CN103948977B - 减压深组织闭合系统和方法 - Google Patents

减压深组织闭合系统和方法 Download PDF

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CN103948977B
CN103948977B CN201410203186.0A CN201410203186A CN103948977B CN 103948977 B CN103948977 B CN 103948977B CN 201410203186 A CN201410203186 A CN 201410203186A CN 103948977 B CN103948977 B CN 103948977B
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克里斯托弗·盖伊·科沃德
詹姆士·约瑟夫·西利
科林·约翰·霍尔
基思·帕特里克·希顿
马克·斯蒂芬·詹姆士·彼尔德
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Abstract

本发明涉及减压深组织闭合系统和方法。一种用于在深组织上施加闭合力的减压深组织闭合设备包括可收缩的基质，该基质形成有第一多个孔且具有第一侧面和面朝内的第二侧面。可收缩的基质用于设置成接近深组织。减压源被流体连接至可收缩的基质且可操作来将减压传送至可收缩的基质。当在减压作用下时，可收缩的基质夹持邻近可收缩的基质的深组织并在深组织上提供闭合力。还提出了一种系统和方法。

Description

减压深组织闭合系统和方法
本申请是申请日为2009年5月15日，申请号为200980142665.3，发明名称为“减压深组织闭合系统和方法”的申请的分案申请。
相关申请
根据美国法典第35卷第119条(e)款，本发明要求享有下述专利的汇集的利益：2008年10月29日提交的美国临时专利申请序列号61/109,448，题目为“Reduced-pressure,Deep-tissue Closure System and Method”；2008年10月29日提交的美国临时专利申请序列号61/109,486，题目为“Reduced-Pressure,Abdominal Treatment System andMethod”；2008年10月29日提交的美国临时专利申请序列号61/109,390，题目为“Open-Cavity,Reduced-Pressure Wound Dressing and System”；以及2008年10月29日提交的美国临时专利申请序列号61/109,410号，题目为“Reduced-Pressure,Wound-Closure Systemand Method”。所有这些临时申请为了所有目的在此通过引用被并入。
技术领域
本发明通常涉及医学治疗系统，且更具体涉及减压深组织闭合系统和方法。
背景
无论伤口或组织的受损区域的病因是外伤、手术或其他原因，合适地护理伤口对结果都是重要的。当伤口涉及需要再进入的位置如腹膜腔且更通常是腹腔时，存在唯一的挑战。通常当手术或外伤涉及腹腔时，建立有利于再进入的伤口处理系统允许更好且更容易的护理并有助于解决诸如腹膜、腹腔间室综合征以及可能抑制伤口和内部器官最终愈合的感染的情形。在提供这种护理时，可能期望从腔中去除不需要的流体，帮助接近筋膜和其他组织，且最终帮助在表皮水平处的伤口本身上提供闭合力。
当一个人被暂时闭合腹部时，可能需要处理许多深组织如脂肪、肌肉或尤其是筋膜。除非另外指明，否则正如本文中使用的，“或”并不要求相互排他性。如果未被处理，那么深组织可能进一步回缩到腹腔中且随后造成困难。外科医生可以缝合深组织如筋膜，同时使筋膜处于拉紧状态下。然而，如果在该区域内期望减压治疗或如果需要更换敷料，这可能是有问题的。而且，缝合深组织有时可以造成坏死。如果涉及复杂的伤口，如受感染的伤口，那么筋膜可能非常脆弱且可能不能够忍受缝合。如果网状物用于帮助后一种情形，那么网状物的去除可能很难且可能需要手术。同时，如果深组织尤其是筋膜未被闭合，那么该情形可能导致疝和其他并发症。
除了接近腔以便再进入之外，还可能期望从腔中去除流体。还可能期望向组织或伤口——包括可能在腹腔内的伤口——提供减压治疗。此治疗(在医学界通常称为“负压伤口治疗”，“减压治疗”或“真空治疗”)可以提供许多益处，包括愈合更快和增加肉芽组织的形成。
将期望提供一种系统和方法，该系统和方法能够促进减压治疗并有助于以避免并发症或使并发症最少的方式闭合深组织，并发症是例如深组织的回缩或坏死。
概述
通过本文描述的示例性实施方案的系统、设备和方法解决了现有的深组织闭合系统、设备和方法存在的问题。根据一个示例性的实施方案，一种用于靠近深组织施加闭合力的减压深组织闭合系统包括可收缩的基质，其形成有第一多个孔，且具有第一侧面和面朝内的第二侧面。减压源被流体连接至可收缩的基质且可操作来将减压传送至可收缩的基质。
根据另一个示例性的实施方案，一种用于靠近深组织施加闭合力的减压深组织闭合系统包括可收缩的基质，其形成有第一多个孔且具有第一侧面和面朝内的第二侧面。第二侧面形成有第一多个小室，每一个敞开的小室具有小室壁。第二多个孔在小室壁内形成。减压源被流体连接至可收缩的基质且可操作来将减压传送至可收缩的基质。
根据另一个示例性的实施方案，一种用于向患者的体腔内的深组织伤口施加闭合力的减压治疗系统包括可收缩的基质，其形成有第一多个孔且具有第一侧面和面朝内的第二侧面。第二侧面形成有多个小室且形成有第二多个孔。示例性的减压治疗系统还包括可操作来分配减压的歧管构件以及被流体连接至歧管构件和可收缩的基质的减压源。减压源将减压传送至歧管构件和可收缩的基质。示例性的减压治疗系统还包括密封构件，其可操作来对所述体腔提供气动密封。
根据另一个示例性的实施方案，一种用于制造向患者的体腔内的深组织施加闭合力的减压治疗系统的方法包括下述步骤：形成可收缩的基质，可收缩的基质具有第一多个孔，且具有第一侧面和面朝内的第二侧面。第二侧面形成有多个小室且还形成有第二多个孔。该方法还包括提供可操作来分配减压的歧管构件和提供可操作来在体腔上提供气动密封的密封构件。
根据另一个示例性的实施方案，一种向患者的体腔内的深组织提供闭合力的方法包括下述步骤：将可收缩的基质放置在邻近深组织的体腔内。可收缩的基质形成有第一多个孔，且具有第一侧面和面朝内的第二侧面。第二侧面形成有第一多个小室和第二多个孔。该方法还可包括将减压源流体连接至可收缩的基质并用密封构件密封体腔。
根据另一个示例性的实施方案，本发明提供了一种减压深组织闭合系统，其用于靠近深组织施加闭合力，该系统包括：
可收缩的基质，其用于设置成接近深组织，
在可收缩的基质的第一侧面上形成有第一多个孔，
还包括多个小室，
其中可收缩的基质具有第一侧面和面朝内的第二侧面，
其中多个小室当不在减压作用下时具有第一体积(V1)而在减压作用下时具有第二体积(V2)，其中V1>V2；以及
减压源，其被流体连接至可收缩的基质且可操作来将减压传送至可收缩的基质。
所述小室可以与所述第一多个孔流体相通。
所述小室可以具有柔性的侧壁。
所述多个小室还可以包括流体连接所述多个小室的第二多个孔。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并从未收缩位置移动至收缩位置。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并在所述深组织上产生闭合力。
所述可收缩的基质可以包括蜂窝状基质。
所述可收缩的基质可以包括热塑性弹性体的蜂窝状基质。
所述多个小室可以包括多个齿轮形的小室。
根据另一个示例性的实施方案，本发明提供了一种减压组织闭合系统，其用于靠近组织施加闭合力，该减压组织闭合系统包括：
可收缩的基质，其形成有第一多个孔且具有第一侧面和面朝内的第二侧面，面朝内的第二侧面形成有多个小室，每一个敞开的小室具有小室壁，且至少一个室间的孔在多个小室的每一个敞开的小室内形成，可收缩的基质用于设置成靠近组织；以及
减压源，其被流体连接至可收缩的基质且可操作来将减压传送至可收缩的基质。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述组织上产生夹持力并从未收缩位置移动至收缩位置。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述组织上产生夹持力并在所述组织上产生闭合力。
所述可收缩的基质可以包括蜂窝状基质。
所述可收缩的基质可以包括热塑性弹性体的蜂窝状基质。
所述多个小室可以包括多个齿轮形的小室。
根据另一个示例性的实施方案，本发明提供了一种减压治疗系统，其用于向患者的体腔内的深组织伤口施加闭合力且用于提供体腔内的减压治疗，该系统包括：
可收缩的基质，其形成有第一多个孔且具有第一侧面和面朝内的第二侧面，面朝内的第二侧面形成有第二多个孔，可收缩的基质用于设置成靠近深组织伤口；
歧管构件，其可操作来分配减压；
减压源，其被流体连接至歧管构件和所述可收缩的基质，减压源用于将减压传送至歧管构件和可收缩的基质；以及
密封构件，其可操作来对体腔提供气动密封。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并从未收缩位置移动至收缩位置。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并产生所述深组织伤口上的闭合力。
所述可收缩的基质可以包括蜂窝状基质。
所述可收缩的基质可以包括热塑性弹性体的蜂窝状基质。
所述可收缩的基质可以包括具有多个小室的材料，且其中所述材料可以包括多个齿轮形的小室。
根据另一个示例性的实施方案，本发明提供了一种制造减压治疗系统的方法，减压治疗系统用于向患者的体腔内的深组织施加闭合力，该方法包括下述步骤：
形成可收缩的基质，可收缩的基质具有第一多个孔，且具有第一侧面和面朝内的第二侧面，可收缩的基质用于设置成靠近深组织；
提供可操作来分配减压的歧管构件；以及
提供可操作来对体腔提供气动密封的密封构件。
所述可收缩的基质的所述面朝内的第二侧面可以形成有多个小室，且还可以形成有第二多个孔。
所述可收缩的基质的所述面朝内的第二侧面可以形成有多个小室，且还可以形成有第二多个孔；且其中形成可收缩的基质的步骤可以包括由蜂窝状基质形成所述可收缩的基质。
所述可收缩的基质的所述面朝内的第二侧面可以形成有多个小室，且还可以形成有第二多个孔；且其中形成可收缩的基质的步骤可以包括由热塑性弹性体的蜂窝状基质形成所述可收缩的基质。
所述可收缩的基质的所述面朝内的第二侧面可以形成有多个小室，且还可以形成有第二多个孔；且其中形成可收缩的基质的步骤可以包括将所述多个小室形成为多个齿轮形小室。
根据另一个示例性的实施方案，本发明提供了一种向患者的体腔内的组织提供闭合力的方法，该方法包括下述步骤：
将可收缩的基质邻近组织放置在体腔内，其中可收缩的基质形成有第一多个孔，且具有第一侧面和面朝内的第二侧面，且具有多个小室，以及还形成有用于流体连接多个小室的第二多个孔；以及
向可收缩的基质提供减压。
提供减压的步骤可以包括下述步骤：
气动密封所述体腔；以及
将减压源流体连接至所述可收缩的基质。
所述多个小室当不在减压作用下时可具有第一体积(V1)而在减压作用下时可具有第二体积(V2)，且其中V1>V2。
所述方法还可以包括在所述体腔内设置歧管构件并将所述歧管构件流体连接至所述减压源的步骤。
所述多个小室可以与所述第一多个孔流体相通。
所述小室可以具有柔性的侧壁。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并从未收缩位置移动至收缩位置。
所述可收缩的基质可以可操作来在所述减压源供给减压时在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并在所述深组织上产生闭合力。
所述可收缩的基质可以包括蜂窝状基质。
所述可收缩的基质可以包括热塑性弹性体的蜂窝状基质。
所述多个小室可以包括多个齿轮形的小室。
参照附图和下面的详细描述，示例性的实施方案的其他目的、特征以及优势将变得明显。
附图的简要说明
图1是减压深组织闭合系统的示例性实施方案的一部分在横截面中的示意图；
图2是图1的示例性的减压深组织闭合系统的细节的示意性横截面图，其显示了可收缩的基质的一部分；
图3是示例性的可收缩的基质的第一侧面的示意性透视图；
图4是图3的示例性的可收缩的基质的第二侧面的示意性透视图；
图5是可收缩的基质的另一个示例性实施方案的示意性俯视图；
图6是图5的可收缩的基质的一部分的详图；以及
图7是可收缩的基质的另一个示例性实施方案的示意性透视图。
示例性实施方案的详述
在下面示例性实施方案的详述中，参照了构成示例性实施方案的一部分的附图。足够详细地描述这些实施方案，以使本领域的技术人员能够实施本发明，而且应该理解，可使用其他实施方案，并可做出逻辑结构、机械、电及化学变化，而并不偏离本发明的精神或范围。为避免对使本领域技术人员能够实施本发明不必要的细节，描述可省略对本领域技术人员熟知的某些信息。因此，以下详细描述不应在限制性的意义上被理解，并且示例性实施方案的范围仅由所附权利要求限定。
参考图1-2，呈现了一种减压深组织闭合系统100，该闭合系统100包括减压深组织闭合设备102。减压深组织闭合系统100和减压深组织闭合设备102在包括深组织例如患者筋膜110内的深组织伤口108的体腔106内靠近组织部位104使用。在一些情形中，闭合系统100和闭合设备102可以用在其他组织上。正如本文中使用的，“伤口”指受损的组织区域，而不考虑损伤原因。
在此示例性的实施方案中，伤口穿过患者的表皮112、脂肪层114、肌肉116和筋膜110延伸。在这些层中，常常对闭合该筋膜110给予特别关注。虽然此示例性的实施方案集中于筋膜110，但是应该理解，减压深组织闭合系统100和减压深组织闭合设备102能够用在其他深组织或深组织伤口上。
在此实例中，筋膜110内的深组织伤口108包括产生筋膜边缘118的裂口或切口。期望使用闭合力将筋膜边缘118闭合在一起或将筋膜边缘118推在一起。正如本文中使用的，除非另外指明，否则“或”并不要求互相排他性。当可能需要再进入时，筋膜110的暂时闭合是优选的。因而，期望通过靠近筋膜边缘118来闭合筋膜110或在筋膜110上施加闭合力。正如下面将更详细描述的，此示例性实施方案的减压深组织闭合设备102帮助闭合筋膜110或在筋膜110上施加闭合力。
在此示例性的实施方案中，体腔106是腹腔，且组织部位104是腹部内容物122的一部分或接近腹部内容物122的组织。在利用减压深组织闭合系统100提供开放式伤口处理时，可能期望首先将体腔敷料120置于腹部内容物122上。腹部内容物122为体腔敷料120提供支撑。
体腔敷料120可能包括不粘合的被包封的歧管构件124。体腔敷料120的包封层可以形成有窗或孔，例如孔126，其允许流体进入体腔敷料120。体腔敷料120可以形成有不粘合的盖布，该盖布具有不连续的多个支腿构件。体腔敷料120被设置在腹部内容物122上且优选地至少部分地被设置在一个或多个结肠沟128内。减压深组织闭合设备102接着可以邻近体腔敷料120被设置，正好在筋膜110下面(图1显示的方位)。
减压深组织闭合设备102包括可收缩的基质130，该基质130具有第一侧面132和面朝内(面朝患者的)的第二侧面134。第一侧面132邻近组织层如筋膜110被放置，闭合设备102用来将该组织层如筋膜110闭合或推到一起。可收缩的基质130可以形成有穿过可收缩的材料或结构的第一多个孔136。第一多个孔136可以采用任何形状，如狭缝(线性开口)、矩形开口、不规则形状的开口等。可收缩的基质130可以在面朝内的第二侧面134上或可收缩的基质130的任何部分上形成有多个小室、隔室或局部隔室，如敞开的小室138。第一多个孔136可以与第一多个小室138流体相通。如图2所示，第一多个小室138可以形成有小室壁140且可以包括第二多个孔142。
当减压被传送至可收缩的基质130时，产生夹持力和向内的力。减压穿过第一多个孔136起作用以在筋膜110上提供夹持力。夹持力保持或夹持筋膜110。减压可以从下面(对于所示的方位)穿过体腔敷料120且尤其是穿过孔126或穿过歧管144被供给至可收缩的基质130。筋膜110上的夹持力由箭头146表示。
除了通过孔136提供夹持力外，减压还向内，即，在由箭头148所示的方向上推可收缩的基质130。在此背景中，“向内”意指朝向减压深组织闭合设备102的中心部分。可选地，对于所部置的减压深组织闭合设备102，“向内”可以被定义为在将组织如筋膜110拉向组织伤口108的边缘118的方向上。当减压作用于可收缩的基质130上时，可收缩的基质130夹持筋膜110并从未收缩位置变化到收缩位置。在一个实施方案中，可收缩的基质130包括横向缩陷的小室且由此收缩。在减压的影响下，小室的柔性侧壁移动得更接近于彼此。由于第一多个孔136上的减压夹持筋膜110且减压还使可收缩的基质130收缩，因此，闭合力产生并被施加到筋膜110，这将筋膜边缘118推得更靠近。因此，筋膜110经受闭合力，闭合力使筋膜110闭合或被推至闭合位置。
在一个实施方案中，可收缩的基质130包括多个小室，即，小室138，当未施加减压时，多个小室共同界定了第一体积(V1)。当向小室施加减压时，小室缩陷或以其他方式移动，使得第二体积被界定(V2)。第二体积小于第一体积(V1)，即，V1>V2，且此体积变化与收缩有关。
正如本文中使用的，“减压”一般指小于在正受到治疗的组织部位104处的环境压力的压力。在大多数情况下，此减压将小于患者所处位置的大气压力。可选地，减压可小于组织部位104处的流体静压。除非另外指明，否则本文中所述的压力值是表压。
歧管144被置于接近减压深组织闭合设备102的体腔106内，该闭合设备102接近体腔敷料120。歧管144可以被可收缩的基质130的第一侧面132支撑或可以被设置成邻近可收缩的基质130的第一侧面132。正如本文中使用的，术语“歧管”通常指被提供来帮助将减压施加至组织部位104或其他位置、将流体传送至组织部位104或其他位置或从组织部位104或其他位置去除流体的物质或结构。歧管144通常包括将所提供的流体分配至围绕歧管144的区域或从围绕歧管144的组织去除所提供的流体的多个流体通道或路径。歧管144通常包括互连的多个流体通道或路径以改善流体的分配。歧管144可以是能够被放置成与组织接触的可生物相容的材料。歧管144的实例可以包括但不限于具有布置成形成流动通道的结构元件的设备、多孔状泡沫例如开孔泡沫、多孔的组织结缔、以及包括或固化以包括流动通道的液体、凝胶和泡沫。歧管144可以是多孔的且可以由泡沫、纱布、毡垫或适于特定生物应用的任何其他材料制成。在一个实施方案中，歧管144是多孔的泡沫且包括多个起到流动通道作用的互连的小室或孔。多孔的泡沫可以是聚氨酯、开孔泡沫、网状泡沫，例如由德克萨斯州San Antonio的Kinetic Concepts股份有限公司制造的材料。其他实施方案可以包括“封闭的小室”。歧管144的这些封闭的小室部分包含多个小室，它们中的大多数并未流体连接至邻近的小室。封闭的小室可以选择性地被设置在歧管144内以防止流体通过歧管144的外周表面的传输。在一些情形中，歧管144还可以用于将诸如药物、抗菌剂、生长因子和其他溶液的流体分配至伤口108或体腔106。其他层或材料可以作为歧管144的一部分被包括在内，这些部分是例如吸收性材料、芯吸材料、疏水性材料、亲水性材料等。
密封构件154被置于体腔106的体腔开口156之上并提供足以使减压深组织闭合设备102在体腔106内保持减压的气动密封。密封构件154可以是盖，该盖还用于将歧管144固定在体腔敷料120的中心部分上。当密封构件154可能是不可渗透的或可半渗透的时，在将密封构件154安装到体腔开口156上后，密封构件154能够在组织部位104处维持减压。密封构件154可以是由聚硅氧烷基化合物、丙烯酸类、水凝胶或形成水凝胶的材料或任何其他可生物相容的材料形成的柔性的上盖布或膜，任何其他可生物相容的材料包括期望用在组织部位或减压深组织闭合设备102上的不可渗透性或渗透性特征。
密封构件154还可以包括附接装置158以将密封构件154固定至患者的表皮112。附接装置158可以采用许多形式。例如，附接装置158可以包括设置在密封构件154上或密封构件154的任何部分上以提供气动密封的粘合剂160。粘合剂160可以预先敷贴或覆盖有在被敷贴至患者时去除的可释放的背衬或构件。
诸如肘形口164的减压接驳体162可以被应用于密封构件154以通过密封构件154提供减压，且被应用于歧管144且尤其被应用于可收缩的基质130。减压接驳体162可以用于此目的，但还可以采用其他方法。例如，在一个实施方案(未显示)中，减压传送导管166被直接放置到歧管144中。在所示的示例性实施方案中，减压传送导管166被流体连接至减压源168。
减压源168可以适应宽范围的减压。该范围可以包括-50mm Hg到-400mm Hg。在一个示例性的实施方案中，减压源168可以包括对-100mm Hg、-125mm Hg和-150mm Hg的预置选择器。减压源168还可以包括许多警报器，例如堵塞警报器、渗漏或电池电量低警报器。减压源168可以是便携式源、壁源或用于腹腔的其他单元。减压源168可以选择性地传送恒定压力、间歇压力、动态压力或具有设定模式的压力。
减压传送导管166的中间部分170可以包括许多设备，例如代表性的设备172。设备172可以是容纳渗出物、腹水或其他去除的流体的流体收集构件或罐储器；压力反馈设备；容积检测系统；血液检测系统；感染检测系统；流量监测系统；过滤器；温度监测系统等。一些代表性的设备172如流体收集构件可以与减压源168整体地形成。例如，减压源168上的减压口174可以包括过滤器构件，过滤器构件可以包括一个或多个过滤器，例如防止液体进入内部空间的疏水过滤器。可以包括多个设备。
减压深组织闭合系统100可操作来在筋膜110上提供闭合力。此外，减压深组织闭合系统可以在体腔106内和在组织部位104处或接近组织部位104处提供减压治疗。减压治疗可以被应用在体腔106内和组织部位104处以帮助促进腹水、渗出物或其他流体的去除。减压还可以刺激额外的组织的生长。在组织部位104处的伤口的情形中，肉芽组织的生长以及渗出物和细菌的去除可以有助于促进愈合。在组织部位104处的非伤口或非感染的组织的情形中，减压可以用于促进可以被获得并移植至另一组织部位的组织的生长。
在操作中，在已经将体腔敷料120设置在体腔106内并邻近腹部容纳物122之后，减压深组织闭合设备102可以被设置成邻近减压深组织闭合设备102并在筋膜110下面(对于图1所示的方位)。歧管144可以随后被插入体腔106内并被设置成靠近减压深组织闭合设备102。密封构件154可以随后被设置在体腔开口156之上的患者的表皮112上以在体腔106上形成气动密封。减压接驳体162如肘形口164可以被连接至密封构件154。减压传送导管166可以被流体连接在减压接驳体162与减压源168之间。
当激活减压源168时，减压通过减压传送导管166被传送至减压接驳体162且由此被传送至歧管144以及减压深组织闭合设备102。由减压深组织闭合设备102经受的减压使减压深组织闭合设备102通过第一多个孔136夹持筋膜110并收缩。当减压深组织闭合设备102收缩时，指向筋膜边缘118的闭合力由筋膜110经受。筋膜边缘118由此被靠近。在无需刺穿或损伤筋膜110或其他组织的情况下产生由筋膜110经受的闭合力。除了靠近筋膜边缘118外，被供给至减压接驳体162且由此被供给至歧管144的减压在体腔106内提供减压治疗且可以将减压治疗提供至接近组织部位104的组织。
现在参考图3和4，呈现了另一个示例性的可收缩的基质200。可收缩的基质200具有第一侧面202和面朝内的第二侧面204。图3呈现了第一侧面202，而图4呈现了面朝内的第二侧面204。可收缩的基质200可以被用在图1的减压深组织闭合系统100中。在此特定的示例性实施方案中，可收缩的基质200形成有实心的圆形形状，但可以使用许多其他形状，例如图5所示的椭圆形形状、弓形形状、矩形形状等。可收缩的基质200的第一侧面202具有穿过第一侧面形成并延伸至面朝内的第二侧面204的第一多个孔206。如图4所示，多个小室208在面朝内的第二侧面204上形成。多个小室208的每一个小室具有小室壁210。每一个小室208具有孔206和开孔部分。每一个小室壁210可以具有穿过小室壁210的一个或多个孔以形成类似于图2中的第二多个孔142的第二多个孔。在此特定的示例性的实施方案中，多个小室208可以形成为在第一多个孔206的每一个周围位于中心的蜂窝状小室。
现在参考图5和6，呈现了可收缩的基质300的另一个示例性实施方案。可收缩的基质300可以被用在图1的减压深组织闭合系统100中。可收缩的基质300具有第一侧面302(未显示)和面朝内的第二侧面304。在此特定的示例性实施方案中，可收缩的基质300形成具有中心开口306的卵形，但可收缩的基质300可以被形成而没有中心开口306。可收缩的基质300的面朝内的第二侧面304可以形成有多个小室308。第一多个孔310可以穿过可收缩的基质300形成且可以与多个小室308流体相通。多个小室308可以由多个互连的小室壁312形成。如同图2所示的实施方案一样，多个互连的小室壁312可以形成有室间的孔(未显示)以形成第二多个孔。
现在参考图7，呈现了可收缩的基质400的另一个示例性实施方案。可收缩的基质400可以被用在图1的减压深组织闭合系统100中。在此示例性的实施方案中，可收缩的基质400是矩形形状且具有从可收缩的基质400的第一侧面402延伸至面朝内的第二侧面404的第一多个孔410。第二多个孔411可以连接第一多个孔410或其某个部分。
在可选的实施方案中，可收缩的基质400可以在第一侧面402上具有孔410，但在面朝内的第二侧面404上无对应的孔。因而，可收缩的基质400具有仅对第一侧面402敞开的小室且可以具有孔411，这将减压提供到小室中。当减压穿过孔411被供给时，深组织被孔410夹持且小室的侧壁被拉得更靠近，使可收缩的基质400收缩。
许多不同的物质可以用于形成可收缩的基质130(图1)、可收缩的基质200(图3和4)、可收缩的基质300(图5和6)以及可收缩的基质400(图7)。通常使用柔性的可收缩的基质。例如，这些可收缩的基质130、200、300、400可以由柔性的热塑性弹性体(TPE)、热塑性氨基甲酸酯(TPU)、硅橡胶等形成。此外，许多不同的小室几何形状可以被用在可收缩的基质中。例如，可能的小室几何形状包括蜂窝形、圆形、菱形、齿轮形等。泡沫并不用于可收缩的基质。可收缩的基质优选地由避免任何组织生长的材料形成。在一个示例性的实施方案中，可收缩的基质可以由TPU蜂窝状材料形成，该蜂窝状材料包括用熔合粘结料形成的蜂窝状小室。在一个实施方案中，虽然通常并不使用泡沫，但是可收缩的基质可以由密封的或包封的泡沫构件形成，该泡沫构件具有用于夹持组织的孔和减压供应接驳体。
在另一个示例性的实施方案中，可收缩的基质可以由允许在xy平面(图5的页面内的平面)内膨胀和收缩同时在z方向(从图5的页面出来)上保持相当恒定的尺寸的热塑性弹性体(TPE)形成。在此实施方案中，可收缩的基质具有在z方向上比在xy方向上集中得更强的材料(或更多的材料)。可选地或此外，可以增加空隙以规定缩陷模式。可选地或此外，可以在z方向上添加强化构件如丝以避免在该方向上缩陷。在另一个示例性的实施方案中，可以使用热塑性氨基甲酸酯(TPU)材料形成可收缩的基质，该TPU材料可以在图5的可收缩的基质300的第一侧面如侧面302上具有在可收缩的基质上的额外的膜。
在可选的实施方案中，通过采用在减压作用下收缩的气动元件或设备可以使收缩基质形成为在减压作用下收缩。因而，例如，参考图7，孔410可以在顶部和底部上被密封以形成多个气动小室。第二孔411可以保持敞开以接收减压。当减压被传送至由第一孔410形成的室时，室缩陷并提供向内的收缩力。可以采用其他气动设备，但在每一种情形中，气动设备优选地夹持筋膜，而不会产生伤口且不会在减压作用下收缩。
虽然已经在某些示例性的、非限制性的实施方案的背景下公开了本发明及其优势，但是应当理解，可以做出各种变化、替换、置换和改动而并不偏离由所附权利要求限定的本发明的范围。

Claims (8)

1.一种可收缩的基质，其用于靠近深组织施加闭合力，所述可收缩的基质包括：
第一侧面和第二侧面；
在所述第一侧面上的第一多个孔；以及
多个小室，所述多个小室中的每一个包括与所述第一多个孔流体连通的敞开的小室部分；
其中所述多个小室当不在减压作用下时具有第一体积而在减压作用下时具有第二体积，其中所述第一体积大于所述第二体积。
2.如权利要求1所述的可收缩的基质，其中所述多个小室具有柔性的侧壁。
3.如权利要求1所述的可收缩的基质，其中所述多个小室还包括流体连接所述多个小室的第二多个孔。
4.如权利要求1所述的可收缩的基质，其中所述可收缩的基质可操作来在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并从未收缩位置移动到收缩位置。
5.如权利要求1所述的可收缩的基质，其中所述可收缩的基质可操作来在邻近所述可收缩的基质的所述第一侧面的所述深组织上产生夹持力并在所述深组织上产生闭合力。
6.如权利要求1所述的可收缩的基质，其中所述可收缩的基质包括蜂窝状基质。
7.如权利要求1所述的可收缩的基质，其中所述可收缩的基质包括热塑性弹性体的蜂窝状基质。
8.如权利要求1所述的可收缩的基质，其中所述多个小室包括多个齿轮形的小室。
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