CN102186511A - 模块化减压伤口闭合系统及方法 - Google Patents

模块化减压伤口闭合系统及方法 Download PDF

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CN102186511A
CN102186511A CN2009801414800A CN200980141480A CN102186511A CN 102186511 A CN102186511 A CN 102186511A CN 2009801414800 A CN2009801414800 A CN 2009801414800A CN 200980141480 A CN200980141480 A CN 200980141480A CN 102186511 A CN102186511 A CN 102186511A
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基思·帕特里克·希顿
伊恩·詹姆士·哈德曼
克里斯托弗·盖伊·科沃德
科林·约翰·霍尔
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Abstract

一种用于在患者身上的表面伤口上产生闭合力的模块化减压伤口闭合系统包括：密封的收缩构件、多个附接基部构件和多个连接构件。多个附接基部构件和多个连接构件的组合形成围绕表面伤口的环形壁。密封的收缩构件可操作为被布置在由环形壁界定的内部空间内，并且与环形壁的至少一部分联接。当减压被提供至密封的收缩构件时，密封的收缩构件收缩，并且环形壁输送闭合力。还提供了其它的系统和方法。

Description

模块化减压伤口闭合系统及方法
相关申请
根据美国法典第35卷第119条(e)款，本发明要求下列申请的汇集的权益：2008年10月29日提交的标题为“Reduced-Pressure，Wound-Closure System and Method(减压伤口闭合系统及方法)”的美国临时专利申请序列号61/109,410、2008年10月29日提交的标题为“Reduced-Pressure，Abdominal Treatment System and Method(减压腹部处理系统及方法)”的美国临时专利申请序列号为61/109,486、2008年10月29日提交的标题为“Open-Cavity，Reduced-Pressure Wound Dressing and System(开口腔减压伤口敷料和系统)”的美国临时专利申请序列号为61/109,390以及2008年10月29日提交的标题为“Reduced-Pressure，Deep-Tissue Closure System and Method(减压深部组织闭合系统及方法)”的美国临时专利申请序列号为61/109,448。为了所有的目的，所有这些临时申请在此通过引用被并入。
背景
本发明大体上涉及医疗处理系统，并且更具体地涉及减压伤口闭合和处理系统及方法。
无论伤口或损伤的组织区域的病因是创伤、手术还是其它原因，伤口的适当护理对于结果都很重要。当伤口涉及需要再进入的位置例如腹膜腔和更一般地腹腔时，存在独特的挑战。很多时候，当手术或创伤涉及腹腔时，建立便于再进入的伤口管理系统允许更好和更容易的护理，并且帮助解决例如腹膜炎、腹腔间隔室综合症(ACS)以及可能抑制伤口和内部器官的最终愈合的感染的情况。在提供这样的护理中，可能期望从腔移除不需要的流体、帮助接近筋膜和其它组织、或最终帮助在表皮水平面处的伤口本身上提供闭合力。除非另外指明，如本文所使用的，“或”不要求相互排他性。
目前，可使用缝合线、U形钉、夹具和其它机械设备来闭合表皮上的腹部开口。这样的设备经常引起穿刺性伤口或可引起其它伤口。而且，如果出现严重的浮肿，极大的压力可能被置于闭合设备上，且该压力可引起伤害。例如，如果压力因浮肿而升高，则缝合可能会撕开。
关于用于允许再进入腹腔的整个系统，已开发了大量的技术。一种方法是将毛巾放入腔中，且然后使用例如止血钳的夹具使皮肤在毛巾上方闭合。虽然简单并迅速，但结果被视为不是最佳的。另一种方法是所谓的“Bogota袋(Bogota bag)”。使用这种方法，将袋缝入覆盖打开的腹部的位置中，以便提供屏障。有时称为“真空填塞(vac pack)”的再一种方法，是将毛巾填塞在伤口中，且然后将引流管放入腹部中，并用盖布覆盖腹部。最后，已经使用一种减压方法。这种方法在授予Hunt等人的并且转让给德克萨斯州San Antonio的KCI Licensing，Inc.的美国专利7,381,859中被说明。为了所有的目的，在此通过引用将美国专利7,381,859并入。
概述
现有伤口闭合设备和减压处理系统的问题通过本文所描述的说明性实施方式的系统、装备和方法来解决。根据一个说明性实施方式，一种模块化减压伤口闭合系统包括密封的收缩构件、多个附接基部构件和多个连接构件。多个附接基部构件可运动地联接至多个连接构件，以形成界定内部空间的环形壁。收缩构件可操作为被布置在内部空间内。
根据另一个说明性实施方式，一种制造用于在患者身上的表面伤口上产生闭合力的模块化减压伤口闭合和处理系统的方法包括以下步骤：形成密封的收缩构件、形成多个附接基部构件以及形成多个连接构件。多个附接基部构件和多个连接构件可操作为可运动地联接，以形成界定内部空间的环形壁。
根据另一个说明性实施方式，一种在患者身上的表面伤口上产生闭合力的方法包括以下步骤：提供密封的收缩构件和提供多个附接基部构件。每个附接基部构件具有基部和第一壁，该第一壁具有第一端和第二端。第一壁的第一端包括第一可运动的联接构件，且第二端包括第二可运动的联接构件。每个附接基部构件用于可释放地附接至患者的表皮的一部分，并且用于联接至密封的收缩构件。该产生闭合力的方法还包括提供多个连接构件。多个连接构件中的每个连接构件包括具有第一端和第二端的第二壁。第二壁的第一端具有第三可运动的联接构件，且第二壁的第二端具有第四可运动的联接构件。每个连接构件用于可运动地联接至多个附接基部构件中的两个附接基部构件。该产生闭合力的方法还包括将减压提供给密封的收缩构件。该提供闭合力的方法还包括可运动地联接多个附接基部构件和多个连接构件，以形成界定内部空间的环形壁。该提供闭合力的方法还包括将密封的收缩构件布置在内部空间内，并将减压供应至收缩构件，由此形成力，该力向内牵引附接基部构件，以在表面伤口上产生闭合力。
根据另一个说明性实施方式，一种用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统包括伤口闭合子系统和减压处理子系统。
参考附图和下面的详细描述，说明性实施方式的其它目的、特征和优势将变得明显。
附图简述
图1是减压伤口闭合和处理系统的说明性实施方式的、一部分以框图呈现的示意性横截面；
图2是用作减压伤口闭合系统的说明性实施方式的一部分的附接基部构件的说明性实施方式的示意性透视图；
图3是用作减压伤口闭合系统的说明性实施方式的一部分的联接构件的说明性实施方式的示意性透视图；
图4是用作减压伤口闭合系统的说明性实施方式的一部分的减压接口构件的说明性实施方式的示意性透视图；
图5A和图5B是处于非收缩位置(图5A)和收缩位置(图5B)中的减压伤口闭合系统的说明性实施方式的示意性平面图；以及
图6是减压伤口闭合系统的说明性实施方式的示意性透视图。
说明性实施方式的详细描述
在下面的说明性实施方式的详细描述中，参考形成其一部分的附图。这些实施方式足够详细地被描述，以使本领域技术人员能够实践本发明，且应理解，可利用其它的实施方式并且可进行逻辑结构的、机械的、电的以及化学的改变而不偏离本发明的精神或范围。为避免对于使本领域技术人员能够实践本文所述的实施方式来说不必要的细节，本描述可省略本领域技术人员已知的某些信息。因此，下面的详细描述不应在限制的意义上被理解，且说明性实施方式的范围仅由所附的权利要求限定。
参考图1-2，并最初参考图1，示出了减压伤口闭合和处理系统100的说明性实施方式。减压伤口闭合和处理系统100可包括减压处理子系统102和伤口闭合子系统104。减压处理子系统102可用于使用减压来处理组织部位106。组织部位106可以是任何人类、动物或其它生物体的身体组织，包括骨组织、脂肪组织、肌肉组织、皮组织、血管组织、结缔组织、软骨、腱、韧带或任何其他组织。组织部位106可以在例如腹腔110的体腔内，并且可包括各种组织层，组织层包括表皮108中的伤口。使用减压处理子系统102的处理可包括移除例如腹水或渗出物的流体、输送减压或提供保护性屏障。
在说明性的实施方式中，减压伤口闭合和处理系统100呈现在腹腔110和具有伤口边缘112的表面伤口111的环境中。其它的皮下组织114也可以被打开，例如脂肪组织、肌肉、筋膜等。腹腔110显示为具有形成表面或支撑物的腹部内容物116。
减压伤口闭合和处理系统100的减压处理子系统102帮助将减压输送至组织部位106和腹腔110。减压处理子系统102包括布置在腹腔110内的歧管118，以在腹腔110内分配减压并且接收流体。歧管118可包括在非粘附外壳(non-adherent envelope)122中的歧管构件120或第二歧管或者与歧管构件120或第二歧管相关。非粘附外壳122在第一侧上具有孔124，并且在第二面向内(或面向组织)的侧上具有孔126。孔124和126便于如箭头128所示的流体流动。孔124和126可采用任何形状，例如矩形开口、圆形开口、多边形、狭缝(细长槽)等。非粘附外壳122可由柔性膜例如聚氨基甲酸酯膜、盖布材料或任何非粘附材料形成。
通过减压处理子系统102可将减压施加至腹腔110和组织部位106，以帮助促进渗出物、腹水或其它液体、细菌、纤维蛋白、死组织、毒素、残留血等的移除。减压还可在某些情况中用于刺激另外组织的生长。在组织部位106处的伤口的情况下，肉芽组织的生长以及渗出物和细菌的移除可帮助促进伤口愈合。在非创伤性或非缺陷性组织的情况中，减压可用于促进可被切除并移植到另一组织部位的组织的生长。在其它情况中，流体移除可能是施加减压的主要原因。
如本文所使用的，“减压”一般指小于组织部位106处的环境压力的压力。在大部分情况中，减压将小于患者所在位置处的大气压。可选地，减压可小于组织部位106的流体静压。除非另外指明，本文所陈述的压力值是表压。
歧管118和歧管构件120布置在腹腔110中，并且可布置在组织部位106处或在组织部位106附近处。通常，容纳歧管构件120的非粘附外壳122靠着组织部位106且特别是紧邻腹部内容物116布置。歧管118相邻于非粘附外壳122布置。歧管118和歧管构件120可采用多种形式。如本文所使用的，术语“歧管”一般指被设置成帮助向例如组织部位106的组织部位施加减压、输送流体到例如组织部位106的组织部位或从例如组织部位106的组织部位移除流体的物质或结构。歧管118和歧管构件120通常包括多个流动通道或路径，该多个流动通道或路径相互连接，以改善被提供至紧邻歧管118和歧管构件120的区域以及从紧邻歧管118和歧管构件120的区域所移除的流体的分配。歧管118和歧管构件120可由生物相容性材料形成，该生物相容性材料能够被放置成与组织接触并且分配减压。歧管的示例可包括且不限于：具有被布置成形成流动通道的结构元件的设备、例如开孔泡沫的多孔状泡沫、多孔组织聚集物以及包括或固化成包括流动通道的液体、凝胶和泡沫。
歧管118和歧管构件120可以是多孔的，并且可以由泡沫、纱布、毡垫或任何其它适合于特定生物应用的材料制成。在一个实施方式中，歧管118和歧管构件120由多孔泡沫制成，该多孔泡沫包括充当流动通道的多个相互连接的小室或孔。多孔泡沫可以是聚氨基甲酸酯开孔网状泡沫，例如由德克萨斯州San Antonio的Kinetic Concepts，Incorporated制造的GranuFoam
Figure BPA00001349322900061
材料。其它的实施方式可包括在某些位置处的“闭室”，以帮助引导流动。在一些情况中，歧管118、歧管构件120和非粘附外壳122可用于将例如药物、抗菌药、生长因子和其它溶液的流体分配至组织部位106。其它层可作为歧管118或歧管构件120的一部分例如吸收材料、芯吸材料(wicking material)、疏水性材料和亲水性材料而被包括。
密封构件132可放置在表皮108中的表面伤口上方，并且特别是被制成叠盖伤口边缘112以提供气动密封。因此，密封构件132在歧管118和非粘附外壳122上方提供密封。密封构件132可以是用于将歧管118和非粘附外壳122固定在组织部位106处的覆盖物。虽然密封构件132可以是不可渗透的或半渗透的，但是密封构件132在密封构件132安装在歧管118上方之后能够维持在组织部位106处的减压。密封构件132可以是由基于硅氧烷的化合物、丙烯酸、水凝胶或形成水凝胶的材料或包括预期的组织部位所需的不渗透性特性或渗透性特性的任何其它生物相容性材料形成的柔性的上盖布(over-drape)或膜。
密封构件132还可包括附接设备136，以将密封构件132固定至患者的表皮108。附接设备136可采用多种形式；例如，可使用密封胶带或可将粘合剂134沿着密封构件132的周边或密封构件132的任何部分定位，以提供气动密封。粘合剂134还可以被预先涂敷并且用可释放的构件(未示出)覆盖，所述可释放的构件在应用的时候被移除。
例如口140或连接器的第一减压接口138或处理减压接口可用于将减压从第一减压输送导管142输送至歧管118。第一减压接口138还可将任何渗出物、腹水或其它流体从歧管118输送至第一减压输送导管142。歧管118中的减压以由箭头144所示的方向牵引流体并且将流体牵引至第一减压输送导管142。第一减压接口138允许流体从歧管118传递至第一减压输送导管142。例如，使用歧管构件120和歧管118从组织部位106收集的流体可经由第一减压接口138进入第一减压输送导管142。在另一个实施方式中，减压处理子系统102可不包括第一减压接口138，并且第一减压输送导管142可直接插入密封构件132和歧管118中。第一减压输送导管142可以是医用导管、多腔构件、管道或用于输送减压的任何其它装置。
减压子系统148可用于供应被输送至第一减压输送导管142的减压。减压子系统148可包括将减压输送至导管152的第一减压单元或源150，导管152将减压输送至三通阀154。减压的一部分可穿过第二减压输送导管156离开三通阀154。减压的另一部分可穿过减压导管158离开三通阀154。减压导管158上可设置任何数量的设备，例如减压反馈单元160，其例如可向三通阀154提供有关减压导管158内的减压的调节的反馈。减压导管158将减压输送至罐162，罐162可操作为容纳从组织部位106输送至罐162的任何流体。离开罐162的减压被输送至第一减压输送导管142。因为通过减压子系统148将第一减压输送导管142中的减压置于所需的压力和条件下，以用在组织部位106处的减压处理中，因此第一减压输送导管142可被认为是输送处理减压。被输送至第一减压输送导管142的减压通常被选择为在组织部位处在-50mmHg至-500mmHg的范围中，并且更通常在-100mmHg与-300mmHg之间。
很多不同的设备例如代表性设备166可被添加至第一减压输送导管142的中部164。代表性设备166可以是压力反馈设备、体积检测系统、血液检测系统、感染检测系统、流量监控系统、温度监控系统等。这些设备中的一些可与其它部件整体地形成；例如，罐162可包括一个或多个过滤器，例如阻止液体离开的疏水性过滤器。
有很多形成与减压伤口闭合和处理系统100一起使用的减压的方式。在所示的说明性实施方式中，第一减压单元150用于两种应用，即用于伤口闭合和用于减压处理。在可选的实施方式中，将第一减压单元150用作第二减压输送导管156的源并且使第二减压单元151(以虚线所示)将减压输送至减压导管158可能是合乎需要的。
作为减压伤口闭合和处理系统100的一个方面，帮助将闭合力提供给表面伤口111并且特别是在伤口边缘112之间施加闭合力也可能是合乎需要的。如图1所示，伤口闭合子系统104可用于这种目的。伤口闭合子系统104形成由箭头170表示的闭合力。闭合力被传递至表皮108，并且将伤口边缘112推向彼此。伤口闭合子系统104可以是用于闭合任何表面伤口的独立系统，或用作较大系统例如减压伤口闭合和处理系统100的一部分。
伤口闭合子系统104可包括多个附接基部构件，例如第一附接基部构件172和第二附接基部构件184。每个附接基部构件与连接构件(类似于下面图3中的第一连接构件326)可运动地联接，以形成具有内部空间(类似于下面图5A中的内部空间381)的环形壁(类似于下面图5A中的环形壁380)。密封的收缩构件188布置在内部空间内，并且联接至附接基部构件中的至少两个附接基部构件，例如第一附接基部构件172和第二附接基部构件184。环形壁可操作为随着密封的收缩构件188收缩而弯曲或运动。
第一附接基部构件172具有第一基部174和第一壁176。第一基部174具有第一侧178和第二面向内的侧180。第一基部174和第一壁176可由多种材料制成，但是提供柔性的材料是优选的；例如，第一附接基部构件172可形成有由聚丙烯或刚性硅树脂等制成的第一基部174和第一壁176。第一粘合剂182可应用于第一基部174的第二面向内的侧180，以允许第一基部174可释放地直接附接至患者的表皮108的一部分，或者如果聚氨基甲酸酯膜或其它密封构件132首先被放置在表皮108上，允许第一基部174可释放地间接地附接至患者的表皮108的一部分。除了第一粘合剂182之外，U形钉、或缝合线、或其它有创的方法可在某些情况中用于将第一基部174附接至无损伤的表皮组织。第一附接基部构件172可直接地应用在表皮108之上或密封构件132之上，使得施加在第一附接基部构件172上的闭合力被直接地或间接地传送至表皮108。提到将第一附接基部构件172应用于表皮108，应被认为也包括在密封构件132上的应用。第一附接基部构件174可包括可运动的联接构件175和第二减压接口177或闭合减压接口，可运动的联接构件175被按尺寸制造并配置成与另一个可运动的联接构件(参见例如图3中的第三可运动的联接构件334)配合，第二减压接口177或闭合减压接口便于减压向密封的收缩构件188的输送。
第二附接基部构件184与第一附接基部构件172类似，除了第二附接基部构件184不包括第二减压接口177之外。第二附接基部构件184具有基部185和壁187。虽然伤口闭合子系统104仅示出两个附接基部构件172、184，但是其它附接构件可按与连接构件之间成间隔开的方式围绕表面伤口111散布，以形成围绕表面伤口111的环形壁。与密封的收缩构件188连用的附接基部构件例如附接基部构件172、184允许形成由箭头170表示的穿过不同形状的表面伤口111的闭合力。
附接基部构件中的一个或多个例如附接基部构件172具有第二减压接口177，用于从第二减压输送导管156接收减压。穿过第二减压接口177被输送的减压用于形成闭合力。第二减压输送导管156中的减压或闭合减压可被选择为在-100mmHg至-1000mmHg的范围内。
伤口闭合子系统104包括密封的收缩构件188，以形成闭合力。密封的收缩构件188可由收缩歧管材料形成，收缩歧管材料可以是与歧管118相同类型的材料。可选地，使用比用于歧管118的材料具有更少的孔或洞的收缩歧管材料可能是合乎需要的。另外，具有一种在竖直方向(对于图1中所示的方位)上收缩得较少而在水平或横向平面(对于图1中所示的方位)中收缩得较多的材料即各向异性材料可能是合乎需要的。密封的收缩构件188具有第一侧190和第二面向内(面向组织)的侧192。
密封的收缩构件188还具有外围边缘194。密封的收缩构件188可通过具有被应用于第一侧190的第一密封构件196和被应用于密封的收缩构件188的第二面向内(面向组织)的侧192的第二密封构件198而被密封。密封的收缩构件188的外围边缘194可由外围密封构件200密封。可选地或另外地，第一壁构件176也可用作外围密封构件以密封外围边缘194，或可使用另一块密封材料。相似地，第二面向内(面向组织)的侧192可通过靠着密封构件132或患者的表皮108放置而被密封。密封的收缩构件188还可通过被涂覆有不透气材料来密封。密封的收缩构件188可使用第一密封构件196和第二密封构件198来密封，第一密封构件196和第二密封构件198可由聚氨基甲酸酯膜或硅树脂形成。第一密封构件196和第二密封构件198可在它们的端部被超声焊接或RF焊接，以覆盖外围边缘194。当减压被提供至密封的收缩构件188时，密封的收缩构件188收缩以形成由箭头170表示的闭合力。密封的收缩构件188可在密封的收缩构件188的一部分上形成有用于接收第一减压接口138的延伸部分202的开口201。延伸部分202可延伸穿过密封的收缩构件188并进入歧管118中。
在操作中，通过首先将歧管材料应用在腹部内容物116上可将减压伤口闭合和处理系统100用在体腔例如腹腔110中。例如，具有非粘附外壳122的歧管构件120可放置在腹部内容物116上，并且歧管118紧邻非粘附外壳122布置。可将表面伤口111的伤口边缘112尽可能集合在一起，且然后将密封构件132放置在表皮108上，以在表面伤口111上方提供气动密封。使用第一粘合剂182可将第一附接基部构件172应用于患者的表皮108或密封构件132上。然后，可将联接构件和附接构件围绕表面伤口111布置。附接构件例如第一附接基部构件172和第二附接基部构件184被联接至患者的表皮108(或密封构件)，并且密封的收缩构件188被联接至例如第一附接基部构件172和第二附接基部构件184的附接构件。在例如第一附接基部构件172和第二附接基部构件184的附接构件与密封的收缩构件188之间的这种联接可以用多种不同的方式来实现，例如通过使用粘合剂189和191。
可以应用可以是减压口140的第一减压接口138，使得延伸部分202进入歧管118中。第一减压输送导管142可联接至第一减压接口138，以提供与第一减压单元150(或可选的第二减压单元151)的流体联接。第二减压输送导管156可流体地联接至第二减压接口177。
减压伤口闭合处理系统100被启动，以使第一减压单元150将减压输送穿过准备处理减压和闭合减压的三通阀154，处理减压被输送至第一减压输送导管142，闭合减压被输送至第二减压输送导管156。处理减压被输送穿过第一减压输送导管142并且在歧管118处得以实现，歧管118如由箭头144和128所示牵引流体，并且在腹腔110内分配减压。同时，被输送穿过第二减压输送导管156的闭合减压通过密封的收缩构件188来实现，闭合减压引起密封的收缩构件188收缩，形成由箭头170表示的闭合力。该闭合力将第一附接基部构件172和第二附接基部构件184拉向彼此，并由此拉伤口边缘112。减压伤口闭合处理系统100可单独地使用，以闭合某些应用中的伤口。
现在参考图2至图5B，现将呈现模块化减压伤口闭合系统300的一部分。模块化减压伤口闭合系统300使用多个模块化部件，多个模块化部件可被运动地联接，以适应各种尺寸和形状的伤口并且提供指向伤口中央的闭合力，即将伤口边缘推在一起的闭合力。模块化部件的使用允许适应多种尺寸和形状的表面伤口，而不需要大批不同尺寸和形状的伤口敷料或设备存货供应。
主要参考图2，可使用多个附接基部构件，例如第一附接基部构件302。每个附接基部构件302具有基部304，基部304具有第一侧306和第二面向内(面向组织)的侧308。基部304的第二面向内(面向组织)的侧308可具有用于将第一附接基部构件302附接至患者的表皮(或至患者表皮上的密封构件)的粘合剂(未明确地示出)。在可选的实施方式中，机械设备例如缝合线还可用于将第一附接基部构件302固定至患者的表皮。在第二面向内的侧308上的粘合剂最初可用可释放的衬底材料覆盖，在应用于患者的表皮之前该衬底材料可被移除。第一附接基部构件302还包括例如与基部304附接或整体地形成而联接至基部304的壁310。壁310具有第一端312和第二端314。第一端312可形成有被作为整体部分形成或被附接至壁310的第一可运动的联接构件316。第二端314可形成有被作为整体部分形成或被附接至壁310的第二可运动的联接构件318。如下面所进一步描述的，钩构件320可用于刺穿、夹紧或支撑密封的收缩构件322。钩构件320可与壁310或基部304整体地形成或附接到壁310或基部304。
现在主要参考图3，多个连接构件例如第一连接构件326可用作模块化减压伤口闭合系统300的一部分。每个连接构件326具有带有第一端330和第二端332的第二壁328。第二壁328可成形为具有弓形的构型或可以是直的构型。第一端330可形成有或具有被联接至第一端330的第三可运动的联接构件334。相似地，第二端332可形成有或具有被联接至第二端332的第四可运动的联接构件336。可运动的联接构件334和336被按尺寸制造并配置成以协调的方式与可运动的联接构件316和318配合，协调的方式允许每个附接基部构件302和每个相邻的所联接的连接构件326之间的相对运动，例如可绕枢轴转动的运动。在该说明性实施方式中，可运动的联接构件334和336被显示出是销形构件(pin-shaped member)，该销形构件被按尺寸制造并配置成滑入第一可运动的联接构件316和第二可运动的联接构件318，第一可运动的联接构件316和第二可运动的联接构件318是被按尺寸制造并配置成接收销形状的可运动的联接构件334和336的插孔。当然，销形构件和插孔能够被反过来地布置或被混合并匹配。
虽然减压导管例如图1中的第二减压输送导管156可穿过壁310被直接地应用，但是减压接口342可被用在第一附接基部构件302的壁310上。例如，可修改第一附接基部构件302以形成如图4中所示的减压接口构件340。除了添加有减压接口342之外，减压接口构件340与第一附接基部构件302的减压接口构件类似。减压接口342可以是延伸穿过壁346的口344。可选地，减压接口可形成有被设置成穿过连接构件326的口，例如口344。
之前所呈现的模块化部件即第一附接基部构件302、第一连接构件326和减压接口构件340可被组合以形成不同的形状并由此适应不同尺寸和形状的伤口。图5A和图5B中示出了一个示例。组合的构件在表面伤口301上方形成模块化减压伤口闭合系统300。特别是参考图5A，模块化减压伤口闭合系统300被显示出具有多个附接基部构件：第一附接基部构件302、第二附接基部构件350和第三附接基部构件352。第四附接基部构件被示出但被修改以形成具有减压接口342的减压接口构件340。减压导管354可流体联接至减压接口342。
多个连接构件用于连接多个附接基部构件302、350、352、340(接口)中的每一个。因此，在该说明性实施方式中，第一附接基部构件302的第一端312在第一连接构件326的第二端332处联接至第一连接构件326。相似地，第二附接基部构件350联接至第二连接构件356。第二连接构件356还联接至第三附接基部构件352。第三附接基部构件352联接至第三连接构件358，第三连接构件358还联接至减压接口构件340。减压接口构件340联接至第四连接构件360。以这种方式，多个附接基部构件和多个连接构件形成界定内部空间381的环形壁380，密封的收缩构件322被布置在内部空间381中。密封的收缩构件383可通过钩例如在第一附接基部构件302上的钩320或通过粘合剂、粘合、焊接或其它附接设备而紧邻附接基部构件被支撑。密封的收缩构件322可附接至环形壁380的全部或一部分。
应理解，多个附接基部构件和多个连接构件的交替构件(alternating member)提供能够运动的连接。该运动在模块化减压伤口闭合系统300从图5A的非收缩位置转至图5B中所示的收缩位置时是有益的。还应理解，虽然在该说明中仅示出四个连接构件和四个附接基部构件，但可使用任何数量的这些部件以形成更大或更小的系统。例如，图6中的模块化减压伤口闭合系统400示出了更大的系统构型。
在该说明性实施方式中的模块化减压伤口闭合系统400包括具有七个附接基部构件402和被修改以形成减压接口404的另一个附接基部构件的多个附接基部构件。模块化减压伤口闭合系统400还包括在该说明性实施方式中包括八个连接构件406的多个连接构件。多个附接基部构件402和多个连接构件406可运动地联接以形成界定内部空间410的环形壁408。密封的收缩构件412被放置在内部空间410内并且被联接到至少多个附接基部构件402。密封的收缩构件412可按类似于图2的钩320的方式使用位于多个附接基部构件402上的钩或使用其它附接设备来联接。当减压穿过减压接口构件404上的减压接口414被供应时，减压引起密封的收缩构件412收缩，且使多个附接基部构件402中的每个附接基部构件向内拉并因此提供闭合力。
虽然在某些说明性、非限制性的实施方式的上下文中已公开了本发明和它的优势，但应理解，可以进行不同的改变、替换、置换和变更，而不偏离如所附的权利要求所界定的本发明的范围。

Claims (22)

1.一种用于在患者身上的表面伤口上产生闭合力的模块化减压伤口闭合系统，所述系统包括：
密封的收缩构件，所述密封的收缩构件可操作为在被放置在减压下时收缩；
多个附接基部构件，每个附接基部构件具有基部和第一壁，所述第一壁具有第一端和第二端，所述第一壁的所述第一端具有第一可运动的联接构件，且所述第一壁的所述第二端具有第二可运动的联接构件，每个附接基部构件用于可释放地附接至患者的表皮的一部分并且用于联接至所述密封的收缩构件；
多个连接构件，每个连接构件具有第二壁，所述第二壁具有第一端和第二端，所述第二壁的所述第一端具有第三可运动的联接构件，且所述第二壁的所述第二端具有第四可运动的构件，每个连接构件用于可运动地联接至所述多个附接基部构件中的一个附接基部构件；
第一减压接口，所述第一减压接口流体地联接至所述密封的收缩构件，所述第一减压接口可操作为将减压输送至所述密封的收缩构件；并且
其中，所述多个附接基部构件和所述多个连接构件可操作为可运动地联接，以形成界定内部空间的环形壁，并且其中所述密封的收缩构件可操作为在所述内部空间内被布置和联接。
2.如权利要求1所述的模块化减压伤口闭合系统，其中，所述多个附接基部构件中的每个附接基部构件的所述第一可运动的联接构件和所述第二可运动的联接构件包括销形构件，并且其中所述多个连接构件中的每个连接构件的所述第三可运动的联接构件和所述第四可运动的联接构件包括插孔，所述插孔被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合。
3.如权利要求1所述的模块化减压伤口闭合系统，其中，所述多个附接基部构件通过第一粘合剂被联接至所述密封的收缩构件，并且所述多个连接构件通过第二粘合剂被联接至所述密封的收缩构件。
4.如权利要求1所述的模块化减压伤口闭合系统，其中，所述减压接口包括在所述环形壁上形成的口。
5.如权利要求1所述的模块化减压伤口闭合系统，其中，所述多个附接基部构件和所述多个连接构件包括柔性材料。
6.如权利要求1所述的模块化减压伤口闭合系统，还包括被联接至所述多个附接基部构件中的至少一个附接基部构件的一部分的钩构件，并且其中所述钩构件可操作为固定所述密封的收缩构件的至少一部分。
7.如权利要求1所述的模块化减压伤口闭合系统，还包括被联接至所述多个附接基部构件中的至少一个附接基部构件的一部分的钩构件，并且其中所述钩构件可操作为固定所述密封的收缩构件的至少一部分；并且其中：
所述多个附接基部构件中的每个附接基部构件的所述第一可运动的联接构件和所述第二可运动的联接构件包括销形构件；
所述多个连接构件中的每个连接构件的所述第三可运动的联接构件和所述第四可运动的联接构件包括被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合的插孔；并且
所述多个附接基部构件和所述多个连接构件包括柔性材料。
8.一种制造模块化减压伤口闭合系统的方法，所述模块化减压伤口闭合系统用于在患者身上的表面伤口上产生闭合力，所述方法包括以下步骤：
形成密封的收缩构件，所述密封的收缩构件可操作为在受到减压时收缩；
形成多个附接基部构件，每个附接基部构件具有基部和第一壁，所述第一壁具有第一端和第二端，所述第一壁的所述第一端具有第一可运动的联接构件，且所述第一壁的所述第二端具有第二可运动的联接构件，每个附接基部构件用于可释放地附接至患者的表皮的一部分并且用于联接至所述密封的收缩构件；
形成多个连接构件，每个连接构件具有第二壁，所述第二壁具有第一端和第二端，所述第二壁的所述第一端具有第三可运动的联接构件，且所述第二壁的所述第二端具有第四可运动的构件，每个连接构件用于可运动地联接至所述多个附接基部构件中的至少两个附接基部构件；并且
其中，所述多个附接基部构件和所述多个连接构件可操作为可运动地联接，以形成界定内部空间的环形壁。
9.如权利要求8所述的制造模块化减压伤口闭合系统的方法，其中，形成多个附接基部构件的步骤包括形成具有作为销形构件而形成的所述第一可运动的联接构件和所述第二可运动的联接构件的所述多个附接基部构件中的每个附接基部构件；并且其中形成多个连接构件的步骤包括形成具有作为被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合的插孔而形成的所述第三可运动的联接构件和所述第四可运动的联接构件的所述多个连接构件中的每个连接构件。
10.如权利要求8所述的制造模块化减压伤口闭合系统的方法，还包括步骤：将所述多个附接基部构件联接至所述密封的收缩构件和将所述多个连接构件联接至所述密封的收缩构件。
11.如权利要求8所述的制造模块化减压伤口闭合系统的方法，还包括步骤：将钩构件联接至所述多个附接基部构件中的至少一个附接基部构件的一部分。
12.如权利要求8所述的制造模块化减压伤口闭合系统的方法，还包括以下步骤：
将钩构件联接至所述多个附接基部构件中的至少一个附接基部构件的一部分；
其中，形成多个附接基部构件的步骤包括形成具有作为销形构件而形成的所述第一可运动的联接构件和所述第二可运动的联接构件的所述多个附接基部构件中的每个附接基部构件；并且
其中，形成多个连接构件的步骤包括形成具有作为被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合的插孔而形成的所述第三可运动的联接构件和所述第四可运动的联接构件的所述多个连接构件中的每个连接构件。
13.一种用于在患者身上的表面伤口上产生闭合力的方法，所述方法包括以下步骤：
提供密封的收缩构件；
提供多个附接基部构件，每个附接基部构件具有基部和第一壁，所述第一壁具有第一端和第二端，所述第一壁的所述第一端具有第一可运动的联接构件，且所述第二端具有第二可运动的联接构件，每个附接基部构件用于可释放地附接至患者的表皮的一部分；
提供多个连接构件，每个连接构件具有第二壁，所述第二壁具有第一端和第二端，所述第二壁的所述第一端具有第三可运动的联接构件，且所述第二壁的所述第二端具有第四可运动的联接构件，每个连接构件用于可运动地联接至所述多个附接基部构件；
可运动地联接所述多个附接基部构件和所述多个连接构件，以形成界定内部空间的环形壁；
将所述密封的收缩构件布置在所述内部空间内；
将所述密封的收缩构件联接至所述环形壁的至少一部分；以及
将减压供应至所述密封的收缩构件，由此形成力，所述力朝着所述表面伤口的内部牵引所述附接基部构件，以在所述表面伤口上产生闭合力。
14.如权利要求13所述的用于在患者身上的表面伤口上产生闭合力的方法，其中，提供多个附接基部构件的步骤包括提供满足以下条件的多个附接基部构件：其中该多个附接基部构件中的每个附接基部构件的所述第一可运动的联接构件和所述第二可运动的联接构件包括销形构件；并且其中提供多个连接构件的步骤包括提供满足以下条件的多个连接构件：其中该多个连接构件中的每个连接构件的所述第三可运动的联接构件和所述第四可运动的联接构件包括被按尺寸制造的插孔，所述插孔被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合。
15.如权利要求13所述的用于在患者身上的表面伤口上产生闭合力的方法，其中，将所述密封的收缩构件联接至所述环形壁的至少一部分的步骤包括将所述多个附接基部构件联接至所述密封的收缩构件。
16.如权利要求13所述的用于在患者身上的表面伤口上产生闭合力的方法，还包括在所述环形壁的一部分上形成减压接口的步骤，并且其中将减压供应至所述密封的收缩构件的步骤包括将减压供应至所述减压接口。
17.一种用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统，所述系统包括：
伤口闭合子系统，其包括：
密封的收缩构件，所述密封的收缩构件可操作为在被放置在减压下时收缩，
多个附接基部构件，每个附接基部构件具有基部和第一壁，所述第一壁具有第一端和第二端，所述第一壁的所述第一端具有第一可运动的联接构件，且所述第一壁的所述第二端具有第二可运动的联接构件，每个附接基部构件用于可释放地附接至患者的表皮的一部分并且用于联接至所述密封的收缩构件，
多个连接构件，每个连接构件具有第二壁，所述第二壁具有第一端和第二端，所述第二壁的所述第一端具有第三可运动的联接构件，且所述第二壁的所述第二端具有第四可运动的构件，每个连接构件用于可运动地联接至所述多个附接基部构件，
闭合减压接口，所述闭合减压接口流体地联接至所述密封的收缩构件，所述第一减压接口可操作为将减压输送至所述密封的收缩构件，
其中，所述多个附接基部构件和所述多个连接构件可操作为可运动地联接，以形成界定内部空间的环形壁，并且其中所述密封的收缩构件可操作为在所述内部空间内被布置和联接，以及
减压处理子系统，其包括：
歧管，其用于紧邻组织部位布置，所述歧管可操作为分配减压并且接收流体，
密封构件，其用于放置在患者的表皮上并且可操作为在所述歧管上方形成气动密封，以及
处理减压接口，其用于流体地联接至所述歧管，所述处理减压接口可操作为将第二减压输送至所述歧管。
18.如权利要求17所述的用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统，其中，所述多个附接基部构件中的每个附接基部构件的所述第一可运动的联接构件和所述第二可运动的联接构件包括销形构件，并且其中所述多个连接构件中的每个连接构件的所述第三可运动的联接构件和所述第四可运动的联接构件包括被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合的插孔。
19.如权利要求17所述的用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统，其中，所述多个附接基部构件通过粘合剂联接至所述密封的收缩构件。
20.如权利要求17所述的用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统，其中，所述多个附接基部构件和所述多个连接构件包括柔性材料。
21.如权利要求17所述的用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统，还包括被联接至所述多个附接基部构件中的至少一个附接基部构件的一部分的钩构件，并且其中所述钩构件可操作为固定所述密封的收缩构件的至少一部分。
22.如权利要求17所述的用于给患者身上的表面伤口提供闭合力并且用于将减压输送至组织部位的减压伤口闭合和处理系统，还包括被联接至所述多个附接基部构件中的至少一个附接基部构件的一部分的钩构件，并且其中所述钩构件可操作为固定所述密封的收缩构件的至少一部分；并且其中：
所述多个附接基部构件中的每个附接基部构件的所述第一可运动的联接构件和所述第二可运动的联接构件包括销形构件；
所述多个连接构件中的每个连接构件的所述第三可运动的联接构件和所述第四可运动的联接构件包括被按尺寸制造并配置成与所述多个附接基部构件的所述销形构件配合的插孔；并且
所述多个附接基部构件和所述多个连接构件包括柔性材料。
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US20100106115A1 (en) 2010-04-29
CA2741271C (en) 2013-03-19
EP2896414A1 (en) 2015-07-22
RU2011114221A (ru) 2012-12-10
BRPI0914367A2 (pt) 2019-09-24
CA2741742C (en) 2017-02-28
EP2594299B1 (en) 2019-07-03
MX2011004524A (es) 2011-05-24
EP2623137B2 (en) 2022-06-08
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JP5390625B2 (ja) 2014-01-15
AU2009310394B2 (en) 2015-07-30
US20180256406A1 (en) 2018-09-13
EP2594299A2 (en) 2013-05-22
JP6502439B2 (ja) 2019-04-17
RU2011114219A (ru) 2012-12-10
US9931249B2 (en) 2018-04-03
MX2011004415A (es) 2011-05-31
EP2623137B1 (en) 2019-07-03
TW201016252A (en) 2010-05-01
AU2009310392A1 (en) 2010-05-06
JP2012507348A (ja) 2012-03-29
JP5138816B2 (ja) 2013-02-06
BRPI0914486A2 (pt) 2020-04-14
CN102196830A (zh) 2011-09-21
US20100106184A1 (en) 2010-04-29
EP2594299A3 (en) 2018-03-07
KR20110083692A (ko) 2011-07-20
CN102196828B (zh) 2014-03-12
CA2740646A1 (en) 2010-05-06
AU2009310392B2 (en) 2012-07-05
KR20110086125A (ko) 2011-07-27
EP2340061A1 (en) 2011-07-06
EP2974755A1 (en) 2016-01-20
CN102186511B (zh) 2013-12-18
CN102196828A (zh) 2011-09-21
EP2601984B1 (en) 2015-04-01
BRPI0914377A2 (pt) 2019-09-24
TW201016253A (en) 2010-05-01
WO2010051073A1 (en) 2010-05-06
CN102196829B (zh) 2014-03-26
JP2012507352A (ja) 2012-03-29
RU2011114218A (ru) 2012-12-10
AU2009310388A1 (en) 2010-05-06
JP6202692B2 (ja) 2017-09-27
US8192409B2 (en) 2012-06-05
AU2009310391B2 (en) 2015-07-09
CN103877627A (zh) 2014-06-25
EP2341955B2 (en) 2021-09-01
US20120220985A1 (en) 2012-08-30
JP2014208291A (ja) 2014-11-06
TW201016254A (en) 2010-05-01
MX2011004465A (es) 2011-05-25
JP2012507347A (ja) 2012-03-29
JP5329672B2 (ja) 2013-10-30
EP2896414B1 (en) 2020-11-04
KR20110087270A (ko) 2011-08-02
US9289326B2 (en) 2016-03-22
US20100106106A1 (en) 2010-04-29
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US9549856B2 (en) 2017-01-24
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US20190282405A1 (en) 2019-09-19
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JP2012507353A (ja) 2012-03-29
EP2340062B2 (en) 2021-10-13
AU2009310394A1 (en) 2010-05-06
US8197467B2 (en) 2012-06-12
CN103877628B (zh) 2018-04-06
MX2011004464A (es) 2011-05-25
MX2011004463A (es) 2011-05-25
BRPI0914387A2 (pt) 2019-09-24
KR101587673B1 (ko) 2016-01-21
HK1159003A1 (zh) 2012-07-27
EP2601984A2 (en) 2013-06-12
US10350114B2 (en) 2019-07-16
US9895270B2 (en) 2018-02-20
CN103908705A (zh) 2014-07-09
KR20160013252A (ko) 2016-02-03
BRPI0914485A2 (pt) 2019-09-24
US20100106187A1 (en) 2010-04-29
US9289327B2 (en) 2016-03-22
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AU2009310389B2 (en) 2015-08-20

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