FR2754174A1 - Surgical skin dressing - Google Patents

Abstract

A surgical skin dressing, designed to hold together the edges of a wound to produce a fine and supple scar, consists of an inner layer (1) of a semi-rigid and semi-permeable material which allows evaporation from the skin to pass through but is impermeable to bacteria, and an outer layer (2) which is thin, semi-permeable, sterile and adhesive. It is resistant to water and to greater frictional than the inner layer, and is reinforced on its non-adhesive surface by a film of polyethylene or supple silicone-coated card. The inner layer is of a hydrocolloid dressing which projects beyond the edges of the wound by a distance equivalent to a half of whole length of the wound, while the outer layer, which can be of polyurethane, covers the inner one and extends by 0.5 to 1 cm beyond it in all directions.

Description

TITLE: Dermato-surgical long-term support dressing
a wound or scar in the process of healing to avoid the occurrence of cheloid, hypertrophic, painful and / or unsightly scars.

 The present invention is a dressing for improving the quality of healing of a sutured wound or a wound in the process of healing.

 The purpose is not to make a bandage to cover a wound sutured or not during the few days which follow the occurrence of this wound, but of a bandage aiming to avoid the long-term disorders which involve these wounds. The dressings proposed to cover a wound immediately after its occurrence are numerous and of good quality.

 On the other hand, in the more or less long term, whatever the surgical technique used for wounds (simple structure, overlock, absorbable overlock, or directed scarring), whatever the dressing used, these scars are regularly unsightly: loose structure, scar large, thick and painful (regardless of how long the strings are held: 10 to 21 days) even if the initial appearance of the wound seems satisfactory because the complete healing of a dermal wound lasts for approximately 18 months.

 The purpose is to make a dressing allowing long-term maintenance of these wounds to avoid these disorders occurring at a distance from immediate healing, this dressing will replace the immediate dressing and will be maintained over the long term.

Findings:
On the one hand, that scarring is subject to stretching due to the patient's movements and that these scars are finer when a intervention necessitates the placement of a plaster for several months after this intervention (orthopedic surgery: scoliosis for example );
On the other hand, that a dermo-hypodermic skin opening made by a surgeon is the seat of stretching, tightness of swelling felt by the patient according to the different movements he performs.

 These observations did not lead us to think that the phenomenon of scarring required a compression of the scar from the intervention by a semi-rigid bandage during the whole period of scarring. Currently we remove all dressing after removal of the son.

For the compliance of this treatment to be good, this dressing must be:
- semi-rigid (avoiding the feeling of "cardboard" on the skin), but not flexible so that the scar does not move in all directions, which would remove the desired maintenance effect.

 It will at best be hydrocoliolde in substance; the too rigid elastomeric substances dissociate too quickly from the skin, the double-faced microporous polyurethane substances are too flexible, not immobilizing the wounds and scars under the dressing.

It is also necessary that this dressing remains in place for several weeks: in fact, even if the patient was cooperative and put the dressing on every day for a year (little
possible) successive detachments of this dressing would reduce to zero the desired maintenance effect, it is also necessary that this pleasant dressing is forgotten and that the patient gets a new one only once every eight weeks or so when dressing will peel off the doctor having shown him how to apply it the first time.

The invention consists of the combination of two dressings:
- one (1) semi-rigid - semi-elastic of stable composition so as not to denature during the two months when it will be in contact with the closed wound and in the process of terminal healing, having to be adhesive on the wound and on the peripheral part of the wound, holding it to avoid stretching.

 - the other (2) flexible, very very fine, larger than the semi-rigid (completely covering it) adhesive over its entire face in contact with the skin and the semi-rigid dressing (1) to reinforce the maintenance of this semi-rigid part (1) on the scar (3) or the wound (4) while leaving the patient freedom of movement. This dressing (2), with rounded edges, may be made of polyurethane covered on its non-adhesive face by a protective stiffening film of polyethylene (5) or light siliconized cardboard, retained by a static phenomenon, it may also be made of any quality material. identical, the adhesive part of these two dressings will be covered by a protective sheet (6) usually made of plastic, or light siliconized cardboard overflowing the dressing (2) to facilitate gripping and application.

 It will be necessary for medical reasons that these parts are waterproof, semi-permeable (allowing skin evaporation but not bacteria or absorbing this evaporation) sterile, hypoallergenic resistant to water and friction: the film polyurethane meets in particular these requirements if it is put in an individual sterilized blister.

 It seems preferable that the overhang of the semi-rigid part (1) on either side of the scar or the wound is between x and x / 2 if the scar (3) measures x centimeter (it.

could be x / 3 for large wounds (4)) and that this semi-rigid part is centered under the thin part extending by 0.5 to 1 centimeter the semi-rigid part (1) in all directions.

 For a better result, it seems preferable to pose the assembly of the two dressings (realizing a finished product of only one dressing) as of the installation of the suture threads (3) and from the epidermisation of the wound (4).

 Such a device could be kept in place for two months and renewed by the patient, it must withstand the usual showers and activities.

Briefly, in the figures appear:
- Fig. 1: a top view of the dressing on a wound.

 - Fig. 2: a top view of the dressing on a scar.

 - Fig. 3: a sectional view relating to the application of the dressing.

Installation technique: (FIG. 3)
a) Peeling off the protective paper from the adhesive side.

 b) Application next to the wound of part of the adhesive face.

 c) Decrease in skin tension by bringing the area not yet covered slightly towards the area already covered.

 d) Application of the entire dressing.

 e) Removal of the stiffening film from the non-adhesive side.

Claims (7)

Claims  1) Bandage for holding the edges of a scar (3) or a wound (4) in the process of healing to obtain a fine and flexible scar, characterized in that it comprises:  - A semi-rigid, semi-permeable lower part (1) allowing the cutaneous evaporation to pass but not the bacteria (or absorbing this evaporation) sterile adhesive to the part (2) and to the skin, not disintegrating for a minimum two months.  - A fine flexible upper part (2), semi-permeable allowing skin evaporation but not bacteria to pass, sterile, adhesive, resistant to water and friction greater than the lower part extending beyond it to keep it in placed on the scar, this upper part (2) is stiffened on its non-adhesive face by a polyethylene film or flexible silicone cardboard retained by a static phenomenon.  2) Dressing according to claim 1, characterized in that the part (1) is a hydrocolloid dressing.  3) A dressing according to any one of the preceding claims, characterized in that the part (1) extends x to x / 2 cm on each side of a scar x cm in length.  4) Dressing according to any one of the preceding claims, characterized in that the part (2) projects beyond the part (1) by 0.5 to 1 cm in all directions.  5) Dressing according to any one of the preceding claims, characterized in that the part (1) is pre-bonded centrally under the part (2), and that the assembly is adhesive to the skin.  6) Semi-rigid dressing (1) semi-permeable allowing passage (or absorbent) Skin evaporation, but not letting bacteria pass, sterile, self-adhesive, characterized in that it is used in a long-term (12 months) maintenance dressing for the edges of a wound or scar in the process of cicatrization, not disintegrating over two months according to one of the preceding claims.  7) Flexible dressing (2), thin, semi-permeable allowing skin evaporation to pass but not allowing bacteria to pass through, sterile, self-adhesive, resistant to water and rubbing, characterized in that it can be made of reinforced polyurethane on its non-adhesive side by a polyethyten film or flexible silicone cardboard projecting from the polyurethane film to promote gripping; this dressing is also characterized in that it is used in a device for long-term maintenance (12 months) of the banks of a wound or scar in the process of healing, not disintegrating over two months depending on the one of the preceding claims.