TW200808396A - System and method for purging a reduced pressure apparatus during the administration of reduced pressure treatment - Google Patents

Abstract

A reduced pressure delivery system for applying a reduced pressure to a tissue site is provided. The system includes a manifold having a plurality of flow channels. The manifold is configured to be placed adjacent the tissue site. A first conduit is in fluid communication with the flow channels of the manifold to deliver a reduced pressure to the flow channels. A second conduit is in fluid communication with the flow channels of the manifold and is operably connected to a valve. The valve selectively purges the second conduit with ambient air when the valve is positioned in an open position, and a controller is operably connected to the valve to place the valve in the open position for a selected amount of time at a selected interval during delivery of reduced pressure through the first conduit.

Description

200808396 IX. DESCRIPTION OF THE INVENTION: TECHNICAL FIELD OF THE INVENTION The present invention relates generally to a system and method for promoting tissue growth, and more particularly to a method for applying decompression to a tissue site Tissue treatment system. [Prior Art]

Decompression therapy is increasingly being used to promote wound healing in soft tissue wounds that heal very slowly or not heal without the use of decompression therapy. Typically, the reduced pressure is applied to the wound site by an open-cell foam that acts as a manifold to distribute the reduced force. The open-cell foam is sized to be suitable for existing wounds, in contact with the wound, and then periodically replaced with the amount of tissue that is periodically elongated into the pores of the foam as the wound begins to heal and becomes smaller, requiring Frequently more = hole foam. The large amount of tissue that is growing during the removal of the foam can cause pain to the patient. Decompression therapy is usually applied to non-healing open wounds. In some cases, the tissue being treated is subcutaneous tissue, and in other instances, the tissue is located in or on the skin tissue. Traditionally, decompression therapy—mainly applied to soft, and lytic decompression treatments, has not been used to treat closed deep tissue wounds because it is difficult to access such wounds. In addition, decompression therapy has not been used in conjunction with the treatment of skeletal skeletal defects or the promotion of bone growth, which is mainly due to the difficulty of accessing the iliac. Applying decompression therapy by surgically exposing the bone may cause more problems than the problem it solves. Finally, the development of devices and systems for the application of decompression/sigma therapy has barely exceeded the open-cell foam 119763.doc 200808396. The shape of the open-cell foam is adapted to the wound site by hand and subsequently treated under reduced pressure. Remove it after the cycle. SUMMARY OF THE INVENTION The system and method of the present invention addresses the problems associated with prior wound healing systems and methods. In accordance with an embodiment of the present invention, a reduced pressure delivery system is provided for applying a reduced pressure to a tissue site. The reduced pressure delivery port comprises a manifold having a plurality of flow channels. The manifold is configured to be placed adjacent to the tissue site. A first conduit is in fluid communication with the flow passages of the manifold to deliver a reduced pressure to the flow passages. A second conduit is in fluid communication with the flow passages of the manifold and is operatively coupled to a valve. The valve selectively cleans the second conduit with a surrounding space when the valve is positioned in an open position, and a controller is operatively coupled to the valve to deliver reduced pressure via the first conduit The valve is placed in the open position for a selected amount of time at a selected interval. In accordance with another embodiment of the present invention, a method of administering a reduced pressure tissue treatment to a tissue site is provided. The method includes positioning a manifold having a plurality of flow channels adjacent the tissue site such that at least a portion of the flow channels are in fluid communication with the tissue site. Applying a reduced pressure to the tissue site via a first conduit having at least one outlet in fluid communication with the flow channels and delivering a fluid to the abutment via a second conduit An area of the at least one outlet of the first conduit to clean the obstruction in or near the first conduit. According to still another embodiment of the present invention, there is provided a method of performing 119763.doc 200808396 decompression tissue treatment on a tissue site. The method includes positioning a manifold having a plurality of flow channels adjacent the tissue site such that at least a σ file of the flow channels is in fluid communication with a 5 kel portion. A reduced pressure is applied to the tissue site via a first conduit having at least one outlet in fluid communication with the flow channels. An operatively associated valve is coupled to the second conduit to expose the conduit to a fluid at a pressure greater than the reduced pressure. The valve is opened for a selected amount of time at a selected interval to permit fluid to be delivered via the second conduit to assist in clearing obstructions in or near the first conduit. Other (four), features, and advantages of the present invention will become apparent from the accompanying drawings. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described in detail with reference to the accompanying drawings. The embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is understood that other embodiments may be utilized and may be modified in the logical, mechanical, electrical, and chemical aspects. The spirit or scope of the invention is not departed. In order to avoid obscuring the details required to enable the skilled artisan to practice the invention, this description may omit certain information that is known to those skilled in the art. Therefore, the following detailed description is not to be considered as limiting, and the scope of the invention 4 The term "elasticity" as used herein means having the properties of an elastomer. The term 'elastomer' large system refers to a polymer material having the same properties as rubber^119763.doc 200808396 More specifically, most elastomers It has an elongation of more than 1% and a significant degree of resilience. The resilience of a material means that the material recovers from elastic deformation. Examples of the elastomer may include, but are not limited to, natural rubber, polyisophthalene 'styrene butadiene rubber', chloroprene rubber, polybutadiene, nitrile rubber, isobutyl rubber, ethylene propylene rubber, Ethylene, propylene, women and women monomer ^ glue 'chlorosulfonated polyethylene, polysulfide rubber, polyamino phthalate oxygen. The term "flexible" as used herein refers to an object or material that is capable of bending or flexing. The elastic material is generally flexible, but the flexible materials referred to herein do not necessarily define the selected material only as an elastomer. The use of the term "flexible" in conjunction with a material of the invention or a reduced pressure delivery device means that the material is capable of conforming or closely matching the shape of a tissue site. For example, the flexible nature of the delivery device for treating a bone defect allows the device to wrap or wrap around a portion of the bone that has a defect. The term "fluid" as used herein generally refers to a gas or liquid, and also includes any other flowable material including, but not limited to, a gel, a gel or a foam. The term "impervious" as used herein generally refers to films, coverings, and the ability of other materials to block or slow the penetration of liquids or gases. Unexpected properties can be used to refer to coverings, sheets or other films that block the passage of liquids and allow gases to pass through the film. Although the impermeable film may be impermeable to liquids' however, the film may simply reduce the transmission of all or only certain liquids. The use of the term "impermeable" is not intended to imply that the impervious film is above or below any particular industry standard impermeability measurement, such as the specific value of water vapor transmission 119763.doc 200808396 rate (WVTR). . As used herein, the term "manifold," large system refers to a substance or structure provided to facilitate the application of reduced pressure to a tissue site, the delivery or removal of fluid from the tissue site. The manifold typically includes a plurality of flow passages or passages for each other to improve the distribution of fluid supplied to or removed from the tissue region surrounding the manifold. Examples of manifolds can include, but are not limited to, devices having structural elements configured to form flow channels, honeycomb hair/packages (eg, open cell foams), porous tissue collection devices, and packages containing or solidified Liquid, gel and foam in the flow channel. As used herein, the term "reduced pressure" means a pressure that is less than the surrounding pressure at the tissue site being treated. In most cases, the reduced pressure will be less than the environmental pressure at the patient's location. Optionally, the reduced pressure can be less than the hydrostatic pressure of the tissue at the tissue site. Although the terms vacuum, and "negative pressure" can be used to describe the pressure applied to the tissue site, the actual pressure applied to the tissue site can be significant. Below the pressure normally associated with _ pure vacuum. The reduced pressure creates fluid flow in the area of the tube and tissue at the beginning. As the hydrostatic pressure around the tissue site approaches the desired reduced pressure, the flow may slow down and, subsequently, maintain the reduced pressure. Unless otherwise stated, the pressure values _ described herein are gauge pressures. The term "stent" as used herein refers to a substance or structure that is used to reinforce or promote cell growth and/or tissue formation. The scaffold is typically a three-dimensional porous structure that provides a template for cell growth. Coated with or consisting of cells, growth factors or other nutrient composition for promoting cell growth, H9763.doc -10- 200808396. The scaffold can be used as a manifold according to the embodiment of the Taisho , , Decompression tissue treatment is used. The term "plate key Qiu You" in this article refers to a wound or defect located above or within any tissue, including 徊^: 1 t 匕 仁 is not limited to skeletal tissue , adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage, tendon, or belch. The term "organizational site" may further refer to the region of any organization that may not be injured or have Defects, but want to enhance or promote the growth of additional tissue in these regional tissues. For example, in some tissue areas, the use of reduced-texture silk growth additional groups can be used in some tissue areas. The additional tissue can then be harvested and transplanted to another tissue site. Referring to Figures 1 through 5, a reduced pressure delivery device or wing manifold 211 in accordance with the principles of the present invention includes a ridge portion 215 a flexible barrier 213 and a pair of wing portions 219. Each wing portion 219 is clamped along an opposite side of the ridge portion 215. The ridge portion 215 forms an arcuate passage 223 through which the arcuate passage 223 can extend The entire length of the wing manifold 211 may not extend. Although the ridge portions 215 may be centrally positioned on the wing manifold 211 such that the widths of the wing portions 219 are equal, the ridge portions 215 may also be as in Figure 1-5. The offset is shown such that one of the wing portions 219 is wider than the other wing portion 219. If the wing manifold 211 is used in conjunction with bone regeneration or healing and the wider wing manifold 211 will be wrapped around the attachment The extra width of one of the wing portions 219 may be particularly useful around the fixed hardware on the bone. The flexible barrier 213 is preferably made of an elastic material such as a polyoxyl polymer. An example includes a bit Carpinteria,

MED-6015 manufactured by Nusil Technologies of California. While 119763.doc -11- 200808396, it should be noted that the flexible barrier 213 can be made of any other biocompatible, flexible material. The flexible barrier 213 encloses a flexible backing 227 to enhance the strength and durability of the traction backing 213. The flexible barrier 213 enveloping the flexible backing 227 may have a thickness in the arcuate channel 223 that is less than the thickness in the wing portion. By using a polyoxyl polymer to form the flexible barrier 213 to the right, a poly-xylene adhesive can also be used to help bond the flexible backing 227. An example of a polyoxynoxy binder may include med 1011, also sold by the company Nusil Teehn〇1〇gies. The flexible backing 227 is preferably made of a polyester knit fabric, for example, 6 〇 13 manufactured by Tempe, Arizonai C. R. Bard. However, the flexible backing 227 can be made of any biocompatible, flexible material that enhances the strength and durability of the flexible barrier 213. In some cases, the flexible backing 227 can be dispensed with if the flexible barrier 213 is made of a material of suitable strength. Preferably, the flexible barrier 213 or flexible backing 227 is impermeable to liquids, air and other gases, or alternatively, both the flexible backing 227 and the flexible barrier 213 are impermeable to liquids, air and other gases. The flexible barrier 213 and flexible backing 227 can also be made of a bioresorbable material that does not have to be removed from the patient after use of the reduced pressure delivery device 211. Suitable bioresorbable materials can include, but are not limited to, polymeric blends of polylactic acid (PLA) and polyglycolic acid (PGA). The polymeric blends can also include, but are not limited to, polycarbonates, polyfumarates, and capralact〇ne. The flexible P early wall 213 and the flexible backing 227 can be further used as a new cell growth support, or a stent material can be used in combination with the flexible barrier 213 and the flexible backing 227 to promote cell growth. Suitable scaffolding materials can include, but are not limited to, I19763.doc -12- 200808396 tank acid, collagen, PLA/PGA, sulphate, carbonate, or treated allograft material. Preferably, the scaffold material will have a high void fraction (i.e., a high air content). In one embodiment, the flexible backing 227 can be secured to the surface of the flexible P early wall 213 in an adhesive manner. If a polysiloxane polymer is used to form the flexible barrier 213, the flexible backing can also be secured to the flexible P early wall 213 using a polyoxyxylene adhesive. Although the adhesive is a preferred method of attachment when the surface of the flexible backing 227 is bonded to the flexible backing 213, any suitable attachment method can be used. The flexible barrier 2 1 3 includes a plurality of protrusions 231 extending from the wing portion 219 on the surface of the flexible barrier 2 3-1. The protrusions 231 may be cylindrical, 'spherical, hemispherical, cubic, or any other shape, as long as at least some portion of each protrusion 231 is located at a different plane than the flexible backing η) The plane associated with the side of 231 is sufficient. In this regard, it is not even required that a particular protrusion 231 has the same shape or size as the other protrusions 231; in fact, the protrusions 231 may comprise a random mixture of different shapes and sizes. Therefore, the distance from each of the protrusions 231 from the flexible barrier 213 can be varied, but it can also be phased out in the plurality of protrusions 23丨. The projections 231 are disposed on the flexible barrier 213 to form a plurality of flow passages 233 between the projections. When the projections 231 have the same shape and size and are evenly spaced across the flexible barrier 213, the flow passages 233 formed between the projections 231 are equally uniform. The size, shape and spacing of the protrusions 231 can also be used to vary the size of the flow channel 233 119763.doc -13- 200808396 and flow characteristics. As shown in Fig. 5, a reduced pressure delivery tube 241 is located in the arcuate passage 223 and ported to the flexible barrier 213. The reduced pressure delivery tube 241 can be attached only to the flexible P early wall 213 or the flexible backing 227, or the tube 241 can be simultaneously secured to both the flexible cadaver 213 and the tractable back 227. The reduced pressure delivery tube 241 includes a distal opening 243 at the distal end of the tube 241. The tube 241 can be positioned such that the distal aperture 243 is located at any point along the arcuate channel 223, but the tube is preferably clamped such that the distal aperture 243 is located at approximately the midpoint along the longitudinal length of the arcuate channel 223. The distal aperture 243 is preferably formed in an elliptical or circular shape by cutting the tube 241 along a plane oriented less than ninety (9 ft) degrees with respect to the longitudinal axis of the tube 241. Although the aperture 243 may also be circular, the elliptical shape of the aperture 243 enhances fluid communication with the flow passage 233 formed between the projections 23!. The reduced pressure delivery tube 241 is preferably made of poly-stone or urethane coated with paralyne. However, any medical grade tube material can be used to construct the reduced pressure delivery tube 241. Other coatings that can be applied to the tube include heparin, anticoagulant agents, anti-fibrinogen, anti-adherent agents, anti-prothrombin, and hydrophilic coatings. In one embodiment, as an alternative to or in addition to the distal aperture 243, the reduced pressure delivery tube 241 may also include a discharge opening or discharge orifice 25 positioned along the reduced pressure delivery tube 241. To further enhance the fluid communication between the reduced pressure delivery tube 241 and the flow channel 233. The reduced pressure delivery tube 241 can be positioned only partially along one of the longitudinal lengths of the arcuate channel 223 as shown in Figures 1 through 5 or alternatively can be along the entire longitudinal length of the arched passage 223 119763.doc • 14 - 200808396 degrees. If positioned such that the reduced pressure delivery tube 241 occupies the entire length of the arcuate passageway, the distal orifice 243 can be capped such that all fluid communication between the tube 241 and the flow passage 233 is via the discharge opening 251. The reduced pressure delivery tube 241 further includes a proximal aperture 255 at the proximal end of the tube 241. The proximal orifice 255 is configured to cooperate with a source of reduced pressure, which will be described in greater detail below with respect to Figure 9. The reduced pressure delivery tube 241 shown in Figures 3, 4, and 5 contains only a single lumen or passage 259. However, the reduced pressure delivery tube 241 can be provided with a plurality of lumens, such as the dual lumen tube 261 shown in Figure 4B. The double lumen tube 261 includes a first lumen 263 and a second lumen 265. The use of a dual lumen tube provides a separate fluid communication path between the proximal end of the reduced pressure delivery tube 241 and the flow channel 233. For example, a dual lumen tube 261 can be used to achieve communication between the reduced pressure source and the flow channel 233 along the first lumen 263. The second lumen 265 can be used to introduce fluid into the flow channel 233. The fluid may be filtered air or other gas, an antibacterial agent, an anti-disease agent, a cell growth promoter, a flushing fluid, a chemically active fluid, or any other fluid. If it is desired to introduce a plurality of fluids into the flow channel 233 via separate fluid communication paths, the reduced pressure delivery tube can have more than two lumens. Still referring to Fig. 4B, a horizontal spacer 271 separates the first and second lumens 263, 265 of the reduced pressure delivery tube 261 such that the first lumen 263 is positioned above the second lumen 265. The relative positions of the first lumen and the second lumen 263, 265 may vary depending on how fluid communication is provided between the lumens 263, 265 and the flow channel 233. For example, when the first lumen 263 is positioned as shown in Figure 4B, a discharge opening 119763.doc -15-200808396 similar to the discharge opening 251 can be provided to achieve communication with the flow passage 233. ^ Positioned outside the Tiandi two lumens as shown in Figure 4, the end of the cavity 263 can communicate with the flow channel 233 via a notification orifice similar to the distal orifice (4). In addition, the trace of \k is selected as 'by allowing each g face to be separated from the vertical spacer to make the one-to-one 昼 昼 多个 并 ' ' ' ' ' 或者 或者 或者 或者The cavity is positioned concentrically or coaxially.

It will be readily apparent to one of ordinary skill in the art that independent fluid communication paths are implemented in a manner that is W, including as described above, in the case of a chamber. Alternatively - the option can be provided to provide a separate fluid communication path by securing a single lumen tube to another single lumen tube, or by (iv) a single, undefined tube with a single or multiple lumens. If a separate tube is used to provide a separate fluid communication path with the flow channel 233, the ridge portion 215 can include a plurality of arcuate channels 223, each of the arcuate channels 223. Alternatively, the dome-shaped passage 223 can be enlarged to accommodate a plurality of tubes. An example of a reduced-pressure delivery tube with a dust-removing delivery tube separate from the fluid delivery tube will be described in more detail below with reference to FIG. Referring to Figures 6-8, a reduced pressure delivery device or wing manifold 311 in accordance with the principles of the present invention includes a flexible barrier 313 having a ridge portion 315 and a pair of wing portions 319. Each wing portion 319 is clamped along the opposite side of the ridge portion 3 15 . The ridge portion 3 15 defines an arcuate passage 323 that may or may not extend over the entire length of the wing manifold 3 i. The ridge portions 315 can be centrally positioned on the wing manifolds 3 such that the wings are 319 degrees apart, but the ridge portions 315 can also be offset as shown in FIGS. 6-8. Thus, one of the wing portions 319 is wider than the other wing portion 119763.doc -16 - 200808396 319. The extra width of one of the wing portions 319 may be particularly useful if the wing manifold 311 is used in conjunction with bone regeneration or healing and the wider wing manifold 311 will wrap around a fixed hardware attached to the bone. . A honeycomb material 327 is secured to the flexible barrier 313 and is provided as a single piece of material that covers the entire surface of the flexible barrier 313 across the ridge portion 3 15 and the two wing portions 319. The honeycomb material 327 includes a fixed surface (not visible in Fig. 6) disposed adjacent to the flexible barrier 313, a distribution surface 329 opposite the fixed surface, and a plurality of peripheral surfaces 33A. In an embodiment, the flexible barrier 313 can be similar to the flexible barrier 213 and includes a flexible backing. Although the adhesive is a preferred method for securing the honeycomb material 327 to the flexible barrier 313, the flexible barrier 313 and the honeycomb material can be secured by any other suitable fastening method, or It is left to the user for assembly at the treatment site. The flexible barrier 及 and/or the flexible backing acts as an impervious barrier to block the passage of fluids such as liquids, air or other gases. Lining to support the road to stay from the 丨. 〇 7 «

The ridge portion and the wing portion of the wall 3 13 . In an embodiment, the 彳 does not provide a sturdy barrier and a sinusal integral barrier. Then, the material 327 - the flexible barrier 313 is preferably polymerized by, for example, polysulfide

119763.doc Arbitrarily made of elastic materials such as polymers, examples include by Carpinteria, -17- 200808396

MED-6015 manufactured by Nusil Technologies of California. However, it should be noted that the flexible barrier 3 13 can be made of any other biocompatible, flexible material. If the flexible barrier encloses or otherwise comprises a flexible backing, the flexible backing is preferably made of a polyester knit fabric, such as Bard 6013 manufactured by C. R. Bard, Inc. of Ternpe, Arizona. However, the flexible backing 227 can be made of any biocompatible, flexible material that enhances the strength and durability of the flexible fence 313. In one embodiment, the honeycomb material 327 is an open cell, reticulated polyether amine phthalate foam having a pore size in the range of from about 400 to about 600 microns. An example of such a foam may include GranuFoam manufactured by Kinetic Concepts, Inc. of San Antonio, Texas. Honeycomb material 328 can also be gauze, felt, or any other biocompatible material that provides fluid communication in a plurality of dimensions in a plurality of channels. Honeycomb material 327 is primarily an "open cell" material that includes a plurality of holes that are fluidly connected to adjacent holes. A plurality of flow channels are formed between the "open holes" by the "open holes" of the honeycomb material 327. The flow channels are capable of achieving fluid communication in the entire portion of the honeycomb material 327 having open pores. The cells and flow channels can have a uniform shape and size, or can include patterned or random shapes and dimensional changes. Variations in the size and shape of the apertures in the honeycomb material 327 can cause variations in the flow passages and these characteristics can be used to alter the flow characteristics of the fluid flowing through the honeycomb material 327. The honeycomb material 327 can further include a portion containing a "closed pore." The closed cell portion of the honeycomb material 327 includes a plurality of holes, most of which are not fluidly connected to adjacent holes. An example of a closed portion of the 119763.doc -18 - 200808396 hole portion is described above as a barrier layer that can replace the flexible barrier 313. Similarly, a closed hole portion can be selectively provided in the honeycomb material 327 to prevent fluid from passing through the peripheral surface 33 of the honeycomb material 327. The flexible barrier 3 13 and the honeycomb material 327 may also be made of a bioresorbable material that does not have to be removed from the patient after use of the reduced pressure delivery device 311. Suitable bioresorbable materials may include, but are not limited to, poly A polymeric blend of lactic acid (PLA) and polyglycolic acid (PGA). The polymeric blends can also include, but are not limited to, polycarbonates, polyfumarates, and capralact〇ne. The flexible P early wall 3 13 and the honeycomb material 327 can be further used as a new cell growth scaffold, or a scaffold material can be used in combination with the flexible barrier 313, the flexible backing 327, and/or the honeycomb material 327 to promote Cell growth. Suitable scaffold materials can include, but are not limited to, calcium phosphate, collagen, pLA/pGA, coral hydroxyapatite, carbonate, or treated allograft materials. Preferably, the scaffold material will have a high void fraction (i.e., a high air content). A reduced pressure delivery tube 341 is positioned within the arcuate passage 323 and secured to the flexible barrier 313. The reduced pressure delivery tube 341 can also be secured to the honeycomb material, or in the presence of only the honeycomb material 327, the reduced pressure delivery tube 341 can be fixed only to the honeycomb material 327. The reduced pressure delivery tube 341 includes a distal opening 343 at the distal end of the tube Mi, which is similar to the distal opening M3 of FIG. The reduced pressure delivery tube 341 can be positioned such that the distal aperture 343 is located at any point along the arcuate channel 3, but is preferably positioned along the longitudinal length of the arcuate channel 323: approximately at the midpoint. The distal aperture 343 is formed into an expanded circular or circular shape by cutting the tube 341 along a plane oriented at an angle of less than ninety (90) degrees with respect to the longitudinal axis of the tube 341. Although the orifice may also be in the shape of a circle 119763.doc -19-200808396, the elliptical shape of the orifice enhances fluid communication with the flow passage in the honeycomb material milk. In the embodiment, the reduced pressure delivery tube 341 may also include a discharge opening or discharge orifice (not shown) similar to the discharge opening 251 of FIG. As an alternative to or in addition to the distal aperture 343, a discharge opening H is placed along the tube (4) to enhance fluid communication between the delivery tube (4) and the flow channel. As previously described, the reduced pressure delivery #341 can be positioned only partially along the longitudinal length of the arched passage 323, or alternatively, can be positioned along the entire longitudinal extent of the shaped passage 323. If positioned such that the reduced pressure conduit occupies the entire arcuate passage 323, the distal orifice 343 can be shrouded such that all fluid communication between the official 341 and the flow passage is through the discharge opening. At the rut, the honeycomb material 327 covers and directly contacts the reduced pressure delivery pipe 341. The honeycomb material 327 can be attached to the reduced pressure delivery tube, or the honeycomb material 327 can be attached only to the flexible barrier 313. If the pressure-reducing duct 341 is clamped so as to extend only to a point in the arched passage 323, the honeycomb material 327 may also be connected to the barrier barrier in a region of the arched passage 323 that does not include the reduced-pressure duct 341. 3 13 ridge portion 3 15 . The reduced pressure delivery officer 341 further includes a proximal aperture 355 at the proximal end of the tube 341. The proximal orifice 355 is configured to cooperate with a source of reduced pressure, which will be described in greater detail below with respect to Figure 9. The reduced pressure delivery tube 341 shown in Figures 6 through 8 contains only a single lumen or passage 359. However, the reduced pressure sputum 341 can include a plurality of lumens, such as the plurality of lumens previously described with reference to Figure 4A. As previously described, the use of a multi-lumen tube provides a separate fluid communication path between the proximal end of the reduced pressure delivery tube 341 119763.doc 200808396 and the flow channel. The separate fluid communication paths may also be provided by separate tubes having single or multiple lumens in communication with the flow channels. Referring to Figures 8A and 8B, a reduced pressure delivery device in accordance with the principles of the present invention includes a reduced pressure delivery tube 373 having an extension 375 at a distal end 377 of the reduced pressure delivery tube 373. The extension portion 375 is preferably arched to match the curvature of the reduced pressure delivery tube 373. The extension portion 375 can be formed by removing a portion of the reduced pressure delivery tube 373 at the distal end 377, thereby forming a slit 381 having a shoulder 3 83. A plurality of protrusions 385 are disposed on an inner surface 387 of the reduced pressure delivery tube 373 to form a plurality of flow channels 391 between the protrusions 385. The size, shape and spacing of the protrusions 385 can be similar to the protrusions described with reference to Figures 1 to 5. The reduced pressure delivery device 371 is particularly useful for applying reduced pressure to connective tissue that can be received within the incision 381 and regenerating tissue on connective tissue. The ligaments, tendons, and cartilage are non-limiting examples of tissue that can be treated by the reduced pressure delivery device 371. Referring to Figure 9, a reduced pressure tissue treatment is applied to a tissue site 413 (e.g., the patient's human bone 415) using a reduced pressure delivery device 411 similar to other reduced pressure delivery devices described herein. When used to promote bone tissue growth, decompression tissue treatment increases the rate of healing associated with fractures, non-union, voids, or other bone defects. It is further believed that reduced pressure tissue treatment can be used to improve the recovery of osteomyelitis. This treatment can be further used to increase the local bone density in patients with osteomyelitis. Finally, decompression tissue treatment can be used to accelerate and improve 〇seointegration of orthopedic implants such as hip implants, knee implants, and fixation devices. 119763.doc -21- 200808396 Still referring to Fig. 9', the reduced pressure delivery device 411 includes a reduced pressure delivery tube 419 having a proximal end 421 fluidly coupled to a reduced pressure source 427. The reduced pressure source 427 is a pump or any other device capable of applying a reduced pressure to the tissue site 413 via a plurality of flow channels associated with the reduced pressure delivery tube 419 and the reduced pressure delivery device 411. Applying a reduced pressure to the tissue site 413 is accomplished by arranging the wing portion of the reduced pressure delivery device 411 adjacent the tissue site 413, which in this particular example involves wrapping the wing portion around the void defect 429 in the bone 415. . The reduced pressure delivery device 411 can be inserted by surgery or through the skin. When inserted through the skin, the reduced pressure delivery tube 419 is preferably inserted through a sterile insertion sheath that penetrates the skin tissue of the patient. The application of reduced pressure tissue treatment typically produces granulation tissue in the area surrounding the tissue site 413. Granulation tissue is a common tissue that is often formed before tissue repair in the human body. Under normal conditions, granulation tissue may form during the presence of foreign bodies or during wound healing. Granulation tissue is commonly used as a scaffold for healthy replacement tissue and further to form certain scar tissue. The granulation tissue is a tissue that is vascularized, and the increased growth rate of such highly vascularized tissue promotes the growth of new tissue at the tissue site 413 in the presence of reduced pressure. Still referring to Fig. 9, a fluid delivery tube 43 1 can be fluidly coupled to the flow passage of the reduced pressure delivery device 411 at a distal end. Fluid delivery tube 43A includes a proximal end 432 that is fluidly coupled to a fluid delivery source 433. If the system air is being delivered to the tissue site, the air is preferably filtered by a filter 434 capable of filtering microparticles as small as 22 μηι, thereby purifying the air and killing the bacteria 119763.doc-22 200808396. Especially when the tissue site 413 is positioned beneath the surface of the skin, it may be important to introduce air into the tissue site 413, which facilitates good clearance of the tissue site 413, thereby relieving or preventing clogging of the reduced pressure delivery tube 419. Fluid delivery tube 431 and fluid delivery source 433 can also be used to introduce other fluids to tissue site 413 including, but not limited to, antibacterial agents, antiviral agents, cell growth promoters, irrigation fluids, or other chemically active agents. When inserted through the skin, the reduced pressure delivery tube 43 1 is preferably inserted through a sterile insertion sheath that penetrates the skin tissue of the patient. A pressure sensor 43 5 can be operatively coupled to the fluid delivery tube 431 ' to indicate whether the fluid delivery tube 431 is blocked by blood or other bodily fluids. Pressure sensor 435 can be operatively coupled to fluid delivery source 433 for feedback to control the amount of fluid introduced to tissue site 413. A check valve (not shown) may also be operatively coupled to the vicinity of the distal end of the fluid delivery tube 431 to prevent blood or other bodily fluids from entering the fluid delivery tube 43 1 . The independent fluid communication # path provided by the reduced pressure delivery tube 419 and the fluid delivery tube 43 can be achieved in a number of different ways, including providing a single multi-lumen tube as previously described with reference to Figure 4B. One of ordinary skill in the art will recognize that if a multi-lumen tube is used, the sensing, valves, and other components associated with the fluid delivery tube 431 can similarly be associated with one of the reduced pressure delivery tubes 419. Specific bureaucratic associations. Preferably, any lumen or body in fluid communication with the tissue site is coated with an anticoagulant to prevent clogging of body fluids or blood within the lumen or tube. Other coatings that can coat such lumens or tubes include, but are not limited to, heparin, anticoagulants, anti-fibrinogen, anti-adherents, anti-prothrombin, and hydrophilic coatings. 119763.doc -23- 200808396 ♦ Figure 1 Gi Figure 19 'The test has proved that when the decompression group is applied to the bone n-ray, the treatment will have a positive effect. In a specific trial, decompression tissue treatment was applied to the first month of a rabbit to determine its specific target for bone growth and fruiting. The specific goal of this test was to find that there was no defect or injury in the first month of the decompression tissue treatment. The effect of rabbits, the effect of decompression tissue treatment on rabbits with critical size defects on the skull, and the effect of using a stent material with decompression tissue treatment on the treatment of critical size defects on the skull. The specific test protocol and number of rabbits are listed in table i below. Soil L quantity - _ test plan __ ^ no defect on the top, with the honeycomb foam (GranuFoam) on the top of the periosteum of Yuanhao applied decompression tissue treatment (RPTT) for 6 days 'then immediately harvested tissue ____ skull No defect; no decompression tissue treatment (GranuFoam) placed on top of intact periosteum for 6 days in RPT, followed by immediate harvesting of tissue

4 4 kr\2 # # t inch inch ruler J 孓f in the pro-Tu; ρτ grid R wire branch steel calcium small rust acid 24 non-phosphorus placement should be placed on the surface of the loss There is a critical dimension defect on which a stainless steel wire mesh is placed on each of the two sets of receiving damage weeks; a critical dimension of the calcium phosphate stent placed thereon; 24 hours for the two defects RPTT; harvested tissue 1 h week after surgery with a critical size defect with stainless steel mesh placed thereon; a critical size defect with a calcium phosphate scaffold placed thereon; 6 days RPTT applied to both defects; 2 weeks after surgery The harvested tissue has a critical size defect on which the stainless steel mesh is placed; a critical size defect on which the acid is placed on the stent; a 6-day RPTT is applied to the two defects; and the tissue is harvested 12 weeks after the surgery 119763.doc - 24- 200808396 Ten has a critical dimension of stainless steel mesh placed on it; a critical size defect in which a calcium phosphate stent is placed; no RPTT (control) is applied; tissue is harvested after 2 weeks of surgery The group is inch-inch and the ruler is bounded by the border of the 12th. The grid wire is hand-rolled with calcium in the rust acid; not filled with the Ϊ#, put the T (f face T on the upper RP in use) Should be a mountain, ··, with damage

4 sham operation (no defect, no RPTT): harvesting tissue after 6 days of surgery Table 1: Test plan s defect in the defect size tissue (such as the skull), the size is large enough that it cannot be used only by Self recovery to heal. For rabbits, drilling a full thickness hole of approximately 15 mm in diameter through the skull creates a critical dimension defect in the skull. Referring more specifically to Figure 10, a tissue section of a rabbit skull having primitive, undamaged bones is illustrated. The skeletal tissue of the skull is magenta, the surrounding soft tissue is white, and the periosteal layer is highlighted by a yellow asterisk in Figure 11, illustrating the rabbit skull after application of decompressed tissue treatment for 6 days followed by immediate harvesting of the tissue. The bones and periosteum can be seen and a layer of granulation tissue has formed. In Fig. 12, a rabbit skull after application of decompression tissue treatment for 6 days and subsequent harvesting of tissue immediately is illustrated. The tissue section in the figure is characterized by the formation of a new skeletal tissue beneath the granulation tissue. The bone county organization is highlighted by a yellow asterisk. In Fig. 13, the rabbit skull after the application of the decompressed tissue treatment for 6 days and immediately after harvesting the tissue is illustrated. You can see new bones and periosteum. The tissue appearance of bone tissue formed by decompressive tissue treatment is very similar to the tissue appearance of bone formation in very young animals that are undergoing rapid new bone growth and deposition in 119763.doc -25-200808396. Referring more specifically to Figures 14 through 19, several photographs and tissues are illustrated which show the procedure and results of decompression, //oral therapy for rabbit skulls having critical size defects. In Fig. 14, a rabbit skull having two critical size defects formed thereon is illustrated. These full thickness critical dimension defects are about 15 inches. In Figure 15, one of the critical dimension defects has been placed - no wire mesh is recorded, i is placed in the ^ critical dimension defect - calcium phosphate stent. In Fig. 16, a pressure similar to that described herein is used, and the weaving treatment is applied to reduce the critical dimension defect. The pressure applied to each of the missing applications is _125 mm Hg gauge. This reduced pressure is applied according to one of the test protocols listed in Table 1. In Fig. 17, a skull after application of a 6-day decompression tissue treatment and collecting tissue after 12 weeks of surgery is illustrated. The slice shown contains a calcium phosphate scaffold, which is indicated by a red arrow. The use of decompression tissue treatment results in significant growth of new bone tissue, which is highlighted by a yellow asterisk in Figure 17. The amount of bone growth is significantly greater than the amount of bone growth in critical size defects that are treated with the same calcium phosphate scaffold but not treated with decompressive tissue. This observation suggests that there may be a treatment threshold or duration required to induce a new bone formation response. The effect of decompression tissue treatment was evident in the samples collected 12 weeks after surgery. This indicates that decompression tissue treatment caused a cascade of biological events to enhance the formation of new bone tissue. The critical size defect covered with a stainless steel mesh (Fig. 15) but without the stent material in the defect was used as an intra-animal control with minimal bone growth. 119763.doc -26 - 200808396 Qian Si Yuke cried out the advantages of proper scaffolding materials and the positive effects of decompression tissue on stent fusion and bioavailability. In Figures 18 and 19; a radiograph of the critical ruler = defect of the stent after six days of decompression tissue treatment is illustrated. Figure 18 illustrates the defect two weeks after surgery and shows that a certain new bone has been deposited in the stent. The main structure of the stent is still obvious; see. Figure 19® illustrates the defect after 12 weeks of surgery and shows that the critical dimension defect is almost completely healed and the main stent architecture is nearly completely lost due to tissue fusion (ie, the formation of a new bone path within the stent matrix). Referring to Fig. 20, a reduced pressure delivery system m according to an embodiment of the present invention performs decompression tissue treatment on a tissue site 713 of a patient. The reduced pressure delivery system 711 includes a manifold delivery tube 721. The manifold delivery tube 721 can be a catheter or cannula and can include means for enabling the manifold delivery tube 721 to be guided to the tissue site 713, such as a guide unit 725 and a guide wire. The placement and guidance of the guide wire 727 and the manifold delivery tube 721 is accomplished using endoscopy, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique. Manifold delivery tube 721 is provided. For use to insert a reduced pressure delivery device through the skin into the tissue site 7 i 3 of the patient. When inserted through the skin, the manifold delivery tube 721 is preferably inserted through a sterile insertion sheath that penetrates the patient's skin tissue. 20, the tissue site 713 includes bone tissue at a fracture site 73 1 adjacent the patient's bone 733. The manifold delivery tube 721 is inserted through the skin 735 of the patient and any soft tissue 739 surrounding the bone 733. As previously described, the tissue Site 713 can also comprise any type of tissue including, but not limited to, adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue 119763.doc -27- 200808396 woven, cartilage, sputum, or Referring to Figures 21 and 22, it further illustrates a reduced pressure delivery system 7n. The manifold delivery tube 721 can include a tapered distal end 743 for easy insertion through the patient's skin 735 and soft tissue 739. The tapered distal end 743 It may be further configured to flex radially outwardly to an open position such that the inner diameter of the distal end 743 will be substantially the same or greater than the inner diameter of the other portions of the tube 721. The open position of the distal end 743 is in Figure 21 The manifold delivery tube 721 further includes a passageway 751 including a pressure relief delivery device 761 or any other reduced pressure delivery device. The reduced pressure delivery device 761 includes a flexible barrier. 765 and/or honeycomb material 767, similar to that described with reference to Figures 6-8. The flexible barrier 765 and/or honeycomb material 767 is preferably wound, folded or otherwise compressed around the reduced pressure delivery tube 769 to The cross-sectional area of the reduced-pressure delivery device 761 within the passage 751 is reduced. The reduced-pressure delivery device 761 can be placed within the passage 751 and guided to the tissue site after the distal end 743 of the manifold delivery tube 721 is placed at the tissue site 713 Another option for 713° is The reduced pressure delivery device 761 is pre-positioned in the passage 751 prior to insertion of the manifold delivery tube 721 into the patient. To push the reduced pressure delivery device 761 through the passage 751, a biocompatible lubricant can be used. The friction between the reduced pressure delivery device 761 and the manifold delivery tube 721 is reduced. After the distal end 743 has been positioned at the tissue site 713 and the reduced pressure delivery device 761 is delivered to the distal end 743, the reduced pressure delivery device 761 is then placed The distal end 743 is urged toward the distal end 743 to expand radially outward to the open position. The reduced pressure delivery device 761 is pushed out of the manifold delivery tube 721, preferably into the void or space adjacent the tissue site 713. This void or space is usually formed by cutting the soft tissue 119763.doc -28 - 200808396, which can be done by the skin route. In some cases, the tissue site 713 can be located at the wound site and naturally present - voids due to wound anatomy. In other cases, the void may be formed by aeration bladder separation, sharp separation, blunt separation, hydraulic separation, pneumatic separation, ultrasonic separation, electrocautery separation, laser separation, or any other suitable separation technique. When the pressure delivery device 761 enters the gap of the thief adjacent tissue portion 713, the flexible barrier 765 and/or the honeycomb material 767 of the reduced pressure delivery device 761 is unwound, unfolded, or decompressed (see Fig. " The delivery device 761 can be placed in contact with the tissue site 713. Although this need not be the case, the flexible barrier 765 and/or the honeycomb material 767 can be subjected to a vacuum or reduced pressure provided via the reduced pressure delivery tube 769 for compression flexing. The barrier 765 and/or the honeycomb material 767. The unfolding of the flexible barrier 765 and/or the honeycomb material 767 can be achieved by releasing the reduced pressure delivered via the reduced pressure delivery tube 769 or by depressurizing Delivery tube 769 provides positive pressure to assist in the process of unwinding. Endoscopy, ultrasound, fluoroscopy, auscultation, palpation, or any of its can be used. His suitable localization technique is used to achieve final placement and manipulation of the reduced pressure delivery device 761. After placement of the reduced pressure delivery device 761, the manifold delivery tube 721 is preferably removed from the patient, but associated with the reduced pressure delivery device 761 The reduced pressure delivery tube remains in place so as to be able to apply a reduced pressure to the tissue site 713 through the skin. Referring to Figures 23 through 25, the reduced pressure delivery system 811 according to an embodiment of the present invention includes a conical shape The manifold delivery tube 821 of the end 843, the tapered distal end 843 is configured to flex radially outwardly to an open position such that the inner diameter of the distal end 843763.doc -29 - 200808396 will be substantially the same or greater than The inner diameter at the other portion of the tube 821. The opening position of the distal end 843 is schematically shown by dashed lines 837 in Figures 23 through 25. The manifold delivery tube 821 further includes a passageway containing a similar The reduced pressure delivery device Mi of the other reduced pressure delivery device described herein. The reduced pressure delivery device 861 comprises a flexible barrier 865 and/or honeycomb material 867, flexible barrier 865 and/or honeycomb material %? Winding, folding It is compressed around the reduced pressure delivery tube 869 in other manners to reduce the cross-sectional area of the reduced pressure delivery device 861 in the passage. The impermeable membrane 871 having an inner surface 873 is disposed around the reduced pressure delivery device 861 to reduce The pressure delivery device 861 is contained within the inner surface 873 of the impermeable membrane 871. The impermeable membrane 871 can be an inflatable bladder, a sheath, or any other type of membrane capable of preventing fluid permeation, such that the impervious membrane The 871 can take at least one of a compressed position (see Figure 23), a relaxed position (see Figure 24), and an expanded position (see Figures 25 and 25). The impervious film 871 is sealingly coupled to the manifold delivery tube 821 to communicate the interior space 873 of the impermeable membrane 871 with the passage body of the manifold delivery tube 821. Alternatively, the impermeable membrane 87 can be secured to the reduced pressure * delivery 869 such that the interior space 873 of the impermeable membrane 871 is in fluid communication with the passage of the reduced pressure delivery 869. The impermeable membrane 871 can in turn be secured to a separate control tube or control lumen in fluid communication with the interior space 873 (see, for example, Figure 25A). The impervious film 871 can be provided in the only embodiment to further reduce the cross-sectional area of the reduced pressure delivery device 861 within the passage. To this end, a pressure lower than the ambient pressure of the impervious film "I is applied to the internal space 873 of the impervious 119763.doc •30-200808396 film 871. A substantial portion of the air or other fluid within the interior space 873 is thereby expelled to place the impermeable membrane 871 in the compressed position shown in FIG. In this compressed position, the impermeable film 871 is attracted inwardly, thereby applying a pressure to the reduced pressure conveying device 861 to further reduce the cross-sectional area of the reduced pressure conveying device 861. As previously described with reference to Figures 21 and 22, the reduced pressure delivery device 861 can be delivered to the tissue site after the distal end 843 of the manifold delivery tube 821 is disposed at the tissue site. The placement and manipulation of the impermeable membrane 871 and the reduced pressure delivery device 861 can be accomplished using endoscopic k-scanning, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique. The impermeable film 871 can include a radiopaque marker 881 which improves the visibility of the impermeable film 871 under the screen inspection prior to its removal. After pushing the reduced pressure delivery device 861 through the distal end 843, the reduced pressure applied to the interior space 873 can be released to place the impermeable membrane 871 in a relaxed position (see Figure 24), thereby facilitating easier The reduced pressure delivery device 861 is removed from the impervious diaphragm 871. A removal device 885 (e.g., a cannula, a needle or other sharp instrument) can be provided to break the impermeable membrane 871. Preferably, the removal tool 885 is inserted through the reduced pressure delivery tube 869 and advanced enough to contact the impermeable membrane 87 1 . After the impervious film 871 is broken, the removal device 885 and the impermeable film 871 can be withdrawn via the manifold transfer tube 821, so that the flexible barrier 865 and/or the honeycomb material 867 of the reduced pressure delivery device 861 can be unwound. Winding, unfolding or uncompressing allows the reduced pressure delivery device 861 to be placed in contact with the tissue site. The unwinding of the flexible barrier 119763.doc -31- 200808396 865 and/or the honeycomb material 867 can occur automatically after releasing the reduced pressure in the interior space 873 and removing the impermeable membrane 871. In some cases, positive pressure may be delivered via the reduced pressure delivery tube 869 to help unwind or uncompress the flexible barrier 865 and/or the honeycomb material 867. After the final placement of the reduced pressure delivery device 861, the manifold delivery tube 821 is preferably removed from the patient, but the reduced pressure delivery tube 869 associated with the reduced pressure delivery device 861 remains in place so as to be able to pass through the skin to the tissue Apply a reduced pressure to the area. The impermeable film 871 can also be used to separate tissue adjacent to the tissue site prior to placement of the reduced pressure delivery device 861 against the tissue site. After pushing the reduced pressure delivery device 861 and the intact impermeable membrane 871 through the distal end 843 of the manifold delivery tube 821, air or another fluid is injected or pumped into the internal space of the impermeable membrane 81. 3 inside. It is preferred to use a liquid to swell the impermeable film 871 because the incompressibility of the liquid allows the impervious film 871 to expand more uniformly and more uniformly. The impermeable film 871 may expand radially as shown in Figure 25, or may expand in an orientation depending on the method of manufacture and the manner in which it is secured on the manifold tube 821. When the impermeable film 871 is expanded outward to the expanded position due to the pressure of air or fluid (see Fig. 25), a void is separated adjacent to the tissue portion. When the void is large enough, air or other fluid in the interior space 873 can be released to enable the impermeable membrane 871 to assume a relaxed position. Then, the impervious film 871 can be broken as explained above, and the decompression transfer device 861 can be inserted adjacent to the tissue site. % Referring to Fig. 25A, if the impermeable film 871 is mainly used to separate the tissue at the site adjacent to the tissue 119763.doc -32 - 200808396, the impermeable film 871 can be hermetically fixed to the manifold delivery tube 821, thereby making the interior Space 873 is in fluid communication with an auxiliary lumen or tube 891 associated with or secured to manifold delivery tube 821. The auxiliary lumen 891 can be used to deliver liquid, air or other fluid to the interior space 873 to place the impermeable membrane 871 in the expanded position. After the separation, the impermeable film 871 can be relaxed and broken as described above with reference to Fig. 24. Referring to Figure 26, a reduced pressure delivery system 9 in accordance with an embodiment of the present invention includes a manifold delivery tube 921 having a tapered distal end 943 that is configured to flex radially outwardly to An open position such that the inner diameter of the distal feed 3 will be substantially the same or greater than the inner diameter at other portions of the tube 921. The position of the opening of the distal end 943 is schematically shown by dashed line 937 in FIG. The gaudal delivery officer 921 further includes a passageway in which a reduced pressure delivery device 961 similar to other reduced pressure delivery devices described herein is included. The reduced pressure transport device 961 includes a flexible barrier 965 and/or honeycomb material 967 that is preferably wound, folded or otherwise compressed around the reduced pressure delivery tube 969 to The cross-sectional area of the reduced pressure delivery device 961 within the passage of the manifold delivery tube 921 is reduced. An impervious film 971 having an inner surface 973 is disposed around the reduced pressure delivery device 961 such that the reduced pressure delivery device 961 is contained within the inner surface 973 of the impermeable membrane 971. The impermeable film 971 encloses a seal 977 on the impervious film π] to provide an alternative method of removing the reduced pressure delivery device 961 from the impermeable film 971. The impermeable membrane 9^1 is sealingly coupled to the manifold delivery tube 921 such that the 119763.doc -33-200808396 internal space 973 of the impermeable membrane 971 is in fluid communication with the passage of the manifold delivery tube 921. Alternatively, the impermeable membrane 971 can be secured to a separate control tube (not shown) in fluid communication with the medial space 973. Similar to the impermeable film 871 of Fig. 23, the impermeable film 971 can prevent fluid from permeating so that the impermeable film 971 can take at least one of a compressed position, a relaxed position, and an expanded position. Since the procedure for placing the impermeable film 791 at the compression position and the expansion position is similar to the impermeable film 871, only the process of removing the decompression conveying device 961 will be described. Delivery of the reduced-pressure delivery device 916 to the tissue site within the impermeable membrane 971 using endoscopy, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique and then correcting it Positioning. The impermeable film 971 can include a radiopaque marker 981 which improves the visibility of the impermeable film 971 under fluorescent screen inspection prior to its removal. The reduced pressure delivery device 961 is then pushed through the distal end 943 of the manifold delivery tube 921. The reduced pressure applied to the interior space 973 can be released to place the impermeable membrane 971 in a relaxed position. Then, the reduced pressure conveying device 961 is pushed through the glue seal 977 to push out the impervious film 971. Referring to Figure 26A', a reduced pressure delivery system 985 in accordance with an embodiment of the present invention may not include a manifold delivery tube similar to the manifold delivery tube 921 of Figure 26. Rather, the reduced pressure delivery system 985 can include a guide wire 987, a reduced pressure transport officer 989, and a reduced pressure delivery device 991. The reduced pressure delivery device 991 includes a plurality of fluids connected to the flow passage of the reduced pressure delivery tube 989. Instead of using a separate manifold delivery tube to deliver the reduced pressure delivery device 991, a 119763.doc -34 - 200808396 reduced pressure delivery device 991 and a reduced pressure delivery tube 989 are placed over the guide wire 987 through the skin. The guide wire 987 is guided to a tissue site 993. Preferably, the guide wire 987 and the reduced pressure delivery tube 989 penetrate the skin of the patient by a sterile sheath. By guiding the reduced pressure delivery tube 989 and the reduced pressure delivery device 991 along the guide wire 987, the reduced pressure delivery device 991 can be placed at the tissue site 993 to effect application of reduced pressure tissue through the skin. Since the reduced pressure delivery device 991 is not constrained in a manifold delivery tube during delivery to the tissue site 993, it is preferred to maintain the reduced pressure delivery device 991 in the compressed position during delivery. If an elastic foam is used as the reduced pressure conveying means 991, the foam can be coated with a biocompatible soluble adhesive and the foam can be compressed. After reaching the tissue site, the body fluid or other fluid delivered via the reduced pressure delivery tube 989 dissolves the binder, thereby expanding the foam to contact the tissue site. Alternatively, a reduced pressure delivery device 991 can be formed from a compressed dry hydrogel. The hydrogel absorbs moisture after being transported to the tissue site 993, so that the reduced pressure delivery device 991 can be inflated. Further, the reduced pressure delivery device 991 can be made of a heat active material such as polyethylene glycol which expands when subjected to the patient's body temperature. In a further embodiment, the compressed reduced pressure delivery device 99 can be delivered to the tissue site in a dissolvable film. Referring to Fig. 27, a reduced pressure delivery system according to an embodiment of the present invention includes a manifold delivery tube 1021 having a distal end 1043 inserted distally through a tissue of a patient to contact a tissue site 1025. . The tissue site 1025 can include a void 1029 associated with the wound or other defect, or alternatively can be formed by knife separation (including the separation techniques described herein) to form an empty space 119763.doc -35 - 200808396. After the distal end 1043 is placed adjacent to the tissue site 1〇25 in the void ι 29, an injectable, pourable or flowable reduced pressure delivery device 1035 is delivered to the tissue site 1 through the manifold delivery tube!021. At the office. The reduced pressure delivery device 1035 is preferably present in a flowable state during delivery to the tissue site: and then, upon arrival, a plurality of flow channels are formed to distribute the reduced pressure or fluid. In some cases, the flowable material can be hardened to a solid state by a drying process, a curing process, or other chemical or physical reaction after reaching the tissue site. In other cases, the flowable material can form a foam in situ after delivery to the tissue site. Still other materials may exist in the gel state at the tissue site 1 〇 25, but still have a plurality of flow channels for delivering reduced pressure. The amount of reduced pressure delivery device 1035 delivered to the tissue site 5 may be sufficient to partially or completely fill the void 1029. The reduced pressure delivery device 1035 can include both a manifold and a stent. As the manifold, the pressure-reducing conveying device 1〇35 includes a plurality of holes or open holes which can be formed in the material after being conveyed to the gaps 1〇29. The holes or open holes communicate with each other, thereby forming a plurality of flow channels. These flow channels are used to apply and reduce the pressure on the tissue site 1〇25. As a stent, the reduced-pressure delivery device 1 is bioresorbable and serves as a substrate on which new tissue can be grown. In one embodiment, the reduced pressure delivery device 1035 can comprise p〇ragen, such as NaCl or other salts, distributed throughout the liquid or viscous gel. After the liquid or viscous gel is delivered to the tissue site 1025, the material is applied to the void 1029 and subsequently cured into a solid. The water-soluble NaCl poragen dissolves in the presence of body fluids at 119763.doc -36 - 200808396, leaving a structure with interconnected pores or flow channels. The reduced flow and/or fluid is delivered to the flow channels. As the new organization is formed, the tissue will grow into the bore of the reduced pressure delivery device 1 〇 35 and then eventually replace the pressure reducing delivery device 1035 with the degradation of the reduced pressure delivery device 1 〇 35. In this particular example, the reduced pressure delivery device 1〇35 is used not only as a manifold but also as a new tissue growth scaffold. In another embodiment, the reduced pressure delivery device 1〇35 is an alginate mixed with 4〇〇μηι mannose particles. The p〇ragen or granules may be dissolved at the tissue site by local body fluids or by the irrigated fluid or other fluid delivered to the reduced pressure delivery device 丨〇3 5 . After dissolving P〇ragen or particles, the space previously occupied by the poragen or particles becomes a void which is interconnected to form a flow passage in the reduced pressure conveying device 1〇35. The use of poragen in materials to form flow channels is effective, but it also forms pores and flow channels that are limited in size to the particle size of the selected poragen. A chemical reaction can be used in place of poragen to form larger pores by forming gaseous by-products. For example, in one embodiment, a flowable material comprising sodium bicarbonate and citric acid microparticles (which may be non-stoichiometric) may be delivered to tissue site 1025. When the flowable material forms a foam or solid in situ, the body fluid will cause an acid-base reaction between sodium bicarbonate and citric acid. The formed carbon dioxide gas particles form larger pores and flow channels throughout the reduced pressure delivery device 1035 as compared to the technique of relying on poragen dissolution. The conversion of the reduced pressure delivery device 1035 from a liquid or viscous gel to a solid or foam can be by pH, temperature, light, or with body fluids, chemicals, or other delivery to the tissue site of 119763.doc -37-200808396 The reaction of matter triggers. This transformation can also be carried out by mixing a plurality of reactive components. In one embodiment, the reduced pressure delivery device 1035 is prepared by selecting bioresorbable microspheres made from a bioresorbable polymer. The microspheres are dispersed in a solution containing a photoinitiator and a hydrogel forming material such as hyaluronic acid, collagen or polyethylene glycol. The microsphere/gel mixture is exposed to light for a brief period of time to partially crosslink the hydrogel and immobilize the hydrogel on the microspheres. Excess solution is drained and the microspheres are subsequently dried. The microspheres are delivered to the tissue site by injection or pouring, and after delivery, the mixture absorbs moisture and the hydrogel coating becomes a hydrated coating. The mixture is then exposed to light again, thereby crosslinking the microspheres, thereby forming a plurality of flow channels. The crosslinked microspheres are then used as a manifold for delivering reduced pressure to the tissue site and a porous scaffold for promoting new tissue growth. With the exception of the foregoing embodiments herein, the reduced pressure delivery device i 5 can be made from a variety of materials including, but not limited to, calcium phosphate, collagen, alginate, cellulose, or any other gas, liquid, A gel, paste, putty, slurry, suspension, or other flowable material is delivered to the set, 哉U 并 position and is sufficient to form an equivalent of a plurality of flow paths in fluid communication with the tissue site. The flowable material may further comprise solid particles, such as particles, which are capable of flowing via the manifold wheel 1021 if the particle size of the solid particles is sufficiently small. The material delivered to the tissue site in a flowable state can be polymerized in situ or form a gel. As described above, the reduced-pressure delivery device 1〇35 can be directly injected or poured into the gap 1〇29 of the 119763.doc-38-200808396 field adjacent tissue site 1〇25. Referring to Fig. 27A, the manifold delivery tube 1021 can include an impermeable or semi-permeable membrane 1051 at the distal end 1043 of the manifold delivery tube 1〇21. The membrane 1051 includes an interior space 1055 that is in fluid communication with an auxiliary lumen 1〇57 that is secured to the manifold delivery tube 1〇21. The manifold delivery tube 1021 is guided to a tissue portion 1025 on a guide wire 1061. The reduced pressure delivery device 1035 can be injected or poured through the auxiliary lumen 1〇57 to fill the interior space 1055 of the membrane 1051. When the fluid or gel fills the film 1051, the film 1051 expands to fill the voids 1〇29, thereby causing the film to contact the tissue site 1025. When the film 1051 is inflated, the film 1〇51 can be used to separate additional tissue adjacent to or near the tissue site 1〇25. If the film 1〇51 is an impermeable film, it can be physically broken and removed, so that the reduced pressure delivery device 1035 contacts the tissue site 1〇25. Alternatively, the film ι〇5ι can be made from a soluble material that will dissolve in the presence of a body fluid or a biocompatible solvent delivered to the film 1〇51. If the film 1〇51 is semi-permeable, the film 1051 can remain in place. The semi-permeable membrane 1〇51 is capable of delivering reduced pressure and possibly other fluids to the tissue site 1025. Referring to Fig. 28, a method for performing decompressive tissue treatment & mi includes surgically inserting a manifold at an adjacent tissue site at 1115, the organ having a plurality of protrusions extending from a flexible barrier. A plurality of flow channels are formed between the protrusions. The manifold is positioned at 1119 such that at least a portion of the projections contact the tissue site. At 1123, a reduced pressure is applied to the tissue site via the manifold. Referring to Figure 29, a method for decompressing tissue treatment of a tissue site 119763.doc -39- 200808396

1211 includes inserting a manifold at 1215 through the skin adjacent the tissue site. The manifold can include a plurality of protrusions extending from the flexible barrier to form a plurality of flow channels between the canines. Alternatively, the manifold can comprise a honeycomb material having a plurality of flow channels within the honeycomb material. Alternatively, the manifold may be formed from an injectable or pourable material that is delivered to the tissue site and that forms a plurality of flow channels upon reaching the tissue site. At 1219, the ambiguity is positioned 'to bring at least a portion of the flow channels in fluid communication with the tissue site. At 1 1223, a reduced pressure is applied to the tissue site via the manifold. Referring to Fig. 30, a method of applying reduced pressure tissue treatment to a tissue site 1311 includes inserting a tube having a passage through the skin through a skin at 1315 such that the distal end of the tube is placed adjacent to the tissue site. At i3i9, the balloon associated with the tube can be inflated to separate tissue adjacent to the tissue site to form a void. At 1323, the manifold is transported through the passage. The manifold can include a plurality of protrusions extending from the flexible barrier to form a plurality of flow channels between the protrusions. Alternatively, the manifold may comprise a honeycomb material in which a plurality of flow channels are formed. Another option is that the manifold can be formed from an injectable or pourable material that is delivered to the tissue site as described above with reference to Figure 27. At 1327, the manifold is positioned such that at least a portion of the flow channels are in fluid communication with the tissue site. At 1331, the tissue site is subjected to a reduction by pressure via a manifold or any other delivery route: pressure. / ^ 119763.doc •40- 200808396 See Figure 3 1 'A method of performing decompressive tissue treatment on a tissue site 1411 includes inserting a tube with a passage through the skin through a tissue at 1415 to allow the tube to The distal end is placed adjacent to the tissue site. At 1423, a manifold is delivered to the tissue site via the passageway in an impervious jacket which has been subjected to a first reduced pressure at 1419 that is less than the sheath ambient pressure. At 1427, the sheath is broken to contact the manifold with the tissue site. At 1431, a second reduced pressure is applied to the tissue portion via the manifold.

Referring to Figures 32 and 33', a reduced pressure delivery device 1511 in accordance with an embodiment of the present invention includes a plastic surgical hip prosthesis 15 15 for replacing an existing femoral head of a patient leg segment 1517. The hip prosthesis 15丨5 includes a column portion 52 and a head portion 1525. The post portion 1521 is elongated to be inserted into a passage 1529 that is inserted into the backbone of the leg section 1517. A porous coating 1535 is disposed around the portion of the column and is preferably constructed of sintered or vitrified ceramic or metal. Alternatively, a honeycomb material having a porous property may be disposed around the column portion. A plurality of flow channels 1541 are disposed within the post portion 1521 of the hip prosthesis 1515 to fluidly communicate the flow channel 1541 with the porous coating 153 5 . A connection port 1545 is fluidly coupled to the flow channel 1541 which is configured to be releasably coupled to a reduced pressure delivery tube 1551 and a reduced pressure delivery source 1553. The flow channel 1541 is used to deliver a reduced pressure to the porous coating 1535 and/or the bone path surrounding the hip prosthesis 1515 after implantation of the hip prosthesis 1515. The flow channel η 41 can include a main feed line 1543 in fluid communication with a plurality of lateral branch lines 547, the plurality of lateral branch lines 1547 being in communication with the porous coating 1535. The rib branch line 1545 can be oriented perpendicular to the main feed line 119763.doc -41 - 200808396 1543 as shown in Figure 32, or can be oriented at some angle to the main feed line 1543. An alternative method for distributing reduced pressure includes providing a hollow hip prosthesis and filling the interior of the prosthesis with a honeycomb-like (preferably open-cell) material that is in fluid communication with the porous coating 1535. space. Referring more specifically to Figure 33, the hip prosthesis 1515 can further include a second plurality of flow channels 1561 within the post portion 1521 to provide fluid to the porous coating 1535 and/or bone surrounding the hip prosthesis 15 15 . The fluid may include filtered air or other gas, an antibacterial agent, an antiviral agent, a cell growth promoter, a flushing fluid, a chemically active fluid, or any other fluid. Additional fluid communication paths may be provided if it is desired to introduce multiple fluids into the bone surrounding the hip prosthesis 15 15 . A port 1565 is fluidly coupled to the flow channel 1561 which is configured to be releasably coupled to a fluid delivery tube 1571 and a fluid delivery source 1573. The flow channel 1561 can include a main feed line 1583 in fluid communication with a plurality of lateral branch lines 1585 that are in communication with the porous coating 1535. The lateral branch line 1585 can be oriented perpendicular to the main feed line 1583 as shown in Figure 33, or can be oriented at some angle to the main feed line 1583. The delivery of the reduced pressure to the first plurality of flow channels 154 and the delivery of fluid to the second plurality of flow channels 1561 can be accomplished by separate tubes (e.g., reduced pressure delivery tube 1551 and fluid delivery tube i57). Alternatively, a tube having a plurality of lumens as previously described herein can be used to separate the communication path for delivery of reduced pressure and fluid. It should be further noted that although a separate fluid communication path is provided within the body prosthesis 15 15 , the first plurality of flow channels 1541 can be used to deliver both the reduced pressure and the fluid wheel 119763.doc -42 - 200808396 The bone surrounding the hip prosthesis 15 15 . As mentioned earlier, the application of reduced stress to bone tissue promotes and accelerates the growth of new bone tissue. By using the hip prosthesis 1515 as a manifold to deliver the reduced pressure to the bone region surrounding the hip prosthesis, the leg segment 1517 will recover faster' and the hip prosthesis 1515 will more successfully engage the bone. Providing a second plurality of flow channels 1561 to discharge the bone path around the hip prosthesis 1515 will improve the successful regeneration of the new bone surrounding the prosthesis. After applying the reduced pressure through the hip prosthesis 1 5 1 5 for a selected amount of time, the decompression delivery tube 1551 and the fluid delivery tube 1571 can be disconnected from the connection ports 1545, 1565 and removed from the patient's body. Good does not use surgical invasive procedures. The connection between the ports 1545, 1565 and the tubes 1551, 1571 can be a connection that can be released by hand, which can be performed by applying an axial pulling force to the tubes 1551, 1571 outside the body of the patient. Alternatively, the ports 1545, 1565 can be bioresorbable or soluble in the presence of the selected fluid or chemical so that the essence can be compromised by the connection of the 璋15 4 $, 1 $ 6 5 Release of the tubes 1551, 1571 is achieved in a fluid or chemical. Tubes 1551, 1571 can also be made from a bioresorbable material that will dissolve over a period of time or an activating material that will dissolve in the presence of a particular chemical or other material. A reduced pressure delivery source 1553 can be provided outside the patient and connected to a reduced pressure delivery tube 1551 to deliver the reduced pressure to the hip prosthesis 1515. Alternatively, the reduced pressure delivery source 1553 can be implanted into the patient, on or near the hip prosthesis 15 15 . Placing the reduced pressure delivery source 1553 into the patient does not require the use of a fluid connection through the skin. The implanted reduced pressure delivery source 1553 can be coupled to the conventional pump of the flow channel 1541 in an operable manner 119763.doc -43 - 200808396. The pump can be powered by a battery implanted in the patient's body or by an external battery that is electrically connected to the pump via the skin. The pump can also be directly driven by a chemical reaction that delivers reduced pressure through the flow channels 丨54丨, i56i and circulates fluid through the flow channels 丨54丨,丨56 i. In the figures 32 and 33, only the column portion 1521 of the hip prosthesis 1515 and the head segment 1525 are illustrated. However, it should be noted that the flow channels described herein and the components for applying the reduced pressure tissue treatment may also be applied to the hip. Any component of the prosthesis i 5 〗 5 that contacts bone or other tissue, including, for example, a cup. Referring to Figure 34', a method for repairing a patient's joint includes the implantation of a prosthesis within the bone adjacent to the joint at 1615. The prosthesis can be a hip prosthesis as described above or any other prosthesis that can help restore joint mobility in a patient. The prosthesis includes a plurality of flow channels configured to be in fluid communication with the bone. At 1619, the reduced pressure is applied to the bone via the plurality of flow channels to improve the ose〇integrati〇n of the prosthesis. Referring to Figures 35 and 36, a reduced pressure delivery device 1711, in accordance with an embodiment of the present invention, includes an orthopaedic fixation device 1715 for fastening a bone 1717 of a patient that includes a fracture site 1719 or other defect. The orthopaedic fixation device 1715 shown in Figures 35 and 36 is a plate having a plurality of passages 1721 for anchoring the orthopaedic fixation device 1715 to the bone using screws 1725, pins, bolts or other fasteners. On 1717. An evening coating 173 5 may be provided on the surface of the contact bone 1717 of the orthopedic fixation device 1715. The porous coating is preferably constructed of sintered or vitrified ceramic or metal. Another option is to fix the bone 1717 with orthopedics 119763.doc -44- 200808396

A honeycomb material having a porous property is disposed between the devices 1715. A plurality of flow channels 1741 are disposed within the orthopaedic fixation device 1715 to fluidly communicate the flow channel 1741 with the porous coating 1735. A port 1745 is fluidly coupled to the flow channel 1741 which is configured to be coupled to a reduced pressure delivery tube 1751 and a reduced pressure delivery source 1753. The flow channel 1741 is used to deliver a reduced pressure to the bone layer of the porous coating 1735 and/or the orthopaedic surgical device 1715 after the orthopedic fixation device 1715 is secured to the bone 1717. The flow channel 1741 can include a main feed line 1743' in fluid communication with a plurality of lateral branch lines 1747. The plurality of lateral branches f-line 1747 are associated with the porous coating (10). The lateral branch line 1747 can be oriented perpendicular to the main feed line 1743 as shown in Figure 35 or can be oriented at some angle to the main feed line 1743. An alternative method for distributing the reduced pressure includes providing a hollow orthopedic fixation device and filling the shaping with a honeycomb (preferably open pore) material capable of communicating with the porous coated coffee body Externally determine the internal space of the device. The orthopedic IU set 1715 can be as shown in Fig. 35, and can be attached to a fixed device such as a cannula, an orthopedic column, or any other poem (4). The whole ==1715 can be further used to fix the prosthesis or other whole materials. Piece or implanted tissue (eg, skeletal tissue or conditions such that the fasteners contain flow passages for lowering the pressure of her adjacent or ring-solid = tissue. These fasteners =; cattle: brackets, bolts , screw or any other suitable fastener. Referring more specifically to Figure 36, the orthopedic fixation member (7) 5 can be advanced to include a second plurality of flows within the orthopaedic fixation device 1715 at 119763.doc -45 - 200808396 The channel 1761 provides fluid to the porous coating 1735 and/or bone county of the %-wound orthopaedic fixation device 1715. The fluid may include filtered air or other gases, antibacterial agents, antiviral agents, cell growth promoters, rinses Fluid, chemically active agent, or any other fluid. If it is desired to introduce multiple fluids into the bone surrounding the hip prosthesis 1715, an additional fluid communication path may be provided. A port 1765 is fluidly coupled to the flow channel 1761, which is configured Connected to a body delivery tube 1771 and a fluid delivery source 773. The flow channel 76 can include a main feed line 1783 in fluid communication with a plurality of lateral branch lines 1785, the number The lateral branch line 1785 is in communication with the porous coating 1735. The k-direction branch line 178 5 can be oriented perpendicular to the main feed line 1783 as shown in Figure 33, or can be oriented at some angle to the main feed line 1783. The delivery of pressure to the first plurality of flow channels 1741 and the delivery of fluid to the second plurality of flow channels 1761 can be accomplished by separate tubes (eg, reduced pressure delivery tube 1751 and fluid delivery tube 1771). Alternatively, A tube having a plurality of lumens as previously described herein can be used to separate the communication path for delivery of reduced pressure and fluid. It should be further noted that a separate fluid communication path is provided within the hip prosthesis 1715 as soon as possible. However, it is also possible to use a plurality of flow channels 17 41 to deliver both the reduced pressure and fluid to the bone of the adjacent orthopaedic fixation device 1715. The orthopedic fixation device 1715 is used as a manifold to the adjacent orthopaedic fixation device 1715. The reduced pressure in the osseous region will accelerate and revert to the restoration of the defect 1719 of the skeleton 1717. A second plurality of flow channels 1761 are provided to deliver fluid to The bone around the orthopedic fixation device 1715 will improve the successful regeneration of the new bone near the 119763.doc -46- 200808396 shaped surgical fixation device. See Figure 37 - The method used to cure the bone defect of the bone path is included The orthopedic fixation device is used to secure the bone network at 15 locations. The orthopaedic fixation device includes a plurality of motorized channels disposed within the orthopaedic fixation device. At 1819, the application of the bone path defect is reduced via the plurality of flow channels Pressure 38. Referring to Figure 38, a method 1911 for treating a tissue site with reduced pressure tissue includes: at 1915, a manifold having a plurality of flow channels = 仃疋 position such that at least the flow channels are at least A portion of the body is in communication with the tissue site at 1919, the reduced pressure is applied to the tissue site via the flow channels, and at 1923, a fluid is delivered to the tissue site via the flow channels. Referring to Fig. 39, a method for performing decompression tissue treatment on a tissue site 2011 includes positioning a distal portion of a manifold delivery tube adjacent to the tissue site at 2〇15. At 2019, a fluid is delivered to the tissue site via the manifold delivery tube. The fluid is capable of filling a void adjacent the tissue site and becoming a solid manifold having a plurality of flow channels in fluid communication with the tissue site. At 2023, a reduced pressure is applied to the tissue portion via the flow path of the solid manifold. Referring to Figures 40 through 48, a reduced pressure delivery system 21A includes a primary manifold 2115 having a flexible wall 2117 surrounding a primary flow path 2121. The flexible wall 2117 is coupled to a reduced pressure delivery tube 2125 at a proximal end 2123. Since the shape of the reduced pressure delivery tube 2125 will generally be a circular cross section, and since the cross-sectional shape of the primary manifold 2115 may be different from the circular shape (ie, rectangular in FIGS. 4A to 119763.doc -47 - 200808396 45, A triangle is shown in Figures 46-48, thus providing a transition zone 2129 between the reduced pressure delivery tube 2125 and the primary manifold 2115. The main manifold 2115 can be joined by adhesive means to the reduced pressure delivery tube 2125, using other means such as fusion or insert molding, or alternatively selected to be integrally joined by coextrusion. The reduced pressure delivery tube 2125 delivers the reduced pressure to the primary manifold 2115 for distribution at or near the tissue site. An anti-blocking member 213 5 is positioned within the main manifold to prevent the main manifold 2115 from collapsing and thereby blocking the main flow path 211 during application of the reduced pressure. In one embodiment, the anti-blocking member 2135 can be provided with a plurality of protrusions 2137 (see FIG. 44) disposed on an inner surface 2141 of the flexible wall 2117 and extending into the main flow path 2121. In another embodiment, the anti-blocking member 2135 can be provided with a single or multiple ridges 2145 on the inner surface 2141 (see Figures 40 and 41). In yet another embodiment, the anti-blocking component 2135 can comprise a honeycomb material 2149 disposed within the main flow path, such as shown in FIG. The anti-blocking member 2135 can be any material or structure that can be embedded within the flow passage or that can be integrally or otherwise secured to the flexible wall 2117. The anti-blocking member 2135 is capable of preventing the flexible wall 2117 from completely collapsing while still allowing fluid to flow through the main flow path 2121. The flexible wall 2117 further includes a plurality of apertures 2155' that penetrate the flexible wall 2117. The apertures 2155 are in communication with the main flow path 2121. The aperture 2155 enables the reduced pressure delivered to the main flow path 2121 to be distributed to the tissue site. Aperture 2155 is selectively positionable about the circumference of manifold 2115 to preferentially direct the delivery of vacuum. For example, in Figure 51, the holes can be placed facing the bones 119763.doc -48 - 200808396, facing the covering tissue or facing both. The reduced pressure delivery tube 2125 preferably includes a first conduit 2161 having at least one outlet fluidly coupled to the main flow passage 2i2i for delivering a reduced pressure to the primary > 1L moving passage 2121. A first conduit 2163 can also be provided to clean the main flow path 2121. and the first conduit 2161 with a fluid to prevent or dissolve blockages caused by wound secretions and other fluids aspirated from the tissue site. The second conduit 2163 preferably includes at least one outlet positioned adjacent to at least one of the at least one of the main passage 2121 and the first conduit 2丨61. Referring more specifically to Figures 40 and 41, in the reduced pressure delivery system 2111, the second conduit 2163 can include a plurality of conduits for flushing the main flow path 2121. and the first conduit 2161. Although the end of the flexible wall 2117 opposite the end fixed to the reduced pressure delivery tube 2125 can be open as shown in Fig. 40, it has been found that covering the end of the flexible wall 2117 can improve the cleaning function. Performance and reliability. Preferably, a head gap 2171 is provided between the covered end of the flexible wall and the end of the second conduit 2163. The headspace 2171 is capable of achieving accumulation of cleaning fluid during the cleaning process, which helps drive the flushing fluid to flow into the first conduit 2161 through the primary flow path 2121. The spacer used as the anti-blocking member 2135 is also illustrated in FIG. The centrally positioned spacer branches the main flow path 2121 into the two chambers, which causes the main manifold 2115 to continue to operate when one of the chambers is blocked and cannot be dissolved by the cleaning. Referring to Figures 49 and 50, a reduced pressure delivery system 2211 includes a primary manifold 2215 integral with the reduced pressure delivery conduit 2217. The reduced pressure delivery tube 2217 includes a central 119763.doc -49 - 200808396 lumen 2223 and a plurality of auxiliary lumens 22 k & the auxiliary lumen 2225 can be used to measure the pressure knife at or near the tissue site. However, the auxiliary lumen 2225 can be further For cleaning the central lumen 2223, υ κ 士 l ^ ^ U to prevent or dissolve the obstruction. A plurality of apertures 2231 communicate with the central lumen 2223 to distribute the reduced pressure delivered by the central lumen 2223. As shown in the B5G towel, it is preferred that the aperture 2231 does not extend through the auxiliary lumen 2225. The counterbore end of the reduced pressure delivery tube is also illustrated in Fig. 5A, which forms a headspace 2241 outside the end of the auxiliary lumen 2225. If the tissue, stent or other material is shouted during application of the reduced pressure, the end portion 2241 of the reduced pressure delivery tube 2217 will continue to allow delivery of cleaning fluid to the central lumen 2223. During use, the reduced pressure delivery systems 2111, 2211 of Figures 40 through 50 can be applied directly to the tissue site to distribute the reduced pressure to the tissue site. The low profile of the primary manifold is highly advantageous for rinsing and removing the techniques described herein. Similarly, the main manifold can also be embedded by surgery. Referring to Figure 51, the main manifolds 21, 5, ms can be used in conjunction with an auxiliary manifold 2321. In Figure 51, the auxiliary manifold 2321 includes a two layer felt pad. The first layer of the auxiliary manifold 2321 is placed in contact with a bone tissue site containing the fracture site. The primary manifold 2115 is placed in contact with the first layer, and the second layer of the secondary manifold 2321 is placed on top of the primary manifold 2115 and the first layer. The auxiliary manifold 2321 is capable of achieving fluid communication between the primary manifold 2115 and the tissue site and still prevents direct contact between the tissue site and the primary manifold 2115. Preferably, the auxiliary manifold 2321 is bioabsorbable, which enables the auxiliary manifold 2321 to remain in place after the decompression therapy is completed. Once the reduction is completed, the main manifold 2ii5 can be removed from the layers of the auxiliary g. with little or no disturbance to the tissue site. In one embodiment, the primary officer may be coated with a lubricating material or a material that will form a hydrogel to facilitate removal of the primary manifold from between the layers. The auxiliary manifold is preferably used as a support for new tissue growth. As a stent, the manifold may be composed of at least one material selected from the group consisting of polylactic acid, polyglycolic acid, polycaprolactone, polyhydroxybutyrate, polyhydroxyl /, cyclodecylamine, polyorthoesthers, polysquaric nitrile, polyaluminum hydrazide 1, collagen, hyaluronic acid, polyaminoglucose, gram-based limestone, calcium phosphate, calcium sulfate, calcium carbonate, bioglass, stainless steel , titanium, tantalum, allograft tablets and autologous tissue grafts. The cleaning functions of the reduced pressure delivery systems 2111, 2211 described above can be used with any of the manifolds described herein. The ability to clean the manifold or conduit that delivers reduced pressure prevents the formation of obstructions that would impede the pressure to perform the reduction. Such obstructions are typically formed when the pressure near the tissue site reaches equilibrium and the outflow of fluid around the tissue site becomes slow. It has been found that the use of air to purge the manifold and decompression catheter at a selected interval for a desired amount of time can help prevent or dissolve the obstruction. More specifically, air is delivered via a second conduit that is separated from the first conduit that delivers the reduced pressure. One of the outlets of the second conduit is preferably adjacent to or adjacent to one of the outlets of the first conduit. Although the air can be pressurized or "pushed" to the outlet of the second conduit, it is preferred to draw air through the second conduit by the reduced pressure at the tissue site. It has been found that in many cases, air is delivered at intervals of sixty (60) seconds during the application of reduced pressure. 119763.doc -51 - 200808396 (2) seconds is sufficient to prevent the formation of obstructions. Such a cleaning program can provide the air of the foot to fully move the manifold and the fluid in the first conduit, while preventing the introduction of excessive lines of excess air, or introducing air at too high a frequency will result in a It is not possible to return to the decompression system of the reduced target pressure between wash cycles. The amount of time selected to deliver the cleaning fluid and the interval between the selected cleaning fluids will generally vary depending on the design and specifications of the system components (eg, pumps, tubes, etc.). However, the amount and frequency of delivery air should be high enough to adequately remove obstructions while still recovering the full target pressure between wash cycles. Referring to Fig. 52', in an exemplary embodiment, a reduced pressure delivery system 2411 includes a manifold 2415 that is fluidly coupled to a first conduit 2419 and a second conduit 24U. The first conduit 2419 is coupled to a reduced pressure source 2429 to provide reduced pressure to the manifold 2415. The second conduit 24 includes an outlet 2435 that is positioned in fluid communication with the manifold 2415 and adjacent the outlet of the first conduit 2419. The second conduit 2423 is fluidly coupled to a valve 2439 which is capable of achieving communication between the second conduit 2423 and ambient air when the valve 2439 is placed in the open position. Valve 2439 is operatively coupled to a controller 2453 that is capable of controlling the opening and closing of valve 2439 to regulate cleaning of the second conduit using ambient air to prevent memory in manifold 2415 and first conduit 2419 In the obstruction. It should be noted that any fluid (including liquids or gases) can be used to achieve the techniques described herein. It is preferred that the force used to clean the fluid is the suction created by the reduced pressure at the tissue site, although similar to that described with reference to Figure 9, the fluid delivery member can also deliver fluid in a similar manner. 119763.doc •52- 200808396 According to the system and method described herein, decompression tissue treatment of tissue sites can be achieved by: applying a low enough scholastic ability to the tissue site' and then at a selected time Maintain this low enough pressure within the segment. Alternatively, the reduced pressure applied to the tissue site can be cyclic. More specifically, the magnitude of the applied reduced pressure may vary depending on the selected time cycle. Yet another method of applying the reduced pressure can randomly vary the magnitude of the reduced pressure. Similarly, the rate or amount of fluid delivered to the tissue site can be ambiguous, periodic, or random. If it is periodic, the fluid delivery can be carried out during the application of the reduced pressure or during the cycle in which the reduced pressure is not applied. Although the magnitude of the reduced pressure applied to the tissue site will generally vary depending on the pathology of the tissue site and the environment in which the decompressive tissue treatment is performed, the reduced pressure is typically between about -5 mm Hg and -500 mm Hg. More preferably, the system is between about _5 melons (five) Hg and -300 mm Hg. The system, methods, and methods of the present invention are described above with reference to tissue growth and patient healing. However, it should be understood that such systems and methods for applying reduced pressure tissue therapy can be used in any of them where it is desired to promote tissue growth or healing. In the living body. Similarly, the systems and methods of the present invention are applicable to any tissue including, but not limited to, bone woven, adipose tissue, muscle tissue, nervous tissue, skin, and, my blood: tissue, connective tissue, cartilage tissue, sputum or ligament. Although tissue healing may be one of the focuses of applying reduced-pressure tissue treatment as described herein, however, decompression tissue treatment (especially for tissues located under the patient's skin) may also be used in the absence of disease, defect or injury. Formed in the tissue, and woven and grown. For example, it may be desirable to use a transdermal tissue 119763.doc-53-200808396 technique to apply reduced pressure tissue treatment' to grow additional tissue at the tissue site, which is subsequently harvested. The tissue of (4) can be transplanted to another tissue site to replace the diseased or damaged tissue, or alternatively, the harvested tissue can be transplanted to another patient. It should be noted that the reduced pressure delivery device described herein can be combined with a stent material to increase the growth and growth rate of new tissue, which is also important. The stent material can be placed between the tissue site and the reduced pressure delivery device, or the reduced pressure delivery device itself can be made from a bioresorbable material that is used as a new tissue growth stent. It should be apparent from the above description that this document provides an invention with significant advantages. While the present invention has been shown in its several forms, the present invention is not limited thereto, but various modifications and changes can be made without departing from the spirit of the invention. [Simple description of the schema] This patent or application file contains at least one graphic with color. The patent or patent application publication with color drawings may be provided by the Patent Office upon request and after payment of the necessary fee. 1 is a perspective view of a reduced pressure conveying device having a plurality of protrusions extending from a flexible barrier to form a plurality of flow passages according to an embodiment of the present invention; FIG. 2 is a diagram illustrating FIG. Figure 3 is a plan view of the reduced pressure conveying device shown in Figure 1; Figure 4A is a side view of the reduced pressure conveying device shown in Figure 4, the reduced pressure conveying device has a single tube Cavity decompression tube; 119763.doc -54- 200808396 Figure 4B shows Figure 1

a material, the flexible barrier having a see-through ridge portion and a pair of wing portions attached to a flexible barrier wall of the vacuum conveying device of the embodiment, the honeycomb material having a plurality of flow passages; Figure 7 illustrates a front view of one of the reduced-pressure conveying devices shown in Figure 6; Figure 8 illustrates a side view of the reduced-pressure conveying device shown in Figure 7 taken at χνπ-χνιι; ° Figure 8A illustrates a Figure 1 is a side elevational view of the reduced pressure delivery device of Figure 8A; Figure 9 illustrates a reduced pressure delivery device in accordance with an embodiment of the present invention. A front view for applying decompressive tissue treatment to the bone of the patient; Figure 10 depicts a colored tissue section of a rabbit skull showing the original, undamaged bone; Figure 11 illustrates a color tissue section of a rabbit skull , which shows the granulation tissue induced after the treatment of the inexpensive decompression tissue; FIG. 12 shows a color tissue section of a rabbit skull showing the deposition of the new bone network after the application of the decompressed tissue treatment, FIG. A color tissue section of a rabbit skull is shown, which shows the deposition of new bones after application of decompressed tissue treatment; Figure 14 depicts a color photograph of a rabbit skull in which two 119763.doc -55 - 200808396 are formed. Figure 15 illustrates a color photograph of the rabbit skull shown in Figure 14 showing a calcium phosphate scaffold embedded in one of the critical dimension defects and a stainless steel mesh covering the second critical dimension defect; Figure 16 illustrates Figure 14 is a color photograph of a rabbit skull showing the application of a reduced-pressure tissue treatment to a critical size defect; Figure 17 illustrates a color tissue section of a rabbit skull after performing a reduced-pressure tissue treatment showing the new bone in calcium phosphate Figure 18 shows a radiograph of the critical dimension defect filled with the stent shown in Figure 15 after performing the decompressed tissue treatment for six days and two weeks after the operation; Figure 19 shows the decompression tissue treatment for six days. And a radiograph of the critical dimension defect filled by the stent shown in FIG. 15 after performing the surgery for twelve weeks; FIG. 20 illustrates a photo according to the present invention. A front view of a reduced pressure delivery system of the embodiment having a manifold delivery tube for inserting a reduced pressure delivery device through a skin into a tissue site; FIG. 21 illustrates the manifold of FIG. An enlarged front view of the delivery tube, the manifold delivery tube comprising a reduced pressure delivery device having a flexible barrier and/or a honeycomb material in a compressed position; FIG. 22 depicts the difference shown in FIG. An enlarged front view of the tube delivery tube showing the flexible barrier and/or honeycomb material of the reduced pressure delivery device in an expanded position after being pushed in from the manifold delivery tube; Figure 23 illustrates a first embodiment in accordance with the present invention A front view of the reduced pressure delivery system of the embodiment, the reduced pressure delivery system having a reduced pressure 119763.doc-56-200808396 through the skin showing the reduced permeability film delivery device inserted into a tissue site Manifold delivery tube, the pressure delivery device is outside the manifold delivery tube, but is constrained to a compression position; the figure shows impermeability. Figure 24 shows one of the reduced pressure delivery systems shown in Figure 23. The pressure reducing conveying device is located outside the manifold conveying pipe but is restrained by a film at a relaxed position; FIG. 25 illustrates one of the pressure reducing conveying systems shown in FIG. 23, and the drawing is shown in the figure. The conveying device is located outside the manifold conveying pipe, and the first breaking and the non-permeable membrane are constrained to an expansion position; FIG. 25A illustrates the vacuum conveying system shown in FIG. 23, which is shown in the figure. The reduced pressure delivery device is outside the manifold delivery tube. i is called, but surrounded by an impermeable film at an expanded position; FIG. 26 is a front elevational view of a reduced pressure delivery system having a skin for use in accordance with an embodiment of the present invention; - the reduced pressure delivery and closing device is inserted into the manifold delivery tube of a tissue site, the figure shows that the decompression = _ delivery device is outside the manifold delivery tube, but is bound by a non-penetrating film with a glue seal; &quot 26A is a front elevational view of a reduced pressure delivery system in accordance with an embodiment of the present invention, and FIG. 27 illustrates a front view of a reduced pressure delivery system having a reduced pressure delivery system in accordance with an embodiment of the present invention. a manifold delivery tube for injecting a reduced pressure delivery device to a tissue site for overlying the skin; FIG. 27A illustrates a front view of a reduced pressure delivery system having a decompression delivery system in accordance with an embodiment of the present invention; Manifold delivery tube for use in 119763.doc -57 - 200808396 = over-skin-reduced delivery device to an impermeable film at the tissue site; FIG. 28 depicts an embodiment in accordance with the present invention - Save the purposes of the tissue site it flowchart of the method for treating tissue; ... illustrated in FIG. 29 - Species according to the invention - Example flowchart of a method of reduced pressure tissue treatment administered to the site of knitting row n;

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 3 is a flow chart showing a method for performing decompression tissue treatment on a tissue site according to an embodiment of the present invention; FIG. 3 illustrates a flow of a method for treating tissue according to the present invention. Figure 32 is a cross-sectional elevation view of a reduced pressure delivery device in accordance with the present invention. The reduced pressure delivery device includes a competitive body having a plurality of flow passages for surrounding Applying reduced pressure to the bone road area of the competitive body;

Figure 33 illustrates the hip of Figure 32 having a plurality of flow channels, a skeletal region of the prosthesis; a cross-sectional elevation view of the ham prosthesis for delivering fluid to the surrounding hip. A flow chart of a method for repairing a joint of a patient using reduced pressure tissue treatment in accordance with the present invention - FIG. 35 illustrates a cross-sectional elevation view of a reduced pressure delivery device in accordance with the present invention - an embodiment of the reduced pressure delivery device includes - (4) Surgical fixation device The continuation surgical fixation device has a plurality of flow passages for reducing the pressure of the bone path region of the adjacent surgical fixation device; FIG. 36 is the edge of the bridge surgical fixation device shown in FIG. The front view of the section, the 119763.doc -58-200808396 performance/surgical fixation ☆ piece has a second plurality of flow channels for delivering fluid to the bone path area of the orthopaedic solid member; 37 illustrates a flow chart of a method for treating a bone path defect of a bone road using reduced pressure tissue therapy in accordance with an embodiment of the present invention; FIG. 38 illustrates a set for use in a group according to an embodiment of the present invention. The flowchart of a method of treating tissue site administered decompression; and

Figure 39 is a flow chart showing a method for performing decompression tissue treatment on a tissue portion in accordance with the present invention. 40 to 48 are various views of a reduced pressure delivery system having a main manifold including a core surrounding a flexible flow wall of a main flow passage, and a vacuum manifold according to an embodiment of the present invention. a plurality of holes in the flexible wall; FIGS. 49-50 illustrate a perspective view and a top cross-sectional view of a reduced pressure delivery system having an integral connection to the vacuum delivery system in accordance with an embodiment of the present invention a main manifold of a reduced pressure delivery tube; FIG. 51 is a perspective view of the main manifold shown in FIGS. 40 to 50 applied to a bone tissue portion together with an auxiliary manifold; and FIG. 52 illustrates a method according to the present invention. An embodiment has a schematic view of a reduced pressure delivery system fluidly coupled to a valve of a second conduit. [Main component symbol description] 211 Pressure reducing device or wing manifold 213 Flexural barrier 215 Ridge portion 219 Wing portion 119763.doc •59- 200808396

223 arched channel 227 flexible backing 231 protrusion 233 flow channel 241 decompression delivery tube 243 distal orifice 255 proximal orifice 259 lumen or passage 261 double lumen 263 first lumen 265 second lumen 271 Horizontal spacer 311 Vacuum delivery device or wing manifold 313 Flex barrier 315 Ridge portion 319 Wing portion 323 Arched channel 327 Honeycomb material 329 Distribution surface 330 Peripheral surface 341 Pressure relief tube 343 Distal orifice 355 proximal orifice 359 lumen or passage 119763. doc -60- 200808396

371 Reduced pressure delivery device 3 73 Reduced pressure delivery tube 3 75 Extension 377 distal end 381 Incision 3 83 Shoulder 385 Protrusion 3 87 Inner surface 391 Flow channel 411 Reduced pressure delivery device 413 Tissue site 415 Human bone 419 Decompression tube 421 proximal end 427 decompression source 429 void defect 431 fluid delivery tube 432 proximal end 433 fluid delivery source 434 filter 435 pressure sensor 711 decompression delivery system 713 tissue site 721 manifold delivery tube 119763.doc -61 - 200808396

725 Guide unit 727 Guide wire 731 Fracture site 733 Patient bone 735 Skin 739 Soft tissue 743 Tapered distal end 751 Path 761 Reduced pressure delivery device 765 Flexible barrier 767 Honeycomb material 769 Decompression delivery tube 811 Decompression delivery system 821 Manifold duct 837 dotted line 843 distal end 861 decompression conveyor 865 flexible barrier 867 honeycomb material 869 decompression duct 871 impervious membrane 873 inner surface 881 label 885 removal device 119763.doc -62- 200808396

891 auxiliary lumen or tube 911 decompression delivery system 921 manifold delivery tube 937 dashed line 943 distal end 961 decompression delivery device 965 flexible barrier 967 honeycomb material 969 decompression delivery tube 971 impervious film 973 inner surface 977 plastic seal 981 standard 985 decompression conveying system 987 guiding wire 989 decompression conveying pipe 991 decompression conveying device 993 tissue part 1011 decompression conveying system 1021 manifold conveying pipe 1025 tissue part 1029 gap 1035 decompression conveying device 1043 distal end 119763 .doc -63 - 200808396

1055 Internal space 1057 Auxiliary lumen 1061 Guide wire 1511 Reduced pressure delivery device 1515 Orthopedic hip prosthesis 1517 Patient leg section 1521 Column section 1525 Head section 1529 Path 1535 Porous coating 1541 Flow channel 1543 Main feed line 1545 Transverse branch line 1547 Transverse branch line 1551 Decompression line 1553 Reduced pressure supply 1565 Connection 埠1571 Fluid delivery line 1573 Fluid delivery source 1583 Main feed line 1585 Transverse branch line 1711 Reduced pressure delivery device 1715 Orthopedic fixation device 1717 Bone 119763.doc •64 - 200808396

1719 Fracture site 1721 Passage 1725 Screw 1735 Porous coating 1741 Flow channel 1743 Main feed line 1745 Connection 埠 1747 Lateral branch line 1751 Reduced pressure line 1753 Reduced pressure supply 1761 Flow channel 1765 Connection 埠 1771 Fluid delivery tube 1773 Fluid delivery source 1783 Main feed line 1785 Transverse branch line 2111 Reduced pressure delivery system 2115 Main manifold 2117 Flexible wall 2121 Main flow path 2123 Near end 2129 Transition zone 2135 Anti-blocking part 2137 Protrusion -65- 119763.doc 200808396

2141 Inner surface 2145 Ridge 2149 Honeycomb material 2155 Hole 2161 First conduit 2163 Second conduit 2171 Headspace 2211 Reduced pressure delivery system 2215 Main manifold 2217 Pressure relief tube 2223 Central lumen 2225 Secondary lumen 2231 Hole 2241 Clearance 2321 Auxiliary manifold 2411 decompression delivery system 2415 manifold 2419 first conduit 2423 second conduit 2429 decompression source 2435 out π 2439 valve 2453 controller 119763.doc -66 -

Claims (1)

200808396 X. Patent Application Range: A reduced-pressure delivery system for applying a reduced-pressure tissue treatment to a tissue site, comprising: a manifold having a plurality of flow channels, the manifold being configured to be placed adjacent to the tissue site The first pilot' is in fluid communication with the flow passages of the manifold to deliver a reduced pressure to the flow passages; the first pilot' is in fluid communication with the flow passages of the manifold; a valve operatively coupled to the second conduit to selectively clean the second conduit with the circumferential space when the helium valve is positioned in an open position; and: a controller operatively coupled To the valve, the valve is placed in the open position for a selected amount of time at a selected interval during the pressure reduction via the first s delivery. 2. 3. 4. 5. 6. In the system of claim 1, wherein the selected time is approximately two seconds; and “the selected interval is approximately sixty seconds. The system of claim 1 is Wherein the reduced pressure is applied cyclically. The system of claim 1 wherein the air is delivered via the second conduit during a time/month/month of application of the reduced pressure. 4ζί3 jg / such as bite 2, 1 a system, wherein the tissue site comprises a hard tissue. 1 / , a system, a first, wherein the tissue site comprises a soft tissue. If the gray matter is selected, the tissue site is selected from the group consisting of: , , And weaving composition: adipose tissue, muscle tissue, nerve tissue, 119763.doc 200808396 Skin tissue, vascular tissue, connective tissue, cartilage, tendon, and ligament. 3 The system of claim 1 'the manifold is a honeycomb 9. The system of claim 1, wherein the first catheter and the second catheter are lumens within a multi-lumen tube. 10. The system of the present invention, wherein the first catheter and the first Two conduits are separate tubes. Μ ιι· a pair The method of performing a reduced-pressure tissue treatment, comprising: 〆, _________ positioning a manifold having a plurality of flow channels adjacent to the tissue site such that at least a portion of the flow channels are in fluid communication with the tissue site; a complex-m ^ u * ¥ & apply a reduced pressure to the tissue site, the first guide is an ancient $, 丨 &&; at least one outlet in fluid communication with the flow channels; and - by A fluid is delivered to a region of the first conduit that is in close proximity to the at least one outlet of the first conduit via a second conduit to clean the obstruction in or near the first conduit. Wherein the pressure of the fluid is greater than the reduced pressure 0 wherein the flow system is selected from the group consisting of filtered air and a method of nitrogen. 14. 15. The method of claim 11 ^ & ' Wherein the reduced pressure is applied cyclically. Method 4 of the method of claim 11 wherein the fluid is transferred via the first ballast A during a period of application of the reduced pressure. 119763.doc The method of claim 15, wherein the fluid flow rate is less than the flow rate due to the reduced pressure. The method of claim 15, wherein the fluid flow rate is less than the flow rate due to the reduced pressure 18. The method of claim 15, wherein the fluid flow rate is less than 1 / 1 流动 of the flow rate of 5 kPa due to the reduced pressure. 19. The system of claim 11, wherein the tissue site comprises Hard organization. 20. The system of claim 11, wherein the tissue site comprises soft tissue. The method of claim 11, wherein the tissue site is composed of a tissue selected from the group consisting of adipose tissue, muscle tissue, nerve tissue, skin, and vasculature, connective tissue, cartilage, sputum, and ligament. The method of claim 11, wherein the manifold is a honeycomb foam. The method of claim 11, wherein the first catheter and the second catheter are a lumen within the plurality of lumens. A method of claim 11, wherein the first conduit is separate from the second conduit. 25. The method of claim u, wherein the fluid is filtered prior to delivery to prevent ingress of contaminants. 26. A method of performing a reduced pressure tissue treatment on a tissue site, comprising: positioning a manifold having a plurality of flow channels adjacent to the tissue site such that at least a portion of the flow channels are in fluid communication with the tissue site; Applying a reduced pressure to the tissue site by the first catheter, 119763.doc 200808396 An open-and-second catheter in fluid communication with the flow channels is <> The pressure reducing pressure is exposed to a fluid at a selected interval for opening the valve for a selected amount of time to permit delivery of the fluid via the second conduit to assist in clearing the obstruction in the vicinity:円 or 27·If the method of requesting %, where ·· The selected amount of time is approximately two seconds; and ~ ~ ~' — __ The selected interval is approximately sixty seconds. — 28 — The method of claim 26 wherein the flow system is a gaseous fluid. 29. The method of claim 28 wherein the gaseous flow system is selected from the group consisting of filtered air, oxygen, and nitrogen. 3. The method of claim 26, wherein the flow system is selected from the group consisting of: The first catheter has at least a mouth; and a microbial agent, an antiviral agent, a cell growth promoter, a cleaning fluid, a chemically active fluid, and an analgesic. 31. The method of claim 26, wherein the reduced pressure is applied cyclically. 32. The method of claim 26, wherein the fluid is delivered via the second conduit during a period of time during which the reduced pressure is applied. 33. The method of claim 26, wherein the tissue site comprises a hard tissue. 34. The method of claim 26, wherein the tissue site comprises soft tissue. The method of claim 26, wherein the tissue site is composed of a tissue selected from the group consisting of adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage, tendon, and ligament. 6. The method of claim 26, wherein the manifold is a honeycomb foam. 37. The method of claim 26, wherein the first catheter and the second catheter are a lumen within a plurality of lumens. 38. The method of claim 26, wherein the first conduit is separate from the second conduit. 119763.doc