TWI325328B - System for percutaneously administering reduced pressure treatment using balloon dissection - Google Patents

Description

1325328 IX. INSTRUCTIONS OF THE INVENTION: TECHNICAL FIELD OF THE INVENTION The present invention relates generally to a system and method for promoting tissue growth and, more particularly, to a method for applying decompression tissue to a tissue site The system of treatment. [Prior Art] Decompression therapy is being gradually used to promote wound healing of soft tissue wounds that heal very slowly or not heal without using decompression therapy. Typically, the reduced pressure is applied to the wound site by an open-cell foam that acts as a manifold to distribute the reduced pressure. The open-cell foam is sized to be in contact with the wound in the prior art, and is then periodically replaced with a smaller foam as the wound begins to heal and become smaller. In order to minimize the amount of tissue growing into the pores of the foam, it is necessary to frequently replace the open pore foam. During the removal of the foam, the large amount of tissue that is growing can cause pain to the patient. Decompression therapy is usually applied to non-healing open wounds. In some cases, the tissue being treated is subcutaneous tissue' and in other instances, the tissue is located in or on the skin tissue. Traditionally, decompression therapy has been used primarily in soft tissue. Decompression therapy is not currently used to treat closed deep tissue wounds because it is difficult to access such wounds. In addition, decompression therapy has not been associated with the treatment of bone defects or the promotion of bone growth, which is mainly due to the difficulty of approaching the moon. Applying decompression therapy by surgically exposing the bone path may cause more problems than the problem it solves. Finally, the device used for the application of decompression therapy and "the development of almost no open hole foam H9637.doc 1325328 one hand to make the shape of the open-cell foam suitable for the wound site and then in a decompression treatment cycle Thereafter, the system and method of the present invention solves the problems of the prior wound healing system and method. According to an embodiment of the present invention, a reduced pressure delivery system is provided for use in an organization The reduced pressure is applied to the portion. The reduced pressure delivery system includes a manifold delivery tube having at least two lumens and a manifold having a plurality of flow channels. The manifolds are disposed on the manifolds of the manifold conduits In the first of the chambers, a balloon is provided, the balloon having an interior space and capable of adopting a collapsed position and an expanded position. The interior space of the balloon is fluidly coupled to the second of the lumens of the manifold delivery tube According to another embodiment of the present invention, a reduced pressure delivery system is provided that includes an impermeable membrane having an interior space. The impermeable membrane can be compressed a state and a relaxed state. A manifold having a plurality of flow channels is disposed in an inner space of the impermeable film. The pressure in the inner space of the impermeable film is reduced by less than the pressure outside the impermeable film to reduce According to still another embodiment of the present invention, there is provided a reduced pressure delivery system comprising a manifold delivery tube having at least one passage and a distal end, The distal end is disposed adjacent to the tissue site. A manifold having a plurality of flow channels is configured to be delivered to the tissue site via the channel of the manifold delivery tube. An impermeable membrane is provided that can be positioned at the dislocation The distal end of the tube delivery tube. The impermeable membrane includes an interior space and is capable of taking at least one of an expanded position and a collapsed position. 119637.doc *: ^ 1325328 Referring to the drawings and the following detailed description, Other objects, features and advantages of the invention will become apparent from the following description. Particular embodiments of the present invention are shown in the drawings and are intended to be illustrative of the preferred embodiments of the present invention. Other embodiments, and modifications may be made in the logical structure, mechanical, electrical, and chemical aspects without departing from the spirit or scope of the invention. To avoid the details required to enable the skilled artisan to practice the invention, This description may omit certain information that is familiar to those skilled in the art. Therefore, the following description should not be taken as limiting, and the scope of the invention is defined only by the scope of the accompanying claims. The term "elastic" means having the properties of an elastomer. The term "elastomer" large system refers to a polymer material having the same properties as rubber. More specifically, most elastomers have an elongation of greater than 1% and a significant degree of resilience. The resilience of a material means that the material recovers from elastic deformation. Examples of the elastomer may include, but are not limited to, natural rubber, polyisobutylene, styrene butadiene rubber, gas butadiene rubber, polybutadiene, nitrile rubber 'isobutyl rubber, ethylene propylene rubber, Ethylene propylene diene monomer, chlorosulfonated polyethylene, polysulfide rubber, polyamino phthalate, and polyfluorene oxide. The term "flexibility" as used herein refers to an object or material that is capable of bending or flexing. Elastomeric materials are generally flexible. Mdan is referred to herein as flexibility (iv) 119637.doc::炙) 1325328. The selected material is not necessarily limited to only elastomers. The use of the term "winding" in conjunction with the material of the invention or a reduced pressure delivery device means that the material can be applied or closely matched to the shape of a tissue site. For example, the flexible nature of a reduced pressure delivery device for treating a bone defect can enable the device to wrap or wrap around a bone portion having a defect. The term "fluid" as used herein generally refers to a gas or liquid, but may also include any other flowable material including, but not limited to, a gel, a gel or a bead. The term "impermeable" as used herein. " generally refers to the ability of a film, covering or other material to block or slow the penetration of liquids or gases. Impermeability can be used to refer to a covering, sheet or other film that blocks the passage of liquid while allowing gas to pass through the film. Although the impermeable film may be impermeable to liquids, the film may only reduce the transmission of all or only certain liquids. The term "imperviousness" is not intended to imply that the impervious film is above or below Any special standard impermeability measurement, such as a specific value of water vapor transmission rate (WVTR). The term "manifold" large system used herein refers to the pressure to help reduce the application of a tissue site. a substance or structure that delivers fluid to or removes fluid from the tissue site. The manifold typically includes a plurality of interconnected flow channels or pathways To improve the distribution of fluids provided to or removed from the tissue region surrounding the manifold. Examples of manifolds may include, but are not limited to, devices having structural elements configured to form flow channels, honeycomb-like foams (eg, Open-cell foams] 'Porous tissue collection devices, and liquids, gels, and foams containing or containing flow channels after solidification. U9637.doc 1325328 The term "reducing pressure" used in this article refers to receiving The tissue site of the treatment is less than the pressure of the surrounding pressure. In most cases, the pressure of this reduction will be less than the environmental pressure at which the patient is located. Alternatively, the pressure of the reduction may be less than the static water of the tissue at the tissue site. Pressure. Although the terms "vacuum" and "negative pressure" can be used to describe the pressure applied to a tissue site, the actual pressure applied to the tissue site can be significantly lower than the pressure typically associated with a pure vacuum. The reduced pressure creates fluid flow in the area of the tube and tissue at the beginning. As the hydrostatic pressure around the tissue site approaches the desired reduced pressure, the flow may slow down and then maintain the reduced pressure. Unless otherwise stated, the pressure values described in this document are gauge pressures. The term "scaffold" as used herein 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. Coated with or consisting of cells, growth factors or other nutrients for promoting cell growth. A scaffold can be used as a manifold according to embodiments described herein to treat tissue sites with reduced pressure tissue treatment. The term "tissue site" refers to a wound or defect located above or within any tissue, including but not limited to bone tissue, adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage, tendon, or ligament. The term "tissue site" may further refer to the region of any tissue, which may not be injured or defective, but rather enhance or promote the growth of additional tissue in such regions. For example, in some organizations Decompression tissue treatment is used in the area to grow additional tissue, which can then be harvested 119637.doc -10- 1325328 to obtain the additional winter tissue and transplant it to another tissue site. See Figure 1-5, a broad The reduced pressure delivery device or wing manifold 211 includes a ridge portion 215 having a flexible barrier 213 and a pair of wing portions 219. Each wing portion 219 is positioned along the opposite side of the ridge portion 2 15 . The ridge portion 215 forms an arcuate passage 223 that may or may not extend over the entire length of the wing manifold 21. Although the ridge portion 215 may be centered on the wing manifold 211, To make the width of each wing portion 219 equal, however, the ridge portion 215 can also be offset as shown in Figure _5 such that one of the wing portions 219 is wider than the other wing portion 219. If the wing is to be Manifold 211 with bone regeneration or medical The combined use of a wider wing-shaped manifold 211 will wrap around a fixed hardware attached to the bone path, and the extra width of one of the wing portions 219 may be particularly useful. The flexible barrier 2 1 3 is preferably made of, for example, a poly An elastic material such as a sulphuric acid polymer. One example of a suitable polyoxyl polymer includes MED_6〇15 manufactured by Nusil Technologies of Carpinteria, California. However, it should be noted that the flexible barrier 21 3 may be any other organism. Made of a compatible, flexible material, the flexible barrier 2 1 3 encloses a flexible backing 227 to enhance the strength and durability of the flexible barrier 213. The flexible barrier 213 enclosing the flexible backing 227 is The thickness in the arcuate channel 223 can be less than the thickness in the wing portion 219. If a polysilicon polymer is used to form the flexible barrier 213, a polyoxygen oxide adhesive can also be used to help bond the flexible backing 227. Examples of polyoxynoxy binders may include med-1, also sold by the company Nusil Technol〇gies. The flexible backing 227 is preferably made of a polyester knit fabric, such as manufactured by CR Bard, Inc. of Tempe, Arizona. (9) by system 1 19637.doc 1325328 However, the flexible backing 227 can be made of any biocompatible, flexible material that enhances the strength and durability of the flexible barrier 2丨3. In some cases, the right flexible barrier 213 Made of a material of suitable strength, the flexible backing 227 can be dispensed with. Preferably, the flexible barrier 2U or flexible backing 227 is impermeable to liquids, air and other gases, or alternatively, the flexible backing 227 Both with flexible barriers] are impermeable to liquids, air and other gases. The barrier 213 and the flexible backing 227 can also be made of a bioresorbable material that does not have to be removed from the patient after use of the reduced pressure delivery device 2U. Suitable bioresorbable materials can include, but are not limited to, polymeric blends of polylactic acid (PLA) and polyglycolic acid (PGA). The polymeric blends can also include, but are not limited to, polycarbonate, polyfumarate, and. The flexible barrier 213 and flexible backing 227 can be used as a new cell growth support or the stent material can be used in conjunction with the flexible barrier 213 and flexible backing 227 to promote cell growth. Suitable scaffolding materials can include, but are not limited to, lateral arch, collagen, PLA/PGA, ashstone, discate, or treated allograft material. Preferably, the scaffold material will have a high void fraction (i.e., a high air content). In a implementation, the consumable backing is applied to the surface of the flexible barrier 213 as in the form of a (4) joint. If a polysiloxane polymer is used to form the flexible barrier 213', the flexible back can also be applied to the flexible barrier 213 using a polyoxo adhesive. Although the adhesive is a preferred method of attachment when the surface of the flexible backing 227 is bonded to the flexible barrier 213. The solid method, however, any suitable 119637.doc 1325328 flexible barrier 213 includes a plurality of protrusions 231 extending from the wing portion 219 on the surface of the flexible barrier 213. The protrusions 231 may be cylindrical, spherical, hemispherical, cubic, or any other shape as long as at least a portion of each of the protrusions 231 is located in a plane different from the protrusion 23 1 fixed to the flexible backing 213. The plane associated with the side can be. In this regard, it is not even required that a particular protrusion 231 have the same shape or size as the other protrusions 231; in fact, the protrusions 231 may comprise a random mixture of different shapes and sizes. Therefore, the distance from each of the protrusions 231 from the flexible barrier 213 may vary, but may also be uniform in the plurality of protrusions 23A. The projections 231 are disposed on the flexible barrier 213 to form a plurality of flow passages 233 between the projections. When the projections 23 have the same shape and size and are uniformly spaced on the flexible barrier 213, the flow passages 233 formed between the projections 231 are equally uniform. The size, shape and spacing of the protrusions 23 1 can also be used to vary the size and flow characteristics of the flow channel. As shown in Fig. 5, a reduced pressure delivery tube 24 is located in the arcuate passage 223 and is fixed to the flexible barrier 213. The reduced pressure delivery tube 241 may be fixed only to the flexible barrier 213 or the flexible backing 227, or the tube may be simultaneously fixed to both the barrier 213 and the flexible backing 227. The reduced pressure delivery tube μ contains a distal end opening 243 at the distal end of the tube ice. The tube 241 can be positioned such that the distal orifice = 3 is located at any point along the arcuate passage 223, but the tube 241 is positioned more than (four) such that the end orifice 243 is located at approximately the midpoint along the longitudinal length of the arcuate passage 223. The distal opening 243 is formed into an elliptical or oval shape by a planar cutting tube 241 oriented at an angle of less than ninety (9) 119637.doc 1325328 along the longitudinal axis of the phase tube 241. Although the aperture 243 may also be circular, the elliptical shape of the aperture 243 enhances fluid communication with the flow passage 233 formed between the projections 231. The reduced pressure delivery tube 241 is preferably made of polyoxyl or urethane coated with paraiyne. However, any medical grade tubing material can also be used to construct the reduced pressure delivery tube 241. Other coatings that can be applied to the tube include heparin, anticoagulant, antifibrinogen, anti-adherent, anti-prothrombin And a hydrophilic coating. In one embodiment, as an alternative to or in addition to the distal aperture 243, the reduced pressure delivery tube 241 can also include a discharge opening or discharge orifice 25 positioned along the reduced pressure delivery tube 24j. 1, to further enhance the fluid communication between the reduced pressure delivery pipe 241 and the flow passage 233. The reduced pressure delivery tube 241 can be positioned only partially along one of the longitudinal lengths of the arcuate passage 223 as shown in Figures 1-5, or alternatively selected to be "positioned along the entire longitudinal extent of the arcuate passage 223." If positioned such that the reduced pressure delivery tube 24 1 occupies the entire length of the arched passage 223, the distal opening 243 can be covered so that all fluid communication between the tube 24 1 and the flow passage 23 3 is discharged Hole 25 1 is performed. The reduced pressure delivery tube 241 further includes a proximal aperture 255 at the proximal end of the tube 241. The proximal orifice 255 is configured to cooperate with a source of reduced pressure, which will be described in greater detail below with respect to Figure 9. The reduced pressure delivery tube 241 shown in Figures _3, 4a and 5 contains only a single lumen or passage 259. However, the reduced pressure delivery reservoir 24 1 can include a plurality of lumens, such as the dual lumen lumen 261 shown in Figure 4B. The double lumen tube 261 includes a first lumen 263 and a second lumen 119637.doc -14-1325328 265. The use of a dual lumen tube provides a separate fluid communication path between the proximal end of the reduced pressure delivery tube 241 and the flow channel 233. For example, a dual lumen tube 261 can be used to achieve communication between the reduced pressure source and the flow channel 233 along the first lumen 263. The second lumen 265 can be used to introduce fluid into the flow channel 233. The fluid can be filtered air or other gas, antibacterial agent, antiviral agent, cell growth promoter, rushing fluid, chemically active fluid or any other fluid. If it is desired to introduce a plurality of flow bodies into the flow channels 233 via separate fluid communication paths, the reduced pressure delivery tubes can have more than two lumens. Still referring to Fig. 4'', a horizontal spacer 271 separates the first and second lumens 263, 265 of the reduced pressure delivery tube 261 such that the first lumen 263 is positioned above the first lumen 265. The relative positions of the first lumen and the second lumen 263, 265 may vary depending on how fluid communication is provided between the lumens 263, 265 and the flow channel 233. For example, when the first lumen 263 is positioned as shown in FIG. 4A, a discharge opening similar to the discharge opening 251 can be provided to achieve communication with the flow passage 233. When the second lumen is positioned as shown in Figure 4A, the second lumen 265 can be in communication with the motorized passage 233 via an orifice similar to the distal aperture 243. Alternatively, the plurality of lumens in a reduced pressure delivery tube can be positioned side by side by a vertical spacer separating the respective lumens, or the lumens can be positioned concentrically or coaxially.

To another morning, on the # lumen, or by means of a number of single lumen tubes with single or multiple lumens. Alternatively, the present invention can include a separate fluid communication path by attaching a single lumen tube to a single, unsecured tube as described above. If a separate tube is used to provide a separate fluid communication path with the flow passage 233, the ridge portion 215 can include a plurality of arcuate passages 223, each of which is an arcuate passage 223. Alternatively, the arched passage a] may be enlarged to accommodate a plurality of tubes. An example of a reduced pressure delivery tube pressure reducing delivery device having a separation from a fluid delivery tube will be described in more detail below with reference to FIG.

Bright. Referring to Figures 6-8, a reduced pressure delivery device or wing manifold 311 in accordance with the principles of the present invention includes a flexible barrier 313 having a ridge portion 315 and two pairs of wing portions 319. Each wing portion 319 is positioned along the opposite side of the ridge portion 315. The ridge portion 315 defines an arcuate passage 323 that may or may not extend over the entire length of the wing manifold 311. Although the ridge portions 315 can be centrally positioned on the wing manifold 311 such that the width of the two wing portions 3 19 are equal, the ridge portions 315 can also be offset as shown in the figures to provide one of the wings Portion 319 is wider than the other wing portion 319. The extra width of one of the wing portions 319 may be particularly useful if the winged manifold 311 is used in conjunction with bone regeneration or healing and the wide winged manifold 311 will wrap around a fixed hardware attached to the bone. . A honeycomb material 327 is secured to the flexible barrier 313 and is provided as a single piece of material that covers the entire surface of the flexible barrier 313 across the ridge portion 3 15 and the two wing portions 319. The honeycomb material 327 includes a fixed surface (not visible in Fig. 6) disposed adjacent to the flexible barrier 313, a distribution surface 329 opposite the fixed surface, and a plurality of peripheral surfaces 33A. In one embodiment, the flexible barrier 3 13 can be similar to the flexible barrier 2丨3, and 119637.doc •16·1325328 includes a flexible backing. Although the adhesive is a preferred method 1 for securing the honeycomb material 327 to the flexible barrier 313, the flexible barrier 313 may be fixed to the honeycomb material by any suitable fixing method, or It is left to the user for assembly at the treatment site. The flexible barrier 313 and/or flexible backing acts as an impermeable barrier to block the passage of fluids such as liquids, air or other gases. In an embodiment, the conductive barrier and the flexible back φ are not provided in a separable manner to substantially support the honeycomb material 327. Alternatively, the honeycomb material 327 can have an integral barrier layer that is an impermeable portion of the honeycomb material 327. The barrier layer may be formed of a closed cell material to prevent fluid from penetrating, thereby replacing the flexible barrier 313. If a monolithic barrier layer is used with the honeycomb material 327, the barrier layer may comprise raised portions and wing portions as described above with reference to the flexible barrier 313. The flexible barrier 313 is preferably made of an elastic material such as a polyoxynitride polymer. An example of a suitable polyoxyl polymer includes med_6〇i5 manufactured by Nusil Techn〇1〇gies, Inc. of Carpinteria, California. However, it should be noted that the flexible barrier 3 13 can be made of any other biocompatible, flexible material. If the flexible barrier encloses or otherwise comprises a flexible backing, the flexible backing is preferably made of a polyester knit fabric, such as gard 6013 manufactured by CR Bard, Inc. of Tempe, Arizona. . However, the flexible backing 227 can be made of any biocompatible, flexible material that enhances the strength and durability of the flexible barrier 3丨3. In one embodiment, the honeycomb material 327 is an open cell, reticulated urethane foam having a pore size between about 4 Å and 6 Å μm H9637.doc 1325328. An example of such a foam may be included by being located in San Antonio,

GranuFoam, manufactured by Kinetic Concepts, Texas. The honeycomb material 3 2 7 can also be gauze, a number of pads, or any other biocompatible material that provides fluid communication in a plurality of dimensions in a plurality of channels. Honeycomb material 327 is primarily an "open-hole" material that includes a plurality of holes that are fluidly connected to adjacent holes. A plurality of flow channels are formed by the "open holes of the honeycomb material 327 between the 5 mm open holes". The flow channels are capable of achieving fluid communication in the entire portion of the honeycomb material 327 having open holes. The equal pores and flow channels can have a uniform shape and size, or can include patterned or random shapes and dimensional changes. Variations in the size and shape of the pores in the honeycomb material 327 can cause changes in the flow channels' and such characteristics are available. The flow characteristics of the fluid flowing through the honeycomb material 327 are varied. The honeycomb material 327 may further include a portion containing a "closed hole". The closed hole portion of the honeycomb material 327 includes a plurality of holes, among which Most are not fluidly connected to adjacent holes. One example of a closed hole portion is described above as a barrier layer that can replace the flexible barrier 3 13. Similarly, a closed hole can be selectively provided in the honeycomb material 327. Partially 'to prevent fluid from passing through the peripheral surface 330 of the honeycomb material 327. The flexible barrier 3 13 and the honeycomb material 3 2 7 may also be used by a reduced pressure delivery device The bioresorbable material that does not have to be removed from the patient after 3 11 can be made. Suitable bioresorbable materials can include, but are not limited to, polymeric blends of polylactic acid (PLA) and polyglycolic acid (PGA). The polymer blend may also be used as a new cell growth branch H9637.doc - not limited to poly vinegar, polyfumaric acid, and capralactone. The barrier barrier 3 13 and the honeycomb material 327 can be further used as a new cell growth branch H9637.doc - 18· 1325328, or a stent material may be used in conjunction with the flexible barrier 313, the flexible backing 327, and/or the honeycomb material 327 to promote cell growth. Suitable scaffold materials may include, but are not limited to, calcium phosphate, collagen, pLA/pGA, coral hydroxyapatite, carbonate, or treated allograft material. Preferably, the scaffold material will have a high void ratio (ie, a high air content). It is positioned in the arched passage 323 and fixed to the flexible barrier 313. The reduced pressure delivery tube 341 can also be fixed to the honeycomb material 327, or in the case where only the honeycomb material 327 is present, the reduced pressure delivery tube 341 can only Fixed to honeycomb material 327. The reduced pressure delivery tube 341 includes a distal opening 343 at the distal end of the tube 341, which is similar to the distal opening 243 of Figure 5. The reduced pressure delivery tube 341 can be positioned such that the distal opening 343 It is located at any point along the arcuate channel 323, but is preferably located at approximately the midpoint along the longitudinal length of the arcuate channel 323. Preferably, it is less than ninety (90) degrees along the longitudinal axis of the tube 341. The angle-oriented planar cutting tube 341 has an open-end aperture 343 formed in an elliptical or circular shape. Although the aperture may also have a circular φ shape, the elliptical shape of the aperture may be enhanced with the honeycomb material 327. The fluid communication of the flow channels. In one embodiment, the reduced pressure delivery tube 341 may also include a discharge opening or discharge orifice (not shown) similar to the discharge opening 25 in Figure 5. In addition to or in addition to the distal aperture 343, a discharge aperture is disposed along the tube 341 to further enhance fluid communication between the reduced pressure delivery tube 341 and the flow channel. As previously described, the reduced pressure delivery tube 341 can be positioned only partially along one of the longitudinal lengths of the chevable channel 323, or alternatively, can be positioned along the entire longitudinal length of the arcuate passage 323. If positioned such that the reduced pressure delivery tube 119637.doc • 19-“occupies the entire arched passage 323, the distal orifice can be capped such that all fluid communication between the tube 341 and the flow passage is via the discharge opening Preferably, the honeycomb material 327 covers and directly contacts the reduced pressure delivery tube M1. The honeycomb material 327 can be connected to the reduced pressure delivery tube 341, or the honeycomb = material 327 can be fixed only to the flexible barrier 3 The duct 341 is positioned such that it extends only to a point in the chevron channel 323, and the honeycomb material 327 can also be connected to the flexible barrier 313 in the region of the arched passage 323 that does not include the reduced pressure duct "I". The ridge portion 315. The reduced pressure delivery tube further includes a proximal orifice 355 at the proximal end of the tube 341. The proximal orifice 355 is configured to cooperate with a source of reduced pressure, which will be described in greater detail below with respect to Figure 9. The reduced pressure delivery tube 341 shown in Figures 6-8 contains only a single lumen or passage 359. However, the reduced-pressure delivery officer 341 can be provided with a plurality of lumens, such as the plurality of lumens previously described with reference to Figure 4β. As previously described, the use of a multi-lumen tube provides a separate fluid communication path between the proximal end of the reduced pressure delivery tube 341 and the flow channel. The separate fluid communication path can also be provided by a separate tube having a single or multiple lumens in communication with the flow channel. 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 extension 375 at a distal end 377 of the reduced pressure delivery tube 373. The extension portion 375 is preferably arched to match the curvature of the reduced pressure delivery tube 373. The extension portion 375 can be formed by removing a portion of the reduced pressure delivery tube 373 at the distal end 377 thereby forming a slit 381 having a shoulder 383. Multiple protrusions 385 set

Il9637.doc -20- 1325328 is formed on one of the inner surfaces 387 of the delivery tube 373 to form a plurality of flow channels 391 between the protrusions 385. The protrusions 385 of the protrusions 385, the shape and the spacing may be similar to the protrusions described with reference to Figures 1-5. The reduced pressure delivery device 371 is particularly useful for applying reduced pressure to connective tissue that can be received within the incision 381 and regenerating tissue on connective tissue. The ligaments, tendons, and cartilage are non-limiting examples of tissue that can be treated by the reduced pressure delivery device 371. Referring to Figure 9, a reduced pressure tissue treatment is applied to a tissue site 413 (e.g., a human bone skeletal 41 5 of a patient) using a reduced pressure delivery device 411 similar to other reduced pressure delivery devices described herein. When used to promote bone tissue growth, decompression tissue treatment increases the rate of healing associated with fractures, non-union, voids, or other bone defects. It is further believed that reduced pressure tissue treatment can be used to improve the recovery of osteomyelitis. This treatment can be further used to increase the local bone density in patients with osteomyelitis. Finally, reduced pressure tissue treatment can be used to accelerate and improve the oseointegration of orthopedic implants such as buttock implants, knee implants, and fixation devices. Still referring to Figure 9, the reduced pressure delivery device 411 includes a reduced pressure delivery tube. 419, the reduced pressure delivery tube 419 has 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 but through a plurality of flow channels associated with the reduced pressure delivery tube 419 and the reduced pressure delivery device 411. Applying a reduced pressure to the tissue site 4丨3 is achieved by arranging the wing portion of the reduced pressure delivery device 4丨丨 adjacent the tissue site 4 13 , which in this particular example involves a void defect in the bone 415 The 429-wound wing portion ◊ decompression delivery device 4 ι can be inserted by surgery or through the skin. When inserted through the skin, the reduced pressure 119637.doc 1325328 delivery tube 419 preferably passes through a sterile insertion sheath that penetrates the patient's skin tissue. 0 Application of decompression tissue treatment typically produces granulation in the area surrounding the tissue site 4 1 3 organization. The granulation tissue is a common tissue formed by the month 1J, which is often repaired in the human body. Under normal conditions, granulation tissue may form during the presence of foreign bodies or during wound healing. Granulation tissue is commonly used as a scaffold for healthy replacement tissue and further to form certain scar tissue. meat

The bud tissue is highly vascularized and the enhanced growth rate of such highly vascularized tissue promotes the growth of new tissue at tissue site 413 in the presence of reduced pressure.

Still referring to Fig. 9, a fluid delivery tube 431 can be fluidly coupled to the flow passage of the reduced pressure delivery device 4 11 at a distal end. Fluid delivery tube 43A includes a proximal end 432 that is fluidly coupled to a fluid delivery source 433. If the flow system air being delivered to the tissue site is filtered, the air is preferably filtered and sterilized by a filter 434 capable of filtering particles as small as 〇22 _. Particularly when the tissue site 413 is positioned beneath the surface of the skin, it may be important to introduce a deflation into the tissue site 413, which facilitates good drainage of the tissue portion to relieve or prevent occlusion of the reduced pressure delivery tube 419. The fluid delivery tube 431 and the fluid delivery source 433 can also be used to introduce other fluids to the tissue site 4, including but not limited to antimicrobial agents, antiviral agents, cell growth promoters, irrigation fluids, or other chemically active substances. The pressure delivery tube 43 1 is preferably inserted through a sterile insertion sheath that penetrates the patient's skin tissue through the space $ φ i ^ tooth 0. A pressure sensor 435 can be operatively coupled to the fluid delivery tube

Il9637.doc *22-, 3 431 ' to indicate if the fluid is being delivered ^ ^ 1疋 is blocked by blood or other body fluids. The pressure sensing state 435 can be coupled to the fluid delivery source 433 by means of a fallback to provide feedback, whereby the amount of fluid that is forced into the tissue site 4 13 by the batch. A port valve (not shown) may also be attached to the vicinity of the distal end of the fluid delivery tube 431 in a manner that prevents blood from entering the fluid delivery tube 43 1 . The separate fluid communication paths provided by the delivery tube 419 and the delivery private, metaphysical, and body delivery 431 can be achieved by a variety of non-return methods, including providing a single multi-lumen tube as previously described with reference to Figure 4 (d). . A person skilled in the art will use a sinus tube, a sensor associated with the fluid delivery tube 43 1 , and the member may similarly be associated with one of the iliac lumens of the reduced pressure delivery tube 419. Union. Preferably, any lumen or fistula in fluid communication with the tissue site is coated with an anticoagulant ' to prevent body fluids or blood from clogging within the lumen or tube. Other coatings that coat the lumens or tubes include but not Limited to heparin anticoagulants, anti-fibrinogen, anti-adherent agents, anti-prothrombin, and hydrophilic coatings. See Figure 10-19. 'Experiments have shown that when decompressed tissue treatment is applied to bone tissue, a positive effect is obtained. In a specific trial, a logarithmic rabbit was treated with decompression tissue and treatment to determine its effect on bone growth and regeneration. The specific goal of the test was to find the effect of decompressive tissue treatment on rabbits with deficiencies or injuries on _month, the effect of decompression on rabbits with critical size defects on the skull, and the stent material. With the reduction of a tissue treatment - use for the treatment of the skull on the critical rule; lack of talent. The H test plan and the number of rabbits are listed in the following table i. H9637.doc -; -23- quantity 4 4 4 4 4 Μ^ΓΤ-γ-γ--the _ bone loss by the honeycomb foam (GrailUF〇am) in the intact decompression tissue treatment (RPTT ) for 6 days, followed by immediate damage; in the absence of decompression fresh weaving treatment (RPTT), two bees, nested foam (G_F_) up to 6 Ϊ 个 个 放置 放置 不锈钢 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界 临界First, the critical dimension defect of the calcium phosphate stent placed on the surface; the RPIT for the two hours; the critical size defect of the stainless steel mesh placed on the tissue after 2 weeks of surgery; the critical size defect of the calcium phosphate stent placed above The two-hour RPTT; in the operation of the 12th encounter, the Jiang group has a critical dimension defect on which the stainless steel mesh is placed; a f placed the critical dimension defect of the calcium phosphate stent; Day RPTT; harvested tissue after 2 weeks of surgery had a critical size defect with a stainless steel mesh placed thereon; a critical size defect with a calcium phosphate scaffold placed thereon; 6 days RPTT applied to the two employees; 12 weeks after surgery After harvesting organization __ has one on top The critical dimension defect of the stainless steel wire mesh; a critical size defect in which the calcium phosphate stent is placed; no gjTT (control) is applied; the tissue 4 is harvested after 2 weeks of surgery has a critical dimension defect on which the stainless steel mesh is placed; Place the critical size defect of the calcium phosphate scaffold on it; do not apply RPTT (control); harvest tissue after 12 weeks of surgery _. I control (no surgery; no RPTT) - 4 sham surgery (no defect, no implementation) RPTT): Harvested tissue after 6 days of surgery Table 1: Defects in the critical dimension defect tissue (eg, skull) of the trial protocol are sufficiently large that they will not heal by their own recovery. For rabbits, drilling a full thickness hole of approximately 15 mm in diameter through the skull creates a critical dimension defect in the skull. Referring more specifically to Figure 10, a tissue section of a rabbit skull having an original, undamaged 119637.doc -24-1325328 bone path is illustrated. The skeletal tissue of the skull is magenta. The surrounding soft tissue is white, and the periosteal layer is highlighted by a yellow asterisk. The rabbit skull is illustrated in Figure 11 after application of reduced-pressure tissue treatment for 6 days and subsequent immediate harvesting of tissue. The bones and periosteum can be seen and a layer of granulation tissue has formed. In Figure I2, the rabbit skull is illustrated after application of decompression tissue treatment for 6 days followed by immediate harvesting of tissue. The tissue section of Figure 12 is characterized by the formation of a new skeletal tissue beneath the granulation tissue. This skeletal tissue is highlighted by a yellow asterisk. In Fig. 13, the rabbit skull after the application of the decompressed tissue treatment for 6 days and immediately after harvesting the tissue is illustrated. You can see new bones and periosteum. The tissue appearance of the Moon Road tissue, which is opened by decompression tissue treatment, is very similar to the tissue appearance of bone formation in very young animals that are experiencing extremely rapid new bone growth and deposition. Referring more specifically to Figures 14-19, several photographs and tissue cuts are illustrated which show procedures and results for decompressing tissue treatment of a rabbit skull having a critical size defect. In Fig. 14, 'a rabbit skull having two critical size defects formed thereon is illustrated. These full thickness critical dimension defects have a diameter of about 15. In Figure 15, a stainless steel wire mesh has been placed over one of the critical dimension defects and a calcium phosphate stent has been placed within the second critical dimension defect. In Figure 16, a reduced pressure is applied to the critical dimension defects using a reduced pressure tissue treatment device similar to that described herein. The pressure applied to each buckle is _125 mm Hg gauge. The reduced pressure is applied according to one of the test protocols listed in Table 1. In the figure, the figure shows that after 6 days of decompression tissue treatment and 12 weeks after surgery, the skull was harvested after 119637.doc -25-, and woven. The slice shown contains a calcium phosphate scaffold, which is indicated by a red arrow to the significant growth of new bone tissue using decompressive tissue treatment, which is highlighted by a yellow asterisk in Figure 17. The amount of bone growth was significantly greater than the amount of bone growth in critical size defects that were treated with the same calcium phosphate scaffold but not treated with decompressive tissue. This observation suggests that there may be a treatment threshold or duration required to induce a new bone formation response. The effect of decompression tissue treatment was most pronounced in the samples collected 12 weeks after surgery, suggesting that decompression tissue treatment caused a cascade of biological events that enhanced the formation of new bone pathways. The critical size defect covered with a stainless steel mesh (Fig. 15) but without the stent material in the defect was used as an intra-animal control with minimal bone growth. "Hai and other shell materials highlight the advantages of proper scaffold materials and the positive effects of decompressive tissue treatment on stent fusion and bioavailability. In Figures 18 and 19, a radiograph of a critical dimension defect filled with a stent after six days of decompression tissue treatment is illustrated. Figure 18 illustrates a defect two weeks after surgery and shows that a certain new bone has been deposited in the stent. The main structure of the bracket is still clearly visible. Figure 19 illustrates the defect after twelve weeks of surgery and shows that the critical dimension defect is almost completely healed and the main stent architecture is nearly completely lost due to tissue fusion (i.e., the formation of a new bone path within the stent matrix). Referring to the circle 20', a reduced-pressure delivery system 7 11 according to an embodiment of the present invention performs decompression tissue treatment on the tissue site 7 of the patient. The reduced pressure delivery system 711 includes a manifold delivery tube 721. Manifold delivery tube 721 can be a catheter or cannula' and can include a device that enables manifold delivery tube 72i to be guided to tissue portion 713, such as a guide unit and a guide wire 727. Li9637.doc -26- 1325328 Endoscopic examination, ultrasound, fluoroscopy, auscultation, palpation or any other suitable localization technique can be used to achieve placement of the guide wire 727 and manifold delivery tube 721 and Guidelines. A manifold delivery tube 721 is provided for inserting a reduced pressure delivery device through the skin into the tissue site of the patient. 713. When passing through the skin, the manifold delivery tube 7; 21 preferably passes through a patient's skin group. The woven sterile insert is inserted into the sheath. In Figure 20, the tissue site 713 contains skeletal tissue at the fracture portion of the patient's bone 733. Manifold delivery tube 72 1 is inserted through skin 735 of the patient and any soft tissue 739 surrounding bone 733. As previously mentioned, the tissue site 713 can also comprise any type of tissue including, but not limited to, fat, muscle, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage, tendon, or ligament. Referring to Figures 21 and 22, a reduced pressure delivery system 711 is further illustrated. The manifold transfer tube 721 can include a tapered distal end 743 for easy insertion through the patient's skin 735 and soft tissue 739. The tapered distal end 743 can be further configured to flex radially outwardly to an open position such that the inner diameter of the distal end 743 will be substantially the same or larger than the inner diameter of other portions of the tube 721. The opening position of the distal end 743 is schematically shown by dashed line 737 in FIG. Manifold delivery tube 721 further includes a passageway 751 in which a reduced pressure delivery device 761 or any other reduced pressure delivery device is included. The reduced pressure wheeling device 761 includes a flexible barrier 765 and/or a honeycomb material π?, as described with reference to Figures 6-8. The flexible barrier 765 and/or the honeycomb material % is preferably wound, folded or otherwise compressed around the reduced pressure delivery tube 769, = reducing the cross-sectional area of the reduced pressure delivery device 761 within the passage 751. 119637.doc

, A • 27· 1325328 The reduced pressure delivery device 761 can be placed in the passage 751 and guided to the tissue site 713 after the distal end 743 of the manifold delivery tube 721 is placed at the tissue site 713. Alternatively, the reduced pressure delivery device 761 can be pre-positioned in the passage 751 at a month 'J' where the manifold delivery tube 721 is inserted into the patient. To push the pressure reducing delivery device 761 through the passage 751, a biocompatible lubricant can be used to reduce the friction between the reduced pressure delivery device 761 and the manifold delivery tube 721. After the distal end 743 has been positioned at the tissue site 713 and the reduced pressure delivery device 761 is rotated to the distal end 743, the reduced pressure delivery device 761 is then pushed toward the distal end 743 such that the distal end 743 is radially outward. Expand to the open position. The reduced pressure delivery device 761 is pushed out of the manifold delivery tube 721, preferably into a void or space adjacent the tissue site 713. This void or space is usually formed by incision of soft tissue, which can be accomplished by a route through the skin. In some cases, the tissue site 7丨3 can be located at the wound site and naturally exists due to the anatomy of the wound—in other cases, the void can be separated by a balloon, separated by a sharp device, separated by a pure device, and hydraulically Separation, pneumatic separation, ultrasonic knife separation from electrocautery, laser separation or any other suitable separation technique to open/field decompression delivery device 761 into the gap adjacent to the tissue site 7丨3 'reduced delivery device 761 The flexible barrier 765 and/or the honeycomb material 767 are unwound, unfolded, or decompressed (see FIG. 22) such that the reduced pressure delivery device 761 can be placed in contact with the tissue site 713. Although not necessarily required, the flexible barrier 765 and/or the honeycomb material may be subjected to a vacuum or reduced force provided via the reduced pressure delivery tube 769 to compress the flexible barrier 765 and/or the honeycomb material W. The relief of the aid barrier 765 and/or the honeycomb material 767 can be achieved by reducing the delivery of the delivery tube 769 via 119637.doc -28-13325328, or via the (four) delivery tube 769. Provides positive dust to help complete the unwinding process. End placement, manipulation, manipulation, auscultation, palpation, or any other suitable localization technique can be used to achieve final placement and manipulation of the reduced pressure delivery device 76i. After placement of the reduced pressure delivery device 761, the manifold delivery tube 721 is preferably removed from the patient, but the reduced delivery tube associated with the reduced pressure delivery device 761 remains in place to enable passage of the skin to tissue site 713 Apply a reduced pressure. Referring to Figures 23-25, a reduced pressure delivery system 8 in accordance with an embodiment of the present invention includes a manifold delivery tube 82i having a tapered distal end 843 that is configured to flex radially outwardly. The curve is bent to an open position such that the inner diameter of the distal end 843 will be substantially the same or larger than the inner diameter at the other portion of the tube 82. The position of the opening of the distal end 843 is shown schematically by dashed line 837 in Figures 23-25. Manifold delivery tube 821 further includes a passageway containing a reduced pressure delivery device 861 similar to other reduced pressure delivery devices described herein. The reduced pressure delivery device 861 includes a flexible barrier 865 and/or honeycomb material 867 that is preferably wound, folded, or otherwise compressed around the reduced pressure delivery tube 869 to reduce The small decompression transporter sets the cross-sectional area of the 8 6 1 in the passage. An impervious film 871 having an inner surface 873 is disposed around the reduced pressure delivery device 86 1 such that the reduced pressure delivery device 861 is contained within the inner surface 873 of the impermeable membrane 87 1 . The impervious film 87 1 can be a balloon, a sleeve, or any other type of film capable of preventing fluid permeation so that the permeable film 871 can take a compressed position (see Figure 23), At least one of a relaxed position (see Figure 24) and an expanded position (see Figures 25 and 25). The impervious film 871 is sealingly coupled to the manifold delivery tube 821 such that the interior space 873 of the impermeable membrane 871 communicates with the passageway of the manifold delivery tube 821. Alternatively, the impermeable membrane 871 can be secured to the reduced pressure delivery: 869 such that the interior space of the impermeable membrane crucible is in fluid communication with the passage of the reduced left delivery tube 869. The impermeable membrane 871 can in turn be φ fixed to a separate control tube or control lumen in fluid communication with the interior space 873 (see, for example, Figure 25A). In one embodiment, an impermeable membrane 8<71 can be provided. Further reducing the cross-sectional area of the reduced pressure conveying device 861 in the passage, for this purpose, applying a pressure lower than the pressure of the surrounding ring of the impervious film π to the β卩 space 873 within the impermeable film 871 This discharges a relatively large amount of Deng knife gas or other fluid within the interior space 873, thereby placing the impermeable membrane 871 in a compression position not shown in the figure. At the compressed position, the impermeable film 871 φ is attracted inwardly, thereby applying a pressure to the decompression conveying device 861 to reduce the cross-sectional area of the decompression conveying device 86. As previously described with reference to Figures 2i and 22, the reduced pressure delivery device 861 can be delivered to the tissue site after the distal end 843 of the manifold delivery tube 821 is disposed at the tissue site. Endoscopy k-checks, ultrasound, fluoroscopy, auscultation, palpation, or any other appropriate procedure can be used. Deuteration technology is used to achieve placement and manipulation of the impervious film 87 and the reduced pressure delivery device 861. The impermeable film 1 may contain the radiopaque label μ'881, which improves the visibility of the impermeable film W1 under the fluorescent screen inspection before it is removed. 119637.doc -30-, , 3⁄4 1325328 After pushing the reduced pressure delivery device 861 through the distal end 843, the reduced pressure applied to the interior space 873 can be released to place the impermeable membrane 871 in a relaxed position ( Referring to Figure 24), it is advantageous to more easily remove the reduced pressure delivery device 861 from the impermeable membrane 871. A removal device 885 (e.g., a cannula, a needle or other sharp instrument) can be provided to break the impermeable membrane 871. Preferably, the removal tool 885 is inserted through the reduced pressure delivery tube 869 and is advanced enough to contact the impermeable membrane 81. After the impervious film 871 is broken, the removal device 885 and the impermeable film 871' can be withdrawn via the manifold delivery tube 821 to enable the flexible barrier 865 and/or the honeycomb material 867 of the reduced pressure delivery device 861 to be unwound. Winding, unfolding or uncompressing allows the reduced pressure delivery device 861 to be placed in contact with the tissue site. The unwinding of the flexible barrier 865 and/or the honeycomb material 867 can occur automatically after releasing the reduced pressure in the interior space 873 and removing the impermeable membrane 81. In some cases, positive pressure may be delivered via the reduced pressure delivery tube 869 to help unwind or depress the flexible barrier 865 and/or the honeycomb material 867. After the final placement of the reduced pressure delivery device 86, the manifold delivery tube 821' is preferably removed from the patient but the reduced pressure delivery tube 869 associated with the reduced pressure delivery device 861 remains in place to enable passage through the skin pair The tissue site is subjected to reduced pressure. The impervious film 871 can also be used to separate tissue adjacent to the tissue site prior to placement of the reduced pressure delivery device 86(R) against the tissue site. After the reduced pressure delivery device 861 and the intact impermeable membrane 871 are pushed through the distal end 843 of the manifold delivery tube 821, air or another fluid is injected or pumped into the interior space 873 of the impermeable membrane 871. It is better to use liquid to make it impervious. il9637.doc •31 ·

Interrupted to break the impervious film 871, <two rolling or other fluids, so as not to position. Then, the reduced pressure delivery device 861 can be inserted as described above and at the site of the adjacent tissue. Referring to Fig. 25A, if the impervious sheet 871 is primarily used to separate tissue adjacent to the tissue site, the impermeable membrane 871 can be sealingly secured to the manifold tube 821, thereby correlating the interior space 873 with Or the auxiliary lumen or tube 891 secured to the manifold delivery tube 821 is in fluid communication. The auxiliary lumen 891 can be used to deliver liquid, air or other fluid to the interior space 873 to place the impermeable membrane 871 in the expanded position. After the separation, the impermeable film 871 can be relaxed and broken as described above with reference to Fig. 24. Referring to Figure 26, a reduced pressure delivery system 911 in accordance with an embodiment of the present invention includes a manifold delivery tube 921 having a tapered distal end 943 that is configured to flex radially outwardly to a The open position 'so that the internal control of the distal end 943 will be substantially the same or greater than the internal control at other portions of the tube 921. The open position of the distal end 943 is schematically distorted by the dashed line 937 in Figure 26. The delivery tube 921 further includes a passageway containing a 119637.doc -32-1325328 similar to other reduced pressure delivery devices described herein. The pressure reducing conveying device 96ι. The reduced pressure delivery device 961 includes a flexible barrier 965 and/or honeycomb material 967 that is preferably wound, folded or otherwise compressed around the reduced pressure delivery tube 969 to reduce The cross-sectional area of the small reduced pressure delivery device 961 within the passage of the manifold delivery tube 92. An impervious film 971 having an inner surface 973 is disposed around the reduced pressure delivery device 961 such that the reduced pressure delivery device 961 is contained within the inner surface 973 of the impermeable membrane 971. The impermeable film 97A includes a seal 977 on one end of the impermeable film 971 to provide an alternative method of removing the reduced pressure delivery device 961 from the impermeable film 971. The impermeable membrane 971 is sealingly coupled to the manifold delivery tube 921 such that the interior space 973 of the impermeable membrane 971 is in fluid communication with the passage of the manifold delivery tube 921. Alternatively, the impervious sheet 971 can be secured to a separate control tube (not shown) in fluid communication with the interior space 973. Similar to the impermeable film 871 of Fig. 23, the impermeable film 971 can prevent fluid from permeating so that the impervious sheet 971 can take at least one of a compression position, a relaxed position, and an expanded position. Since the procedure for placing the impermeable film 971 on the compression position and the expansion position is similar to the impermeable film 871, only the process of removing the decompression conveying device 961 will be described. The reduced pressure delivery device 961 is delivered to the tissue site within the impermeable membrane 97i using endoscopy, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique and then correctly Positioning. The impermeable film 971 can include a radiopaque marker 981 which improves the visibility of the permeable film 971 under the screen inspection prior to its removal. The reduced pressure delivery device 961 is then pushed through the distal end 943 of the manifold delivery tube 921. The reduced pressure applied to the interior space 973 can be released to place the impermeable membrane 971 in a relaxed position. Then, the reduced pressure conveying device 961 is pushed through the glue seal 977 to push out the impervious film 971. Referring to Figure 26A, a reduced pressure delivery system 985 in accordance with an embodiment of the present invention may not include a manifold delivery tube similar to the manifold delivery tube 921 of Figure 26. Rather, the reduced pressure delivery system 985 can include a guide wire 987, a reduced pressure delivery tube 909, and a reduced pressure delivery device mi. The reduced pressure delivery device 99 includes a plurality of fluids connected to the flow passage of the reduced pressure delivery tube 989. Instead of using a separate manifold delivery tube to deliver the reduced pressure delivery device 991, the reduced pressure delivery device 991 and the reduced pressure delivery tube 989 are placed over the guide wire 987, which guides the guide wire 987 through the skin. To a tissue part 993. Preferably, the guide wire 987 and the reduced pressure delivery tube 989 penetrate the skin of the patient by a sterile sheath. The reduced pressure delivery device 991 can be placed at the tissue site 993 by guiding the reduced pressure delivery tube 989 and the reduced pressure delivery device 991' along the guide wire 987 to effect application of reduced pressure tissue treatment through the skin. Since the reduced pressure delivery device 991 is not constrained in a manifold delivery tube during delivery to the tissue site 993, it is preferred to maintain the reduced pressure delivery device 991 in the compressed position during delivery. If an elastic foam is used as the reduced pressure conveying means 991, the foam can be coated with a biocompatible soluble adhesive and the foam can be compressed. After reaching the tissue site, the body fluid or other fluid delivered via the reduced pressure delivery tube 989 dissolves the binder, thereby expanding the foam to contact the tissue site. Alternatively, a reduced pressure delivery device 991 can be fabricated from a compressed dry hydrogel of 119637.doc • 34·1325328. The hydrogel absorbs moisture after being transported to the tissue site 993, so that the reduced pressure delivery device 991 can be inflated. Still another reduced pressure delivery device 991 can be made from a thermally active material (e.g., polyethylene glycol)' that thermally expands upon exposure to the patient's body temperature. In a further embodiment, the compressed reduced pressure delivery device 991 can be delivered to the tissue site 993 in a dissolvable film. Referring to Fig. 27, a decompression delivery system according to an embodiment of the present invention includes a manifold delivery tube 1〇21 having a distal end 〇43, and a distal end 〇43 inserted through one of the patient tissues. The tissue portion 1025 is accessed. Tissue site 1 〇 25 may comprise a void 1029 associated with a wound or other defect, or alternatively, a void may be formed by separation, including the separation techniques described herein. After the distal end 1043 is placed adjacent to the tissue site 1〇25 in the void 1〇29, an injectable, pourable or flowable reduced pressure delivery device 1035 is delivered to the tissue site 1025 via the manifold delivery tube 1〇21. . The reduced pressure delivery device 1035 is preferably present in a flowable state during delivery to the tissue site, and then, upon arrival, forms a plurality of flow channels for distributing the reduced pressure or fluid. In some cases, the flowable material can be hardened to a solid state by a drying process, a curing process, or other chemical or physical reaction after reaching the tissue site. In other cases, the flowable material can form a foam in situ after delivery to the tissue site. Still other materials may exist in the gel state at the tissue site 1 〇 25, but still have a plurality of flow channels for delivering reduced pressure. The amount of reduced pressure delivery device 1 035 delivered to the tissue site 1 〇 25 may be sufficient to partially or completely fill the void 119637.doc 1325328 1029. The reduced pressure delivery device 1A can include both the manifold and the stent. As a discriminator, the reduced pressure delivery device 丨035 includes a plurality of holes or open holes which may be formed in the material after being transported to the gaps 1〇29. The three holes or the open holes communicate with each other, thereby forming a plurality of flow channels. These flow channels are used to apply and reduce the pressure on the tissue site 1〇25. As a stent, the reduced pressure delivery device is bioresorbable and serves as a substrate on which new tissue can be grown. In one embodiment, the reduced pressure delivery device 1035 can comprise a poragen, such as NaCl or other salt, distributed throughout the liquid or viscous gel. After the liquid or viscous gel is delivered to the tissue site 1 〇 25, the material is applied to the void 1029 and subsequently cured into a solid. Water-soluble]^3(:1 卩 吨 (3) dissolves in the presence of body fluids, leaving a structure with interconnected pores or flow channels that deliver reduced pressure and/or fluid to the flow channels. With the formation of a new tissue, the tissue leader enters the hole of the decompression transfer device 丨〇 35 and then eventually replaces the reduced pressure delivery device 1035 with the degradation of the reduced pressure delivery device 1035. In this particular example, the reduced pressure delivery The device 1〇35 is used not only as a manifold but also as a new tissue growth scaffold. In another embodiment, the 'reduced delivery device 1035 is an alginate mixed with 4〇〇μη mannose granules. P〇ragen or particles may be dissolved at the tissue site by local bodily fluids or by the flushing fluid or other fluids delivered to the reduced pressure delivery device 1〇35. After dissolving the p〇ragen or particles, previously occupied by the poragen or particles The space becomes a void that interconnects with each other to form a flow channel within the reduced pressure delivery device 1035. The use of poragen in the material to form the flow channel is effective, but its I19637.doc -36-1325328 will also form a ruler. It is limited to pores and flow channels of the particle size of the selected poragen. Chemical reactions can be used in place of poragen to form larger pores by forming gaseous by-products. For example, in one embodiment, one can contain hydrogen carbonate. The flowable material of sodium and citric acid microparticles (which can be used without a stoichiometry) is delivered to the tissue site 1025. When the flowable material forms a foam or solid in situ, the body fluid will cause sodium bicarbonate and citric acid. Acid-base reaction. Compared with the technology of relying on poragen dissolution, the formed dioxide

The carbon gas particles form larger pores and flow channels throughout the reduced pressure delivery device 1〇35. The conversion of the reduced pressure delivery device 1035 from a liquid or viscous gel to a solid or foam can be triggered by pH, temperature, ", or reaction with body fluids, chemicals, or other materials delivered to the tissue site. This transformation can also be carried out by mixing a plurality of reactive components. In one embodiment, the reduced pressure transport device 1035 is prepared by selecting bioresorbable microspheres made from a bio:resorbable polymer. The microspheres are dispersed in - containing a photoinitiator and

A solution of a hydrogel forming material such as hyaluronic acid, collagen or polyethylene glycol having a red group. The microsphere-gel mixture is exposed to light for a temporary period of time to partially crosslink the hydrogel and immobilize the hydrogel on the microspheres. Sister Shan μ μ μ 排出 排出 多余 多余 多余 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出 排出The gel coat becomes hydrated. After you χ ,, the mixture is again exposed to light, thereby crosslinking the microspheres, π 2... + Form a plurality of flow channels. The crosslinked microspheres are then used as a manifold for the delivery of reduced pressure to the tissue site and 119637.doc -37-.$:; 'i a porous scaffold for promoting new tissue growth. With the exception of the foregoing embodiments herein, the reduced pressure delivery device 1〇35 can be made from a variety of materials including, but not limited to, calcium phosphate, collagen, alginate, cellulose, or any other capable of being a gas or a liquid. , gel, paste putty, slurry, suspension, or other flowable material in the form of an equivalent material that is routed to the tissue site and capable of forming a plurality of flow paths in fluid communication with the identified portion. The flowable material may further comprise solid particles, such as particles, which if the particle size of the solid particles is sufficiently small to flow 35 by the manifold wheel 1021. The material delivered to the tissue site in a flowable state can be polymerized in situ or form a gel. As previously described, the reduced pressure delivery device 1〇35 can be directly injected or poured into the void 1029 adjacent the tissue site 1025. Referring to Fig. 27A, the manifold transfer tube 1021 may include an impermeable or semi-permeable membrane 1051 at the distal end 1〇43 of the manifold delivery tube 1〇21. The membrane 1〇51 includes an internal space 1〇55, internal The space 1055 is in fluid communication with an auxiliary lumen 1〇57 secured to the manifold delivery tube 1〇21. The manifold delivery tube 1021 is guided to a tissue portion 1025 on a guide wire 1〇61. The reduced pressure delivery device 1035 can be injected or poured through the auxiliary lumen 1〇57 to fill the interior space 1055 of the membrane 1051. When the fluid or gel fills the film 1051, the film 1〇51 expands to fill the voids 1〇29, thereby causing the film to contact the tissue site 1 025. When the film 1 〇5 1 is inflated, the film 1 〇5丨 can be used to separate the additional tissue adjacent to or close to the tissue site 1025. If the film 丨〇5丨 is an impermeable film, it can be physically broken and moved. In addition, the reduced pressure delivery device 1035 is brought into contact with the tissue site 1〇25. Alternatively, the film 1〇51 li9637.doc -38-1325328 can be made from a soluble material that will dissolve in the presence of a body fluid or a biocompatible solvent delivered to the film. If the film 丨〇5 is semi-permeable, the film 1051 can remain in place. The semi-permeable membrane is capable of delivering reduced pressure and possibly other fluids to the tissue site 1025. Referring to Figure 28, a method of performing reduced pressure tissue therapy includes surgically inserting a manifold at an adjacent tissue site at 1115, the manifold having a plurality of protrusions extending from a flexible barrier. To form a plurality of flow channels between the protrusions. The manifold is positioned at 1119 such that at least a portion of the projections contact the tissue site. At II23, a reduced pressure is applied to the tissue site via the manifold. See 0 0 9 Methods for performing decompressive tissue treatment on a tissue site 1211 includes inserting a manifold at 1215 through the skin adjacent to the tissue site. The manifold can include a plurality of protrusions extending from a flexible barrier to form a plurality of flow channels between the protrusions. Alternatively, the manifold can comprise a honeycomb material having a plurality of flow channels within the honeycomb material. Alternatively, the manifold can be formed from an injectable or pourable material that is delivered to the tissue site and that forms a plurality of flow channels upon reaching the tissue site. At 1219, the dislocation I is positioned 'to bring at least a portion of the flow channels in fluid communication with the tissue site. At 1223, a reduced pressure is applied to the tissue site via the manifold. Referring to Fig. 30, a method of applying reduced-pressure tissue treatment to a tissue site 1311 includes inserting a tube having a passage through the skin through a skin at 1315 such that the distal end of the tube is adjacent to the tissue site. At 1319 I19637.doc -39-13325328, a balloon associated with the tube can be inflated to separate tissue adjacent the tissue site to form a void. At 1323, a manifold is transported through the passage. The manifold can include a plurality of protrusions extending from a flexible barrier to form a plurality of flow channels between the protrusions. Alternatively, the manifold can comprise a honeycomb material having a plurality of flow channels therein. Alternatively, the manifold can be formed from an injectable or pourable material that is delivered to the tissue site as described above with reference to Figure 27. At 1327, the manifold is positioned such that at least a portion of the flow channels are in fluid communication with the tissue site. At 1331, the reduced pressure is applied to the tissue site via the manifold via a reduced pressure delivery tube or any other delivery route. Referring to Fig. 3 1 'A method of performing decompressive tissue treatment on a tissue site 1411 includes inserting a tube having a passage through the skin through a skin at 1415 such that the distal end of the tube is placed adjacent to the tissue site. At 1423, a manifold is conveyed through the passage to the tissue portion in an impervious jacket which has been subjected to a first reduced pressure at 1419 that is less than the sheath ambient pressure. At 1427, the sheath is broken to contact the manifold with the tissue site. At 丨43丨, a second reduced pressure is applied to the tissue portion via the manifold. Referring to Figures 32 and 33, a reduced pressure delivery device 1511 in accordance with an embodiment of the present invention includes an orthopaedic prosthesis 1515 for replacing an existing femoral head of a patient leg segment 1517. The hip prosthesis 1515 includes a post portion 1521 and a head portion 1525. The post portion 1521 is elongate for insertion into a passage 1529 that is hinged in the backbone of the leg portion 1517. A porous coating 1535 is disposed around the perimeter of the column portion 119637.doc -40- and is preferably constructed of sintered or vitrified ceramic or metal. Alternatively, a honeycomb material having a porous property can be disposed around the crucible portion. A plurality of flow channels 1541 are disposed within the column portion 丨 52 i of the hip prosthesis i 5丨5 such that the flow channel 1541 is in fluid communication with the porous coating port 535. A port 1545 is fluidly coupled to the flow channel 1541, the port is configured to be releasably coupled to a reduced pressure delivery tube 1551 and a reduced pressure delivery source 1 553. The flow channel 1 541 is used to implant the hip prosthesis 15 1 After 5, the reduced pressure is delivered to the porous coating 1535 and/or bone surrounding the hip prosthesis 15 15 . The flow channel 1541 can include a main feed line 1543 in fluid communication with a plurality of lateral branch lines 1 547 that are in communication with the porous coating 1535. The lateral branch line 1545 can be oriented perpendicular to the main feed line 15 43 as shown in Figure 32, or can be oriented at some angle to the main feed line 154. An alternative method for distributing the reduced pressure includes providing a hollow body prosthesis 'and filling the prosthesis with a honeycomb-like (preferably open-cell) material that is in fluid communication with the porous coating 153. Internal space. Referring more specifically to Figure 33, the body prosthesis 1515 can further include a second plurality of flow channels 15 6 1 within the column portion 1521 to the porous coating 1 5 3 5 surrounding the hip prosthesis 15 5 and/or The bone provides fluid. The fluid may include filtered air or other gas, an antibacterial agent, an antiviral agent, a cell growth promoting fluid, a chemically active fluid, or any other fluid. Additional fluid communication paths may be provided if it is desired to introduce multiple fluids into the bone surrounding the hip prosthesis 1515. A port 1565 is fluidly coupled to the flow channel 1561 which is configured to be releasably coupled to a fluid delivery tube i 571 and a fluid delivery source 1573. The flow channel 1 561 can include a main feed official line 15 8 3 in fluid communication with a plurality of lateral branch lines 119637.doc -41 - 1325328 1 5 8 5 that are in communication with the porous coating 1535. The lateral branch line 1585 can be oriented perpendicular to the main feed line 1583 as shown in Figure 33, or can be oriented at some angle to the main feed line 1583. The delivery of the reduced pressure to the first plurality of flow channels 1 5 41 and the transfer of fluid to the second plurality of flow channels 1561 can be accomplished by separate tubes (e.g., reduced pressure delivery tube 1551 and fluid delivery tube 1571). Alternatively, a tube having a plurality of lumens as previously described herein can be used to separate the communication path for delivery of reduced pressure and fluid. It should be further noted that although a separate fluid communication path is preferably provided within the hip prosthesis 1515, the first plurality of flow channels 1 5 4 1 can be used to deliver both the reduced pressure and fluid to the surrounding hip prosthesis 15 15 bones. As mentioned earlier, applying reduced stress to bone tissue promotes and accelerates the growth of new bone tissue. By using the hip prosthesis 15 15 as a manifold to deliver the reduced pressure to the bone area surrounding the hip prosthesis, the recovery of the leg section 15 17 is faster and the hip prosthesis 15 5 5 will be more successful with the bone Combine together. Providing a second plurality of flow channels 1561 to discharge the bone path around the hip prosthesis 1515 will improve the successful regeneration of the new bone surrounding the prosthesis. After the reduced pressure is applied via the body prosthesis 15 15 for a selected amount of time, the reduced pressure delivery tube 1551 and the fluid delivery tube 1571 can be disconnected from the ports 1545, 1565 and removed from the patient's body. Use surgical invasive procedures. The connection between the ports 1545, 1565 and the tubes 1551, 1571 can be a connection that can be released by hand. This can be performed by applying an axial pulling force to the tubes 1S51, 1571 outside the body of the patient. Alternatively, the port 963U9637.doc -42· 1545, 1565 can be bioresorbable or soluble in the presence of the selected fluid or chemical so that the sputum 1545, 1565 can be violently The release of tubes 1551., 1571 is achieved by the passage of fluids or chemicals. Tubes 1551, 1571 can also be made from a bioresorbable material that will dissolve over a period of time or an activating material that will dissolve in the presence of a particular chemical or other material. A reduced pressure delivery source 1553 can be provided outside the patient and attached to the reduced pressure delivery tube 1551' to deliver the reduced pressure to the hip prosthesis 1515. Alternatively, a reduced pressure delivery source 1 5 5 3 can be implanted into the patient, on or near the hip prosthesis 5丨5. Placing the reduced pressure delivery source 1553 into the patient does not require the use of a fluid connection through the skin. The implanted reduced pressure delivery source 15 53 can be operatively coupled to the conventional pump of the flow channel 1 54 1 . The pump can be powered by a battery implanted in the patient's body or by an external battery that is electrically connected to the pump via the skin. The pump can also be directly driven by a chemical reaction that delivers reduced pressure through the flow channels 丨54丨, 丨56 i and circulates fluid through the flow channels 丨 541, 156 1 . Although only the column portion 1521 and the head portion 1 525 of the hip prosthesis 1515 are illustrated in Figures 32 and 33, it should be noted that the flow channels described herein and components for applying reduced pressure tissue treatment may also be applied to hip falsehood. Any component of the body 5 5 that contacts bone or other tissue, including, for example, a cup. Referring to Figure 34, a method for repairing a patient's joint includes the implantation of a prosthesis within the ostium adjacent to the joint at 1<15> The prosthesis can be a hip prosthesis as described above or any other prosthesis that can help restore joint mobility in a patient. The prosthesis includes a plurality of channels 119637.doc -43 - 1325328 that are configured to be in fluid communication with the bone. At 1619, the reduced pressure is applied to the bone via the plurality of flow channels. The improved pressure delivery device 1711 includes an orthopaedic fixation device in accordance with an embodiment of the present invention. 1715, for fastening the patient's bone 1717 containing the fracture site 1719 or other defect. The orthopaedic fixation device 1715 of Figures 35 and 36 is a plate having a plurality of passages 1721 for anchoring the orthopaedic fixation device 1715 to the bone using screws 1725, pins, bolts or other fasteners. On 1717. A porous coating 1735 can be placed on the surface of the contact bone 1717 of the orthopedic fixation device 1715. The porous coating is preferably constructed of sintered or vitrified ceramic or metal. Alternatively, a honeycomb material having a porous property may be disposed between the bone 1717 and the orthopaedic fixation device 1715. A plurality of flow channels 1741 are disposed within the orthopaedic fixation device 1715 for flow. One connection 埠 1745 fluid connection

An orthopaedic fixation device is in fluid communication with the porous coating 丨735 in the channel 1741. An alternative method of connecting to the flow channel 1741 'the raft is configured to be connected to: providing a honeycomb-like (e.g. open pore) material capable of communicating with the porous coating 丨735 stream 119637.doc • 44 - 1325328 To fill the internal space of the orthopaedic fixation device. The orthopaedic fixation device 15 can be a plate as shown in Figure 35, or alternatively, can be a fixation device such as a cannula, orthosis, struts, or any other device for stabilizing a portion of the bone. . The externally shaped '(4) device 1715 can be used to fix the fasteners of the prosthesis or other whole material device or implanted tissue (such as bone tissue or cartilage), and the condition of the φ is that the fasteners contain A flow passage for delivering a reduced pressure to tissue adjacent or surrounding the fasteners. Examples of such fasteners may include pins, bolts, screws or any other suitable fastener. Referring more specifically to Figure 36, the orthopaedic fixation device 1715 can further include a second plurality of flow channels 17 = within the orthopaedic fixation device 1715 to provide fluid to the porous coating 1735 and/or bone surrounding the orthopaedic fixation device 1715. . The fluid may include filtered air or other gases, antibacterial agents, antiviral agents, cell growth promoters, irrigation fluids, chemically active "" or any other fluid. If it is desired to introduce multiple fluids into the bone surrounding the hip prosthesis 1715 An additional fluid communication path may be provided. A port 1765 is fluidly coupled to the flow channel 1761, the crucible 1765 being configured to be coupled to a <il body delivery officer 1 77 1 and a fluid delivery source 773. The flow channel 丨76 The crucible may include a main feed line 1783 in fluid communication with a plurality of lateral branch lines 1785, the plurality of lateral branch lines 1785 being in communication with the porous coating. The tangential branch line 1785 may be as shown in FIG. The orientation is oriented perpendicular to the main feed line 1783, or may be oriented at some angle to the main feed line 1783. The reduced pressure is directed to the first plurality of flow channels 174 and the fluid is directed to the tube of 119637.doc -45 - 1325328 (eg Less

The second plurality of flow channels 1761 can be transported by a separate pressure transfer tube to provide a communication path for the reduced pressure and fluid. It should be further noted that although it is preferred to provide a separate fluid communication path within the body prosthesis 1715, the first plurality of flow channels 1741 can be used to deliver both the reduced pressure and fluid to the bone of the adjacent orthopaedic fixation device 1715. Network. The use of the orthopedic fixation device 1715 as a manifold to deliver reduced pressure to the bone region of the 0 adjacent orthopedic fixation device 1715 accelerates and improves the recovery of the defect 1717 of the bone 1717. Providing a second plurality of flow channels 将 transferring fluid to the bone surrounding the orthopaedic fixation device 1715 improves the successful regeneration of new bone adjacent the orthopaedic fixation device. Referring to Figure 37, a method 18u for healing a bone defect in a bone includes using an orthopedic fixation device at 18 15 to secure the bone. The orthopedic fixation device includes a plurality of flow channels disposed within the orthopaedic fixation device. At 1 8 19, the reduced pressure is applied to the bone defect via the plurality of flow channels. Referring to Figure 3, a method 1911 for performing a reduced-pressure tissue treatment on a tissue site includes: positioning a manifold having a plurality of flow channels at 1915 such that at least a portion of the flow channels are associated with the tissue The part body is connected. At 19 19, the reduced pressure is applied to the tissue site via the flow channels, and at 1923, a fluid is delivered to the tissue site via the flow channels. Referring to Fig. 39, a method for performing decompressive tissue treatment on a tissue site H9637.doc-46-1325328 Method 2011 includes positioning a distal end of a manifold tube adjacent to the tissue site at 2〇15. At 20 19, a fluid is delivered to the tissue site via the manifold delivery tube. The fluid is capable of filling a void adjacent the tissue site and becomes a solid '4 manifold having a plurality of flow channels in fluid communication with the tissue site. At 2023, a reduced pressure is applied to the tissue portion via the flow path of the solid manifold. Referring to Figures 40-48', a reduced pressure delivery system 2111 includes a primary manifold 2115. The primary manifold 2115 has a flexible wall 2117 that surrounds a main flow path 2121. The flexible wall 2117 is coupled to a reduced pressure delivery tube 2125 at a proximal end 2123. Since the shape of the reduced pressure delivery tube 2125 will generally be a circular cross section, and since the cross-sectional shape of the primary manifold 2115 can be different from the circular shape (i.e., rectangular in Figures 40-45 and triangular in Figures 46-48) Thus, a transition zone 2129 is provided between the reduced pressure delivery tube 2125 and the primary manifold 2115. The main manifold 2115 can be joined to the reduced pressure delivery tube 2125 by adhesive means, joined using other means such as fusion or insert molding, or alternatively selected to be integrally joined by coextrusion. The reduced pressure delivery tube 2125 delivers the reduced pressure to the primary ectopic 2 11 5 for distribution at or near the tissue site. An anti-blocking member 2135 is positioned within the main manifold to prevent the main manifold 2115 from collapsing and thereby blocking the main flow path 2121 during application of the reduced pressure. In one embodiment, the anti-blocking member 2135 can be provided with a plurality of protrusions 2137 (see Fig. 44), the plurality of protrusions 2137 are disposed on one of the inner surfaces 2141 of the flexible wall up and extend into the main flow path 2121. In another embodiment, the anti-blocking member 2135 can be disposed on the inner surface 2141 by a single two or more ridges 2丨45 (see Fig. 4 and the same. In another embodiment, the anti-blocking 119637.doc-47- 1325328 The component 2135 can include a honeycomb material 2149 disposed within the main flow path, such as shown in Figure 47. The anti-blocking component 2135 can be any that can be embedded within the flow path or can be integrally or otherwise secured to The material or structure on the flexible wall 2 11 7. The anti-blocking member 2丨35 prevents the flexible wall 2117 from being fully condensed while still allowing fluid to flow through the main flow path 2 121. The tractable wall 2117 further includes a plurality A hole 2155 penetrating the flexible wall 2117, the holes 2155 are in communication with the main flow path 2121. The hole allows the reduced pressure delivered to the main flow path 2121 to be distributed to the tissue site. The hole 2155 can be selected Positionally positioned around the circumference of the manifold 2115 to preferentially direct the delivery of the vacuum. For example, in Figure 51, the apertures may be placed facing the bone path, facing the covering tissue, or facing both at the same time. 2125 preferably includes one At least one outlet first conduit 2161, the at least one outlet being fluidly connected to the main flow passage 2ΐ2ι to deliver a reduced pressure to the main flow passage 2121. A second conduit 2163 may also be provided to clean the main flow passage 2121 with a fluid And the first conduit 2161 to prevent or dissolve the obstruction caused by the wound secretion and other fluids sucked from the tissue site. The second catheter preferably includes at least one of the at least one of the main flow path 2121 and the first conduit 2161. The outlet of at least one of the outlets is positioned. Referring more specifically to Figures 40 and 41, the second conduit 2163 in the reduced pressure delivery system 21u can include a plurality of conduits for flushing the main flow passages 2ΐ2 and the first conduit lake. In the flexible wall 211 7 , the end of the end portion opposite to the end of the decompression duct 2125 can be opened as shown in FIG. 119637.doc -48- 1325328 Now, covering the end of the flexible wall 2117 improves the effectiveness and reliability of the cleaning function. Preferably, at the covered end of the flexible wall and the end of the second conduit 2163 Between mention A headgap 2171. The headgap 2171 is capable of achieving accumulation of cleaning fluid during the cleaning process, which facilitates driving the flushing fluid through the main flow path 2121 into the first conduit 2161. Also illustrated in Figure 41 as an anti-blocking The spacer of the component 2135 "the centering spacer allows the main flow path 2121 to enter the two chambers again. This *the main manifold 2115 is blocked in one of the chambers. The JL can continue to operate when the cleaning cannot dissolve the blockage. Referring to Figures 49 and 50, the reduced pressure delivery system 2211 includes a primary manifold 2215 integral with the reduced pressure delivery tube 2217. The reduced pressure delivery tube 2217 includes a central lumen 2223 and a plurality of auxiliary lumens 2225. [Although the auxiliary lumen 2225 can be used to measure pressure at or near the tissue site, the auxiliary lumen can be further used to clean the central lumen. 2223 to prevent or dissolve obstructions. A plurality of apertures 2231 are in communication with the central lumen to distribute the reduced pressure delivered by the central lumen, such as φ Z . As shown in Figure 5G, it is preferred that the aperture does not pass through the auxiliary cavity 2225. The counterbore end of the reduced pressure delivery tube is also illustrated in Fig. 50, which forms a headspace 2241 outside the end of the auxiliary lumen 2225. If the tissue, stent or other material is kneaded to the end of the reduced pressure delivery tube 2217 during application of the reduced force, the headspace coffee will continue to allow delivery of cleaning fluid to the central lumen 2 2 2 3 . During use, the reduced-pressure delivery system 2iu described in Fig. 4CM0 can be directly used on the tissue site to reduce the distribution of the pressure to the tissue site. The low shape of the main gigaze is very advantageous for skin installation and removal. this

Il9637.doc -49- 1325328 The technique described. Similarly, the main manifold can also be embedded by surgery. Referring to the figure, the main manifolds 2115, 2215 can be used in conjunction with the auxiliary manifold. In Figure 51, the auxiliary manifold includes a two-layer puzzle. The first layer of contact of the auxiliary manifold 2321 - the placement of the bone tissue portion of the fracture site. The main manifold 2115 is placed in the _th layer, and the first layer of the auxiliary manifold is placed on top of the main manifold 2115 and the first layer. Auxiliary manifold twisting can achieve fluid communication between the primary manifold 2115 and the tissue site and still prevent direct contact between the tissue site and the primary manifold 2115. Preferably, the auxiliary manifold 2321 is bioabsorbable and the phantom assist manifold 2321 can remain in place after the decompression therapy is completed. Once the decompression treatment is completed, the main manifold 2115 can be removed from between the layers of the auxiliary manifold with little or no disturbance to the tissue site. In one embodiment, the primary officer may be coated with a lubricating material or a material that will form a hydrogel to facilitate removal of the primary manifold from between the layers. The auxiliary manifold is preferably used as a support for new tissue growth. As a scaffold, the auxiliary manifold may be composed of at least one material of the group consisting of: "lower (four)": polylactic acid, polyglycolic acid, polycaprolactone, polybutyric acid vinegar, polyvaleric acid, polydioxane Hexacyclic guanamine, p〇ly〇nh〇esthers, polyphosphazene, polyuric acid Sl, collagen 'hyaluronic acid, polyaminoglucose, gram-based limestone, calcium phosphate, calcium sulfate, calcium carbonate, bioglass , stainless steel, titanium, group, allograft and autologous tissue grafts. The cleaning function of the decompression transfer system 2m, 2211 described above can be used with any of the manifolds described herein. Manifold of pressure or 119637.doc • 50-1325328 The ability of the catheter to perform cleaning prevents the formation of obstructions that impede the pressure to reduce the pressure. When the pressure near the tissue site reaches equilibrium and the flow of fluid around the tissue site slows down, it is usually These obstructions are formed. It has been found that using air to clean the manifold and decompression catheter at a selected interval for a desired amount of time can help prevent or dissolve the obstruction.

More specifically, S, air is delivered via a second conduit that is separated from the first conduit that delivers the reduced pressure. One of the outlets of the second conduit is preferably adjacent to or adjacent to one of the outlets of the first conduit. Although air may be pressurized or pushed to the outlet of the second conduit, it is preferred to draw air through the second conduit by the reduced pressure at the tissue site. It has been found that in many cases, delivering air for six (2) seconds at intervals of sixty (60) seconds during application of reduced pressure is sufficient to prevent the formation of obstructions. This cleaning program provides sufficient air to adequately move the fluid in the manifold and the first conduit while preventing excessive air introduction. Introducing too much air, or introducing air at too high a frequency interval, will result in a decompression system that is sufficient to return to a reduced target pressure between wash cycles. The amount of time selected to deliver the cleaning fluid and the interval between the selected cleaning fluids will generally vary depending on the design and specifications of the system components (eg, pumps, tubes, etc.). However, the amount and frequency of delivery air should be high enough to adequately remove obstructions while still recovering full target abilities between wash cycles. Referring to Fig. 52', in an exemplary embodiment, a reduced pressure delivery system 24U includes a manifold 2415 that is fluidly coupled to a first conduit 24i9 and a second conduit 2423. The first conduit 2419 is connected to a reduced pressure 2429 to provide a reduced pressure to the manifold 2415. The second conduit includes 119637.doc -5]. 1325328 an outlet 2435, the outlet 2435 is positioned in fluid communication with the manifold 2415 and adjacent The outlet of the first conduit 2419. The second conduit 2423 is fluidly coupled to a valve 2439 which is capable of achieving communication between the second conduit 2423 and ambient air when the valve 2439 is placed in the open position. Valve 2439 is operatively coupled to a controller 2453 that is capable of controlling the opening and closing of valve 2439 to regulate cleaning of the second conduit using ambient air to prevent memory in manifold 2415 and first conduit 2419 In the obstruction.

It should be noted that any fluid (including liquids or gases) can be used to achieve the techniques described herein. Although the force for cleaning the fluid is preferably a suction formed by the reduced pressure at the tissue site, the fluid delivery member can also deliver the fluid in a similar manner, similar to that described with reference to Figure 9. Decompression tissue treatment of tissue sites in accordance with the systems and methods described herein can be accomplished by applying a sufficiently low pressure to the tissue site and then maintaining the sufficiently low pressure for a selected period of time. another

It is selected that the reduced pressure applied to the tissue site can be cyclic. More specifically, the magnitude of the applied reduced pressure may vary depending on the selected time cycle. Yet another method of applying the reduced pressure can randomly vary the magnitude of the reduced pressure. Similarly, the rate or amount of fluid delivered to the tissue site can be constant, periodic, or random. If it is periodic, the fluid delivery can be carried out during the application of the reduced pressure or during the cycle in which the reduced pressure is not applied. Although the magnitude of the reduced pressure applied to the tissue site will generally vary depending on the pathology of the tissue site and the environment in which the decompressed tissue treatment is performed, the reduced pressure is typically between about -5 mm Hg and -500 mm Hg but Better line between about 'mm 119637.doc -52- C 'ι 1325328

Hg is between -300 mm Hg. Although the systems and methods of the present invention are described above with reference to tissue growth and patient healing, it should be understood that such systems and methods for applying reduced pressure tissue treatment can be used in any living body in which tissue growth or healing is desired to be promoted. . Similarly, the systems and methods of the present invention are applicable to any tissue including, but not limited to, bone tissue, adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage tissue, tendon or ligament. Although tissue healing may be a focus of application of reduced-pressure tissue therapy as described herein, decompression tissue therapy (especially for tissues located beneath the patient's skin) may also be used in the absence of disease, defect or injury. Tissue growth is formed in the tissue. For example, it may be desirable to use a transdermal implant technique to apply reduced pressure tissue treatment to grow additional tissue at a tissue site and subsequently harvest the additional tissue. The harvested tissue can be transplanted to another tissue site to replace the diseased or damaged tissue, or alternatively the implanted tissue can be transplanted to another patient. It should be noted that the reduced pressure delivery device described herein can be combined with a stent material to increase the growth and growth rate of new tissue, which is also important. The stent material can be placed between the tissue site and the reduced pressure delivery device, or the reduced pressure delivery device itself can be made from a bioresorbable material that is used as a new tissue growth stent. It should be apparent from the above description that this document provides an invention with significant advantages. While the present invention has been shown in its several forms, the present invention is not limited thereto, but various modifications and changes can be made without departing from the spirit of the invention. 119637.doc -53- 1^25328 [Simple description of the drawing] This patent request (4) contains at least one color pattern. The patent or patent application publication with color drawings may be provided by the Patent Office upon request and after payment of the necessary fee. 1 is a perspective view of a reduced pressure delivery device having a plurality of protrusions extending from a flexible barrier to form a plurality of flow channels in accordance with the present invention; FIG. 2 is a diagram illustrating FIG. Figure 3 is a plan view of the reduced pressure conveying device shown in Figure 3; Figure 4 is a side view of the vacuum conveying device shown in Figure 4, the reduced pressure conveying device has a single tube Cavity decompression delivery tube; diagram showing the reduced pressure delivery device shown in the alternative - side view of an alternative embodiment 'the decompression delivery device has a double lumen decompression delivery tube; Figure 5 illustrates the decompression shown in Figure i Figure 6 illustrates a perspective view of a reduced pressure delivery device having a honeycomb material attached to a flexible barrier, in accordance with an embodiment of the present invention. The flexible barrier has a _ ridge portion and a pair of wing portions, the honeycomb material has a plurality of flow channels; FIG. 7 illustrates a front view of the pressure reducing conveying device shown in FIG. 6; The reduced pressure delivery device shown is cut at XVII-XVII Side view; [deg.]

Figure 8A is a cross-sectional front elevational view of a reduced-pressure delivery skirt in accordance with the present invention; Figure 5A is a side view of the reduced-pressure delivery device of Figure 8A; I19637.doc -54-:; ^ 1325328 FIG. 9 illustrates a front view of a reduced pressure delivery device for applying a reduced pressure tissue treatment to a patient's bone in accordance with an embodiment of the present invention; FIG. 10 depicts a colored tissue section of a rabbit skull, Showing raw, undamaged bones; Figure 11 illustrates a color tissue section of a rabbit skull showing granulation tissue induced after application of reduced pressure tissue treatment;

Figure 12 depicts a color tissue section of a rabbit skull showing deposition of new bone after application of reduced-pressure tissue treatment; it is shown in Figure 13 after a color tissue section of a rabbit skull is treated with decompressed tissue. Figure 14 depicts a color photograph of a rabbit skull in which two critical dimension defects are formed; Figure 15 illustrates a color photograph of the rabbit head # shown in Figure 14, which is shown embedded in one of the critical dimension defects Calcium phosphate scaffold and a stainless steel mesh covering the second critical dimension defect;

Figure 16 illustrates a color photograph of the skating bones of Figure 14 showing the application of reduced pressure tissue treatment to a critical size defect; Figure 17 illustrates the color tissue section of a rabbit skull after performing a heartbroken treatment. The tissue section shows the deposition of the new bone path in the calcium phosphate scaffold; Figure 18 shows the scaffold shown in Figure 15 after the implementation of the dust-removing group iron, 丄 丄.c _ ' and treatment, days and two weeks after the operation Filled with a radiograph of the missing phase J; Figure 19 shows the implementation of the decompression tissue 闰, &; 口 mouth, day and 12 weeks after the operation of the surgery shown in Figure 15 Radiograph of size defect; H9637.doc 1325328 FIG. 2A is a front elevational view of a reduced pressure delivery system having a manifold delivery tube that is used to pass through the skin, in accordance with an embodiment of the present invention. The reduced pressure delivery device is inserted into a tissue site; FIG. 21 illustrates an enlarged elevational view of the manifold delivery tube of FIG. 20, the manifold delivery tube including a reduced pressure delivery device having a resilient barrier and / or one in a compressed position Honeycomb material; Figure 22 depicts an enlarged front elevational view of the manifold delivery tube of Figure 21 showing the flexible barrier and/or honeycomb material of the reduced pressure delivery device after it has been pushed in from the manifold delivery tube Figure 23 illustrates a front view of a reduced pressure delivery system having a manifold for delivering a reduced pressure delivery device through a skin to a tissue site, in accordance with an embodiment of the present invention. The tube shows that the reduced pressure delivery t is placed outside the sig manifold tube but is constrained to a compression position by an impermeable membrane; FIG. 24 is a front view of the reduced pressure delivery system of FIG. The figure shows that the reduced pressure delivery device is outside the manifold tube but is constrained to a loose position by an impervious diaphragm; FIG. 25 illustrates a front view of the reduced pressure delivery system of FIG. The figure shows that the reduced pressure delivery device is outside the manifold tube but is constrained to an expanded position by an impermeable membrane; Figure 25A illustrates a front view of the reduced pressure delivery system of Figure 23, shown The reduction The pressure conveying device is located outside the manifold conveying pipe, but is surrounded by an impervious film at an expansion position; FIG. 26 illustrates a positive pressure 119637.doc-56 of the reduced pressure conveying system according to an embodiment of the present invention, 1325328 view, the reduced pressure delivery system has a manifold delivery tube for inserting a decompression-discharging device through the skin into a tissue site, the pressure reduction is shown in the figure = the delivery device is outside the manifold delivery tube, but Constrained by a j-film with a glue seal; V through Figure 26A illustrates rsr» of a reduced pressure delivery system in accordance with an embodiment of the present invention

Figure 27 illustrates a front view of a reduced pressure delivery system having a manifold delivery tube for injecting a delivery device through a skin to a tissue site, in accordance with an embodiment of the present invention. Figure 27A illustrates a front view of a reduced pressure delivery system in accordance with an embodiment of the present invention. The reduced pressure delivery system has a manifold delivery tube for delivering a reduced pressure delivery device to an tissue through the skin. Permeable film at the site; FIG. 28 is a flow chart showing a method for performing decompression tissue treatment on a tissue site according to an embodiment of the present invention;

29 is a flow chart showing a method for performing decompression tissue treatment on a _@ woven site according to an embodiment of the present invention; FIG. 30 is a view showing a method for performing decompression tissue treatment on a tissue site according to an embodiment of the present invention; FIG. 31 is a flow chart showing a method of performing decompression tissue treatment on a tissue site according to an embodiment of the present invention; FIG. 32 is a cross-sectional elevation view of a decompression roller device according to the present invention. In the figure, the reduced pressure delivery device comprises a hip prosthesis having a plurality of flow channels 'for applying a pressure of U9637.doc • 57· 1325328 to reduce the bone path surrounding the body; FIG. Illustrating a cross-sectional elevation view of the hip prosthesis of Figure 32, the prosthesis having a second plurality of flow channels for delivering fluid to a bone region surrounding the body prosthesis; Figure 34 depicts a Embodiments Flowchart of a method of repairing a joint of a patient using reduced pressure tissue treatment; FIG. 35 illustrates a cross-sectional elevation view of a reduced pressure delivery device in accordance with an embodiment of the present invention, the reduced pressure The delivery device comprises an orthopedic fixation device having a plurality of flow channels for applying a reduced pressure to a bone region adjacent to the orthopedic fixation device; FIG. 36 is a view of the orthopedic fixation device of FIG. A cross-sectional elevational view of the low profile surgical fixation device having a second plurality of flow channels for delivering fluid to the bone region adjacent the orthopedic fixation device; FIG. 37 illustrates an embodiment for use in accordance with an embodiment of the present invention A flow chart of a method for treating bone defects of bone using reduced pressure tissue treatment; FIG. 38 is a flow chart showing a method for performing decompression tissue treatment on a tissue site according to an embodiment of the present invention; and FIG. A flow chart of a method for performing decompression tissue treatment on a tissue site in accordance with an embodiment of the present invention is illustrated. 40-48 illustrate various views of a reduced pressure delivery system having a primary manifold including a flexible wall surrounding a primary flow channel and located therein, in accordance with an embodiment of the present invention A plurality of 孑L in the flexible wall; Figures 49-50 illustrate a perspective view and a top cross-sectional view of a reduced pressure wheeling 119637.doc • 58- - 1325328 system in accordance with an embodiment of the present invention, the reduced pressure delivery system a main manifold having _ & body connected to a reduced pressure delivery tube; FIG. 51 is a perspective view of the main manifold shown in FIG. 40-5 0 applied to a skeletal tissue portion together with an auxiliary manifold; Figure 52 illustrates a schematic diagram of a reduced pressure delivery system having a valve fluidly coupled to a second conduit, in accordance with one embodiment of the present invention. [Main component symbol description]

211 decompression delivery device or wing tube 213 flexible barrier 215 ridge portion 219 wing portion 223 arched channel 227 flexible backing 231 protrusion 233 flow channel 241 decompression delivery tube 243 distal aperture 255 proximal end Orifice 259 lumen or passage 261 double lumen 263 first - lumen 265 second lumen 271 horizontal spacer 311 decompression or pterygium 119637.doc • 59· 1325328 313 315 319 323 327 329 330 341

355 359 371 373 375 377 381 383 385 387 391 411 413 415 419 Flex barrier ridge part wing section arched channel honeycomb material distribution surface peripheral surface decompression duct distal orifice proximal orifice lumen or passage Decompression delivery device decompression delivery tube extension part distal incision shoulder protrusion inner surface flow channel decompression delivery device tissue part human bone decompression delivery tube 119637.doc 1325328

421 proximal end 427 decompression source 429 void defect 431 fluid delivery tube 432 proximal end 433 fluid delivery source 434 filter 435 pressure sensor 711 decompression delivery system 713 tissue site 721 manifold delivery tube 725 guide unit 727 guide metal Silk 731 Fracture site 733 Patient bone 735 Skin 739 Soft tissue 743 Tapered distal end 751 Path 761 Reduced pressure delivery device 765 Flexible barrier 767 Honeycomb material 769 Reduced pressure delivery tube 811 Reduced pressure delivery system 119637.doc -61 1325328

821 manifold duct 837 dotted line 843 distal end 861 decompression conveyor 865 flexible barrier 867 honeycomb material 869 decompression duct 871 impervious membrane 873 inner surface 881 marking 885 removal device 891 auxiliary lumen or tube 911 minus Pressure delivery system 921 manifold delivery line 937 dashed line 943 distal end 961 decompression delivery device 965 flexible barrier 967 honeycomb material 969 decompression delivery tube 971 impervious film 973 inner surface 977 rubber seal 981 standard 119637.doc -62 1325328

985 decompression conveying system 987 guiding wire 989 decompression conveying pipe 991 decompression conveying device 993 organization part 1011 decompression conveying system 1021 manifold conveying pipe 1025 organization part 1029 gap 1035 decompression conveying device 1043 remote end 1055 internal space 1057 Auxiliary lumen 1061 Guide wire 1511 Reduced pressure delivery device 1515 Orthopedic hip prosthesis 1517 Patient leg section 1521 Column section 1525 Head section 1529 Path 1535 Porous coating 1541 Flow channel 1543 Main feed line 1545 Lateral branch line 119637.doc - 63 - 1325328

1547 Transverse branch line 1551 Decompression line 1553 Reduced pressure supply 1565 Connection 埠1571 Fluid delivery tube 1573 Fluid delivery source 1583 Main feed line 1585 Transverse branch line 1711 Reduced pressure delivery device 1715 Orthopedic fixation device 1717 Bone 1719 Fracture 1721 Pathway 1725 Screw 1735 Perforated coating 1741 Flow channel 1743 Main feed line 1745 Connection 埠 1747 Lateral branch line 1751 Reduced pressure line 1753 Reduced pressure supply 1761 Flow channel 1765 Connection 埠 1771 Fluid transfer tube 119637.doc -64- 1325328

1773 Fluid delivery source 1783 Main feed line 1785 Transverse branch line 2111 Reduced pressure delivery system 2115 Main manifold 2117 Flexible wall 2121 Main flow path 2123 Proximal 2129 Transition zone 2135 Anti-blocking part 2137 Protrusion 2141 Inner surface 2145 Ridge 2149 Honeycomb Material 2155 Hole 2161 First conduit 2163 Second conduit 2171 Headspace 2211 Reduced pressure delivery system 2215 Main manifold 2217 Pressure relief tube 2223 Central lumen 2225 Auxiliary lumen 2231 Hole 119637.doc -65 1325328 2241 Top gap 2321 Auxiliary Tube 2411 Pressure Delivery System 2415 Manifold 2419 First Catheter 2423 Second Catheter 2429 Decompression Source 2435 Outlet 2439 Valve 2453 Controller

119637.doc -66

Claims (1)

X. Patent application scope: h kinds of decompression conveying system for decompressing tissue treatment in street-tissue site's includes: a squad wheel with at least two lumens; ^^' S has a plurality of a flow channel, the manifold is placed in a first lumen of the lumen of the manifold delivery tube; and a balloon having an interior space and capable of taking a collapsed and expanded position 'the internal space fluid connection a second lumen in the lumens of the manifold delivery tube. The reduced pressure delivery system of claim 1 further comprising a sharpened tip associated with the operative stalk for selectively puncturing the balloon. 3. The reduced pressure delivery system of claim 1, wherein the first and second lumens are substantially identical. 4. The reduced pressure delivery system of claim 1, further comprising a reduced pressure delivery tube fluidly coupled to at least one of the plurality of flow channels. 5. The reduced pressure delivery system of claim 4, wherein the reduced pressure delivery tube is disconnectable from the at least one flow channel. 6. The reduced pressure delivery system of claim 5, wherein the manifold is bioresorbable. 7. The reduced pressure delivery system of claim 4, further comprising a reduced pressure source fluidly coupled to the reduced pressure delivery tube. 8. The reduced pressure delivery system of claim 4, wherein a reduced pressure is applied to the at least one flow channel by the reduced pressure delivery tube. U9637.doc 9. The reduced pressure delivery system of claim 8, wherein the reduced pressure is applied cyclically. 10. 11. 12. 13. 14. 15. The reduced-pressure delivery system of claim 1, wherein the manifold is a conduit-pipe. The reduced pressure delivery system of claim 1, wherein the manifold delivery tube is a set of tubes. The reduced pressure delivery system of claim 1, further comprising a flag operatively attached to at least one of the manifold delivery tube and the manifold to cause the manifold delivery tube or the manifold The position is visualized relative to one of the tissue parts. The reduced pressure delivery system of claim 12, wherein the markers are radiopaque markers. The reduced pressure delivery system of claim 1, wherein the manifold further comprises: a flexible wall surrounding a main flow path and adapted to be placed against the tissue site 'the flexible wall comprising a plurality of flexures a wall and a hole communicating with the main flow path; an anti-blocking member positioned in the main flow path; a first conduit having at least one outlet fluidly connected to the main flow path for conveying the reduced pressure To the main flow passage; a second conduit having at least one outlet abutting the main flow passage or the at least one outlet of the first conduit to be in a gaseous fluid during application of the reduced pressure Cleaning at least one of the primary flow path and the outlet of the first conduit. The reduced pressure delivery system of claim 14, wherein the anti-blocking member is provided with H9637.doc 1325328 on the inner surface of the flexible wall and extending to a plurality of protrusions in the main flow path. The reduced pressure delivery system of claim 14, wherein the anti-blocking component is a honeycomb material that must be located within the main flow path. Such as the request item! The reduced pressure delivery system, wherein the manifold further comprises: a flexible barrier; a honeycomb material disposed adjacent to the flexible barrier, the honeycomb material comprising the plurality of flow channels; and a reduced pressure delivery tube And fluidly coupled to at least one of the plurality of flow channels. 18. The reduced pressure delivery system of claim 1, wherein the balloon is inflated by injecting a fluid into the interior space. 19. The reduced pressure delivery system of claim 1, wherein the tissue site comprises a hard tissue. 2. The reduced pressure delivery system of claim 1, wherein the tissue site comprises a soft tissue. 2 1 . A reduced-pressure delivery system for applying a reduced-pressure tissue treatment to a tissue site, comprising: an impermeable membrane having an internal space capable of taking a compressed and relaxed state; a tube having a plurality of flow passages positioned in the interior space of the impermeable membrane; and wherein the reduced pressure in the interior space of the impermeable membrane is less than the pressure external to the impermeable membrane To reduce the amount of space occupied by the manifold within the 119637.doc 1325328 permeable membrane. 22. The reduced pressure delivery system of claim 21, wherein the impermeable membrane is sealed to maintain the reduced pressure within the impermeable membrane. 23. The reduced pressure delivery system of claim 21, further comprising a reduced pressure source fluidly coupled to the interior space of the impermeable membrane to maintain the reduced pressure within the interior space. 24. The reduced pressure delivery system of claim 21, wherein the impermeable membrane is soluble upon contact with body fluids or body tissue. 25. A reduced pressure delivery system as claimed in claim 1, wherein the impermeable membrane is capable of adopting an expanded position to separate tissue adjacent to the tissue site. 26. The reduced pressure delivery system of claim 25, wherein the impermeable membrane is expanded by injecting a fluid into the interior space. 27. The reduced pressure delivery system of claim 21, further comprising an instrument having a sharp tip to selectively break the impermeable membrane. 28. The reduced pressure delivery system of claim 21, further comprising: - a seal ' disposed on the impermeable membrane; and - an means for propelling the manifold through the seal. 2 9. The reduced pressure delivery system of claim 2, further comprising a label operatively attached to at least the impervious membrane and the manifold to render the impervious The film or the manifold is visualized relative to the location of one of the tissue sites. 30. The reduced pressure delivery system of claim 29, wherein the markers are radiopaque. 31. The reduced pressure delivery system of claim 21, further comprising a reduced pressure delivery 119637.doc 1325328 tube having a distal end of at least one of the flow channels fluidly coupled to the manifold . 32. The reduced pressure delivery system of claim 3, further comprising a reduced pressure source fluidly coupled to a proximal end of the reduced pressure delivery tube to deliver a second reduced pressure to the at least A flow channel. 33. The reduced pressure delivery system of claim 32, wherein the second reduced pressure is applied cyclically. 34. The reduced pressure delivery system of claim 3, wherein the reduced pressure delivery tube is disconnectable from the at least one flow channel. 35. The reduced pressure delivery system of claim 34, wherein the manifold is bioresorbable. 36. The reduced pressure delivery system of claim 2, wherein the manifold further comprises: a flexible wall surrounding a main flow path and adapted to be placed against the tissue site, the flexible wall comprising a plurality of passes through a flexible wall and a hole communicating with the main flow path; an anti-blocking member positioned in the main flow path; a first conduit having at least one outlet fluidly connected to the main flow path to reduce a pressure is delivered to the main flow passage; a second conduit having at least one outlet abutting the main flow passage or the at least one outlet of the first conduit to use a fluid during application of the reduced pressure Cleaning at least one of the primary flow path and the outlet of the first conduit. 37. The reduced pressure delivery system of claim 36, wherein the anti-blocking member is disposed on an inner surface of the flexible wall and extends into the main flow path. 19637. (10, 1325328 number of protrusions 38. If the wish of the 36th reduction is reversed, the Guganshan-~ buckle side system, wherein the anti-blocking component is a honeycomb material that must be located in the main flow path. 39. A reduced pressure delivery system, wherein the flow system is a gas. 40. The reduced pressure delivery system of claim 36, wherein the flow system is a liquid. 41. The reduced pressure delivery system of claim 21, wherein the a stepped-flexible barrier; a honeycomb material attached to the flexible barrier, the honeycomb material comprising the plurality of flow channels; and a reduced pressure delivery tube fluidly coupled to the plurality of flow channels 42. The reduced pressure delivery system of claim 21, wherein the tissue site comprises a hard tissue. 4 3 . The reduced pressure delivery system of claim 2, wherein the tissue site comprises - soft tissue. 44. One for a tissue part A reduced pressure delivery system using reduced pressure tissue therapy, comprising: a manifold delivery tube having at least one passageway and a distal end, the distal end being positionable adjacent to the tissue site; a manifold having a plurality of flows a passageway configured to pass through the passage of the manifold delivery tube to the tissue site; and an impermeable membrane positioned at the distal end of the manifold delivery tube, the impermeable The film has an internal space and is capable of taking at least one of an expanded position and a collapsed position. I19637.doc .. -a.