TW200836785A - System for administering reduced pressure teratment having a manifold with a primary flow passage and a blockage prevention member - Google Patents

Abstract

A reduced pressure delivery system is provided and includes a primary manifold, a blockage prevention member, and first and second conduits in fluid communication with the primary manifold. The primary manifold includes a flexible wall surrounding a primary flow passage and is adapted to be placed in proximity to a tissue site. The blockage prevention member is positioned within the primary flow passage. A plurality of apertures is disposed in the flexible wall to communicate with the primary flow passage. The first conduit is fluidly connected to the primary flow passage to deliver reduced pressure through the primary flow passage and the plurality of apertures. The second conduit includes an outlet proximate the primary flow passage or an outlet of the first conduit to purge the primary flow passage or first conduit to prevent blockages.

Description

200836785 IX. INSTRUCTIONS OF THE INVENTION: TECHNICAL FIELD OF THE INVENTION The present invention relates to a system or method for promoting tissue growth, and more particularly to a system for applying reduced pressure tissue therapy to a tissue site. [Prior Art] Decompression therapy is increasingly being used to promote wound healing of soft tissue wounds that heal slowly or fail to heal without decompression therapy. Typically, fψ 1 is applied to the wound site via an open-cell foam used as a manifold for distributing reduced pressure. The apertured foam is sized to fit the existing wound, placed in contact with the wound and then periodically replaced with a smaller foam sheet as the wound begins to heal and become smaller. It is necessary to frequently replace the open-cell foam to minimize the amount of tissue grown into the pores of the foam. The growth of a large amount of tissue in the pores of the foam may cause pain to the patient during removal of the foam. Decompression therapy is usually applied to open wounds that cannot heal. In some cases, the healing tissue is subcutaneous tissue, and in other cases, the tissue is located within or on the dermal tissue. Decompression therapy is mainly used

119640.doc 200836785 The advancement of open-cell foam tablets removed after a period of decompression therapy. SUMMARY OF THE INVENTION The problems of existing wound healing systems and methods can be solved by the system and method of the present invention. According to one embodiment of the invention, a reduced pressure delivery system is provided to apply reduced pressure to a tissue site. The reduced pressure delivery system includes a primary manifold having a plurality of flexible flow walls disposed about a primary flow channel and adapted for placement adjacent a tissue site. The flexible wall includes an inner surface having a plurality of protrusions extending from at least a portion of the inner surface and into the main flow passage. The flexible wall additionally includes a plurality of apertures that communicate with the primary flow passage through the flexible wall. A first conduit is fluidly coupled to the primary flow passage to deliver a reduced pressure via the primary flow passage and the plurality of orifices. The second conduit includes at least one retardation at or near at least one outlet of the first official passage adjacent the primary flow passage or the at least one outlet of the first conduit. Port to Purify This another embodiment of the present invention provides a reduced pressure delivery system and includes a flexible wall having a primary sulcus that surrounds the primary flow channel and is adapted to be placed proximate to the tissue site. The flexible wall includes an aperture through which the plurality of teeth communicate with the main flow passage. The multi-bubble material is located in the main flow channel, and the multi-bubble material comprises a plurality of flow channels 0, a first total, a bitter length g, and is fluidly connected to the main flow channel to move the multi-bubble material through the main spoon And a plurality of small holes pass the decompression. a second conduit, close to the main flow passage or at least / outlet of the first conduit to purify at least one outlet of the first conduit or its attachment 119640.doc 200836785

Another embodiment of the present invention provides a reduced pressure delivery system and includes a primary manifold that is a conventional flow passage and is adapted to be placed in the main flow path. A flexible wall near the tissue site. The primary manifold includes a retardation preventing element positioned within the flow channel to be t. A plurality of small holes are disposed therein, and the motorized passages are connected. The secondary manifold is positioned adjacent to the main manifold, the Japanese slave, the field, and adapted to contact the tissue site, thereby making the secondary manifold and the primary manifold _ & The body is connected, but it is also adapted to prevent contact of the primary manifold with the tissue site. The first _ code is connected to the main flow channel k body to transmit the pressure reduction via the main flow passage and the plurality of small holes. In another embodiment of the invention, a method for promoting tissue growth at a tissue comprising surgically positioning a primary manifold proximate to a tissue site. The primary manifold includes a flexible wall that surrounds the primary flow channel. The flexible wall includes a plurality of apertures that communicate with the primary flow passage through the flexible wall. The primary manifold additionally includes a block prevention element located within the main flow channel. The method additionally includes surgically handing the secondary manifold to the surgical site to contact the tissue site, thereby fluidly connecting the secondary manifold and the primary manifold, but preventing the primary manifold The tissue is connected to the tissue site, and the decompression system is delivered to the tissue site through a plurality of small holes and a secondary manifold through the main flow channel. Other objects, features and advantages of the invention will be apparent from the description and appended claims. [Embodiment] Hereinafter, in the detailed description of the preferred embodiments, reference is made to the accompanying drawings of the portions forming the h-th embodiment, and wherein the specific example of the invention is 119640.doc 200836785 The preferred embodiment is shown. The present invention has been 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 the logical structure may be practiced without departing from the spirit or scope of the invention. Mechanical, electronic and chemical changes. To avoid the details necessary for the practice of the invention, the description may omit certain information known to those skilled in the art. Therefore, the following embodiments are not to be construed as limiting, and the scope of the invention is defined only by the scope of the accompanying claims. As used herein, the term "elastic" means having the properties of an elastomer. The term "elastomer" generally refers to a polymeric material having rubber-like properties. More specifically, most elastomers have an elongation of greater than 1% and a large amount of elastic properties. The elastic energy of a material refers to the ability of the material to recover from elastic deformation. Examples of the elastomer may include, but are not limited to, natural rubber, polyisoprene, styrene butadiene rubber, chloroprene rubber, polybutadiene, nitrile rubber, butyl rubber, ethylene propylene rubber, ethylene. Propylene diene monomer, chlorosulfonated polyethylene, polysulfide rubber, polyurethane, and polyoxyn oxide. As used herein, the term "flexible" refers to an article or material that is capable of bending or flexing. Elastomeric materials are generally flexible, but reference herein to flexible materials is not necessarily limited to the choice of materials to elastomers. The term "flexibility" as used in connection with the materials or reduced pressure delivery devices of the present invention generally refers to the ability of the material to conform to or closely match the shape of the tissue site. For example, a reduced pressure delivery device for treating bone defects may be used. The flexible material allows the device to be wrapped or folded around the portion of the bone having the defect. As used herein, the term "fluid" generally refers to a gas or liquid, but also 119640.doc 200836785

Body and foam.

The measured value, such as a specific value of the water vapor transfer rate (WVTR).

Generally refers to a substance or structure provided to assist in the application of reduced pressure to a tissue site, delivery of fluid to a tissue site, or removal of fluid from a tissue site. The manifold typically includes a plurality of flow passages or paths interconnected to improve the distribution of fluid provided to the tissue region surrounding the manifold and from the tissue region surrounding the manifold. Examples of manifolds can include, but are not limited to, devices having structural elements arranged to form flow channels, multi-foam foams (such as open cell foams), porous tissue collections, and including or treated to include flow paths. Liquid, gel and foam. As used herein, the term "decompression" generally refers to a pressure that is lower than the ambient pressure at the tissue site undergoing treatment. In most cases, this reduced pressure will be less than the atmospheric pressure at which the patient is located. Can be less than the tissue hydrostatic pressure 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 significantly lower than the full vacuum. Related pressures. Decompression can initially create fluid flow in the area of the tube and tissue. When the hydrostatic pressure around the tissue site is close to the required reduction, the flow can be attenuated and subsequently reduced. Repeatedly maintained. Unless otherwise indicated, the pressure values described herein are gauge pressure. * As used herein, the term "scaffold" refers to a substance or structure used to enhance or promote cell growth and/or tissue formation. The scaffold is typically a three-dimensional porous structure that provides a template for cell growth. The scaffold can be infused, coated or contained with cells, growth factors or other nutrients that promote cell growth. The stent can be used as a manifold to administer a reduced Fortune tissue therapy to a tissue site in accordance with the embodiments described herein. The term "tissue site" as used herein refers to, but is not limited to, bone tissue, adipose tissue, muscle tissue, nerve tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendon or ligament. Trauma or defect in or on any tissue. The term "tissue site" may additionally refer to any tissue region that does not require injury or defect but is a metastatic region where additional tissue or additional tissue growth is desired. For example, decompression tissue therapy may be used in certain tissue regions. Growing additional tissue that can be harvested and transplanted to another tissue location. Referring to Figures 1-5, a reduced pressure delivery device or winged jaw 211 in accordance with the principles of the present invention includes a canine portion 2 1 $ and a pair of flank portions 21 P. flexible P early wall 213. Each of the side wing portions 219 is positioned along the opposite side of the protruding portion 215. The protruding portion 215 forms an arcuate passage 233 that extends or does not extend the entire length of the winged manifold 211. The portion 215 can be located in the wing manifold 211 to make the width of the side wing portions 219 equal, but as shown in FIG. U, the portion 21 5 can also be biased, so that one wing portion 2丨9 is larger than the other. The flank P-knife 219. The extra width of a 119640.doc 200836785 flank portion 2 19 may be particularly useful when using the wing-shaped manifold 211 for bone regeneration or healing, and will result in a wider wing-shaped 219 Wrapped in The flexible barrier 213 is preferably formed of an elastomeric material such as a neon polymer. Examples of suitable oxygenated polymers include Nusil Techn〇1〇gies 〇f Carpmteria, manufactured by Calif0rnia MED-6〇15. However, it should be noted that the flexible barrier 213 may be made of any other biocompatible flexible material to prevent the growth of the sheep wall 2 13 and the addition of the flexible barrier 213 Flexible substrate 227 of strength and durability. In the arcuate passage 223, the thickness of the flexible barrier 2 丨 3 coated with the flexible substrate 227 may be lower than that in the flank portion 219. Forming the flexible barrier 213 may also allow the polyoxygen adhesive to aid adhesion to the flexible substrate 227. The example of the polyoxygenated adhesive may include one of 1011, also sold by Nusil. The bottom 227 is preferably made of a polyester knit fabric such as Bard 6〇13 manufactured by d Bard Tempe, Arlzona. However, the flexible substrate 227 can also be made to increase the strength and wealth of the flexible barrier 213. Made of biocompatible, flexible material. In this case, if it is resistant [the bioshield J 2 13 is made of a suitably strong material, the flexible substrate 227 can be omitted. The friendable barrier 213 or the flexible substrate 227 is impermeable to liquid, empty. ^ A gas or another flexible substrate 227 and the flexible barrier 213 are not permeable. Liquid, air and other gases are preferred. It may also be removed from the patient by using the reduced pressure delivery device 211. In addition to the resorbable material construction of the flexible barrier and the removable substrate, the bioresorbable material of the field may include, but is not limited to, polylactic acid 119640.doc -12- 200836785 (PLA) and poly A polymeric blend of glycolic acid (PGA). Polymeric blends can also include, but are not limited to, polycarbonates, polyfumarates, and caprolactone. The barrier barrier 213 and the flexible substrate 227 may additionally serve as a support for new cell growth, or the stent material may be used in combination with the flexible barrier 213 and the flexible substrate 227 to promote cell growth. Suitable scaffolding materials can include, but are not limited to, squamous acid, collagen, PLA/PGA, coral-based apatite, carbonate, or processed allograft materials. Preferably, the stent material will have a high void fraction (i.e., high air content). In an embodiment, the flexible substrate 227 can be adhered to the surface of the flexible barrier 213. If the flexible barrier 213 is formed using a polyoxyl polymer, the flexible substrate 227 can also be attached to the flexible barrier 2 13 using a polyoxygen adhesive. Adhesion is a preferred method of attachment when the flexible substrate 227 is bonded to the surface of the flexible barrier 2丨3, but any suitable attachment method can be used. The flexible barrier 213 includes a plurality of protrusions 231 extending from the side wing portions 219 on the surface of the flexible barrier 2丨3. The protrusions 231 may be cylindrical, spherical, hemispherical, cubic, or any other shape as long as at least some portion of each of the protrusions 23 is in a plane different from the plane associated with the side of the attachment protrusion 23 of the flexible substrate 213. . In this regard, the specific protrusions 23丨 do not even need to have the same shape or size as the other protrusions 231; in fact, the protrusions 231 may include random blends of different shapes and sizes. Therefore, the distance over which the projections 23 are extended from the flexible early wall 213 can be varied, but the plurality of projections 231 can also maintain a uniform distance. The position of the protrusion 23 on the flexible barrier 213 creates a plurality of 119640.doc -13 - 200836785 flow paths 233 between the protrusions. When the projections 231 have a uniform shape and size and are uniformly spaced apart on the flexible front wall 213, the flow passages 233 generated between the projections 23 1 have similar uniformity. The size, flow, and flow characteristics of the flow path 233 can be varied using the size, shape, and spacing of the protrusions 23丨. As shown in Fig. 5, the reduced pressure transmission tube 241 is positioned in the arcuate passage 223 and attached to the flexible barrier 213. The reduced pressure transfer tube 241 may be attached only to the flexible P early wall 2 13 or the flexible substrate 227, or the tube 241 may be attached to the flexible barrier 213 and the flexible substrate 227. The reduced pressure transfer tube 241 includes a reverse end hole 243 at the return of the tube 241. The tube 24 1 can be positioned such that the distal aperture 243 is located at any point along the arcuate passage 223, but the tube 241 is preferably positioned such that the distal aperture 243 is located approximately midway along the longitudinal length of the arcuate passage 223 . The distal aperture 243 is preferably elliptical or oval by means of a planar cutting tube 241 oriented less than 9 degrees from the longitudinal axis of the tube 241. Although the aperture 243 can also be circular, the elliptical aperture 243 increases fluid communication with the flow path 233 formed between the projections 231. The reduced pressure transfer tube 241 is preferably made of polyfluorene oxide or urethane coated with a coating material called paraiyne2. However, the reduced pressure delivery tube 241 can be constructed using any medical grade tubing. Other coatings that can be applied to the tube include heparin, anticoagulants, anti-fibrinogen, anti-adhesion, anti-prothrombin and hydrophilic coatings. In an embodiment, the reduced pressure transfer tube 241 may also include or be included in the vent or vent 251 as an alternative to the distal opening 243. The pressure transfer tube 241 is positioned to further increase fluid communication between the reduced pressure transfer tube 241 and the flow passage 233. 119640.doc -14- 200836785 = 1-5 The 'decompression transfer tube 241 can be clamped to the length only along one of the arcuate passages 223, or alternatively along the entire longitudinal extent of the arcuate passage 223. If the position is such that the damper transfer tube 241 occupies the arcuate passage (2), the squat return passage 243 causes all fluid communication between the tube 241 and the flow passage 233 through the vent 25 1 to occur. The reduced pressure delivery tube 241 additionally includes a proximal aperture 255 at the proximal end of the tube 241. The proximal aperture 255 is configured to closely mate with a reduced pressure source, which will be described in greater detail below with reference to FIG. The transfer e 241 described in Figure 3, and from $, includes only a single lumen or channel 259. However, the reduced pressure delivery e 241 includes a plurality of lumens (such as the double lumen tube plus described in Fig. 1). The possible dual lumen tubes 261 include a first lumen 263 and a second lumen plus. The dual official tube is used to provide a fluid communication path between the proximal end of the separate reduced pressure delivery tube 241 and the flow path 233. For example, the use of a dual lumen tube can be used to connect the depleted source to the flow path 233 along the first lumen. The second lumen 265 can be used to introduce fluid into the flow passage 233. The fluid can be filtered air or other gas, antibacterial agent, antiviral agent, cell growth promoter, irrigation fluid, chemically active fluid or any other fluid. If it is desired to introduce a plurality of fluids into the flow passage 233 via a separate fluid communication path, the reduced pressure transfer tube can have more than two lumens. 4B, the horizontal spacer 271 separates the -b cavity 263 and the second lumen 265 of the reduced pressure delivery tube 261 such that the first lumen is positioned above the second lumen 265. The relative position of the first lumen 263 to the second lumen 265 can vary depending on how fluid communication is made between the lumens 263, 265 and the flow passage 233. For example, when the first lumen 263 is positioned as described in FIG. 4B, the plurality of lumens of the 119640.doc -15-200836785 delivery tube can be positioned relative to each other with respect to the vertical spacers separating the lumens. The lumens can be arranged concentrically or coaxially. A vent similar to vent 251 is provided to communicate with flow passage 233. 1 When the second lumen 263 is positioned as illustrated in Figure 4B, the second lumen can be in communication with the flow passage 233 via a distal aperture similar to the distal aperture 243. In addition, decompression

It will be apparent to those skilled in the art that the supply of independent fluid communication paths can be achieved in a variety of different paths, including providing a multi-lumen tube path as described above. Alternatively, the independent fluid communication path can be provided by attaching a single lumen to another single lumen or by using a separate unattached tube having a single lumen or multiple lumens. If a separate tube is used to provide a separate fluid communication path to the flow path 233, the protruding portion 215 can include a plurality of arcuate passages 223, one for each tube. In addition, the arcuate passage 223 can be enlarged to accommodate a plurality of tubes. An example of reduced pressure transfer (4) having a reduced pressure transfer tube separate from the fluid transfer tube will be discussed in greater detail below with reference to FIG. Referring to Figures 6-8, a reduced pressure transfer device or wing manifold 311 in accordance with the principles of the present invention includes a flexible barrier 313 having a projection 315 and a pair of wing portions 319. Each of the side wing portions 3 19 is positioned along the opposite side of the protruding portion 3 15 . The projecting portion 3 15 forms a full length scooped arcuate passage 323 that may or may not extend over the wing manifold 311. Although the protruding portion 315 can be located at the center of the wing-shaped manifold 31丨 such that the flank portion 319 is equal in size, as shown in the ", the dog portion 3 1 5 can also be biased, thereby making the flank portion 3 丨 9 ratio See the other wing knife 3 19 . The extra width of the side wing portion 319 can be particularly useful when the wing manifold 3 is used for bone regeneration or healing, and will wrap the wider wing shape 119640.doc -16 - 200836785 笞3 11 Attached to the fixed hardware attached to the bone. The smear material 327 is attached to the flexible barrier 313 and may be provided as a single material workpiece covering the surface of the sturdy H P flat wall 313 (extending across the projection 315 and the two flank P knives 9). The multi-bubble material 327 includes an attachment surface (not visible in FIG. 6) disposed adjacent the flexible barrier 313, a major attachment surface 329 opposite the name attachment surface, and a plurality of peripheral surfaces 330°. In one embodiment, The flexible barrier 313 can be similar to the flexible barrier 213 and includes a flexible substrate. Although the flexible barrier 313 and the multi-foaming material 327 can be attached by any other suitable attachment method or by combining the treatment sites with the user, adhesion is a preferred method of attaching the multi-foam material 327 to the flexible barrier 313. The flexible barrier 313 and/or flexible substrate serves as an impervious barrier for transporting fluids such as liquids, air, and other gases. In an embodiment, the flexible barrier and the flexible base may not be provided separately to support the multi-foam material 327. In contrast, the multi-foam material 327 may have a bulk barrier layer as an impermeable portion of the multi-foam material 3 27 . The barrier layer may be formed of a closed cell material to prevent fluid transfer, thereby replacing the flexible barrier 313. If a one-piece barrier layer and a multi-bubble material 327 are used, the barrier layer can include projections and flank portions as previously described with reference to the flexible barrier 313. The flexible barrier 313 is preferably formed of an elastomeric material such as a polyoxyl polymer. Examples of suitable polyoxyl polymers include Nusil 〇f

CarPnueria, MED6〇i5 manufactured by CaHf〇rnia. It should be noted, however, that the flexible barrier 3i3 can be made of any other biocompatible flexible material: If the flexible barrier is packaged or otherwise incorporated into a flexible substrate, the flexible 119640.doc • 17-200836785 is preferably made of a poly-knitted fabric (such as c r. Bard 〇f Tenipe,

Made in Arizona, Bard 6〇13). However, the flexible substrate 227 can be made of a biocompatible flexible material capable of increasing the strength and durability of the flexible barrier 313. In one embodiment, the multivesicular material 327 is an open cell, reticulated polyester amine phthalate foam having a pore size in the range of from about 400 to about 600 microns. Examples of such a foam may include GranuF〇am manufactured by Kinetic Concepts, lnc·〇f San Antonio, Texas. The multi-foam material 327 can also be a tissue, a felt pad or any other biocompatible material that provides fluid communication via a plurality of two-dimensional channels. The eve/package material 327 is primarily an open cell material comprising a plurality of holes fluidly connected to adjacent cells. The plurality of flow paths are formed by a multi-bubble material, the openings are formed and formed between the "openings" of the multi-bubble material 327. The flow path allows the entire multi-bubble material 327 to have partial fluid communication of the openings. The shape and size of the chamber and/or political pathways may be uniform or may include patterned or random variations in shape and size. Variations in the shape and size of the cells of the multi-bubble material 327 result in changes in the flow path, and such characteristics are available. The flow characteristics of the fluid passing through the multi-bubble material 327 are varied. The multi-foam material 327 may additionally include a portion containing, closed cells. These closed cells of the multi-bubble material 327 contain a plurality of cells, most of which are not in fluid connection with adjacent cells. An example of a closed cell portion is described above as a barrier layer that can replace the flexible barrier 3丨3. Similarly, the closed cell portion can be selectively disposed in the multi-foam material 327 to prevent fluid transport through the peripheral surface 33A of the luminescent material 327. The flexible barrier 313 and the multi-foam material 327 can also be constructed from the bioresorbable material 119640.doc -18- 200836785 after the use of the reduced pressure delivery device 311. Suitable bioresorbable materials can include, but are not limited to, polymeric blends of polylactic acid (pla) and polyglycolic acid (PGA). Polymeric blends can also include, but are not limited to, polycarbonates, polyfumarates, and caprolactones. The flexible barrier 313 and the multi-foam material 327 can additionally be used as a scaffold for new cell growth, or the scaffold material can be used in combination with the flexible barrier 313, the flexible substrate 327, and/or the multi-foam material 327 to promote cell growth. . Suitable scaffolding materials may include (but are not limited to) calcium phosphate, collagen, PLA/PGA, coral hydroxyapatite, stone, carbonate or processed allograft materials. Preferably, the scaffold material will have a high void fraction (i.e., high air content). The reduced pressure transmission tube 341 is positioned in the arcuate passage 323 and attached to the flexible P early wall 3 13 . The reduced pressure transfer tube 34A may also be attached to the multifoam material 327, or only in the presence of the multifoam material 327, the reduced pressure transfer tube 341 may be attached only to the multifoam material 327. The reduced pressure delivery tube 341 includes a distal end opening 343 at the distal end of the tube 341 that is similar to the distal aperture 243 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 passage 323, but preferably at a near intermediate position along the longitudinal length of the arcuate passage 323. Preferably, the distal aperture 343 is elliptical or oval by cutting the tube 341 in a plane oriented less than 90 degrees from the longitudinal axis of the tube 34 1 . Although the aperture may also be circular, the elliptical aperture increases fluid communication with the flow path in the multi-bubble material 327. In a consistent embodiment, the reduced pressure transfer tube 341 may also include a vent or vent (not shown) similar to the vent 25 of Figure 5. The venting port is positioned along the tube 341 as an alternative to the distal hole 343, or the venting port is located 119640.doc -19-200836785 along the tube 341 in addition to the distal hole 343, thereby The pressure transmitting tube 341 is in communication with the grasping body between the flow passages. As previously described, the reduced pressure transfer tube 341 can be positioned only along one of the longitudinal lengths of the arcuate passage 323, or alternatively along the full longitudinal length of the arcuate passage 323. If the (four) position is such that the reduced pressure transfer tube (4) occupies the entire arcuate passage 323, the distal end opening 343 can be closed to create all fluid communication between the tube 341 and the flow passage via the vent. The evening bubble material 327 preferably covers and directly contacts the reduced pressure transfer tube (4). Multiple ', the material 327 can be connected to the reduced pressure transfer tube (4), or the multi-bubble material 327 can be simply attached to the flexible barrier (4) 3. If the reduced pressure transfer tube 341 is positioned such that it extends only to a point in the arcuate passage 323, the multifoam material 327 may also be in the region where the arcuate passage 323 does not contain the reduced pressure transfer tube 341 and the flexible barrier 3 13 The protruding portion 3 1 5 is connected. The reduced delivery tube 341 additionally includes a proximal aperture 355 at the proximal end of the tube 341. The proximal bore 355 is configured to closely mate with a source of reduced pressure, which will be described in more detail below with reference to FIG. The reduced pressure delivery tube 341 illustrated in Figures 6-8 includes only a single lumen or channel 359. However, the reduced pressure delivery tube 341 may include a plurality of lumens (such as those previously described with reference to Figure 4). A multi-lumen tube is used to provide a separate fluid communication path between the proximal end of the reduced pressure delivery tube 341 and the previously described flow path. These separate fluid communication paths may also be provided by a separate flow path connecting the tubes having a single lumen or multiple lumens. Referring to Figures 8A and 8B, a reduced pressure delivery device 371 in accordance with the principles of the present invention includes a reduced pressure delivery tube 373 having an expanded portion of milk at a distal end 377 of the reduced pressure delivery tube 373. The wide section 375 is preferably bowed to match the curvature of the reduced pressure transfer tube 119640.doc -20- 200836785 373. The cut portion 381 having the shoulder 383 can be formed by removing a portion of the reduced pressure transfer tube at the distal end π to form the expanded portion 375. A plurality of protrusions 385 are placed on the inner surface 387 of the reduced-pressure transfer tube to form a plurality of flow paths 391 between the protrusions 385. The protrusions 385 can have similar dimensions, shapes, and spacings as the dogs described. The reduced pressure delivery sigh 371 is particularly suitable for applying reduced pressure and for regenerating tissue on the sputum tissue. Non-limiting examples of treatments f by the reduced pressure delivery device 371 are ligaments, tendons, and cartilage. i. 2, looking at Figure 9, decompression tissue therapy is applied to tissue site 413 (e.g., human patient's bone 41 5) using a reduced pressure delivery device 411 similar to another reduced pressure delivery device described herein. When used to promote bone tissue growth, decompression tissue therapy can increase the healing rate associated with fractures, nonunion, voids, or other bone defects. In addition, Xianxin can use the decompression tissue therapy to improve the recovery of osteomyelitis. This therapy can be additionally used to increase the local bone density of patients suffering from osteomyelitis. Finally, decompression tissue therapy can be used to accelerate Q and improve the integration of orthopedic implants (such as hip implants, knee implants, and fixation devices) (〇860丨1^6 8^1:丨〇] 1). Still referring to Fig. 9, the reduced pressure delivery device 411 includes a reduced pressure delivery tube 419 having a proximal end 421 that is 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 reduced pressure delivery tube 419 and a plurality of flow paths connected to the reduced pressure delivery device 41A. The reduced pressure is applied to the tissue site 413 by placing the flank portion of the reduced pressure delivery device 411 adjacent the tissue site * 13, which in this example involves the flank portion around the void defect 429 in the cladding 415 . The reduced pressure delivery device 411 can be inserted or surgically 119640.doc -21 - 200836785. When percutaneously inserted, it is preferred to insert a reduced pressure delivery tube via a sterile insertion cannula that penetrates the skin tissue of the patient. 419 ° The application of reduced pressure tissue therapy typically produces granulation tissue in the area surrounding the tissue site 413. The granulation tissue is formed by the tissue that is usually formed before tissue repair in the body. Under normal conditions, granulation tissue can react with foreign bodies or form during the healing process. Granulation tissue is commonly used as a replacement for health, and, and, in addition, it causes the development of certain scar tissue. The granulation tissue is highly vascularized, and growth and growth rate in tissues that are highly vascularized under reduced pressure promotes new tissue growth at the tissue site 413. Still referring to Fig. 9, fluid transfer tube 431 can be fluidly coupled to the flow path of reduced pressure delivery device 411 at the distal end. Fluid transfer tube 431 includes a proximal end 432 that is fluidly coupled to fluid transfer source 433. If the fluid delivered to the tissue site is air, it is preferred to filter the air by filtering the filter 434, which is capable of filtering at least particles as small as 22 Å, to clean the air and sterilize it. Introduction of air into the tissue site 413, particularly when the tissue site 413 is below the surface of the skin, is extremely important to promote good drainage of the tissue site 413 to reduce or prevent occlusion of the reduced delivery 419. Other fluids may also be introduced into tissue site 413 using fluid transfer plumbers and fluid transfer sources 433, including but not limited to antimicrobial agents, antiviral agents, cell growth promoters, irrigation fluids, or other chemical active agents. When percutaneously inserted, preferably inserted into the fluid transfer tube 431 via a sterile insertion cannula that penetrates the patient's skin tissue, the pressure sensor 435 can be operatively coupled to the fluid transfer tube 431 to indicate 119640.doc -22-200836785 Whether the fluid transfer tube 43 1 occludes blood or other body fluid. Pressure sensor 435 can be operatively coupled to fluid delivery source 433 to provide feedback to control the amount of fluid introduced into tissue site 413. A check valve (not shown) may also be operatively coupled to the distal end of the fluid transfer tube 431 to prevent blood or other bodily fluids from entering the fluid transfer tube 431. f

The independent fluid communication paths provided by the reduced pressure delivery tube 419 and the fluid transfer tube 431 can be implemented in a variety of different paths, including providing a single lumen, multi-lumen tube path as previously described with reference to Figure 4B. Those skilled in the art will recognize that if multiple lumen tubes are used, the sensors, valves, and other components associated with fluid delivery tube 431 can similarly be coupled to particular lumens in reduced pressure delivery tube 419. Any lumen or tube in fluid communication with the tissue site is coated with an anticoagulant to prevent bodily fluid or blood accumulation within the lumen or tube. Other coatings that can be coated with 其#其孟复&amine or official include, but are not limited to, heparin, anticoagulant, anti-fibrinogen, anti-adhesion, anti-prothrombin and hydrophilic coatings. Referring to Fig. 10-19, the positive effects of decompression tissue therapy when the ρ display-also h, ... has been added to the bone tissue. In a 疋 疋 / 贝 J 4, decompression tissue therapy was applied to the skulls of several rabbits to determine their effects on bone growth and regeneration. The specific goal is to discover the effect of tissue therapy on the skull without defect or Gu bone ρ & the tissue therapy for the skull has a critical size lack of antiquity: use 'and use scaffold material and decompression tissue therapy to treat the skull = two The role of the defect in the boundary size. The special (4) test plan and rabbit number are listed in Table 1 below. U9640.doc -23 - 200836785 Rabbit No. _ -—-~ 4 Gu Yue has no defect, and the decompression group (RPTT) is applied to the top of the intact periosteum via a multi-bubble foam (Gr_F〇am) for 6 days, then immediately The sputum was also woven. There was no sham of the skull. In the absence of RPTT, the multi-foam foam (GranuF〇am) was placed on the top of the intact periosteum (control) for 6 days, followed by a fine 嫱4 mouth 1 boundary size. Defective and stainless steel sieve placed on the defect; a critical size defect and squamous acid placed in the defect about the stent; applied to two RPTT; 2 weeks postoperatively, the tissue J 4 lateral size missing mussel And a stainless steel sieve placed on the defect; a critical size defect and a calcium phosphate stent placed in the defect; applied to two defects, B RPTT; tissue collected 12 weeks after surgery, 4 t. The defect and the stainless steel placed on the defect screened the second lesion and the calcium phosphate stent placed in the defect; the tissue was collected 2 weeks after the 6-day RPTT applied to the two defects. ______ 4 Two criticality and placed on the defect Stainless steel sieve size defect and calcium phosphate stent placed in the defect; applied to two 6 days of damage, RPTTTjJ^12 weeks of tissue collection of '4 Emi boundary size defect and stainless steel sieve placed on the defect; a critical size defect and calcium phosphate stent placed in the defect; no RPTT applied (pair); 2 weeks after surgery, ', 4 ί i-- and placement of the defect on the stainless steel screen boundary size of the 'spot and the calcium phosphate stent placed in the defect; no RPTT (pair); 12 weeks after surgery Only ^___ ..., .4 4 [ surgery; no RFnp - " ------- loss; no RPTT); 6 days after surgery to collect tissue Table 1: test protocol, and, 哉 (for example, Gu The defect in the bone is a critical size defect that is large enough that the injury cannot heal only through life restoration. For rabbits, a critical dimension defect of the skull is produced by drilling a fuii_thickness hole with a diameter of about 15 mm from the skull. Referring more specifically to Figure 10, a tissue section of a 119640.doc-24-200836785 rabbit skull having natural, unaffected bone is described. The bone tissue of the skull is painted in purple, the surrounding human tissue is white and the periosteum is highlighted by a yellow asterisk. In the figure, the rabbit skull after the tissue was collected immediately after applying the decompressed tissue therapy for 6 days was described. The bone and meniscus are visible and the granulation tissue layer is developed. In Fig. 2, the rabbit skull was described after applying a decompression group, sputum therapy for 6 days, and immediately collecting tissue. The tissue of the figure is characterized by the development of new bone tissue beneath the granulation tissue. Take the yellow oyster out of the bone tissue. In Fig. 13, the rabbit skull was described after the tissue was collected immediately after the application of the reduced-pressure tissue therapy for 6 days. New bones and periosteum are visible. The histological appearance of skeletal tissue development in response to decompression tissue therapy is very similar to the histological appearance of skeletal development in very young animals undergoing rapid growth and deposition of new bone. More specifically, referring to Figure 1 9, a number of photographs and tissue sections are shown, showing the reduction of the weight, and, and the private order of my treatment, and the effect of the treatment of rabbit skull with critical size defects. In Figure 14, the description has been Rabbit skulls with two critical size defects. The full thickness critical dimension defect has a diameter of about 15 mm. In Figure 15, the stainless steel screen has been placed on a critical dimension defect and the calcium phosphate stent is placed in another critical dimension defect. In Fig. 16, the pressure applied to each defect at a critical dimension defect using a reduced pressure tissue treatment device similar to that described herein is a standard pressure of -125 mm Hg. Decompression was applied according to one of the protocols listed in Table 1. In Fig. 17, a six-day decompression tissue therapy and a skull tissue slice after twelve weeks of postoperative treatment are described. The section includes a Weiyue stent, which is indicated by a red arrow. The application of decompression tissue therapy resulted in significant growth of new bone tissue, which is highlighted by a yellow asterisk in Figure 17. The amount of bone growth was significantly higher than the critical size defect containing the same calcium phosphate branch 119640.doc -25-200836785 but without decompression, and, and my treatment showed that it can be "...# In the growth. The threshold content or the treatment of the surname Jie Shi long should be the new one. In the samples collected 12 weeks after surgery, the effect of the reduction, 'and 1 therapy is the most significant, indicating the beginning of decompression tissue therapy H Weaving forms a cascade of enhanced biological events. ί Critical dimensions of stainless steel screens (Fig. 15) but not covered by scaffolds: damage is used as an intra-animal pair with minimal new bone growth, etc. The poor material showed the advantages of appropriate scaffold materials and the positive effects of decompression tissue therapy on stent integration and bioavailability. In Figures 18 and 19, radiographs of critical size defects filled with stents after 6 days of decompression tissue therapy are described. Figure 18 depicts the defect after two weeks of surgery and indicates the basic structure of some of the new bone deposition branches within the stent. Figure 19 depicts the defect after 12 weeks of surgery and is shown to be integrated by tissue (ie, new in the stent matrix). skeleton Almost complete healing of the critical size defect caused and complete loss of primary stent construction. Referring to Figure 20, a reduced pressure delivery system 7 of one embodiment of the present invention delivers reduced pressure tissue therapy to a tissue site 713 of a patient. The reduced pressure delivery system 711 includes a manifold transfer tube 721. The manifold transfer tube 721 can be a catheter or cannula and can include features that direct the manifold transfer tube 721 to the tissue site 713, such as the steering member 725 and lead 727 The placement and orientation of lead 727 and manifold transfer tube 721 can be accomplished by endoscopic examination, hypersonic, fluorescent examination, auscultation, palpation, or any other suitable positioning technique. Manifold delivery tube 721 is provided. The perfusion delivery device is percutaneously inserted into the tissue site 7丨3 of the patient. When percutaneously inserted, preferably through a sterile insertion sleeve 119640.doc -26-200836785 through the patient's skin tissue, the tube is inserted into the manifold delivery tube. 721. In Figure 20, tissue site 713 includes bone tissue adjacent to fracture 731 on patient bone 733. Manifold delivery tube 721 is via skin 735 of the patient and any soft tissue surrounding bone 733 7 39 insertion. As previously discussed, the tissue site 71 3 may also include any other type of tissue including, but not limited to, adipose tissue, muscle tissue, nerve tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendon or ligament f

Referring to Figures 21 and 22, the reduced pressure delivery system 7丨1 is further described. The manifold delivery officer 721 can include a tapered distal end 743 to attenuate insertion through the patient's skin 735 and soft tissue 739. The tapered distal end 743 can be additionally configured to flex radially outwardly of the open position such that the inner diameter of the distal end 743 is substantially the same as or greater than the inner diameter at the other portion of the tube 721. . The position of the opening of the distal end 743 is schematically depicted by a broken line 737 in FIG. Manifold transfer tube 721 additionally includes a passage 751 containing a reduced pressure delivery device 761 or any other reduced pressure delivery device. The reduced pressure delivery device 761 includes a flexible barrier 765 and/or a multi-foaming material π? similar to those described with reference to Figures 6-8. The resistant barrier 765 and/or the multi-bubble material 767 is preferably wound, folded or otherwise compressed around the reduced pressure transfer tube 769 to reduce the cross-sectional area of the reduced pressure transfer device 761 in the passage 751. After the distal end 743 of the manifold delivery tube 721 is placed at the tissue site 713, the reduced pressure delivery device 761 can be placed in the channel 751 and guided to the tissue site 713. In addition, named Jiang, AA-Yi Bu, in the insertion of the skeletal delivery tube 721 into the patient's body = front can be scheduled to be located in the channel 751. If the pressure reducing transmission device 76 1 is pushed through the passage 75 1, the target - Γ / 士, I 逋迢 / 51 can use the biocompatible lubrication 119640.doc -27- 200836785 agent to reduce the reduced pressure transmission device 761 Friction with the manifold transfer tube 721. When the distal end 743 has been positioned at the tissue site 713 and the reduced pressure delivery device 761 has been delivered to the distal end 743, then the reduced pressure delivery device 761 is pushed toward the distal end 743 ' resulting in the distal end 743 expanding radially outward to In the opening position. The reduced pressure delivery device 761 is pushed out of the manifold transfer tube 721, preferably into the void or space of the tissue site 713. Voids or spaces are typically formed by soft tissue stripping that can be achieved by transdermal means. In some cases, the tissue site 713 can be located at the wound site, and naturally there can be voids due to anatomical trauma. In other cases, it may be by balloon peeling, sharp stripping, blunt peeling, hydrodissection, pneumatic dissecting, ultrasonic peeling, electrocautery stripping, laser stripping or any other suitable The stripping technique produces a jade gap. § When the reduced pressure delivery device 76 enters the gap adjacent the tissue site 73, the flexible barrier 765 and/or the multifoam material 767 of the reduced pressure delivery device 761 opens, expands or decompresses (see Figure 22), thereby The reduced pressure delivery device 761 can be placed in contact with the tissue site 713. Although not required, the flexible barrier 765 and/or the multi-foaming material 767 can be subjected to vacuum or reduced pressure supplied via the reduced pressure delivery officer 769 to compress the flexible barrier and/or multi-bubble material 767. The flexible P early soil 765 and/or the evening bag material 767 can be stretched by relaxing the reduced pressure supplied by the reduced pressure transfer tube 769 or by supplying a positive pressure from the reduced pressure transfer tube 769 to assist the opening process. Final placement and manipulation of the reduced pressure delivery device 761 can be accomplished by endoscopic examination, hypersonic, fluorescent examination, auscultation, palpation, or any other suitable positioning technique. After the reduced pressure delivery device 761 is placed, the manifold delivery f72i is preferably removed from the patient, but the reduced pressure delivery tube associated with the reduced pressure delivery device 761 is retained in place to allow 119640.doc -28-200836785 to be reduced. The pressure is applied to the tissue site 7 1 3 percutaneously. Referring to Figures 23-25, a reduced pressure delivery system 811 of one embodiment of the present invention includes a manifold transfer tube 821 having a tapered distal end 843 that is configured to flex radially outwardly of the open position. Thus, the inner diameter of the distal end 843 is substantially the same as or greater than the inner diameter at the other portion of the tube 821. The position of the opening of the distal end 843 is schematically depicted by dashed lines 837 in Figures 23-25. The responsive officer 821 additionally includes a passageway containing a reduced pressure delivery device 861 similar to the other reduced pressure delivery devices described herein. The reduced pressure delivery device 861 includes a flexible barrier 865 and/or a multi-bubble material that is preferably wound, folded, or otherwise compressed around the reduced pressure transfer tube 869 to reduce the cross-sectional area of the reduced pressure transfer passage 861 within the passage. . The impervious membrane 871 having the internal space 873 is placed around the reduced-pressure delivery device 861 such that the internal space 873 of the impermeable membrane 871 contains the reduced-pressure delivery device 861. The impermeable membrane 871 can be a balloon, a cannula, or any other type of membrane capable of preventing fluid transport, such that the impermeable membrane 871 can assume a compressed position (see Figure 23), a relaxed position (see Figure 24), and an expanded position. (See Figures 25 and 25 A) at least one of them. The impermeable membrane 871 can be hermetically connected to the manifold transfer member 821 such that the interior space of the impermeable membrane 871 is in fluid communication with the passage of the eccentric transfer tube 821. The impermeable membrane 871 may be additionally attached to the reduced pressure transfer tube 869 such that the inner space 873 of the impermeable membrane 871 is in fluid communication with the passage of the reduced pressure transfer tube 869. Alternatively, the impermeable membrane can be attached to a separate control tube or control lumen in fluid communication with internal space 873 (see, for example, Figure 25A). 119640.doc -29- 200836785 In an embodiment, an impermeable membrane 871 may be provided to further reduce the cross-sectional area of the in-channel reduced pressure delivery device 861. To achieve this, a C force smaller than the surrounding pressure around the impermeable film 871 is applied to the inner space 873 of the impermeable film 871. Thereby, most of the air or other fluid in the interior space 873 is withdrawn, leaving the impermeable membrane 871 in the compressed position shown in FIG. The impermeable membrane 871 is stretched inward at the compression position, thereby applying a compressive force to the reduced pressure delivery device 861 to further reduce the cross-sectional area of the reduced pressure delivery device 861. As described earlier with reference to Figures 21 and 22, after the distal end 843 of the manifold delivery tube 821 is placed at the tissue site, the reduced pressure delivery device 861 can be delivered to the tissue site. The impervious membrane 871 and the decompression transfer device 861 can be manipulated by using endoscopic examination, supersonic, fluorescent examination, auscultation, palpation or any other suitable positioning technique. The impermeable membrane 871 can include a radiopaque marker 881' which observes the impermeable membrane 871 under a modified fluoroscopy prior to removal. After pushing the reduced pressure delivery device 861 through the distal end 843, the reduced pressure applied to the internal space 873 can be weakened to bring the impermeable membrane 87A into the relaxed position (see Fig. 24) 'thus enabling easier decompression The transfer device 86 is removed from the impermeable membrane 871. A removal instrument 885 (such as a trocar, stylet or other sharp instrument) can be provided to rupture the impermeable membrane 871. The removal instrument 885 is preferably inserted via the reduced pressure delivery tube 869 and is capable of being advanced to contact the impermeable membrane 871. After the impervious membrane 871 is broken, the removal instrument 8 85 and the impermeable membrane 87} can be extracted via the manifold transfer tube 821 to open the flexible barrier 865 and/or the multi-foam material 867 of the reduced pressure delivery device 86. , stretched or decompressed so that the reduced pressure delivery device 861 can be placed in contact with the tissue site. Attenuation of application 119640.doc -30- 200836785 After the decompression of internal space 873 and removal of impervious film 871, the opening of flexible barrier 865 and/or multi-foam material 867 may automatically occur. In some cases, a positive pressure may be delivered via the reduced pressure delivery tube 869 to assist in opening or decompressing the flexible barrier 865 and/or the multi-bubble material 867. After the decompression delivery device 861 is finally placed, the manifold delivery tube 821 is preferably removed from the patient, but the reduced pressure delivery tube 869 connected to the reduced pressure delivery device 861 is retained in place to allow for transdermal application of reduced pressure. To the tissue site. An impermeable membrane 871 can also be used to detach tissue adjacent to the tissue site, followed by placement of a reduced pressure delivery device 861 to offset the tissue site. After the reduced pressure delivery device 861 and the intact impervious membrane 871 are pushed past the distal end 843 of the manifold transfer tube 821, air or another fluid can be injected or aspirated into the interior space 873 of the impermeable membrane 871. Since the incompressibility of the liquid allows the impervious film 871 to expand more uniformly and uniformly, it is preferred to use a liquid to swell the impermeable film 871. As shown in Fig. 25, the impervious film 871 may be radially or directionally expanded, depending on the method of manufacture and the attachment of the manifold transfer tube 821. Since the impermeable membrane 87 1 expands outward to the expanded position due to the pressure of air or fluid (see Fig. 25), the void adjacent to the tissue site is peeled off. When the void is sufficiently large, liquid, air or other fluid may be released from the interior space 873 to cause the impermeable membrane 871 to assume a relaxed position. Subsequently, the impermeable membrane 871 can be ruptured as explained previously, and the reduced pressure delivery device 861 is inserted into a position adjacent to the tissue site. Referring to FIG. 25A, if the tissue adjacent to the tissue site is mainly peeled off using the impermeable membrane 871, the impermeable membrane 871 can be hermetically attached to the manifold transfer tube M1, thereby allowing the internal space 873 and the same manifold transfer tube. The 821 is connected or attached to H9640.doc-31 - 200836785 to the secondary lumen or tube 891 of the MIS discharge tube 821 for fluid communication. Liquid, air or other fluid may be delivered to the interior space 873 using a human lumen 891 to place the impermeable membrane 871 at the expanded position. After peeling, the impermeable membrane 871 can be relaxed and ruptured as previously described with reference to Figure 24. Referring to Figure 26, a reduced pressure delivery system 9A of one embodiment of the present invention includes a manifold transfer tube 921 having a tapered distal end 943 that is radially deflected outwardly toward the open position by the set of distal ends 943. The inner diameter of the distal end 943 is substantially the same as or greater than the inner diameter at other portions of the tube 921. The opening position of the distal end 943 is schematically depicted by a broken line 937 in FIG. Manifold transfer tube 921 additionally includes a passageway containing a reduced pressure delivery device 916 similar to the other reduced pressure delivery 5 described herein. The reduced pressure transfer device 916 includes a flexible barrier 965 and/or a multi-bubble material 967 that is preferably wound, folded or otherwise compressed around the reduced pressure transfer tube 969 to reduce the reduction in the passage of the manifold transfer tube 921. The cross-sectional area of the pressure transmitting device 961. The impervious film 971 having the internal space 973 is disposed around the reduced pressure transfer device 961' such that the internal space 973 of the impermeable film 971 contains the reduced pressure transfer device 961. The impermeable membrane 971 includes a seal 977' at one end of the impermeable membrane 971 to provide an alternative method of removing the reduced pressure delivery device 96 1 from the impermeable membrane 971. The other end of the impermeable membrane 971 can be sealed to the manifold delivery tube 9 1 1 such that the internal space 973 of the impermeable membrane 791 is in fluid communication with the passage of the manifold transfer tube 921. Alternatively, the impermeable membrane 971 can be attached to a separate control tube (not shown) in fluid communication with the interior space 973. Similar to the impervious membrane 87 1 1 of Figure 23, the impermeable membrane 197 prevents fluid 119640.doc -32, 200836785 from being transported, so the impervious membrane 971 can take compression/position, relaxed position and expansion At least one of the locations. Since the procedure for placing the impermeable membrane in the compressed position and the expanded position is similar to that of the impervious membrane 871, only the different methods of removing the reduced pressure delivery device 961 will be described. - delivery of the reduced pressure delivery device 96 1 to the tissue site within the impervious membrane 97" and subsequent use of endoscopy, ultrasound, fluoroscopy, auscultation, palpation or any other suitable positioning technique Make it properly positioned. The impermeable membrane 971 can include a radiopaque marker 98i that improves the observation of the impermeable membrane 971 under fluoroscopy prior to removal. Next, the reduced pressure delivery device 96 is pushed past the distal end 943 of the manifold transfer tube 921. The depressurization applied to the internal space 973 can be weakened to place the impermeable membrane 971 in a relaxed position. Next, the reduced pressure delivery device 961 is pushed through the glue seal 977 to withdraw the impermeable film 971. Referring to Figure 26A, a reduced pressure delivery system 985 of one embodiment of the present invention may not include a manifold transfer tube 92 1 similar to the manifold transfer tube of Figure 26 . In other words, the reduced pressure delivery system 985 can include a lead 987, a reduced pressure transfer tube 989, and a reduced pressure delivery device 99 1 . The reduced pressure delivery device 991 includes a plurality of flow paths that are fluidly coupled to the reduced pressure delivery tube 989. The pressure-reducing device 991 and the pressure-reducing transfer tube 9 8 9 are placed on the lead 9 8 7 that is percutaneously guided to the tissue portion 913, instead of using the independent manifold transfer tube to transmit the pressure-reducing device. 9 91. Lead 9 8 7 and reduced pressure delivery tube 9 8 9 preferably penetrate the skin of the patient via a sterile cannula. By guiding the reduced pressure delivery tube 989 and the reduced pressure delivery device 991 along the lead 987, the reduced pressure delivery device 991 can be placed at the tissue site 993 to allow percutaneous application of reduced pressure tissue therapy. Since the 119640.doc -33 - 200836785 pressure reducing device 911 is not constrained in the manifold transfer tube during delivery to the tissue site 993, it is preferred to hold the reduced pressure delivery device 99 1 in compression during delivery. position. If an elastic foam is used as the pressure reducing transfer device 99 1, a biocompatible, soluble adhesive can be applied to the foam and the foam can be compressed. Upon reaching the tissue site, the body fluid or other fluid delivered via the reduced pressure delivery tube 989 dissolves the adhesive and expands the foam to contact the tissue site. Alternatively, the reduced pressure transfer device 991 may be formed by a compressed anhydrous hydrogel. The hydrogel absorbs moisture after delivery to the tissue site 993, thereby expanding the reduced pressure delivery device 991. Another reduced pressure delivery device 99 1 can be made from a thermally active material (e.g., polyethylene glycol) that expands at the tissue site 993 upon exposure to body heat of the patient. In another embodiment, the compressed reduced pressure delivery device 917 can be delivered to the tissue site 913 for film unwinding. Referring to Figure 27, a reduced pressure delivery system 之一 of one embodiment of the present invention includes a manifold delivery tube 1 〇 21 having a distal end 1043 that is inserted through tissue of a patient to access tissue site 1025. . The tissue site 25 can include voids 1029 associated with wounds or other defects, or alternatively can be created by exfoliation, including stripping techniques as described herein. After the distal end 1043 is placed in the gap 1〇29 adjacent to the tissue site 1〇25, the injectable, pourable or flowable reduced-pressure delivery device 1035 is delivered to the tissue site via the manifold transfer tube 1〇21. 1025. In the case of delivery to the tissue site, the 'reduced pressure transfer device 1 〇 3 5 preferably exists in a flowable state, and then forms a plurality of flow paths for distributing the reduced pressure or fluid after arrival, in some cases, The flowable material can be hardened after reaching the tissue site through a drying process, a curing process or other chemical reaction or physical reaction to form a solid H9640.doc -34 - 200836785 sad. In other cases, the flowable material can form a foam in situ after delivery to the tissue site. Other materials may be present in the gel-like state at the tissue site 1025, but still have a plurality of flow paths for delivering reduced pressure. The amount of reduced pressure delivery device 1 〇 3 5 delivered to the tissue site 1 〇 2 5 may be sufficient to partially fill the gap 1029. The reduced pressure delivery device 1A can include the manifold and the stent. As a manifold, the reduced pressure transfer device 1035 includes a plurality of holes or openings that are formed in the material after being transferred to the voids 1029. The holes or openings are connected to each other' to create a plurality of flow paths. The flow path is used to apply and distribute the decompression to the tissue site! 025. As a stent, the reduced pressure delivery device 1035 is bioresorbable and serves as a substrate for new tissue to grow thereon and therein. In one embodiment, the reduced pressure delivery device 1035 can include P〇ragens, such as NaCU^ other salts, distributed throughout the liquid or viscous gel. After the liquid or adhesive is delivered to the tissue site 1025, the material conforms to the void 1〇29 and subsequently solidifies into a solid mass. The water-soluble NaC1 sputum (9) dissolves in the presence of body fluids, and retains a structure having interconnected pores or flow paths. The reduced pressure and/or fluid is transferred to the flow path. When a new tissue develops, the tissue grows in the pores of the reduced pressure delivery device 1035, and then the tissue eventually replaces the reduced pressure delivery device 1〇35 as the reduced pressure delivery device 1〇35 is degraded. In this particular example, the reduced pressure delivery device 1035 functions not only as a manifold but also as a stent for new tissue growth. In another embodiment, the reduced pressure delivery device 1035 is alginate mixed with 4 〇 () μ η mannose beads. The p〇ragen or 119640.doc-35-200836785 beads may be dissolved by a local body fluid or irrigant or other fluid delivered to the reduced pressure delivery device 丨035 at the tissue site. After the poragen4 beads are dissolved, the space previously occupied by p〇ragen or beads becomes a void which is interconnected with other spaces to form a flow path in the pressure-reducing transfer device 丨〇35. The use of poragen to create a flow path within the material is extremely effective, but it also forms pores and flow paths that are limited in size to the particle size of the selected poragen. Instead of progen, a chemical reaction can be used to create larger pores due to the formation of gaseous by-products. For example, in one embodiment, a flowable material comprising sodium bicarbonate and citric acid microparticles (which may be used in non-stoichiometric amounts) can be delivered to tissue site 1025. When the flowable material forms a foam or solid in situ, the body fluid will react with the acid and base between the initial sodium bicarbonate and the citric acid. The resulting carbon dioxide gas particles produced generate larger pores and flow paths throughout the reduced pressure transfer device 1 to 35 than those produced by the poragen dissolution technique. The conversion of the reduced pressure delivery device 1035 from a liquid or glue to a solid or foam can be triggered by pH, temperature, light or reaction with body fluids, chemicals or other materials delivered to the tissue site. It is also possible to describe the σ海 transformation by mixing multiple reaction groups. In one embodiment, the reduced pressure delivery device 1035 is prepared by selecting bioresorbable microspheres made from any bioresorbable compound. The microspheres are dispersed in a solution of a hydrogel-forming material (such as hyaluronic acid, collagen or polyethylene) containing a photoinitiator and a photoreactive group. The microsphere-gel mixture was exposed to light for a short period of time to bind the hydrogel to the 7-knife and fix the hydrogel to the microspheres. The excess solution was drained' and the microspheres were subsequently dried. The microspheres are delivered to , , , , , and by injection or pouring. The niobium is removed and the mixture absorbs moisture and the hydrogel coating hydrates 119640.doc -36-200836785. The mixture is then ' again exposed to light which crosslinks the microspheres to produce a plurality of flow paths. The crosslinked microspheres are then used as a manifold to deliver reduced pressure to the tissue site and promote new tissue growth as a porous scaffold. In addition to the foregoing embodiments described herein, the reduced pressure delivery device 丨〇35 can also be made from a variety of materials including, but not limited to, calcium phosphate, collagen, alginate, cellulose, or capable of being gas, liquid, condensed. Glue, paste, slurry, suspension, or other flowable material is delivered to the tissue site and can be shaped into any other equivalent material that is in fluid communication with the tissue site. The flowable material may additionally comprise particulate solids (such as beads) which are capable of flowing through the manifold transfer tube 1021 if the size of the particulate solids is sufficiently small. The material that is delivered to the tissue site in a flowable state can be polymerized or gelled in situ. As previously described, the reduced pressure delivery device 1〇35 can be directly injected or poured into the gap 1〇29 adjacent to the tissue site 1025. Referring to Fig. 27A, the manifold transfer tube 1021 may include an impermeable membrane or semi-permeable membrane 1051 at the distal end 1〇43 of the manifold transfer tube 1〇21. The membrane 1051 includes an interior space 1 〇 55 in fluid communication with a secondary chamber 1057 attached to the manifold transfer tube 1021. The manifold transfer tube 1〇21 is guided to the tissue site 1025 via the lead 1〇61. The pressure reducing transfer device 1〇35 can be injected or poured into the internal space 1〇55 of the membrane 1051 via the secondary chamber 1〇57. When the fluid or gel-filled film is 1〇5丨, the film 1〇51 is expanded to fill the voids 1〇29, thereby making the film and the tissue site. contact. When the membrane 1051 is expanded, the membrane 1〇51 can be used to strip additional tissue adjacent or adjacent to the tissue site 1025. If the membrane My is an impermeable membrane, the shell can be broken and removed, leaving a reduced pressure 119640.doc -37-200836785 pressure delivery device 1035 in contact with the tissue site 1〇25. Alternatively, membrane 1〇51 can be made of a dissolvable material that dissolves in the presence of body fluids or biocompatible solvents that can be delivered to membrane 1051. If the membrane 1051 is a semipermeable membrane, the membrane 1〇51 can remain in place. The semipermeable 臈 1051 connects the reduced pressure and possibly other fluids to the tissue site ι 25 . Referring to Figure 28, a method of administering reduced-pressure tissue therapy to a tissue site includes surgically inserting a manifold adjacent the tissue site at 1115, the manifold having a plurality of self-flexible barriers extending The protrusions create a plurality of flow paths between the protrusions. The manifold is positioned at 1119 such that at least a portion of the protrusions are in contact with the tissue site. At 1123, a reduced pressure is applied to the tissue site via the manifold. Referring to Figure 29, a method of administering reduced-pressure tissue therapy to a tissue site includes inserting a manifold percutaneously at 1215 adjacent to the tissue site. The manifold may include a plurality of protrusions extending from the flexible barrier to create a flow path between the protrusions. Additionally, the manifold can include a multi-vesicle material having a plurality of flow passages within the multi-vesicle material. Alternatively, the manifold may be formed of an injectable or pourable material that is delivered to the tissue site and that forms a plurality of flow paths upon reaching the tissue site. At 1219, the manifold is positioned such that at least a portion of the flow path is in fluid communication with the tissue site. At 1223, a reduced pressure is applied to the tissue site via the manifold. Referring to Figure 30, a method of administering reduced-pressure tissue therapy to a tissue site 1 3 1 1 includes percutaneously inserting a tube having a passage through the patient's tissue at 13 15 to place the distal end of the tube with the tissue The location is adjacent to the location. At 1319, the balloon associated with the tube can be inflated to strip tissue adjacent to the tissue site, thereby creating a void. At Π23, the manifold is passed through the passage. The manifold can be packaged 119640.doc -38- 200836785 to include a plurality of protrusions extending from the flexible barrier to create a flow path between the protrusions. Additionally, the manifold can include a multi-vesicle material having a plurality of flow passages within the multi-bubble material. Alternatively, the manifold can be formed from an injectable or pourable material that is delivered to the tissue site as previously described with reference to the drawings. At η", the manifold is positioned "in," and at least a portion of the flow path is in fluid communication with the tissue site. At 1331, reduced pressure is applied to the tissue site via a manifold via a reduced pressure delivery tube or any other delivery member. 8 Referring to Figure 31, a method of administering reduced-pressure tissue therapy to a tissue site 14 includes percutaneously inserting a tube having a passage through the patient's tissue at 14 15 to place the distal end of the tube with the tissue site. Adjacent to the location. At 1423, the manifold is transferred to the tissue site within the impermeable cannula via the channel, and the MB^pass impermeable sleeve has experienced a first depressurization that is less than the pressure around the cannula. At 1427, the cannula is ruptured to bring the manifold into contact with the tissue site. The decompression was applied to the tissue site via a manifold at 14 31. Tea looking at Figures 32 and 33, the reduced pressure delivery device of the present invention - ΐ5ΐι & includes an orthopaedic hip prosthesis 1515 for the surviving femoral head of the patient's month and bone i 5 i 7 . The hip prosthesis 1515 includes a stem portion 1521 and a head portion 15 . The extension rod portion 1521 is inserted into the reamed passage 1529 in the shaft of the femur 1517. The porous coating 1535 is placed around the stem portion and is preferably constructed of sintered or vitrified pottery or metal. Or 'a multi-foam material having a porous property can be placed on the cup file to place a plurality of flow passages 1541 in the rod portion 1 5 2 1 of the hip prosthesis 1 5 1 5, % 2 | 彳 < Flow passage 1541 is in fluid communication with porous coating 1 535. The connection port 1545 is fluidly coupled to the flow path mi, which is configured to release the connection to the reduced pressure transfer and reduced pressure transfer source 119640.doc -39 - 200836785 1553. After implantation, the reduced pressure is delivered to the bone around the porous coating 1535 and/or hip prosthesis 1515 using flow path 1541. The flow path i54i can include a primary feed line 1543 in fluid communication with a plurality of lateral branch lines 1 547 that are in communication with the porous coating 1535. As shown in Fig. 32, the transverse branch lines 1545 can be oriented perpendicular to the main feed line 1543 or can be oriented at an 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 multi-bubble (preferably open cell) material that is in fluid communication with the esophageal coating 1535. Referring more specifically to Figure 33, the hip prosthesis 15 15 can additionally include a second plurality of flow passages 丨 56 in the stem portion 1521 to provide fluid to the porous coating 1 5 3 5 and/or the body prosthesis 1 5 1 5 surrounding bones. The fluid may include filtered work gas or other gas, antibacterial agent, antiviral agent, cell growth promoter, irrigation fluid, chemically active fluid, or any other fluid. Additional fluid communication is provided if multiple fluids need to be introduced into the bone around the hip prosthesis 151 5 . The port 1565 is fluidly coupled to a flow passage 1561 that is configured to relieve connection to the fluid transfer tube 1571 and the fluid transfer source 1573. The flow passage 1561 can include a primary feed line 1583 in fluid communication with a plurality of transverse branch lines 158, the transverse branch lines 1585 being in communication with the porous coating 1535. As shown in Figure 33, the transverse branch lines 1585 can be oriented perpendicular to the main feed line 1583 or can be oriented at an angle to the main feed line 1 583. The pressure reduction to the first plurality of flow passages 1541 and the flow to the second 119640.doc -40 - 200836785 plurality of flow passages 1561 can be achieved by separate tubes (such as the reduced pressure transfer tube 1551 and the fluid transfer tube 1571) transfer. Further, a communication path for transferring the pressure reduction and the fluid may be separated by a tube having the plurality of lumens. Additionally, it should be noted that a separate fluid communication path is preferably provided within the hip prosthesis 15 15 , but the first plurality of flow passages 1541 can also be used to deliver reduced pressure and fluid to the bone surrounding the body prosthesis 1515 . As previously described, application of reduced pressure to bone tissue promotes and accelerates the growth of new bone tissue. By transferring the reduced pressure to the bone region around the hip prosthesis using the hip prosthesis 1515 as a manifold, the femur 1517 recovers faster and allows the hip prosthesis 1515 to more successfully integrate with the bone. A second plurality of flow paths 1561 are provided to open the bone around the hip prosthesis 151 5 to improve the successful creation of new bone around the prosthesis. After the decompression is applied through the body prosthesis 15 15 for a selected amount of time, the reduced pressure delivery tube 1551 and the fluid transfer tube 1571 can be disconnected from the connection ports 1545, 1565, and preferably without the use of a surgical invasive procedure. Remove it from the patient. The connection between the connecting ports 1545, 1565 and the tubes 1551, 1571 can be a manually removable connection which can be achieved by applying axial tension to the officials 1551, 1571 outside the patient. Alternatively, the connection ports 1545, 1565 can be bioresorbed or dissolved in the presence of a selected fluid or chemical, such that the removal of the tubes 1551, 1571 can be achieved by connecting the ports 1545, body or chemical. Tube Road = can also be made from bioresorbable materials that have been dissolved over a period of time or active materials that are dissolved in the presence of specific chemicals or other substances. A reduced pressure delivery source 1553 can be provided outside the patient and coupled to the reduced pressure delivery officer 1551 to deliver reduced pressure to the hip prosthesis 1515. Alternatively, the reduced pressure 119640.doc -41 - 200836785 delivery source 1553 can be implanted on or near the hip prosthesis 151 5 in the patient. The reduced pressure delivery source 1 5 5 3 is placed in the patient to eliminate the need for a percutaneous fluid connection. The implanted reduced pressure delivery source 553 can be a conventional pump that is operatively coupled to the flow path 1541. A battery that can be implanted in the patient powers the pump, or an external battery that can be electrically connected to the pump and connected percutaneously to power the pump. The pump can also be driven directly by a chemical reaction that delivers a reduced pressure and circulates fluid through the flow passages 1541, 1561. Although only the stem portion 1521 and the head portion 1 525 ' of the hip prosthesis 15 15 are depicted in FIGS. 32 and 33, it should be noted that flow passages and members for applying the reduced pressure tissue therapy described herein can be applied to the hip prosthesis 1515. Any other component that touches a bone or other tissue, such as a body. Referring to Figure 34, a method 1611 for repairing a patient's joint includes implanting the prosthesis into the bone adjacent the joint at 1651. The prosthesis can be a hip prosthesis as described above or any other prosthesis that assists in restoring the joint mobility of the patient. The prosthesis includes a plurality of flow passes configured to be in fluid communication with the bone

road. At 1619, decompression is applied to the bone via a plurality of flow paths to improve skeletal integration of the prosthesis. Referring more to Figures 3 5 and 3, the reduced pressure delivery device 17 of the consistent embodiment of the present invention "includes a surgical fixation device 1717 for fixation of the patient's bone path 1717 (including fracture 1719 or other illusion. Figures 35 and 36) The orthopaedic fixation sputum 72 is configured as a panel having a plurality of channels 1721 for using a screw, a pin, a screw or other fastener to advance the orthopedic fixation device to the bone road 1717. 1 The sapporo layer 1735 female placed on the surface of the orthopedic fixation device to be contacted with the bone 171 7 . The porous coating is preferably H9640.doc -42- 200836785 from sintered or vitrified pottery or metal Alternatively, a multi-vesicular material having porous properties can be placed between the bone 1717 and the orthopedic fixation device 1715. A plurality of flow passages 1741 are placed within the orthopedic fixation device i7i5 to thereby make the flow passage 1741 and the porous coating 1735 is in fluid communication. The connection port (10) is fluidly coupled to the flow passage 1741, the port being configured to be coupled to the reduced pressure transfer tube 1751 and the reduced pressure delivery source 1753. The bridge surgical fixation device 1715 is secured to the bone path 1 After 717, the reduced pressure is transmitted using the flow path 1741 (

C is delivered to the porous coating 1735 and/or the bone path around the orthopedic fixation device m3. The flow passage 1741 can include a primary feed line 丨 743 in fluid communication with a plurality of transverse branch lines 1747, a layer 17 Λ 3 (four) & a branch line m7 and a porous coating! H. Figure 35, the lateral branch line 1747 can be in line with the line 1743 The vertical orientation 'may be one to two directions with the main feed line (10); an alternative method for distributing the reduced pressure includes: providing: an orthopedic fixation device; and a multi-bubble capable of being connected with (preferably Open hole) material 35 internal space of the body. The true orthopedic orthopedic fixation device is shown in Fig. 35, and the orthopedic surgery can be mu, m~ can be a "panel, or a different tender" arm, a struts or a stable - part of the skeletal skeletal Any other device. Orthopedic external attachments for attachment prostheses or other orthopedics 15 may additionally be woven or cartilage, etc., such as the skeletal group adjacent to the fasteners or the buckles; The reduced pressure is transmitted to the flow path of each of the #/α surrounding tissues of the fasteners. When the fasteners can include pins, screws, screws or any other suitable 119640.doc -43 - 200836785 More specifically 36, the orthopedic fixation device 1715 can additionally include a second plurality of flow passages 1761 within the orthopaedic fixation device 1715 to provide fluid to the bone surrounding the porous coating 173 and/or the orthopedic fixation device 1715. The fluid may include filtered air or other gas, antibacterial agent, antiviral agent, cell growth promoter, irrigation fluid, chemical active agent, or any other fluid. If desired, multiple fluids are introduced into the bone surrounding the orthopedic fixation device 17 15 , providing additional fluid communication paths.

The port 1765 is in fluid connection with a flow path 1761 that is configured to interface with the fluid transfer tube 1771 and the fluid transfer source 1773. The flow passage 1761 can include a primary feed line 1783 in fluid communication with a plurality of transverse branch lines 1785 that are in communication with the porous coating 1735. As depicted in Figure 33, the transverse branch lines 1785 can be oriented perpendicular to the main feed line 1783, or can be oriented at an angle to the main feed line 1783. - can be hunted by separate tubes (such as reduced pressure transfer tubes 1751 and fluid transfer tubes) 1771) The pressure is reduced to the transfer of the first plurality of flow paths HU and the transfer of the fluid to the second 5 (four) moving path 1761. Further, a communication path for transferring the pressure reduction and the fluid may be separated by a tube having the plurality of the above-mentioned official chambers. In addition, it should be noted that: a separate flow through the orthopedic fixation device 1715 can also be used to transfer the reduced pressure helium fluid to the bone adjacent to the orthopedic fixation device i7i5 using the first plurality of flow passages 1741 Network. Shape = Section Fixing Device 1715 acts as a manifold to transfer the reduced pressure to the collateral region of the 1717, 1715 phase to accelerate and improve the recovery of the defect 1719 of the bone path. Providing a second plurality of flow paths 1761 to connect the 119640.doc-44-200836785/wave body to the bone surrounding the orthopedic fixation device 171 5 will improve the successful creation of new bone near the bridge surgical fixation device. Referring to Figure 37, a method 1811 for healing a bone defect in a bone graft includes securing the bone at 1815 using an orthopedic fixation device. The orthopedic fixation device includes a plurality of flow paths disposed within the orthopedic fixation device. At 1819, a reduced pressure is applied to the bone defect via the plurality of flow paths. See Figure 38 for a method of administering reduced-pressure tissue therapy to a tissue site. 1911 includes positioning a manifold having a plurality of flow passages at 1915 such that one of the flow passages is in fluid communication with the tissue site. The reduced pressure is applied to the tissue site via the flow path at 丨9 〖9, and at 1923, the fluid is delivered to the tissue site via the flow paths. Referring to Figure 39, a method of administering reduced-pressure tissue therapy to a tissue site "includes positioning the distal end of the manifold delivery tube at a location adjacent to the tissue site at 2015. At 2019, via the manifold The tube delivers fluid to the tissue site. The fluid is capable of filling a void adjacent the tissue site and becomes a solid manifold having a plurality of flow paths in fluid communication with the tissue site. The flow path through the solid manifold at 2〇23 Decompression is applied to the tissue site. Referring to Figures 40-48, the reduced pressure delivery system 2111 includes a primary manifold 2115 having a flexible wall 2117 around the primary flow channel 2121. The flexible wall 2117 is attached at the proximal end 2123. The reduced pressure transfer tube 2125 is connected. Since the cross-sectional shape of the reduced pressure transfer tube 2125 will generally be circular, and since the main manifold cross-sectional shape may be other than a circular shape (i.e., the rectangle in Fig. 4〇_45) And the triangle in FIGS. 46-48), so that the transfer zone 2129 is provided between the reduced pressure transfer pipe 2125 and the main differential 119640.doc -45 - 200836785 2115. The main manifold 2115 can be adhered to the reduced pressure transfer officer 2125. Connect, use, etc. Other means of fusion or insert molding may be connected or otherwise integrally joined by co-injection molding. The reduced pressure delivery tube 2125 delivers reduced pressure to the primary manifold 2115 for distribution at the tissue site or The vicinity of the tissue site. The resistance preventing element 213 5 is positioned within the main manifold to prevent the manifold 2 from colliding, and thus preventing the enthalpy blockage of the main flow channel 2121 during application of decompression. In an embodiment The retardation preventing member 2135 may be a plurality of protrusions 2137 (see FIG. 44) that are disposed on the inner surface 2141 of the flexible wall 2117 and extend into the main flow channel 2121. In another embodiment, the block prevention is prevented. Element 2135 can be a single ridge or ridges 2145 disposed on inner surface 2141 (see Figures 40 and 41). In another embodiment, retardation preventing element 2 1 35 includes a female placed in the main flow channel. A multi-bubble material 2149, such as that described in Figure 47. The retardation preventing element 2丨3 5 can be any Q material that can be inserted into the flow channel or that can be integrally or otherwise attached to the flexible wall 2丨丨7 Or structure. Blocking preventing element 2135 It is sufficient to prevent the king of the flexible wall 2117. The collapse of the crucible also causes the fluid to flow through the main flow channel 2丨2 i. The σ海flexible wall 2117 additionally includes a plurality of flexible walls 2丨丨7 and the main The flow channel 2121 communicates with the small hole 2155. The small hole 2155 allows the reduced pressure to be transmitted to the main flow channel 2121 to be distributed at the tissue site. The small hole 21 55 can be selectively placed around the circumference of the manifold 211 5 to preferentially guide the vacuum. For example, a small hole can be placed in Figure 5A to face the bone, face up the tissue, or both. The reduced pressure transfer command 2125 preferably includes a first conduit 2i6i having an outlet connected to the main flow passage 2121, 119640.doc - 46 - 200836785, to deliver the reduced pressure to the primary flow passage 2121. A second conduit 2 (6) may also be provided to purify the primary (four) channel 2121 and the first conduit with fluid to prevent or eliminate blockage caused by the wound exudate and other fluids obtained from the tissue site: the second conduit 2163 preferably includes at least An exit pupil positioned at least adjacent to at least one of the main flow passages 2121 and the first conduit 2i6i. Referring more specifically to Figures 40 and 41, the reduced pressure delivery system 2111 second conduit 2163 can include a plurality of & passages for purifying the primary flow passage and the first conduit 2161. When the end of the flexible wall 2117 opposite the end attached to the reduced pressure transfer tube 2125 is opened as shown in the drawing, it has been found that the end of the cover replaceable wall 2117 can improve the efficiency and reliability of the purification. Preferably, a headspace is provided between the sealed end of the flexible wall and the end of the second conduit 2163. 2 171 The top space 21 71 allows for the accumulation of purge fluid during the purification process, which helps drive the purge fluid through the primary flow channel 2121. And enter the first pipe 2161. The spacer used as the retardation preventing member 2135 is also described in FIG. The centrally located spacer divides the primary flow channel 2121 into two chambers which allow the primary ambiguity 2115 to continue operation when one of the chambers is blocked and cannot be purged to eliminate the block. The view of Figures 49 and 50' decompression transfer system 22A includes a main manifold 2215 that is coupled to the reduced pressure transfer tube 2217. The reduced pressure delivery tube 2217 includes a central lumen 2223 and a plurality of accessory lumens 2225. The accessory lumen can be used to measure the pressure at or near the tissue site, and the central lumen 2223 can be further cleaned by the accessory lumen 2225 to prevent or eliminate blockage. A plurality of small holes 2231 communicate with the central lumen 2223 to distribute the reduced pressure of the central lumen. As shown in Fig. 50, the aperture 2231 preferably does not penetrate the accessory lumen 2225. Also shown in Fig. 50 is the countersunk end of the reduced pressure delivery tube which creates a headspace 2241 outside the end of the accessory lumen 2225. If tissue, stent or other material is engaged with the end of the reduced pressure delivery tube 2217 during application of reduced pressure, the headspace 2241 will continue to deliver the purified fluid to the central lumen. f In operation, the yoke of the reduced pressure delivery system 2111, 22 11 of Figures 40-50 can be directly applied to the tissue site to distribute the reduced pressure to the tissue site. The percutaneous mounting and removal techniques described herein specifically require a primary manifold having a low profile shape. Similarly, the primary manifolds can also be surgically inserted. Referring to Figure 51, the primary manifolds 2115, 2215 can be combined with the secondary manifolds. In Figure 51, the secondary manifolds 2321 include two layers of felt pads. The first layer of the secondary manifolds 2321 is coupled. Placed in contact with the skeletal tissue site including the fracture. The main manifold 2115 is placed in contact with the first layer, and (the second layer of the secondary manifold 2321 is placed in the main manifold 2115 and The top layer of the layer 232 1 allows fluid communication between the main manifold 211 5 and the tissue site, and also prevents direct contact between the tissue site and the primary manifold 2ii 5. The secondary manifold 232 is preferably Bioabsorbable, which allows the secondary manifold to remain in the original # after completion of the decompression method. After the decompression therapy is completed, the main manifold 2115 can be made with little or no interference from the tissue site. The interlayers are removed between the layers. In the embodiment, the material can be lubricated to reduce the Jc refill material to coat the main manifold to facilitate easy inter-layer migration. H9640.doc -48- 200836785. / Minor The manifold is preferably used as a support for new tissue growth. As a stent, the secondary manifold can contain at least a material selected from the group consisting of polylactic acid, polyglycolic acid, polycaprolactone, polybutyl butyrate, polyvalerate, polydioxanone, polyorthoester, poly Phosphazene, polyurethane urethane, collagen, hyaluronic acid, polyglucamine, hydroxyapatite, scaly mother, calcium sulfate, calcium carbonate, bioglass, stainless steel, titanium, button, allograft and self Body grafts. The purification function of the reduced pressure delivery systems 2111, 2211 described above can be used in any of the manifolds described herein. The ability to purify the manifold or conduit that delivers decompression will prevent the formation of obstructions. The decompression block is applied. These blocks usually occur when the pressure near the tissue site reaches equilibrium and the fluid flow around the tissue site slows down. It has been found that the air purification manifold and the reduced conduit are selected at selected intervals. - The selected amount of time will assist in preventing or eliminating the block. More specifically, the air is delivered via a second conduit that is independent of the first conduit to which the subtraction is passed. The outlet of the second conduit is preferably near the manifold or first The exit of the pipeline. Pressing the air and pushing it to the exit of the second pipe, it is better to use the decompression at the tissue site to pump the air out. It has been found that in the case of Xu Xi, the application is reduced. During the process of pressing, Xue Shi T will deliver air melon for 2 seconds at intervals of 60 seconds, which will be enough to prevent the blockage of the shape. The Yinhua time provides enough air to fully remove the manifold and the first pipe. Excessive air or over = two at the same time to prevent the introduction of the system * can not return to the purification 彳 (four) ^ the frequency of the introduction of air will reduce the target between the two. For the value # > Yinhua fluid selected time and The selected interval for passing the '1匕 profile' typically varies from 119640.doc - 49- 200836785 based on the design and size of the system components (eg, pumps, tubes, etc.). However, air should be delivered at a level and frequency high enough to adequately remove the blockage while restoring the full target pressure between the purge cycles. Referring to Fig. 52, in an exemplary embodiment, the reduced pressure delivery system 2411 includes a manifold 2415 that is fluidly coupled to the first conduit 2419 and the second conduit 2423. The first conduit 2419 is coupled to a reduced pressure source 2429 to provide reduced pressure to the manifold 2415. The second conduit 2423 includes an outlet 2435 that is positioned in fluid communication with the manifold 2415 and proximate the outlet of the first conduit 2419. The second conduit 2423 is in fluid connection with the valve 2439 which is capable of communicating the second conduit 2423 with ambient air when the valve is in the open position. The valve 2439 is operatively coupled to a controller 2453 that is capable of controlling the opening and closing of the valve 2439 to regulate the purification of the ambient air by the second conduit, thereby preventing the manifold 2415 and the first conduit from blocking within the wig . It should be noted that any fluid (including liquid or gas) can be used to achieve the purification techniques described herein. Although the driving force for purifying the fluid is preferably the suction force at the tissue site, the fluid can be similarly transferred by a fluid transfer member similar to that discussed with reference to FIG. Administration of reduced pressure tissue therapy to tissue sites according to the systems and methods described herein can be accomplished by applying sufficient decompression to the tissue site and then maintaining the sufficient decompression for a selected period of time. In addition, the decompression applied to the tissue site may be periodic. More specifically, the amount of reduced pressure applied can vary depending on the selected time period. Another method of applying decompression can vary the amount of decompression randomly. Similarly, the fluid rate or fluid volume actually delivered to the P-site of the tissue can be constant, periodic or random. In the case of periodic delivery, fluid transfer may occur during the application of reduced pressure, or fluid transfer may occur during the period in which no reduced pressure is applied. Although the amount of decompression applied to the tissue site will generally vary depending on the pathology of the tissue site and the administration of decompression tissue therapy, the decompression will typically be between about _5 mm Hg and _500 mm Hg and More preferably between about -5 mm Hg and -300 mm Hg. Although the systems and methods of the present invention have been described with reference to tissue growth and healing of human patients, it will be appreciated that such systems and methods for applying reduced pressure tissue therapy can be used for any activity that requires tissue growth or healing. organism. Similarly, the systems and methods of the present invention can be applied to any tissue including, but not limited to, bone county tissue, adipose tissue, muscle tissue, neural tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendon or ligament. When the healing tissue can be a focus of application of reduced pressure tissue therapy as described herein, it is also possible to use a therapy that applies reduced pressure tissue therapy, particularly to tissue located under the patient's skin, to an unaffected, defective or damaged tissue. Middle-aged ij 纟 tissue growth. For example, it may be desirable to apply decompression tissue therapy using percutaneous implantation techniques to grow additional tissue at subsequent tissue sites that may be harvested. The harvested tissue can be transplanted into another tissue site to replace diseased or damaged tissue, or the harvested tissue can be transplanted to another patient. It should also be noted that the reduced pressure delivery device described herein can be used in combination with a scaffolding material to increase the growth and growth rate of new tissue. 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 stent for new tissue growth. It will be apparent from the foregoing that the invention has been provided with significant advantages. Although the present invention has been shown in a limited number of forms, it is not limited thereto, and various changes and modifications may be made without departing from the spirit of the invention. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view of a reduced-pressure transmission apparatus according to an embodiment of the present invention. The δ-Hui pressure-reducing device has a plurality of protrusions extending from a self-releasable barrier to generate a plurality of flow paths; 3 is a front view of the reduced pressure transfer device of FIG. 1; FIG. 3 is a side view of the reduced pressure transfer device of FIG. 1; FIG. 4 is a side view of the reduced pressure transfer device of FIG. FIG. 4B depicts a side view of an alternative embodiment of the reduced pressure delivery device of FIG. 1 having a dual lumen, reduced pressure delivery tube; FIG. 5 depicts the reduced pressure delivery device of FIG. Figure 6 depicts a perspective view of a reduced pressure delivery device having an embodiment of the present invention, the reduced pressure delivery device having a multi-foam material attached to a flexible barrier having a raised portion and a pair of side portions, The multi-bubble material has a plurality of flow paths; FIG. 7 depicts a front view of the reduced pressure transfer device of FIG. 6; FIG. 8 depicts a cross-sectional side view of the reduced pressure transfer device of FIG. 7 taken at χνπ-χνπ; hair A cross-sectional front view of a reduced pressure delivery device of one embodiment; FIG. 8B depicts a side view of the reduced pressure delivery device of FIG. 8A; FIG. 9 depicts an embodiment of the present invention for applying a reduced pressure to a patient's bone network 119640. Doc -52- 200836785 Front view of the decompression delivery device for tissue therapy; Figure 10 depicts the color tissue section of the rabbit skull, showing the unnatural, undamaged bones; Figure 11 depicts the application of decompression tissue therapy Color tissue section of a rabbit skull showing the induction of granulation tissue; Figure 12 depicts a color tissue section of a rabbit skull after application of reduced-pressure tissue therapy showing the deposition of new bone; Figure 13 depicts the color of the rabbit skull after application of reduced-pressure tissue therapy Tissue section, which shows the deposition of new bones; Figure 14 depicts a color photograph of two rabbit skulls with critical size defects formed in the skull; Λ Figure 15 depicts the color photograph of the rabbit bone of Figure 14 showing its insertion a calcium phosphate scaffold in one of the critical dimension defects and a stainless steel mesh covering the other of the critical dimension defects; FIG. 16 depicts a color photograph of the rabbit skull of FIG. Decompression tissue therapy was applied to the critical dimension defect; Figure 17 depicts a color histological section of the rabbit skull after decompression tissue therapy showing the deposition of new bone in the calcium phosphate scaffold; Figure 18 depicts decompression tissue therapy for six days and surgery Radiographs of the critical dimension defects filled with stents in Figure 15 after the last two weeks; Figure 19# Tian Shu decompression tissue therapy for six days and twelve weeks after surgery Figure 1 Photograph of the critical size defect of stent-filled前 203⁄4 A front view of a reduced pressure delivery system of one embodiment of the present invention having a percutaneous insertion for transdermal insertion of a reduced pressure delivery device into a tissue 119640.doc-53 - 200836785 Figure 21 depicts an enlarged front elevational view of the manifold transfer tube of Figure 20, the manifold transfer tube containing a reduced pressure transfer device having a flexible barrier and/or a multi-bubble material in a compressed position; Figure 22 depicts Figure 21 An enlarged front view of the manifold transfer tube showing the flexible barrier and/or multi-foam material of the reduced pressure transfer device in an expanded position after the manifold transfer tube is pushed out; FIG. 23 depicts an implementation of the present invention A front view of a reduced pressure delivery system having a manifold transfer tube for percutaneous insertion of a reduced pressure delivery device into a tissue site, the reduced pressure delivery device being displayed on the outside of the manifold transfer tube However, it is constrained by an impermeable membrane in a compressed position; Figure 24 depicts a front view of the reduced pressure delivery system of Figure 23, shown in an outer membrane on the outside of the manifold transfer tube but in a relaxed position Figure 25 depicts a front view of the reduced pressure delivery system of Figure 23, shown on the outside of the manifold transfer tube but constrained by an impermeable membrane in the expanded position; Figure 25A depicts the reduced pressure of Figure 23 A front view of the delivery system, the reduced pressure delivery device being shown on the outside of the manifold transfer tube but surrounded by an impermeable membrane in an expanded position; FIG. 26 depicts a front view of the reduced pressure delivery system of the present invention. The reduced pressure delivery system has a manifold transfer tube for percutaneously inserting the reduced pressure delivery device into the woven portion, the reduced pressure delivery device being displayed on the outer side of the distraction: but being sealed by an impermeable membrane having a seal Constraint; 119640.doc -54- 200836785 Figure 26A depicts a front view of a reduced pressure delivery system in accordance with one embodiment of the present invention; Figure 27 depicts a front view of a reduced pressure delivery system in accordance with one embodiment of the present invention, the reduced pressure delivery system having A manifold transfer tube for percutaneously injecting a reduced pressure delivery device into a tissue site; FIG. 27A depicts a front view of a reduced pressure delivery system having an embodiment of the present invention, the reduced pressure delivery system having a reduced pressure delivery device A manifold delivery tube that is transdermally delivered to an impermeable membrane located in the tissue site; Figure 28 depicts a flow diagram of a method of administering decompression tissue therapy to a tissue site in accordance with an embodiment of the present invention; DETAILED DESCRIPTION OF THE INVENTION A flowchart of a method of administering reduced-pressure tissue therapy to a tissue site; FIG. 30 depicts a flow diagram of a method of administering reduced-pressure tissue therapy to a tissue site in accordance with an embodiment of the present invention; A flow chart of a method of administering reduced-pressure tissue therapy to a tissue site in accordance with an embodiment of the present invention; FIG. 3 is a cross-sectional front view of a reduced pressure delivery device in accordance with an embodiment of the present invention, the reduced pressure transmission The delivery device includes a hip prosthesis having a plurality of flow passages for applying a reduced pressure to the region of the bone region of the body prosthesis; Figure 33 depicts a cross-sectional front view of the hip prosthesis of Figure 32 having another plural Flow path for transferring fluid to the bone region of the hip prosthesis; FIG. 34 depicts a flow chart of a method for repairing a joint of a patient using reduced pressure tissue therapy in accordance with an embodiment of the present invention; FIG. A cross-section of a reduced-pressure delivery device of one embodiment 119640.doc-55-200836785 Front view, the reduced-pressure delivery device includes an antelope κ, a sacral surgical fixation device having a plurality of applications for applying reduced pressure to adjacent sputum Figure 36 depicts a cross-sectional front view of the orthopaedic fixation device of Figure 35 with a plurality of other embodiments for delivering fluid to adjacent the orthopedic fixation device Flow path of the skeletal region; Figure 37 depicts a flow chart of a method for healing bone damage of bone using reduced pressure tissue therapy in accordance with an embodiment of the present invention; DETAILED DESCRIPTION OF THE INVENTION A flowchart of a method of administering reduced-pressure tissue therapy to a tissue site; and Figure 39 depicts a flow diagram of a method of administering reduced-pressure tissue therapy to a tissue site in accordance with an embodiment of the present invention; 48 depicts various views of a reduced pressure delivery system having a primary manifold including a flexible wall surrounding a primary flow channel and a plurality of small ones in the flexible wall, in accordance with an embodiment of the present invention Figure 49-5 is a perspective view and a cross-sectional top view of a reduced pressure transfer system having a primary manifold integrally connected to a reduced pressure transfer tube, in accordance with an embodiment of the present invention; 40-50 are perspective views of a primary manifold applied to a bone tissue site with a secondary manifold; and FIG. 52 depicts a schematic view of a reduced pressure delivery system having a valve fluidly coupled to a second conduit in accordance with an embodiment of the present invention. . [Main component symbol description] 211 wing manifold/pressure reducing transmission equipment 119640.doc -56- 200836785

213 Flexibility barrier 215 Projection 219 Flap section 223 Arched passage 227 Flexible substrate 231 Protrusion 233 Flow path 241 Pressure relief tube 243 Remote hole 255 Proximal hole 259 Single lumen/channel 261 Double lumen 263 First lumen 265 Second lumen 271 Horizontal spacer 311 Winged manifold/pressure relief device 313 Flexible barrier 315 Projection 319 Flank portion 323 Arched passage 327 Foam material 329 Main distribution surface 330 Peripheral surface 341 decompression transfer tube 119640.doc -57- 200836785 343 distal hole 355 proximal hole 359 single lumen / channel 371 decompression transfer device 373 decompression transfer tube 375 expanded portion 377 distal end 381 cut 383 shoulder 385 protrusion 387 Inner surface 391 Flow path 411 Reduced pressure transfer device 413 Tissue site 415 Human bone 419 Reduced pressure transfer tube 421 Proximal end 427 Decompression source 429 Void defect 431 Fluid transfer tube 432 Proximal end 433 Fluid transfer source 434 Filter 435 Pressure sensor 119640.doc -58- 200836785 711 Reduced pressure transfer system 713 Organization site 721 Manifold transfer tube 725 Component 727 Lead 731 Fracture 733 Bone 735 Patient skin 737 Dotted line 739 Soft tissue 743 Wedge distal 751 Channel 761 Pressure relief device 765 Flexible barrier 767 Multifoam material 769 Pressure relief tube 811 Pressure relief system 821 Manifold transfer tube 837 Dotted line 843 Wedge-shaped distal end 861 Decompression transfer device 8 65 Flexible barrier 867 Multi-foam material 869 Decompression transfer tube 119640.doc -59 200836785 871 Impervious film 873 Internal space 881 Radiopaque marker 885 Removal of instrument 891 times Stage tube/tube 911 Pressure relief system 921 Manifold transfer tube 937 Dotted line 943 Wedge-shaped distal end 961 Pressure relief transfer device 965 Flexible barrier 967 Multi-foam material 969 Decompression transfer tube 971 Impervious film 973 Interior space 977 Glue Seal 981 Radiopaque marker 985 Pressure relief system 987 Lead 989 Pressure relief tube 991 Pressure relief device 993 Tissue site 1011 Pressure relief system 1021 Manifold transfer tube 119640.doc -60- 200836785 1025 1029 1035 1043 1051 1055 1057 1061 1111 1211 1311 1511 1515 1517 1521 1525 1529 1535 1541 1543 1545 1547 1551 1553 Tissue site void pressure reduction device distal impermeable membrane or semipermeable membrane internal space secondary lumen lead method method orthopedic hip prosthesis femoral stem part head part channel porous coating flow path main feeding line connection Outlet lateral branch line decompression transfer tube decompression transfer source 119640.doc -61 - 200836785 f

1561 Flow path 1565 Connection port 1571 Fluid transfer tube 1573 Fluid transfer source 1583 Main feed line 1585 Transverse branch line 1611 Method 1711 Reduced pressure transfer device 1715 Orthopedic fixture 1717 Bone 1719 Fracture 1721 Channel 1725 Screw 1735 Porous coating 1741 Flow path 1743 Main feed line 1745 Connection port 1747 Lateral branch line 1751 Reduced pressure transfer line 1753 Reduced pressure transfer source 1761 Flow path 1765 Connection port 1771 Fluid transfer tube 1773 Fluid transfer source 119640.doc -62- 200836785 1783 Main feed line 1785 Landscape Branch line 1811 Method 1911 Method 2011 Method 2111 Reduced pressure transfer system 2115 Main manifold 2117 Flexible wall 2121 Main flow channel 2123 Proximal end 2125 Decompression transfer tube 2129 Adapter zone 2135 Blocking prevention element 2137 Protrusion 2141 Inner surface 2145 Ridge 2149 Multi-bubble material 2155 Small hole 2161 First pipe 2163 Second pipe 2171 Head space 2211 Pressure-reducing transfer system 2215 Main manifold 2217 Pressure-reducing transfer pipe -63 119640.doc 200836785 2223 Central lumen 2225 Auxiliary lumen 2231 Small hole 2241 Headspace 2321 Secondary manifold 2411 Pressure relief system 2415 Manifold 2419 First pipe 2423 Second pipe 2429 Pressure source 2435 Outlet 2439 Valve 2453 Controller 119640.doc -64-

Claims (1)

200836785 X. Patent Application Range: 1 · A reduced pressure delivery system for applying reduced pressure tissue therapy to a tissue site, comprising: a primary manifold having a surrounding primary flow channel and adapted for placement in proximity a flexible wall at the tissue site, the flexible wall including an inner surface having a plurality of protrusions extending from at least a portion thereof into the main flow channel, the flexible wall additionally comprising a plurality of a small hole that passes through the flexible wall and communicates with the main flow channel; a first pipe fluidly connected to the main flow channel to transmit a pressure reduction through the main flow channel and the plurality of small holes; and A second conduit having at least one outlet proximate to the primary flow passage or at least one outlet of the first conduit to purge a block at or near at least one outlet of the first conduit. 2. The system of claimants, wherein the first conduit and the second conduit are part of a multi-tube lumen. Wherein the flexible wall and the multi-lumen tube are collectively injection molded according to the system of claim 2. 4) The system of claim 1, wherein the first conduit and the second conduit are part of a multi-lumen tube; one end of the flexible wall is connected to the multi-lumen tube; the main flow channel of the foot is The flexible wall is capped at the end opposite the multi-lumen. 5. The system of claim i, wherein the second Lv逍 main 4 is located in the flexible wall of the 119640.doc 200836785. 6. The system of claim 1, wherein the taxable wall system is constructed from a pharmaceutical grade oxygen polymer. 7. The system of claimants, wherein the flexible wall is substantially rectangular in cross section. 8. The system of claim i wherein the flexible wall is substantially cylindrical along at least a portion of its axial length. 9. The system of claim 8, wherein the substantially cylindrical flexible wall is sandwiched into a 360 degree arc. 10. The system of claimants, wherein the protrusions prevent occlusion of the primary flow channel by preventing the flexible wall from completely collapsing during application of decompression via the primary flow channel. The system of claim 1, wherein the tissue site comprises a tissue selected from the group consisting of adipose tissue, muscle tissue, nerve tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendon, and ligament. 12. A system as claimed, further comprising a secondary manifold adapted to be positioned adjacent to the primary manifold and to provide reduced pressure from the primary manifold to the tissue portion. 13 • The system of claim 2, wherein the secondary manifold is bioabsorbable. 14. The system of claim 12, wherein the secondary manifold is a system. The system of claim 12, wherein the secondary manifold is a stent, and each of the packets is selected from the group consisting of polylactic acid, polyglycolic acid, polycaprolactone, and poly Hydroxybutyrate, polyhydroxyvalerate, 119640.doc 200836785 polydioxanone, polyorthoesters, polyphosphazenes, polyurethanes, collagen, hyaluronic acid, polyglucamine, hydroxyl Apatite, calcium phosphate, calcium sulfate, calcium carbonate, bioglass, stainless copper, titanium, knobs, allografts, and autografts. 16. A reduced pressure delivery system for applying reduced pressure tissue therapy to a tissue site, comprising: a primary manifold having a surrounding and a primary flow channel adapted (to be placed at a location proximate to the tissue site) a flexible wall comprising a plurality of small arms L passing through the flexible wall and in communication with the primary flow channel; a multi-bubble material positioned within the primary flow channel, the multi-vesicle material having a plurality a flow passage; a first conduit fluidly connected to the main flow passage to transmit a pressure reduction via the main flow passage, the multi-bubble material and the plurality of small holes; and C, a second conduit having at least one Approaching the outlet of the primary flow channel or at least one outlet of the first conduit to purge a block at or near at least one outlet of the first conduit. 17. The system of claim 16, wherein the first conduit and The second conduit is part of a multi-lumen tube. 18. The system of claim 17, wherein the flexible wall and the multi-lumen tube are formed by ugly extrusion. ~ 19 The system of claim 16 Wherein: the first conduit and the second conduit are part of a multi-lumen tube; 119640.doc 200836785 one end of the flexible wall is connected to the multi-lumen tube; and the main flow channel of the δH is at the end The old flexible wall of the 古古古山 is connected to the end of the multi-lumen tube at the opposite end. 20· The system of claim 16 is in the flexible wall. ... The second pipe is at least partially positioned The medical grade 矽oxypoly 21 · According to the system of claim 16, the straight middle 兮 /, r smart flexible wall system is constructed by the compound. 2 2 · As for the system of the clear item 16, the straight middle 兮, eight w can The spasm wall is reinforced to prevent collapse under reduced pressure. The cross section of the wall is substantially a moment 23. The system of claim 16, wherein the flexible shape is 0 2 (such as the system of claim 16 wherein the pullable The wall is substantially cylindrical along at least a portion of its axial length. 25. The system of claim 24 wherein the substantially cylindrical flexible wall is sandwiched into a 360 degree arc. The system of item 16, wherein the multi-bubble material is applied by subtraction through the primary flow channel Preventing the flexible wall from completely collapsing during the process to prevent clogging of the primary flow channel. 27. If the request portion contains a structure selected from the group consisting of adipose tissue, muscle tissue, nerve tissue, dermal tissue, tissue, connective tissue, The organization of the group consisting of the tibia, the tendon, and the ligament. 28. The system of claim 16, wherein the multifoam material is a reticular polyurethane foam. It additionally includes a secondary manifold that is adapted to be positioned adjacent to the primary manifold at 119640.doc 200836785 and to provide reduced pressure from the primary manifold to the tissue site. 30. The system of claim 29, wherein the secondary manifold is bioabsorbable. 31. The system of claim 29, wherein the secondary manifold is a felt. 32. The system of claim 29, wherein the secondary manifold is a stent and comprises at least one material selected from the group consisting of polylactic acid, polyglycolic acid, caprolactone, polyhydroxybutyric acid Esters, polyhydroxyvalerate, polydioxanone, polyorthoesters, polyphosphazenes, polyurethanes, collagen, hyaluronic acid, polyglucosamine, hydroxyapatite, calcium phosphate, Calcium sulfate, calcium carbonate, bioglass, stainless steel, titanium, tantalum, allografts and autografts. 33. A reduced pressure delivery system for applying reduced pressure tissue therapy to a tissue site, comprising: a primary manifold having a wrap around a primary flow channel and adapted for placement at a location proximate to the tissue site a main wall comprising a retardation preventing member located in the main flow passage, the flexible wall including a plurality of small holes passing through the flexible wall and communicating with the main flow passage; Officially positioned adjacent to the primary manifold and adapted to contact the tissue site for fluid communication with the primary manifold, but which is also adapted to prevent contact of the primary manifold with the tissue site; The first tube is ' fluidly coupled to the primary flow passage to deliver reduced pressure via the primary flow passage and the plurality of orifices. 119640.doc 200836785 The component is a plurality of the primary flow channels. The system of claim 33, wherein the block is prevented from extending onto the inner surface of the flexible wall and extending to the protrusion. 35. The system of claim 33, wherein the block prevention element is a multi-foam material disposed within the primary flow channel. 3 6 ·If the system of claim 3 3, 苴中々々|土势亍,,九甲4 —人要为官为生物可吸收性0 37. As requested in item 33 of the system The tube is a felt pad. 38. The system of claim 33, wherein the secondary manifold is a stent and comprises at least one material selected from the group consisting of polyglycolic acid, polycaprolactone, and polybutyrate vinegar , polyvaleric acid vinegar, polydioxanone, polyorthoesters, polyphosphazenes, polyurethanes, collagen, hyaluronic acid, polyglucamine, hydroxyapatite, calcium phosphate, Calcium sulfate, calcium carbonate, bioglass, stainless steel, titanium, tantalum, allografts and autografts. 39. A method of promoting tissue growth at a tissue site, comprising: surgically positioning a primary manifold proximate to the tissue site, the primary manifold having a flexible wall surrounding a primary flow channel, The flexible wall includes a plurality of apertures through the flexible wall and in communication with the primary flow channel, the primary manifold additionally comprising a blocking element positioned within the primary flow channel; surgically positioned Once the manifold is to be in contact with the tissue site to thereby make the secondary manifold in fluid communication with the primary manifold, but preventing the distal primary manifold from contacting the tissue site; and 119640.doc 200836785 via the primary flow channel, The plurality of small holes and the secondary manifold deliver reduced pressure to the tissue site. The method of claim 39, wherein the retardation preventing member is a multi-bubble material disposed in the main flow channel, the multi-bubble material having a plurality of flow paths. The method of claim 39, wherein the retardation preventing member is a plurality of methods of extending from the inner surface of the anti-f sputum into the main flow channel, such as the method 39, The secondary manifold is a felt pad. 43. The method of claim 39, wherein the secondary manifold is a stent and the packages are each > a material selected from the group consisting of polylactic acid, :: glycolic acid, $hexine _, Polyhydroxybutyrate, hydroxyvalerate, dioxin, polyorthoester, polyphosphazene, polyurethane, collagen, white, hyaluronic acid, polyglucamine, sulphate Gray stone, calcium calcium phosphate, calcium carbonate, bioglass, stainless steel, titanium, button, allograft and autograft. 44. The method of claim 39, further comprising: 45. 46. removing the primary manifold after percutaneous tissue therapy is completed. The method of claim 39, further comprising: removing the primary manifold after the completion of the salty C, phlegm and woven therapy; and/, the secondary manifold of the Zhongyihai is bioabsorbable. For example, in the method of the garment item 39, it is additionally packaged with a free net/:, and an air force to purify the main channel by ambient air to prevent blockage in the main flow channel. 119640.doc