PT1171065E - Aparelho para tratamento de feridas que emprega pressão reduzida - Google Patents
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- PT1171065E PT1171065E PT00920925T PT00920925T PT1171065E PT 1171065 E PT1171065 E PT 1171065E PT 00920925 T PT00920925 T PT 00920925T PT 00920925 T PT00920925 T PT 00920925T PT 1171065 E PT1171065 E PT 1171065E
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Landscapes
- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
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- Food Preservation Except Freezing, Refrigeration, And Drying (AREA)
- Manufacture Of Motors, Generators (AREA)
- Massaging Devices (AREA)
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- Soil Working Implements (AREA)
Description
ΕΡ 1 171 065 /PT
DESCRIÇÃO "Aparelho para tratamento de feridas que emprega pressão reduzida" O presente invento refere-se a um aparelho para a cicatrização de feridas e, mais particularmente, para impedir a progressão de queimaduras de espessura parcial, conhecido, por exemplo, a partir do documento US-A-4,969,880.
Quando uma pessoa sofre uma queimadura, as camadas da derme e epiderme na região da ferida são danificadas. O fecho da ferida resultante é importante para impedir a perda de fluidos corporais e invasão por microrganismos. No caso de uma queimadura de espessura parcial, tecido epitelial e subcutâneo adjacente à ferida irá migrar para fora e eventualmente crescer novo tecido sobre a ferida. Foi desenvolvida uma vasta gama de coberturas de feridas para acelerar o fecho da ferida e permitir que os processos naturais de reparação do tecido danificado prossigam. O prognóstico de uma ferida provocada por uma queimadura depende da severidade do ferimento e, em particular, da profundidade da queimadura. Em geral, uma queimadura de espessura parcial irá sarar mais rapidamente e com menos complicações do que uma queimadura de penetração profunda. Foi observado que as queimaduras de espessura parcial muitas vezes pioram e tornam-se queimaduras mais sérias e mais profundas, se não forem prontamente tratadas a seguir a ter ocorrido o ferimento de queimadura.
As mãos sofrem mais frequentemente ferimentos de queimadura do que as outras partes do corpo. Provavelmente, isto é devido à reacção natural de tentar proteger a face com as mãos e, em muitos casos, o ferimento de queimadura é nas costas das mãos. Outras partes do corpo que mais frequentemente sofrem queimaduras podem ser os braços, pés e pernas. O presente invento procura proporcionar um aparelho para tratar ferimentos numa parte do corpo, especialmente ferimentos provocados por queimaduras. 2
ΕΡ 1 171 065 /PT
De acordo com um aspecto do presente invento é proporcionado um aparelho para estimular a cicatrização de feridas que compreende um invólucro para recepção de uma parte do corpo afectada, incluindo o dito invólucro uma cobertura substancialmente estanque ao ar e uma almofada porosa no interior da cobertura, estando a dita almofada adaptada para contactar a superfície de ferida e meios de ligação para ligação do interior do invólucro a uma fonte de pressão negativa, tendo a cobertura uma abertura que pode ser repetidamente selada que permite que a ferida seja inspeccionada a intervalos.
Por cobertura substancialmente "estanque ao ar" pretende-se dizer uma que seja suficientemente estanque ao ar, que por aplicação de sucção à almofada porosa, possa ser mantida uma pressão inferior à do ambiente no interior do invólucro. Contudo, não é necessário que o material do invólucro seja totalmente oclusivo ao ar.
Foi verificado que, quando é aplicada terapia de pressão negativa a uma queimadura, utilizando o aparelho do invento dentro de um tempo relativamente curto desde a ocorrência do ferimento (por exemplo dentro de cerca de 12 horas), não só se melhora a velocidade de cicatrização mas é interrompida a progressão de uma queimadura de espessura parcial para um ferimento mais profundo.
Numa concretização, do aparelho do invento o invólucro compreende uma luva, manga ou meia. Por exemplo, o aparelho pode incluir uma luva, formada por uma espuma de borracha ou plástico flexível, a qual está contida no interior de uma cobertura de baixa porosidade ao ar. Tipicamente, a espuma de plástico flexível é espuma de álcool polivinílico (pva) ou de poliuretano que tem células de intercomunicação ou uma combinação de tais espumas, por exemplo, como um laminado. Num tal laminado, a camada de pva pode estar adjacente à ferida.
As características adicionais do presente pedido irão tornar-se evidentes a partir da descrição seguinte e dos desenhos anexos, nos quais:- 3
ΕΡ 1 171 065 /PT a Fig. 1 é uma vista em perspectiva explodida da almofada porosa; a Fig. 2 é uma vista em perspectiva guando a almofada porosa é montada em conjunto; a Fig. 3 é uma vista em perspectiva da almofada porosa no interior da sua cobertura; as Figs. 4a a 4d mostram várias vistas de uma ligação para a ligação pneumática da almofada porosa a uma fonte de pressão negativa; e a Fig. 5 é uma vista de cima de uma cobertura modificada. A concretização mostrada nos desenhos anexos está concebida para ser utilizada no tratamento de queimaduras na mão.
Será apreciado que são possíveis várias modificações apropriadas para tratar queimaduras de outras partes do corpo, tais como pés dentro do âmbito do invento.
As Figs. 1, 2 e 3 mostram o aparelho (10) para tratar feridas nas mãos, que compreende uma almofada porosa que tem uma base inferior (22), uma secção média (24) e uma secção superior (26) incorporada no interior de uma cobertura (12) de baixa porosidade ao ar. A almofada porosa tem a forma de uma luva ou luva sem dedos e pode ser construída pela fixação da secção superior (26) à base (22), retendo ao mesmo tempo a secção média (24) no interior da cavidade assim formada. Tipicamente, a almofada porosa é uma espuma de plástico reticulada e pode ser formada por colagem ou soldadura das secções separadas umas às outras. Quando colocada no interior da almofada, a mão é mantida no lugar com dedos afastados por separadores de dedos (25) e ranhuras do tipo corte em V (14). Como é mostrado nas Figs. 2 e 3, a espuma pode ser moldada para proporcionar um compartimento de suporte separado (27) para o polegar, de modo a ajudar à obtenção das posições óptimas para os dedos e polegar cicatrizarem. Contudo, isto não é essencial. A almofada é feita, de preferência, a partir 4
ΕΡ 1 171 065 /PT de uma espuma reticulada tal como poliuretano como descrito no pedido PCT WO 96/05873, espuma de álcool polivinilico ou uma combinação dos mesmos. A Fig. 3 mostra a almofada montada a seguir à inserção numa cobertura (12). A cobertura (12) é um invólucro formado a partir de um material em folha impermeável ao ar, por exemplo, pelicula de poliolefina ou poliuretano e está dimensionada de modo a cercar a almofada porosa em forma de luva. Uma extremidade da cobertura (12) tem uma grande abertura que pode ser fechada por um meio que pode ser repetidamente selado facilmente (4) tal como um vedante do tipo fecho de correr, utilizado em sacos para alimentos. A outra extremidade (8) inclui um adesivo de resina acrílica sensível à pressão substancialmente impermeável (9), cujo lado de baixo é fixo como um vedante justo à pele do paciente. A extremidade aberta (8) pode ser revestida na sua superfície interna com um adesivo de resina acrílica sensível à pressão (9), a fim de vedar a cobertura à pele do paciente, por exemplo, no pulso ou antebraço. Em alternativa, a extremidade (8) pode ser selada ao pulso do paciente com uma peça separada de fita adesiva, tal como uma película de poliuretano revestida com um adesivo sensível à pressão. A extremidade aberta (8) está aberta e é afunilada como mostrado. Ao proporcionar uma forma afunilada, a extremidade aberta pode ser cortada para um tamanho, para que a abertura fique justa em volta do pulso do paciente. Uma ligação (100) está fixa à cobertura (12) na região de uma parte central da almofada porosa. A ligação (100) pode estar fixa à cobertura por adesivo. A Fig. 5 é uma vista de cima de uma cobertura semelhante à cobertura (12) mostrada na Fig. 3. São utilizados os mesmos números de referência para indicar partes correspondentes. A cobertura mostrada na Fig. 5 difere da mostrada na Fig. 3 por a extremidade (8) para fixação ao pulso do paciente ter uma forma um pouco mais afunilada e estar concebida de maneira a que a extremidade possa ser cortada de modo a servir ao paciente. A ligação (100) tem uma flange geralmente circular (101), cuja face debaixo (isto é a face que em utilização contacta com a placa de espuma 20) é formada com pequenos botões que se projectam. A construção deste aspecto da 5
ΕΡ 1 171 065 /PT ligação é como a descrita no pedido de patente GB n.° 2,333,965. Em vez de utilizar uma selagem de fecho de correr, pode ser utilizado uma selagem tipo "Velcro". Nesta concretização, uma selagem de fecho de correr (4) é formada a partir de polietileno e este é unido ao resto da cobertura, a qual é formada por poliuretano, por fita adesiva.
As Figs. 4a a 4d mostram várias vistas da ligação (100) e irá ser observado que compreende uma porção de flange de plástico moldada (101) e orifício de sucção que tem um cano posicionado centralmente (102) e abertura (106). A ligação (100) está fixa firmemente à cobertura por um adesivo. O cano prolonga-se através de um furo cortado na cobertura e a superfície superior da flange 101 está ligada com adesivo à cobertura (12). O cano (102) está dimensionado para aceitar como um encaixe deslizante justo, a extremidade de um tubo de múltiplos ou único lúmen (30), que emerge debaixo da cobertura de ferida (12) . O tubo (30) pode ser construído como descrito no pedido de patente copendente WO 97/18007. Onde é utilizado um tubo de alúmenes múltiplos, pode ser utilizado um lúmen para medir a pressão no sítio da queimadura. Também está dentro do âmbito deste invento irrigar a queimadura ou outra ferida através de um dos lúmenes ou por intermédio de uma ligação separada para a almofada de espuma. A ligação ou ligações podem ser utilizados para introduzir medicamentos, por exemplo, antibióticos, para o sítio da ferida. O pano de cobertura (12) é feito, de preferência, a partir de uma película flexível ou de baixa permeabilidade ao ar tal como poliuretano e pode incluir uma camada protectora de polietileno. São descritos materiais adequados no pedido de patente GB No. 2,333,965.
Em utilização, a mão de um paciente que tem um ferimento de queimadura é introduzida na cobertura externa (12) através da extremidade aberta (8) . A abertura que pode ser repetidamente selada (4) pode em seguida ser aberta e dobrada para trás para expor a mão ferida. Em seguida a mão é introduzida na almofada porosa a qual pode ser pré-montada ou montada no lugar, em volta da mão ferida. No último caso, pode ser conveniente fixar a secção superior (26) à secção inferior (24) através de sutura ou agrafamento, em vez de 6
ΕΡ 1 171 065 /PT colagem ou soldadura da espuma. Com a almofada de espuma no lugar a rodear a mão ferida, a cobertura (12) é puxada para trás sobre a almofada porosa e a abertura (4) é vedada novamente. Em seguida o cano (102) é ligado por um tubo a uma bomba de sucção, por exemplo, utilizando a técnica descrita no documento wo 97/18007. Pressão negativa por impulsos, intermitente ou continua pode ser aplicada à mão do paciente em conformidade com um programa que pode ser controlado automaticamente por um dispositivo de controlo associado à bomba como descrito no nosso pedido de patente acima. Foi determinado que a terapia de pressão negativa utilizando o aparelho do invento estimula a cicatrização de queimaduras e reduz a progressão da morte das células por baixo de um ferimento de queimadura. Do mesmo modo, ao melhorar o escoamento sanguíneo para a área da ferida, a infecção é controlada e a granulação da ferida é estimulada.
Um efeito benéfico adicional da terapia, que utiliza o aparelho deste invento, é que durante a terapia, a mão é mantida firmemente numa posição meia fechada, a qual é a posição óptima para a promoção da cicatrização. Isto pode ser ainda encorajado pela introdução de uma tala rígida ou semi-rígida, por exemplo, de plástico, que é formada ou moldada na forma desejada, sendo o curativo colapsado amarrado à tala durante ou a seguir à aplicação da sucção, de maneira a que a posição de cicatrização desejada possa ser mantida a seguir ao fim da sucção. A bomba de sucção é controlada, de preferência, por meios de controlo que incluem um transdutor de pressão para monitorizar a pressão no sítio da ferida como descrito no nosso pedido PCT acima. Um dispositivo temporizador também pode estar associado à bomba para proporcionar funcionamento ligado/desligado se necessário a intervalos seleccionados. O aparelho também pode incluir um receptáculo localizado entre a almofada porosa e a bomba para recolher o exsudado da ferida. Tipicamente, a bomba é uma bomba de diafragma mas pode ser substituída por outros tipos de bombas e componentes equivalentes, tais como garrafas de vácuo. O aparelho também pode ser utilizado com uma fonte de sucção de parede como descrito no pedido de patente GB No. 2,342,584. 7
ΕΡ 1 171 065 /PT
Os termos e expressões que foram empregues são utilizados como termos de descrição e não de limitação. Embora o presente invento se refira principalmente a queimaduras de espessura parcial, é entendido que o presente invento pode ser utilizado com feridas abertas bem como um possivel tratamento de úlceras de pressão.
Lisboa,
Claims (6)
- ΕΡ 1 171 065 /PT 1/1 REIVINDICAÇÕES 1 - Aparelho para estimular a cicatrização de feridas, que compreende um invólucro para recepção de uma parte do corpo afectada, incluindo o dito invólucro uma cobertura substancialmente estanque a ar (12) e uma almofada porosa (22, 24, 26) no interior da cobertura, estando a dita almofada adaptada para contactar a superfície ferida, e meios de ligação (100) para ligação do interior do invólucro a uma fonte de pressão negativa, tendo a cobertura uma abertura que pode ser repetidamente selada (4), a qual permite a inspecção intervalada da ferida.
- 2 - Aparelho de acordo com a reivindicação 1, em que o invólucro compreende uma luva, meia ou manga (20).
- 3 - Aparelho de acordo com a reivindicação 2, que se destina ao tratamento de feridas na mão e compreende uma luva (22, 24, 26) formada a partir de uma espuma de borracha ou de plástico flexível e uma cobertura externa (12) de material em folha impermeável ao ar.
- 4 - Aparelho de acordo com a reivindicação 3, em que os meios de ligação compreendem um tubo (102) que comunica com a espuma no interior da cobertura.
- 5 - Aparelho de acordo com qualquer uma das reivindicações anteriores, em que a fonte de pressão negativa é uma bomba de sucção.
- 6 - Aparelho de acordo com qualquer uma das reivindicações anteriores, que inclui um receptáculo para recolher o o exsudado da ferida. Lisboa,
Applications Claiming Priority (1)
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GBGB9909301.5A GB9909301D0 (en) | 1999-04-22 | 1999-04-22 | Wound treatment apparatus employing reduced pressure |
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PT1171065E true PT1171065E (pt) | 2007-05-31 |
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PT00920925T PT1171065E (pt) | 1999-04-22 | 2000-04-20 | Aparelho para tratamento de feridas que emprega pressão reduzida |
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US (5) | US7279612B1 (pt) |
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RU (1) | RU2240763C2 (pt) |
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1999
- 1999-04-22 GB GBGB9909301.5A patent/GB9909301D0/en not_active Ceased
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2000
- 2000-04-20 WO PCT/GB2000/001566 patent/WO2000064394A1/en active IP Right Grant
- 2000-04-20 DK DK00920925T patent/DK1171065T3/da active
- 2000-04-20 AT AT00920925T patent/ATE356601T1/de active
- 2000-04-20 CN CNB008065780A patent/CN1173676C/zh not_active Expired - Lifetime
- 2000-04-20 CA CA002368085A patent/CA2368085C/en not_active Expired - Lifetime
- 2000-04-20 MX MXPA01010614A patent/MXPA01010614A/es active IP Right Grant
- 2000-04-20 DE DE06027012T patent/DE06027012T1/de active Pending
- 2000-04-20 RU RU2001131421/14A patent/RU2240763C2/ru active
- 2000-04-20 PT PT00920925T patent/PT1171065E/pt unknown
- 2000-04-20 BR BR0009867-1A patent/BR0009867A/pt not_active IP Right Cessation
- 2000-04-20 ES ES06027012T patent/ES2280152T1/es active Pending
- 2000-04-20 EP EP06027012.1A patent/EP1762205B1/en not_active Expired - Lifetime
- 2000-04-20 IL IL14528600A patent/IL145286A0/xx active IP Right Grant
- 2000-04-20 EP EP15177132.6A patent/EP2959872A1/en not_active Withdrawn
- 2000-04-20 US US10/009,294 patent/US7279612B1/en not_active Expired - Lifetime
- 2000-04-20 DE DE60033921T patent/DE60033921T2/de not_active Expired - Lifetime
- 2000-04-20 ES ES00920925T patent/ES2283295T3/es not_active Expired - Lifetime
- 2000-04-20 AU AU41336/00A patent/AU772162B2/en not_active Expired
- 2000-04-20 JP JP2000613386A patent/JP4796230B2/ja not_active Expired - Lifetime
- 2000-04-20 GB GB0009933A patent/GB2351025B/en not_active Expired - Lifetime
- 2000-04-20 EP EP00920925A patent/EP1171065B1/en not_active Expired - Lifetime
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2001
- 2001-08-28 ZA ZA200107099A patent/ZA200107099B/xx unknown
- 2001-09-05 IL IL145286A patent/IL145286A/en not_active IP Right Cessation
- 2001-10-01 CR CR6468A patent/CR6468A/es not_active Application Discontinuation
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2002
- 2002-06-19 HK HK02104586A patent/HK1044697A1/xx not_active IP Right Cessation
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2007
- 2007-04-30 HK HK07104631.0A patent/HK1099192A1/zh not_active IP Right Cessation
- 2007-06-11 CY CY20071100761T patent/CY1107664T1/el unknown
- 2007-10-05 US US11/973,227 patent/US7754936B2/en not_active Expired - Lifetime
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2008
- 2008-08-27 US US12/199,695 patent/US8350115B2/en not_active Expired - Lifetime
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2011
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2013
- 2013-03-11 JP JP2013047926A patent/JP2013150816A/ja active Pending
- 2013-03-11 JP JP2013047927A patent/JP5470480B2/ja not_active Expired - Lifetime
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