CN111407344A

CN111407344A - Adjustable skin stretching device for intracutaneous use and stretching method

Info

Publication number: CN111407344A
Application number: CN202010297504.XA
Authority: CN
Inventors: 何泽亮; 李晓东; 张盼盼; 李锦�
Original assignee: 980th Hospital of the Joint Logistics Support Force of PLA
Current assignee: 980th Hospital of the Joint Logistics Support Force of PLA
Priority date: 2020-04-16
Filing date: 2020-04-16
Publication date: 2020-07-14
Anticipated expiration: 2040-04-16
Also published as: CN111407344B

Abstract

The invention relates to an adjustable skin stretching device used in skin and a stretching method, wherein the stretching device comprises a bracket erected on the skin, a tightener arranged on the bracket, a left suture and a right suture, one end of the left suture is connected with the tightener, the other end of the left suture is connected with a connecting block after penetrating through the skin; the invention is arranged at two sides of the skin wound edge through the bracket, the left suture and the right suture are fixed on the connecting block after penetrating through the skin, the other end of the suture penetrates into the tightener, the connecting plate can only move upwards but not move downwards under the matching action of the anti-retreat teeth and the ratchets, when tightening work is needed, the suture can be gradually tightened by lifting the connecting plate upwards, the distance between the two wound edges is reduced, the use is more convenient, the suture adopts an intracutaneous path, subcutaneous tissues at two sides are effectively fixed, the damage to the skin at the surface layer is avoided, the scar formation is reduced, and the device is obviously different from the existing traction type device.

Description

Adjustable skin stretching device for intracutaneous use and stretching method

Technical Field

The invention relates to the field of medical instruments, in particular to an intradermal adjustable skin stretching device and a stretching method.

Background

Wound repair is a common clinical problem, and mainly includes traumatic wounds, diabetic wounds, radiation ulcers, dynamic and static ulcers, pressure ulcers and the like, and can also be caused by intentional surgical operations, such as formation after tumor resection and the like. The conventional trauma or wound can be solved by means of direct surgical suture, but some limited cases cannot be directly sutured, such as wound skin defect caused by various reasons, or excessive tension of adjacent skin, and the like. The wound surface which can not be directly sutured is clinically encountered, the simplest solution is to repair the wound surface by changing the dressing for a long time, but the method is long in time consumption, the wound surface is exposed for a long time in the period and then is high in infection risk, and the work and the life of a patient are seriously influenced. Therefore, in clinic, if the physical condition of a patient allows, the treatment is usually carried out through an operation mode, and the wound repair is accelerated. Such as local or distant skin flap transfer, skin grafting, acellular artificial dermis or other novel dressing covering repair, but the mode often has high requirements on the surgical skill and medical level, is complex to operate, or has high surgical expense and high cost, and seriously increases the economic burden of patients.

In recent years, a new wound repair mode, namely a skin stretching device, appears, and has a remarkable effect clinically. However, the existing skin stretching devices are mainly divided into two categories. One type is a thread gluing type skin stretching device, namely the stretching device is adhered to the skin at two sides of a wound edge, and the stretching device is gathered through a drawing device in the middle to achieve the effect of closing the wound surface. However, this method has significant disadvantages: 1. the adhesive force of the distractor can not meet the satisfaction of people, the fixation effect is poor, the distractor is easy to slip, the adhesive property of the distractor is damaged under the condition that the wound surface has chronic exudation or skin sweating, and the falling of the distractor is accelerated; 2. the skin of a normal person has mobility, and the skin of a person can twist or stretch in an adhesion area when participating in some necessary activities, so that the distractor slips; 3. the skin may be chemically corroded or damaged by the long-time contact of the retractor and the skin in the process of adhering the retractor and the skin, blisters are generated, or the skin on the surface layer of the skin falls off along with the falling of the retractor in the process of intentionally or unintentionally removing the retractor, so that the skin is damaged. The other type is an embedded skin stretching device, wherein the sharp part of the stretching device penetrates through the whole skin layer and then passes through various types of stretching devices to gather and polymerize the wound surface. This method also has significant disadvantages, as follows: 1. the distractor can form a new wound surface in the process of being embedded into the skin and is exposed on the surface of the original normal skin. After the original wound surface is pulled, tightened and healed, the wound surface of the embedding area of the distractor is not healed, and the treatment of changing the medicine for many times is still needed; 2. after the stretching device is embedded into the skin to form a wound surface, new scar tissues are formed at the same time. Particularly in a state of sustained high tension throughout the stretching process, studies have now clearly shown that a high tension state can accelerate and exacerbate scar tissue formation. Therefore, serious scar tissues are often formed at the pore diameter of the skin where the distractor is embedded, the beauty of the skin is seriously influenced, discomfort such as pruritus and pain often appears after the scar tissues are formed, and the life quality of a patient is seriously influenced.

Disclosure of Invention

The invention aims to provide an intradermal adjustable skin stretching device and a stretching method, which can effectively reduce the wound surface.

The technical scheme adopted by the invention is as follows: an adjustable skin retractor for intracutaneous use comprises a bracket erected on skin, a tightener arranged on the bracket, a left suture and a right suture, wherein one end of the left suture is connected with the tightener, and the other end of the left suture and the right suture are connected with a connecting block after penetrating through the skin.

The tightener comprises a shell, a middle plate arranged in the shell and anti-back teeth respectively arranged on the left side and the right side of the middle plate;

connecting plates are arranged at the upper ends of the left and right sutures, the lower ends of the left and right sutures are connected with a suture needle, the connecting plates of the left and right sutures are respectively arranged at the left and right sides of the middle plate, and ratchets matched with the anti-withdrawal teeth are arranged on the connecting plates; the ratchet and the anti-back teeth are matched to limit the connecting plate to move downwards.

Furthermore, a mounting plate is arranged between the anti-back teeth and the middle plate, the anti-back teeth are longitudinally arranged on the mounting plate, and a return spring is arranged between the mounting plate and the middle plate.

Furthermore, the lifting device is used for lifting the connecting plate upwards, and comprises a rotating shaft which penetrates through the tightener shell and a gear arranged on the rotating shaft, wherein gear teeth of the gear are matched with the ratchet teeth, and the rotating shaft is rotatably arranged on the support.

Further, the position of the gear in the tightener shell is located between the anti-back tooth and the connecting plate.

Furthermore, the connecting block comprises a U-shaped block with a U-shaped longitudinal section and a clamping block which is arranged in the U-shaped block and is matched with the U-shaped block, and a first through hole is formed in the side wall of the U-shaped block.

Furthermore, the horizontal section of the connecting block is wedge-shaped, and the shape of the clamping block is matched with that of the connecting block.

Furthermore, the support includes the sponge bed course, sets up the supporting layer and the supporting shoe of setting on the supporting layer above the sponge bed course, and the both ends of tightener are erect on the supporting shoe that corresponds.

Further, a flat part is arranged on the rotating shaft.

An intradermal stretching method, comprising the steps of:

respectively clamping the sewing needles of the left suture and the right suture by using a needle holder, inserting the needles from the surface layer of the skin, and withdrawing the needles from the deep layer of the skin;

after the needle is withdrawn, cutting off the suture from the rear side of the suture needle, removing the suture needle, respectively connecting the left suture and the right suture with the connecting block, and respectively placing the two brackets of the distractor on the two sides of the wound edge;

penetrating the connecting plates of the left suture and the right suture from the lower end of the tightener to ensure that the ratchets on the two connecting plates are respectively matched with the corresponding anti-back teeth;

when the distance between the two sides of the wound edge needs to be adjusted, the rotating shaft is rotated clockwise by using a tool, the connecting plate is driven to move upwards through the gear teeth, and the left suture and the right suture are tightened to tighten the skin on the two sides of the wound edge;

rotating the rotating shaft at regular intervals to gradually tighten the skin at the wound edges on the two sides;

and when the skin at the two sides of the wound edge is tightened to a distance less than 1cm, continuously pulling for required time to enable the skin at the two sides of the wound edge to be loose, cutting off the suture line by using scissors, and removing the distractor.

The invention has the positive effects that: the invention is arranged at two sides of the skin wound edge through the bracket, the left suture and the right suture are fixed on the connecting block after penetrating through the skin, the other end of the suture penetrates into the tightener, the connecting plate can only move upwards but not move downwards under the matching action of the anti-retreat teeth and the ratchets, when tightening work is needed, the suture can be gradually tightened by lifting the connecting plate upwards, the distance between the two wound edges is reduced, the use is more convenient, the suture adopts an intradermal path, subcutaneous tissues at two sides are effectively fixed, the damage to the skin at the surface layer is avoided, the scar formation is reduced, and the invention is obviously different from the existing traction type device.

Drawings

FIG. 1 is a schematic structural view of the present invention;

FIG. 2 is an enlarged view taken at A of FIG. 1 in accordance with the present invention;

FIG. 3 is a schematic view of the return spring of the present invention;

FIG. 4 is a schematic view of the gear structure of the present invention;

FIG. 5 is a schematic view of a right suture configuration of the present invention;

FIG. 6 is a schematic view of a connecting block according to the present invention;

FIG. 7 is a schematic view of the stent structure of the present invention.

Detailed Description

As shown in fig. 1 to 7, the retractor of the present invention comprises a frame 2 erected on both sides of the wound edge of the skin 1, a tightener 4 provided on the frame 2, and a left suture 7 and a right suture 5 connected to a connecting block 6 after one end thereof is connected to the tightener 4 and the other end thereof passes through the skin 1.

The tightener 4 comprises a shell, a middle plate 10 arranged in the shell and anti-back teeth 11 respectively arranged at the left side and the right side of the middle plate 10; the middle plate 10 and the left and right inner side walls of the shell form a left space and a right space which are respectively used for being matched and connected with the left suture 7 and the right suture 5.

The left and

right stitches

7, 5 have the same structure, the upper ends of the stitches are both provided with a connecting plate 8, the lower ends of the stitches are connected with a sewing needle 15, the connecting plates 8 of the

stitches

7, 5 are respectively arranged in the spaces at the left and right sides of the middle plate 10, and the connecting plate 8 is provided with a ratchet 9 matched with the anti-back teeth 11; the space formed by the left and right sides of the middle plate 10 and the inner side wall of the shell is narrow enough, so that when the connecting plate 8 penetrates from the lower part of the shell, the ratchet 9 and the anti-back teeth 11 can be matched. The outer side surface of the ratchet 9 is gradually inclined towards one side close to the anti-back teeth 11 from top to bottom, so that the connecting plate 8 can smoothly move upwards, and the anti-back teeth 11 can abut against the lower end of the ratchet 9 to prevent the ratchet 9 from moving downwards when the ratchet moves downwards.

In order to further improve the smooth upward movement of the connecting plate 8 and prevent the downward movement thereof, a mounting plate 16 is arranged between the anti-back teeth 11 and the middle plate 10, the anti-back teeth 11 are arranged on the mounting plate 16 along the longitudinal direction, and a return spring 17 is arranged between the mounting plate 16 and the middle plate 10. Thus, when the connecting plate 8 moves upwards, the inclined outer side surface of the ratchet 9 gradually pushes the mounting plate 16 to move to the side far away from the ratchet 9, and when the ratchet 9 is disengaged from the anti-back tooth 11, the mounting plate 16 is reset under the action of the reset spring 17, and the anti-back tooth 11 is propped against the lower end of the ratchet 9 again to prevent the downward movement.

The invention also comprises a lifting device for lifting the connecting plate 8 upwards, said lifting device comprising a rotating shaft 3 traversing the housing of the tightener 4 and a gear wheel 12 arranged on the rotating shaft 3, the teeth 13 of the gear wheel 12 cooperating with the ratchet 9, said rotating shaft 3 being rotatably arranged on the bracket 2. The rotating shaft 3 is provided with a flat portion 14 for cooperating with a tool such as a pliers to drive the rotating shaft 3 to rotate. In order to prevent the rotation of the shaft 3 and the rotation of the tightener 4, a fixed shaft may be additionally provided on the tightener 4, and both ends of the fixed shaft are also provided on the bracket 2.

In a practical arrangement, the position of said gear 12 inside the housing of the tightener 4 is between the anti-backlash tooth 11 and the coupling plate 8. The gear 12 is not interfered with the anti-back teeth 11 in the rotating process, and the gear teeth 13 only contact with the ratchets 9 to drive the ratchets 9 to move upwards.

As shown in fig. 6, the connection block 6 includes a U-shaped block 601 having a U-shaped longitudinal section and a fixture block 603 disposed in the U-shaped block 601 and matched with the U-shaped block, first through holes 602 are disposed on two side walls of the U-shaped block 601, a third through hole is disposed at the bottom of the U-shaped block 601, when connecting, a left suture and a right suture without a sewing needle sequentially pass through the first through hole and the third through hole on the corresponding side, and then the fixture block 603 is inserted into the U-shaped block 601 to form a fit, and the connection is achieved by a pressing force and a friction force.

The horizontal section of the connecting block 6 is wedge-shaped, and the shape of the fixture block 603 is matched with that of the U-shaped block 601. When the connecting block is connected with the left suture and the right suture, the direction of the connecting block is adjusted, so that the pressure of the left suture and the right suture acting on the connecting block 6 is consistent with the wedge-shaped direction, when the pulling force is increased, the matching between the clamping block 603 and the U-shaped block 601 is tighter, and the friction force is larger.

The bracket 2 comprises a sponge cushion layer 201, a supporting layer 202 arranged above the sponge cushion layer 201 and supporting blocks 203 arranged on the supporting layer 202, and two ends of the tightener 4 are erected on the corresponding supporting blocks 203. Sponge cushion 201 directly contacts with the skin, cushions the longitudinal pressure of whole device to skin tissue, avoids the damage, and supporting layer 202 then adopts hard material.

An intradermal stretching method, comprising the steps of:

s01: the needles 15 of the left suture 7 and the right suture 5 are respectively held by a needle holder, and are inserted into the skin surface layer and withdrawn from the skin deep layer.

S02: after the needle is withdrawn, cutting off the suture from the 2mm position of the rear side of the suture needle 15 to remove the suture needle, respectively connecting the left suture 7 and the right suture 5 with the connecting block 6, and respectively placing the two brackets of the distractor at the two sides of the wound edge; the outer shell of the tightener is of a flat rectangular structure, the thickness of the outer shell is about 5mm, and the tightener has certain length and can gather the upper edge of the suture below the passage to achieve the effect of gathering the suture.

S03: the connecting plates 8 of the left and

right sutures

7, 5 are threaded from the lower end of the tightener 4, so that the ratchets 9 on the two connecting plates 8 are respectively matched with the corresponding anti-back teeth 11.

S04: when the distance between the two sides of the wound edge needs to be adjusted, a tool (such as a pliers and the like) is utilized to clockwise rotate the rotating shaft 3, the gear teeth 13 drive the connecting plate 8 to move upwards, and the left and

right stitches

7 and 5 are tightened, so that the skin on the two sides of the wound edge is tightened and is under proper traction force; if the connecting plate 8 is passed out from above the tightener 4, the exposed excess portion is subtracted.

S05: rotating the rotating shaft at regular intervals (such as 2-3 days according to actual conditions), gradually tightening the skin at the wound edges at two sides, and changing the dressing regularly every day.

S06: and when the skin at the two sides of the wound edge is tightened to a distance less than 1cm, continuously pulling for required time to enable the skin at the two sides of the wound edge to be loose, cutting off the suture line by using scissors, and removing the distractor.

After the device is removed, the tension of the wound edge is obviously loosened, and the skin at two sides is sutured and fixed by adopting the principle of suturing the plastic outer side intradermal and/or subcutaneous tissues at the moment, and the dressing change and the thread removal treatment are carried out at proper time. The operation is ended.

Based on clinical actual needs, the invention creatively designs the skin retractor with the intradermal route, effectively fixes subcutaneous tissues at two sides, avoids the damage to the surface skin and can gradually reduce the wound surface. The traction fixing device has definite traction fixing effect, avoids the damage effect of an external distractor on skin, reduces the scar formation, is obviously different from the existing traction devices, is simple to operate, can effectively shorten the healing time, and has strong practicability.

The above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.

Claims

1. An adjustable skin stretching device used in the skin is characterized by comprising a bracket (2) erected on the skin (1), a tightener (4) arranged on the bracket (2), a left suture (7) and a right suture (5), wherein one end of the left suture is connected with the tightener (4), and the other end of the left suture is connected with a connecting block (6) after penetrating through the skin (1);

the tightener (4) comprises a shell, a middle plate (10) arranged in the shell and anti-back teeth (11) respectively arranged on the left side and the right side of the middle plate (10);

the upper ends of the left and right sutures (7, 5) are respectively provided with a connecting plate (8), the lower ends of the left and right sutures are connected with a suture needle (15), the connecting plates (8) of the left and right sutures (7, 5) are respectively arranged at the left and right sides of the middle plate (10), and the connecting plate (8) is provided with ratchets (9) matched with the anti-withdrawal teeth (11); the ratchet (9) is matched with the anti-back teeth (11) to limit the connecting plate (8) to move downwards.

2. The intradermal adjustable skin retractor of claim 1 wherein a mounting plate (16) is disposed between the anti-back tooth (11) and the middle plate (10), the anti-back tooth (11) is disposed longitudinally on the mounting plate (16), and a return spring (17) is disposed between the mounting plate (16) and the middle plate (10).

3. The adjustable intradermal skin retractor of claim 1 further comprising a lifting device for lifting the connecting plate (8) upward, the lifting device comprising a shaft (3) traversing the housing of the retractor (4) and a gear (12) disposed on the shaft (3), teeth (13) of the gear (12) cooperating with the ratchet teeth (9), the shaft (3) rotatably disposed on the bracket (2).

4. An adjustable intradermal skin retractor according to claim 3 wherein the gear (12) is located in the housing of the retractor (4) between the anti-back teeth (11) and the connecting plate (8).

5. The adjustable intradermal skin retractor of claim 1 wherein the connecting block (6) comprises a U-shaped block (601) having a U-shaped longitudinal section and a block (603) disposed in and engaged with the U-shaped block (601), a first through hole (602) is disposed on a side wall of the U-shaped block (601).

6. The adjustable intradermal skin retractor of claim 5 wherein the horizontal cross-section of the connecting block (6) is wedge-shaped, and the shape of the latch (603) is adapted to the shape of the connecting block (6).

7. The adjustable intradermal skin stretching device of claim 1, wherein the holder (2) comprises a sponge cushion layer (201), a support layer (202) disposed above the sponge cushion layer (201), and support blocks (203) disposed on the support layer (202), and both ends of the tightener (4) are mounted on the corresponding support blocks (203).

8. The adjustable intradermal skin retractor of claim 3 wherein a flattened portion (14) is provided on the shaft (3).

9. An intradermal stretching method is characterized by comprising the following steps:

respectively clamping a sewing needle (15) of a left suture (7) and a right suture (5) by using a needle holder, inserting the needle from the surface layer of the skin, and withdrawing the needle from the deep layer of the skin;

after the needle is withdrawn, cutting off the suture from the rear side of the suture needle (15) to remove the suture needle, respectively connecting the left suture (7) and the right suture (5) with the connecting block (6), and respectively placing the two brackets of the distractor at the two sides of the wound edge;

connecting plates (8) of the left and right sutures (7, 5) are penetrated from the lower end of the tightener (4), and ratchets (9) on the two connecting plates (8) are respectively matched with corresponding anti-back teeth (11);

when the distance between the two sides of the wound edge needs to be adjusted, the rotating shaft (3) is clockwise rotated by using a tool, the connecting plate (8) is driven to move upwards through the gear teeth (13), and the left and right sutures (7 and 5) are tightened to tighten the skin on the two sides of the wound edge;

the rotating shaft is rotated at regular intervals, and the skin at the wound edges on the two sides is gradually tightened.

10. The intradermal distraction method of claim 9, wherein: