Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
  • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
  • A61F5/30—Pressure pads
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F13/00—Bandages or dressings; Absorbent pads
  • A61F13/14—Bandages or dressings; Absorbent pads specially adapted for the breast or abdomen
  • A61F13/148—Abdomen bandages or bandaging garments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F15/00—Auxiliary appliances for wound dressings; Dispensing containers for dressings or bandages
  • A61F15/008—Appliances for wound protecting, e.g. avoiding contact between wound and bandage
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
  • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
  • A61F5/03—Corsets or bandages for abdomen, teat or breast support, with or without pads

Definitions

• the present invention is intended to treat preventively or curatively: hypertrophy, retraction, fibrosis, etc. ... secondary to deep lesions of the skin and soft masses. It is taught in patent EP824,016 that the pressure exerted by pressure bands has proved to be insufficient while the rigid form strips manufactured according to the rule of the art in a hard plastic material prevent healing of the skin. To remedy these drawbacks, a device for healing healing tissues is described in this patent, consisting of a covering body made of a soft and compatible polymer, coming into contact with the healing tissue and of a support part in one. rigid material.
• the device is applied in particular to the patient's face to distribute the pressure between the raised bone parts and the hollow parts, so as to make the wearing of this device bearable for the patient.
• this mask requires heavy and complex means: for its production, renewal and maintenance. Such a device is difficult to disinfect and is the source of many infections.
• the invention provides a selective means of innovative pressotherapy because it differs from those known to date by the specificity of its actions. It is easily recognized by the appearance of its compressive surface. This consists of inconsistent grooves in depth and in width; they are schematized by variable lines in curvature, size, arrangement which delimit closed spaces which are not necessarily joined. These sinuosities of the compression area are opposite the scar area to be treated or extend beyond the healthy skin. This orthosis exerts selective prolonged pressures and allows its components to be controlled.
• each scar anomaly in particular the anchors or adhesion zone of the gliding planes, the bridles, the fibroses ... and re-harmonizes them.
• Each complication, location, scar form corresponds to an arrangement of the grooves.
• the richness of these grooves reflects the complexity of its action, unlike conventional therapeutic means. It achieves limited local pressures, well tolerated, reproducible doses capable of targeting the chosen intra-scarring lesions. It administers such pressure that there is scar whitening opposite the bottom of the grooves, reflecting effective neovascular compression, ischemic but not necrotizing. She performs hyperpressure peaks on the scar.
• the average pressure in contact with the grooves is greater than that achieved with conventional pressotherapy techniques: compressive clothing, transparent rigid compressions, including pneumo-hydraulic due to their overall, homogeneous action linked to their large and smooth bearing surface. Its action allows a discriminating compression according to the place and a modulated regulation of the neo capillary pressure by zone, refining the possibilities of controlled ischemia. In addition, it takes into account the functional stresses specific to the area to be treated. In total, it harmonizes the intra-scar tensions and optimizes the scar mechanical properties.
• the orthosis has the advantage of being extracorporeal, non-invasive for the patient, with no other mode of action than the pressure exerted. It acts favorably on reflex points.
• the burned child has an evolution which critically on the vital level, in the past remains difficult functionally and esthetically with several months of constraining treatment.
• the interest of the orthosis goes beyond the acute phase and its inflammation.
• the sequelae at the end remain significant and growth is the dominant factor of aggravation during this period which corresponds to a therapeutic vacuum or almost.
• Negligence leads to scar fibrosis and the limitation of sliding plans, functional discomfort and sometimes major aesthetic damage.
• the invention by its prolonged mechanical action, proposes to use the natural potential of the patient to aid in healing. It reduces the initial phase, improves functional and aesthetic results. It potentiates scar growth.
• the invention makes large injured surfaces and their development during the growth of young patients accessible for treatment.
• the outcome of both initial and restorative surgery depends a lot on the neo dermis and in particular on the existence of anchors.
• the orthosis according to the invention allows the patient to optimize his scar condition, to meet functional needs and to access cosmetic repair surgery.
• Figure 1 shows a scar and a cross section of the healing orthosis (1) centered on a therapeutic unit (2). It shows that any direct pressure (18) on the dome (5) increases the divergent centrifugal (15) and vertical penetration (16) pressures on the groove (6). Therefore it acts beyond the scar contact surface.
• Figure 2 shows an aerial view of the orthosis centered on the unit (2).
• the activator (3) generally encloses a limb segment and is locked with an adhesive (10). It can be seen that any traction on the banks of the grooves (17) leads to divergent centrifugal scarring tensions (19) at the periphery of the unit.
• Figure 3 is a cross section of the orthosis and scar showing the activator (3) and its pulling action (17) on the unit (2).
• the divergent pressure forces are increased (15) and those of penetration (16) maintained or increased.
• the model shows that pressures correspond to intra-scar tensions (19).
• Figure 4 shows an orthosis composed of an open system where several subunits interact (4) reproducing the action of the base unit (2) of the closed system; according to the principles of the invention. This is useful for the treatment of large scars.
• Figure 5 shows a metacarpal cross section.
• This hand is equipped with a posture splint (30) serving as a support and immobilization in the event of an extensive burn of the palm.
• the plate (9) in this example is modeled in units. It attaches to the banks of the splint (30).
• the activator (3) exercises pressure (18) on the domes (5); here through small nipples (31) whose hardness and size allow to modulate the action. This orthosis and splint association makes it possible to treat concave areas.
• Figure n ° 6 schematizes the current model of pressotherapy treatments common to: compression garments (36), foams (37), silicones, rigid pneumatic compressions.
• the indication for compression is based on global examination criteria which essentially take into account scar relief and incidentally scar structure or localization.
• the entire hypertrophic scar is compressed without adjustable intra-scar pressure differential, neither diverging action, nor taking into account the areas: anchoring (23), hypertrophy (22) ...
• Figure n ° 7 shows a dorsal view of a child equipped with an original kyphosis corrector with its thermo-formable plastic hemi valve inter scapular molded in the corrected position and its padded axillary bases pulling the shoulders.
• Figure 8 shows the profile and the anterior hemi valve under the costal canopies. The two valves are articulated so that they are mobilized by the respiratory movements. Expansion in the vertical axis of the rib cage is facilitated at the expense of the anteroposterior. The kyphosis corrects itself with each inspiration.
• Figure 9 shows the orthosis (1).
• the orthosis (1) acts effectively on the thoracic scar.
• Figure n ° 10 shows the periammary cutout and the necessary adaptations in adolescent girls with the fixation of the orthosis to the elements of the corrector.
• Treating scar breasts requires adapting bras and including curved units (2).
• Figure 11 shows the different original cutout of the posterior valve required for an adolescent undergoing correction for proven kyphoscoliosis.
• the posterior valve provides support in front: in the center and at the top of the kyphosis summit, laterally of the subacromial regions and at the bottom of the pelvic hemi-belt.
• Figure 12 is the side view. The posterior and anterior iliac spines are covered.
• the orthosis (1) is positioned similarly to Figures (9) and (10).
• the healing orthosis (1) has reliefs which exert differential pressure on the scar (15,16) so as to control the enlargement (22), the anchors (23), the retractions and the fibrosis.
• the orthosis (1) is divided into isolated or associated treatment units (2); closed or open system.
• the reliefs are produced in a preferably elastic plate (9).
• the reliefs constitute grooves (6) of curvature and depth regulating the pressures so as to act on certain hypertrophic or keloid scarring outgrowths as well as on deep lesions in the scar dermis.
• the transverse radius of curvature of the groove (6) intended for contact is between 0.1 and 15 mm.
• the dome (5) extends beyond the plane of the plate, starts from an edge of the groove, increasing its elasticity in its deep plane and modulating the pressures exerted there. An external force at its summit strengthens this action.
• the elementary plate (9) is composed of several layers or associated juxtapositions: plastics, foams, gels, silicones or any other material, giving it a hardness gradient "shores" and a different elastic power locally.
• the current therapeutic model scrupulously administers a uniform pressure over the entire hypertrophic surface without which the uncompressed hypertrophic zones escape and do not evolve favorably. The objective is to obtain a scar smoothing of this unsightly curvature, which is bothersome and painful when pinched.
• a pneumatic or hydraulic system can be a means contributing to the production of an orthosis, but it is neither essential nor sufficient since it has an adjunct role and in no case represents the key element of the invention. It can be combined either as an activator on conventional units, or connected to tubular grooves. Mechanization allows massages. In all cases, the specificity of the contact surface and its grooves must exist.
• the teaching disclosed in patent EP824,016 (LEUVEN KU RES ⁇ DEV; BOCK ORTHOPED IND (DE)) dissuades from using pressure by the fact that "it prevents healing" and reports a variant based on current therapeutic models while the orthosis of the invention is based on the application of an innovative therapeutic model.
• the shape of the grooves (6) transversely follows a curvature determined according to the zones and the depth of the scar to be treated.
• the plate (9) is divided into several units comprising one or more grooves (6) producing a closed or not shape (Fig. 4). At least two grooves are in contact with the skin so as to have a sufficiently elastic power to store the necessary energy and exert an adequate pressure. They are modeled in a plate (9) in the same way as the element sold under the name of ERCOFLEX R.
• the activator (3) makes it possible to fix the orthosis (1) on the patient and comprises, according to the needs of the scar, elements, means intended to locally increase the pressure on the deep areas of the grooves.
• the healing orthosis (Fig1) is capable of restoring pressures in a targeted, oriented, measured manner, modulating its action on intra-scar areas delimited by the abnormalities of the scar: anchoring, retraction, bridle, hypertrophy, fibrosis by distributing the intra-scar tensions. It corrects a parietal blood pressure imbalance and contributes to the intrinsic restructuring of the scar. It has high pressure zones (11) bordering low pressure zones (12). In addition to its elastic properties, it must also include this pressure gradient. The movements, voluntary or automatic during sleep, deliver additional energy (17), activate the units and make the device more efficient (Fig3). In case of total immobilization, the action is less but is very suitable for recently burnt skin.
• This orthosis (1) acts on all dermal and infra-dermal components: nerve endings, vascularization, inflammation, fibroblasts, myofibroblasts, extra cellular matrix ... Surprisingly and not evident, the action of the orthosis (1) is fast ; for example after 6 weeks it gives its first clinical results which are not definitive but which allow us to foresee the improvement to come. Its pressure action associated with the original back pad described allows it to act on associated phenomena such as contractures or retractions encountered in kyphoscolioses.
• the healing orthosis (1) is a device comprising a plate (9) or reference plane (Fig1); parts in positive upper relief or dome (5) ensuring the elasticity, and the overpressure of the negative reliefs in hollow or groove (6) in contact with the scar.
• the orthosis is at least composed for a unit (2) of two types of reliefs relative to the surface in contact with the skin one negative or grooves (6) encircling, the other positive tumescence or dome (5): hollow and bump.
• the groove is at least on either side of the dome; preferably in a loop. Some grooves have a wavy surface at the bottom.
• the dome (5) must equal or exceed the reference surface of the plastic (9) (Fig1).
• the shape delimited by the groove (6) is advantageously in a ring and also kidney-shaped in bean seed, or other shapes closed or not depending on the result of intra cicatricial tension that one wants to achieve and the lesion to be treated.
• the depth of the furrows, the size and shape of the unit make it possible to vary the therapeutic plan more specifically: from the dermal plane to the deep planes.
• Each unit (2) performs a relative immobilization of the scar inside the surface delimited by the grooves, and has its own action which can be doubled with a combined action if they are coupled.
• the healing orthosis comprises a plate (9) and or an activator. It is composed of one or more materials of different shore hardness: elastic resultant devices capable of accumulating and restoring energy.
• the processing units (2) are reliefs capable of amplifying this mechanism, while targeting and directing its action.
• the activator (3) starts outside the scar pressure delta zone of the unit (Fig. 2) or of the subunits (4) which make up the orthosis (Fig4).
• the healing orthosis (1) consists of at least one unit (2), but may include several, juxtaposed or interactive, of very variable size (Fig. 4, 9,10).
• the unit (2) is an open system if it is produced by grooves in hyphen or peripheral sub-units (4). In this case of the open system (Fig. 4), the unit (2) consists of peripheral units equivalent to the grooves (6); the "dome” (5) corresponds to the area between them. It is a closed system if only one groove composes the unit.
• the units (2) can then include prefabricated reliefs, modular or not by crushing or injections into a material to cubicles; wedges stamped or cut into loops. They (2) are also differently riveted, screwed, fitted, welded separately to the activator.
• a pneumatic, hydraulic, possibly mechanized variant intended for massages will only be effective if it meets the criteria of the invention and more particularly has an active contact surface with suitable grooves.
• the complete custom model is the most effective.
• the interface separates the skin from the unit (2). It is reduced to a simple surface treatment of the component (s) of the unit (2) or individualized in: silk, metalline R , cotton bridal veil or any other material.
• the orthosis can be produced by shaping from a single material.
• Activator (3) and units are worked from a flexible plate (9) and adhesive.
• One of the products suitable for producing the orthosis is sold under the name of Ercoflex R with a thickness of 2, 3, 4 mm.
• the bases are capable of positioning and transmitting energy to the grooves and domes. They usually enclose the body perpendicular to the axis of the limbs. We report the position and contours of the units, plotted on the scar.
• the unit takes an impression by silicon molding or any other material, taking the curve of the body and making the counter type of the groove.
• a cylinder is produced which is placed on the outline of the unit drawn by the prescriber on the patient. Once the cold polymerization has been obtained, this impression is transferred to the flexible thermoformable plastic. It is the mirror modeling, against type, type, negative, positive which allows the realization of the orthosis. Being a memory material, it is produced, as often as possible, with controlled cooling in an aqueous medium in order to preserve both the elastic, mechanical and curving properties.
• the device is presented on the scar and there is a predominant support on the zones corresponding to the grooves.
• the activator must then be made using an adhesive tape fixed by a rivet, sewn or welded to the outer bank of the groove. He realizes the base which encloses the member. The stroke of the base plates during the movements modulates the action of the orthosis.
• the forms of orthosis by their units and or their activators vary depending on the indication. For example: the units, one or more, treat the anchoring zones at the ends of the flanges. The flange body requires perpendicular stresses on small areas. The scar closet is surrounded or more often cleaved.
• the activator achieves more than a simple fixing by flange. It can be flexible or rigid, inextensible or elastic, for example Velcro R adhesive tape (registered trademark), or any other material that meets the needs depending on the area to be treated. It is often complex and delicate in design (Figs. 7 to 12). Simply, we use a custom made compression garment, commercial or not, of specific elasticity to allow additional overall pressure and contribute to the fixation of the orthosis.
• the orthosis in the form of an isolated flexible mask or in addition under a rigid activating mask.
• a flexible mask we model on positive a flexible mask then a rigid mask over it.
• the flexible mask worn under the rigid mask is the most effective, this acting as many external pressure points on the tops of the domes.
• the masks can be worn together or in isolation, which makes it possible to vary the skin constraints. Separate units can also be permanently fixed or removable to the internal face of the rigid mask.
• the orthosis (1) associated with a hand immobilization splint (Fig5) having an activating device composed of a rigid counter support and an elastic part; for example a thermoformable cover associated with materials with a lower shore index such as small cylinders cut from PLASTAZOTE R exerting pressure on the tops of the domes.
• the hardness and size of the cylinders or nipples modulate the support.
• This device makes it possible to treat concavities. It can be presented as a simple metacarpal bracelet for a moderately complicated palm burn; units and activators worked in a single plate.
• the orthosis (1) associated here with the kyphosis corrector The kyphosis corrector must meet the positioning requirements of the orthosis.
• the kyphosis corrector deals with analgesic attitudes or constitutional kyphosis. It consists of an inverted T in thermoformable plastic molded between the shoulder blades and starting from the upper point of the T: two inextensible padded straps including the axillary hollows.
• the device is completed with a strap abdominal potentially carrying an articulated anterior valve molding the costal canopies to make it even more corrective in the case of a cyphotic attitude too emphasized (Fig. 7, 8, 9,10) or an attitude or constitutional kyphoscoliosis.
• the thermoformable posterior valve will cover the subacromial part of the two shoulder blades, without going beyond the top of the kyphosis (Fig. 11, 12) at the top and the anterior and posterior iliac spines at the bottom.
• the healing orthosis thus has an optimized action on the anterior thoracic integuments.
• the orthosis has concentric units but not necessarily of the same center; one unit capable of covering one or more others; which treat large heterogeneous asymmetric scars and achieve progression in treatment.
• the orthosis can be used on all or part of the body: face, cant hi, auricular pavilions, trunk, perineum, limbs, hands, interdigital spaces, fingers, toes, feet and soles by adding units to the soles. .
• the orthosis is optimized at its design by tests, para-clinical scarring examinations (Doppler echo, Doppler laser measuring the thickness of the residual dermis, etc.), supplemented by CAD or CAD / CAM computer processing which makes it possible to determine the shape, the components and characteristics of the optimal visco-elastic system. It integrates the calculation of the deformation induced by the movements in the usual degrees of freedom of the adjacent joints.
• Orthoses (1) derived from the invention can be prefabricated for a topographic impairment defined according to statistical data, based on the frequency of complications. They are less active than those made to measure because they do not adapt to the great individual variability linked to the accident, to care, to the field ...
• Less efficient units can be made of plastic, foam, gel, silicone, or any other material including a discharge zone by cutting or combining different shore materials.
• a simple ring of silicone, a corrugated elastic material pressurized by a compression garment or stretching fulfills a small part of the functions of custom-made units.
• the associated activator is often rudimentary.
• the action of the orthosis differs from that of pressure distribution as a good anti-bedsore mattress achieves. Beyond the preventive action, it has a therapeutic action oriented on the scar, zone by zone.
• the action of the orthosis (1) is to be distinguished from the action of a compression garment (36) (Fig 6) which distributes a variable staged pressure over the height of a segment of limbs, without the possibility of modulating the pressures on the scar at a given level.
• a compression garment (36) Fig 6
• the interposition of foam (37) Fig6), silicone ... in smooth plate patterned on the scar allows at most to increase and focus the pressures to obtain a global scar smoothing, without variability of the action or effect intra cicatricial restructuring.
• the rigid pneumatic or hydraulic mask has an action comparable to clothing.
• a simple unit (2) under the garment is more effective, it provides another dimension consisting of a new selectivity of the areas subjected to compression and acts beyond the scar contact surface. It can be silicone polymerized in the fiber or stuck to custom made compression garments. A manufactured fabric containing at the level of its cicatricial face, silicone or other types of protrusions will also only be partially effective. All are only incomplete derivatives of the invention.
• the orthosis is made of flexible thermoformable plastic with a thickness of 1 to 4 mm.
• the depth of the groove and the width intended for the contact are 0.1 to 15 mm.
• the dome measures between 0.2 and 25 cm in its large diameter. In the presence of flange, retraction, or anchoring it is considered that all the units interact.

Landscapes

• Health & Medical Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Vascular Medicine (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Nursing (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Epidemiology (AREA)
• Orthopedics, Nursing, And Contraception (AREA)

Applications Claiming Priority (3)

Publications (1)

Family

ID=8867051

Family Applications (1)

Country Status (5)

Families Citing this family (5)

Family Cites Families (19)

• 2001
  • 2001-09-07 FR FR0111574A patent/FR2829379A1/fr active Pending
• 2002
  • 2002-09-05 CN CNB028216342A patent/CN100405994C/zh not_active Expired - Fee Related
  • 2002-09-05 WO PCT/FR2002/003010 patent/WO2003022184A2/fr not_active Ceased
  • 2002-09-05 EP EP02783143A patent/EP1424965A2/de not_active Withdrawn
  • 2002-09-05 US US10/488,832 patent/US7540850B2/en not_active Expired - Lifetime

Non-Patent Citations (1)

Also Published As

Similar Documents

Legal Events