of an upper portion of the central connection 86A. The external levers 88B may extend obliquely, outwardly and upwardly respectively from upper portions of the rods 90.

[0113] Levers 88A, 88B may be configured as and/or comprise cables 94. For example, in the embodiment depicted in Figures 2A and 2B, a cable 94 may include adjacent levers 88A, 88B that are connected together. These connections may comprise adjacent levers 88A, 88B being directly connected to each other near their upper ends, and crosspieces 96 connected to and comprised between the adjacent levers.

[0114] The applicator tool 80 may be a unitary (e.g., single-piece) injection molded article formed from an elastic, generally injection moldable, material such as, but without limitation, polycarbonate, polyethylene, or any other suitable injection moldable material. Alternatively, the applicator tool 80 may be made of metal, metal alloys, steel, or any other suitable materials that may permit rhesterization. For example, joints or other suitable connections that allow relative movement between subparts may be included in the applicator tools 80, such as when the applicator tools are produced from relatively rigid materials. As further examples, several different connections, levers 88A, 88B, and cables 94 are within the scope of this disclosure, as will be discussed in greater detail below.

[0115] According to an example of the first embodiment depicted in Figure 2E, the tissue bridge 20 and the applicator tool 80 are configured cooperatively so that the applicator tool can be releasably fitted to the tissue bridge, and the applicator tool can be used to manipulate the tissue bridge as part of a method of assembling the tissue bridge onto the tissue. For example, Figure 2E depicts the bearing or contact surface 82 in face-to-face relationship with an upper surface of the arch 28, and the rods 90 extending through the holes 56. In the configuration of Figure 2E, the protrusions 92 are hidden from view within the receptacles 52, as partially schematically illustrated by dashed lines. More generally, the above-discussed locking portions of the applicator tool 80 and the tissue bridge 20 are respectively fitted together in Figure 2E. However, several differently configured locking parts are within the scope of this disclosure.

[0116] The applicator tool 80 may optionally additionally include one or more features to facilitate, at least partially, predetermined cooperative interaction between the applicator tool and the tissue bridge 20. For example, the levers 88A, 88B and/or the cables 94 , or features associated therewith, may be configured to contact each other when the desired degree of deformation is achieved in the fabric bridge 20 thereby seeking to prevent excess distortion of the fabric bridge. Additionally, or alternatively, the levers 88A, 88B and/or the cables 94, or features associated therewith, may be configured to (e.g., may include one or more fasteners, rows of fasteners, or the like, configured to) make whereby the applicator tool 80 maintains the tissue bridge 20 in one or more predetermined states of deformation (e.g., one or more predetermined stretched, deformed, or extended configurations) without requiring the user to continually squeeze together the cables 94, or similar. For example, the applicator tool 80 may include mechanisms (e.g., rows of fasteners) that can be activated sequentially, in a manner similar to surgical forceps mechanisms, such as a click (e.g., a first predetermined fit between the fasteners or the like). can cause a relatively low state of deformation in the fabric bridge, two clicks (e.g., a second predetermined fit between fasteners or the like) can cause a relatively intermediate state of deformation in the fabric bridge, and three clicks (e.g., one third predetermined fit between fasteners or the like) may cause a relatively large state of deformation in the tissue bridge (e.g., complete deformation). Furthermore, levers 88A, 88B, handles 94 and/or other suitably associated features may be differently shaped to aid in ergonomically optimized use, for example, by comprising partial or full rings, molded recesses to accept the finger(s). s) of the user and/or other appropriate resources. Cooperative interaction between the applicator tool 80 and the tissue bridge 20, such as fit between their locking parts, will be discussed in greater detail below, after a discussion of the option for the tissue bridges and applicator tools to be conveniently provided as parts of kits.

[0117] In accordance with the first embodiment, and as depicted, at least partially, in Figure 3A, one or more of the tissue bridges 20 and, optionally, at least one applicator tool 80 may be provided as part of a kit or package. 120 which may additionally include release liner 62 and adhesive material 64 (Figure 1E). In the example shown in Figures 3A to 3C, the package 120 may include a container in the form of an injection-molded or vacuum-formed tray 122, or the like. The tray 122 may have a base panel 124 and side walls 126 that extend upwardly from the periphery of the base panel to define a tray cavity. Furthermore, the package 120 and/or the tray 122 may optionally include at least one divider 128 that extends upwardly from the base panel 124 and is positioned between and away from opposing side walls 126 to at least partially divide , the tray cavity into at least first and second compartments configured to respectively receive the applicator tool 80 and one or more tissue bridges 20. The first tray compartment 122 or, more specifically, the divider 128 and the side walls 126 defining , at least partially, the first compartment of the tray, may define a shape that is complementary to the peripheral shape, and approximately the same size, of the applicator tool 80, so that a releasable forced fit can be defined between the first compartment and the applicator tool inside the first compartment. As another example, the first tray compartment 122, the divider 128, and the applicator tool 80 may be omitted from the tray 122. Any applicator tool 80 may be provided as part of a package that is separate from the package that includes the tray 122.

[0118] As an example, tray 122 may be an inner tray that may be placed in an outer tray, a bag, and/or other suitable packaging. As other examples, the tray 122 may include other features, e.g., slots or other surface features that may be used to secure the tray to the user's body (e.g., non-dominant forearm), to a light fixture (e.g., a instrument tray), or in other suitable configurations.

[0119] Referring to the exploded view of Figure 3B, and the isolated top plan view of the tray 122 in Figure 3C, the base panel 124 may be configured in the form of and/or to define a ridge-shaped support which, in generally extends along at least a portion of the length of the tray. The ridge support may include a raised central section 130 of the base panel and downwardly inclined outer sections 132 of the base panel. The center section 130 may be flat, although exact flatness may not be required so that the center section may generally be either substantially flat, or in any other suitable configuration. For example, the central section may be concave, or the like. The outer sections 132 may extend obliquely, or more specifically, outward and downward, from opposing portions or edges of the raised center section 130. For example, the outer sections 132 may extend obliquely inward. and upward from lower marginal portions 134 of the base panel 124. Two or more pairs of outer sections 132 may be included in each tray 122. Alternatively, the central section 130 may be recessed relative to the inner portions of the outer sections 132.

[0120] Referring to Figures 1E, 3A, 3B, 3D and 3E, the release liner 62 may include a series of tear lines 136. Each tear line 136 may comprise one or more cuts, tears, tamperable tear lines, perforations and/or overlapping and/or sequential combinations thereof, to define, at least partially, flaps 138 in the removable liner 62, as will be discussed in greater detail below. The break lines 136 can be configured in various patterns. In some examples, the pattern may be symmetrical with respect to each associated (e.g., subsequently assembled) tissue bridge 20. In other examples, the tear lines 136 may be asymmetric with respect to each associated (e.g., subsequently assembled) tissue bridge 20. In the first embodiment, each break line 136 extends partially around the shim 24 that is mounted to the tab 138 defined by the break line, and opposite ends of the break line extend below the shim.

[0121] According to the first embodiment, the fabric bridges 20 can be assembled manually and/or at least partially assembled through one or more automated coating, laminating and cutting processes. For example, release liner 62 may be a base layer or layer of a laminate that is suitably cut (e.g., die cutting) and partially delaminated to form at least partially shims 24 in the release liner, and thereafter the bodies 22 can be mounted respectively on the shims 24, or similar. The tear lines 136 may be formed by one or more of the appropriate cutting steps (e.g., die cutting), or the like, so that the tear lines (e.g., tears, perforations, or other suitable cuts) may extend , at least partially, to one or more layers of the shim 24. As a more specific example, tear lines 136, or extensions thereof, or the like, may extend into the outer adhesive layer 40 (Figure 1E). At an appropriate time, typically after die cutting, or the like, the lower part of the release liner 62 may be fixedly attached to the surface of the outer sections 132 of the tray 122 by means of, for example, adhesive material 64 (Figure 1E) disposed in a pattern such that the adhesive material is omitted between the tabs 138 on the release liner and respective portions (e.g., outer sections 132) of the tray so that the tabs can be moved relative to the remainder of the release liner, as will be discussed in greater detail below. More generally, any adhesion or other suitable connection between the flaps 138 and respective portions (e.g., outer sections 132) of the tray 122 is weaker than the adhesion or other suitable connection between the remainder of the release liner 62 and the tray, so that the flaps can be moved in relation to the rest of the removable liner, as will be discussed in greater detail below.

[0122] Referring to Figures 4A to 4F, a method of using applicator tool 80 to remove a tissue bridge 20 from tray 122 is described below, in accordance with the first embodiment. In Figures 4A to 4F, the tray 122 and the release liner 62 are cut transversely along line 4-4 of Figure 3E. Referring to Figure 4A, initially, the applicator tool 80 (e.g., in its undeformed or resting configuration) may be fitted against the tissue bridge 20 (e.g., in its undeformed or resting configuration) by means of of relative movement that causes an increase in the approximation between the applicator tool 80 and the tray 122 (for example, movement of the applicator tool towards the fabric bridge mounted on the removable liner 62 in the tray). Referring to Figures 4A and 4B, in response to relative movement, protrusions 92 of tool locking portions 84 may enter receptacles 52 through holes 56 (Figures 1A and 1B). That is, the protrusions 92 may enter the receptacles 52 by moving through the holes 56. For example, the applicator tool 80 may be pushed downward to engage the fabric bridge 20 in such a manner that the protrusions 92 of the locking portions of the tool 84 enters the receptacles 52 through the holes 56 and, optionally, also the contact surface of the tool 82 engages the central apex or any other suitable surface of the arc 28. The applicator tool 80 may be in its undeformed configuration or in rest throughout the length of the protrusions 92 of the tool locking parts 84 that enter the receptacles 52 through the holes 56. As another example, the distance between the tips of the protrusions 92 may be greater than the distance between the edges of the hole 58 (Figures 1A and 1B) so that the protrusions "fit" into holes 56 and/or receptacles 52 and are optionally releasably contained in the receptacles by means of a forced fit, or the like.

[0123] The relative movement that causes increased approximation between the applicator tool 80 and the tray 122 can be facilitated by a user manually holding the handles 94 of the applicator tool and moving the applicator tool towards the tissue bridge 20 on the tray, or the fabric bridge may be supported by any other suitable surface. Referring to Figure 4B, the protrusions 92 may engage the respective surfaces of the middle struts 48 in response to relative movement that causes increased approximation between the applicator tool 80 and the tray 122.

[0124] To achieve serially the configurations of Figure 4C and Figure 4D, simultaneously and/or in series, the relative movement that causes increased approximation between the applicator tool 80 and the tray 122 can continue, and the cables 94 can be tightened manually together (e.g., pushed toward each other) so that the applicator tool reconfigures toward its actuated or deformed configuration and applies deformation forces to the tissue bridge 20. As the applicator tool 80 is pushed, e.g. , simultaneously with greater force against the fabric bridge 20 and caused to deform further towards its deformed configuration, the applicator tool applies forces against the fabric bridge 20 so that the fabric bridge is responsively deformed towards its stretched, deformed or extended configuration. For example, the applicator tool 80 may simultaneously apply a downward force through the contact surface 82 and laterally outward forces through the locking portions 84.

[0125] In transitioning from the configuration of Figure 4C to the configuration of Figure 4D, the outer portions of the shims 24 have moved, or more specifically rotated, away from the outer sections of the tray 132. As discussed above, the tabs 138 can be attached to the outer portions of the shims 24 by means of the outer adhesive layer 42 (Figure 1E). Therefore, the flaps 138 can be carried by, and rotate with, the outer portions of the shims 24. Therefore, the flaps 138 rotate outwardly relative to a remainder of the removable liner 62 that remains fixedly mounted on the base panel of the tray 124. This that is, the flaps 138 may rotate outwardly relative to (e.g., delaminate, at least partially, from) a remainder of the release liner 62 and the tray 122 in response to respective movement, reconfiguration, and/or the like of the bridge. of fabric 20 and the applicator tool 80. In the first embodiment, the release liner 62 is a support that supports the fabric bridge, and each flap 138 can be referred to as a first section of the support, and the remainder of the release liner 62 and/or or tray 122 may be termed as a second support section, or the like.

[0126] As another example, in the transition from the configuration of Figure 4C to the configuration of Figure 4D, the protrusions 92 pushed (e.g., deflected) the middle struts 48 downward toward the recessed center section 130 of the tray 122 to close a or more gaps 140 (Figures 4A and 4B) positioned between the middle struts and the center section of the tray. However, such strut deviation and/or closure of the gaps 140 may be optional and may not occur. As other examples, the gaps 140 may be at least partially closed, only partially closed, and/or it is believed that it may be possible in some situations to omit the gaps 140. That is, in one example, the middle struts 48 may rotate downwardly. relative to a remainder of the shims 24 in response to respective movement, reconfiguration, and/or the like of the tissue bridge 20 and the applicator tool 80.

[0127] Referring to Figures 4C to 4F, the applicator tool 80 and the tissue bridge 20 may be cooperatively configured and fitted together in a predetermined manner so that, in response to the cables 94 being manually tightened or pushed closer to a on the other hand, at least the lower portions of the tool locking parts 84 are moved further away from each other and the contact surface 82 moves toward a line between the locking parts 84, and this movement of the applicator tool 80 forces the tissue bridge 20 into its fully deformed or extended configuration, an example of which is shown in Figure 4F. For example, the manual inward force applied to opposite sides of the cables 94 to achieve this configuration may be in a range of more than 0.091 kgf (0.2 pounds force (0.89 newtons)) to less than 0.91 kgf (2 pounds force (8.9 newtons)).

[0128] In the transition from the configuration of Figure 4E to the configuration of Figure 4F, the removable liner 62 typically separates completely from the fabric bridge 20, and the flaps 138 may rotate/recede to their original positions in response to the relative movement it causes. increasing the distance between the applicator tool 80 and the tray 122. The release liner 62 typically separates completely from the fabric bridge 20 in a manner that fully exposes the outer adhesive layer 42 (Figure 1E) (e.g., contact adhesive with the patient), so that there is no remnant of the release liner attached to the fabric bridge and the outer adhesive layer is ready to be used to secure the fabric bridge to tissue, such as a patient's skin.

[0129] For example, in Figure 4F the tissue bridge 20 and the applicator tool 80 are fitted together, and both the tissue bridge and the applicator tool are in their deformed configurations so that the tissue bridge is firmly grasped or deformed. another shape held by the applicator tool, so that as the applicator tool is manually moved away from the tray 122, the applicator tool carries the tissue bridge away from the tray. While the tissue bridge 20 is held securely by the applicator tool 80, the applicator tool can be used to apply the tissue bridge to tissue, such as a patient's skin.

[0130] Referring to Figures 4G to 4K, a method of using applicator tool 80 to apply a tissue bridge 20 to tissue 152 on either side of a cut 150 in a patient's skin 152 is described below, in accordance with the first modality. Figure 4G schematically depicts with dashed lines 154 the originally separated edges of the cut 150, and a solid line 156 schematically depicts that the edges of the cut can be manually pushed together before applying the fabric bridge 20 over the cut. The applicator tool 80 that retains the tissue bridge 20 may be moved toward the cut 150 so that the tissue bridge 20 extends transversely or, specifically, substantially perpendicular to the length of the cut 150, and the first contact between the bridge of fabric and the fabric or skin 152 occurs in the inner end sections or portions of the middle struts 48 on either side of the cut. Referring to Figures 4H and 4I, the applicator tool 80 may continue to be pushed closer to the cut 150 so that the inner portions of the middle struts 48 begin to be adhered to the skin 152 by the outer adhesive layer 42 (Figure 1E) ( e.g. patient contact patch). For example, the transmission of force from the applicator tool 80, through the locking portions 84, against the middle struts 48 may cause the pressure-sensitive adhesive layer 42 to be coupled against the fabric 152 with sufficient force to make so that the inner portions of the middle struts 48 are adhered to the fabric 152 on opposite sides of the cut 150. Then, the manual force on the handles 94 of the applicator tool 80 can be reduced, so that the fabric bridge 20 returns to its configuration in rest, and the middle struts 48 come closer together and push the portions of the fabric 152 to which they are adhered towards each other. Then, in response to the fabric bridge 20 returning further toward its resting configuration, the reconfiguration of the fabric bridge causes the outer portions of the shims 24 to move or rotate downwardly in contact with the fabric 152 on the sides. opposite sides of the cut 150. In one example, this contact between the outer portions of the shims 24 and the fabric 152 on opposite sides of the cut 150 may occur with sufficient force to cause the pressure-sensitive adhesive layer 42 to adhere securely to the outer portions. from shims 24 to fabric 152 on opposite sides of cut 150.

[0131] According to the first embodiment, the inner portions of the middle struts 48 are adhesively mounted to the fabric 152 while the fabric bridge 20 is in its deformed or extended configuration and thereafter, as the fabric bridge 20 returns toward its resting configuration and reaches an intermediate configuration that is between the extended and resting configurations, the remaining or outer portions of the shims 24 are adhesively mounted to the fabric. When the fabric bridge 20 is first coupled against the fabric 152, the point of first contact and adhesive assembly to the fabric may be at the inner end sections or portions of the middle struts 48, and this assembly may occur while the middle struts are being pushed downward by means of the applicator tool 80. In the first embodiment, as the deformation force that is applied to the tissue bridge 20 by the applicator tool 80 is reduced, the middle struts 48 move or rotate inward, thereby pushing toward the center the fabrics 152 to which they are adhesively mounted, and this action by the middle struts 48 occurs before the outer portions of the shims 24 are adhesively attached to the fabric. At this intermediate point, at which the middle struts 48 are at least partially attached to the fabric 152 and are moved inward, and the outer portions of the shims 24 are not yet attached to the fabric, the shear stress and/or deformation in the fabric predetermined (i.e., tissue that is lateral to the most lateral point of contact between the middle strut and the tissue) is distributed laterally and in a gradual manner. Then, when the side or outer portions of the shims 24 are pressed down and adhered to the fabric 152, the predetermined fabric underneath and on the side edges or outer edges of the shims 24 is trapped (e.g., adhered to the shims) in its state in which The stress and/or deformation in the predetermined fabric is distributed laterally and in a gradual manner, which seeks to prevent sudden high stress on the side edges (e.g., opposite ends) of the fabric bridge 20.

[0132] Referring to Figure 4K, the applicator tool 80 can then be removed from the tissue bridge 20 so that the tissue bridge remains mounted over the cut 150; then the applicator tool can be used to install another tissue bridge. As an example, the distance between the tips of the protrusions 92 may be greater than the distance between the edges of the hole 58 (Figures 1A and 1B). In this example, the upper surfaces or mating lugs 93 of the locking portions 84 may extend obliquely downward from the rods 90 so that there may be relative sliding between the lugs 93 and the edges 83 when the applicator tool 80 is removed from the tissue bridge. In response to such sliding, the locking parts 84 may rotate toward each other and thereby be released from the holes 56. Alternatively, the locking parts 84 may be moved toward each other in any other suitable manner such as portion of the locking portions 84 that are from the holes 56. As another example, after a tissue bridge 20 is mounted on a patient and the applicator tool 80 is allowed to return to its relaxed configuration, the tissue bridge 20 may reconfigure itself to the its relaxed configuration without fully reaching its relaxed configuration, so that the protrusions 92 can pass freely through the holes 56.

[0133] A user may manually push down with their fingers 157 on the shims 24, for example, with sufficient force to ensure that the pressure-sensitive adhesive layer 42 securely adheres the shims 24 to the fabric 152 on opposite sides of the cut 150. According to the first embodiment, the fabric bridge 20 may be mounted on the fabric 152 in such a manner that the fabric bridge and the fabric apply force against each other, and the force applied by the fabric typically constrains the bridge. tissue from fully returning to its resting configuration. As a result, tissue bridge 20 applies compressive force to tissue 152 via shims 24, as depicted schematically in Figure 4K by arrows 158, in a manner that can, for example, reduce tension in the tissue, help close the wound. 150, help inhibit wound reopening and/or inhibit scar disfigurement (e.g., enlargement). In the example shown in Figure 4K, tissue 152 near scar and/or wound 150 swells in the central area over which arch 28 extends.

[0134] In association with the forces that are applied against each other by the fabric 152 and the fabric bridge 20 when the fabric bridge is assembled, for example, as shown in Figure 4K, the middle struts 48 are typically under compression longitudinal. Furthermore, the middle struts 48 may be configured in a manner that seeks to allow the arch 28 and the middle struts to move in a manner that provides a wide opening 160 (Figure 4G) to at least partially enclose the fabric 152. wound 150, scar, or the like, so that the tissue bridge 20 can function to substantially inhibit any tissue tension, wound reopening, and/or scar disfigurement (e.g., enlargement). Furthermore, the middle struts 48 may advantageously direct inward toward the margins of the wound (or scar). Furthermore, the middle struts 48 can flex up or down independently to compensate for changes in tension in the tissue (e.g. due to swelling) or for non-centralized positioning of the tissue bridge; therefore, medium struts can help align the wound margins (or scar) to the same vertical height.

[0135] In alternative embodiments, the applicator tool 80 may be replaced by one or more different suitable tools or features configured to provide one or more forces corresponding to the downward force provided through the contact surface 82 and the laterally outward forces provided by means of the locking parts 84. Such alternative tools may comprise a plunger mechanism, a side-directed pliers mechanism, a cam-activated mechanism, and/or any other suitable features, and such alternative tools may be multi-piece tools. . As another example, fabric bridges 20 may be applied to fabric 152 with the use of one or more loops, or the like, as will be discussed in greater detail below.

[0136] Numerous other modalities are within the scope of this disclosure. For example, other embodiments (e.g., embodiments two through fourteen) of this disclosure may be configured and/or function at least generally similar to the first embodiment, except for observed variations and variations that will be reasonably apparent to persons skilled in the art. technique. Accordingly, some of the drawing reference numerals used above are used below and/or reference numerals for similarly configured and/or similarly functioning features may be incremented by two hundreds, or other quantities below.

[0137] Referring to Figures 5A to 5D in relation to a fabric bridge 320 of a second embodiment, the outer extension(s) 350 of the outer sheets 334 extend(s) further outward when compared to the corresponding resources of the first modality. Additionally, the inner sheets 336 include outer extensions 350' that extend beyond the outer edges of the respective base plate or flange 326, and are recessed inwardly relative to the outer edge of the respective outer extension 350. The holes 356 may be included in the bodies 322, or these holes may be omitted, since the fabric bridge 320 may be assembled using resources other than the applicator tool 80 of the first embodiment.

[0138] As shown in Figures 5A to 5D, through the outer adhesive layer 42 (Figure 1E) (e.g., patient contact adhesive), at least one central release or peel liner 462 and one or more handles release or peel-off liner mounting brackets 464 are respectively mounted on shims 324. Inner ends of the mounting lugs 464 may include at least one folded overlay flap 465. The central removable liner 462 may define or include at least one lamella 466, and the lamella may extend from the side of the central release liner. In the second embodiment, the mounting lugs 464 are longer than the central release liner 462 and configured so that they can be used as an applicator tool to mount the fabric bridge 320 to the fabric 452. Each of the release liners 462, 464 may be, for example, a release liner in the form of a sheet of paper- or plastic-based film coated with a release agent that is coupled against the outer adhesive layers 42 so that the fabric bridge 320 is releasably mounted. in removable liners 462, 464.

[0139] Referring to Figures 6A to 6F, a method that applies tissue bridge 320 over tissue 452 that includes a wound 450 is described below, in accordance with the second embodiment. Referring to Figure 6A and then Figures 6B through 6D, the coverslip 466 (Figures 5A through 5C) can be manually grasped and pulled to remove the central release liner 462 and expose the outer adhesive layer 42 on at least the middle struts 348. Then, the free ends of the release liner mounting loops 464 can be drawn together and pulled, such as by fingers 457, while another finger 457 pushes the arch 328 downward so that deformation forces are applied to the fabric bridge. 320, and the inner portions of the middle struts 348 begin to be adhered to the tissue 452 by the outer adhesive layer 42 (Figure 1E) (e.g., patient contact adhesive). In the second embodiment, the assembly of the fabric bridge 320 onto the fabric 452 may be carried out, at least generally, in a similar manner to the first embodiment, so that after the middle struts 348 are at least partially fixed to the fabric 452 and have moved inward, and the outer portions of the shims 324 are not yet secured to the fabric, the shear stress and/or deformation in the predetermined fabric (i.e., fabric that is lateral to the most lateral point of contact between the middle strut and the tissue) is distributed laterally and in a gradual manner; and then, when the side or outer portions of the shims 324 are pressed down and adhered to the fabric 452, the predetermined fabric underneath and on the side edges or outer edges of the shims 324 is secured (e.g., adhered to the shims) in its state in the in which the stress and/or deformation in the predetermined fabric is distributed laterally and in a gradual manner, which seeks to prevent sudden high stress on the side edges (e.g., opposite ends) of the fabric bridge 320.

[0140] Referring to Figures 6E and 6F, the mounting lugs 464 can be removed from the fabric bridge 320 by manually grasping and pulling the tabs 465. Then, a user can manually push down the shims 324 with force. sufficient to ensure that the layer of pressure-sensitive adhesive 42 securely adheres the pads to the tissue 452 on opposite sides of the scar or wound 150.

[0141] Referring to Figure 7, in a third embodiment, the outer ends of the mounting lugs 464 may be fixedly connected to each other by means of any mechanical fasteners 459, adhesive material 459, or the like, so that a user can apply the fabric bridge using the fingers 457 of a single hand. Referring to Figures 6C and 7, joining the outer ends of the mounting lugs 464 together, e.g., manually and/or with one or more fasteners 459 and/or adhesive material 459, may cause not only the arch 328 to flex. , but also the shoulders 432 and the base plates or flanges 426 flex when the fabric bridge 320 is in its deformed or extended configuration.

[0142] Figure 8A depicts an applicator tool 580; Figure 8B depicts the applicator tool 580 receiving a tissue bridge 520; and Figure 8C depicts that the tissue bridge 520 and the applicator tool 580 are engaged together, and both the tissue bridge and the applicator tool are in their deformed configurations so that the tissue bridge is gripped or otherwise held firmly. by the applicator tool, according to a fourth embodiment. Referring to Figure 8A, the contact surface 582 may be a lower end face of a center link 586A, and the outer links 586B may extend obliquely upward from the center link 586A for levers 588 or cables 594. Locking portions 584 may include rods 590 that extend downwardly from lower ends of levers 588 or cables 594. Each locking portion 584 may additionally include at least one protrusion 592 that extends outwardly from the lower end of the rod. 590 in a direction that may be transverse to the length of the rod. The protrusions 592 may extend along the length of, or more specifically parallel to, the length of the contact surface 582. Referring to Figures 8B and 8C, the protrusions 592 may enter the receptacles 552 (which are partially defined by the middle struts 548). ) through the side openings of the receptacles 552.

[0143] Figure 9A depicts an applicator tool 780; Figure 9B depicts the applicator tool 780 receiving a tissue bridge 720; and Figures 9C and 9D depict that the tissue bridge 720 and the applicator tool 780 are engaged together, and both the tissue bridge and the applicator tool are in their deformed configurations so that the tissue bridge is gripped or otherwise gripped. held firmly by the applicator tool, according to a fifth embodiment. Referring to Figure 9A, the contact surface 782 may be a lower end face of a center link 786A, and the outer links 786B may extend obliquely upward from the center link 786A to levers 788 or cables. 794 joined together at their upper ends. Locking portions 784 may include rods 790 extending downwardly from lower ends of levers 788 or cables 794. Each locking portion 784 may additionally include at least one protrusion 792 extending outwardly from the lower end of the rod 790 in a direction that may be transverse to the length of the rod. The protrusions 792 may extend along the length of, or more specifically parallel to, the length of the contact surface 782. Referring to Figures 9B to 9D, the protrusions 792 may enter receptacles 752 (which are partially defined by the middle struts 748 ) through side openings of the receptacles 752.

[0144] Figure 10A depicts a tissue bridge 920, according to a sixth embodiment. Locking holes 956, which extend through body 922 and are open for receptacles 952, may also be open on the side edges of the body. Figures 10B and 10C depict an applicator tool 980 receiving tissue bridge 920; and Figures 10D and 10E depict that the tissue bridge 920 and applicator tool 980 fitted together are both in their deformed configurations so that the tissue bridge is grasped or otherwise held firmly by the applicator tool, in accordance with the sixth embodiment. . The locking part rods 990 can enter respective locking holes 956 from the side, and the locking part protrusions 992 can enter the receptacles 952 (which are partially defined by the middle struts 948) through side openings of the receptacles. 952.

[0145] Figure 11A depicts a tissue bridge 1120 of a seventh embodiment. In the seventh embodiment, the locking holes 1156 are in the form of a slot 1156 that extends through the body 1122 and is open to the receptacles 1152. Figures 11B and 11C depict an applicator tool 1180 receiving the tissue bridge 1120; and Figures 11D and 11E depict that the tissue bridge 1120 and the applicator tool 1180 fitted together are both in their deformed configurations so that the tissue bridge is grasped or otherwise held firmly by the applicator tool, in accordance with the seventh modality. The locking portions 1184 extend downwardly through the slot 1156. An enlarged section of the lower end of the center link of the applicator tool 1186A fits into the slot 1156, and protrusions 1187 extending from opposite sides of the lower end of the center link 1186A fit against the upper surfaces of the arch 1128 on opposite sides of the slot 1156. The levers 1188 or cables 1194 may be joined together at their upper ends, and the lamellas 1168 or other suitable structures extending into the levers 1188 or cables 1194 may engage each other to restrict any further movement into the levers 1188 or cables 1194 when the fabric bridge 1120 and the applicator tool 1180 fitted together are both in their deformed configurations. For example, the lamellae 1168 and/or other suitable features may be configured to come into contact with each other when the desired degree of deformation is achieved in the tissue bridge 1120 thereby seeking to prevent excessive distortion of the tissue bridge.

[0146] As at least alluded to above, the tissue bridges and applicator tools of the third to seventh embodiments can be configured cooperatively relative to one another, at least in a general manner, similar to the tissue bridges and applicator tools of the first embodiment. For example, and again with reference to Figures 4C and 4D, the tissue bridges and applicator tools of the third through seventh embodiments may be cooperatively configured to function similarly to the tissue bridges and applicator tools of the first embodiment with respect to fasteners or protrusions. 92 that engage and push (e.g. deflect) the middle struts 48 downward.

[0147] Figures 12A and 12B depict an applicator tool 1380 receiving a tissue bridge body 1320; and Figures 12C and 12D depict that the applicator tool 1380 and the fabric bridge body 1320 fitted together are both in their deformed configurations so that the fabric bridge body is grasped or otherwise held firmly by the applicator tool, so according to an eighth modality. The locking portions 1384 may comprise receptacles or, more specifically, slots into which opposite ends of the fabric bridge body 1320 respectively extend. The levers 1388 or handles 1394 may have loops, partial loops, handles, and/or other suitable features fixedly attached to or along their upper ends to receive the fingers of an operator of the tool 1380, and another finger may be pressed down. on a platform and/or other suitable features at the upper end of the central connection 1186A.

[0148] The applicator tool 1380 may have a first body comprising a first lever 1388 connected to a first locking part 1384, and a second body comprising a second lever 1388 connected to a second locking part 1384. Referring to Figures 12B and 12C, the reconfigurable link (e.g., links 1186A, 1186B) may connect the first and second bodies together, and be configured so that (e.g., simultaneously): the first and second bodies are pivotable relative to each other. to the other around the first and second geometric axes 1371, 1372, respectively; and the first and second geometric axes 1371, 1372 are movable towards and away from each other. Levers 1388, cables 1394, linkage (e.g., links 1186A, 1186B), and/or other suitably associated features may have a number of different configurations to aid in ergonomically optimized use, e.g., by comprising partial or full rings, molded recesses to receive the user's finger(s) and/or other suitable resources.

[0149] Figures 13A and 13B depict a tissue bridge 1520 of a ninth embodiment. As shown in Figures 13A to 13C, the locking holes 1556 may extend through the base plates or flanges 1526. Referring to the exploded view of Figure 13C, the fabric bridge 1520 includes inner and intermediate adhesive layers 1538, 1540 that lie respectively between and fixedly connect the inner sheets 1536 to the flanges 1526, and the outer sheets 1534 to the inner sheets. The fabric bridge 1520 may additionally include lower holes 1527 in the inner adhesive layers 1538 and inner sheets 1536. The lower holes 1527 may be opened for the locking holes 1556, and the lower holes 1527 may also extend outwardly to be opened in the outer edges of the inner adhesive layers 1538 and the inner sheets 1536. As discussed in greater detail below, the locking holes 1556 may mate with respective portions of applicator tools. Additionally and/or alternatively, holes 1527, 1556 (e.g., open windows) may provide pathways for ventilation/moisture transmission.

[0150] Figure 13D depicts the tissue bridge 1520 mounted on a tray 1622, and Figures 13E and 13F depict some of the steps of a method for using the applicator tool 1580 to remove the tissue bridge from the tray 1622, in accordance with the ninth modality. For example, in response to the relative movement that causes the applicator tool 1580 to increase in proximity to the tray 1622 or, more specifically, to the movement of the applicator tool toward the tissue bridge 1520 mounted on the tray, the locking portions of the tool 1584 may enter the inner lower holes 1527 through the outer holes 1556, so that respective portions of the outer sheets 1534 may be engaged by, and pushed (e.g., stretched) out by, the protrusions 1592; and the locking portions 84 are releasably connected to the fabric bridge 1520. The inner bottom holes 1527 may additionally extend through other layers of the shims 1524. In the ninth embodiment, when the applicator tool 1580 is operated to cause both the applicator tool and fabric bridge 1520 are in their deformed configurations so that the fabric bridge is gripped or otherwise held firmly by the applicator tool, not only does the arch 1528 flex, but also the shoulders 1532 and base plates or flanges 1526 flex, in a similar way to that shown in Figures 6C and 7.

[0151] Figure 14 is a pictorial bottom view of an applicator tool 1780, in accordance with a tenth embodiment. In the tenth embodiment, the bearing or contact surface 1782, which is positioned between the locking parts 1784 to press against the apex of the arch of a fabric bridge, is defined at the junction between the connections 1786 and/or at the bottom point of at least one connection 1786. The one or more connections 1786 may extend obliquely upward from the contact surface 1782 to the levers 1788 or the handle 1794. , at least partially, the applicator tool 1780 and a series of tissue bridges 1720.

[0152] Other modalities are also within the scope of this disclosure. For example, locking portions of the fabric bridges may include hook-shaped members, shelves, lugs, or other lock-like features that extend upwardly from the base plates or flanges to engage with applicator tool fasteners. In another example, the shoulders and base plates or flanges may be omitted from the body of a fabric bridge, and curved shims, which may comprise curved mid-struts, may be connected directly or indirectly to the arch of such a fabric bridge.

[0153] As another example, one or more therapeutic agents may optionally be included in any of the kits, packages described above and/or in or on the tissue bridges. For example, a medicinal, a biologic (e.g., amnion or chorion), growth factors, wound healing factors, pharmaceuticals (wound modulators, steroids, antibiotics), and/or other suitable therapeutic agents may be included in the kits. , packaging and/or in or on tissue bridges in a manner that seeks to improve wound healing, reduce scarring and/or reduce complications. As a specific example, an element or means that is added to or an additional part of a tissue bridge may comprise the therapeutic agent, and such means may be associated with any of the tissue bridges described above.

[0154] Figures 16A to 16C depict some of the steps of a method of associating a medium with one or more of the tissue bridges 20 of the first embodiment, although the method can be carried out with any other suitable tissue bridges, or the like. The medium may be in the form of a strip 170 of material such as, but not limited to, silicone tape. Figure 16A depicts an elongated scar or wound 150 on tissue 152, e.g., the outer surface of a patient's epidermis. Also referring to Figure 16B, scar or wound 150 may be covered with strip 170, wherein the covering strip typically extends along the scar or wound. Referring to Figures 16C and 16D, one or more of the fabric bridges 20 may be mounted on the fabric 152 so that the fabric bridges extend across the strip 170, and for each fabric bridge the strip extends between the inner edges of the shims 24 or, more specifically, the strip extends between the inner edges of the middle struts 48.

[0155] In the example shown in Figure 16D, the strip 170 is not fixedly connected to the fabric bridges 20, but may optionally be connected to the fabric 152 with releasable adhesive material 172. Alternatively, in the example shown in Figure 16E, the strip 170 can be fixedly connected to the arch 28 with adhesive material 174. Referring to Figure 16E, the relative sizes of features can be such that the strip 170 can be attached to both the bottom of the arch 28 and the scar or wound 150, e.g. example, in a manner that seeks to keep the strip in place whether adhesive material 174 is present or not. For example, the strip or medium 170 may be a foam of a thickness such that the one or more tissue bridges 20 gently push down the foam to maintain good contact between the foam and the scar or wound 150, wherein the foam is or may optionally include one or more therapeutic agents, such as silicone.

[0156] In addition to or alternatively, the strip may be mounted on the arch 28. For example, in connection with a method related to Figure 16E, the bottom of one or more of the arches 28 may be fixedly connected to the strip 170 by the adhesive material 174 during original fabrication of the one or more tissue bridges, so that the strip 170 is originally coupled against the scar or wound 150 in the tissue 152 at the same time that the one or more tissue bridges are assembled into the tissue. That is, multiple fabric bridges 20 may be fixedly mounted on a single strip 170 and/or each fabric bridge may be mounted on a separate strip. For the last example, for each fabric bridge 20, the strip 170 may be wider than the width of the fabric bridge so that end sections of adjacent strips abut and/or overlap each other when a series of fabric bridges adjacent to each other is applied.

[0157] Referring to Figure 16F, in addition to the strip or means 170 being positioned between the inner edges of the shims 24 or middle struts 48, the strip or means may also extend, at least partially, over the middle struts, such as , for example, to accommodate a relatively larger area of adhesive material 174. In one aspect of this disclosure, the strip or means 170 may or may not extend laterally to the level of the middle edges of the middle struts 48 in the rest configuration of the bridge. fabric 20. For example, Figure 16G depicts a side view of a fabric bridge 20 in its resting configuration, wherein the strip or means 170 is fixedly connected to the bottom of the arch by adhesive material 174, and the strip or means 170 is configured to be positioned, at least partially, between the shims 24 and/or mid-struts 48 when the fabric bridge is mounted on the fabric 152, for example, as shown in one or more of Figures 16D to F.

[0158] Reiterating the above, in one example the strip 170 may comprise silicone or be a silicone strip. As further examples, strip 170 may be any suitable medium comprising one or more therapeutic agents, examples of which are mentioned above. As further examples, the strips or means 170 may comprise or otherwise encompass other materials and various geometries/shapes of materials such as, but not limited to, foams, cloths (wovens, non-wovens, and/or felts), laminations of materials same/different, and similar, which may carry and/or comprise one or more therapeutic agents. Materials may have one or more properties that work with or enable therapeutic agents. As another example, the strips or media 170 may comprise biodegradable materials such as, but without limitation, polymers that may be "doped" with therapeutic agents so that, as the polymers break down, therapeutic agents are released. Alternatively, the strip or means 170 may not contain or otherwise carry any therapeutic agent, and may be, or may function as, a bandage, tape, or other suitable medical covering to wrap the scar or wound 150. As another example, a or more therapeutic agents may be applied to the scar or wound 150 in a conventional manner, and thereafter the strip or means 170 and tissue bridge 20 may be mounted over the one or more therapeutic agents on the scar or wound.

[0159] An eleventh embodiment of this disclosure is the same as the first and ninth embodiments discussed above, except for variations noted, and variations that will be apparent to those skilled in the art. Accordingly, for example, reference numerals of similar designs are used for the first and eleventh embodiments, except that the reference numerals for the eleventh embodiment are typically incremented by two thousand as compared to the first embodiment.

[0160] Figures 17A to 17E depict the at least partially elastic (e.g., generally elastic) medical article 2020 in its undeformed or resting configuration, according to the eleventh embodiment. Reiterating, at least partially, the foregoing, the medical article 2020 may optionally be referred to as a force modulating tissue bridge 2020, or simply tissue bridge 2020, and throughout this disclosure the tissue bridge may be, more generally referred to as a medical article.

[0161] Referring primarily to Figure 17A, the fabric bridge 2020 of the eleventh embodiment comprises a generally elastic body 2022 and one or more multi-layer shims 2024 mounted on the body, although in some examples one or more of the shims and/or portions thereof may be omitted (for example, a shim may consist of, or consist essentially of, a single layer). The body 2022 may generally be styled as and/or generally function as a backbone or other suitable structure configured to movably connect two or more of the wedges 2024 together. The body 2022 may include at least two flanges 2026 (e.g., feet) that respectively extend obliquely, e.g., outwardly and downwardly, from opposing lower portions of a central section or arch 2028 of the body. Each of the flanges 2026 may be flat, or they may be substantially or approximately flat since it may not be critical that the flanges are exactly flat. Flanges 2026 can extend divergently from one another, and obliquely from one another. The arc 2028 may include a central expansion section 2030, and lower sections 2032 that respectively extend downwardly from opposite portions of the expansion section. The lower sections 2032 of the arch 2028 may optionally be configured as and/or referred to as bosses 2032. The flanges 2026 may respectively extend obliquely, e.g., outward and downward, from lower portions of the bosses 2032 The lugs 2032 can provide a smoothly curved transition between the expansion section 2030 of the arch 2028 and the flanges 2026.

[0162] In one example, the central expansion section of the arch 2030 may be thicker than the flanges 2026, and other variations are within the scope of this disclosure. For example, although arc 2028 is typically depicted in drawings as being, at least generally, arched, it is believed that in some situations arc 2028 may be at least more of a flat arc, or expansion section 2030 of the arch may be flat, or the arch or features thereof may be in any other suitable configurations that allow the fabric bridge 2020 to function generally or substantially as described herein.

[0163] Each of the parts of the 2020 fabric bridge will typically be constructed of materials suitable for medical use. For example, the body 2022 may be a unitary article (e.g., one-piece) injection molded or mechanically thermoformed, such that the expansion section 2030, the shoulders 2032, and the flanges 2026 may be formed together as a single article. from a generally elastic injection moldable or conformable material such as, but without limitation, polycarbonate, or any other suitable injection moldable or conformable material. Each of the expansion section 2030, the shoulders 2032 and the flanges 2026 may be approximately the same thickness or, alternatively, the thickness of the body 2022 may vary along its length. The width of the body 2022 may, for example, taper along its length so that the expansion section 2030 is relatively narrow (e.g., has a narrowed waist) when compared to the shoulder 2032 and the flanges 2026, so that the section expansion joints can be deformed more readily when compared to bosses and flanges. For example, the side edges of the expansion section 2030 may be inwardly curved or concave, or they may have a stepped configuration or other suitable configurations. Alternatively, the side edges of the expansion section 2030 may extend generally or substantially straight in a top plan view of the fabric bridge 2020, or they may extend in any other suitable manner.

[0164] The shims 2024 may be separated from each other, and the shims may be fixedly mounted to the flanges 2026. Each shim 2024 may be or include being a blanket, laminate, or other suitable structure comprising one or more layers of material. For example, each shim 2024 may include an outer layer or sheet 2034 configured to be attached to the fabric (e.g., fur fabric), and an inner layer or sheet 2036 positioned between, and fixedly connected to, each of the sheets. external 2034 and the respective flange 2026.

[0165] Referring to the exploded view of Figure 17F, the fabric bridge 2020 may include inner, middle, and outer adhesive layers 2038, 2040, 2042. The inner adhesive layers 2038 may be between and fixedly connect the inner sheets 2036 to the flanges 2026 , the intermediate adhesive layers 2040 may be between and securely connect the outer sheets 2034 to the inner sheets, and the outer adhesive layers 2042 may be on the outer sides of the outer sheets to secure the fabric bridge 2020 to the fabric (e.g., a skin of the patient).

[0166] The outer and inner sheets 2034, 2036 can be provided by cutting them from suitable fabrics or larger sheets of material, such as cloth or microporous polymeric sheet, fused to the outer sheets 2034, and an extruded polymer or plastic sheet for the inner sheets 2036. The outer sheets 2034 may be produced from cloth materials, cast materials, films or other suitable materials of the type from which skin contact layers of bandages or other wound dressings are formed, or from any other suitable material. The plastic inner sheets 2036 may be produced from suitable materials such as, for example, polyethylene, polyethylene terephthalate, or any other suitable materials. The outer adhesive layer 2042 may have a lower adhesive strength than the inner and intermediate adhesive layers 2038, 2040, such as when the tissue bridge 2020 is to be removably mounted on tissue (e.g., a patient's skin).

[0167] Both the body 2022 and the inner sheet 2036 may have a higher modulus of elasticity (e.g., be formed of stiffer material) than the outer sheet 2034. More generally, the body 2022 and the inner sheet 2036 may be stiffer than the outer sheet 2034 due to several factors, such as being larger, thicker and/or comprising material that has a higher modulus of elasticity. The body 2022, including its flanges 2026, may be thicker than each of the outer and inner sheets 2034, 2036, although the thicknesses may be varied. The arc 2028 may extend over an area into which portions of the outer and inner sheets may optionally extend. The area over which the arc 2028 extends may be referred to as a central area, a treatment area, an area under the arc, and/or the like.

[0168] Referring to Figure 17C, inner extensions 2048 of the outer and inner sheets 2034, 2036 may extend congruently to each other into the central area over which the arc 2028 extends so that the inner extensions 2048 are not overlapped. nor coextensive with the flanges 2026. More generally, each shim 2024 may include at least one extension 2048 that extends into the central area over which the arc 2028 extends such that the inner extension 2048 cannot be overlapped or coextensive with flanges 2026. The inner extensions 2048 may be referred to as middle extensions 2048, for example, since they extend towards the center of the area over which the arc 2028 extends. The inner or middle extensions 2048 may be configured so that they resist, at least partially, longitudinal compression when the tissue bridge 2020 in its extended configuration is mounted on the tissue (e.g., skin tissue) and then left to, in generally, elastically reconfigure itself from its extended configuration, at least partially, to its resting configuration. Accordingly, the inner or middle extensions 2048 can be referred to as middle struts 2048. A gap can be defined between adjacent ends of the middle extensions 2048, and the gap can be configured, for example, so that the adjacent ends of the middle extensions 2048 are separated each other and do not contact each other.

[0169] Referring to Figure 17B, for each shim 2024, one or more (e.g., four) outer margins or extensions of the outer sheets 2034 may extend outwardly beyond the inner sheet 2036 so that they are not overlapped or coextensive with the inner sheet 2036. In the eleventh embodiment, each middle strut 2048 includes the inner extensions 2048 of both sheets 2034, 2036, but one or more layers or sheets of the middle strut 2048 may be omitted, so that each middle strut may be formed from one or more layers of material.

[0170] Referring to Figure 17C, the middle struts 2048 may be separated (e.g., at least partially separated) from the arch 2028 and extend into the central area over which the arch extends, so that the gaps or receptacles 2052 are at least partially defined between the middle struts and the arch. The receptacles 2052 may, at least partially, define or be at least part of locking portions configured to interact with corresponding features of an applicator tool that may be used, for example, in mounting the tissue bridge 2020 to the tissue (e.g., a patient's skin). For example, fabric bridge 2020 may include one or more locking parts that respectively comprise receptacles 2052. Various differently configured locking parts are within the scope of this disclosure.

[0171] The body 2022 may include at least two locking parts that further comprise internal holes 2056 that extend through the body 2022 and are open to the receptacles 2052. The internal holes 2056 may be defined in the arc 2028 or, more specifically, the inner holes 2056 may be positioned in opposite end portions of the expansion section 2030. The inner holes 2056 may be open to the central area over which the arch 28 extends or, more specifically, the inner holes may be open to the receptacles 2052; and the middle struts 2048 can extend below the inner holes. The internal holes 2056 may be of any suitable shape. For example, they may be generally polygonal, or generally rectangular, with an edge 2058 of the arc 2028 defining the internal hole 2056 extending transversely to the length of the arc.

[0172] The respective locking portion may additionally include the edge 2058 and a protrusion or rib 2057 that extends downwardly from (e.g., downwardly from the proximity of) the edge 2058. The edge 2058 and rib 2057 may interlock. extend parallel, or more generally substantially parallel or approximately parallel, to the boundary between the expansion section 2030 and the respective shoulder 2032. In other words, the edge 2058 and the rib 2057 may extend perpendicular to, or more generally generally, substantially perpendicular to or approximately perpendicular to the geometric axis in the lengthwise or longitudinal direction of the body 2022. Furthermore, the internal holes 2056, when present, may reduce the area or volume of the external portions of the expansion section 2030 in a manner that increase the deformability of the outer portions of the expansion section. Reiterating the foregoing, at least partially, each locking portion may include a projecting portion 2057 of the lower surface of the arch 2028, wherein the projecting portion or rib 2060 extends outward from the edge 2058, or adjacent thereto. .

[0173] The internal holes 2056 may be omitted and/or the body 2022 may have one or more other holes formed in or through it. For example, the outer holes 2059 may extend through the base plates or flanges 2026. Referring to the exploded view of Figure 17F, the adhesive layers 2038, 2040 and the inner sheets 2036 may additionally include lower holes 2027. The lower holes 2027 may be opened to the outer holes 2059, and the lower holes 2027 may also extend outwardly to be opened at the outer edges of the adhesive layers 2038, 2040 and the inner sheets 1536. The outer holes 2059 may be of any suitable shape. For example, the outer holes 2059 may generally be polygonal or generally rectangular. The bottom holes 2027 can be molded complementary to the outer holes 2059.

[0174] Figure 17F, in addition to depicting fabric bridge 2020 in an exploded configuration, further depicts fabric bridge 2020 exploded away from a schematically depicted section of a release liner 2062 and associated adhesive material 2064. As an example , after a fabric bridge 2020 is manufactured or as part of the manufacturing process for the fabric bridge, the fabric bridge, or more specifically, the outer sheets 2034 via the outer adhesive layers 2042, may be releasably assembled into the upper surface of the release liner 2062. Furthermore, the lower surface of a portion of the release liner 2062 may be fixedly mounted to a support (e.g., tray) by means of the adhesive material 2064. The release liner 2062 may be, e.g. a sheet of paper or plastic based film coated with a release agent that is fitted against the outer adhesive layers 2042 so that the fabric bridge 2020 is releasably mounted to the release liner. The release liner 2062 may include a series of tear lines 2136. Each tear line 2136 may comprise one or more cuts, tears, tamperable tear lines, perforations and/or overlapping and/or sequential combinations thereof, to define, at least less partially, the flaps 2138 on the removable liner 2062. The tear lines 2136 can be configured in various patterns. In the eleventh embodiment, each tear line 2136 extends partially around the shim 2024 that is mounted to the tab 2138 defined by the break line 2136, and opposite ends of the break line 2136 extend below the shim. The tear lines 2136 may be formed as part of a cutting step (e.g., die cutting), or the like, so that the tear lines 2136 (e.g., slots, perforations, or other suitable cuts) may extend , at least partially, to one or more layers of the shim 2024. As a more specific example, tear lines 2136, or extensions thereof, or the like, may extend to the outer adhesive layer 2040 and the outer sheet 2034. Similarly, additional perforations or tear lines 2137 (e.g., serially arranged perforations) may be defined in the outer sheet 2034 and/or the release liner 2062. The adhesive material 2064 is typically arranged in a so-called pattern. that the adhesive material is omitted between the tabs 2138 on the release liner 2062 and respective portions of the tray so that the tabs can be moved relative to the remainder of the release liner. In this regard, 2064 adhesive material can be applied in any suitable pattern. For example, for a representative flap 2138, the adhesive material 2064 may extend along at least one edge of the flap without adhering the flap to the associated tray, or the like.

[0175] For example, and similar to the first embodiment and at least some of the other embodiments, the fabric bridge 2020 of the eleventh embodiment may be configured so that each flange 2026 has opposing top and bottom surfaces that are each larger than that a defined thickness between the upper and lower surfaces of the flange; each shim 2024 has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the shim; and for each flange 2026 and the respective shim 2024 connected thereto, the upper surface of the shim and the lower surface of the flange: may face each other, may be overlapping one another, may be parallel (e.g., substantially parallel ) to each other, and/or can be directly connected to each other by the internal adhesive layers 2038 positioned between them.

[0176] It is believed that the configuration (e.g., size) of the fabric bridge 2020 can be adjusted so that the fabric bridge can be well suited for a number of different situations. Although, to promote ease of understanding, and not for the purpose of limiting the scope of the present invention, a few examples of dimensions and reasons are provided in this Detailed Description section of this disclosure. For example, in Figure 17B, the lengths "L1" and widths "W1" of the top and bottom surfaces of flanges 2026 are indicated. In Figure 17C the "T" thicknesses defined between the top and bottom surfaces of flanges 2026 are indicated. T flange thicknesses are smaller than L1 flange lengths and W1 widths. Furthermore, in Figure 17B, a "W2" width of the central expansion section 2030 of the arc 2028 is designed, and the same is narrower than the W1 widths of the flanges 2026. As an example, the total length of the fabric bridge 2020 in its relaxed state (that is, in its resting configuration) can be in a range of about 25 mm (about 1 inch) to about 41 mm (about 1.6 inches), or more specifically, about 33 mm (about 1.3 inches); the L1 lengths of the top and bottom surfaces of the 2026 flanges may be in a range of about 5.6 mm (about 0.22 inch) to about 8.9 mm (about 0.35 inch) or, more specifically , about 7.1 mm (about 0.28 inch); the W1 widths of the top and bottom surfaces of the 2026 flanges may be in a range of about 7.6 mm (about 0.3 inch) to about 12.7 mm (about 0.5 inch) or, more specifically , about 10.2 mm (about 0.4 inch); T flange thicknesses defined between the top and bottom surfaces of the 2026 flanges may be in a range of about 0.41 mm (about 0.016 inch) to about 0.61 mm (about 0.024 inch) or, more specifically , about 0.51 mm (about 0.02 inch); and the width W2 of the central arc expansion section 2030 may be in a range of about 5.1 mm (about 0.2 inch) to about 7.6 mm (about 0.3 inch) or, more specifically, about 6.3 mm (about 0.25 inch). Accordingly, the upper and lower surfaces of the flanges 2026 (e.g., the L1 lengths and/or W1 flange widths) may be at least two, several, or many times greater than the thickness T defined between the upper and lower flange surfaces. . Other dimensions and/or reasons are within the scope of this disclosure.

[0177] In other examples, the total length of tissue bridge 2020 in its relaxed state (i.e., in its resting configuration) may be in a range of about 16 mm (about 0.65 inch) to about 88 mm (about 3.5 inches) or, more specifically, about 33 mm (about 1.3 inches); the L1 lengths of the top and bottom surfaces of the 2026 flanges may be in a range of about 3.6 mm (about 0.14 inch) to about 16.7 mm (about 0.66 inch) or, more specifically , about 7.1 mm (about 0.28 inch); the W1 widths of the top and bottom surfaces of the 2026 flanges may be in a range of about 4.9 mm (about 0.2 inch) to about 23.8 mm (about 0.9 inch) or, more specifically , about 10.2 mm (about 0.4 inch); T flange thicknesses defined between the top and bottom surfaces of the 2026 flanges may be in a range of about 0.27 mm (about 0.010 inch) to about 1.14 mm (about 0.045 inch) or, more specifically , about 0.51 mm (about 0.02 inch); and the width W2 of the central arc expansion section 2030 may be in a range of about 3.3 mm (about 0.13 inch) to about 14.3 mm (about 0.56 inch) or, more specifically, about 6.3 mm (about 0.25 inch). Other dimensions and/or reasons are within the scope of this disclosure.

[0178] With continued reference to Figure 17B, the arch 2028 may have a "L2" length of about 17.8 mm (about 0.7 inch) while the fabric bridge 2020 is in its relaxed state. In the relaxed state of the 2020 fabric bridge, the ratio of the arc length L2 to the total length of the fabric bridge (L1 plus L2 plus L1) (i.e. L2 divided by (L1 plus L2 plus L1)) can vary from greater than 0.35 to less than 0.75 or, more specifically, it can be about 0.3. In the relaxed state of the 2020 fabric bridge, the ratio of arc length L2 to flange length L1 (i.e. L2 divided by L1) can vary from greater than 1 to less than 5 or, more specifically, can be about 0.23. The ratio of flange length L1 to flange width W1 (i.e. L1 divided by W1) can vary from greater than 0.5 to less than 3 or, more specifically, can be about 0.77. Other dimensions and/or reasons are within the scope of this disclosure.

[0179] In a similar manner (e.g., measuring in the same directions as indicated by the lengths L1, L2, widths W1, W2 and thicknesses T projected in Figures 17B and 17C), the fabric bridge 2020 of the eleventh embodiment can be configured so that each shim 2024 has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the shim. As an example, the defined thicknesses between the top and bottom surfaces of each shim 2024 may be in a range of about 0.25 mm (about 0.01 inch) to about 0.36 mm (about 0.014 inch). or, more specifically, it may be about 0.3 mm (about 0.012 inch). The upper and lower surfaces of each shim 2024 may be at least two, several, or many times greater than the thickness defined between the upper and lower surfaces of the shim. In one example, each inner sheet 2036 may be biaxially oriented polyethylene terephthalate film having a thickness in a range of about 0.063 mm (about 0.0025 inch) to about 0.38 mm (about 0.015 inch) or , more specifically, can be about 0.13 mm (about 0.005 inch). Regarding the length and width directions shown in Figure 17B, in one example, for each inner sheet 2036, its length is at least twice its width, although there may be other reasons. Several other configurations (e.g., dimensions and/or ratios) are within the scope of this disclosure.

[0180] Referring to Figure 17B, in a top plan view of the fabric bridge 2020, the ratio of the area of an external hole 2059 (if present) to the area of the flange 2026 not counting the hole (i.e., the area of the outer hole 2059 divided by the area of the flange 2026 not counting the hole) may vary from greater than 1 to less than 3. Other dimensions and/or ratios are within the scope of this disclosure.

[0181] Referring to Figure 17C, for a fabric bridge 2020 to be used in an area of skin where skin curvature is minimal, angles "A1" between a plane tangent to the top of arch 2028 and flanges 2026 it may be within a range of about 15 degrees to about 19 degrees, or more specifically, it may be about 17 degrees while the tissue bridge is in its relaxed state. In another example, the A1 angles may be within a range of about 7 degrees to about 27 degrees or, more specifically, may be about 17 degrees while the tissue bridge is in its relaxed state. For areas of skin with greater or lesser curvature, the A1 angles can be adjusted to obtain a desired level of skin eversion. Other angles are within the scope of this revelation.

[0182] Referring to Figure 17D, for each middle strut 2048, the length "L3" of the middle strut may be less than the length "L4" of half the arch 2028 in its relaxed state. More specifically, the ratio between the length L3 of mid-strut 2048 and the length L4 of half-arch 2028 (i.e., L3 divided by L4) may be in a range from greater than 0.3 to less than one, while the 2020 fabric bridge is in its relaxed state. Other dimensions and/or reasons are within the scope of this disclosure.

[0183] Referring to Figure 17B, in a top plan view of the fabric bridge 2020, each of the side edges of the arch 2028 may have a radius of curvature of about 9.5 mm (about 0.375 inch). The ratio between this radius of curvature of the arch 2028 and the length L3 (Figure 17D) of the middle strut 2048 (i.e., the radius of curvature of the arch 2028 divided by the length L3) may vary from greater than 0.18 to less than than 0.6 or, more specifically, it could be about 0.3. Other dimensions and/or reasons are within the scope of this disclosure.

[0184] Referring to Figure 17D, the distance "D1" between adjacent ends of the middle struts 2048 may be in a range of about 1 mm (about 0.04 inch) to about 18 mm (about 0.7 inch) or, more specifically, it can be about 4 mm (about 0.16 inch). Other dimensions and/or reasons are within the scope of this disclosure.

[0185] Figures 18A to 18D depict an applicator mechanism in the form of an applicator tool 2080 that can be used, for example, to manipulate a tissue bridge 2020 or other suitable medical article, for example, as part of a method of assembling bridging tissue on tissue (e.g., a patient's skin), according to the eleventh embodiment. For example, the applicator tool 2080 may include one or more parts or features that may be separated from one another and may be configured to releasably engage the tissue bridge 2020. In the eleventh embodiment, the one or more parts or features of the applicator tool 2080 that are configured to engage the tissue bridge 2020 may comprise at least one bearing or contact surface 2082 and/or one or more locking portions 2084. For example, the contact surface 2082 may be positioned between the locking 2084. The applicator tool 2080 may additionally include a reconfigurable frame that connects the contact surface 2082 and the locking portions 2084 together.

[0186] The applicator tool frame 2080 may include a reconfigurable link (e.g., one or more links 2086) that connects the contact surface 2082 and the locking portions 2084 together. The frame of the applicator tool 2080 may additionally include one or more levers 2088 comprising and/or extending upwardly from the links 2086. The applicator tool 2080 may be configured so that when the bearing or contact surface 2082 is downwardly facing , the locking portions 2084 extend below the connection (e.g., connection(s) 2086), and the levers 2088 extend above the connection. The linkages 2086 and the levers 2088 may be configured cooperatively so that at least portions of the locking portions 2084 move away from each other, and the contact surface 2082 moves toward a line extending from one to the other of the locking portions 2084, in response to at least portions of the levers 2088 being moved toward each other, as will be discussed in greater detail below.

[0187] The contact surface 2082 may be a lower end face of a pivotable joint (e.g., flexible joint, live joint (e.g., reduced thickness area), or the like) between the connections 2086. The locking parts 2084 may include rods 2090 extending from upper ends of links 2086 and/or lower ends of levers 2088. Links 2086 may be referred to as lower sections of levers 2088. Each locking portion 2084 may additionally include at least one external protrusion 2092 extending outwardly from the lower end of rod 2090 in a direction that is transverse to the length of the rod. The external protrusions 2092 may face away from each other. Each outer protrusion 2092 may be generally rectangular and include an outer tip 2091 and a mating boss 2093. An acute angle may be defined between the mating surfaces 2093 and the rods 2090. The linkages 2086 and the levers 2088 may be be cooperatively configured so that the external protrusion 2092 moves away from each other in response to at least portions of the levers 2088 being moved toward each other.

[0188] The applicator tool 2080 may optionally include additional protrusions 2095 (e.g., stabilizing and/or aligning protrusions) that extend outwardly from opposite sides of the rods 2090. A distance between the engagement boss 2093 and the most adjacent projections of the stabilizing and/or aligning protrusions 2095 may be approximately equal to, or slightly greater than, a thickness of the expansion section 2030 of the fabric bridge 2020. As another example, the distance between the engagement projection 2093 and the most adjacent projections/bottom surfaces of the stabilizing and/or aligning protrusions 2095 may be in a range of about 1 time to about 3.5 times the thickness of the expansion section 2030 of the fabric bridge 2020.

[0189] Links 2086 may extend obliquely outward and upward from contact surface 2082 respectively to upper portions of rods 2090. Levers 2088 may extend obliquely outward and upward respectively from upper portions of rods 2090.

[0190] Levers 2088 may define or comprise cables 2094. For example, in the embodiment depicted in Figures 18A to 18D, cables 2094 may be arcuate and/or concave sections recessed into levers 2088, although cables configured differently are within the scope of this disclosure. As an example, Figure 18B depicts two differently configured handles 2094, each of which has an outer upper surface 2097 that extends transversely the length of the applicator tool 2080 in a manner intended to restrict a user's fingers from inadvertently slipping. down and away from the cable. The top surface 2097 may be a top surface of a column or other suitable protrusion. As another example, the upper surface 2097 may be a lower portion of an arcuate, concave, or otherwise suitable curved surface. The handles 2094 may also include, for example, serrations configured in a manner that seeks to restrict a user's fingers from inadvertently sliding down and off the handle. As depicted in Figures 18A through 18D, the serration may be in the form of hemispherical protrusions or protrusions, although other features may be included to restrict a user's fingers from inadvertently sliding down and off the handle.

[0191] Optionally, the levers 2088 may be lower levers 2088 that extend obliquely upward (e.g., from the vicinity) of the contact surface 2082 and/or locking parts 2084 for upper levers 2089. The upper levers 2089 can be joined together at their upper ends. The upper connection between the upper levers 2089 may be a hinged joint (e.g., flexible joint, live joint (e.g., reduced thickness area), or the like) between the upper levers 2089. Alternatively, the upper levers 2089 may be omitted. .

[0192] The applicator tool 2080 may be a unitary injection molded article (e.g., single piece) formed from a generally elastic, injection moldable material such as, but without limitation, polycarbonate, polyethylene, or any other suitable injection moldable material. Alternatively, the applicator tool 2080 may be made of metal, metal alloys, steel, or any other suitable materials that may allow for rhesterization. For example, hinges (e.g., at joints between respective portions of levers 2088, 2089 and/or links 2086) or other suitable connections that allow relative movement between subparts may be included in applicator tools 2080, such as when applicator tools are produced of relatively rigid materials. As further examples, a variety of different applicator tool 2088 linkages, levers, and handles are within the scope of this disclosure.

[0193] According to examples of the eleventh embodiment depicted in Figures 18D to 20L, the tissue bridge 2020 and the applicator tool 2080 are configured cooperatively so that the applicator tool can be releasably fitted to the tissue bridge, and the tool applicator can be used to manipulate the tissue bridge as part of a method of mounting the tissue bridge to the tissue. For example, Figure 18D depicts the bearing or contact surface 2082 in face-to-face relationship with an upper surface of the arch 2028, and the rods 2090 extending through the internal holes 2056. In the configuration of Figure 18D, the protrusions 2092 (Figures 18A to 18C) are hidden from view within the receptacles 2052. More generally, the locking parts of the applicator tool 2080 and the tissue bridge 2020 are respectively fitted together in Figure 18D. However, a variety of differently configured locking parts are within the scope of this disclosure.

[0194] Referring to Figures 19A to 19F, a method of using applicator tool 2080 to remove a tissue bridge 2020 from tray 122 is described below, in accordance with the eleventh embodiment. Referring to Figure 19A, initially, the applicator tool 2080 (e.g., in its undeformed or resting configuration) may be fitted against the tissue bridge 2020 (e.g., in its undeformed or resting configuration) by means of of relative movement that causes increased approximation between the applicator tool 2080 and the tray 122 (for example, movement of the applicator tool towards the fabric bridge mounted on the removable liner 2062 in the tray). In the eleventh embodiment, the applicator tool 2080 is elastic and thus propelled towards its undeformed or resting configuration.

[0195] Referring to Figures 19A and 19B, in response to relative movement, the external protrusions 2092 of the tool locking parts 2084 may enter the receptacles 2052 through the internal holes 2056 (Figure 17A). That is, the outer protrusions 2092 may enter the receptacles 2052 by traveling through the inner holes 2056. For example, the applicator tool 2080 may be pushed downward to engage the tissue bridge 2020 in such a manner that the outer protrusions 2092 of the locking portions of the tool 2084 enter the receptacles 2052 through the internal holes 2056 and, optionally, also the contact surface of the tool 2082 fits, or at least is closer to the central apex or any other suitable surface of the arc 2028. In some Embodiments, the contact surface of the tool 2082 may not (e.g., may never) engage the fabric bridge 2020.

[0196] The applicator tool 2080 may be in its undeformed configuration or at rest throughout the entire step in which the external protrusions 2092 of the locking parts of the tool 2084 enter the receptacles 2052 through the internal holes 2056. As another example, the The distance between the tips of the outer protrusions 2092 may be greater than the distance between the edges of the hole 2058 (Figure 17B) so that the outer protrusions 2092 "fit" into the inner holes 2056 and/or receptacles 2052 and are optionally contained in a releasable manner into the receptacles by means of a forced fit, or similar. The outward movement of the external protrusions 2092 relative to each other associated with "docking" is represented schematically by a pair of arrows in Figure 19C.

[0197] In the eleventh embodiment, the internal holes 2056 are larger than the external protrusion 2092 so that the external protrusions can pass through the internal holes. Measuring in the same directions as indicated by the widths W1, W2 in Figures 17B, the widths of the external protrusions 2092 (e.g., the widths of the dovetail lugs 2093) may be within a range of less than about 1 times the about 0.4 times the width (or length) of the edges 2058 of the arc 2028 that partially defines the internal holes 2056.

[0198] The relative movement that causes increased approximation between the applicator tool 2080 and the tray 122 can be facilitated by a user manually holding the levers 2088 and/or handles 2094 (Figures 18A to 18C) of the applicator tool and moving the applicator tool toward the 2020 fabric bridge on the tray, or the fabric bridge may be supported by any other suitable surface. Referring to Figure 19B, the external protrusions 2092 may engage respective surfaces of the middle struts 2048 in response to relative movement that causes increased approximation between the applicator tool 2080 and the tray 122. As a more specific example depicted in Figure 19C, the projections or mating surfaces 2093 of tool 2080 may engage mating surfaces or ribs 2057 of fabric bridge 2020.

[0199] Then, to serially achieve the configurations of Figure 19C and Figure 19D, simultaneously and/or in series, the relative movement that causes increased approximation between the applicator tool 2080 and the tray 122 can continue, and the cables 2094 can be manually squeezed together (e.g., pushed toward each other) so that the applicator tool reconfigures itself to its actuated or deformed configuration and applies deformation forces to the tissue bridge 2020. As the applicator tool 2080 is, e.g. , simultaneously pushed with greater force against the fabric bridge 2020 and caused to deform further to its deformed configuration, the applicator tool applies forces against the fabric bridge 2020 so that the fabric bridge is responsively deformed to its stretched configuration, deformed or extended. For example, the applicator tool 2080 may simultaneously apply a downward force through the contact surface 2082 and laterally outward forces through the locking portions 2084.

[0200] Referring to Figure 19C, the distance between the middle struts 2048 and the inner holes 2056 (Figure 17A) may be approximately the same as, or less than, the distance between the docking bosses 2093 and the outer tips 2091 of the protrusions. 19C. As another example, the distance between the docking bosses 2093 and the outer tips 2091 of the outer protrusions 2092 may be in a range of about one to two times the distance between the middle struts 2048 and the inner holes 2056 in the relaxed configuration of the bridge. of fabric 2020.

[0201] Continuing with reference to Figure 19C, as the applicator tool 2080 of the eleventh embodiment is passed from its undeformed or resting configuration (e.g., Figure 19C) to its actuated or deformed configuration (e.g., Figure 19E), each side of the applicator tool and the associated tissue bridge 2020 may deform substantially symmetrically. For example, in Figure 19C, the distance "D2" schematically depicts the range of joint displacement between the adjacent link 2086 and the rod 2090 that occurs during the transition of the applicator tool 2080 from its undeformed or resting configuration to its actuated configuration. or deformed, and vice versa, and the displacement range D2 can be about 11.5 mm (0.45 inch). As another example, the distance "D3" schematically depicts how far the contact point or area between the fitting rib 2057 and fitting shoulder 2093 moves during the transition of the applicator tool 2080 from its undeformed or resting configuration to its actuated configuration. or deformed, and vice versa, and the distance D3 may be about 5.4 mm (2.1 inches).

[0202] As depicted schematically in Figure 19C, one side of a triangle or distance "S1" is defined between the center point of the upper surface of the arch of the fabric bridge 2028 and the junction of the link 2086 and the rod 2090. One side of the triangle or distance "S2" is defined between the junction of link 2086 and rod 2090 and the contact point or area between mating rib 2057 and mating shoulder 2093. An angle "A2" defined between a side of triangle " S3" and the triangle side S2 can be less than 120 degrees or, more specifically, approximately 93 degrees. The ratio of distance S1 to distance S2 (i.e., S1 divided by S2) may vary from about 1.0 to about 1.4, or may vary from about 1.1 to about 1.2, or , more specifically, can be about 1.14.

[0203] In transitioning from the configuration of Figure 19C to the configuration of Figure 19D, the outer portions of the shims 2024 have moved, or more specifically rotated, away from the outer tray sections 132. As discussed above, the removable liner flaps 2138 can be attached to the outer portions of the shims 2024 by means of the outer adhesive layer 2042. Therefore, the tabs 2138 can be carried by, and rotate with, the outer portions of the shims 2024. Therefore, the tabs 2138 rotate outwardly relative to to a remainder of the release liner 2062 that remains fixedly mounted to the base panel of the tray 2124. That is, the flaps 2138 may rotate outwardly relative to (e.g., delaminate, at least partially, from) a remainder of the release liner 2062 and of the tray 122 in response to respective movement, reconfiguration, and/or the like of the fabric bridge 2020 and applicator tool 2080. In the eleventh embodiment, the removable liner 2062 is a support that supports the fabric bridge 2020, and each flap 2138 can be termed a first support section, and the remainder of the removable liner 2062 and/or the tray 122 may be termed a second support section, or the like.

[0204] As another example, in the transition from the configuration of Figure 19C to the configuration of Figure 19D, the outer protrusions 2092 pushed (e.g., deflected) the middle struts 2048 downward toward the recessed center section 2130 of the tray 122. This is, in one example, the middle struts 2048 may rotate downward relative to a remainder of the shims 2024 in response to respective movement, reconfiguration, and/or the like of the fabric bridge 2020 and the applicator tool 2080.

[0205] Referring to Figures 19C to 19F, the applicator tool 2080 and the tissue bridge 2020 may be cooperatively configured and fitted together in a predetermined manner so that in response to the cables 2094 being squeezed or manually pushed closer together on the other, at least the lower portions of the locking parts of the tool 2084 are moved further away from each other and the contact surface 2082 moves toward a line between the locking parts 2084, and this movement of the applicator tool 2080 Force the 2020 fabric bridge to its deformed or fully extended configuration, an example of which is shown in Figure 19F. For example, the manual inward force applied to opposite sides of the 2094 cables to achieve this configuration may be in a range of more than 0.091 kgf (0.2 pounds force (0.89 newtons)) to less than 0.91 kgf (2 pounds force (8.9 newtons)).

[0206] In transitioning from the configuration of Figure 19D to the configuration of Figure 19E, the removable liner 2062 typically separates completely from the fabric bridge 2020, and the flaps 2138 may rotate/return to their original positions in response to relative movement that causes increasing the distance between the applicator tool 2080 and the tray 122. The release liner 2062 typically separates completely from the tissue bridge 2020 in a manner that fully exposes the outer adhesive layer 2042 (e.g., patient contact adhesive), so that there are no remnants of the release liner 2062 attached to the fabric bridge and the outer adhesive layer is ready to be used to secure the fabric bridge to tissue, such as a patient's skin.

[0207] For example, in Figure 19F the tissue bridge 2020 and the applicator tool 2080 are fitted together, and both the tissue bridge and the applicator tool are in their deformed configurations so that the tissue bridge is grasped or otherwise shape held firmly by the applicator tool, so that as the applicator tool is manually moved away from the tray 122, the applicator tool carries the tissue bridge away from the tray. While the tissue bridge 2020 is held securely by the applicator tool 2080, the applicator tool can be used to apply the tissue bridge to tissue, such as a patient's skin.

[0208] At least Figures 19C to 19E can be characterized as schematically depicting the stretching of the release liner 2062. However, any such stretching can be avoided, for example, as shown in Figure 19G, by including a tear line 2063 (e.g., cut, slit, or tear line) between respective sections of release liner 2062. As another example depicted in Figure 19H, a length of the portion of release liner 2062 positioned between the inner ends of shims 2024 may be greater than the distance between the inner ends of the shims 2024. The excess length of the portion of the release liner 2062 between the inner ends of the shims 2024 may be in the form of a bulge or overlapping section of the release liner 2062, or the like.

[0209] Referring to Figures 19I to 19L, a method of using applicator tool 2080 to apply a tissue bridge 2020 to tissue 2152 on either side of a cut 2150 in a skin of patient 2152 is described below, in accordance with the eleventh modality. Figure 19I schematically depicts with dashed lines 2154 the originally separated cut edges 2150, and a solid line 2156 schematically depicts that the cut edges can be manually pushed together before applying the fabric bridge 220 over the cut. The applicator tool 2080 holding the fabric bridge 2020 may be moved toward the cut 2150 so that the fabric bridge 2020 extends transversely to, or more specifically substantially perpendicular to, the length of the cut 2150, and the first contact between the fabric bridging and the fabric or skin 2152 occurs in the inner end sections or portions of the middle struts 2048 on either side of the cut. Referring to Figure 19J, the applicator tool 2080 may continue to be pushed closer to the cut 2150 so that the inner portions of the middle struts 2048 begin to be adhered to the skin 152 by the outer adhesive layer 2042 (e.g., contact adhesive with the patient). For example, the transmission of force from the applicator tool 2080, through the locking portions 2084, against the middle struts 2048 may cause the pressure-sensitive adhesive layer 2042 to be engaged against the fabric 2152 with sufficient force to make causing the inner portions of medium struts 2048 to be adhered to the fabric 2152 on opposite sides of the cut 2150. So, for example, as depicted, at least partially, in Figure 19K, the manual force on the handles 2094 of the applicator tool 2080 can be reduced , so that the fabric bridge 2020 returns to its resting configuration, and the middle struts 2048 come closer together and push the portions of the fabric 2152 to which they are adhered toward each other. Then, in response to the fabric bridge 2020 returning more toward its resting configuration, the reconfiguration of the fabric bridge causes the outer portions of the shims 2024 to move or rotate downwardly in contact with the fabric 2152 on opposite sides of the cut 2150. In one example, such contact between the outer portions of the shims 2024 and the fabric 2152 on opposite sides of the slit 2150 may occur with sufficient force to cause the pressure-sensitive adhesive layer 2042 to securely adhere to the outer portions of the shims. 2024 to fabric 2152 on opposite sides of cut 2150.

[0210] According to the eleventh embodiment, the inner portions of the middle struts 2048 are adhesively mounted to the fabric 2152 while the fabric bridge 2020 is in its deformed or extended configuration; and thereafter as the fabric bridge 2020 returns to its resting configuration and reaches an intermediate configuration that is between the extended and resting configurations, the remaining or outer portions of the shims 2024 are adhesively mounted to the fabric. When the fabric bridge 2020 is first fitted against the fabric 2152, the point of first contact and adhesive assembly to the fabric may be at the inner end sections or portions of the middle struts 2048, and this assembly may occur while the middle struts are being pushed downward by means of the applicator tool 2080. In the eleventh embodiment, as the deformation force that is applied to the fabric bridge 2020 by the applicator tool 2080 is reduced, the middle struts 2048 move or rotate inward, thereby pulling to the center the fabrics 2152 to which they are adhesively mounted, and this action by the middle struts 2048 occurs before the outer portions of the shims 2024 are adhesively attached to the fabric. At this intermediate point, at which the middle struts 2048 are at least partially attached to the fabric 2152 and have moved inward, and the outer portions of the shims 2024 are not yet attached to the fabric, the shear stress and/or deformation in the fabric is predetermined ( that is, the tissue that is lateral to the most lateral point of contact between the middle strut and the tissue) is distributed laterally and in a gradual manner. Then, when the side or outer portions of the shims 2024 are pressed down and adhered to the fabric 2152, the predetermined fabric underneath and on the side edges or outer edges of the shims 2024 is trapped (e.g., adhered to the shims) in its state in which The stress and/or deformation in the predetermined fabric is distributed laterally and in a gradual manner, which seeks to prevent sudden high stress on the side edges (e.g., opposite ends) of the fabric bridge 2020.

[0211] Referring to Figure 19L, the applicator tool 2080 can then be removed from the tissue bridge 2020 so that the tissue bridge remains mounted over the cut 2150; then the applicator tool can be used to install another tissue bridge. Additionally, a user may manually push down with their fingers 2157 on the shims 2024, for example, with sufficient force to ensure that the pressure-sensitive adhesive layer 2042 securely adheres the shims 2024 to the fabric 2152 on opposite sides of the cut 2150 According to the eleventh embodiment, the fabric bridge 2020 may be mounted on the fabric 2152 in a manner such that the fabric bridge and the fabric apply force against each other, and the force applied by the fabric typically constrains the bridge. tissue from fully returning to its resting configuration. As a result, the tissue bridge 2020 applies compressive force to the tissue 2152 via the shims 2024 in a manner that can, for example, reduce tension in the tissue, help close the wound 2150, help inhibit reopening of the wound, and /or inhibit scar disfigurement (e.g., enlargement). In the example shown in Figure 191, tissue 2152 near scar and/or wound 2150 swells in the central area over which arch 2028 extends.

[0212] The fabric bridge 2020, the removable liner 2062, and the applicator tool 2080 may be configured differently than discussed above. For example, one or more of the layers of the fabric bridge 2020 may be configured differently than discussed above. As a more specific example, in the fabric bridge variation 2020 depicted in Figures 20A to 20D, each of the inner sheets 2036 and the intermediate adhesive layers 2040 may include opposing outwardly extending lateral extensions 2037, 2041. Accordingly, the sheets internal 2036, the intermediate adhesive layers 2040 and the shims 2024 become wider in the inward direction and taper in the outward direction, so that the middle bracing sections 2048 of the shims are wider than the outer sections of the shims. Each of the outer sheets 2034 and the outer adhesive layers 2042 may generally be in the form of a quadrilateral, trapezoid, isosceles trapezoid, or any other suitable shapes.

[0213] Referring to Figure 20D and in an example of some versions of this disclosure, the removable liner 2062 may not be associated with (e.g., mounted on) any tray 122 (Figures 18A to 18D). For example, for the version depicted in Figure 20D, when the fabric bridge 2020 is fully assembled on the release liner 2062, thereafter at least a portion of the release liner can be removed, and then the fabric bridge 2020 can be applied by hand. (e.g. not with the use of an applicator). In this example, a user may manually grasp and pull a lamella 2466 set in the release liner 2062 between a pair of tamperable rupture lines (e.g., tear lines). The lamella 2466 may be part of a central section 2462 of the release liner 2062 that is defined, at least partially, between the rupture lines. Outer portions of the release liner 2464 can be grasped by hand and used to mount the fabric bridge 2020 to the fabric.

[0214] As further examples, Figures 21 and 22 depict variations of the applicator tool 2080, in which the external protrusions 2092 are configured differently and the stabilizing and/or alignment protrusions 2095 may optionally be omitted. For example, in Figure 21, the engagement shoulder 2093 may be defined, at least partially, by a bend in the rod 2090. As another example, in Figure 22 the outer tip 2091 and the engagement shoulder 2093 are relatively rounded.

[0215] Figures 23A to 23C depict an applicator tool 2080 in accordance with a twelfth embodiment, wherein the tissue bridge 2020 is depicted schematically in dashed lines in Figures 23B and 23C. The applicator tool of the twelfth embodiment 2080 includes parts or features that are separated from each other and configured to releasably engage the tissue bridge 2020. In the twelfth embodiment, the parts or features of the applicator tool 2080 that are configured to engage the fabric bridge 2020 include support or contact surfaces 2082 and locking portions 2084. For example, the contact surfaces 2082 may be positioned between the locking portions 2084. The twelfth embodiment applicator tool 2080 additionally includes a reconfigurable frame that connects the contact surfaces 2082 and the locking parts 2084 with each other.

[0216] Referring to Figure 23A, the applicator tool frame of the twelfth embodiment 2080 includes a reconfigurable link (e.g., links 2086A, 2086B) that connects the contact surfaces 2082 and the locking parts 2084 to each other. The locking portions 2084 extend below the levers 2088 and/or cables 2094 and/or linkage (e.g., linkages 2086A), and the levers 2088 and/or cables 2094 extend upwardly from at least some of the linkages. Links 2086A are connected to each other by means of one or more additional links, e.g., links 2086B, which form a hinge or hinge-like member (e.g., a hinged joint, flexible joint, live joint (e.g., example, area of reduced thickness), or similar). The contact surfaces 2082 may be lower surfaces of protrusions extending outward from the lower end sections of the connections 2086A. Links 2086A, 2086B and levers 2088 and/or cables 2094 may be configured cooperatively so that at least the lower portions of the locking portions 2084 move away from each other and the contact surfaces 2082 move toward a line which extends from one to the other of the locking portions 2084 in response to at least portions of the levers 2088 and/or cables 2094 being moved toward one another.

[0217] In the version of the twelfth embodiment depicted in Figures 23B and 23C, the locking portions 2084 of the applicator tool 2080 are configured to mate respectively with the outer holes of the tissue bridge 2059 (Figure 17A), for example, as discussed above with reference to the ninth modality. Similarly, the lower ends of the connections 2086A are configured to respectively mate with (e.g., extend into and/or through) the internal holes of the fabric bridge 2056 (Figure 17A). The bearing or contact surface 2082 is configured to be in face-to-face relationship with (e.g., face-to-face contact with) the upper surface of the arch of the fabric bridge 2028. Additionally or alternatively, the lower surfaces of the Links 2086A and/or 2086B may be configured to be in face-to-face relationship with (e.g., face-to-face contact with) the top surface of the arch of the fabric bridge 2028. For example, Figures 24A to 24C depict a thirteenth embodiment applicator tool 2080 that is similar to the twelfth embodiment applicator tool, except, for example, that the bearing or contact surfaces 2082 are the bottom surfaces of the connections 2086B that are configured to be in face-to-face relationship. opposite face with (e.g., opposite face-to-face contact with) the upper surface of the arch of the fabric bridge 2028.

[0218] Figures 25A to 25C depict an applicator tool 2380 receiving a tissue bridge 2020; and Figure 25C depicts that the applicator tool 2380 and the tissue bridge 2020 fitted together are both in their deformed configurations so that the tissue bridge is grasped or otherwise held firmly by the applicator tool, in accordance with a fourteenth embodiment. . Locking parts 2384 comprise receptacles or, more specifically, inwardly open holes or slots that may be defined between parts, plates, plates, or other suitable features. In the fourteenth embodiment, opposite ends of the fabric bridge 2020 respectively extend into the inwardly open holes or slots of the locking portions 2384. The thickness of the slots of the locking portions 2384 may be slightly greater than the thickness of the locking sections. opposite ends of the fabric bridge 2020. The handles 2394 may be loops, partial loops, and/or other features suitable for receiving the fingers of an operator of the tool 2380 and, optionally, another finger may be pressed down onto a platform and/or or other suitable resources positioned along the link (e.g., links 2186A, 1186B).

[0219] The applicator tool 2380 may have a first body comprising a first lever 2388 connected to a first locking part 2384, and a second body comprising a second lever 2388 connected to a second locking part 2384. Referring to Figures 25B and 25C, the reconfigurable link (e.g., links 2186A, 2186B) may connect the first and second bodies together, and be configured so that (e.g., simultaneously): the first and second bodies are pivotable relative to each other. around first and second geometric axes 2371, 2372, respectively; and the first and second geometric axes 2371, 2372 are movable towards and away from each other.

[0220] As depicted in Figures 25A-25C, release or peel-off liner strips 2464 are respectively mounted on shims 1024 and partially positioned in the receptacles or slots of the locking parts 2384 so that the patient contact adhesive is prevented from adhering. to locking portions 2384. Inner ends of release strips 2464 may include at least one folded overlap tab 2465.

[0221] As depicted in Figures 26A to C, the central connection 2186A of the applicator tool 2380 may extend upwardly from the other connections 2186B. A platform and/or other suitable features at the upper end of the central link 2186A may be pressed by a user as part of a process of deforming the tool 2380 and the fabric bridge 2020. As depicted in Figures 27A and 27B, at least a portion of the connection (e.g., connections 1186A, 1186B of Figures 25A to 26C) can be omitted. Referring to Figures 28A and 28B, the inner ends of the release strips 2464 may be pulled away from the inner portions of the shims 2024 to form the folded overlap tabs 2465. The outer end sections of the folded overlap tabs 2465 may be ( e.g., in a releasable manner) secured to an external surface of the applicator tool 2380 with adhesive material 2381 and/or any other suitable fastening features 2381.

[0222] Referring to Figures 28C to 29E, a method using an applicator tool 2380 to apply a tissue bridge 2020 over tissue 2052 that includes a wound 2150 is described below, in accordance with the fourteenth embodiment. Referring to Figure 28C, the applicator tool 2380 may be deformed or otherwise reconfigured by manually rotating the locking portions 2384 via levers 2088 and/or cables 2094 and/or any suitable external features (e.g., linkage). ions)), so that deformation forces are applied to the fabric bridge 2020. Then, referring to Figure 28D, the inner portions of the middle struts 2048 may begin to be adhered to the fabric 2052. After the middle struts 2048 are at least partially attached to the fabric 2052, and the outer portions of the shims 2024 are not already attached to the fabric, the side or outer portions of the shims 2024 may be released from the locking portions 2384 so that the removable liners 2464 are pulled out of the shims 2024. Side or outer portions of the shims 2024 may be pressed down and adhered to the fabric 2052.

[0223] Referring to Figures 29A to 29C, trays 122, which may be configured to support one or more of the tissue bridges discussed above (e.g., tissue bridges 2020), may include or be otherwise associated with one or more fastening features (e.g. fasteners, or the like) to facilitate fastening of the trays to a wide variety of suitable supports. For example, the trays 122 depicted in Figures 29A to 29C include one or more fastening features in the form of holes 4001 that may extend through the tray and be configured to receive fasteners, positions and/or any other suitable features. The holes may extend through external peripheral flanges or any other suitable portions of the trays 122, or the holes or other suitable fastening features may be associated with the trays in any other suitable manner.

[0224] Referring to Figures 29A, 30 and 31, fastening features in the form of straps 4002 with fasteners 4003 (e.g., hook-and-loop releasable fasteners (e.g., VELCRO) or other suitable fasteners) may extend through holes 4001 and be used to mount tray 122 to the frame. For example, the structure may be the arm 4004 (e.g., forearm and/or wrist) of a user, so that the user's hands may remain free for other purposes, such as to use one of the applicator tools discussed above, or another suitable tool, to extract the 2020 fabric bridges from tray 122 and apply the fabric bridges appropriately. Other structures to which the tray 122 may be mounted include, for example, a user or patient body part, surgical drapes, trays and/or any other suitable structures. For example, the structure may be a user's finger or thumb, the back of a user's hand, the user's clothing, or any other suitable areas or structures.

[0225] Referring to Figure 32, holes 4001 or other fastening features of the trays 122 may be used to mount the trays to other suitable supports. For example, Figure 32 depicts the tray 122 with the fabric bridges 2020 of Figure 30 with the securing lugs removed, wherein the tray is exploded away from a mounting base 4005, in accordance with an embodiment of this disclosure. The mounting base 4005 may include one or more fastening features in the form of protrusions 4006 or other devices suitable for extending into holes 4001 to at least partially secure the tray 122 to the mounting base 4005. The tray 122, or the tray 122 mounted on the base 4004, may be seated on/supported by a tray, such as the tray of an instrument holder, or the like.

[0226] Figure 33 depicts a tray 122 that is carrying a series of fabric bridges 2020 and is equipped with other types of attachment loops 4002 (e.g., elastic loops), wherein a variety of attachment features configured so as to (e.g., attachment straps) and mounting bases are within the scope of this disclosure.

[0227] Figure 34 depicts a tray 122 with fabric bridges 2020 exploded away from a mounting base 4005 equipped with fastening features in the form of clamps 4007 and fastening handles 4002, in accordance with another embodiment of this disclosure. The handles 4002 may be configured to detachably mount the mounting base 4005 to a user's arm 4004, and the clamps 4007 may be configured to releasably engage the edges of the tray 122, or other suitable features associated with the tray. Releasably secure the tray to the mounting base, so that the mounting base can be serially refilled with trays containing 2020 fabric bridges without having to remove the mounting base from the user's arm.

[0228] As another example, Figure 35 depicts a tray 122 with fabric bridges 2020 exploded away from a mounting base 4004 equipped with adhesive material 4008 and fastening lugs 4002, in accordance with another embodiment of this disclosure. The handles 4002 may be configured to detachably mount the mounting base 4005 to a user's arm, and the adhesive material 4008 may be configured to releasably engage the tray 122 to releasably secure the tray to the mounting base. so that the mounting base can be serially refilled with trays containing 2020 fabric bridges without having to remove the mounting base from the user's arm. As depicted in Figures 34 and 35, the bottom surface of the mounting base 4005 may be shaped to generally conform to the shape of the user's forearm, such as by having a recessed, arched, or concave surface that extends along the length of the bottom surface of the mounting base.

[0229] As further examples, variations in the geometry of the tissue bridge can be altered for different relative effects and for use on or in different parts of the body (e.g., to compensate for different anatomical variations, such as different skin thicknesses, curvatures different orientations, different tissue qualities such as fat layer thickness or changes due to aging). For example, the shoulders of fabric bridges may be larger when it is desirable for the middle strut to push lower. As another example, the arch can be made narrower or wider, or thicker or thinner. For example, a relatively narrow arch can be used for thinner skin, and more vertical (eversion) forces. A relatively wider arc can be used for thicker fabrics, and more horizontal forces. A relatively thicker arc can be used for greater voltage reduction. A relatively thinner archwire can be used over bony surfaces where there is more horizontal than vertical movement. As another example, the midstrut may be thicker or thinner, or may widen beyond the width of the body. A thicker midstrut can provide more mediation, and a thinner midstrut can provide more eversion. There may also be different distances defined by the gap between adjacent ends of the mid-struts. Additionally, there may be different overall sizes of the fabric bridges.

[0230] At least tissue bridges should typically be sterilized before use, and any suitable sterilization can be used. As an example, packages containing one or more tissue bridges and/or applicators may be exposed to radiation (e.g., ionizing radiation) in a manner that sterilizes at least the tissue bridge(s) and/or applicator(s) in them. Depending on the types of materials from which the tissue bridge(s) and/or applicator(s) are constructed, sterilization (e.g., by exposure to radiation) may affect the material properties. In this regard, the materials from which the tissue bridge(s) and/or applicator(s) are constructed can be selected based on the sterilization process to which the tissue bridge(s) are constructed. fabric and/or applicator(s) may be exposed.

[0231] As further examples, the fabric bridge bodies discussed above can be constructed of formed polymers. The polymers formed may be polymers that are molded from a constitutive polymer material through processes such as injection molding, compression molding, stamping, thermoforming, casting and 3D printing such as melt deposition modeling, stereolithography, printing selective laser processing, polyjet technology processing, digital light processing, and other processes that are known to those skilled in the art. The polymers formed may comprise any materials suitable for processing and application. Such materials may include non-allergenic, lightweight polymers such as acrylonitrile butadiene styrene, polyoxymethylene, polypropylene, polyethylene, polyethylene terephthalate, polycarbonate, polyamide, polylactic acid, polyvinyl chloride, polytetrafluoroethylene, polyaryletherketone, polysulfone, and others that include mixtures and copolymers thereof with modifying additives such as dyes, reinforcers, impact modifiers, thermal stabilizers, and others. Such a polymer can have a modulus between 0.1 and 10 GPa and elongation between 1% and 100%. As a more specific example, fabric bridge bodies can be constructed of polycarbonate that has an elastic modulus of about 2.4 GPa and a yield elongation of about 7%.

[0232] As other examples, the inner layers or sheets of the shims discussed above may be film layers. Such film layers can be produced from extruded polymers comprising polymers such as those discussed for formed polymers. The polymer for the film layer can have a modulus between 0.1 and 10 GPa and elongation between 1% and 100%. As a more specific example, the inner layers or sheets of the shims may be extruded polyethylene terephthalate having an elastic modulus of about 2.6 GPa and a yield elongation of about 5%. The inner layer may be about 0.013 cm (0.005 inch) thick, or about 0.018 cm (0.007 inch) thick, and its opposite sides may be treated with Acrylic. The adhesive layer between the body and the inner layer may be a UV curable adhesive, or any other suitable adhesive.

[0233] As further examples, the outer layers or sheets of the shims discussed above may be layers of cloth or other suitable substrates. These layers can be produced from non-woven or woven polymers, microporous melt polymers, or other suitable substrates. Fibers for non-woven or melt-blown substrates can be produced from polymers such as those discussed for formed polymers. The polymer for the outer layers or sheets of the shims can have a modulus between 0.1 and 10 GPa and elongation between 1% and 100%. The apparent elastic properties of the outer layers or sheets of the shims may result from the diameter, density and orientation of the fibers that constitute the non-woven or melt-blown substrates. In general, the resulting non-woven or cast substrate layer can have a modulus between 0.01 and 1 GPa and elongation between 10% and 1,000%. As a more specific example, the outer layers or sheets of the shims may be a permeable polyurethane substrate having an apparent elastic modulus of about 0.2 GPa and a yield elongation of 100%. Polyurethane substrate may allow moisture transmission. The outer layer may be about 0.08 cm (0.003 inch) thick. In a fabric bridge, both the body and the inner sheet can have a higher modulus of elasticity than the outer sheet. For example, in a fabric bridge, both the body and the inner sheet may have an elastic modulus in a range of about two times to about forty times the elastic modulus of the outer sheet, from about five times to about thirty times the elastic modulus of the outer sheet, from about ten times to about twenty-five times the elastic modulus of the outer sheet, and/or any other subranges or values therebetween. The adhesive between the inner layer and the outer layer may be a pressure-sensitive silicone adhesive, or any other suitable adhesive.

[0234] As an example, the release liners may be silicone release liners that are about 0.08 cm (0.003 inch) thick. The adhesive between the outer layer and the release liner may be a pressure-sensitive acrylic adhesive, or any other suitable adhesive. The adhesive between the outer layer and the release liner is typically for adhering the tissue bridge to the patient (e.g., the patient contact adhesive). The patient contact adhesive may include one or more additives, for example, one or more medicinal substances. The one or more medicinal substances in the patient contact patch may include hydroquinone, sun block, antihistamines, steroids and/or any other suitable additives.

[0235] A variety of examples are within the scope of this disclosure, including those set out below.

[0236] Example 1. A medical article for at least partially covering a wound and/or scar, wherein the medical article comprises: a body comprising a central section extending over an area, and flanges extending respectively outward from opposing lower sections of the center section, at least the center section of the body being elastically configured to be deformed from a resting configuration to an extended configuration, and to return to the resting configuration in response to being released from the extended configuration , wherein the lower sections are further apart from each other in the extended configuration than in the resting configuration, and a first of the flanges having opposing upper and lower surfaces that are each greater than a defined thickness between the upper surfaces and bottom of the first flange; and a wedge connected to the first flange for moving, at least partially, with the first flange, the wedge extending into the area over which the center section extends, the wedge having opposing upper and lower surfaces which are, each greater than a defined thickness between the upper and lower surfaces of the shim, and the upper surface of the shim and the lower surface of the first flange are facing each other.

[0237] Example 2. The medical article according to Example 1, wherein: the central section comprises an arc extending over the area over which the central section extends; the shim is a first shim; a second of the flanges has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the second flange; the medical article comprises a second shim connected to the second flange to move, at least partially, with the second flange; the second wedge extends into the area over which the center section extends the second wedge has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the second wedge, and the upper surface of the second shim and the lower surface of the second flange face each other.

[0238] Example 3. The medical article according to Example 1, in which the body is more rigid than the wedge.

[0239] Example 4. The medical article according to Example 1, wherein: the central section of the body extends at least partially around the area over which the central section extends, and the wedge comprises an extension that extends into the area over which the central section extends.

[0240] Example 5. The medical article according to Example 1, wherein the upper surface of the wedge is adhered to the lower surface of the first flange.

[0241] Example 6. The medical article according to Example 1, wherein the wedge comprises: an outer sheet configured to be attached to the tissue, and an inner sheet positioned between the outer sheet and the first flange, wherein the sheet inner sheet is stiffer than the outer sheet.

[0242] Example 7. The medical article according to Example 6, wherein the outer sheet is larger than the inner sheet, and an extension of the outer sheet extends beyond an outer edge of the inner sheet.

[0243] Example 8. The medical article according to Example 1 in combination with a tool configured to be used to manipulate the medical article, wherein a portion of the tool extends into a space between the body and at least one portion of the wedge.

[0244] Example 9. The medical article according to Example 1, wherein the body further comprises a locking portion configured to interact with a tool.

[0245] Example 10. The medical article according to Example 9, wherein: the locking part comprises a hole extending through the body, and at least a portion of the wedge extends below the hole.

[0246] Example 11. The medical article according to Example 9, wherein a section of the shim extends: inwardly from the first proximal flange and below the locking portion.

[0247] Example 12. The medical article according to Example 9, wherein the locking part comprises a receptacle configured to receive at least a portion of a tool.

[0248] Example 13. The medical article according to Example 12, wherein the body and the shim are cooperatively configured to jointly define, at least partially, the receptacle.

[0249] Example 14. The medical article according to Example 12, wherein: the body comprises an arc, the arc extends partially around the area over which the central section extends, and the wedge extends inwardly from the first flange to the area over which the center section extends to at least partially define the receptacle.

[0250] Example 15. The medical article according to Example 14, wherein the locking portion comprises a hole extending through the arch and is configured to receive an end section of a tool therethrough, so that the hole is a receptacle opening.

[0251] Example 16. A medical article for covering, at least partially, a wound and/or scar, wherein the medical article comprises: an arc extending over an area; a middle strut connected to the arch and extending into the area over which the central section extends, the middle strut comprising: an outer layer configured to be attached to the fabric, and an inner layer positioned between the outer layer and the arch, in which the inner layer is stiffer than the outer layer.

[0252] Example 17. The medical article according to Example 16, wherein the inner layer has a higher modulus of elasticity than the outer layer.

[0253] Example 18. The medical article according to Example 16, wherein the medical article further comprises a removable liner adhered to the middle strut.

[0254] Example 19. The medical article according to Example 16, which further comprises a base plate, wherein the middle strut is connected to the arch via at least the base plate.

[0255] Example 20. The medical article according to Example 19, wherein: the middle strut is a first middle strut, the base plate is a first base plate, the arch comprises first and second lower sections that are opposite to each other, the first middle strut is connected to the first lower section by means of at least the first base plate, and the medical article further comprises a second middle strut connected to the second lower section by means of at least one second base plate.

[0256] Example 21. The medical article according to Example 20, which further comprises a means configured to be positioned, at least partially, between the first and second middle struts.

[0257] Example 22. The medical article according to Example 21, wherein the medium comprises a therapeutic agent.

[0258] Example 23. The medical article according to Example 21, wherein the means comprises a silicone strip.

[0259] Example 24. The medical article according to Example 21, wherein the means is mounted on the arch.

[0260] Example 25. A tool configured to be used to manipulate a medical article, the tool comprising: first and second parts that are separate from each other and each configured to releasably engage a medical article; a reconfigurable link that connects the first and second parts together; and levers extending from the proximity of the connection; wherein the linkage and levers are cooperatively configured so that at least portions of the first and second parts are moved away from each other in response to at least portions of the levers being moved toward each other.

[0261] Example 26. The tool according to Example 25, wherein the levers comprise handles.

[0262] Example 27. The tool according to Example 25, wherein: the first part comprises a first locking part configured to releasably fasten to a medical article, and the second part comprises a second locking part configured to attach in a releasable way to the medical article.

[0263] Example 28. The tool according to Example 27, wherein: each of the first and second locking parts comprises a shank and a protrusion extending outward from the shank; and the protrusions are facing away from each other.

[0264] Example 29. The tool according to Example 27, which comprises a support surface that is: positioned between the first and second locking parts, connected to the first and second locking parts by the link, and configured to engage the medical article while the first and second locking parts are fitted to the medical article.

[0265] Example 30. The tool according to Example 29, wherein when the support surface is facing downwards:

[0266] the first and second locking parts extend downwardly from the proximity of the connection, and the levers extend upwardly from the proximity of the connection.

[0267] Example 31. A tool configured to be used to manipulate a medical article, the tool comprising: a first body comprising a first lever connected to a first part, wherein the first part is configured to engage a first end of a medical article; a second body comprising a second lever connected to a second part, the second part being configured to engage a second end of the medical article; wherein a reconfigurable connection connects the first and second bodies to each other, wherein the connection is configured so that: the first and second bodies are articulable with respect to each other around the first and second geometric axes, respectively, and the first and according to geometric axes are movable towards and away from each other.

[0268] Example 32. The tool according to Example 31, in which the connection is configured so that, simultaneously: the first and second bodies are articulable with respect to each other around the first and second geometric axes, respectively, and the first and second geometric axes are movable towards and away from each other.

[0269] Example 33. The tool according to Example 31, wherein the connection is constructed of elastic material.

[0270] Example 34. The tool according to Example 31, wherein the levers comprise handles.

[0271] Example 35. The tool according to Example 31, wherein: the first part comprises a receptacle configured to releasably receive a first end of a medical article, and the second part comprises a receptacle configured to receive a second end of the medical item.

[0272] Example 36. The tool according to Example 35, comprising a support surface that is carried by the connection and positioned between the first and second parts, and configured to engage the medical article while the first and second parts are engaged in the medical article.

[0273] Example 37. The tool according to Example 36, wherein: the first lever extends outwardly from the first part; and the second lever extends outward from the second part.

[0274] Example 38. A package, comprising: a support comprising a central section and outer sections extending outwards and downwards respectively; and a medical article contained, at least partially, in the packaging and supported by the support, the medical article comprising a central section and pads extending respectively outwardly and downwardly from opposite lower portions of the central section of the medical article, wherein the shims are respectively close to the outer sections of the support, and a gap is defined between at least a portion of the central section of the medical article and the central section of the support.

[0275] Example 39. The packaging according to Example 38, wherein the gap is configured to receive a portion of a tool.

[0276] Example 40. The packaging according to Example 38, which further comprises a liner positioned between the support and the medical article, wherein: the medical article is releasably mounted on the liner, at least a portion of the liner is fixedly mounted on the support, and the liner comprises a tear line to facilitate, at least partially, relative movement between the medical article and the support.

[0277] Example 41. The packaging according to Example 40, wherein the tear line defines, at least partially, a flap in the liner.

[0278] Example 42. The packaging according to Example 40, wherein at least a portion of the tear line is positioned below a wedge of the wedges.

[0279] Example 43. The package according to Example 38, which further comprises at least one handle configured to at least partially mount the support to one of the user's arm.

[0280] Example 44. The packaging according to Example 43 in combination with a base, wherein: the support comprises a tray; the tray is releasably connected to the base; and at least one handle is configured to at least partially mount the base to the user's arm to connect the tray to the user's arm via the base.

[0281] Example 45. The packaging according to Example 43, wherein at least a portion of the tear line is positioned below a wedge of the wedges.

[0282] Example 46. A method, which comprises: deforming a medical article from a resting configuration to an extended configuration, which comprises reconfiguring a tool while the tool and the medical article are engaged together, wherein: the tool and the medical article that are fitted together are comprised of: a first tool part and a first medical article part that are fitted together, and a second tool part and a second medical article part that are fitted together; tool reconfiguration is comprised of moving the tool levers toward each other so that: the first and second parts of the tool move away from each other in response to the movement of the tool levers toward each other, and the first and second parts of the medical article move away from each other in response to the first and second parts of the tool moving away from each other.

[0283] Example 47. The method according to Example 46, wherein a support, on which the medical article is mounted, delaminates, at least partially, in response to at least part of the deformation of the medical article.

[0284] Example 48. The method according to Example 46, further comprising there being relative movement between first and second sections of a support for the medical article in response to at least part of the deformation of the medical article.

[0285] Example 49. The method according to Example 48, wherein the relative movement comprises rotating the first section relative to the second section.

[0286] Example 50. The method according to Example 46, further comprising disassembling the medical article from a support while the tool and the medical article are engaged together, wherein at least part of the disassembly occurs after at least part of the deformation of the medical article.

[0287] Example 51. The method according to Example 46, which further comprises detaching the tool from the medical article after deformation of the medical article, wherein the deformation of the medical article is comprised of deforming the medical article so that the medical article be propelled to the resting configuration and reconfigure from the extended configuration in response to the tool being detached from the medical article.

[0288] Example 52. The method according to Example 51, which further comprises, prior to detaching the tool from the medical article, at least partially mounting the medical article to the fabric while simultaneously: the medical article is in the extended configuration and the tool and the medical article are fitted together.

[0289] Example 53. A method, comprising: deforming a medical article from a resting configuration to an extended configuration so that shims of the medical article are further apart from each other in the extended configuration than in the resting configuration, wherein each one of the shims comprises an inner portion extending into an outer portion of the shim so that the inner portions are positioned between the outer portions of the shims; adhesively mounting the internal portions to the fabric while the medical device is in its extended configuration; then the medical article reconfigures itself from the extended configuration to an intermediate configuration that is between the resting configuration and the extended configuration; and adhesively mounting the outer portions of the shims to the fabric while the medical device is in its intermediate configuration.

[0290] Example 54. The method according to Example 53, wherein the adhesive assembly of the outer portions of the shims to the fabric occurs, at least partially, in response to the reconfiguration of the medical article.

[0291] Example 55. The method according to Example 53, wherein: the inner portions comprise middle struts, and reconfiguration from the extended configuration to the intermediate configuration comprises the middle struts approaching each other and pushing portions of the fabric together. towards the other.

[0292] Example 56. A medical article for at least partially covering a wound and/or scar, wherein the medical article comprises: an arch comprising an expansion section positioned between opposing lower sections of the arch, wherein: the arc is configured to be deformed from a resting configuration to an extended configuration, and in the resting configuration, any space between the lower sections of the arc is smaller than a space between the lower sections of the arc in the extended configuration; and shims respectively connected to the lower sections of the arch to move with the lower sections of the arch when the arch is passed between resting and extended configurations, wherein a first shim of the shims comprises: an outer layer configured to be fixed to the fabric, and an inner layer positioned between the outer layer and the arch, wherein the inner layer is stiffer than the outer layer.

[0293] Example 57. The medical article according to Example 56, wherein the inner layer has a higher modulus of elasticity than the outer layer.

[0294] Example 58. The medical article according to Example 56, wherein the inner layer is a flange extending outward from the first lower section of the arch.

[0295] Example 59. The medical article according to Example 56, which further comprises a flange, wherein the inner layer is positioned between the flange and the outer layer.

[0296] Example 60. The medical article according to Example 56, which further comprises a base plate, wherein the inner layer is positioned between the base plate and the outer layer.

[0297] Example 61. The medical article according to Example 56, wherein: the expansion section extends over an area, a middle strut extends into the area, and the middle strut comprises at least a portion of each the outer layer and the inner layer.

[0298] Example 62. The medical article according to Example 56, wherein: the inner layer is an intermediate layer of the first wedge, and the first wedge additionally comprises an inner layer positioned between the intermediate layer and the first lower section of the bow.

[0299] Example 63. The medical article according to Example 62, wherein the inner layer is a flange extending outward from the first lower section of the arch.

[0300] Example 64. The medical article according to Example 62, wherein: the expansion section extends over an area, a middle strut extends into the area, and the middle strut comprises at least a portion of each of the intermediate layer and the inner layer.

[0301] Example 65. A medical article for at least partially covering a wound and/or scar, wherein the medical article comprises: a body comprising a central section and flanges extending respectively outwardly from opposing lower sections of the center section, so that the center section is positioned between the flanges, wherein the body is configured to be deformed from a resting configuration to an extended configuration; a shim mounted on at least one of the first flanges to move at least partially with the first flange, wherein the shim comprises an outer sheet configured to be secured to the fabric, and an inner sheet positioned between the outer sheet and the first flange, where the inner sheet is more rigid than the outer sheet.

[0302] Example 66. The medical article according to Example 65, wherein the inner sheet has a higher modulus of elasticity than the outer sheet.

[0303] Example 67. The medical article according to Example 65, wherein: the central section extends over an area, a middle strut extends into the area, and the middle strut comprises at least a portion of each of the outer leaf and inner leaf.

[0304] Example 68. The medical article according to Example 65, wherein: the extended configuration comprises an extended configuration in which the first and second flanges are separated by a distance, and in the resting configuration, any space between the first and second flanges is smaller than the space between the first and second flanges in the extended configuration.

[0305] Example 69. The medical article according to Example 65, wherein: at least a portion of the body extends over and at least partially around an area, and the wedge comprises an extension extending into the area.

[0306] Example 70. The medical article according to Example 65, wherein an extension of the outer sheet extends beyond an outer edge of the inner sheet.

[0307] Example 71. The medical article according to Example 19, in which the outer sheet is larger than the inner sheet.

[0308] Example 72. The medical article according to Example 65, wherein the wedge is a first wedge, and the medical article further comprises a second wedge mounted on the second flange to move with the second flange, wherein the second shim comprises an outer sheet configured to be secured to the fabric, and an inner sheet positioned between the second flange and the outer sheet of the second shim, wherein the inner sheet of the second shim has a higher modulus of elasticity than the outer sheet of the second wedge.

[0309] Example 73. The medical article according to Example 65 in combination with a tool configured to be used to manipulate the medical article, wherein a portion of the tool extends into a space between the body and at least a portion of the chock.

[0310] Example 74. A medical article for at least partially covering a wound and/or scar, wherein the medical article comprises: a body comprising a central section, flanges extending respectively outward from lower portions of the section central, and a locking portion configured to interact with a tool; and a shim mounted on at least one of the first flanges to move at least partially with the first flange, wherein a section of the shim extends below the locking portion and is configured to interact with a tool.

[0311] Example 75. The medical article according to Example 74, wherein: the locking part comprises a hole extending through the body, and at least a portion of the wedge extends below the hole.

[0312] Example 76. The medical article according to Example 74, wherein a section of the shim extends into the first flange and below the locking portion.

[0313] Example 77. The medical article according to Example 74, wherein a section of the wedge is a middle strut.

[0314] Example 78. The medical article according to Example 74, wherein: the locking part comprises a hole extending through the expansion section of the body, and the wedge section is a middle strut extending below of the hole.

[0315] Example 79. The medical article according to Example 78, in which there is a gap between the hole and the middle strut.

[0316] Example 80. The medical article according to Example 74, wherein the locking part comprises a receptacle configured to receive at least a portion of a tool.

[0317] Example 81. The medical article according to Example 80, wherein the body and the shim are cooperatively configured to jointly define, at least partially, the receptacle.

[0318] Example 82. The medical article according to Example 80, wherein: the body comprises an arc, the arc extends partially around an area, the shim extends into the first flange into the area for define, at least partially, the receptacle.

[0319] Example 83. The medical article according to Example 82, wherein the locking portion comprises a hole extending through the arch and is configured to receive an end section of a tool therethrough, so that the hole is a receptacle opening.

[0320] Example 84. A medical article for covering, at least partially, a wound and/or scar, wherein the medical article comprises: an arc extending over an area; medium struts connected to the arch and extending into the area; adhesive material connected to the middle struts; It is

[0321] a removable liner connected to both middle struts by means of the adhesive material.

[0322] Example 85. The medical article according to Example 84, which further comprises a first base plate and a second base plate, wherein: a first middle strut of the middle struts is connected to the arch by means of at least the first base plate; and a second middle strut of the middle struts is connected to the arch via at least the second base plate.

[0323] Example 86. The medical article according to Example 84, wherein: the removable liner is a first removable liner, and the medical article further comprises a second removable liner connected to the arch and extending outwardly relative to the first removable lining.

[0324] Example 87. The medical article according to Example 86, which further comprises a third removable liner connected to a first lower arch section and extending outwardly relative to the first removable liner, wherein: the first liner The removable liner is positioned between the second and third removable liners, and the second removable liner is connected to a second lower arch section that is opposite the first lower arch section.

[0325] Example 88. The medical article according to Example 87, which further comprises a first base plate and a second base plate, wherein: both the third removable liner and a first middle strut of the middle struts are connected to the first lower section of the arch through at least the first base plate; and both the second removable liner and a second middle strut of the middle struts are connected to the second lower section of the arch by means of at least the second base plate.

[0326] Example 89. A medical article for at least partially covering a wound and/or scar, wherein the medical article comprises: an arch comprising opposing lower sections, shims respectively connected to the lower sections, and a means configured to be positioned at least partially between the wedges and optionally comprise a therapeutic agent.

[0327] Example 90. The medical article according to Example 89, wherein the means comprises a silicone strip.

[0328] Example 91. The medical article according to Example 89, in which the means is mounted on the arch.

[0329] Example 92. The medical article according to Example 89, wherein: each of the shims comprises a middle strut extending into an area over which the arch extends, and the middle is positioned between the middle struts .

[0330] Example 93. The medical article according to Example 89, wherein the medium comprises a therapeutic agent.

[0331] Example 94. The medical article according to Example 92, wherein the therapeutic agent comprises silicone.

[0332] Example 95. A tool configured to be used to manipulate a medical article, the tool comprising: first and second parts that are separate from each other and each configured to releasably engage a medical article; a reconfigurable link that connects the first and second parts together; and levers that extend the connection; wherein the linkage and levers are cooperatively configured so that the first and second parts are moved away from each other in response to at least portions of the levers being moved toward each other.

[0333] Example 96. The tool according to Example 95, wherein the levers comprise handles.

[0334] Example 97. The tool according to Example 95, wherein: the first part comprises a first locking part configured to releasably fasten to a medical article, and the second part comprises a second locking part configured to fix in a releasable way on the medical article.

[0335] Example 98. The tool according to Example 97, wherein: each of the first and second locking parts comprises a receptacle for receiving a respective portion of the medical article.

[0336] Example 99. The tool according to Example 97, wherein: each of the first and second locking parts comprises a shank and a protrusion extending outward from the shank; and the protrusions face away from each other.

[0337] Example 100. The tool according to Example 97, comprising a support surface that is positioned between the first and second locking parts, connected to the first and second locking parts by linkage, and configured to engage the medical article while the first and second locking parts are fitted to the medical article.

[0338] Example 101. The tool according to Example 100, wherein when the support surface is facing downwards: the first and second locking parts extend below the link, and the levers extend above the connection.

[0339] Example 102. A package, comprising: a support comprising a central section and outer sections extending respectively outwards and downwards from opposite portions of the central section; and a medical article contained, at least partially, in the packaging and supported by the support, the medical article comprising a central section and pads extending respectively outwardly and downwardly from opposite lower portions of the central section of the medical article, wherein the shims are respectively close to the outer sections of the support, and a gap is defined between at least a portion of the central section of the medical article and the central section of the support.

[0340] Example 103. The packaging according to Example 102, wherein the gap is configured to receive a portion of a tool.

[0341] Example 104. The package according to Example 103, wherein: the package at least partially contains the tool, and the tool is configured to be used to apply the medical article to the tissue.

[0342] Example 105. The packaging according to Example 102, which further comprises a liner positioned between the support and the medical article, wherein: the medical article is releasably mounted on the liner, the liner is fixedly mounted on the support , and the liner comprises a tear line to facilitate, at least partially, relative movement between the medical article and the support.

[0343] Example 106. The packaging according to Example 105, wherein the tear line defines, at least partially, a flap in the liner.

[0344] Example 107. The packaging according to Example 105, wherein at least a portion of the tear line is positioned below a wedge of the wedges.

[0345] Example 108. A method, which comprises: deforming a medical article from a resting configuration to an extended configuration, which comprises reconfiguring a tool while the tool and the medical article are engaged together, wherein: the tool and the medical article that are fitted together are comprised of: a first tool part and a first medical article part that are fitted together, and a second tool part and a second medical article part that are fitted together; Tool reconfiguration is comprised of moving tool levers toward each other so that: the first and second tool parts move away from each other in response to the movement of the tool levers toward each other, and the first and second parts of the medical article move away from each other in response to the first and second parts of the tool moving away from each other.

[0346] Example 109. The method according to Example 108, wherein a support, on which the medical article is mounted, delaminates, at least partially, in response to at least part of the deformation of the medical article.

[0347] Example 110. The method according to Example 108, further comprising there being relative movement between the first and second sections of a support for the medical article in response to at least part of the deformation of the medical article.

[0348] Example 111. The method according to Example 110, wherein the relative movement comprises rotating the first section relative to the second section.

[0349] Example 112. The method according to Example 108, which further comprises disassembling the medical article from a support while the tool and the medical article are engaged together, wherein at least part of the disassembly occurs after at least part of the deformation of the medical article.

[0350] Example 113. The method according to Example 108, which further comprises causing a fit between the tool and the medical article.

[0351] Example 114. The method according to Example 108, which further comprises detaching the tool from the medical article after deformation of the medical article, wherein the deformation of the medical article is comprised of deforming the medical article so that the medical article be propelled to the resting configuration and reconfigure from the extended configuration in response to the tool being detached from the medical device.

[0352] Example 115. The method according to Example 114, which further comprises, prior to detaching the tool from the medical article, at least partially mounting the medical article to the fabric while simultaneously: the medical article is in the extended configuration, and the tool and the medical article are fitted together.

[0353] Example 116. Any one or more of Example 1 through Example 115 in combination with a therapeutic agent.

[0354] Example 117. Any one or more of Example 1 through Example 116 in combination with any other one or more of Example 1 through 116.

[0355] To supplement the present disclosure, this application fully incorporates by reference the following patent application publications: U.S. Patent Application Publication 2014/0128819 and U.S. Patent Application Publication 2014/0227483.

[0356] In the specification and/or figures, typical embodiments of the invention have been disclosed. The present invention is not limited to such exemplary embodiments. For example, the present invention is not limited to the specific details (e.g., dimensions and ratios) that have been disclosed. Use of the term "and/or" includes any and all combinations of one or more of the associated listed items. Figures may be schematic representations and therefore are not necessarily drawn to scale. Unless otherwise noted, specific terms are used in a generic, descriptive sense and not for limiting purposes.

Claims (14)

1. Combination of a medical item (20, 520, 720, 920, 1120, 1520, 1720, 2020) to cover, at least partially, a wound and/or scar, with a tool (80, 580, 780, 980, 1180 , 1580, 1780, 2080) configured to be used to manipulate the medical article, the medical article being characterized by the fact that it comprises: a body (22, 922, 2022) comprising a central section (30, 2030) which extends over an area, and flanges (26, 2026) respectively extending outwardly from opposite lower sections (32, 2032) of the central section, at least the central section of the body being elastically configured to be deformed to from a resting configuration to an extended configuration, and to return to the resting configuration in response to being released from the extended configuration, wherein the lower sections are further apart from each other in the extended configuration than in the resting configuration, and wherein a first of the flanges has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the first flange; and a shim (24, 2024) connected to the first flange to move at least partially with the first flange, the shim extending into the area over which the center section extends, the shim having surfaces opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the shim, and the upper surface of the shim and the lower surface of the first flange are facing each other; wherein a portion (92, 597, 792, 992, 1184, 1592, 1784, 2092) of the tool is configured to extend into a space (52, 552, 752, 952, 1152, 2052) between the body and at least a portion of the wedge so that the tool is releasably fitted to the medical article. 2. Combination according to claim 1, characterized by the fact that: the central section (30, 2030) comprises an arc (30, 2030) extending over the area over which the central section extends; the shim (24, 2024) is a first shim; a second flange (26, 2026) has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the second flange; the medical article (20, 520, 720, 920, 1120, 1520, 1720, 2020) comprises a second shim (24, 2024) connected to the second flange; the second wedge extends into the area over which the central section extends, the second wedge has opposing upper and lower surfaces that are each greater than a defined thickness between the upper and lower surfaces of the second wedge; the upper surface of the second shim and the lower surface of the second flange face each other; the second shim is configured to at least partially move with the second flange, in response to at least the center section of the body being released from the extended configuration; and a second portion (92, 597, 792, 992, 1184, 1784, 2092) of the tool (80, 580, 780, 980, 1180, 1780, 2080) is configured to extend into a space (52, 552 , 752, 952, 1152, 2052) between the body and at least a portion of the second wedge, so that the tool is releasably fitted to the medical article. 3. Combination, according to claim 1, characterized by the fact that the body (22, 922, 2022) is more rigid than the shim (24, 2024). 4. Combination according to claim 1, characterized by the fact that: the central section (30, 2030) of the body (22, 922, 2022) extends at least partially around the area over which the central section extends extends, the wedge (24, 2024) comprises an extension that extends into the area over which the central section extends, such that the extension is neither overlapping nor coextensive with the first flange (26, 2026), the space (52, 552, 752, 952, 1152, 2052) is a receptacle configured to receive the portion (92, 597, 792, 992, 1184, 1784, 2092) of the tool (80, 580, 780, 980, 1180, 1580, 1780, 2080), and the extension at least partially defines the receptacle. 5. Combination, according to claim 1, characterized by the fact that the upper surface of the shim (24, 2024) is adhered to the lower surface of the first flange (26, 2026). 6. Combination, according to claim 1, characterized by the fact that the shim (24, 2024) comprises: an outer sheet (34, 2034) configured to be fixed to the fabric, and an inner sheet (36, 2036) positioned between the outer sheet and the first flange (26, 2026), wherein the inner sheet is stiffer than the outer sheet. 7. Combination according to claim 1, characterized by the fact that the outer sheet (34, 2034) is larger than the inner sheet (36, 2036), and an extension (50) of the outer sheet extends beyond of an outer edge of the inner sheet. 8. Combination according to claim 1, characterized in that the body (22, 922, 2022) additionally comprises a locking part (56, 58, 60, 956, 1156, 2056, 2057, 2058) configured to interact the tool (80, 580, 780, 980, 1180, 1580, 1780, 2080). 9. Combination according to claim 8, characterized by the fact that: the locking part (56, 58 952, 1156, 2056) comprises a hole (56, 58 952, 1156, 2056) extending through the body (22, 922, 2022), and at least a portion of the shim (24, 2024) extends below the hole. 10. Combination according to claim 8, characterized by the fact that a section (48, 948, 2048) of the shim (24, 2024) extends: inwardly from the next first flange (26, 2026), and below the locking part (56, 58 952, 1156, 2056). 11. Combination according to claim 8, characterized by the fact that the space (52, 552, 752, 952, 1152, 2052) is a receptacle configured to receive the portion (92, 597, 792, 992, 1184, 1592, 1784, 2092) of a tool (80, 580, 780, 980, 1180, 1580, 1780, 2080). 12. Combination according to claim 11, characterized by the fact that the body (22, 922, 2022) and the shim (24, 2024) are cooperatively configured to define together, at least partially, the receptacle (52, 2022) 552, 752, 952, 1152, 2052). 13. Combination according to claim 11, characterized by the fact that: the central section (30, 2030) comprises an arc (30, 2030), the arc partially extending around the area over which the central section extends extends, and the shim (24, 2024) extends inwardly from the first flange (26, 2026) into the area over which the center section extends to at least partially define the receptacle (52, 552, 752 , 952, 1152, 2052). 14. Combination according to claim 13, characterized in that the locking part (56, 58 952, 1156, 2056) comprises a hole (56, 58 952, 1156, 2056) extending through the arch ( 30, 2030) and is configured to receive an end section (92, 597, 792, 992, 1184, 1592, 1784, 2092) of the tool (80, 580, 780, 980, 1180, 1580, 1780, 2080) through thereof, so that the hole is an opening of the receptacle (52, 552, 752, 952, 1152, 2052).