CN105007870A - 在利用负压处理伤口中使用的可压缩的伤口填充物、系统和方法 - Google Patents
在利用负压处理伤口中使用的可压缩的伤口填充物、系统和方法 Download PDFInfo
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Abstract
本文公开的设备和方法涉及伤口填充物的各种实施例,所述伤口填充物在有些情况下相对于另一方向优选地在一个方向上塌陷。这样的设备和方法可帮助伤口的闭合,并且可与压力传感器和控制器结合使用,以提供伤口填充物的受控塌陷。
Description
相关申请的交叉引用
本申请要求2013年3月14日提交的名称为“COMPRESSIBLE WOUND
FILLERS AND SYSTEMS AND METHODS OF USE IN TREATING WOUNDS WITH NEGATIVE
PRESSURE”的美国临时申请No.61/784,868的权益。前述申请的内容在此如同本文充分阐述一样全文并入作为参考。前述申请的优先权的权益根据的合适的法律基础、包括无限制地根据35 U.S.C. §119(e)而被要求保护。
技术领域
在此描述的实施例涉及能用于用负压处理伤口的装置和方法。特定的实施例还能用于例如在腹部伤口中帮助伤口闭合。
发明内容
通常,本文描述的实施例能用于用负压帮助伤口的处理。实施例在处理诸如腹部伤口的大伤口中能特别有用,其中,伤口边缘的闭合与接近是具有挑战性的。本文描述的某些实施例涉及可压缩的伤口填充物、它们的使用方法和结合所述可压缩的伤口填充物及它们的使用方法的系统,其中,可压缩的伤口填充物构造成当伤口在负压下闭合的时候,例如水平地压缩或塌陷。
在有些实施例中,一种处理伤口的方法包括:
将例如泡沫的多孔的伤口接触层放置在伤口中;
将可膨胀的伤口填充物定位在多孔的伤口接触层上,其中,可膨胀的伤口填充物可以是半膨胀的,可膨胀的伤口填充物包括构造成允许流体通过的多个孔;
将至少一个伤口覆盖物定位在可膨胀的伤口填充物上,以围绕伤口形成与皮肤的密封;
对伤口施加负压,其中,负压的施加使可膨胀的伤口填充物进一步膨胀;以及
从可膨胀的伤口填充物释放流体,其中,流体从可膨胀的伤口填充物的释放使可膨胀的伤口填充物收缩并使伤口的边缘靠得更拢。
在某些实施例中,负压处理设备可包括多孔的伤口接触层、可膨胀的伤口填充物、伤口覆盖物和构造成执行如上所述的方法的负压源。
如本文所描述地,在有些实施例中,用于与负压一起使用的伤口处理设备包括任何数量的伤口填充物。在有些实施例中,伤口处理设备还可包括构造成放置在伤口填充物上并围绕伤口密封皮肤的覆盖物。在某些实施例中,伤口处理设备还可包括构造成将伤口覆盖物连接至负压源的端口。在另外的实施例中,伤口处理设备可包括构造成将负压提供至伤口的负压源。
在有些实施例中,一种用于用负压处理伤口的伤口填充物能包括:
多孔的伤口填充材料;
多个竖直延伸的构件,其当将伤口填充物定位在伤口床内时竖直地延伸,竖直延伸的构件由比多孔的伤口填充材料刚性的材料制成;并且
其中,当对伤口填充物施加负压时,伤口填充物构造成在竖直延伸的构件减少伤口填充物的竖直运动的情况下水平地收缩。
在有些实施例中,一种用于用负压处理伤口的伤口填充物能包括:
多个竖直延伸的麦秆状物(straw),其构造成当将伤口填充物定位在伤口床内时竖直地延伸;
多个接合部,其连接相邻的竖直延伸的麦秆状物;并且
其中,当对伤口填充物施加负压时,伤口填充物构造成在竖直延伸的麦秆状物减少伤口填充物的竖直运动的情况下水平地收缩。
在有些实施例中,竖直延伸的麦秆状物可以是实心的。在某些实施例中,麦秆状物能够是中空的。有些实施例可能需要接合部是柔性的和/或刚性的。在某些实施例中,伤口填充物还可构造成以螺旋构造放置在伤口床中。在特定的实施例中,伤口处理设备还可包括至少一个压力传感器。
在有些实施例中,一种用于用负压处理伤口的伤口填充物能包括:
柔性中空管;
竖直支杆,其定位在柔性中空管内,竖直支杆构造成当将伤口填充物定位在伤口床内时竖直地延伸,竖直支杆由比柔性中空管更刚性的材料制成;并且
其中,当对伤口填充物施加负压时,伤口填充物构造成在竖直支杆减少伤口填充物的竖直运动的情况下水平地收缩。
伤口处理设备的某些实施例可能需要定位在柔性中空管的外侧上的夹持构件的添加,夹持构件构造成夹持伤口床。在有些实施例中,柔性中空管可构造成以螺旋构造放置在伤口床内。在有些实施例中,柔性中空管包括挤塑泡沫。
在有些实施例中,一种处理伤口的方法可包括:
将多孔的伤口接触层放置在伤口中;
将可溶解的材料定位在多孔的伤口接触层上,可溶解的材料例如包括聚乙烯醇;以及
对伤口施加负压,其中,负压的施加将水分从伤口吸入可溶解的材料,以使可溶解的材料溶解。
在某些实施例中,一种负压处理设备可包括如上所述的可溶解的材料、伤口覆盖物和构造成执行如上所述的方法的负压源。
在某些实施例中,一种用于用负压处理伤口的伤口填充物包括:
一个或多个同心环,其围绕伤口填充物的中心部分,同心环构造成再吸收到伤口中;并且
其中,一个或多个环包括构造成比剩余的环再吸收得更快的外环。
在有些实施例中,一种用于用负压处理伤口的伤口填充物包括:
多个细长的上层,其中,上层可在上顶点处以第一角度连接;
多个细长的下层,其中,下层可在下顶点处以第二角度连接;
其中,上层与下层连接,以形成重复的平行排的图案;
其中,第二角度大于第一角度;并且
其中,当对伤口填充物施加负压时,伤口填充物构造成在竖直方向上保持刚性的同时在水平方向上塌陷。
在某些实施例中,一种用于用负压处理伤口的伤口填充物可包括:
层,其包括遍布层的表面的多个可变大小的气泡;并且
其中,气泡构造成在负压下塌陷。
在某些实施例中,一种用于用负压处理伤口的伤口填充物能包括:
包括气泡的多个层,其中,层构造成使得气泡相互面对;并且
其中,当对伤口填充物施加负压时,气泡构造成在竖直方向上保持刚性的同时在水平方向上塌陷。
在有些实施例中,处理伤口的方法包括:
将伤口填充物放置到伤口中;
将覆盖物涂覆在伤口填充物上并使覆盖物围绕伤口密封皮肤;
通过覆盖物对伤口施加负压;以及
当伤口在负压下闭合的时候,控制伤口填充物的塌陷。
有些实施例可能需要压力传感器的添加,以监测内部压力。在某些实施例中,内部压力可通过监测膀胱压力、主动脉压力、结肠内的压力、子宫内的压力、肢体压力或血液流动速率中的至少一个来测量。在某些实施例中,伤口填充物可以是可膨胀的囊体,并且控制伤口填充物的塌陷包括控制囊体内的压力。有些实施例可能需要动态地调整体积、刚度、压力中的至少一个,以当伤口闭合的时候使伤口填充物塌陷。在特定的实施例中,基于患者的内部压力读数动态地调整伤口填塞构件的体积、刚度、压力和塌陷中的至少一个。
附图说明
现在将在下文中参考附图仅作为示例描述本发明的实施例,其中:
图1图示负压伤口治疗系统的实施例。
图2图示半膨胀伤口填充物的实施例。
图3A-B图示包括支柱的伤口填充物的实施例。
图4A-B图示包括支柱的伤口填充物的实施例。
图5A-B图示包括刚性麦秆状物的伤口填充物的实施例。
图6A-C图示包括挤塑泡沫的伤口填充物的实施例。
图7A-C图示可溶解的伤口填充物的实施例。
图8A-C图示带有具有各种溶解速率的各种部分的伤口填充物的实施例。
图9A-C图示伤口闭合装置的实施例。
图10A-B图示包括可变大小的气泡的伤口填充物的实施例。
图11A-C图示包括在一个方向上塌陷的气泡的伤口填充物的实施例。
图12是用于向伤口提供负压伤口治疗的设备的实施例的示意图示。
图13用于向伤口提供负压伤口治疗的设备的另一实施例的示意图示,以示出第一收缩状态。
图14用于向伤口提供负压伤口治疗的设备的另一实施例的示意图示,以示出第二收缩状态。
具体实施方式
现在将参考随后的附图和说明描述能用于伤口的处理的各种实施例。当然应理解的是,能在不偏离本公开的精神的情况下作出所图示的实施例的形式和细节的各种省略、替换和变化。另外,以上描述的各种特征和过程能相互独立地使用,或者能以各种方式组合。所有可能的组合和子组合确定为属于该公开的范围。以上描述的实施例中的许多实施例包括相似的部件,并且同样地,这些相似的部件在不同的实施例中能互换。
本文公开的实施例涉及用降低的压力处理伤口的设备和方法,包括泵、伤口敷料组分和设备。通常,本文描述的包括伤口填充物的实施例可与包括放置在填充物上的盖布或伤口覆盖物的负压系统结合使用。诸如泵的真空源可例如通过连接至在覆盖物中或下制成的孔口或端口的一根或多个管连接至覆盖物。如果有的话,则包括伤口叠加和填塞材料的设备和部件在本文有时被共同地称为敷料。在以下的申请中找得到可与本文描述的实施例一起使用的方法和设备的另外的细节,所述申请在此全文并入作为参考:2011年9月1日公布为US 2011/0213287的名称为“SYSTEMS AND METHODS FOR USING NEGATIVE PRESSURE
WOUND THERAPY TO MANAGE OPEN ABDOMINAL WOUNDS”的美国申请No.12/886,088;2011年11月17日公布为US2011/0282309的名称为“WOUND DRESSING AND
METHOD OF USE”的美国申请No.13/092,042。
应意识到的是,贯穿该说明书,对一个或多个伤口作出参考。应理解的是,术语“伤口”应宽广地解释并包括皮肤被撕裂、切割或刺穿、或者创伤引起挫伤的开放或闭合伤口、或者在患者的皮肤上或以另外的方式受益于降压处理的任何其他表面或其他的状况或缺陷。伤口因而被宽广地限定为组织的可能或可能不产生流体的任何受损区域。这样的伤口的示例包括但不局限于急性伤口、慢性伤口、手术切口及其他切口、亚急性及开裂伤口、创伤伤口、皮片及皮肤移植、撕裂、擦伤、挫伤、烧伤、糖尿病溃疡、压力溃疡、人造口、手术伤口、创伤及静脉溃疡等。在有些实施例中,本文描述的负压处理系统的部件能尤其地适合于渗出少量伤口渗出液的切口伤口。
如本文所使用地,降低的或负的压力水平、诸如-X mmHg表示低于标准大气压力的压力水平,所述标准大气压力与760mmHg(或1atm、29.93inHg、101.325kPa、14.696psi等)对应。因此,-X mmHg的负压值表达比760mmHg低X mmHg的绝对压力,或者换句话说,(760-X)mmHg的绝对压力。另外,比-X mmHg“低”或“小”的负压与较接近大气压力的压力对应(例如,-40mmHg低于-60mmHg)。比-X mmHg“大”或“高”的负压与离大气压力较远的压力对应(例如,-80mmHg大于-60mmHg)。
对于本公开的有些实施例的负压范围能近似为-80mmHg,或者在大约-20mmHg与-200mmHg之间。应指出的是,这些压力是相对于正常的周围大气压力。因而,-200mmHg实际上为大约560mmHg。在有些实施例中,压力范围能在大约-40mmHg与-150mmHg之间。替代性地,能使用达到-75mmHg、达到-80mmHg或超过-80mmHg的压力范围。此外,在其他实施例中,能使用低于-75mmHg的压力范围。替代性地,能由负压设备供应近似超过-100mmHg、乃至-150mmHg的压力范围。
转向图1,在某些实施例中通过负压的伤口的处理如在此所示意性图示地使用负压处理系统101。在该实施例中,在此图示为腹部伤口部位的伤口部位110可受益于通过负压的处理。这样的腹部伤口部位可能是由于例如事故或由于手术介入。在有些情况下,诸如腹部腔室综合征、腹部血压过高、脓毒症或流体水肿的医疗状况可能需要腹部的通过腹部壁的手术切口的减压,以暴露腹膜空间,这之后,开口可能需要保持在开放的可进入状态,直到状况消退为止。其他状况还可能需要例如如果需要多个手术程序(可能附带创伤),或者有证据表明诸如腹膜炎或坏死性筋膜炎的临床状况,则尤其地在腹腔中的开口保持开放。
在尤其地在腹部有伤口的情况下,不管伤口是否保持开放或者如果其将闭合,都需要与器官和腹膜空间的暴露相关的可能的并发症的管理。优选地利用负压的施加的治疗能针对在促进组织活力和有害物质从伤口部位的去除的同时,使感染的风险最小。此外,已发现降低的或负的压力对伤口部位的施加通常促进更快的愈合、增强的血液流动、降低的细菌负担、提高的肉芽组织形成速率,以刺激成纤维细胞的繁殖、刺激肉皮细胞的繁殖、使慢性开放伤口闭合、禁止烧伤穿透、和/或增强皮片与移植附着。还有报道称,通过负压的施加对处理表现积极响应的伤口包括感染的开放伤口、褥疮溃疡、开裂切口、部分厚度烧伤和皮片或移植已附着于的各种损伤。因此,负压对伤口部位110的施加对患者能够是有益的。
因此,某些实施例提供放置在伤口部位110上的伤口接触层105。优选地,伤口接触层105能够是极为接近不粘附至伤口部位或暴露内脏的薄的柔性材料。例如,可使用诸如聚氨酯、聚乙烯、聚四氟乙烯或它们的混合物的聚合物。在一个实施例中,伤口接触层是可渗透的。例如,伤口接触层105能设置有诸如孔、狭缝或通道的开口,以允许流体从伤口部位110的去除或负压到伤口部位110的传输。以下更详细地描述伤口接触层105的附加实施例。
负压处理系统101的某些实施例还可使用多孔伤口填充物103,所述多孔伤口填充物103能设置在伤口接触层105上。该衬垫103能由例如泡沫的多孔材料构成,其柔软、弹性柔性、并且通常可顺应伤口部位110。这样的泡沫能包括例如由聚合物制成的开孔网状泡沫。合适的泡沫包括例如由聚氨酯、硅酮、聚乙烯醇组成的泡沫。优选地,当对伤口施加负压时,该衬垫103能引导伤口渗出液及其他流体通过其本身。有些衬垫103可包括用于这样的用途的预制通道或开口。在某些实施例中,衬垫103可具有在大约一英寸与大约两英寸之间的厚度。衬垫还可具有在大约16与17英寸之间的长度和在大约11与12英寸之间的宽度。在其他实施例中,厚度、宽度和/或长度能具有其他合适的值。以下更详细地讨论可代替衬垫103或除衬垫103之外使用的伤口填充物的其他实施例。
优选地,盖布107用于密封伤口部位110。盖布107至少能部分地不可渗透液体,使得在伤口部位处可至少维持部分负压。用于盖布107的合适的材料无限制地包括不明显地吸收水性流体的合成聚合材料,包括诸如聚乙烯聚丙烯的聚烯烃、聚氨酯、聚硅氧烷、聚酰胺、聚酯及其他共聚物和它们的混合物。用于盖布的材料可以是疏水的或亲水的。合适材料的示例包括可从DeRoyal购得的Transeal®和可从Smith & Nephew购得的OpSite®。为了帮助患者舒适度并避免皮肤浸渍,某些实施例中的盖布至少部分地透气,使得水蒸气在不保持被困在敷料下的情况下能够穿过。在盖布107的下侧的至少一部分上可设置有粘附层,以将盖布固定至患者的皮肤,但某些实施例可改为使用单独的粘附剂或粘附带。可选择地,在粘附层上可设置有释放层,以在使用之前保护所述粘附层并便于盖布107的操纵;在有些实施例中,释放层可由多个部分组成。
负压系统101能连接至例如泵114的负压源。合适的泵的一个示例是可从Smith & Nephew购得的Renasys EZ泵。盖布107可经由导管112连接至负压源114。导管112可连接至位于盖布107中的孔口109上的端口113,或者导管112可在不使用端口的情况下直接连接通过孔口109。在另外的替代中,导管可在盖布的下面经过并从盖布的一侧延伸。美国专利No.7,524,315公开了负压系统的其他相似的方面,在此全文并入作为参考并且应被看作是该说明书的一部分。
在许多应用中,在负压源114与导管112之间可介入有容器或其他储存单元115,以便允许伤口渗出液及从伤口去除的其他流体在不进入负压源的情况下被储存。某些类型的负压源、例如蠕动泵还可允许将容器115放置在泵114之后。有些实施例还可使用过滤器,以防止流体、气溶胶及其他微生物污染离开容器115和/或进入负压源114。另外的实施例还可在容器中包括截止阀或闭塞疏水和/或疏油过滤器,以防止溢出;其他的实施例可包括诸如电容传感器或其他流体水平检测器的感测装置,如果容器中的流体的水平接近容量,则所述感测装置用于停止或截止负压源。在泵排气处,还可优选的是,提供诸如活性炭罐的气味过滤器。
图2A-11C的伤口填充物与伤口闭合装置
图2A-2C图示了可用于如本文所描述的负压系统和方法的伤口填充物的一个实施例。如图2A所图示地,可将泡沫或其他多孔材料层放置在伤口中。可将诸如袋或其他结构的可膨胀的伤口填充物在多孔材料上放置在伤口中。可膨胀的伤口填充物可以半膨胀的状态放置在伤口中。可将伤口覆盖物放置在伤口填充物上,所述伤口覆盖物密封围绕伤口的皮肤。导管可将伤口覆盖物连接至负压源(未示出)。当如图2B所示通过伤口覆盖物对伤口施加负压时,伤口覆盖物下的真空水平的提高使袋进一步膨胀(由于周围压力的下降)。袋的膨胀提供对伤口覆盖物的向上的力,以防止伤口覆盖物向下延伸到伤口中。当施加负压的时候,伤口渗出液可通过多孔材料移动至可位于伤口覆盖物外的收集位置(诸如以上描述的罐115)乃至移动至位于伤口覆盖物下的收集位置。
可膨胀的伤口填充物可包括至少一部分多孔材料,并且例如可具有多个微孔或开口,以允许空气或其他膨胀流体从可膨胀的填充物泄露。如图2B所示,膨胀流体能从伤口填充物泄露出来,并且如图2C所示,随着时间的过去,当伤口由于伤口填充物的泄露而愈合的时候,填充物收缩,并且可膨胀的填充物将收缩,以允许伤口的边缘和侧面靠得更拢。
图3A-4B图示了诸如毡制泡沫的多孔伤口填充材料的实施例,其具有遍及隔开的多个竖直延伸的支柱。支柱可布置成平行的排,并且彼此可近似等距地隔开。在图3A-3B的实施例中,支柱可由比多孔伤口填充材料的密度高的材料制成。在有些实施例中,支柱可以线性排列布置在排内,从而由于支柱之间的相互作用而限制塌陷的量。在某些实施例中,支柱可以交错排列布置在排内,从而由于支柱不再以相同的程度相互阻止而允许较大的塌陷。在某些实施例中,支柱可一个一个地以它们交错的排列交替,而在其他排列中,支柱可两个两个地、三个三个地等交替。
在图4A-4B的实施例中,支柱可以是流体能通过其流动的刚性圆柱、中空构件。当在负压下放置在伤口中时,支柱允许填充物水平地塌陷,但防止竖直的塌陷。
图5A图示了包括多个竖直麦秆状物的伤口填充物的实施例,所述多个竖直麦秆状物沿着麦秆状物的长度彼此串联并排连接,以形成细长的材料带。麦秆状物可以是实心的或中空的。细长材料带优选地是竖直刚性的,但在连接相邻麦秆状物的接合部附近可以是柔性的,以允许细长材料被操纵,从而适合伤口。例如,如图5B(其示出了伤口的顶视图)所示,细长材料带能被切割成合适的长度,并且可以螺旋或其他期望的构造放置在伤口中,其中,麦秆状物在伤口内竖直地取向。麦秆状物同样在水平方向上可压缩,使得当伤口在负压治疗下愈合时,麦秆状物在伤口内水平地塌陷,但竖直地保持刚性的。
图6A-6B图示了包括细长的柔性中空管的伤口填充物的实施例,所述细长的柔性中空管可以期望的构造放置在伤口中。如图6C所图示地,中空管可以螺旋构造布置到伤口中,但也可能有其他的构造。管可由挤塑泡沫或其他材料制成。如所图示地,管可包括延伸通过管的中间的竖直支杆,以给管提供竖直刚性。在某些实施例中,伤口填充物不包含竖直支杆,但仍然保持竖直刚性。另外,如图6B所示,管可由可水平压缩的材料制成。管还可具有夹持构件,所述夹持构件可用于将管的侧面连接至管的其他部分或连接至伤口的边缘。当为了负压伤口治疗而将管布置在伤口中时,竖直支杆优选地竖直布置在伤口中,以提供竖直刚性,同时,管的侧面构造成当伤口闭合的时候水平地塌陷。在某些实施例中,包括细长的柔性中空管的伤口填充物可膨胀。
图7A-7C图示了包括由诸如可溶解的聚乙烯醇(PVA)填充物的可溶解材料制成的伤口填充物的实施例。如图7A所图示地,可将可溶解的PVA材料在多孔材料(诸如泡沫)上放置在伤口中,其中,多孔材料提供流体路径。可溶解的PVA材料可以任何合适的形式提供,包括片、卷、粉末或其他构造。在负压伤口处理期间,来自伤口的水分随着时间的过去缓慢地溶解PVA,以允许伤口闭合。在一个实施例中,如图7B-7C所图示地,当处理发生的时候,能将盐水引入填充物,以增强和/或控制PVA填充物的溶解。
图8A-8C图示了包括围绕伤口填充物的中心部分的一个或多个同心环的伤口填充物的实施例。中心部分与一个或多个环能由刚性材料制成,但可具有可变的吸收速率。在负压伤口治疗下,如从图8B至8C的过渡所示,外环可构造成比内环溶解得更快。因而,当伤口闭合的时候,伤口填充物的量减少,以允许伤口的边缘进一步靠拢。
图9A-9C图示了具有手风琴或六角风琴构造的伤口填充物的实施例。伤口填充物可包括一起形成重复的平行排的图案的上层和下层。伤口填充物可由任何合适的材料制成,包括硅酮、刚性塑料、半刚性塑料、生物相容材料、柔性塑料材料、复合材料和泡沫。每排的上层包括第一面和第二面,所述第一面和第二面分别包括在上顶点彼此成一定角度连接的大体上平坦、细长、矩形的材料片。每排的下层包括第一面和第二面,所述第一面和第二面分别包括在下顶点彼此成一定角度连接的大体上平坦、细长、矩形的材料片。如所图示地,上顶点通常在下顶点上方,并且在下层的第一与第二面之间形成的角度大于在上层的第一与第二面之间形成的角度。
在伤口填充物的相邻排之间可选择地设置有泡沫插入物。如图9B所图示地,泡沫插入物在横截面中可具有三角形状,以与上层的第一与第二面之间的三角形间隙对应。
伤口填充物与泡沫插入物可如图9A所示被切割成合适的大小,用于放置到伤口中。可如上所述将伤口覆盖物定位在伤口填充物和泡沫插入物上,并且可通过伤口覆盖物将负压提供至伤口。如图9C所示,在负压下,伤口填充物优选地可仅在一个水平方向上塌陷。当伤口填充物塌陷的时候,在上下顶点处的角度减小,并且在每排中的面进一步靠拢。泡沫插入物当施加负压的时候可在上层的第一与第二面之间被压缩,并且能被期望地选择成当伤口在负压下闭合时,当伤口填充物压缩的时候控制伤口填充物的压缩量。
图10A-10B图示了包括气泡包裹材料的伤口填充物的实施例。材料可包括具有层,所述层具有遍布层的表面的多个可变大小的气泡。如图10B所图示地,层当放置在伤口中时可包裹或卷成螺旋或其他构造。图10B图示了伤口的顶视图,以示出在一个实施例中如何将气泡包裹物放置在伤口中,但气泡包裹物可以任何合适的构造放置在伤口中。当伤口填充物如上所述用于负压系统时,可变大小的气泡在伤口中的变化压力下塌陷。
图11A-11C图示了包括气泡包裹材料的伤口填充物的另一实施例。在该实施例中,气泡包裹材料层可一个在另一个之上地设置在伤口中。例如,如图11B所示,相邻的层可在气泡彼此面对的情况下设置。如图11C所示,当如上所述用于负压系统时并且当在负压下时,气泡可优选地在一个方向(例如,水平方向)上塌陷,但竖直地保持刚性。
在有些实施例中,可能希望通过控制本文在说明书中的该部分或其他地方描述的任何伤口填充物的体积、刚度、压力和/或塌陷来控制伤口的闭合。在有些实施例中,能基于伤口内的内部压力的测量、例如通过监测膀胱压力、主动脉压力、结肠内的压力、子宫内的压力、肢体压力和血液流动速率中的至少一个来控制闭合。例如,如以下将更详细地描述地,来自内部压力机构的反馈能用于人工或自动地控制伤口填充物的塌陷或压缩的速率,从而控制伤口的闭合速率。关于这些及其他实施例的另外的细节在以下并且在2013年3月14日提交的名称为“APPARATUSES AND METHODS FOR WOUND THERAPY”的美国临时申请No.61/785,026中描述,所述美国临时申请的全部在此并入作为参考。
图12-14的设备与方法
当过高的压力积聚在身体中的封闭空间内时,能出现腔室综合征。例如,如果对腹部主动脉施加过高的压力,则腹部腔室中的过高的压力能阻碍血液往返于受影响的组织、身体器官乃至下肢的流动。附加地或替代性地由于对腹部腔室的负压伤口治疗的应用而对腹部区域施加的力,腹部腔室内的压力积聚能由于腹部腔室中过多的流体积聚。
这样过高的压力能引起对组织、器官(诸如肝脏、肠、肾脏及其他器官)及受血液流动减少影响的其他身体部分的永久损伤或损害。因此,防止腹部间室中过高压力的积聚有利于腹部损伤的处理。
腹内压力还可利用胃内、结肠内、膀胱内(膀胱)、下腔静脉插管、或通过诸如经由子宫的其他合适的方法间接地测量和/或监测。在有些布置中,例如,内部压力可通过将插管插入到患者的膀胱中来测量。主动脉血压同样能利用本领域已知的技术监测。对于基于肢体的腔室综合征,内部压力能够通过插入到受影响的肢体中的针测量,并且优选地,在那里测量得压力应在患者的舒张血压的20-30mmHg内。临床医生还能监测受影响的四肢远侧的脉搏。
除用于测量内部压力的任何前述方法或装置或它们的任何组合之外,在有些实施例中,负压伤口治疗能以使引起腔室综合征的过高压力的积聚最少或防止其的方式应用于患者的伤口。例如,本文公开的任何负压伤口治疗敷料组分和/或填充物能造成支撑或包含一个或多个压力传感器,所述一个或多个压力传感器构造成允许临床医生监测腔室、伤口腔或腹腔内的内部压力。在有些实施例中,负压敷料组分可包括可具有诸如可膨胀的囊体的可调整的体积的伤口填充物及如以下描述的其他伤口填充物,其当放置在伤口内时能控制伤口能闭合多少。在一个示例中,能向敷料组分添加一个或多个压力传感器,无限制地包括将一个或多个压力传感器定位在本文所公开的任何可膨胀的囊体实施例的表面上和/或内(诸如以下参考图12所描述地),所述可膨胀的囊体实施例能定位腹腔中。压力传感器能支撑在本文公开的任何可膨胀的囊体实施例的外和/或内表面上、嵌入其内或与之一体,并且能用于监测从腹腔内相邻的组织和器官对可膨胀的囊体施加的压力,以当在腹腔内出现阈值或潜在有害的压力时警告患者或护理者。
附加地或替代性地,一个或多个压力传感器能定位在定位于伤口腔内或邻近伤口腔的任何伤口填塞或伤口填充组分的一部分上或由其支撑,或者嵌入伤口填充物和/或敷料叠加或覆盖物的一部分内,包括由叠加本身和/或敷料的任何导管部件支撑。因此,压力传感器能定位在本文公开的敷料组分的任何组合上、由其支撑或嵌入其内。
此外,除本文定位的任何传感器位置之外或替代性地,一个或多个压力传感器还能定位成邻近被治疗的空腔中的器官中的一个或多个器官,例如膀胱、一个或多个肾脏、和/或任何其他器官或位于近侧的组织表面。
有些实施例能具有由伤口填塞层或伤口填充物支撑或在其上或嵌入其内的一个或多个压力传感器、由空腔中的器官(诸如膀胱)中的一个或多个器官或组织层支撑或在其上或嵌入其内的一个或多个压力传感器、和由定位在伤口腔内的一个或多个可膨胀的囊体支撑或在其上或嵌入其内的一个或多个压力传感器。
监测这三个位置中的一个、有些或全部位置能允许护理者优化或控制对伤口腔施加的负压水平,优化或控制放置在伤口内的可膨胀的囊体的膨胀或压力水平,优化或控制放置在伤口内的伤口填充物的塌陷、刚度或体积,和/或监测对受闭合压力影响的一个或多个器官、组织层、血管或其他身体部分施加的压力水平。护理者于是能通过向囊体添加流体或从囊体内将流体释放至定位在身体外的贮器或容器来调整可膨胀的囊体中的压力水平,调整伤口填充物的塌陷、刚度或体积,调整对伤口腔施加的负压水平,和/或调整对伤口施加以增大或减小闭合力的任何其他闭合力。在有些实施例中,这些调整能由计算机控制器动态地或自动地进行,所述计算机控制器接收指示过高压力的一个或多个读数或其他数据,并将控制信号发送至泵或其他装置,以进行调整。
在某些实施例中,当计算机控制器从诸如本文该部分或说明书中的其他地方公开的任何传感器的传感器收到信号时,控制器可触发警报。这样的警报可以是听觉和/或视觉警报,以使护理者警惕特定的读数。然而,可使用任何合适的警报。在有些实施例中,当压力读数超过或低于特定阈值时,诸如当器官上的压力太高时,可触发警报。在某些实施例中,当负压水平上升高于或下降低于某一阈值时,可触发警报。如本领域的技术人员所意识到地,由于可能存在该说明书内公开的许多可能的传感器构造,所以同样可能存在任何数量的合适的对应警报。
当真空缓慢地提高至伤口敷料的时候,或者当从可膨胀的构件缓慢地释放空气的时候,临床医生可监测内部压力。在一个实施例中,人膀胱压力被控制成低于近似40mmHg、或低于近似30mmHg、近似20mmHg、或近似15mmHg。在有些实施例中,能自动地控制内部压力的测量与真空和空气释放的控制。这样,当水肿减轻的时候,伤口能例如在几小时到几天的一段时间内进一步缓慢地闭合(例如,通过七天闭合)。应意识到的是,在能通过基于患者的生命体征或在本文或http://www.uptodate.com/contents/abdominal-compartment-syndrome中描述的其他监测提供的压力反馈缓慢地施加真空的情况下,能采用该系统。
图12是设备120的示意图示,所述设备120用于向伤口提供负压伤口治疗并基于定位在伤口腔内的压力传感器控制伤口的治疗和/或闭合,以使腔室综合征的风险最小。例如并且无限制地,在有些实施例中,设备120能具有背衬层122,用于在伤口上提供大致气密和液密的密封。在叠加下,设备120能具有伤口填塞构件或伤口填充物124,所述伤口填塞构件或伤口填充物124能具有可调整的体积和/或内部压力。例如,伤口填塞构件124的有些实施例能具有密封构件126(诸如密封袋),所述密封构件126能经由与密封构件126内的密封空间连通的导管128从诸如泵的压力源可控制地膨胀和收缩。密封构件126能在伤口中定位成与伤口组织界面接触。例如,在用于腹部伤口的任何实施例中,密封构件126能构成并且能定位在伤口腔中,以便接合在身体中的器官上的所有组织层。例如,在有些实施例中,密封构件126能定位在伤口中,以便接触在腹部伤口中能出现的任何或所有层,诸如(从最深到最表面)腹膜、腹膜外筋膜(深筋膜)、肌肉、浅筋膜、皮下组织和皮肤。然而,各种层的存在或不存在是位置相关的,因而不是所有的这些层可出现在可用本公开的设备处理的每个腹部伤口中。
在有些实施例中,在密封构件126与内脏或其他器官之间能定位有器官保护层127,诸如在2010年9月20日提交的名称为“SYSTEMS AND METHODS FOR USING NEGATIVE PRESSURE WOUND THERAPY TO MANAGE
OPEN ABDOMINAL WOUNDS”的美国申请公布No.2011/0213287、序号12/886,088中公开的伤口接触层的实施例,所述申请在此如同本文充分阐述一样在本文并入作为参考。本文公开的设备120的实施例还能包括在美国申请No.12/886,088中公开的负压系统的任何其他部件、材料、特征或任何实施例或部件的细节。如上所述,在美国申请No.12/886,088中公开的负压系统的所有实施例或部件在此如同本文完全阐述一样并入作为参考。
能将压力传感器130(本文还被称为第一压力传感器)用于监测密封构件126内的压力水平。压力传感器130能提供密封构件126内的压力水平的视觉读数,和/或能基于密封构件内的压力水平将信号提供至控制器132。
如上所述,密封构件126内的压力水平能部分地由泵127(本文还被称为第一泵)控制,并且能被调整成正的或负的压力。另外,在有些实施例中,泵127能构造成使压力水平在任何期望的正或负的压力水平之间循环,或对密封构件126施加间歇压力。密封构件126的有些实施例或本文公开的任何密封构件的实施例内的正压能在0mmHg到60mmHg或更高中变化。密封构件126的有些实施例或本文公开的任何密封构件的实施例内的负压能在0mmHg到-180mmHg或更高中变化。
在本文公开的任何实施例中,能独立于背衬层122下的空间134中的压力控制密封构件126内的压力水平。背衬层122下的压力能由与背衬层122下的空间134连通的压力传感器(诸如压力传感器138,其在本文还被称为第二压力传感器)检测。第二压力传感器138能构造成将信号提供至控制器132。在本文公开的任何实施例中,诸如泵136的第二泵能用于将负压源提供至背衬层122下的空间134。替代性地,设备能构造成仅具有一个泵(未图示),所述泵具有多个导管和多个阀,以独立地控制密封构件126和在背衬层122下的空间134内的压力水平。
在有些实施例中,能独立于空间134中的降低的压力水平调整密封构件126内的压力水平,以增大或减小密封构件126的体积,这就控制对腹部区域中的一个或多个器官施加的压力水平来说能够是有益的,并因此就控制腔室综合征的风险或使腔室综合征的风险最小来说能够是有益的。能将压力传感器140(其在本文还被称为第三压力传感器)放置成与例如人膀胱的人器官连通,以监测人膀胱内的压力。第三压力传感器140还能构造成基于由第三压力传感器140检测的压力读数将信号提供至控制器。
如果如由压力传感器140所检测的在诸如人膀胱的一个或多个器官中检测的压力超过阈值,则控制器132能调整一个或多个压力水平,以减小对一个或多个器官施加的压力。在有些实施例中,对于腹部区域中的器官的压力测量的阈值能够是10mmHg(或近似10mmHg)、或12mmHg(或大约近似12mmHg)、或15mmHg(或大约15mmHg),但这样的值可以是器官特定的和/或患者特定的。另外,在其中本文公开的任何敷料用于处理大腿上的伤口的有些应用中,例如,腔室压力能高达120mmHg,使得在该区域中的腔室压力的阈值比对于腹部伤口高得多,诸如近似60mmHg或更低到近似80mmHg、或近似100mmHg。在腿中,通常,能触发这样的压力和敷料调整的压力阈值能近似为40mmHg、或从近似40mmHg到近似60mmHg。由于每个患者可适用不同的值,所以设备的有些实施例能构造成使得医生能设定阈值水平。对于较年轻的患者或儿童或有较高的患腔室综合征的风险的患者,例如,能设定较低的阈值。在有些实施例中,阈值能被设定在从近似8mmHg到近似12mmHg。
例如,在腹部负压伤口治疗套件中,为了减少压力积聚,设备能构造成降低对伤口施加的闭合力的水平。这在有些实施例中能通过提高密封构件126中的压力水平实现,从而即使当维持对伤口中的空间134施加提高的降压水平以确保合适的流体去除水平时,也能限制伤口界面的壁中的闭合量。这是能做到的,直到诸如膀胱的器官中的一个或多个器官中的压力水平、或血液流动速率测量再次达到安全或低于阈值的值为止。在有些实施例中,在空间134内但在密封构件126外的压力水平处于负压水平的同时,密封构件126内的压力水平能够是正值(即,高于大气),以对组织界面施加铺展力。其中密封构件126能独立地控制伤口界面闭合水平的该布置还能允许医生超过空间134中的在典型的治疗范围外的正常负压水平,所述典型的治疗范围否则可能受过高的腹内压力水平限制。
在有些实施例或布置中,密封构件126能被尺寸化并构造成当放置在腹部伤口中时,接触腹膜、腹膜外筋膜(深筋膜)、肌肉、浅筋膜、皮下组织和皮肤。当希望限制伤口界面的闭合水平时,诸如当在伤口区域中或邻近伤口区域出现过高的压力水平时,能提高密封构件126内的压力水平,以限制腹膜、腹膜外筋膜(深筋膜)、肌肉、浅筋膜、皮下组织和皮肤中的一个或多个的收缩,从而增大内脏能占用的空间体积并降低对各种器官和血管施加的压力水平。此外,由于能独立于在背衬层122下的空间134内但在密封构件126外的压力水平调整密封构件126内的压力水平,所以能对伤口施加降低的治疗压力水平,以去除在腹部腔室中渗出的过量的液体并改善愈合状况。
在本文公开的实施例的任何一个实施例中,设备能从遍及身体的一个或多个压力传感器收集压力读数,以监测腔室压力。对于腹内腔室压力,能在腹部区域或与之相邻的区域中收集读数。例如,本文公开的任何设备能具有一个或多个血流计(诸如激光多普勒仪血流计),其构造成测量通过目标血管、动脉、毛细血管和/或肌肉的血液流动速率。激光多普勒仪的任何实施例能靠近伤口腔永久安装至患者的皮肤。在有些实施例中,例如,能将一个或多个血流计用于在或靠近腹部区域测量通过股动脉或通过肌肉系统的血液流动速率,并将反馈信号提供至控制器132。
另外,在有些实施例中,例如腹部腔室中的压力水平能利用囊泡技术测量,所述囊泡技术能包括留置导尿管、压力变换器和注射器或能够注入流体的类似装置的使用。另外,腹部腔室中的压力水平能通过左或右股动脉将插管插入下腔静脉来测量。对于有关适合监测腹部腔室综合征的监测技术的更多信息,参见F. Lui, A. Sangosanya, and L.J. Kaplan, “Abdominal Compartment
Syndrome: Clinical Aspects and Monitoring,” Critical Care Clinics, vol. 23, no. 3, pp.
415-433, 2007。
此外,本文公开的密封构件126的任何实施例能由大致密封的不可渗透膜148形成,所述不可渗透膜148围绕导管128密封或密封导管128,所述导管128提供进出不可渗透膜148的流体(例如,空气、氮或氩、或盐水、水或其他液体),与美国专利No.7,753,894中公开的任何可膨胀膜相似,所述导管128能由任何合适的生物相容聚合物膜、片、袋、囊、室或以另外的方式形成,所述美国专利是2007年12月17日提交的名称为“WOUND CLEANSING APPARATUS WITH STRESS”的申请No.12/886,088。
在有些实施例中,密封构件126具有围绕不可渗透膜148的外表面的部分或全部的泡沫层150。在有些实施例中,泡沫层150能围绕不可渗透膜148的整个表面。泡沫150能帮助缓冲由密封构件126对组织施加的任何压力点,并且能帮助遍及伤口腔的负压分布。
另外,尽管未要求,但本文公开的实施例能具有定位在不可渗透膜148内的结构构件160。在有些实施例中,结构构件160能构造成在竖直方向(即,如由图12中的箭头A1所指示地,与背衬层横向)上比在侧向方向(即,如由图12中的箭头A2所指示地,在组织界面的伤口闭合的方向上)上更刚性。能使用的结构构件的示例被发现在公布为US 2012/0209227的2012年2月3日提交的名称为“Negative Pressure Wound Closure Device”的申请No.13/365,615中,所述申请的全部在此并入作为参考。
在有些实施例中,密封构件126能具有多个可独立控制(例如,可膨胀或可收缩)的室。一根或多个歧管能控制各种腔室或室的膨胀与收缩,以如需要适合特定的伤口大小和应用地控制囊体构件的大小和/或形状。
另外,在本文公开的任何实施例中,密封构件126能与定位在密封构件126内或外的竖直刚性但侧向可折叠的结构一起使用。例如,参考图13,图示了设备200的另一实施例。设备200能具有本文公开的任何其他实施例的任何相同的特征、部件或细节,包括以上公开的任何可视化元件和压力传感器。另外,如图13所示,密封构件206能被定位在伤口腔中,并具有本文公开的密封构件126的任何相同的特征、材料或其他细节,包括但不限于围绕不可渗透层210的泡沫层或界面208。
设备200还能具有定位在背衬层218下的支撑构件216。支撑构件216的有些实施例能具有装接至支撑构件216的顶部部分226(在本文还被称为第一部分)的一个或多个腿(在本文还被称为本体部分)220。在有些实施例中,支撑构件216的顶部部分226能沿着支撑构件216的顶点,并限定支撑结构的纵向轴线A1。腿220能够由顶部部分226可旋转地支撑,使得腿220能绕限定通过顶部部分226的轴向中心线的轴线A1旋转。密封构件206能与腿220耦连、连接至、粘附至或以另外的方式装接至腿220,使得密封构件206的收缩或伸展使腿22和支撑构件216对应的收缩或伸展。在有些实施例中,腿220能定位在密封构件206中形成的模制凹口内。在有些实施例中,定位在腿220的底部的一个或多个泡沫凹口能粘附至密封构件206。
在该构造中,当密封构件206从诸如图13所示的体积V1的第一体积收缩至诸如图14所示的体积V2的第二体积的时候,支撑构件216(或具有竖直比侧向大的刚性的任何其他合适的支撑构件)同样能侧向地收缩。另外,密封构件206能构造成从诸如图14所示的体积V2的较小的体积伸展至诸如图13所示的体积V1的较大的体积,以便靠着伤口界面的壁侧向向外地推压支撑构件216及其腿220,从而潜在地减小对腹部腔室内的器官的压力。当伤口在愈合的过程期间闭合的时候,腿220能旋转得更靠拢,使得伤口的闭合不会被敷料背衬层218阻止。
此外,诸如实施例120和200的伤口闭合设备的有些实施例能具有由密封构件或与密封构件连通的支撑构件支撑的一个或多个组织接合元件。组织接合元件能构造成接合伤口界面的一个或多个层,包括腹膜、腹膜外筋膜(深筋膜)、肌肉、浅筋膜、皮下组织和皮肤中的任何一个或组合。图12所示的设备120的实施例的组织接合元件164(在图12中示意性地表示)或设备200的实施例的组织接合元件264能包括组织连接器、组织锚、钩形构件、在杆的端部上的球、和/或可与组织的各种层一起使用的任何其他合适的接合机构中的任何一个或组合。密封构件126的有些实施例能具有需要接合伤口部位中的各种不同组织层的不同组织接合元件的任何组合。
如所讨论地,在本文公开的密封构件的任何实施例中,密封构件内的流体的体积水平能由控制系统自动地控制。另外,在任何实施例中,密封构件内的流体体积的水平能响应于由设备中的任何多个压力传感器获得的压力读数、通过管和手动泵系统、或通过插入到诸如密封构件上的一个或多个注射器端口的密封贮器中的注射器和套管装置添加或去除进入密封构件的流体来手动地改变。
在有些实施例中,密封构件本身在竖直方向上比在侧向方向上更刚性。例如,密封构件的任何实施例能具有使密封构件在侧向方向上比在竖直方向上更刚性的褶皱或波状表面。在有些实施例中,密封构件例如能具有手风琴状的形状。
应意识到的是,在有些实施例中,不需要进行指示患者内的过高压力的任何测量。相反地,可简单地希望通过控制上述任何伤口填充物的体积、刚度、压力和/或折叠来控制伤口的闭合。这样的闭合能基于视觉检查、以上描述的伤口可视化方法和设备的使用来控制,或者能基于期望的预定计划来控制。对这样的闭合的控制能由保健医生手动地进行,或者可自动地或基于如上所述的控制器的输入进行。例如,在将可膨胀的囊体放置在伤口中的情况下,可手动地或自动地控制囊体中的压力,以对于给定的时间段限制和/或允许某一伤口闭合量。该概念在能随着时间的过去控制腿之间的角度的情况下,可通过包括机构(诸如腿之间可调整的囊体)相似地适用于诸如在图13中所描述的伤口填充物。体积、刚度、压力和/或折叠可控制的伤口填充物的其他实施例可与本文公开的任何实施例的任何部件一起使用。在本文并入作为参考的、公布为US2012/0209227的、2012年2月3日提交的名称为“Negative Pressure Wound Closure Device”的申请No.13/365,615中找得到能与本文公开的任何实施例的任何部件一起使用的这样的附加伤口填充物的示例,所述申请的全部在此并入作为参考并应认为是该说明书的一部分。应意识到的是,伤口填充物的任何这些实施例还可结合或代替图12的系统和方法中的可膨胀的囊体使用。
在其他实施例中,这样的闭合能基于视觉检查、如本文该部分或说明书中的其他地方描述的伤口可视化方法和设备的使用、或者基于期望的预定计划来控制。对这样的闭合的控制能由保健医生手动地进行,或者可自动地或基于如本文该部分或说明书中的其他地方描述的控制器的输入进行。例如,在将诸如本文该部分或说明书中的其他地方描述的可膨胀构件放置在伤口中的情况下,可手动地或自动地控制可膨胀构件中的压力,以对于给定的时间段限制和/或允许某一伤口闭合量。该概念在能随着时间的过去控制腿之间的角度的情况下,可通过包括机构(诸如腿之间可调整的囊体)相似地适用于本文的该部分或说明书中的其他地方描述的、例如图13所描述的其他伤口填充物。还能采用其他机构,以通过用户手动地或基于用于控制器的控制自动地控制本文描述的任何伤口填充物的体积、刚度、压力和/或折叠的变化。还应意识到的是,如上所述的伤口填充物的任何这些实施例还可结合或代替图12的系统和方法中的可膨胀的囊体使用。
结合特定的方面、实施例或示例描述的特征、材料、特性或组除非与之不相容,否则应理解为可适用于本文描述的任何其他方面、实施例或示例。在该说明书(包括所有附属的权利要求、摘要和附图)中公开的所有特征、和/或因此公开的任何方法或过程的所有步骤除这样的特征和/或步骤中的至少一些相互排斥的组合外,可以任何组合结合。保护不限于任何前述实施例的细节。保护扩展至在该说明书(包括所有附属的权利要求、摘要和附图)中公开的特征中的任何新颖的一个特征或任何新颖的组合,或扩展至因此公开的任何方法或过程中的任何新颖的一个方法或过程或任何新颖的组合。
尽管已描述了某些实施例,但这些实施例仅作为示例介绍,并且不用于限制保护范围。实际上,本文描述的新颖方法和系统可以各种其他的形式具体化。此外,可作出在本文描述的方法和系统的形式上的各种省略、替换和变化。本领域的技术人员应意识到的是,在有些实施例中,在图示和/或公开的过程中采用的实际步骤可与图中所示的不同。取决于实施例,可去除以上描述的步骤中的某些步骤,可增加其他的步骤。此外,以上公开的特定实施例的特征和属性可以不同的方式组合,以形成全部属于本公开的范围的附加的实施例。
尽管本公开包括了某些实施例、示例和应用,但本领域的技术人员应理解的是,本公开超出具体公开的实施例扩展至其他替代性的实施例和/或使用及其显而易见的变型和等同,包括不提供本文阐述的所有特征和优点的实施例。因此,本公开的范围不受本文优选的实施例的具体公开限制,并且可由如本文介绍的或如将来介绍的权利要求限定。
Claims (14)
1. 一种用于与负压一起使用的伤口处理设备,包括:
用于在利用负压处理伤口中使用的伤口填充物,其包括:
多个竖直延伸的麦秆状物,其构造成当所述伤口填充物位于伤口床内时竖直地延伸;
多个接合部,其连接相邻的竖直延伸的麦秆状物;以及
其中,在对所述伤口填充物施加负压时,所述伤口填充物构造成在所述竖直延伸的麦秆状物减少所述伤口填充物的竖直运动的情况下水平地收缩。
2. 如权利要求1所述的伤口处理设备,其特征在于,所述竖直延伸的麦秆状物是实心的。
3. 如权利要求1所述的伤口处理设备,其特征在于,所述竖直延伸的麦秆状物是中空的。
4. 如权利要求1所述的伤口处理设备,其特征在于,所述接合部是柔性的。
5. 如权利要求1所述的伤口处理设备,其特征在于,所述接合部是刚性的。
6. 如权利要求1所述的伤口处理设备,其特征在于,所述伤口填充物还被构造成以螺旋构造放置在所述伤口床中。
7. 如权利要求1所述的伤口处理设备,还包括至少一个压力传感器。
8. 一种用于与负压一起使用的伤口处理设备,包括:
用于在利用负压处理伤口中使用的伤口填充物,其包括:
柔性中空管;
位于所述柔性中空管内的竖直支杆,所述竖直支杆构造成当所述伤口填充物位于伤口床内时竖直地延伸,所述竖直支杆由比所述柔性中空管刚性的材料制成;以及
其中,在对所述伤口填充物施加负压时,所述伤口填充物构造成在所述竖直支杆减少所述伤口填充物的竖直运动的情况下水平地收缩。
9. 如权利要求8所述的伤口处理设备,还包括位于所述柔性中空管的外侧上的夹持构件,所述夹持构件构造成夹持所述伤口床。
10. 如权利要求8所述的伤口处理设备,其特征在于,所述柔性中空管被构造成以螺旋构造放置在所述伤口床内。
11. 如权利要求8所述的伤口处理设备,其特征在于,所述柔性中空管包括挤塑泡沫。
12. 如前述权利要求中任一项所述的伤口处理设备,还包括构造成放置在所述伤口填充物上并围绕所述伤口密封皮肤的覆盖物。
13. 如权利要求12所述的伤口处理设备,还包括构造成将伤口覆盖物连接至负压源的端口。
14. 如权利要求13所述的伤口处理设备,还包括构造成给所述伤口提供负压的负压源。
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US10159771B2 (en) | 2018-12-25 |
US20160030646A1 (en) | 2016-02-04 |
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AU2014229749A1 (en) | 2015-09-10 |
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WO2014140578A1 (en) | 2014-09-18 |
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CA2904067A1 (en) | 2014-09-18 |
EP2968015B1 (en) | 2018-05-16 |
AU2014229749B2 (en) | 2018-09-20 |
JP2016517290A (ja) | 2016-06-16 |
BR112015021123A2 (pt) | 2017-07-18 |
US11097044B2 (en) | 2021-08-24 |
US20190231945A1 (en) | 2019-08-01 |
ZA201505833B (en) | 2017-03-29 |
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