CZ2020391A3 - A wound dressing for placing a therapeutic agent at a chronic wound treatment site - Google Patents

Abstract

The present invention provides a wound dressing for placing a physical energy-producing therapeutic agent at a chronic wound treatment site, the dressing comprising a biologically active, nanofiber wound dressing (1) (5), a collagen plate (4) and a hydrogel (6). The biologically active, nanofiber cover (1) of the wound (5) is provided with at least one opening (2) for placing a therapeutic agent producing physical energy on the opening (2), a collagen plate (4) being arranged under the biologically active, nanofiber cover (1) surrounded by a hydrogel (6). The biologically active nanofiber cover (1) can be provided on its edges with a nanofiber hydrophilic nonwoven fabric (3) at the bottom. The therapeutic means for producing physical energy is preferably an ultrasonic head for the application of ultrasound and / or a light guide for the application of laser radiation and / or a coil for the non-contact application of an induced electric current. The light guide for the application of the laser radiation can be terminated at the end adjacent to the opening (2) by a terminal or a prism or a mirror surface.

Description

A wound dressing for placing a therapeutic agent at a chronic wound treatment site

Field of technology

The present invention relates to a wound dressing arrangement for placing a physical energy-producing therapeutic agent at a chronic wound treatment site, the arrangement comprising a biologically active nanofiber wound dressing, a nanofiber hydrophilic nonwoven fabric, a collagen plate and a hydrogel. The means arranged in this way will enable the application of physical energies stimulating the application of cellular products in order to promote the healing of chronic wounds.

Prior art

The basis of local treatment of a chronic wound is its good cleaning and proper coverage combined with appropriate nursing care. However, the use of supportive interventions through the application of physical energies to support wound healing, especially in conjunction with the application of physical energies that modulate the behavior of healing cells, should be an essential component of chronic wound treatment. Classically, wounds of phlebological etiology are mainly external compression, without which the required wound healing cannot be expected, for example in shin ulcers and lymphovenous complex. Classic treatment with compression bandages or sleeves is already classic, which can be supplemented by intermittent compression wave device therapy (segment press therapy), which must take place in the required way of pressure of individual chambers of limb sleeve and with required pressures or their gradient and pressure wave speed.

Conversely, in patients with ischemic, neuropathic and mixed chronic wounds, often induced by diabetes or ischemic disease of the lower extremities (eg peripheral arterial diseases), the main cause of trophic defect is a circulatory disorder, which can be favorably affected by physical interventions. vacuum-compression therapy. However, if the chronic wound seeps and shows an increased risk of systemic complications, it is advisable to apply the method of local vacuum therapy (VAC, Vacuum Assisted Closure), sometimes also referred to as Negative Pressure Wound Therapy. This method is widespread especially in surgery in the treatment of complicated postoperative wounds. In this method of treatment, the wound is covered and closed with a foam cover, through which a vacuum of about 125 mmHg is applied. Exudate and infectious material are thus effectively removed from the wound, the risk of maceration and further development of wound contamination is reduced, local swelling is reduced and vasodilation is promoted. The result is support for the healing process, contraction of the wound edges and its faster closing.

Regarding the assistance and intervention of wound healing through selected physical stimuli, ultrasound wound debridement is basically known and used. Devices for this form of wound treatment are manufactured, for example, by the German company Söring, which specializes in ultrasound and high-frequency electrical surgery, for example according to U.S. Pat. No. 6,916,296 B2.

Another system, called MIST Therapy, uses ultrasound to generate salt spray, which is blown onto the wound with some mechanical energy generated by the ultrasound, from which the manufacturer promises a disinfecting and healing effect and, in part, the necessary debridement.

Canadian Patent CA 2900213 introduces a cavity for placing a contact gel and a system for automatically transferring it to the head of an ultrasound device in contact with a treated surface of a patient's body.

A similar problem is addressed in U.S. Pat. No. 4,484,569 A, which discloses, inter alia, a truncated pyramid focusing head with a concave ultrasonic transducer located in a circular pyramid base focused on a small circular membrane at the tip of the pyramid, the resulting cavity being filled with a suitable fluid (water). with a slight overpressure causing

-1 CZ 2020 - 391 A3 convex bulging of the membrane and thus a better transfer of focused ultrasonic energy to the tissues to which the pyramid tip is applied. The described solution can also be used for coagulation and hemostasis. The patent also mentions the solution of ultrasound focusing using acoustic mirrors, dielectric mirrors, telescopic extensions connected to transducers with a concave radiating surface, the possibility of using phase shifts of waves of several sub-transducers, most often annulus, placed concentrically.

The use of ultrasonic amplification waveguides (sono-amplifiers, sonicators) in medicine and industry is based on the need to amplify the ultrasonic waves produced by the converter and the introduction of such amplified ultrasonic waves at the application site. For this purpose, cylindrical extensions firmly connected to the transducer are used, the diameter of which decreases so that the end of the waveguide amplifier has a smaller diameter than the diameter of the waveguide at its point of contact with the transducer and whose length is equal to the wavelength of the transmitted ultrasonic waves. Depending on the shaping method, exponential, stepped, conical and cylindrical sonicators are distinguished. The gain is given by the ratio of the initial and final cross-sections of the waveguide. A special type is the Fourier sonicator.

U.S. Pat. No. 2010022889 A1 discloses placing an ultrasonic applicator on a patient's body surface by means of a flexible two-piece attachment into which a vacuum is applied, thereby inserting the two applicator parts together and pressing the ultrasonic transducer face against the patient's body surface. it also ensures the smooth introduction of the required amount of gel forming the necessary thin layer between the front of the transducer and the surface of the patient's body. However, this application does not address the issue of locating the ultrasound applicator at one site of the patient's body (static application), which is associated with the risk of damaging those tissue sites exposed to wave oscillations, while nodal sites are not treated with ultrasound.

International patent application WO 2008002773 A2 is directed to the treatment of wounds, which describes the solution of a head with an ultrasonic transducer, on which a funnel-shaped attachment (hemisphere) of flexible material is firmly placed, hermetically applied to the wound and filled with saline or other suitable fluid. Ultrasound propagating through this environment has additional intensity to induce borderline cavitation and the chemical (via radicals) and mechanical action of cavitation on the wound surface ensures its debrediment and supports its healing.

U.S. Pat. No. 9,498,850 B2 combines the therapeutic effects of ultrasound and light, with light being introduced from the sides into a light-transmitting optically refractive plate, the edge of which has the shape of a truncated cone, thus ensuring light transmission from the sides of the plate to its surfaces. This plate is placed under the transducer, from which the light is reflected, so that all the light radiation travels together with the ultrasonic waves produced by the transmitter (transducer) into the body, on the surface of which the light-conducting plate with the attached ultrasonic transducer is placed. The light guide plate must be made of a material with a suitable acoustic impedance.

Supportive intervention of chronic wound healing is achieved not only by ultrasound, but also by application of non-destructive laser or electric currents applied as, less often, contact (using electrodes) or more often, non-contact (using time-varying magnetic fields generating induced electric currents or electromagnetic fields) , as well as with the help of other physical interventions. However, the effectiveness of these procedures is often questionable from the point of view of Evidence-Based Medicine (EBM), although it is known that a particularly high-power laser, ie a laser with higher but still non-destructive radiant flux energy, operating in the appropriate wavelength range and with appropriate modulation, can significantly stimulate healing processes. However, for the treatment of chronic wounds, these physical interventions are used only sporadically, rather not at all. The problem is the necessity of laser radiation access to the exposed wound related to the complexity of the application and the required length of the procedure. In addition, the wound should be treated and cleaned prior to the application of laser radiation, as a properly untreated wound surface largely absorbs and reflects laser radiation, thereby minimizing the desired healing stimulus effect in the subsurface compartments of the wound. Applications should be repeated, which can only be ensured when

- 2 CZ 2020 - 391 A3 wound dressings, when, however, it is not usual to apply a laser, moreover in the form of devices not adapted to these forms of use.

For example, U.S. Pat. No. 8,251,982 B2 describes the application of two forms of laser energy of different wavelengths, intensities and time courses in order to synergistically favor both pain and inflammation. At two optimally selected wavelengths, the ability of both biological chromophores (photoreceptive tissue components) in cells and water to absorb energy in electromagnetic quanta is applied.

Similarly, US patent application US 2004010300 A1 applies two wavelengths from two laser radiation sources, one with high power and a wavelength from the NIR region (e.g. Nd: YAG 1064 nm) operating in pulse mode (pulse width e.g. 200 ps) with frequencies of eg 25 Hz, a power density of 8 W / cm ² to 35 W / cm ² , and a second operating in a continuous mode, with a wavelength in the VIS range and less power from the UEUT field (Uow Bevel Baser Therapy, up to 500 to 1000 mW power and with a power density of the order of 1 W / cm ² and the transmitted energy dose of the order of 10 J / cm ² ). The radiant fluxes of both lasers are mixed in a special mixer and led to the head ensuring the necessary defocusing of the beam of common radiation.

Simple low power lasers for home use typically apply a wavelength of 808 nm (or 810 nm) along with 650 nm in the visible red range. In U.S. Pat. No. 6,165,205 A, a wavelength of 980 nm is preferred as most suitable for promoting fibroblast production, stimulating collagen synthesis, promoting angiogenesis, and eradicating microbial invasion. This patent describes the use of a 5 W laser through a submicron or nanofiber wound dressing, where there is sufficient space between the fibers to penetrate the radiant flux of the corresponding power and wavelength into the wound. The patent also introduces a procedure prior to laser application, including debridement and cleaning of the wound, wetting it, and applying a suitable dressing. All this arrangement is considered a condition for the successful implementation of the method for improving wound healing. The choice of a wavelength of 980 nm is considered optimal according to this patent. The energies of shorter wavelength quanta (in vacuum / air) do not penetrate so well into the skin of the attack, quanta with a higher wavelength are again absorbed just at the surface and just below it (eg Nd: YAG 1064 nm, Er: YAG 2940 nm, CO2 10600 nm).

It is obvious that the photoacoustic phenomenon is based on thermal phenomena. The authors of U.S. Pat. No. 6,165,205 A emphasize the discovery of the positive effect of the photoacoustic wave on the structure of hyaluronic acid, and thus on the restoration of cartilage function in the joints. To achieve the desired therapeutic effects, they have created a special laser applicator head that allows you to focus optical radiation into the cartilage area of the joints, using Nd: YAG laser wavelengths of 1064 nm and applying high power up to 3000 W or more with a typical power density of 15,000 W / cm ^2. and a pulse duration in the order of units up to 100 ps. They apply these parameters in a method called HILT (High Intensity Laser Therapy). The device designed according to the above patent is especially recommended for the treatment of osteoarthritis and degenerative cartilage damage, bursitis, synovitis, capsulitis, in the treatment of tendonitis, post-traumatic conditions, edema and hematomas, musculoskeletal pain, enthesopathies, etc.

From the above, it seems that a well-cleaned chronic wound provided with appropriate coverage and supported by the intervention of external physical energy will be successfully treated and will soon heal. Unfortunately, this is far from the case in practice.

The essence of the invention

It is an object of the present invention to provide a new arrangement of individual parts of a wound dressing in combination with therapeutic agents producing physical energy with known effects which allow the application of physical energies stimulating the application of cellular products to promote healing of chronic wounds.

-3GB 2020 - 391 A3

The object is achieved by a wound dressing intended to place a therapeutic agent producing physical energy at the site of treatment of a chronic wound, which comprises a biologically active, nanofiber wound dressing, a collagen plate and a hydrogel. The essence of the present invention is that the biologically active nanofiber wound dressing is provided with at least one opening for placing a therapeutic agent producing physical energy on this opening, a collagen plate surrounded by a hydrogel being arranged under the biologically active nanofiber dressing.

In a preferred embodiment, the biologically active, nanofiber cover (hydrophobic) is provided with a nanofiber hydrophilic nonwoven fabric at its edges from below.

In a preferred embodiment, the physical energy-producing therapeutic means is an ultrasonic head for the application of ultrasound and / or a light guide for the application of laser radiation and / or a coil for the non-contact application of an induced electric current. The light guide for the application of laser radiation can be terminated at the end adjacent to the opening by a terminal or a mirror surface or a prism using total reflection.

The essence of the present invention is to convert a rigid collagen plate, e.g. in the form of a "plate", "target", "lens" or "puck", contained in a hydrogel-filled wound, into a colloidal solution of released collagen fibers by focused ultrasonic energy and / or or energy of laser radiation and / or energy of induced electric current which is sufficient to overcome the forces of hydrogen and other weak chemical bonds and to disrupt the quaternaries and tertiary structure of collagen, or the absorbed energy is large enough to ensure depolymerization, i.e. cleavage of the collagen monomer units by breaking their covalent bonds in the polymer. By the action of focused energy on the solid collagen plate in the state of solid colloidal suspension, ie gel, complexes with lower molecular weight and simpler structure will be formed, which will already represent the state of colloidal solution, so-called sol, from which they will be easily and gradually released. substances derived from the conditioned medium, or the stem cells themselves.

The resulting colloidal solution in the sol state is a viscoelastic substance in which the rate of its deformation increases with the time of constant stress, the so-called thixotropic liquid, which means that with the time of external stress it is still more fluid, its dynamic viscosity decreases from representing a substantially non-flowing gel (dynamic viscosity coefficient above 500 Pa.s or more, eg 500 Pa.s corresponds to solid pastes, 1000 Pa.s already to a solid mass) to values around 100 Pa.s, corresponding to free casting masses, and with advancing the duration of action of the therapeutic agent producing physical energy then up to values around 10 Pa.s, which correspond to physiological fluids (cytoplasm, blood). In this case, for example, ultrasonic energy is supplied with a suitable frequency of 20 kHz to several MHz, which ensures dynamic oscillations of the mechanical pressure action or dynamic oscillations of the external stress acting on the rigid collagen plate. Dynamic oscillations of pressure then cause shear deformations of the gel, which consists mainly of collagen, according to the function:

SM ™ in SMÍM L where:

τ (ΐ) is the time course of the oscillating mechanical stress, it is the maximum stress τ (ΐ), ω is the circular frequency of oscillations, where ω = 2πί, where f is the frequency of ultrasound,

-4GB 2020 - 391 A3 δ is the phase angle expressing the displacement corresponding to the irreversible deformations inside the affected mass.

Thanks to ultrasound and its mechanical oscillating acoustic pressure action, the present technical solution can be used to convert a solid collagen plate (or collagen "target", "lens", "puck") into a liquid sol, formed by macromolecules with degraded quaternary and tertiary structure, or to non-polymerized polypeptides, and with respect to the thixotropic properties of the sol, a further gradual reduction of the dynamic viscosity coefficient of this sol to the level of viscosity of the wound-filling hydrogel or to the level of viscosity of the body fluids themselves, e.g. blood or cytoplasm. This will also gradually release bioactive regenerative factors from the conditioned medium from the stem cells, or the stem cells themselves, which have been seeded in a rigid collagen plate.

Thanks to the suitable acoustic impedance of collagen and its degradable products (acoustic impedance of 1.6 to 1.9 MRayl), however, the ultrasonic waves partially propagate further through the hydrogel, and have a positive therapeutic effect on the wound itself.

Explanation of drawings

The essence of the invention is further elucidated on the basis of examples of its implementation, which are described with the aid of the accompanying drawings, where:

Giant. 1 shows a nanofiber cover in a side view (A) and a perspective view (B);

Giant. 2 shows the individual parts of a nanofiber wound dressing intended for the application of physical energies in a side view (A) and a perspective view (B);

Giant. 3 shows the ultrasonic head on the surface of the nanofiber cover in a side view;

Giant. 4 shows the ends of the light guides on the surface of the nanofiber cover in a side view;

Giant. 5 shows the end of a light guide provided with a prism (A) and a mirror layer (B);

Giant. 6 shows a light guide provided with a prism on the surface of the nanofiber cover in a side view;

Giant. 7 shows exemplary means for applying physical energies in the form of ultrasonic heads and light guide terminals;

Giant. 8 shows exemplary means for applying physical energies in the form of light guides provided with a prism on the surface of the nanofiber cover in a side view;

Giant. 9 shows an exemplary means for applying physical energies in the form of a coil; and

Giant. 10 shows exemplary combinations of all means for applying physical energies.

Examples of embodiments of the invention

The solution of a biologically active nanofiber wound dressing intended for the placement of a therapeutic agent producing physical energy at the site of treatment of a chronic wound will be explained in more detail by means of examples of its embodiment with reference to the respective drawings.

-5GB 2020 - 391 A3

The essence of the solution lies in the connection and specific arrangement of the individual parts of the wound dressing in the order, as can be seen in Fig. 2. In this arrangement, the biologically active nanofiber wound dressing includes:

• Biologically active nanofiber covering 1 of wound 5. This covering 1 is represented by a nanofibrous skeleton, able to be actively used in the healing process as covering 1 of wound 5, as well as as a carrier of cells involved in regeneration processes (e.g. mesenchymal stromal cells (MSC)). This biologically active dressing 1 of the wound 5 is made as a nanofibrous skeleton, e.g. of hydrophobic polycaprolactone (PCL), or a similar hydrophobic polymer, which is suitable for seeding with mesenchymal stromal cells and can be seeded with these cells.

• Nanofibrous hydrophilic nonwoven fabric 3. It is a fabric made of polyvinyl alcohol (PVA) or similar hydrophilic polymer, or a polymeric fabric which has been treated in a known manner, for example by the action of a low temperature plasma in the presence of oxygen or nitrogen to form -OH and - NH2 groups causing increased wettability.

• Collagen plate 4. This is made as a collagen porous-gel plate solid structure, which is saturated with cellular products, especially extracts from living regenerative cells (eg concentrated conditioned medium, or stem cell secretion with bioactive regenerative factors to cell-free therapy support). ). Alternatively, regenerative mesenchymal stromal cells or an extract thereof may be incorporated directly into this collagen plate 4, which may be in the form of a "target", a "lens" or a "puck".

• Hydrogel 6. This fills the wound space, in which both stromal mesenchymal cells (at least 1 million cells per 1 ml) and conditioned culture medium can also be applied.

Fig. 1 shows a biologically active nanofiber cover 1 of a wound 5, which is provided with several openings 2 and is formed by a nanofiber skeleton. The edges of the biologically active nanofiber cover 1 are underlain by a nanofiber hydrophilic nonwoven fabric 3, as can be seen in Fig. 2. This fabric 3 is made of a polyvinyl alcohol (PVA) -based material. This material, from which the nanofibrous hydrophilic nonwoven fabric 3 is made, is intended to prevent undesired ingrowth into the edges of the wound 5 during its healing.

The nanofiber hydrophilic nonwoven fabric 3 is preferably attached to the edges of the nanofiber cover j. By means of an adhesive, for example a fibrin adhesive. The edges of the biologically active nanofiber coating 1 can be rendered hydrophilic without the need to use a nanofiber hydrophilic nonwoven fabric 3 to underpin them, which can be achieved by treating the edges with low temperature plasma by forming -OH or OH on the polymeric fiber molecules in the presence of oxygen or nitrogen. -NH2 groups, causing an increase in wettability.

A collagen plate 4 is inserted in the space above the wound surface 5 and under the nanofiber cover 1, see Fig. 2. This collagen plate 4, preferably collagen, is saturated with cellular products, especially extracts from living regenerative cells. It is typically a concentrated conditioned medium, respectively a stem cell secretion containing bioactive regenerative factors, serving to cell-free therapy. Optionally, sufficiently viable, cultured regenerative mesenchymal stromal cells cultured in a known manner are directly seeded in this collagen plate 4, which may be in the form of a collagen target, lens or puck.

It can be further seen from FIG. 2 that the wound space 5 is filled with hydrogel 6, in which both stromal mesenchymal cells (at least 1 million cells per ml) and the cell-free conditioned medium formed by them can also be used.

-6GB 2020 - 391 A3

Fig. 3 shows an arrangement of a biologically active nanofiber wound dressing, in which an ultrasonic head 7 with an ultrasonic transducer and impedance matching is used to generate physical energy for stimulating stem cells or applying cellular products, which produces ultrasound that is focused in a known manner. Fig. 3 further demonstrates the focusing 8 of the ultrasonic waves through the environment providing impedance matching - and thus the efficient conduction of the ultrasonic waves to the collagen plate 4. In this embodiment, the openings 2, which are formed in the nanofiber cover, can be Additional ultrasonic heads 7 are included. The transducers of the ultrasonic heads 7 focus the ultrasonic waves into the collagen plate 4 through an environment with suitable acoustic impedance, which promotes the release of bioactive regenerative factors obtained from the conditioned medium from the stem cells and incorporated into the collagen plate 4. Thanks to the suitable acoustic impedance of the collagen plate 4, the ultrasonic waves propagate simultaneously through this collagen plate 4 and further through the hydrogel 6 to the wound 5 itself, which it also has a beneficial therapeutic effect.

Another variant of the arrangement of a biologically active nanofiber wound dressing, in which therapeutic means producing physical energy for generating laser radiation are used for the application of physical energies stimulating the application of cellular products, is shown in Fig. 4. In this variant embodiment the openings 2 in the nanofiber dressing 1 are applied to ends 9 of the light guides 11. By means of the light guides 11, the flow of laser radiation 10 of suitable, biologically effective wavelength and time course is propagated into the wound, typical for this purpose by pulsed waveform of high power laser radiation interrupted cyclically by pauses necessary to eliminate undesired thermal effects of laser radiation The high-power laser radiation 10 of suitable wavelengths and high power density passes through the hydrogel 6 and the collagen plate 4 with little attenuation and hits the wound 5. This ensures both the biologically desired effect of the laser radiation 10 on the wound 5 itself and the laser radiation. 10 hydrog element 6 and the collagen of the collagen plate 4, as well as due to the scattering of the laser radiation 10 in these materials, the stromal cells located in this space, in particular in the hydrogel 6, are also stimulated by this radiation.

A certain drawback is that the terminals 9 of the light guides 11 can be difficult to connect to the surface of the nanofiber cover 1 in the perpendicular direction. However, the laser radiation 10 can also be guided in a direction collinear with the surface of the nanofiber cover 1, using total reflection on the prism 12 connected to the light guide 11, as seen in Fig. 5A, or reflection on the polished end surface of the light guides 11 ground below at an angle of 45 ° and provided with a mirror layer 13, as can be seen from Fig. 5B. In the case of a collinearly positioned light guide 11, which is tightly applied and fixed to the surface of the nanofiber cover 1 and which provides by applying total reflection to the prism 12 a perpendicular radiant flux of laser radiation 10 passing through the hydrogel 6 and the collagen plate 4 into the wound 5. stimulates stromal cells in the hydrogel 6 and on the surface of the wound 5, as well as the wound 5 itself, as can be seen in Fig. 6. The laser radiation 10 is diffusely reflected in all passages through the hydrogel 6 and the collagen plate 4 and its interaction with the wound 5. directions, so that it also acts on the underside of the nanofiber cover 1 and stimulates the stromal cells seeded in this nanofiber cover 1.

Regardless of the method of placing the terminals 9 of the light guides 11 or their terminating prisms 12, or their terminating mirror surfaces 13, as well as regardless of the method of placing the ultrasonic heads 7 on the surface of the nanofiber cover 1, it is clear that at each hole 2 in the surface of the nanofiber either the terminal 9 of the light guides 11 or the terminating prism 12 of the light guides 11 or the terminating mirror surface 13 of the light guides 11 or the ultrasonic head 7 can be placed in the cover 1, see Fig. 7. In this way the wound 5 is covered with higher efficiency of laser radiation and ultrasonic field. also regenerative stromal cells introduced into the hydrogel 6 or into the collagen plate 4, and even stromal cells seeded into the nanofiber cover 1.

-7 CZ 2020 - 391 A3

Fig. 7 shows a partial solution representing an arrangement using several ultrasound sources as well as several laser radiation sources on the treated wound 5, where ultrasonic heads 7a, 7b, 7c with ultrasonic transducers, provided with cables for conductors 16a, 16b, 16c of electrical excitation of the converters, the electrical excitation being provided by ultrasonic excitation generators located in a common ultrasound and laser radiation generator 14. Further are provided on other openings 2 in the nanofiber cover 1 the ends of the light guides 9a, 9b, into which the light guides 11a, 11b open, into which a radiant laser flux from laser sources located in a common ultrasound and laser radiation generator 14 is introduced.

Fig. 8 shows an example of the mounting of five laser radiation sources on the openings 2 in the nanofiber cover 1. The light guides supplying the laser radiation are marked successively Ila, 11b, lie, lid, lie. In the example illustrated in Fig. 8, prisms 12a were used as light guide terminals to provide perpendicular transmission of the light flux of the laser radiation 10 into the wound space. 12b. 12c. 12d. 12e.

The light guides 11 or the terminals 9 of the light guides 11 can be placed directly on the nanofiber cover 1 of the wound 5 and by using total reflection on the prism 12 or reflection on the end mirror surfaces 13, the laser radiation 10 perpendicular can be introduced into the space under the nanofiber cover 1 to wound 5.

For the stimulation of stem cells introduced into the hydrogel 6, or embedded in the nanofiber cover 1, possibly also in the collagen plate 4, or also for the stimulation of the own regenerative stem cells located in the wound 5, as well as to achieve other biological effects promoting wound healing 5. in addition to the laser radiation 10 and the ultrasound applied from the ultrasonic head 7, an induced electric current is also applied, which is generated as a non-contact Foucault electric current by means of a coil 15 flowing through a time-varying electric current. The spool 15 is located on the surface of the nanofiber cover 1, as can be seen in Fig. 9.

According to this solution, both the coil 15 and the terminal 9 of the light guides 11 for the application of the laser radiation 10 can be arranged simultaneously on the surface of the nanofiber cover 1, possibly solved by perpendicular introduction of the laser radiation 10 via the prism 12 or the mirror surface 13 as well as the ultrasonic head 7. , even in greater numbers than always one source of a given physical energy, as shown in principle in Fig. 10.

In this way, the simultaneous application of physical energies of induced electric currents, laser radiation 10 and ultrasound to the wound 5 itself is ensured, but also to stromal cells with which the skeleton of nanofiber cover 1 was fitted, as well as to those introduced into the hydrogel 6 or collagen. plates 4, or those present natively in the wound 5. At the same time, the release of bioactive regenerative factors from the conditioned medium introduced into the collagen plate 4 applied to the wound 5 is supported by ultrasonic energy.

Industrial applicability

The above-described arrangement of biologically active nanofiber wound dressings can be used in modern nanofiber and cellular medical technologies in conjunction with physical interventions in the therapeutic focus on wound healing.

Claims (4)

PATENT CLAIMS A wound dressing for placing a physical energy-producing therapeutic agent at a chronic wound treatment site, the dressing comprising a biologically active, nanofiber wound dressing (1) (5), a collagen plate (4) and a hydrogel (6), characterized in that that the biologically active, nanofiber dressing (1) of the wound (5) is provided with at least one opening (2) for placing a therapeutic agent producing physical energy on the opening (2), a collagen plate (1) being arranged under the biologically active, nanofiber dressing (1) 4) surrounded by a hydrogel (6). Wound dressing according to Claim 1, characterized in that the biologically active, nanofiber dressing (1) is provided at its edges from below with a nanofiber hydrophilic nonwoven fabric (3). Wound dressing according to Claim 1 or 2, characterized in that the physical energy-producing therapeutic means is an ultrasonic head (7) for the application of ultrasound and / or a light guide (11) for the application of laser radiation (10) and / or a coil (15). ) for contactless application of induced electric current. Wound dressing according to Claim 3, characterized in that the light guide (11) for applying the laser radiation (10) is terminated at the end adjacent to the opening (2) by an end piece (9) or a prism (12) or a mirror surface (13). .