CN1438904A - 腹部创口敷料 - Google Patents
腹部创口敷料Info
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- CN1438904A CN1438904A CN01811992A CN01811992A CN1438904A CN 1438904 A CN1438904 A CN 1438904A CN 01811992 A CN01811992 A CN 01811992A CN 01811992 A CN01811992 A CN 01811992A CN 1438904 A CN1438904 A CN 1438904A
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Abstract
创口特别是腹部创口暂时封闭用的系统和方法,可便于经创口再进入、最终封闭和长期的治愈。这里说明一种腹部创口敷料和使用方法,它能将负压力施加到创口位置上促进痊愈,同时还能限定粘结的形成,防止敷料被移去。该敷料包括一层多孔的泡沫材料(36)被封闭在两张弹性体材料(38)的膜片之内,在膜片上制有多个合适布置的孔(34)。多层多孔的泡沫材料也可使用。在一层泡沫材料(12)上设有一个吸管连接器(16)用来连接到负压力源。至少有一层泡沫材料被封闭在弹性体材料内并被放置得与敞开创口内的组织直接接触。液体被负压力抽走通过位在弹性体封套内的孔并通过泡沫材料。如果采用多层,那么下层泡沫材料具有较细的孔,而上层泡沫材料的孔较粗。有一胶粘的弹性体膜片(10)覆盖整个创口敷料,并将其周边密封环绕创口的皮肤上。有一合适的真空器件被连接到吸管连接器上。
Description
本发明一般地涉及用来治愈由伤害或手术造成的创口的方法和器件。更具体点说,涉及的方法和器件可用来使敞开创口如腹部创口的治愈更为容易,其优点为可先暂时封闭,以后在最终封闭之前可再打开。
目前在防止手术后感染方面已取得长足进展。但对接受多种手术特别是腹腔手术的病人的手术后治疗仍旧要靠再次进入腹腔的能力来加强,目的是要查找腹膜炎和其他感染,它们常会阻止创口和内部器官的最终痊愈。虽然最佳的结果是没有手术后感染或任何其他并发症,但这时并发症经常会发生,由此导致现在通用的操作是先将创口暂时封闭,以后再进入创口,目的是清洗腹腔并治疗并发症,并发症必须在最终的或确定的封闭之前治疗好。
在授予Neumann等人的题为外科手术的封闭的US专利5,437,683号中关于背景的说明谈及的内容被本文参考引用,其中综述了与腹部手术有关的各种并发症和腹腔的术后清洗过程。Neumann等人讲授一种多少有些复杂的解决方法,即用柔顺的织物或片状固定件覆盖创口,造成一个可再进入的创口封闭,其上设有一根吸管向外伸出到一根较大的可密封的管内,通过该管可在最终封闭之前根据需要再次进入。
关于腹部手术后的术后暂时封闭还有许多其他技术曾被说明。研究这些技术能够建立目标判据,使用该判据可以判断各种建议的暂时封闭模式的合用性。
一个合适的暂时封闭应该简单、容易敷设、有效地容纳腹部内含物、最小地干扰腹部器官和周围组织、如果多少有一点,也要最小地促使粘结和瘘管的形成、并促使过程向确定的封闭进行。
许多现有的暂时创伤封闭方法有一个共同的问题即在组织和与创口接触的材料之间会形成粘结。这种粘结是不希望有的,会使准备创口最终封闭位置的过程复杂化。放置多孔的材料如纱布、手术巾、甚至开口泡沫材料使与敞开创口位置直接接触会进一步使最终封闭复杂化,因为表面面积的增加会促进粘结的形成,从而使除去这种材料甚至更为困难。
在创口位置上保持负压力而不造成使暂时创口覆盖材料拿掉较为困难的条件显然是有利的。采用合适的多层创口覆盖物既可便于施加负压力又可便于最后除去渗出的液体。为了清洗创口,这种覆盖物可再次进入而不伤害创口位置,对敞开的腹部手术创口将是最有利的,这种器件和技术也可用于其他型式的、治愈过程有困难的创口。
因此显然需要有一种创口覆盖物和治疗处置系统以资施加治疗的负压力而对敞开的创口位置不会增加有害的副作用。目前还不知道有这种创口覆盖物或处置系统。本发明的目标就是要填补这种需要。
本发明的一个目的是要提供一种多层创口敷料用来作为敞开创口的暂时覆盖物并允许施加负压力以资从创口除去渗出的液体。
本发明另一目的是要提供一种创口敷料,该敷料可施加负压力以资除去从创口位置出来的液体使创口容易痊愈,并可在创口敷料和在其下的组织之间尽量减少粘结的形成。
本发明另一目的是要提供一种创口敷料,该敷料可施加负压力以资除去从创口位置出来的液体,这样在创口敷料和在其下的组织之间就不会形成粘结,同时还设有多孔的介质使渗出的液体可通过该介质流出而不会被过分堵塞致使负压力的效果降低。
本发明还有一个目的是要提供一种腹部创口敷料,该敷料用作敞开腹部创口的暂时覆盖物并可施加负压力以资除去从创口渗出的液体,同时又可容易地从创口位置撤走为的是可重复进入胸腔以便进行清洗及/或治疗。
上述这些目的本发明都可达到。本发明提供一种腹部创口敷料及其使用方法,可以施加负压力,促进创口位置痊愈,同时限制粘结的形成,以免妨碍敷料的去除。
按照本发明的一个方案,所提供的可除去的创口封闭物包括一个能透液体的多孔垫用来放置在创口上或创口内,该多孔垫为一具有许多互连细胞的聚合物泡沫材料和一张在其表面具有多孔的柔韧的塑料薄膜,该塑料薄膜与多孔垫的表面接触,使在使用时塑料薄膜位在创口的表面和多孔垫之间;及一张不透液体的薄膜盖布用来放置在多孔垫之上,该薄膜盖布有一胶粘的周边可用来密封创口周围的皮肤区域;和通过薄膜盖布伸出并在流体上与多孔垫连通的连接设施以便用来与负压力源连通,从而促使从创口渗出的液体流动。
在柔韧塑料薄膜内的孔应只构成与创口接触的薄膜面积的一个足够小的部分使纤维组织的生长到敷片内受到限制。这样薄膜就不会粘结创口上而较易被取下。最好薄膜内的孔应构成小于10%、特别是小于5%、或甚至1到2%或更小的薄膜的有效面积。形式为狭缝或槽的开口较好,因为它们构成薄膜面积的一个极小部分。
切口或槽的长度典型地可为0.5到2cm如1到1.5cm并可排列对齐以10到40密耳如20到30密耳(千分之一英寸)的间隔隔开。
柔韧薄膜应足够坚韧以便保持其形状。合用的材料为30到80微米如40到60微米厚的塑化聚氯乙烯。
使用时薄膜被修切成能覆盖创口边的尺寸,而能吸收的聚合物泡沫材料如网状聚氨酯泡沫材料被修切成这样的尺寸使它能配装在创口的边界之内。修切的泡沫垫被放置在切开的薄膜上使薄膜的边缘延伸到泡沫材料的周边之外例如约20到80mm、较好为40到60mm、典型为约50mm。弹性体薄膜状材料的手术盖布被放置在泡沫垫和柔韧塑料薄膜之上将它们包住并在创口敷料上制成气密性密封。有一吸管式连接器被安插通过手术盖布延伸到聚合物泡沫材料内或其十分接近处。吸管式连接器被密封到手术盖布上,由于吸管或连接器被连接到一个负压源上使在盖布之下的空间能被维持在一个低于大气的压力上。较好的吸管连接头曾在GB专利2329127号和US专利6216701号中说明过,它们所公开的内容被本文具体参考引用。
手术盖布在传统上包括一个薄的弹性体膜,在其一侧全部涂覆着发粘而压敏的胶粘剂。通常有一用隔离剂处理过的保护片与胶粘表面接触,正好在使用前将该保护片剥落,便可露出胶粘表面。就本发明而言,胶粘弹性体膜和保护膜的组合件被切割成所需尺寸(如果合适的话,在剥落保护片之前),还制出一个吸管或连接管用的孔。
合适的弹性体膜包括聚氨酯和聚丁二烯。商业上供售的手术盖布包括3M公司以商标“Tegaderm”投放市场的那些盖布。
泡沫材料可包括多个层次。在泡沫材料的上表面上设有一个吸管插口或连接器用来连接到一个负压力源上。除了采用一张与创口接触的柔韧的塑料片和一个分开的聚合物泡沫材料部分外,也可用下法来取代,即将泡沫材料封闭在一个塑料薄膜的封套内。在这实施例中,塑料薄膜可具有弹性体的性质,并且薄膜不需延伸到泡沫材料周边之外。但方便的做法是薄膜设有延伸到泡沫材料周边之外的突缘,如伸出约20到80mm,较常见的为约40到60mm,典型的为约50mm。合用的弹性体薄膜材料与手术盖布所使用的材料类似,包括聚氨酯、聚四氟乙烯、或聚丁二烯薄膜。最好弹性体膜的厚度从约30到70微米,特别是40到60微米,典型的约为50微米。数个不同尺寸的聚合物泡沫材料条被切割、成形并封闭在一个弹性体膜材料的封套内。可以方便地使用超声波或热焊接来焊接薄膜以形成封套。通常胸部创口大致为椭圆形,泡沫垫最好也是椭圆形。泡沫垫的典型尺寸对长轴约为280、320和380mm,对短轴约为140、175和250mm。聚氨酯泡沫材料的厚度从约5到10mm,例如约6mm,比较合适;细孔尺寸每英寸约为30到50孔,以40孔为较好。聚醚泡沫材或聚乙烯醇泡沫材料可替代使用。如果使用多层泡沫材料,那么不同层可使用不同的泡沫材料。例如与下薄膜接触的一层可以是聚乙烯醇泡沫材料而上泡沫层可以是聚氨酯。
在多层的实施例中,至少一个下层泡沫材料可被封闭在弹性体材料内并被放置得与敞开创口内的组织直接接触。在另一个实施例中,只使用单层泡沫材料,而将含有该单层泡沫材料的弹性体材料的封套放置得与敞开的创口直接接触。
液体被负压抽出通过柔韧膜或弹性体材料内的孔,然后通过泡沫材料。在多层实施例中,液体被负压抽出后通过位在弹性体封套内的孔,通过泡沫材料的下层,再通过弹性体封套内的孔,然后通过被放置在包封的下层之上的泡沫材料的上层。
在多层实施例中,泡沫材料下层可具有较细的孔,而上层的孔可较粗。在本发明所有的实施例中,都有一胶粘的弹性体片如手术盖布覆盖整个创口敷料并密封创口周围皮肤的边缘。一个适当的真空器件被连结到吸管插口式连接器上以资提供治疗用的负压。
图1为本发明第一实施例的器件的剖视图示出使用一个封套内的单个泡沫层和一个叠置在其上的第二泡沫层的组合。
图2为与图1相似的本发明第二实施例的剖视图示出使用在一个封套内的双重泡沫层。
图3为包括一张柔韧片和一个在其上的泡沫层的第三实施例。
本发明适宜结合那些在术后需要重复进入腹腔的外科手术使用。本发明的目标为提供一个可移走的有益的敷料使创口的痊愈及其最终的封闭容易进行。
参阅U.S.专利申请08/951,832号以及USSN 09/078,223和GB专利2307180号(WO 94/20041和WO 97/18007),可以看到有关适合产生敷料结构所需真空的负压系统和治疗方法的说明。这些文件所公开的内容被本文参考引用。负压在本文中被定义为小于1个大气压的真空。上述文件还说明负压的控制及渗出液体的收集和处理。结合本文所说敷料结构使用这种系统的方式对本行业具有一般技能的人员来说是容易明白的。
参阅图1中本发明的第一实施例,单一的下泡沫层被用在敷料的创口接触层内。图1和图2都是本发明的敷料的部分分解图。实际使用时泡沫层和弹性体中介片都是紧密接触的,有时互相密封。
图1所示的完整的创口敷料10包括上泡沫层12和下泡沫层36。下泡沫层36被包封在两张弹性体材料的膜片38内。弹性体片38可较好地由聚氨酯膜构成,这种材料可提供必需的强度和与创口直接接触所需的弹性。另一种合适的材料为聚四氟乙烯(PTFE)。弹性体片38在其周边上被密封,例如用焊接或胶粘以环绕下泡沫层36的方式。弹性体片38可阻止创口粘结的形成,因此适宜被放置成与创口内的组织表面和创口周围直接接触。
将这种无孔隙的薄膜材料与创口接触而不是使用开孔泡沫材料或网格材料可大大减少粘结的发生,这种粘结经久时会使敷料难以卸除或造成危险。柔顺易弯曲的下层封套容易插入到创口之上及/或之内。下层包封根据需要可被放置在创口之上使该层的边缘与创口周围的皮肤接触,或者较好是插入到创口之内使下层包封的上表面暴露在创口之上。
整个创口敷料10一般有一扁平的轮廊如图2和图3中的横截面所示。敷料的形状可根据要被敷设创口的大小和形状而有显著的变化。尺寸约为8英寸乘8英寸到18英寸乘18英寸的长方形或正方形可适宜用于上述腹部创口。而其他尺寸和形状如圆形、卵形或长圆形可对其他型式的创口合适。卵形成椭圆形泡沫条的典型的厚度和平面尺寸已在上面给出。这个基本结构可容易地用其中一种或其他的形状和大小来实现。
弹性体片38在其形成的封套的上壁28和下壁30内设有多个孔32和34。这些孔的长度、直径或最大尺寸可约为30mm(
英寸)到6mm(英寸)并且可按25到75mm(1英寸到3英寸)的中心距分布在所形成封套的表面上。最好这些孔为狭缝或槽形。这些孔的位置可与定位并通过下泡沫层的孔关联,下面还要较详细地说明。设在泡沫材料内的孔可具有不同的大小和形状。
下泡沫层36最好由聚氨酯构成,具有高度的网状结构和在抽吸时的良好透水性。具有至少90%、较好为95%的互连细胞的泡沫材料是比较好的。最好泡沫材料每英寸具有20到60个细孔。最好聚氨酯泡沫材料这样制备:在有水存在的条件下用二异氰酸甲代亚苯酯与亲水的聚醚多元醇反应,反应时释出的二氧化碳提供气态的发泡剂。细孔的大小可由温度和搅拌来控制。将泡沫材料保持在泡沫初始形成的室内、使发泡剂进一步膨胀以致裂开细胞壁可增强网状的形成。
如上所述,下泡沫层36上制有许多孔,这些孔完全通过该泡沫层从上表面一直到下表面。从它们相对于弹性体封套内的孔32和34的放置而言,它们形成许多“汲水井”,从创口渗出的液体可通过它们被抽出。在弹性体封套36下表面内的孔34可直接定位在泡沫层36的孔上。
在弹性体封套38上表面内的孔的定位最好不与泡沫层36内的孔和封套38下表面30内的孔对齐。这样,液体就被抽吸(用适当的负压),从创口吸入到封套38下表面30的孔内并进入到下泡沫层36的“汲水井”孔内,液体然后被抽吸到下泡沫层36的各个细胞内而被分散,一直到它们被再次抽吸通过封套38上表面28内的孔。因此将下泡沫层/封套放置在创口上或之内要求将这些孔适当地定向如图所示。
在现有技术中遇到的一个问题是液流会由于介质的堵塞而呆滞,而该介质是渗出的液体和伴随的废屑所必须流动通过的。这个液流被抽向负压源,因此堵塞最容易在直接通往真空源的路径上发生,在本例为吸管,本发明能将真空分散使液流不受位置的限制。泡沫层和在弹性体片内间隔开的孔可提供这个分散。即使没有泡沫层插入,偏置的孔也可完成这个目的。在图1和图2中的箭头示出渗出的液体通过敷料的流动。
上泡沫层12提供将真空分散的初始机制而真空被用来从创口中抽出液体。在图1所示的优选实施例中,上泡沫层12为一较粗的以聚酯为基的或聚氨酯的泡沫材料具有比下层聚氨酯泡沫材料更大的刚度。例如下层泡沫材料36每英寸可具有的细孔约为较粗的泡沫层所具有的1.5到2倍。典型的情况,粗泡沫层每英寸可具有20到30个细孔。上泡沫层12应多少不易弯曲,以资即使在较强负压的影响下仍能保持其形状。上泡沫层12被放置得与含有下泡沫层6的弹性体封套38的上表面28直接接触。还有弹性体盖布14覆盖上泡沫层和敷料的其余部分,该盖布在优选的实施例中是用与弹性体封套38相同型式的聚氨酯膜制成的。
盖布14为一单片被切割成足够大可完全覆盖上泡沫层12和创口位置周围皮肤的增添区域。在盖布14的至少周边上涂敷有压敏胶粘剂如永远发粘的丙烯酸胶粘剂以资在皮肤上造成气密的密封,有效地封闭敷料和在其下的创口。
连接器16被定位在盖布14内一个切出的孔上并用密封补钉22固定在其上。密封补钉22在本优选实施例中为圆形,胶粘在连接器16底上的突缘部和盖布14上。这样,当一合适的抽吸管线被连结到定位在连接器16上的连接管上时,就可在上泡沫层12内造成一个负压。突缘部20可具有一个制有沟道的下表面能将从多孔垫出来的液流导向连接器的管状部18。合适的抽吸头连接器曾在GB 2329127和US6216701(WO 99/13793)中示出。
本发明另一个实施例在图3中画出。在这实施例中,操作原理完全相同,只是该敷料只由单个泡沫层构成,在无孔隙薄膜内的泡沫层被免除。使用的泡沫材料为黑色的开孔聚氨酯,目前已商品化成为受让人的V.A.C产品。
参阅图3一张半硬性塑料的柔韧片例如由塑化聚氯乙烯制成的被放置与创口接触使其修切的边缘配合创口的壁。在片上制有最好为狭缝或狭槽的孔34。有一网状泡沫塑料被放置在片38的顶上。有一抽吸头连接器16的突缘部被放置得与泡沫垫的顶表面接触,还有一盖布14被放置在泡沫垫和片38之上将敷料密封在创口上。
还可以不是提供一个分开的密封补钉22将连接器密封在敷料上而是用手术盖布的一部分来替代补钉如在GB2,329,127和US 6216701中所示。
本发明的敷料结构可被应用在与各种不同创口型式有关的多种情况下。在敞开腹部创口的情况下,含在弹性体封套内的下泡沫层可被定位在创口内,其周边可能在腹壁的筋膜和腹膜之下延伸。然后上泡沫层可被切割成合适的大小以便定位在下层包封的上表面上。盖布连同合适定位的插口于是可被放置在上泡沫层和创口之上,在创口周围的皮肤上延伸2英寸或更多并用胶粘将敷料保持在位。如上所述应用一条抽吸管线可以抽吸在创口上的整个敷料,借以促使溢出物流动通过敷料。
上、下泡沫层的厚度部分取决于将敷料放置在位时希望它有一扁平轮廊的愿望。在优选的实施例中,较为刚性的上泡沫层的厚度在未被压缩的情况下可约为25到75mm(1英寸到3英寸)。在结合创口抽吸和类似情况而正常使用的负压力下,其刚度应能限制压缩到80%-90%。较柔顺的下泡沫层当使用时其厚度应约为5到15mm,例如为5到10mm(约到
英寸)使它能容易地插入到创口内。
当敞开的创口没有关联到一个内部空腔或类似物时,本发明的结构同样可被用在皮肤的表面上。在这种情况下,弹性体下包封的周边可接触创口周围的皮肤。这样也是可以的只要盖布的周边能将合适地延伸到下封套之外的上泡沫层覆盖住,然后粘结到皮肤上,将敷料密封即可。因此可以明白,下弹性体封套可被预制成多种形状和大小,而上泡沫层和盖布可在将敷料放置到创口上时被切割成合适的大小和形状。
图2显示本发明另一个优选的实施例,其中图1所示的单一下层泡沫材料被双层泡沫材料取代。在这实施例中,弹性体封套38将第一下泡沫层40和第二下泡沫层42封闭在内。这个配置的优点在于在两个泡沫层中散布的孔被偏置定位。刺穿弹性体封套38下壁的孔34仍然被定位得与在第二(底)泡沫层42内定位的“汲水井”孔对准。而刺穿弹性体封套38上壁28的孔32如上所述,不与封套下表面内的孔34对准而偏置,但与定位在第一(顶)泡沫层40内的“汲水井”孔对准。在这结构下液流进一步被分散,这样便可减少堵塞废屑的局部化而可延长敷料的有效寿命。敷料的其他构件、用途和使用方法和上面结合图1所说明的相同。
本发明已就某些优选实施例进行说明。本行业的行家当可对本发明作出可替代的实施例和进一步的应用而不离开本发明的基本构思和原理。某些材料曾被说明对特定的泡沫层和薄膜合适,但多种类似的材料也同样合适。某些形状和尺寸曾被说明特别适用于敞开的要重新进入的胸部创口,但这些形状和尺寸只是代表性的,并不能用来限制本发明。因此本发明的范围并不限于上面的说明,而受所附的权利要求书清楚限定。
Claims (18)
1.一种能除去的创口封闭物,包括一个能透液体的多孔垫,用来放置在创口上或创口内,该多孔垫为一具有一些互连细胞的聚合物泡沫材料和一张在其表面上分布有多个孔的柔韧的塑料薄膜,该塑料薄膜与多孔垫的表面接触,使该塑料薄膜在使用时安置在创口的表面和多孔垫之间;及一张不透液体的薄膜盖布,用来放置在该多孔垫上,该薄膜盖布有一胶粘的周边,可用来密封创口周围的皮肤区域;和通过该薄膜盖布伸出并与多孔垫保持流体连通的连接设施,以便用来与负压力源连通,从而促使从创口渗出的液体流出。
2.权利要求1的封闭物,其特征为在柔韧塑料薄膜内的这些孔包括一些狭缝或槽。
3.权利要求1或2的封闭物,其特征为该柔韧塑料薄膜为弹性体薄膜材料。
4.以上权利要求中任一项的封闭物,其特征为该连接设施包括一个安置在该薄膜盖布和多孔垫之间的突缘部,及一个通过该盖布伸出的管状部,用来连接到负压力源。
5.权利要求4的封闭物,其特征为该连接设施的突缘部包括一些沟槽,用来将从多孔垫出来的液流导向该管状部。
6.以上权利要求中任一项的封闭物,其特征为第二张柔韧薄膜安置在该薄膜盖布和多孔垫之间,所说第二张柔韧薄膜的周边被密封到第一张柔韧薄膜的周边上,形成一个封套,并且第二张柔韧薄膜上制有一些孔,使当该连接设施被连接到负压力源上时,创口渗出液能通过该多孔垫再通过第二柔韧薄膜内的这些孔被抽出。
7.权利要求6的封闭物,其特征为这些柔韧薄膜的周边被密封在一起,形成接合薄膜的一个突缘,该突缘向外延伸,超过该多孔垫的周边。
8.权利要求6或7的封闭物,其特征为第一柔韧薄膜内的孔相对于第二柔韧薄膜内的这些孔是偏置的。
9.权利要求6到8中任一项的封闭物,其特征为第一柔韧片内的这些孔与多孔垫第一邻接部内的一些孔对准,而第二柔韧片内的这些孔与多孔垫第二邻接部内的一些孔对准。
10.权利要求9的封闭物,其特征为该多孔垫包括两层或多层具有互连细胞的聚合物泡沫材料。
11.以上权利要求中任一项的封闭物,其特征为该多孔垫包括具有至少90%互连细胞的聚合物泡沫材料。
12.权利要求6到11中任一项的封闭物,其特征为一个增添的多孔垫被安置在第二张柔韧薄膜和该薄膜盖布之间。
13.一种能移走的创口敷料,特别是敷设在大而敞开的创口上,需要从其中排出液体的敷料,所说敷料包括:
一个能透液体的第一多孔垫,被安置成与创口接触,所说第一多孔垫包括:
一个泡沫垫,为一种以聚合物为基础的泡沫材料,具有一些互连的细胞和多个分散的横向孔;和
一些弹性体薄膜,在其周边上接合在一起构成密封,薄膜上各有多个分散的孔,两张薄膜上的孔分别对准;
一张不透液体的薄膜盖布,用来覆盖所说第二多孔垫和安置在所说创口上的所说第一多孔垫,所说薄膜盖布包括一个胶粘的周边,用来将所说盖布胶粘到创口周围区域的皮肤上;及
一个通过所说薄膜盖布定位并与所说多孔垫保持流体连通的管状连接器,用来连接到负压源上,以便促使从所说创口渗出的液体流出。
14.权利要求13的能移走的敷料,其特征为另外还包括:
一个具有第一和第二两张弹性体薄膜、在其周边上密封在一起并将所说泡沫垫封闭在内的弹性体封套,所说第一张弹性体薄膜内有多个分散的孔,这些孔与所说泡沫垫内的所说分散孔偏离而不对准,所说第二张弹性体薄膜内有多个分散的孔,这些孔与所说泡沫垫内的所说分散孔对准;和
一个能透液体的第二多孔垫,用来放置在所说第一多孔垫上并与它接触,所说第二多孔垫包括一个具有一些互连细胞的聚合物泡沫材料。
15.一种可移走的创口敷料,特别是敷设在大而敞开的创口上,需要从其中排出液体的敷料,
所说敷料包括:
一个能透液体的第一多孔垫,被安置或与创口接触,所说第一多孔垫包括:
一个泡沫垫,为一种以聚合物为基础的泡沫材料,具有一些互连的细胞和多个分散的横向孔;和
一个具有第一和第二张弹性体薄膜、在其周边上密封在一起、并将所说泡沫垫封闭在其内的弹性体封套,所说第一张弹性体薄膜内具有多个分散的孔,这些孔与所说泡沫垫内的所说分散孔偏离而不对准,所说第二张弹性体薄膜内具有多个分散的孔,这些孔与所说泡沫垫内的所说分散孔对准;
一个能透液体的第二多孔垫,用来放置在所说第一多孔垫上并与它接触,所说第二多孔垫包括一个具有一些互连细胞的聚合物泡沫材料;
一个不透液体的薄膜盖布,用来覆盖所说第二多孔垫和放置在所说创口上的所说第一多孔垫,所说薄膜盖布包括一个胶粘的周边,用来将所说盖布胶粘在所说创口周围区域的皮肤上;及
一个通过所说薄膜盖布定位并与所说第二多孔垫保持流体连通的管状连接器,用来连接到负压力源上,以便促使从创口渗出的液体流出。
16.一种对敞开创口、特别是对于手术造成的腹部创口暂时封闭和排液的方法,该创口可能需要重复经其进入到腹腔,所说方法包括下列步骤:
提供一张其内具有多个孔的柔韧薄膜,将该薄膜安置成与创口接触,提供一个多孔垫,其尺寸至少与敞开的创口一般大;
将所说多孔垫放置在该薄膜的顶面上,使所说多孔垫的一个表面部外露;
用一可移走的胶粘的弹性体薄膜将在所说创口内的所说柔韧薄膜和多孔垫密封,所说弹性体薄膜与所说创口周围区域的皮肤接触而被定位;及
提供一个通过所说密封进入到所说多孔垫内的负压力,用来抽出从所说创口内渗出的液流。
17.权利要求16的方法,其特征为多孔垫被包含在一个柔韧薄膜的封套,该薄膜在多孔垫的周边被密封,并且形成所说封套的上、下表面,每一表面上有多个孔,而所说方法包括下列步骤:将所说封套安置成与创口接触,使用一个可移走的胶粘的弹性体薄膜将该封套密封在创口内,所说弹性体薄膜被定位在所说封套上,并与创口周围的皮肤接触,然后通过该密封施加负压力。
18.权利要求17的方法,其特征为一个第二多孔垫被放置在所说封套上,再将该胶粘的弹性体薄膜放置在该封套和第二多孔垫上,构成密封。
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