US20200155379A1 - Component for wound dressing - Google Patents
Component for wound dressing Download PDFInfo
- Publication number
- US20200155379A1 US20200155379A1 US16/773,155 US202016773155A US2020155379A1 US 20200155379 A1 US20200155379 A1 US 20200155379A1 US 202016773155 A US202016773155 A US 202016773155A US 2020155379 A1 US2020155379 A1 US 2020155379A1
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- United States
- Prior art keywords
- wound
- layer
- absorbent component
- fibers
- foam
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
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- 230000002745 absorbent Effects 0.000 claims abstract description 51
- 239000002250 absorbent Substances 0.000 claims abstract description 51
- 210000000416 exudates and transudate Anatomy 0.000 claims description 45
- 239000000853 adhesive Substances 0.000 claims description 24
- 230000001070 adhesive effect Effects 0.000 claims description 24
- 239000000835 fiber Substances 0.000 claims description 21
- 230000005540 biological transmission Effects 0.000 claims description 8
- FHVDTGUDJYJELY-UHFFFAOYSA-N 6-{[2-carboxy-4,5-dihydroxy-6-(phosphanyloxy)oxan-3-yl]oxy}-4,5-dihydroxy-3-phosphanyloxane-2-carboxylic acid Chemical compound O1C(C(O)=O)C(P)C(O)C(O)C1OC1C(C(O)=O)OC(OP)C(O)C1O FHVDTGUDJYJELY-UHFFFAOYSA-N 0.000 claims description 6
- 229940072056 alginate Drugs 0.000 claims description 6
- 229920000615 alginic acid Polymers 0.000 claims description 6
- 235000010443 alginic acid Nutrition 0.000 claims description 6
- 150000004676 glycans Chemical class 0.000 claims description 6
- 229920001282 polysaccharide Polymers 0.000 claims description 6
- 239000005017 polysaccharide Substances 0.000 claims description 6
- 239000004753 textile Substances 0.000 claims description 6
- 229920000642 polymer Polymers 0.000 claims description 5
- 238000010521 absorption reaction Methods 0.000 claims description 4
- 239000001768 carboxy methyl cellulose Substances 0.000 claims description 4
- 238000000034 method Methods 0.000 claims description 4
- 229920002134 Carboxymethyl cellulose Polymers 0.000 claims description 3
- 229920001661 Chitosan Polymers 0.000 claims description 3
- ZZSNKZQZMQGXPY-UHFFFAOYSA-N Ethyl cellulose Chemical group CCOCC1OC(OC)C(OCC)C(OCC)C1OC1C(O)C(O)C(OC)C(CO)O1 ZZSNKZQZMQGXPY-UHFFFAOYSA-N 0.000 claims description 3
- 235000010948 carboxy methyl cellulose Nutrition 0.000 claims description 3
- 239000008112 carboxymethyl-cellulose Substances 0.000 claims description 3
- 239000002131 composite material Substances 0.000 claims description 3
- 239000001814 pectin Substances 0.000 claims description 3
- 235000010987 pectin Nutrition 0.000 claims description 3
- 229920001277 pectin Polymers 0.000 claims description 3
- 239000013464 silicone adhesive Substances 0.000 claims description 3
- 238000003475 lamination Methods 0.000 claims description 2
- 238000002604 ultrasonography Methods 0.000 claims description 2
- 239000000203 mixture Substances 0.000 claims 2
- 206010052428 Wound Diseases 0.000 description 75
- 208000027418 Wounds and injury Diseases 0.000 description 75
- 239000012530 fluid Substances 0.000 description 8
- 239000000463 material Substances 0.000 description 6
- 238000005516 engineering process Methods 0.000 description 4
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- 230000000717 retained effect Effects 0.000 description 4
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- 229920000742 Cotton Polymers 0.000 description 2
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- DPXJVFZANSGRMM-UHFFFAOYSA-N acetic acid;2,3,4,5,6-pentahydroxyhexanal;sodium Chemical compound [Na].CC(O)=O.OCC(O)C(O)C(O)C(O)C=O DPXJVFZANSGRMM-UHFFFAOYSA-N 0.000 description 2
- 125000002057 carboxymethyl group Chemical group [H]OC(=O)C([H])([H])[*] 0.000 description 2
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- KIUKXJAPPMFGSW-DNGZLQJQSA-N (2S,3S,4S,5R,6R)-6-[(2S,3R,4R,5S,6R)-3-Acetamido-2-[(2S,3S,4R,5R,6R)-6-[(2R,3R,4R,5S,6R)-3-acetamido-2,5-dihydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-2-carboxy-4,5-dihydroxyoxan-3-yl]oxy-5-hydroxy-6-(hydroxymethyl)oxan-4-yl]oxy-3,4,5-trihydroxyoxane-2-carboxylic acid Chemical compound CC(=O)N[C@H]1[C@H](O)O[C@H](CO)[C@@H](O)[C@@H]1O[C@H]1[C@H](O)[C@@H](O)[C@H](O[C@H]2[C@@H]([C@@H](O[C@H]3[C@@H]([C@@H](O)[C@H](O)[C@H](O3)C(O)=O)O)[C@H](O)[C@@H](CO)O2)NC(C)=O)[C@@H](C(O)=O)O1 KIUKXJAPPMFGSW-DNGZLQJQSA-N 0.000 description 1
- 229920003043 Cellulose fiber Polymers 0.000 description 1
- PTHCMJGKKRQCBF-UHFFFAOYSA-N Cellulose, microcrystalline Chemical group OC1C(O)C(OC)OC(CO)C1OC1C(O)C(O)C(OC)C(CO)O1 PTHCMJGKKRQCBF-UHFFFAOYSA-N 0.000 description 1
- 239000004677 Nylon Substances 0.000 description 1
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 1
- 206010053208 Wound decomposition Diseases 0.000 description 1
- 239000003522 acrylic cement Substances 0.000 description 1
- 238000004458 analytical method Methods 0.000 description 1
- 230000001580 bacterial effect Effects 0.000 description 1
- 230000004888 barrier function Effects 0.000 description 1
- DQXBYHZEEUGOBF-UHFFFAOYSA-N but-3-enoic acid;ethene Chemical compound C=C.OC(=O)CC=C DQXBYHZEEUGOBF-UHFFFAOYSA-N 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 230000001010 compromised effect Effects 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 229920001971 elastomer Polymers 0.000 description 1
- 239000005038 ethylene vinyl acetate Substances 0.000 description 1
- 229920006225 ethylene-methyl acrylate Polymers 0.000 description 1
- 239000005043 ethylene-methyl acrylate Substances 0.000 description 1
- 230000008020 evaporation Effects 0.000 description 1
- 238000001704 evaporation Methods 0.000 description 1
- 230000035876 healing Effects 0.000 description 1
- 229920002674 hyaluronan Polymers 0.000 description 1
- 229960003160 hyaluronic acid Drugs 0.000 description 1
- 239000000416 hydrocolloid Substances 0.000 description 1
- 230000037311 normal skin Effects 0.000 description 1
- 229920001778 nylon Polymers 0.000 description 1
- 229920001200 poly(ethylene-vinyl acetate) Polymers 0.000 description 1
- 229920001495 poly(sodium acrylate) polymer Polymers 0.000 description 1
- 229920000058 polyacrylate Polymers 0.000 description 1
- 229920000728 polyester Polymers 0.000 description 1
- 239000004627 regenerated cellulose Substances 0.000 description 1
- 238000005096 rolling process Methods 0.000 description 1
- 239000005060 rubber Substances 0.000 description 1
- 210000002966 serum Anatomy 0.000 description 1
- 235000019812 sodium carboxymethyl cellulose Nutrition 0.000 description 1
- 229920001027 sodium carboxymethylcellulose Polymers 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- NNMHYFLPFNGQFZ-UHFFFAOYSA-M sodium polyacrylate Chemical compound [Na+].[O-]C(=O)C=C NNMHYFLPFNGQFZ-UHFFFAOYSA-M 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 238000010998 test method Methods 0.000 description 1
- 230000003612 virological effect Effects 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F13/00—Bandages or dressings; Absorbent pads
- A61F13/15—Absorbent pads, e.g. sanitary towels, swabs or tampons for external or internal application to the body; Supporting or fastening means therefor; Tampon applicators
- A61F13/53—Absorbent pads, e.g. sanitary towels, swabs or tampons for external or internal application to the body; Supporting or fastening means therefor; Tampon applicators characterised by the absorbing medium
- A61F13/539—Absorbent pads, e.g. sanitary towels, swabs or tampons for external or internal application to the body; Supporting or fastening means therefor; Tampon applicators characterised by the absorbing medium characterised by the connection of the absorbent layers with each other or with the outer layers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/425—Porous materials, e.g. foams or sponges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
- A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
- A61L15/42—Use of materials characterised by their function or physical properties
- A61L15/60—Liquid-swellable gel-forming materials, e.g. super-absorbents
Definitions
- the present invention relates to a component for a wound dressing and in particular an absorbent component for a wound dressing, the component for use in direct contact with the wound.
- the present invention also relates to a wound dressing comprising the component as an absorbent component.
- wound dressings for use on exuding wounds.
- Such dressings manage the exudate produced by the wound in a variety of ways. For instance, some dressings, mainly those based on foam, manage exudate by absorbing the exudate and allowing the moisture taken up by the dressing to evaporate through the backing or top of the dressing.
- Such dressings are not designed to absorb and retain the exudate but to absorb and expel the exudate by moisture vapour transmission so that they maximise the level of exudate handled within the limitations of their design.
- a disadvantage of such dressings is that the lateral spread of the exudate across the dressing is not contained because of the nature of the open structure of the foam and this can cause normal skin surrounding the wound to become macerated as the whole of the dressing surface becomes saturated.
- a further disadvantage of the open structure of the foam is that when the dressing is put under pressure, for example when compression is applied or when force is applied to the dressing due to the patient sitting, lying or rolling over, the exudate can be squeezed out of the porous, open foam structure and into contact with the wound and/or surrounding skin surfaces creating the potential for peri-wound maceration and, in the case of chronic wounds, further wound breakdown due to damage caused by certain components of chronic wound exudate.
- a further disadvantage of such dressings is that rapid loss of exudate by evaporation can cause the wound surface to become desiccated over time which impedes healing.
- an absorbent component for a wound dressing which alleviates the above problems and there is provided by a first embodiment of the present invention an absorbent component for a wound dressing, the component comprising a wound contacting layer comprising gel forming fibres bound to a foam layer.
- absorbent components according to the invention may mitigate the problems associated with the management of exudate. This is achieved by the combined use of a wound contact layer which absorbs exudate by gelling so that lateral spread of the exudate is contained, with a foam layer which absorbs exudate but readily releases it through moisture vapour transmission.
- the absorbent wound contacting layer appears to control the fluid handling properties of the foam.
- the presence of the gel forming wound contact layer limits the lateral spread of exudate in the foam and increases its exudate retention compared to the use of foam alone.
- the moisture vapour transmission properties of the wound contacting layer may be improved.
- the wound contacting layer is present to transport wound fluid away from the wound and absorb it while containing the lateral spread of exudate.
- the absorbent component preferably has an absorbency of at least 10 g/g, preferably from 15 g/g to 50 g/g and most preferably an absorbency of from 20 g/g to 50 g/g.
- the wound contacting layer is fibrous and comprises gel-forming fibres. We have found that fibrous layers as opposed to polymeric layers have the advantage that they are especially able to gel block which resists the lateral spread of exudate. In addition exudate is absorbed rapidly and is retained under pressure.
- the fibres suitable for use in the absorbent layer of the present invention include hydrophilic fibres, which upon the uptake of wound exudate become moist and slippery and gelatinous and thus reduce the tendency of the surrounding fibres to stick to the wound.
- the fibres can be of the type which retain their structural integrity on absorption of exudate or can be of the type which lose their fibrous form and become a structureless gel or a solution upon absorption of exudate.
- the fibres are preferably chemically modified cellulose fibres and in particular spun sodium carboxymethylcellulose fibres or cellulose ethyl sulphonate fibres.
- the carboxymethylcellulose fibres are preferably as described in PCT WO/9312275 or GB93101258.
- the fibres may also be pectin fibres, alginate fibres and particularly those as described in WO94/17227 or EP433354 or EP476756 or composite fibres of alginate and polysaccharide such as those described in EP 0892863, chitosan fibres, hyaluronic acid fibres, or other polysaccharide fibres or fibres derived from gums.
- the cellulosic fibres preferably have a degree of substitution of at least 0.05 carboxymethyl groups per cellulose unit.
- the gel forming fibres for use in the present invention have an absorbency of either water or saline of at least 15 g/g as measured by the free swell absorbency method, more preferably at least 25 g/g or 50 g/g.
- the degree of substitution of the carboxymethylated cellulose gel forming fibres is preferably at least 0.2 carboxymethyl groups per cellulose unit, more particularly between 0.3 and 0.5.
- the gel forming fibres are preferably mixed to give a wound contacting layer comprising fibres of different absorbencies or properties.
- the wound contacting layer may comprise other fibres such as textile fibres which can be natural or synthetic, but are preferably cellulosic fibres for example viscose rayon, multi-limbed viscose, cotton or regenerated cellulose having a higher absorbency than most textile fibres.
- Textile fibres typically have an absorbency of less than 1 g/g when measured by the free swell absorbency test.
- the wound contacting layer can be made from a non woven, fibrous web formed by any of the following methods: needle punched, spunlaced, wet-laid, dry laid, meltblown or felted.
- the web can then be stitch bonded with strengthening fibres or yarns to provide additional strength to the layer such that it retains its structure when saturated with exudate. Additionally the stitchbonded structure may afford higher absorbency or a degree of extensibility to the dressing depending on the nature of the strengthening fibres and yarns used and their stitchbonding pattern.
- the wound contacting layer is preferably between 20 microns and 5 mm thick, more preferably 2 mm to 3 mm thick and even more preferably from 1 mm to 2 mm thick.
- the foam layer of the present invention is preferably a hydrophilic foam such as polyurethane and more preferably is a hydrophilic open celled foam such as those available from Polymer Health Technologies, Rynel or Filtrona and in particular Filtrona 30 W.
- the foam typically has a thickness of 0.25 mm to 5 mm, preferably from 1 mm to 4.0 mm and most preferably from 1.5 mm to 3 mm.
- the foam layer preferably has an absorbency of 10 to 20 g/g when measured by the free swell absorbency method (BS EN 13726-1:2002)
- the foam layer is bonded to the wound contacting layer preferably by a polymer based melt layer, by an adhesive, by flame lamination or by ultrasound.
- the foam layer may be directly bonded to the wound contact layer to make a laminate structure where the layers co-extend and are separated by the bonding line or the foam layer may form an island in the upper surface of the component surrounded by the wound contacting layer.
- a textile layer may be positioned between the wound contact layer and the foam layer to limit distortion of the component that may occur when the foam layer expands on absorption of exudate.
- the textile layer is preferably made from absorbent fibres such as polyester, nylon, or cotton which may contain superabsorbent components such as cross linked sodium polyacrylate or may be made from a superabsorbent fibre such as polyacrylate.
- a one-way wicking layer may be positioned between the wound contact layer and the foam layer to assist in the prevention of exudate rewetting the wound contact layer outside the area of the wound by transfer down from the foam towards the wound.
- the one-way wicking layer has the property that it resists the passage of exudate in one direction.
- the one-way wicking layer may be Tredegar Premium embossed perforated film made from ethylene-methyl acrylate/Ethylene vinyl acetate.
- a further aspect of the invention relates to a wound dressing comprising the absorbent component.
- the absorbent component contacts the wound so that the gel-forming fibres absorb and retain wound exudate and control the lateral spread of exudate adjacent the wound.
- the absorbent component forms an island in direct contact with the wound surrounded by a periphery of adhesive that adheres the dressing to the wound. The adhesive holds the absorbent component in direct contact with the wound and may seal the dressing to the skin surrounding the wound.
- the adhesive is preferably a silicone adhesive and more preferably a pressure sensitive silicone adhesive such as Dow Corning MD7-4502 or M67-9900.
- the adhesive may also be a hydrocolloid, polyurethane, rubber based adhesive or acrylic adhesive.
- the dressing may also comprise a film layer forming the outer surface of the dressing.
- the film layer has an MVTR of at least 1.500/m2/24 hrs.
- the film layer is present to provide a bacterial and viral barrier, control moisture vapour transmission and provide a low co-efficient of friction to the dressing.
- the dressing may also comprise additional optional layers.
- FIG. 1 is a cross sectional view of one embodiment of the wound dressing according to the invention.
- FIG. 2 is a cross sectional view of a further embodiment of the wound dressing according to the invention showing the foam as an island in the wound contacting layer;
- FIG. 3 is a cross sectional view of a further embodiment of the wound dressing according to the invention showing a one-way wicking layer separating the layers of the absorbent component.
- the wound dressing comprises an absorbent component 2 comprising a wound contacting layer 4 bonded to a foam layer 6 by an adhesive 8 .
- the component 2 is surrounded by an adhesive 10 so that the wound contacting layer 4 forms an island in the adhesive 10 .
- the dressing has a thin film backing 12 bonded to the component 2 and adhesive 10 by an adhesive 14 .
- FIG. 2 shows a wound dressing comprising an absorbent component 2 comprising a wound contacting layer 4 bonded to a foam layer 6 with an adhesive.
- the component 2 is surrounded by adhesive 10 , so that the wound contacting layer forms an island in the adhesive 10 .
- the dressing has a thin film backing 12 bonded to the component 2 and adhesive 10 by an adhesive 14 .
- the foam layer 6 of the component 2 is surrounded by the wound contacting layer 4 so that the foam is an island in the upper surface of the component 2 .
- FIG. 2 shows the foam 6 surrounded by a periphery 16 of the wound contact layer 4 .
- FIG. 3 shows a wound dressing comprising an absorbent component 2 comprising a wound contacting layer 2 bonded to a one-way wicking layer 18 which surrounds a foam layer 6 .
- the foam layer 6 forms an island in the one-way wicking layer 18 to assist in the prevention of the foam rewetting the wound contact layer.
- the surface of the absorbent component 2 furthest from the wound has an island of foam 6 surrounded by a periphery 20 of the one-way wicking layer.
- the component 2 is surrounded by an adhesive 10 so that the wound contacting layer 4 forms an island in the adhesive 10 .
- the thickness, absorbency, retension and lateral spread of the various layers of the wound dressing component were measured alone and in combination.
- Prototype construction began by bonding the relevant Hydrofibere and foam together using one layer of 20 gsm Vilmed and the Prestex PFC 320 set at 200° C. and a motor speed of 1. The completed sheets were then cut to shape using a cutter and Wallace Cutting Press. The various combinations of materials are detailed below.
- Hydrofibre® is a gel forming fibre sold in the product Aquacel® ex ConvaTec.
- Absorbency was measured as per BS EN 13726-1:2002 Test methods for primary wound dressings—Part 1: Aspects of Absorbency, Section 3.2.2 to 3.2.5. Following on from the absorbency test, the wet sample was removed from the balance and placed flat on to a perforated stainless steel plate and immediately covered by a weight equivalent to 40 mmHg (for a 5 cm ⁇ 5 cm sample, weight 1358 g). The weight was left in place for 1 minute before being removed and the sample reweighed.
- the material to be tested was placed on a flat surface and a rigid tube with internal diameter of 29 mm was placed on the centre and held in place. 20 mls of horse serum was injected into the tube and left for 60 seconds. After 60 seconds had elapsed, any non-absorbed fluid was removed from the material surface with a syringe before removing the vial. A ruler was placed below the dressing and a photograph taken with a digital camera. The area of lateral fluid spread was measured by analyses of photograph in an Image Analyses software package. The percentage lateral spread was calculated as follows:
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Abstract
Description
- The present invention relates to a component for a wound dressing and in particular an absorbent component for a wound dressing, the component for use in direct contact with the wound. The present invention also relates to a wound dressing comprising the component as an absorbent component.
- It is known to make wound dressings for use on exuding wounds. Such dressings manage the exudate produced by the wound in a variety of ways. For instance, some dressings, mainly those based on foam, manage exudate by absorbing the exudate and allowing the moisture taken up by the dressing to evaporate through the backing or top of the dressing.
- Such dressings are not designed to absorb and retain the exudate but to absorb and expel the exudate by moisture vapour transmission so that they maximise the level of exudate handled within the limitations of their design. A disadvantage of such dressings is that the lateral spread of the exudate across the dressing is not contained because of the nature of the open structure of the foam and this can cause normal skin surrounding the wound to become macerated as the whole of the dressing surface becomes saturated.
- A further disadvantage of the open structure of the foam is that when the dressing is put under pressure, for example when compression is applied or when force is applied to the dressing due to the patient sitting, lying or rolling over, the exudate can be squeezed out of the porous, open foam structure and into contact with the wound and/or surrounding skin surfaces creating the potential for peri-wound maceration and, in the case of chronic wounds, further wound breakdown due to damage caused by certain components of chronic wound exudate.
- A further disadvantage of such dressings is that rapid loss of exudate by evaporation can cause the wound surface to become desiccated over time which impedes healing.
- Other dressings, mainly those based on absorbents that gel, manage exudate by absorbing it and retaining it within the dressing. The moisture in the absorbent can still be lost by vapour transmission from the dressing, but less readily than with a foam absorbent because the exudate is retained and held within the gelled absorbent. As the absorbent is acting as a reservoir for exudate, it needs to have sufficient capacity to retain exudate throughout the wear time of the dressing. This affects the quantity of absorbent needed in the wound dressing which of course affects the thickness and conformability of the dressing overall. In addition, in general with gelling absorbents, particularly fibrous gelling absorbents, the relationship between the thickness of the gelling absorbent layer or its weight per unit area and its absorbency is not linear. This means that a careful balance needs to be struck between absorbency, conformability and moisture vapour transmission.
- There is a need for an absorbent component for use in wound dressings which is capable of absorbing exudate at the rate at which it is produced by the wound, which also does not cause maceration to the wound and skin surrounding the wound, which gives a reasonable wear time before needing to be replaced and which is conformable.
- We have now developed an absorbent component for a wound dressing which alleviates the above problems and there is provided by a first embodiment of the present invention an absorbent component for a wound dressing, the component comprising a wound contacting layer comprising gel forming fibres bound to a foam layer.
- We have found that absorbent components according to the invention may mitigate the problems associated with the management of exudate. This is achieved by the combined use of a wound contact layer which absorbs exudate by gelling so that lateral spread of the exudate is contained, with a foam layer which absorbs exudate but readily releases it through moisture vapour transmission.
- Surprisingly we have found that the absorbent wound contacting layer appears to control the fluid handling properties of the foam. We believe that the presence of the gel forming wound contact layer limits the lateral spread of exudate in the foam and increases its exudate retention compared to the use of foam alone. In turn the moisture vapour transmission properties of the wound contacting layer may be improved.
- The wound contacting layer is present to transport wound fluid away from the wound and absorb it while containing the lateral spread of exudate. The absorbent component preferably has an absorbency of at least 10 g/g, preferably from 15 g/g to 50 g/g and most preferably an absorbency of from 20 g/g to 50 g/g. The wound contacting layer is fibrous and comprises gel-forming fibres. We have found that fibrous layers as opposed to polymeric layers have the advantage that they are especially able to gel block which resists the lateral spread of exudate. In addition exudate is absorbed rapidly and is retained under pressure.
- The fibres suitable for use in the absorbent layer of the present invention include hydrophilic fibres, which upon the uptake of wound exudate become moist and slippery and gelatinous and thus reduce the tendency of the surrounding fibres to stick to the wound. The fibres can be of the type which retain their structural integrity on absorption of exudate or can be of the type which lose their fibrous form and become a structureless gel or a solution upon absorption of exudate.
- The fibres are preferably chemically modified cellulose fibres and in particular spun sodium carboxymethylcellulose fibres or cellulose ethyl sulphonate fibres. The carboxymethylcellulose fibres are preferably as described in PCT WO/9312275 or GB93101258. The fibres may also be pectin fibres, alginate fibres and particularly those as described in WO94/17227 or EP433354 or EP476756 or composite fibres of alginate and polysaccharide such as those described in EP 0892863, chitosan fibres, hyaluronic acid fibres, or other polysaccharide fibres or fibres derived from gums. The cellulosic fibres preferably have a degree of substitution of at least 0.05 carboxymethyl groups per cellulose unit.
- Preferably the gel forming fibres for use in the present invention have an absorbency of either water or saline of at least 15 g/g as measured by the free swell absorbency method, more preferably at least 25 g/g or 50 g/g. The degree of substitution of the carboxymethylated cellulose gel forming fibres is preferably at least 0.2 carboxymethyl groups per cellulose unit, more particularly between 0.3 and 0.5.
- The gel forming fibres are preferably mixed to give a wound contacting layer comprising fibres of different absorbencies or properties.
- The wound contacting layer may comprise other fibres such as textile fibres which can be natural or synthetic, but are preferably cellulosic fibres for example viscose rayon, multi-limbed viscose, cotton or regenerated cellulose having a higher absorbency than most textile fibres. Textile fibres typically have an absorbency of less than 1 g/g when measured by the free swell absorbency test.
- The wound contacting layer can be made from a non woven, fibrous web formed by any of the following methods: needle punched, spunlaced, wet-laid, dry laid, meltblown or felted. The web can then be stitch bonded with strengthening fibres or yarns to provide additional strength to the layer such that it retains its structure when saturated with exudate. Additionally the stitchbonded structure may afford higher absorbency or a degree of extensibility to the dressing depending on the nature of the strengthening fibres and yarns used and their stitchbonding pattern. The wound contacting layer is preferably between 20 microns and 5 mm thick, more preferably 2 mm to 3 mm thick and even more preferably from 1 mm to 2 mm thick.
- The foam layer of the present invention is preferably a hydrophilic foam such as polyurethane and more preferably is a hydrophilic open celled foam such as those available from Polymer Health Technologies, Rynel or Filtrona and in particular Filtrona 30 W. The foam typically has a thickness of 0.25 mm to 5 mm, preferably from 1 mm to 4.0 mm and most preferably from 1.5 mm to 3 mm. The foam layer preferably has an absorbency of 10 to 20 g/g when measured by the free swell absorbency method (BS EN 13726-1:2002)
- The foam layer is bonded to the wound contacting layer preferably by a polymer based melt layer, by an adhesive, by flame lamination or by ultrasound. The foam layer may be directly bonded to the wound contact layer to make a laminate structure where the layers co-extend and are separated by the bonding line or the foam layer may form an island in the upper surface of the component surrounded by the wound contacting layer. By forming an island of foam in the upper surface of the absorbent component in this way, the tendency of the foam to laterally spread the exudate in the foam layer and rewet the wound contacting layer is physically limited.
- A textile layer may be positioned between the wound contact layer and the foam layer to limit distortion of the component that may occur when the foam layer expands on absorption of exudate. The textile layer is preferably made from absorbent fibres such as polyester, nylon, or cotton which may contain superabsorbent components such as cross linked sodium polyacrylate or may be made from a superabsorbent fibre such as polyacrylate.
- A one-way wicking layer may be positioned between the wound contact layer and the foam layer to assist in the prevention of exudate rewetting the wound contact layer outside the area of the wound by transfer down from the foam towards the wound. The one-way wicking layer has the property that it resists the passage of exudate in one direction. The one-way wicking layer may be Tredegar Premium embossed perforated film made from ethylene-methyl acrylate/Ethylene vinyl acetate.
- A further aspect of the invention relates to a wound dressing comprising the absorbent component. In any wound dressing configuration, the absorbent component contacts the wound so that the gel-forming fibres absorb and retain wound exudate and control the lateral spread of exudate adjacent the wound. Preferably the absorbent component forms an island in direct contact with the wound surrounded by a periphery of adhesive that adheres the dressing to the wound. The adhesive holds the absorbent component in direct contact with the wound and may seal the dressing to the skin surrounding the wound.
- The adhesive is preferably a silicone adhesive and more preferably a pressure sensitive silicone adhesive such as Dow Corning MD7-4502 or M67-9900. The adhesive may also be a hydrocolloid, polyurethane, rubber based adhesive or acrylic adhesive.
- The dressing may also comprise a film layer forming the outer surface of the dressing. Preferably the film layer has an MVTR of at least 1.500/m2/24 hrs. The film layer is present to provide a bacterial and viral barrier, control moisture vapour transmission and provide a low co-efficient of friction to the dressing.
- The dressing may also comprise additional optional layers.
- Preferred embodiments of the invention will now be described by way of example with reference to the accompanying drawings in which:
-
FIG. 1 is a cross sectional view of one embodiment of the wound dressing according to the invention; -
FIG. 2 is a cross sectional view of a further embodiment of the wound dressing according to the invention showing the foam as an island in the wound contacting layer; and -
FIG. 3 is a cross sectional view of a further embodiment of the wound dressing according to the invention showing a one-way wicking layer separating the layers of the absorbent component. - Referring now to
FIG. 1 of the drawings, the wound dressing comprises anabsorbent component 2 comprising a wound contacting layer 4 bonded to a foam layer 6 by an adhesive 8. Thecomponent 2 is surrounded by an adhesive 10 so that the wound contacting layer 4 forms an island in the adhesive 10. The dressing has a thin film backing 12 bonded to thecomponent 2 and adhesive 10 by an adhesive 14. - Similarly
FIG. 2 shows a wound dressing comprising anabsorbent component 2 comprising a wound contacting layer 4 bonded to a foam layer 6 with an adhesive. Thecomponent 2 is surrounded by adhesive 10, so that the wound contacting layer forms an island in the adhesive 10. The dressing has a thin film backing 12 bonded to thecomponent 2 and adhesive 10 by an adhesive 14. The foam layer 6 of thecomponent 2 is surrounded by the wound contacting layer 4 so that the foam is an island in the upper surface of thecomponent 2.FIG. 2 shows the foam 6 surrounded by aperiphery 16 of the wound contact layer 4. -
FIG. 3 shows a wound dressing comprising anabsorbent component 2 comprising awound contacting layer 2 bonded to a one-way wicking layer 18 which surrounds a foam layer 6. The foam layer 6 forms an island in the one-way wicking layer 18 to assist in the prevention of the foam rewetting the wound contact layer. The surface of theabsorbent component 2 furthest from the wound has an island of foam 6 surrounded by aperiphery 20 of the one-way wicking layer. Thecomponent 2 is surrounded by an adhesive 10 so that the wound contacting layer 4 forms an island in the adhesive 10. - The thickness, absorbency, retension and lateral spread of the various layers of the wound dressing component were measured alone and in combination.
- Four prototypes were constructed. Prototype construction began by bonding the relevant Hydrofibere and foam together using one layer of 20 gsm Vilmed and the Prestex PFC 320 set at 200° C. and a motor speed of 1. The completed sheets were then cut to shape using a cutter and Wallace Cutting Press. The various combinations of materials are detailed below.
-
TABLE 1 Component details Foam Hydrofiber ® PHT 2.5 mm 100 gsm Hydrofiber ® PHT 5 mm 100 gsm Hydrofiber ® PHT 2.5 mm 210 gsm Hydrofiber ® PHT 5 mm 210 gsm Hydrofiber ® - Hydrofibre® is a gel forming fibre sold in the product Aquacel® ex ConvaTec.
- Absorbency was measured as per BS EN 13726-1:2002 Test methods for primary wound dressings—Part 1: Aspects of Absorbency, Section 3.2.2 to 3.2.5. Following on from the absorbency test, the wet sample was removed from the balance and placed flat on to a perforated stainless steel plate and immediately covered by a weight equivalent to 40 mmHg (for a 5 cm×5 cm sample, weight 1358 g). The weight was left in place for 1 minute before being removed and the sample reweighed.
- For determining the % Lateral Spread, the material to be tested was placed on a flat surface and a rigid tube with internal diameter of 29 mm was placed on the centre and held in place. 20 mls of horse serum was injected into the tube and left for 60 seconds. After 60 seconds had elapsed, any non-absorbed fluid was removed from the material surface with a syringe before removing the vial. A ruler was placed below the dressing and a photograph taken with a digital camera. The area of lateral fluid spread was measured by analyses of photograph in an Image Analyses software package. The percentage lateral spread was calculated as follows:
-
[(Lateral spread area/vial area)×100]−100 -
-
TABLE 2 Fluid absorbed/retained by dressing Fluid Absorbed Percentage per unit Retained Sample Details area(g/cm2) (%) Vilmed 0.011 43.87 100 gsm Hydrofiber 0.167 80.04 210 gsm Hydrofiber 0.274 91.50 2.5 mm PHT Foam 0.479 63.19 5 mm PHT Foam 0.779 68.88 100 gsm Hydrofiber□ 0.507 77.63 Laminated to 2.5 mm PHT Foam 100 gsm Hydrofiber□ 0.517 80.86 Laminated to 5 mm PHT Foam 210 gsm Hydrofider□ 0.747 74.81 Laminated to 2.5 mm PHT Foam 210 gsm Hydrofiber□ 0.780 77.12 Laminated to 5 mm PHT Foam - Results quoted are the mean of n=3
- It can be seen from the results that doubling the weight of the Hydrofiber or the thickness of foam does not increase the fluid absorbing properties of the materials by a factor of 2. Therefore increasing the thickness of either of these materials does not provide an optimum solution to increasing the absorbency of the dressing as conformability is compromised. Combining the technologies gives a synergy between absorbency and retention. It can also be seen that the PHT foams' ability to retain fluid is less than that of Hydrofiber.
-
TABLE 3 Lateral Spread Lateral Lateral Spread after 60 seconds Sample Details Spread % under 40 mmHg pressure 100 gsm Hydrofiber 12.20 216.69 210 gsm Hydrofiber 22.27 51.67 2.5 mm PHT Foam 64.99 748.58 5 mm PHT Foam 88.40 420.49 100 gsm Hydrofiber□ 28.56 205.04 Laminated to 2.5 mm PHT Foam 100 gsm Hydrofiber□ 30.03 147.29 Laminated to 5 mm PHT Foam 210 gsm Hydrofiber□ 15.59 41.18 Laminated to 2.5 mm PHT Foam 210 gsm Hydrofiber□ 29.18 45.13 Laminated to 5 mm PHT Foam - Results quoted are the mean of n=3.
- These results show that the wound contact layer controls lateral spread to a greater degree than does foam. Combining the wound contact layer and foam significantly reduces lateral wicking compared to foam alone.
Claims (21)
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2014
- 2014-08-06 HR HRP20140749AT patent/HRP20140749T1/en unknown
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2020
- 2020-01-27 US US16/773,155 patent/US20200155379A1/en active Pending
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US11135315B2 (en) | 2010-11-30 | 2021-10-05 | Convatec Technologies Inc. | Composition for detecting biofilms on viable tissues |
US11116884B2 (en) | 2010-12-08 | 2021-09-14 | Convatec Technologies Inc. | Integrated system for assessing wound exudates |
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US11740241B2 (en) | 2016-03-30 | 2023-08-29 | Synovo Gmbh | Construct including an anchor, an enzyme recognition site and an indicator region for detecting microbial infection in wounds |
US11723808B2 (en) | 2016-03-30 | 2023-08-15 | Convatec Technologies Inc. | Detecting microbial infections in wounds |
US11980693B2 (en) | 2016-04-08 | 2024-05-14 | Mölnlycke Health Care Ab | Composite materials in wound treatment |
US11596554B2 (en) | 2016-07-08 | 2023-03-07 | Convatec Technologies Inc. | Flexible negative pressure system |
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US11491042B2 (en) | 2017-11-09 | 2022-11-08 | 11 Health And Technologies Limited | Ostomy monitoring system and method |
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USD935477S1 (en) | 2018-11-08 | 2021-11-09 | 11 Health And Technologies Limited | Display screen or portion thereof with graphical user interface |
US11331221B2 (en) | 2019-12-27 | 2022-05-17 | Convatec Limited | Negative pressure wound dressing |
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Also Published As
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DK2498829T3 (en) | 2014-08-11 |
CA2780238A1 (en) | 2011-05-19 |
NZ599879A (en) | 2014-09-26 |
AU2010317789A1 (en) | 2012-05-31 |
GB0919659D0 (en) | 2009-12-23 |
JP2013509978A (en) | 2013-03-21 |
MX2012005373A (en) | 2012-06-13 |
US20130197460A1 (en) | 2013-08-01 |
US10543133B2 (en) | 2020-01-28 |
ES2489165T3 (en) | 2014-09-01 |
CA2780238C (en) | 2018-01-09 |
HRP20140749T1 (en) | 2014-10-10 |
PL2498829T3 (en) | 2014-10-31 |
AU2010317789B2 (en) | 2015-05-14 |
WO2011058311A1 (en) | 2011-05-19 |
PT2498829E (en) | 2014-08-25 |
EP2498829A1 (en) | 2012-09-19 |
EP2498829B1 (en) | 2014-05-07 |
JP5767236B2 (en) | 2015-08-19 |
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