JP2003510106A - 加熱および冷却するための設備が設けられた真空補助閉鎖システム - Google Patents
加熱および冷却するための設備が設けられた真空補助閉鎖システムInfo
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- JP2003510106A JP2003510106A JP2000608983A JP2000608983A JP2003510106A JP 2003510106 A JP2003510106 A JP 2003510106A JP 2000608983 A JP2000608983 A JP 2000608983A JP 2000608983 A JP2000608983 A JP 2000608983A JP 2003510106 A JP2003510106 A JP 2003510106A
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- wound healing
- heating
- promoting wound
- cooling
- vacuum
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Abstract
Description
ための設備が設けられた真空補助閉鎖システム」を発明の名称とする米国仮特許
出願第60/127,596号に対する優先権を主張するものである。本書では、この米国
仮特許出願第60/127,596号の図面を含む全開示内容をレファレンスとして援用す
る。
するために炎症系の代謝機能を加速または抑制するのに、局部的な加熱または冷
却を使用する、創傷部の真空補助閉鎖体に関する。
必要である。この移動は、血流が増加し、種々のタイプの機能細胞が活性化する
ように、炎症プロセスを通って通常促進される。炎症プロセスを通って、損創傷
を受けたかまたは破壊された血管を通過する血流は毛細管レベルの詰まりによっ
て停止し、その後、クリーンアップおよび再生動作を開始できる。不幸なことに
、このプロセスは創傷部が大きかったり、または感染した場合には阻害される。
かかる創傷部では創傷部の表面の近くにうっ血ゾーン(すなわち組織の局部的な
腫れが組織への血流を制限する領域)が生じる。
び栄養分の量が少なくなるだけでなく、バクテリア感染と戦うことができる能力
が低下し、よって自然に創傷部を閉じる能力も低下する。最近まで治癒が困難な
かかる創傷部は縫合糸またはステープルを使用してしか治療されていなかった。
かかる機械的な閉鎖技術はまだ広く実施されており、有効であることが多いが、
これら閉鎖技術は創傷部に隣接する皮膚組織に引っ張りを生じさせるという主な
欠点を有する。特に縫合糸またはステープルを使用して閉鎖を実行するのに必要
な引っ張り力によって、縫合糸またはステープルの挿入点に極めて高い局所的な
応力が生じる。これら応力は一般に挿入点で組織の破断を生じさせ、これによっ
て最終的に創傷部の裂開を生じさせたり、更に組織の喪失を生じさせ得る。
化したり、炎症が生じるような創傷もある。縫合またはステープリングによって
修復できない創傷部は、一般に長期の入院が必要であり、付き添い人の高いコス
トと、大きな手術、例えば周辺組織の移植が必要となる。例えばステープルまた
は縫合により容易に治療できない創傷の例として、大きい創傷、深い創傷、開い
た創傷;床擦れ潰瘍、慢性骨髄炎から生じる潰瘍および後に全深度熱傷に至るよ
うな部分深度熱傷がある。
加えることにより、創傷部で排出を行うための方法および装置がこれまで開発さ
れている。かかる負圧を創傷部の十分な面積に加えると、かかる負圧は上皮およ
び皮下組織の創傷部に向かう移動を促進することが判っている。実際に創傷部に
負圧を加える方法(一般に真空補助閉鎖(VAC)治療と称される方法)は、一
般に過剰な体液を同時に除去することによる創傷部の機械的な収縮を行っている
。このように、VAC治療は公知の本来の副次的効果の多く、例えば適正な静脈
還流がない場合の浮腫の発生を軽減しながら、体の自然な炎症プロセスを高める
。
治療はこれまで治療できないと考えられており、ある問題も残っている。個々の
患者には炎症プロセスは極めて固有なものであるので、VAC治療を加えても、
特に梗塞、初期のクリーンアップおよび再生ステージ中にある創傷部を適当に治
療するための急速な十分な応答は得られない。従って、本発明の主な目的は、炎
症応答を制御することにより、公知のVAC治療を改善する方法および装置を提
供することにある。
症応答が過度に大きくなり、この結果、浮腫および痛みが生じることがあり得る
。従って、本発明の別の主な目的は、炎症応答を制御しながら抑制することによ
り、公知のVAC治療法を改善するような方法および装置を提供することにある
。
よび/または抑制するための方法および装置は、創傷場所に実質的に挿入するた
めの発泡パッドと、創傷場所の上に添付するための加熱および冷却パッドと、創
傷場所において発泡パッドと加熱および冷却パッドとの閉鎖体をシールするため
の創傷滅菌布とを一般に含む。本発明によれば、発泡パッドは体液の排出を促進
するよう、真空源と流体連通するように設置され、身体の炎症応答の代謝機能部
分をそれぞれ制御しながら加速または抑制するための加熱および冷却パッドを通
過するように、暖かい流体または低温流体が循環される。
御するために、これまで公知のVAC治療に加熱および冷却設備が加えられる。
その他の通常のVAC治療と組み合わせた局部的加熱を行うことにより、急速な
毛細管の詰まりおよびクリーンアップおよび再生ステージの早期の開始が発生す
るように、炎症応答全体を相乗的に加速することができる。同様に、炎症応答が
過度に活性化されたと付き添っている臨床医が判断した場合、浮腫の管理および
その他の方法で提供されるVAC治療の他の特徴を犠牲にすることなく、身体の
炎症応答を抑制するように、VAC治療と組み合わせて局部的冷却を行うことが
できる。
の層を含み、この層は一般に高周波溶接可能な材料から構成された2枚のシート
を含む。パッドのうちの2枚のシートは複数のチャンネルの間に複数の開口部が
形成されたワッフル状パターンにRF溶接されている。これら開口部は患者の皮
膚からの水分の蒸散を可能にし、一方、チャンネルはパッドを加熱または冷却す
るために、このパッドを通して必要とされるように、暖かい、または低温の水を
給水チューブおよび排水チューブを通して循環できるようにしている。
るが、本発明の冷却中には、創傷滅菌布の内部に加熱および冷却パッドを設置す
ることが重要である。このように布の接着剤を緩めたり、最終的に創傷場所にお
いて真空状態を創出させ得る、布の内部およびエッジの近くにおける凝縮物の形
成を最小にできる。特に創傷滅菌布の内部に加熱および冷却パッドを設置すると
、VAC治療の吸引特性によって最小にされている、創傷場所の閉じ込め部内に
生じている水分レベルまで周辺水分量が制限される。
臨床医は任意の時間に冷却が必要であることを示すことができるので、本発明の
好ましい方法は、最初に加熱が指示されているか、または冷却が指示されている
かに拘わらず、発泡パッドおよび創傷パッドの近くにて、創傷滅菌布の下方に加
熱および冷却パッドを設置することを含む。パッドを設置すると、創傷滅菌布は
給水チューブおよび排水チューブのまわりに強固に付着し、真空の漏れを防止す
る。
参照すれば、当業者には本発明の上記以外の特徴、目的および利点が明らかとな
ろう。
好ましい実施例について詳細に説明する。図中、同様な参照番号は同様な部品を
示す。
ついて容易に認識できようが、この詳細な説明は本発明の好ましい実施例、すな
わち特許請求の範囲によってのみ範囲が限定される、加熱および冷却するための
設備が設けられた真空補助閉鎖システムを説明するものである。
泡パッド11と、創傷場所12において発泡パッド11の密閉体をシールするた
めの創傷用減菌布13とを含む、本発明10が示されている。本発明によれば、
発泡パッドは体液の排出を促進するよう、真空源と流体連通するように設置され
、身体の炎症応答の代謝機能部分をそれぞれ制御しながら加速または抑制するた
めの加熱および冷却パッドを通過するように、暖かい流体または低温流体が循環
される。
真空源は公知技術で知られているように実現されており、これらの各々は199
5年8月22日に出願された米国特許出願第08/517,901号に詳細に説明されてい
る。本明細書では、米国特許出願第08/517,901号の完全な開示内容は本明細書に
記載されているが、特許請求の範囲および図面を含むこの特許出願の完全な開示
内容をレファレンスとして援用する。更に、かかるVACシステムは米国テキサ
ス州サンアントニオのカイネティックコンセプツ社および/またはその子会社を
通して容易に入手できるものである。
11は吸引時に、創傷部の体液を良好に透過できる、高度に微細な連続気泡ポリ
ウレタンまたはポリエーテル製発泡体を含むことが好ましい。また、米国特許出
願第08/517,901号に詳細に記載されているように、発泡パッド11はプラスチッ
クまたは同様な材料のホース15を介して真空源に流体連通するように設けられ
ていることが好ましく、真空減は介在された疎水性膜フィルタを介し、真空ポン
プと流体連通することにより、安全に真空状態に置かれたキャニスターを含むこ
とが好ましい。最後に、米国特許出願第08/517,901号は、創傷用減菌布13につ
いても詳細に述べており、この創傷用減菌布14は創傷場所12上にシール張り
付けするための感圧性アクリル接着剤によって少なくとも周辺がカバーされたエ
ラストマー材料を含むことが好ましい。
るような部品を、公知技術で知られているように一般に使用するが、炎症応答の
一部としての局部的代謝機能を制御するのに、本発明の加熱および冷却設備が常
設されている点が異なっている。その他の通常のVAC治療と組み合わせた局部
的加熱を行うことにより、急速な毛細管の詰まりおよびクリーンアップおよび再
生ステージの早期の開始が発生するように、炎症応答全体を相乗的に加速するこ
とができる。同様に、炎症応答が過度に活性化されたと付き添っている臨床医が
判断した場合、浮腫の管理およびその他の方法で提供されるVAC治療の他の特
徴を犠牲にすることなく、身体の炎症応答を抑制するように、VAC治療と組み
合わせて局部的冷却を行うことができる。
な水の層16を含み、この層は一般に高周波溶接可能な材料から構成された2枚
のシート17、18を含む。パッドのうちの2枚のシート17、18は、複数の
チャンネル20の間に複数の開口部19が形成されたワッフル状パターンにRF
溶接されている。これら開口部19は患者の皮膚21からの水分の蒸散を可能に
し、一方、チャンネル20はパッド13を加熱または冷却するために、このパッ
ド13を通して必要とされるように、暖かい、または低温の水を給水チューブ2
2および排水チューブ23を通して循環できるようにしている。
できるが、本発明の冷却中には、創傷滅菌布14の内部に加熱および冷却パッド
13を設置することが重要である。このように布の接着剤を緩めたり、最終的に
創傷場所12において真空状態を創出させ得る、布14の内部およびエッジの近
くにおける凝縮物の形成を最小にできる。特に創傷滅菌布14の内部に加熱およ
び冷却パッド13を設置すると、VAC治療の吸引特性によって最小にされてい
る、創傷場所12の閉じ込め部内に生じている水分レベルまで周辺水分量が制限
される。
臨床医は任意の時間に冷却が必要であることを示すことができるので、本発明の
好ましい方法は、最初に加熱が指示されているか、または冷却が指示されている
かに拘わらず、発泡パッド11および創傷パッド12の近くにて、創傷滅菌布1
4の下方に加熱および冷却パッド13を設置することを含む。パッド13を設置
すると、創傷滅菌布14は給水チューブ22および排水チューブ23のまわりに
強固に付着し、真空の漏れを防止する。
ば、この説明、添付図面および添付されている特許請求の範囲を特に参照すれば
、容易に可能である多くの変形例、変更例、改善例、置換例を思い付くことがで
きよう。例えば当業者であれば、加熱および冷却パッド13を広範な種々の形状
、寸法および内部構造で製造できることを認識できよう。かかる別の実施例では
加熱および冷却パッド13を創傷滅菌布14の多層状変形布内に一体化してもよ
い。いずれの場合においても、本発明の範囲は特定の実施例よりも広いので、こ
れまでの詳細な説明は、特許請求の範囲のみによって限定される発明の範囲を限
定するものであると見なしてはならない。
図である。
Claims (10)
- 【請求項1】 哺乳類の創傷治癒を促進するための方法であって、 哺乳類の創傷場所の一領域に真空を加える工程と、 前記領域に前記真空を加えながら、前記領域における哺乳類の炎症応答の変化
を生じさせる工程とを備えた、創傷治癒を促進するための方法。 - 【請求項2】 前記変化を生じさせる工程が前記領域における哺乳類の局部
的代謝機能を制御することを含む、請求項1記載の、創傷治癒を促進するための
方法。 - 【請求項3】 前記変化を生じさせる工程が、前記領域における哺乳類の局
部的代謝機能を加速し、急速な毛細管の詰まりおよび哺乳類の炎症応答のクリー
ンアップおよび再生ステージの加速された開始を助長することを含む、請求項2
記載の、創傷治癒を促進するための方法。 - 【請求項4】 前記変化を生じさせる工程が、前記領域を加熱することを含
む、請求項3記載の、創傷治癒を促進するための方法。 - 【請求項5】 前記変化を生じさせる工程が、前記領域における哺乳類の局
部的代謝機能を抑制し、哺乳類の炎症応答の過度の活性化を防止する、請求項2
記載の、創傷治癒を促進するための方法。 - 【請求項6】 前記変化を生じさせる工程が、前記領域を冷却することを含
む、請求項5記載の、創傷治癒を促進するための方法。 - 【請求項7】 前記真空を加える工程が、 真空源と流体で連通する発泡パッドにより、前記創傷場所をパックする工程と
、 前記発泡パッドを含む前記領域を創傷滅菌布でシールする工程と、 前記真空源からの前記真空を前記発泡パッドを通して前記領域に伝える工程と
を備えた、先の請求項のいずれかに記載の、創傷治癒を促進するための方法。 - 【請求項8】 前記変化を生じさせる工程が、 前記領域のまわりで流体を循環させる工程と、 前記変化を生じさせるように前記流体の温度を制御する工程とを備えた、請求
項7記載の、創傷治癒を促進するための方法。 - 【請求項9】 前記流体を連通するための入口および出口を有する可撓性エ
ンベロープ内において、前記流体のまわりに前記流体を循環させる、請求項8記
載の、創傷治癒を促進するための方法。 - 【請求項10】 前記発泡パッドと前記創傷滅菌布との間で前記可撓性エン
ベロープを前記創傷滅菌布でシールする工程を更に含む、請求項9記載の、創傷
治癒を促進するための方法。
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US60/127,596 | 1999-04-02 | ||
PCT/US2000/008759 WO2000059418A1 (en) | 1999-04-02 | 2000-03-31 | Vacuum assisted closure system with heating and cooling provision |
Publications (3)
Publication Number | Publication Date |
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JP2003510106A true JP2003510106A (ja) | 2003-03-18 |
JP2003510106A5 JP2003510106A5 (ja) | 2006-12-21 |
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Family
ID=22430926
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US (6) | US7144390B1 (ja) |
EP (2) | EP1726276B2 (ja) |
JP (1) | JP4143265B2 (ja) |
KR (1) | KR100661203B1 (ja) |
CN (3) | CN101278873B (ja) |
AT (1) | ATE337765T1 (ja) |
AU (1) | AU774512B2 (ja) |
BR (1) | BR0009519A (ja) |
CA (1) | CA2369022C (ja) |
CY (1) | CY1106271T1 (ja) |
DE (1) | DE60030419T2 (ja) |
DK (1) | DK1164986T3 (ja) |
ES (1) | ES2270824T3 (ja) |
HK (2) | HK1045453B (ja) |
IL (3) | IL145628A0 (ja) |
MX (1) | MXPA01009910A (ja) |
NZ (1) | NZ514480A (ja) |
PT (1) | PT1164986E (ja) |
RU (1) | RU2239396C2 (ja) |
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
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JP2020501736A (ja) * | 2016-12-19 | 2020-01-23 | ピュアウィック コーポレイション | 創傷手入れを含む、微気候管理された皮膚手入れ |
JP7011660B2 (ja) | 2016-12-19 | 2022-01-26 | ピュアウィック コーポレイション | 創傷手入れを含む、微気候管理された皮膚手入れ |
US11446174B2 (en) | 2016-12-19 | 2022-09-20 | Purewick Corporation | Micro-climate-managed skin care, including wound care |
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