CN101273927A - 带有加热和冷却装置的真空辅助闭合系统 - Google Patents

带有加热和冷却装置的真空辅助闭合系统 Download PDF

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CN101273927A
CN101273927A CNA2008100985741A CN200810098574A CN101273927A CN 101273927 A CN101273927 A CN 101273927A CN A2008100985741 A CNA2008100985741 A CN A2008100985741A CN 200810098574 A CN200810098574 A CN 200810098574A CN 101273927 A CN101273927 A CN 101273927A
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R·R·汉尼甘
J·R·莱宁格
小C·I·比尔茨
F·迪拉扎罗
C·法舍克
R·W·约翰逊
W·J·施雷德
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Abstract

本发明涉及一种用于可控加速和/或抑制身体炎症效应的方法和设备(10)，该设备包括用于基本扦入伤口部位的海绵垫(11)、用于在伤口部位(12)上面的加热和冷却垫(13)、伤口覆盖布(14)或海绵垫(11)的密封包封、在伤口部位(12)处的加热和冷却垫(13)。海绵垫(11)以流体相通方式与真空源相连，以促进身体炎症效应的可加速或抑制。加热和冷却装置控制作为炎症效应要素的局部代谢功能。

Description

带有加热和冷却装置的真空辅助闭合系统
相关申请
本申请是2001年11月29日进入中国国家阶段的的中国专利申请00808258.8的分案申请，并要求于1999年4月2日申请的题为“带有加热和冷却装置的真空辅助闭合系统”的美国临时专利申请序列No.60/127596的优先权。作为参考，在此引入美国临时专利申请序列No.60/127596的全部内部，包括附图。
技术领域
本发明涉及伤口的愈合。更具体地说，本发明涉及伤口的真空输助闭合，其中使用局部的加热或冷却以加速或恢复炎症系统的代谢功能，因此有利于伤口愈合。
背景技术
伤口闭合包括伤口附近的上皮组织和皮下组织的向内迁移。通常，该迁移会通过炎症过程而促进，过程中血流动增加和各种功能细胞被活化。由于炎症过程，通过受损或破裂血管的血液流动会由毛细血管的闭塞而受阻，之后可开始清洗和重建操作。不幸的是，当伤口很大或变成感染时，这种过程受阻。在这样的伤口情况下，在近伤口表面处形成郁积(即组织的局部肿胀限制血液流到组织的区域)。
没有足够的血液流动，伤口周围的上皮组织和皮下组织不仅只得到最少的氧和养分，而且不足以有效地抗细菌感染，因此不足以使伤口自然闭口。直到最近，这种难以处理的伤口还仅通过使用缝线和夹子来解决。虽然这种方法仍广泛使用并常常是有效的，但这种机械闭合技术的主要缺点是在伤口附近的皮肤组织上产生张力。特别是为达到使用缝线或夹子的闭合所需的拉力会在缝线或夹子扦入点产生局部应力。通常，这种应力造成扦入点的组织的破裂，最终会引起伤口开裂和附加的组织损失。
此外，某些伤口硬化和发炎到由于其感染不适于用缝线或夹子来闭合的程度。用缝线或夹子不可回复的伤口通常需要长期住院，这就带来高的花费，并且需要如周围组织的移植的外科操作。用缝线或夹子不易处理的伤口的例子包括大而深的开放性伤口；褥疮溃疡；慢性骨髓炎引起的溃疡；和部分深度烧伤接着发展成全深度烧伤。
由于机械闭合器件的这些和其它缺点，研制了使用连续负压的引流伤口的方法和设备。当在伤口的足够大的面积上使用时，发现这种负压有助于上皮组织和皮下组织向伤口迁移。在实践中，这种通常称作真空辅助闭合(VAC)治疗的在伤口上的负压的应用一般包括伤口的类似机械的收缩，同时排除过量的流体。在这种方法中，VAC治疗增大了身体的自然炎症过程，同时减轻许多已知的固有的副效应，如在没有供静脉回流的维管结构时增加血液流动所引起的水肿。
虽然VAC治疗已经很成功地促使了伤口的闭合，治愈过许多以前认为不可处理的伤口，但仍然有一些困难。因为对各个病人，其炎症过程是非常独特的，甚至增加VAC治疗也未对某些伤口的闭合产生足够快的效果，特别是在闭塞和起始的清洗和重建阶段。所以本发明的基本目的是提供一种方法和设备，使已知的VAC治疗方法通过炎症效应的可控加速而得以改进。
此外，至少部分是由于病人之间的差异，合适引发的炎症效应可能太大，有可能造成水肿和疼感。所以本发明的另一基本目的是提供一种方法和设备，使已知的VAC治疗方法通过炎症效应的可控抑制而得以改进。
发明内容
根据上述目的，本发明，即用于身体炎症效应的可控加速和/或可控抑制的方法和设备通常包括用于基本扦入到伤口部位的海绵垫、用于伤口部位上方的加热和冷却垫和在伤口部位的用于密封海绵垫和加热和冷却垫的创伤覆盖布。根据本发明，海绵垫安置成与真空源以流体相连，以在热流体或冷流体通过加热和冷却垫循环时促进流体排放，该垫分别用于身体炎症效应的代谢功能部分的可控加速或抑制。
按照本发明的优选实施方案，将加热或冷却装置引入以前已知的VAC治疗中以控制作为炎症效应要素的局部代谢功能。与通常的VAC治疗相结合，在提供局部加热时可协同加速炎症效应，以产生快速的毛细血管闭塞及较早地开始清洗和再建阶段。同样，当在场临床医师确定炎症效应已过度活化时，可与VAC治疗相结合提供局部冷却，以抑制身体炎症效应，而不会损失水肿控制和出现其它由VAC治疗引起的问题。
在本发明的该优选实施方案中，加热和冷却垫包含柔性的和可吸入的水层，通常包括两片RF(射频)-可焊接材料。这两片垫可经RF焊在一起成华夫饼干样的形式，其中在多个通道之间形成多个孔。该孔能排出来自病人皮肤的湿汽，而通道能经由供给管和排出管使热水或冷水循环，需要时通过垫以将其加热或冷却。
在本发明的加热方式期间，加热和冷却垫可安置在伤口覆盖布的里面或外面，但重要的是在本发明的冷却方式期间，加热和冷却垫应安置在伤口覆盖布的里面。以这种方式可使在覆盖布的内部的冷凝液的形成最少，冷凝液的形成会引起覆盖布粘附松脱，并最终在伤口部位造成真空损失。特别是，将加热和冷却垫安置在伤口覆盖布的里面限制了在伤口部位包封内存在和产生的周围的湿汽含量，它可通过VAC治疗的抽吸方式减到最小。
因为本发明的冷却方式应以这种方式实施，并且临床医师可在开始VAC治疗后的任何时候指示需要冷却，本发明的优选方法包括将加热和冷却垫安置在伤口覆盖布下面，接近海绵垫和伤口部位，不管开始指示的是加热还是冷却。在换垫时，伤口覆盖布牢牢粘附在供给管和排出管周围以防止真空泄漏。
最后，本发明的许多其它特征、目的和优点对本领域的技术人员是显而易见的，特别是基于上述讨论、下面的附图及典型的详述和所附权利要求。
附图简述
虽然本发明的范围比任何特定实施方案要宽得多，但下面给出优选实施方案的详述并与附图相结合，其中标识数字涉及同样部件。
图1以部分剖面图示出本发明应用于哺乳动物伤口部位的优选实施方案；
图2顶视截面图示出图1中本发明的加热和冷却垫。
实施本发明的最佳模式
虽然本领域的技术人员很容易考虑许多其它的实施方案，但特别是根据这里的附图的详述是本发明优选实施方案的示范例，本发明是一种带有加热和冷却装置的真空辅助闭合系统，其范围仅由所附权利要求所限制。
参阅附图，本发明10通常包括用于基本扦入伤口部位12的海绵垫11、用于在伤口部位上面的加热和冷却垫13和用于在伤口部位密封海绵垫11和加热和冷却垫13的伤口覆盖布14。按照本发明，海绵垫11以流体相通方式与真空源相连，以在热流体或冷流体通过加热和冷却垫13循环时促进流体排放，该垫分别用于身体炎症效应的代谢功能部分的可控加速或抑制。
按照本发明的优选实施方案，海绵垫11、伤口覆盖布14和真空源均按现有技术已知的提供，其各自的详述参看美国专利序列No.08/517901(1995年8月2日申请)。作为参考，该专利申请序列No.08/517901(“901”申请)，包括权利要求和附图均引此作为一个整体。此外，这种VAC系统易于市售获得，可通过Kinetics Concepts，Inc.of San Antonio，Texas，U.S.A.和/或其分公司购得。
如在“901”申请中的详述，海绵垫11优选包含网状的开孔聚氨酯或聚醚海绵，以在抽吸时有良好的伤口流体的可渗透性。如在“901”申请中的详述，海绵垫11以流体相通的方式经由塑料或类似材料的软管15与真空源相通，该真空源优选的包括一个在真空下安全设置的罐，该罐以流体相通的方式经由置于其间的疏水膜过滤器与真空泵相连。最后，“901”申请也详述了伤口覆盖布14，它优选包含至少周边覆盖有用于密封在伤口部位12上的丙烯酸型压合胶粘剂的弹性体材料。
按照本发明的优选方法，在“901”申请中所描述的那些部件通常使用现有技术中已知的，例外的是本发明中附加有加热和冷却装置，以控制作为炎症效应要素的局部代谢功能。与通常的VAC治疗相结合提供局部的加热时可协同加速炎症效应，以产生快速的毛细血管闭塞及较早地开始清洗和再建阶段。同样，当在场临床医师确定炎症效应已过度活化时，可与VAC治疗相结合提供局部冷却，以抑制身体炎症效应，而不会损失水肿控制和出现其它由VAC治疗引起的问题。
在本发明的优选实施方案中，加热和冷却垫13包含柔性的和可吸入的水层16，通常包括两片17、18可用射频焊接的材料。这两片垫17、18可经射频焊在一起成华夫饼干样的形式，其中在多个通道20之间形成多个孔19。孔19能排出来自病人皮肤21的湿汽，而通道能经由供给管22和排出管23使热水或冷水循环，需要时通过垫13以将其加热或冷却。
在本发明的加热方式期间，加热和冷却垫13可安置在伤口覆盖布的里面或外面，但重要的是在本发明的冷却方式期间，加热和冷却垫13应安置在伤口覆盖布的里面。以这种方式可使在覆盖布14的内部和近边缘处的冷凝液的形成最少，冷凝胶的形成会引起覆盖布粘附松脱，并最终在伤口部位12造成真空损失。特别是，将加热和冷却垫13安置在伤口覆盖布14的里面限制了在伤口部位12包封内存在和产生的周围的湿汽含量，它可通过VAC治疗的抽吸方式减到最小。
因为本发明的冷却方式应以这种方式实施，并且临床医师可在开始VAC治疗后的任何时候指示需要冷却，本发明的优选方法包括将加热和冷却垫13安置在伤口覆盖布14下面，接近海绵垫11和伤口部位12，不管开始指示的是加热还是冷却。在换垫13时，伤口覆盖布14牢牢粘附在供给管22和排出管23周围以防止真空泄漏。
因为上面的描述是本发明优选实施方案的示例，本专业领域的技术人员会理解许多改变、替换、修改是可能的，特别是根据该描述、附图和由此引出的权利要求。例如，本专业领域技术人员将理解，加热和冷却垫13可有各种形状、大小和内部结构。另一种实施方案可包括将加热和冷却垫13集成为伤口覆盖布14的多层形式。总之，因为本发明的范围比任何特定实施方案宽得多，所以上述的说明不应是对本发明的限制，本发明仅受限于所附权利要求。
工业应用性
本发明可应用于伤口愈合领域。

Claims (12)

1.一种用于促进哺乳动物伤口愈合的装置，其包括：
负压源；
用于放置在哺乳动物的伤口之中的垫；
用于密封和包围所述伤口之上所述垫的以及用于维持在所述伤口中的低压的覆盖布；
用于在所述负压源和所述垫之间连通的流体相通装置；和
用于主动地加热所述垫的加热部件；
其中所述加热部件与所述垫接触；
其中所述加热部件包括至少两个片层，所述片层具有多个孔隙并且固定连接，使得所述孔隙形成流体通道。
2.一种用于促进哺乳动物伤口愈合的装置，其包括：
负压源；
用于放置在哺乳动物的伤口之中的垫；
用于密封和包围所述伤口之上所述垫的以及用于维持在所述伤口中的低压的覆盖布；
用于在所述负压源和所述垫之间连通的流体相通装置；
用于主动地加热所述垫的加热部件；和
用于在加热所述垫之后主动地冷却所述垫的冷却部件；
并且其中所述冷却部件包括至少两个片层，所述片层具有多个孔隙并且固定连接，使得所述孔隙形成流体通道。
3.权利要求2所述的装置，还包括用于通过所述流体通道流通的温暖流体的源。
4.权利要求2所述的装置，还包括用于通过所述流体通道流通的冷流体的源。
5.一种用于促进哺乳动物伤口愈合的装置，其包括：
负压源；
用于放置在哺乳动物的伤口之中的垫；
用于维持在所述伤口中的低压的盖布；
用于在所述负压源和所述垫之间连通的流体相通装置；和
用于主动地冷却所述垫的冷却部件；其中所述盖布位于所述垫和所述冷却部件之间。
6.权利要求5所述的装置，其中所述冷却元件包括至少两个片层，所述片层具有多个孔隙并且固定连接，使得所述孔隙形成流体通道。
7.权利要求6所述的装置，还包括用于通过所述流体通道流通的冷流体的源。
8.权利要求5所述的装置，还包括用于在冷却所述垫之后主动地加热所述垫的加热部件，并且其中所述加热部件包括至少两个片层，所述片层具有多个孔隙并且固定连接，使得所述孔隙形成流体通道。
9.权利要求8所述的装置，还包括用于通过所述流体通道流通的温暖流体的源。
10.一种用于促进哺乳动物伤口愈合的装置，其包括：
负压源；
用于放置在哺乳动物的伤口之中的垫；
用于维持在所述伤口中的低压的盖布；
用于在所述负压源和所述垫之间连通的流体相通装置；和
用于影响所述伤口处及位于所述垫附近的代谢功能的加热和冷却垫。
11.权利要求10所述的装置，其中所述加热和冷却垫包括至少两个片层，所述片层具有多个孔隙并且固定连接，使得所述孔隙形成流体通道。
12.权利要求10所述的装置，还包括用于通过所述流体通道流通的温暖或冷流体的源。
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JP4143265B2 (ja) 2008-09-03
US8372022B2 (en) 2013-02-12
ES2270824T3 (es) 2007-04-16
CN101273927B (zh) 2011-06-08
AU4189500A (en) 2000-10-23
CA2369022A1 (en) 2000-10-12
CY1106271T1 (el) 2011-10-12
KR20020033606A (ko) 2002-05-07
HK1045453A1 (en) 2002-11-29
KR100661203B1 (ko) 2006-12-22
EP1164986A1 (en) 2002-01-02
US20130204211A1 (en) 2013-08-08
IL186711A (en) 2010-11-30
ZA200107856B (en) 2002-11-27
AU774512B2 (en) 2004-07-01
PT1164986E (pt) 2007-01-31
MXPA01009910A (es) 2003-07-14
US20090240216A1 (en) 2009-09-24
JP2003510106A (ja) 2003-03-18
US8882687B2 (en) 2014-11-11
EP1726276A2 (en) 2006-11-29
US9724243B2 (en) 2017-08-08
CN100402002C (zh) 2008-07-16
WO2000059418A1 (en) 2000-10-12
CA2369022C (en) 2005-08-09
IL186711A0 (en) 2008-02-09
DE60030419D1 (de) 2006-10-12
RU2239396C2 (ru) 2004-11-10
HK1045453B (zh) 2007-03-30
IL145628A0 (en) 2002-06-30
CN1367672A (zh) 2002-09-04
DK1164986T3 (da) 2007-01-08
EP1726276B2 (en) 2015-10-21
EP1726276A3 (en) 2009-07-15
EP1164986B8 (en) 2006-10-25
US20150150730A1 (en) 2015-06-04
US7144390B1 (en) 2006-12-05
ATE337765T1 (de) 2006-09-15
NZ514480A (en) 2005-05-27
EP1164986B1 (en) 2006-08-30
US10736787B2 (en) 2020-08-11
US20070073200A1 (en) 2007-03-29
DE60030419T2 (de) 2007-05-03
US7540848B2 (en) 2009-06-02
EP1726276B1 (en) 2012-11-14
HK1093669A1 (en) 2007-03-09
BR0009519A (pt) 2003-03-05
CN101278873A (zh) 2008-10-08
US20170354542A1 (en) 2017-12-14
CN101278873B (zh) 2012-08-22

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