RU2771915C1 - Apparatus for creating a medium with predetermined characteristics in soft tissue wounds and bandage for implementation of the apparatus - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: group of inventions relates to medical equipment, namely, to an apparatus for creating a medium with predetermined characteristics in soft tissue wounds and to a bandage for creating a medium with predetermined characteristics in soft tissue wounds. The apparatus comprises a tube connected with a waste collection container and a tube for removing waste from the wound, a pump for supplying medicinal solutions to the wound, configured for adjusting the supply of medicinal solutions, a control unit. The container for medicinal solutions, whereto an aeration line is led from the air pump with an attached bacterial filter, connected with the pump for supplying a medicinal solution to the wound, is additionally equipped with a temperature sensor and a heating element configured to adjust the heating temperature. The pump for supplying a medicinal solution is configured to adjust the rate of supply of the medicinal solution to the wound. Additionally installed is a pump for removing waste from the wound, linked to the control unit. The apparatus comprises a bandage for creating a medium with predetermined characteristics in soft tissue wounds. The bandage comprises a polyurethane vapour-permeable film with an adhesive inner layer, polyurethane foam 5 mm in thickness modelled after the shape of the wound is installed under the film, installed wherein are valves for supplying and removing a medicinal solution.

EFFECT: creation of an apparatus for creating a medium with predetermined characteristics in soft tissue wounds, including those with a complex shape, wherein the optimal temperature of the wound is maintained using heating of the solution and heat insulation properties of the applied bandage, reduction of the concentration of pro-inflammatory agents during the introduction of the solution and subsequent evacuation thereof during the change of the solution, and possibility of using multiple active agents and combinations thereof.

6 cl, 1 dwg

Description

The invention relates to the field of medical technology, namely to devices designed for the treatment of purulent and necrotic wounds.

Known external system of exposure to the patient and the method of its application (patent No. 2429887, A61M 35/00, published 27.09.2011), taken as the closest analogue. The device contains an external agent containing an external fluid transfer component for transferring fluid from a wound or incision, and an upper napkin located over said external component in contact with the surrounding skin surface. The fluid transfer component contains a porous core. The top wipe has a liquid outlet. A source of negative pressure is connected to the outlet channel. A pad of absorbent material completely encloses the core and forms a layer between the top wipe and the porous surface of the fluid transfer component at the top of the device. The pad forms a layer between the fluid transfer component and the skin surface at the wound or incision at the bottom of the device and is absorbent to improve the efficiency of fluid transfer from the wound or incision to the fluid transfer component, and from the fluid transfer component to the outlet port. The external means may advantageously be placed over a suture line or staples, which comprises a primary transfer component containing a strip of porous material such as viscose applied directly to the patient to absorb or transfer fluid to a secondary transfer component containing a sponge or foam material. . Placed between the transfer members is a bottom napkin for passing fluid therebetween through passages in the napkin, such as a slit. Placed on top of the secondary transfer component is a top drape that covers the surface of the skin. The patient agent is connected to a vacuum source, such as a vacuum closure assist device, a wall suction device, or a mechanical suction pump. The manual version uses a finite volume liquid reservoir with a shut-off valve to disconnect the drain when sufficient liquid has been collected. The automatic control embodiment uses a microprocessor adapted to be programmed to respond to various inputs to control the operation of the vacuum source. The proposed method for the treatment of a closed wound or incision includes three stages of control action on the fluid, which correspond to different stages of the healing process. At the first stage, active drainage control is performed. In the second step, the components can be disconnected independently of each other or in series. In a third step, the secondary transfer component may optionally be left in place to protect and assist in the evacuation of any residual fluid from the suture line/staples through the primary transfer component.

The disadvantages of the device are:

a) the use of a sealing strip for access to the wound gives a limited field of access for performing manipulations, in addition, there is a high risk of deformation of the operational panel during medical and diagnostic manipulations. In addition, the need to increase the working field requires additional expansion of the existing gap between the edges of the sealing strip, which in turn increases the complexity of the manipulation and can lead to the operation panel peeling off the outer napkin;

b) the use of porous materials eliminates the possibility of visual dynamic control over the course of the wound process without performing a partial dismantling of the device;

c) the use of porous materials makes it difficult for the outflow of the dense component of the wound discharge and requires the replacement of these components as they become contaminated;

d) the inability to control the temperature of the supplied solution, which can cause hypothermia of the wound with a subsequent decrease in the healing rate;

e) the inability to use solutions that carry oxygen and synthetic blood substitutes.

A device for local treatment and dynamic observation of superficial purulent wounds is known, containing a source of negative pressure, tubes connected to a waste collection container and a tube for removing waste from the wound, a pump for supplying medicinal solutions to the wound, through a system of electromagnetic valves for adjusting the supply of medicinal solutions, associated with containers for medicinal solutions, a microprocessor electrically connected to electromagnetic valves, a pump and a source of negative pressure, and an elastic film attached over the wound with an adhesive on the base, while the film is equipped with a removable round-shaped cover with a diameter of up to 150 mm from a translucent material , which is attached to the film by means of an elastic-elastic ring-seal consisting of two parts, one part of which is soldered to the lid and has a rib, and the other is soldered to the film and has a groove (RU163627, А61В 17/00, publ. 07/27/2016) .

The disadvantages of this device are:

a) the complexity of the design;

b) the inability to control the temperature of the supplied solution, which can cause hypothermia of the wound with a subsequent decrease in the healing rate;

c) the inability to use solutions that carry oxygen and synthetic blood substitutes;

d) The presence of rigid elements on the bandage, which reduce the possibility of using the device on soft tissues;

e) inability to work with deep wounds.

The invention is based on the task of creating a device for creating an environment with specified characteristics in soft tissue wounds, including those with a complex shape, in which the optimal wound temperature would be maintained using heating of the solution and heat-insulating means of the applied dressing, reducing the concentration of pro-inflammatory agents when the solution is injected and their subsequent evacuation when changing the solution, as well as the possibility of using a variety of active agents and their combinations.

The solution of the stated technical problem is ensured by the fact that the device for creating an environment with specified characteristics in soft tissue wounds, including a tube connected to a container for collecting waste, and a tube for removing waste from the wound, a pump for supplying medicinal solutions to the wound with the ability to adjust the supply of medicinal solutions, contains a container for medicinal solutions, to which an aeration line is connected from an air pump with an attached bacterial filter, connected to a pump for supplying a medicinal solution to the wound, which is additionally equipped with a temperature sensor and a heating element configured to control the heating temperature, while the pump for supplying the drug solution is configured to control the rate of supply of the drug solution to the wound, while an additional pump is installed to remove waste from the wound, connected to the control unit, while the device contains a bandage to create an environment with given characteristics in soft tissue wounds according to claim 6. The dressing for creating an environment with specified characteristics in soft tissue wounds contains a polyurethane vapor-permeable film with an adhesive inner layer, under the film there is a 5 mm thick polyurethane foam modeled on the shape of the wound, in which taps for supplying medicinal solution and for its removal.

In this case, antiseptics, colloidal solutions of metal microcrystals, solutions with bacteriophages, growth factors, perftoran for active oxygen therapy of the wound surface can be used as a medicinal solution.

Among modern dressings, there is no dressing that allows you to replace the active substance while on the wound. This design allows you to keep the necessary solutions in the wound area, limiting the area of impact, the boundaries of the wound surface. The supply of a heated solution, the heat-insulating properties of the bandage and the reduction in the number of dressings make it possible to maintain the optimal temperature of the wound, control the parameters of the environment at the entrance.

The invention is illustrated in figure 1, which shows a diagram of the device.

A device for creating an environment with specified characteristics in soft tissue wounds includes a container for collecting waste 11 and a pump 6 for supplying medicinal solutions to the wound with the ability to adjust the supply of medicinal solutions, a control unit 12. The device contains a container 3 for medicinal solutions, to which an aeration line is connected from an air pump 2 with an attached bacterial filter 1. The container 3 contains a temperature sensor 4 and a heating element 5. The temperature and rate of supply of the medicinal solution to the wound are controlled by the control unit 12, which also controls the operation of the pump 10 to remove waste from the wound. Dressing 8 for creating an environment with desired characteristics in soft tissue wounds contains a vapor-permeable polyurethane film with an adhesive inner layer. Under the film, a polyurethane foam 5 mm thick, modeled after the shape of the wound, is installed, in which taps for supplying the drug solution 7 and for removing it 9 are installed.

The device works as follows.

The solution is poured into container 3. The necessary preparation of the solution is carried out (heating with heater 5 and, if necessary, oxygenation). Temperature regulation, pump operation is carried out using the control unit 12. Then, using a roller pump 6, part of the solution is pumped into the dressing 8, which is in direct contact with the wound. The solution is there for a given time for a given active medium. Then, with the help of another pump 10, the solution is removed from the wound and the cycle is repeated again.

Clinical cases Patient 65 years old

Chronic venous insufficiency.

Trophic ulcer on the posterior surface of the right leg with signs of infection, size 15×6 cm. With signs of infection. Copious exudation. Lots of fibrin deposits.

Bandage applied. For 2 days, a solution of Prontosan 36°C was applied to the bandage with an exposure of 6 hours and subsequent replacement of the solution.

When the dressing was changed, the signs of inflammation decreased, the wound began to clear from fibrin.

The bandage was reapplied and treatment with Prontosan solution was started with the same parameters.

On the 4th day the dressing was changed.

When the dressing is changed, signs of inflammation are minimal. Some areas of the wound were completely cleared of fibrin.

The bandage was applied again and treatment with Prontosan solution was started, with the initial parameters.

On the 6th day the bandage was removed. The wound is without signs of inflammation, practically cleared of fibrin, exudation is minimal. The beginning of epithelialization of the wound is observed.

Alginate dressings with silver were applied to the wound, and a compression bandage with bandages of low extensibility was applied to the limb.

The patient is 53 years old.

Suffered an ischemic stroke.

Paraplegia of the lower extremities

Decubitus in the region of the trochanter of the left femur.

Condition after necrectomy.

Wound size rounded wound with a diameter of 8 cm

There are signs of inflammation. Profuse exudation. Most of the wound is covered with fibrin.

Bandage applied. During 2 days, Prontosan 36°C solution was applied to the dressing with an exposure of 6 hours, and the subsequent replacement of the solution.

When the dressing was changed, the signs of inflammation decreased, the wound was almost completely cleared of fibrin.

The bandage was reapplied and treatment with Prontosan solution was started, with the same parameters.

On the 4th day the dressing was changed.

When the bandage is changed, there are no signs of inflammation. The wound is completely cleared of fibrin, areas of granulation are visible.

The bandage was applied again and treatment with Prontosan solution was started, with the initial parameters.

On the 6th day the bandage was removed. The wound is without signs of inflammation, fibrin is absent, the entire bottom of the wound is covered with granulation tissue.

An alginate bandage with silver fixed with a polyurethane wound dressing was applied to the wound.

Claims (6)

1. A device for creating an environment with specified characteristics in soft tissue wounds, including a tube connected to a waste collection container and a tube for removing waste from the wound, a pump for supplying medicinal solutions to the wound with the ability to adjust the supply of medicinal solutions, a control unit that differs by the fact that the container for medicinal solutions, to which the aeration line is connected from the air pump with an attached bacterial filter, connected to the pump for supplying the medicinal solution to the wound, is additionally equipped with a temperature sensor and a heating element configured to control the heating temperature, while the pump for supply of the drug solution is configured to control the rate of supply of the drug solution to the wound, while an additional pump is installed to remove waste from the wound, connected to the control unit, while the device contains a bandage to create an environment with specified characteristics in soft wounds x fabrics. 2. The device according to claim 1, characterized in that antiseptics are used as a medicinal solution. 3. The device according to claim 1, characterized in that colloidal solutions of metal microcrystals are used as a drug solution. 4. The device according to claim 1, characterized in that solutions with bacteriophages and growth factors are used as a medicinal solution. 5. The device according to claim 1, characterized in that perftoran is used as a medicinal solution for active oxygen therapy of the wound surface. 6. A dressing of a device for creating an environment with specified characteristics in soft tissue wounds according to claim 1, characterized in that it contains a vapor-permeable polyurethane film with an adhesive inner layer, a 5 mm thick polyurethane foam modeled after the shape of the wound is installed under the film, in which taps for supply of the drug solution and for its removal.

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