CN101052364A - 利用真空处理伤口的装置 - Google Patents

利用真空处理伤口的装置 Download PDF

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CN101052364A
CN101052364A CNA2005800375567A CN200580037556A CN101052364A CN 101052364 A CN101052364 A CN 101052364A CN A2005800375567 A CNA2005800375567 A CN A2005800375567A CN 200580037556 A CN200580037556 A CN 200580037556A CN 101052364 A CN101052364 A CN 101052364A
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比吉特·里辛格
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Abstract

一种利用真空处理人体或动物体的伤口的装置(100)。所述装置包括：一个气密的伤口遮盖元件(4)，其在置于患者身体上时构成一个在相应的伤口和伤口遮盖元件之间存在的伤口空腔(10)；至少一个接头位置(5.1)，其与伤口空腔(10)处于接触并且经由该接头位置将存在于伤口空腔(10)内的空气排空；一个吸收体(2)，其是一个装入包皮内的、由掺杂有超吸收粒子的织物部段构成的层，其中包皮是可透过流体的并且具有气孔，所述气孔的大小基本上不超过超吸收粒子的大小。待置入伤口空腔(10)内的吸收体(2)具有一个初始体积，其在吸收过程中增大并且达到一个最终体积，从而所吸收的脓水—由包皮的气孔大小限定—留在吸收体内并且因此位于伤口遮盖元件之下，直至吸收体由伤口空腔内移除。

Description

利用真空处理伤口的装置
技术领域
本发明涉及一种利用真空处理人体或动物体的伤口的装置，包括：一个气密的伤口遮盖元件，其在置于患者身体上时构成一个在相应的伤口和伤口遮盖元件之间存在的伤口空腔；至少一个接头位置，其与伤口空腔处于接触并且经由该接头位置将存在于伤口空腔内的空气排空；至少一个面状的吸收体，其待设置在伤口遮盖元件之下的伤口空腔内。
背景技术
由US 2004/0030304 A1已知一种用真空治疗伤口的装置，其具有一个被包封的泡沫类型的吸收体，其包皮具有大致3至6mm大小的穿孔。在吸收体上同样设置同等大小的穿孔。此外在被包封的吸收体的上方设置一个附加的可透过流体的泡沫塑料衬里。这个装置的作用涉及已知的疮面漏液(Wunddrainage)原理，其中通过一个产生真空的装置实现脓水的抽出。在大气路径上的抽出同样通过相应大小的气孔支持。
由DE 195 17 699已知一种用于真空密封伤口的装置，其具有一个遮盖薄膜用于表面遮盖以及气密地封盖伤口，从而在遮盖薄膜之下在伤口的区域内存在一个空腔，在其中可以安装一个漏液软管和一个泡沫塑料衬里。
在先前的专利文献DE 29 53 373 C2中同样已知一种使用真空处理伤口的装置，其包括一个伤口覆盖元件、一个位于伤口覆盖元件下方的泡沫塑料衬里以及至少一个与泡沫塑料衬里的气孔连通的软导管。
由US 66 85 681 B2已知另外一种利用真空处理伤口的装置，其中伤口表面上放置一个弹性的压力分配元件，在该压力分配元件上又连接一个抽吸管。抽吸管在伤口边缘和一个粘接在伤口边缘上的伤口覆盖元件之间引导。通过伤口覆盖元件和压力分配元件限定的伤口空腔填满纤维素。
GB 6 92 578描述了一种手术布，手术布的中间的开口在边缘上具有一个环绕的聚合体粘接层，手术布可以借助于所述粘接层固定在患者的皮肤上。
US 55 49 584描述了一种用于真空治疗的装置，其包括一个伤口遮盖部、一个膜片式泵以及一个在膜片式泵之后设置的袋状的收集器。在伤口覆盖部之下设置一个压垫或一个松动的吸收流体的纤维填料，其靠在一个穿孔的层上，在该层之下又存在另外一个粘附的层。纤维仍然通过一个可透过流体的具有多个窗口的上层覆盖，其中窗口分别被一个同样可透过流体的材料部分垫上。如此构造的抽吸头非常复杂并且制造费用高。
发明内容
本发明的目的在于提供一种价格便宜的用于真空治疗的装置，其结构简化。
这个目的通过上述类型的装置这样实现，其中吸收体至少是一个装入包皮内的、由掺杂有超吸收粒子的织物部段构成的层，其中包皮是可透过流体的并且具有气孔，所述气孔的大小基本上不超过超吸收粒子的大小；
待置入伤口空腔内的吸收体具有一个初始体积，其在吸收过程中增大并且达到一个最终体积，从而所吸收的脓水-由包皮的气孔大小限定-保留在吸收体内并且因此位于伤口遮盖元件之下，直至吸收体由伤口空腔内移除；
层在朝向其表面侧的俯视图上具有一个延伸面积(Flchenausdehnung)，所述延伸面积比扁平放置的包皮的延伸面积小3％至90％。
吸收体的织物部段由纤维素无纺布制成。
装置可以包含可透过流体的黏膜友好的保护元件，所述保护元件在吸收体的与伤口遮盖元件对置的一侧上。保护元件的面积大致等于被包封的吸收体的面积大小，优选稍大。黏膜友好的保护元件在其最简单的实施方式中构成为薄膜形状的。
保护元件也可以由软的大开口的泡沫材料或非常松动的无纺布构成物制成。最后，保护元件可以是一个位于吸收体之下的、由无纺布件或泡沫材料件构成的松动的填料，其可以在吸收过程结束后例如借助于一个镊子由伤口中移除。此外体积大的构件不仅满足保护皮肤的功能，而且起吸收体的功能。大开口的泡沫材料或无纺布件可以具有比包皮气孔大得多的气孔，从而可以容纳脓水的较大的粒子。
不可透过流体的伤口覆盖元件优选由薄膜状的材料构成，其如此刚性，使得在正常状态下，即在未使用的和置于患者身体上时不收缩。
此外可能的是，平坦的薄膜状的伤口覆盖元件通过一个壳形的同样薄膜状的且优选透明的覆盖件替代，其设有一个平坦的边缘，用于粘贴在皮肤上。一个壳形的或钟形的覆盖件可以便宜地在深拉工艺中制造。
伤口覆盖元件可以在其表面的至少一部分上是透明的，以便可以观察伤口处理状态。
伤口遮盖元件在其外侧上可以印花。
吸收体可以与伤口覆盖元件至少点状地粘接，其中在伤口遮盖元件上留出一个自由的边缘。
概念“接头位置”基本上应当理解成一个在伤口覆盖元件上加工的排出孔，在其上可以连接软导管和/或压力计、真空泵、真空瓶等，或在其中安装一个阀门。然而接头位置可以通过一个可透过液体和气体的弹性体件替换，其可以通过一个针、例如注射器针头刺穿并且在拉出针后可以收缩到原来的形状。
作为阀门在此可以使用单向止回阀，例如一个由充气床垫或浮水圈领域已知的阀装置或一个由医学技术已知的微型阀门。
在装置粘接在患者身体上时，在伤口覆盖元件之下的空腔内的真空可以手动或机械地制造。一个最简单的手动产生真空的方法可以借助于注射器、一个所谓的Scheerengriff真空泵或一个已知的借助于手可以压缩的橡胶波纹管(球用打气筒)实现。为了通过电方式产生真空，各种在市场上常见的真空泵是合适的，其例如与软管和压力调节器一起提供。
在较长的伤口治疗过程中需要有规律地控制和维持真空。这个目的这样实现，即利用最简单的装置如注射器将聚集的空气根据需要由空腔抽出，如在抽血时，这通过将注射针头插入橡胶阀门或软管内实现。真空的大小可以借助于连接在排出孔上的压力计或安装的真空指示器测定。当然也可以采用真空泵。
这个装置在朝向其表面侧的俯视图上是多边形的、椭圆形的或圆形的。
包皮由可透过流体的黏膜友好的天然材料或塑料制成，脓水不会或几乎不会粘附在上面。这使得可以将可流动的脓水转移到吸收材料内。脓水穿过包皮流出并且被富含超吸收剂的吸收材料吸取。
不仅包皮，而且位于包皮内部的吸收材料可以设有抑制气味的和/或中和气味或掩饰气味的添加剂，例如活性炭过滤剂。非常有利的是，在抽空气体时没有脓水粒子被带出。脓水如此长地保留在吸收体的包皮内部，直至整个装置由患者身体上移除和丢弃或胀大的吸收体被更换。
有利的是，在吸收体的包皮上留出一个包皮材料的边缘伸出部，从而可以限制或完全避免相对较硬的焊缝与伤口表面之间引起疼痛的接触。伸出部在此理解成位于焊缝和包皮外边缘之间的包皮材料。
在伤口覆盖元件之下可以设置一个压力分配器，其位于伤口覆盖元件和被包封的吸收体之间。压力分配器可以是一个由可透过气体的泡沫材料构成的模制件，在其中存在许多气径用于均匀分配的空气流量。
压力分配器也可以至少部分由通过接头位置引导的抽吸管的一个圈形或回形延伸的端部件构成。抽吸管的端部件可以嵌入一个优选平坦的、待与吸收体接触的泡沫材料件中。
总体上提供了一种利用真空处理人体或动物体的伤口的装置，其中脓水通过吸收体的掺杂有超吸收物质的无纺布吸取并且保留在包围吸收体的包皮内部，而不会由包皮流回到被覆盖的空腔内，其中吸收体的横截面面积随着不断的吸收而剧烈地多倍扩大并且接近于圆形形状，并且在借助于一个可连接在装置上的注射器或真空泵维持真空时，即在抽出气体时，脓水几乎不会被带出。此外可能的是，弃用附加的收集容器或漏液软管。这个装置对于使用的患者而言是非常舒适的。
附图说明
下面借助于附图详细阐述本发明的实施例。其中：
图1a至1d一个粘附在患者的皮肤上的装置的示意剖视图；
图2图1的装置的拆分视图；
图3朝伤口覆盖元件观察的图1的装置的俯视图；
图4用于伤口处理的圆形的装置的俯视图；
图5图1d的剖视图A-A；
图6装置的另外一个实施方式的示意剖视图；
图7图1的装置的示意剖视图，然而具有两个接头位置；
图8图1的装置的背面的俯视图；
图9朝包皮的表面侧观察的装置的另外一个实施例的示意俯视图，其具有一个压力分配器；
图10根据图9的剖视图B-B。
具体实施方式
在图1a至1d、图2、图3和图8中示出了用于伤口处理的装置100，其包括一个薄膜状的伤口覆盖元件4、一个黏膜友好的薄膜元件1和一个位于它们之间的吸收体2。该装置在俯视图中在表面侧是大致矩形的并且具有倒圆的角部3。在伤口覆盖元件4的至少一个角部上设置一个撕开舌片12。此外设置一个消毒的气密的包装件(未示出)。
由不可透过流体的透明的薄膜制成的伤口覆盖元件4是相对刚性的，即在未使用的且在置于患者身体上的状态下不会收缩。伤口覆盖元件4在其边缘8上设有粘接面，用于将装置粘附在患者皮肤上。
吸收体2包括一个无纺布类型的纺织材料层22，其包含纤维素纤维并且混杂超吸收粒子(超吸水性树脂，SAP)，在本情况下是丙烯酸钠-丙烯酸-聚合树脂(Natriumacrylat-Acrylsure-Polymerisat)。此外吸收体2富含纳米晶(nanocrystalline)的含银物质，它杀害微生物。纤维素纤维作为突发加入的流体量的中间存储体并且作为传输装置，脓水借助于这种3纤维素纤维到达超吸收体。
层22被一个可透过流体的、织物的、利用环绕的超声波焊缝7焊接的包皮11包围。如特别是由图2可以看出，包皮11具有一个包皮材料的边缘的伸出部30，其位于超声波焊缝7和包皮11的最外部的周边9之间。伸出部30的目的在于阻止伤口与焊缝之前引起疼痛的接触。
与伤口面对的薄膜元件1由一种可透过流体的、极薄的、黏膜友好的材料制成。薄膜元件1也有助于保护免与超声波焊缝7接触。
此外在伤口覆盖元件4上加工一个接头位置5.1，以用于排空气体及真空控制。根据图1a至1d和图2，接头位置5.1大致设置在中间。接头位置5.1然而也可以位于伤口覆盖元件上任何位置，例如在边缘8的附近，如在图3中所示。
根据图7的装置具有两个接头位置5.1、5.2，中间的接头位置用于排空空气，侧面的接头位置用于真空控制。在中间的接头位置5.1上经由一个软导管15连接一个真空瓶20，而在侧面的接头位置5.2上同样经由一个连接软管19连接一个压力计18。附图7的描述自然涉及粘附在患者皮肤上的装置。
图4示出一个装置200，其与在图1中示出的装置100的区别仅仅在于其圆形的或椭圆的外部轮廓。
图6示意示出装置的另外一个实施方式(附图标记300)。装置300具有一个壳形的伤口覆盖元件4，这使得可以在其侧面外皮21上加工接头位置5.2。在接头位置5.2上可以根据需求连接一个必要时具有压力调节装置的真空泵23。
一个粘接在伤口覆盖元件的粘附面6上的硅涂层的撕开薄膜元件13(见图8)把装置100；200或300的各部分集合在一起并且保护免受外部影响。撕开薄膜元件13的面积与伤口覆盖元件4的面积相同。
如图9、10所示，抽吸管15以其端部件29经由接头位置5.1引导并且在薄膜状的伤口覆盖元件4和包皮11之间回形延伸地放置。，通过将端部件29放置在一个未示出的、相应轮廓的、由大开孔泡沫材料制成的模制件中，可以得到所述的端部件形状。从而得到这样一种构造，其中端部件的直径确定了伤口覆盖元件4与被包封的吸收体2之间所需要的距离A。端部件29已知地设有多个与模制件的气孔连通的开口。
工作方式：
通过将根据图1的装置100(一次性装置)粘附在患者皮肤上将一个深的伤口16完全覆盖。之前将在图8中示出的撕开薄膜元件13移除，其释放伤口覆盖元件4底面上的边缘的粘接面6。利用消毒的镊子(未示出)首先将黏膜友好的薄膜元件1，而后将扁平的吸收体2连同包皮11小心地放置在伤口表面上，而后将伤口覆盖元件4围绕伤口粘接。通过将装置粘附到皮肤上，在伤口覆盖元件4和伤口表面之间形成一个空腔10。在设有一个具有塞子的简单的单向止回阀25(见图1a)的中间接头位置5.1上通过上述的软导管15连接一个医用的注射器26。因为空腔10被密封，所以借助于注射器将存在于空腔内的空气抽出。图1b示出了这个状态。装置的扁平元件贴靠在伤口表面上。在此之间借助于一个未示出的真空指示器测量的真空大约为100mlHg。在此注射器的圆柱形壳面可以设有相应的试验测定的真空刻度。
由伤口流出的脓水到达吸收体2内并且在伤口覆盖元件4之下引起压缩。在吸取脓水之后，吸收体2的体积剧烈增大(见图1c)。因为吸收体2的面积大约比包皮11小40％，所以它接近圆形形状(见图5)。
所使用的装置100在此通过提起撕开舌片12和借助于镊子小心地由伤口区域移除。根据需要可以在伤口上粘贴一个新的一次性装置。
应用在伤口上的吸收体的涨大过程对于治疗过程是有利的，因为吸收体经由其重量的增加这样机械地阻止伤口组织的越过皮肤平面的超肉牙形成(Hypergranulation)，这是通过形成面向患者身体中心的压力状态实现的，所述压力状态通过在被抽吸的外部薄膜时的固定而加上的。通过这种方式在可以伤口治疗过程之后，将皮肤更容易地缝合，因为它不突出于其余的皮肤平面。这也带来一定的美容优点。
                        附图标记清单
1   薄膜元件
2   吸收体
3   角部
4   伤口覆盖元件
5.1；5.2  接头位置
6   粘附面
7   超声波焊缝
8   边缘
9   (包皮的)周边
10  空腔
11  包皮
12  撕开舌片
13  撕开薄膜元件
15  软导管(抽吸管)
16  伤口
17  (伤口覆盖元件的)外侧
18  压力计
19  连接软管
20  真空管
22  层
23  真空泵
25   阀门
26   注射器
29   端部件
30   伸出部
40   压力分配器
100  装置
200  装置
300  装置
400  装置
A    距离

Claims (25)

1.一种利用真空处理人体或动物体的伤口的装置(100；200；300；400)，包括：一气密的伤口遮盖元件(4)，其在置于患者身体上的状态下构成一个在相应的伤口和伤口遮盖元件之间存在的伤口空腔(10)；至少一个接头位置(5.1；5.2)，其与伤口空腔(10)处于接触并且经由该接头位置将存在于伤口空腔(10)内的空气排空；至少一个面状的吸收体(2)，其待设置在伤口遮盖元件(4)之下的伤口空腔(10)内，其特征在于，
吸收体(2)至少是一个装入包皮(11)内的、由掺杂有超吸收粒子的织物部段(2)构成的层(12)，其中包皮(11)是可透过流体的并且具有气孔，所述气孔的大小基本上不超过超吸收粒子的大小；
待置入伤口空腔(10)内的吸收体(2)具有一个初始体积(V1)，其在吸收过程中增大并且达到一个最终体积(V2)，从而所吸收的脓水-由包皮(11)的气孔大小限定-保留在吸收体(2)内并且因此位于伤口遮盖元件(4)之下，直至吸收体由伤口空腔内移除；
所述层(12)在朝向其表面侧的俯视图上具有一个延伸面积，其比扁平放置的包皮的延伸面积小3％至90％。
2.如权利要求1所述的装置，其特征在于，吸收体(2)全表面地与伤口遮盖元件(4)粘接，其中在伤口遮盖元件上留出一自由的边缘(8)。
3.如权利要求1所述的装置，其特征在于，吸收体(2)在接近其全部的填充能力时，在吸收体的横截面上观察，接近圆形形状。
4.如权利要求1所述的装置，其特征在于，吸收体(2)的织物部段由纤维素无纺布制成。
5.如权利要求1所述的装置，其特征在于，该装置包含可透过流体的黏膜友好的保护元件(1)，所述保护元件在放置在患者身体上的状态下设置在吸收体(2)与伤口遮盖元件(4)对置的一侧上并且在俯视图中与被包封的吸收体(2)具有大致相同的面积。
6.如权利要求1所述的装置，其特征在于，伤口遮盖元件(4)在放置在患者身体上的状态下不收缩。
7.如权利要求1至6之一所述的装置，其特征在于，伤口遮盖元件(4)在其外侧(17)上可以印花。
8.如上述权利要求之一所述的装置，其特征在于，接头位置(5.1；5.2)具有一个阀门(25)。
9.如上述权利要求之一所述的装置，其特征在于，在接头位置(5.1；5.2)上可以连接一个软导管(15；19)。
10.如上述权利要求之一所述的装置，其特征在于，在接头位置(5.1；5.2)上可以直接地连接或在软导管(15；19)上连接一个压力计(18)。
11.如上述权利要求之一所述的装置，其特征在于，在软导管(15；19)上可以连接至少一个真空瓶(20)或一个真空泵(23)。
12.如上述权利要求之一所述的装置，其特征在于，在接头位置(5.1；5.2)上或者在软导管(15；19)上可以连接一个活塞-气缸装置，如医用注射器(26)。
13.如上述权利要求之一所述的装置，其特征在于，在该装置中整合一个压力指示器。
14.如上述权利要求之一所述的装置，其特征在于，在装置置于患者身体上时吸收体(2)和/或可透过流体的保护元件(1)是可以更换的。
15.如上述权利要求之一所述的装置，其特征在于，吸收体(2)的包皮(11)通过超声波焊缝缝合。
16.如上述权利要求之一所述的装置，其特征在于，在吸收体(2)和/或保护元件的材料上涂敷影响伤口治疗过程的功能物质例如纳米晶的银颗粒。
17.如上述权利要求之一所述的装置，其特征在于，吸收体在其周边上具有一包皮材料的伸出部(30)。
18.如上述权利要求之一所述的装置，其特征在于，保护元件(1)是薄膜状的。
19.如上述权利要求之一所述的装置，其特征在于，保护元件(1)是织物部段。
20.如上述权利要求之一所述的装置，其特征在于，保护元件(1)由泡沫材料制成。
21.如上述权利要求之一所述的装置，其特征在于，保护元件(1)是位于吸收体(2)之下的松动的、由无纺布或泡沫材料块制成的填料。
22.如上述权利要求之一所述的装置，其特征在于，在伤口遮盖元件(4)之下，然而在被包封的吸收体(2)之上设置一个与吸收体(2)的包皮(11)接触的压力分配器(40)。
23.如权利要求22所述的装置，其特征在于，压力分配器(40)是一个由透气的泡沫材料制成的模制件。
24.如权利要求22所述的装置，其特征在于，压力分配器(40)具有通过接头位置(5.1；5.2)引导的抽吸管(15)的一个圈形或回形延伸的端部件(29)，所述端部件(29)限定在伤口遮盖元件(4)与被包封的吸收体(2)之间的距离(A)。
25.如权利要求1至24之一所述的装置，其特征在于，吸收体(2)经由其在涨大过程中重量的增加这样机械地阻止伤口组织的越过皮肤平面的超肉牙形成，这是通过形成面向患者身体中心的压力状态实现的，所述压力状态通过在被抽吸的外部薄膜时的固定加上的。
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US20080009812A1 (en) 2008-01-10
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US20120143157A1 (en) 2012-06-07
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US7775998B2 (en) 2010-08-17
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