WO1990009763A1 - Procede et dispositif pour refermer une plaie - Google Patents

Procede et dispositif pour refermer une plaie Download PDF

Info

Publication number
WO1990009763A1
WO1990009763A1 PCT/US1990/000990 US9000990W WO9009763A1 WO 1990009763 A1 WO1990009763 A1 WO 1990009763A1 US 9000990 W US9000990 W US 9000990W WO 9009763 A1 WO9009763 A1 WO 9009763A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheet
mating surface
sterile
wound
edge
Prior art date
Application number
PCT/US1990/000990
Other languages
English (en)
Inventor
Dietmar H. Wittmann
Original Assignee
Mcw Research Foundation, Inc.
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Mcw Research Foundation, Inc. filed Critical Mcw Research Foundation, Inc.
Publication of WO1990009763A1 publication Critical patent/WO1990009763A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B17/085—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound with adhesive layer
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound

Definitions

  • the present invention generally relates to a wound closing method and device. More particularly, it relates to a method and device for the temporary closing of a wound in such a manner that it can be opened and closed repeatedly.
  • the approximation of the fascia should be aimed as early as possible in order to avoid retraction of fascial and formation of incisional hernias. Due to the decreasing inflammatory edema as treatment progresses, a zipper or glider has to be replaced by a similar member with a smaller cloth side. In some cases replacements were necessary for more than 4 times as shown in a series of 100 cases of planned multiple re-operations.
  • the objects of the present invention are to disclose a simple, effective, improved method and device for the temporary closing of a wound or incision so that it can be subsequently opened and reclosed as needed.
  • the device of the present invention basically comprises a kit which comprises two flexible, trimmable sterile sheets packaged in a sterile container.
  • the first, flexible, trimmable sheet has a relatively smooth bottom for covering the wound, and a top surface which will mate with or form a bond with the bottom surface of the second, flexible, trimmable sheet.
  • the kit consists of a sterile package containing two sterile rectangular sheets of plastic Velcro material, each about 16 x 25 cm.
  • One sheet is characterized by having "hooks" on the bottom, while the other sheet has a top with “loops” to which the "hooks" attach when the two pieces are placed one upon the other with the "hooks" on the “loops”.
  • one edge of the first sheet is sutured to the abdominal wall fascia along one edge of an incision or wound with the top of the sheet with its mating surface ("loops") facing upward, and the relatively smooth bottom facing downward.
  • the first sheet preferably extends from one lateral edge of the fascia to the other side of the wound to provide maximum protection.
  • the second flexible, trimmable sheet is then sutured to the opposite fascia of the abdominal wound with the bottom mating surface ("hooks") facing downward.
  • a pulling pressure is exerted on each of the two sheets to pull the fascia under tension, and the mating surfaces are brought together to close the incision.
  • Intraabdominal organs may be protected during the process by covering the mating surfaces of the second sheet with a towel, as long as the abdomen is open. Subsequently, when the planned re-exploration and repair of the abdomen is performed, the bonds between the mating surfaces are broken and the sheets folded back to open the previously closed wound. If the wound is to be again temporarily closed, the process is reversed taking care to insure that both abdominal wall fasciae are again under tension so that they do not retract. When the wound is reclosed, the edges of the fasciae are closer together than originally and the unnecessary material of the sheets can be trimmed off and removed. The opening and closing can be repeated until the wound is ready to be permanently closed by a continuous suture.
  • the novel method of the present invention is cost effective as ' it better uses hospital resources and it reduces both mortality and morbidity.
  • Fig. 1 is a perspective view of a kit of the present invention
  • Fig. 2 is a perspective view showing the present invention closing an abdominal incision
  • Fig. 3 is a view taken along lines 3-3 in Fig. 2;
  • Fig. 4 is another view like Fig. 2 showing the device of the invention being trimmed with scissors to remove excess material;
  • Fig. 5 is a view like Fig. 2 showing the abdominal incision closed after trimming;
  • Fig. 6 is a perspective view of another embodiment of the kit of the present invention.
  • the kit 10 includes a sealed outer package 11 with a sterile interior which contains a sterile female sheet 12 and a sterile male sheet 13.
  • the female sheet 12 has a smooth bottom 14, and a top 15, which is adapted to mate with the bottom 16, of the male sheet 13.
  • the top 15, of the female sheet 12 is covered with a fuzzy, "looped” surface and the bottom 16, of the male sheet 13, is provided with a multitude of "hook-like” protuberances that mate with the fuzzy, looped surface to releasably bond the sheets together.
  • the sheets 12 and 13 should be made of a biocompatible, easily sterilized fabric which can be easily and securely sutured, and easily trimmed using conventional operating room instruments.
  • the sheets 12 and 13 are of a polyester material, and they are of contrasting colors to avoid confusion.
  • the preferred method of the present invention now will be described in conjunction with Figs. 2 to 5.
  • one edge of the female sheet 12 is attached with sutures 17, to one fascia 18 with the top or "fuzzy" side 15 up, i.e., so that the "fuzzy" side does not contact bowel wall, omentum, or other intraperitoneal organs.
  • FIG. 6 another embodiment of the kit is shown L. which the sheets 12' and 13' are provided with means fnr fascilitating suturing such as the row of apertures 20 : After the last procedure is completed the incision ca- closed by continuous suture through the fasciae using • ' monofil nylon string. No drains are usually requirer 4 It will be readily apparent to those skilled in the -art that a number of changes and modifications can be made without departing from the spirit and scope of the present invention. Therefore, it is intended that the invention be limited only by the claims.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Materials For Medical Uses (AREA)

Abstract

Un kit pour refermer provisoirement une incision abdominale consiste en un emballage contenant deux feuilles stériles (12, 13) dont les surfaces (15, 16) s'engagent de manière détachable. Ces feuilles peuvent être coupées et suturées aux bords d'une incision à l'aide du matériel conventionnel de salle d'opération. L'invention porte en outre sur un procédé pour refermer provisoirement une incision à l'aide des éléments mentionnés.
PCT/US1990/000990 1989-03-02 1990-02-26 Procede et dispositif pour refermer une plaie WO1990009763A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US31789489A 1989-03-02 1989-03-02
US317,894 1989-03-02

Publications (1)

Publication Number Publication Date
WO1990009763A1 true WO1990009763A1 (fr) 1990-09-07

Family

ID=23235721

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1990/000990 WO1990009763A1 (fr) 1989-03-02 1990-02-26 Procede et dispositif pour refermer une plaie

Country Status (1)

Country Link
WO (1) WO1990009763A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992007519A1 (fr) * 1990-10-31 1992-05-14 Martin Neumann Fermeture pour plaies
US5578045A (en) * 1992-01-21 1996-11-26 Regents Of The University Of Minnesota Septal defect closure device
US5743917A (en) * 1993-01-13 1998-04-28 Saxon; Allen Prosthesis for the repair of soft tissue defects
US6991643B2 (en) * 2000-12-20 2006-01-31 Usgi Medical Inc. Multi-barbed device for retaining tissue in apposition and methods of use
US7837706B2 (en) 2006-05-31 2010-11-23 Boston Scientific Scimed, Inc. Tissue attachment device, system, and method
US8469996B2 (en) 2000-09-05 2013-06-25 Dietmar H. Wittmann Prosthesis and method for lowering abdominal pressure
US8926603B2 (en) 2004-03-05 2015-01-06 Hansen Medical, Inc. System and method for denaturing and fixing collagenous tissue

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4825866A (en) * 1987-08-27 1989-05-02 Robert Pierce Wound closure device

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4825866A (en) * 1987-08-27 1989-05-02 Robert Pierce Wound closure device

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1992007519A1 (fr) * 1990-10-31 1992-05-14 Martin Neumann Fermeture pour plaies
US5578045A (en) * 1992-01-21 1996-11-26 Regents Of The University Of Minnesota Septal defect closure device
US6077291A (en) * 1992-01-21 2000-06-20 Regents Of The University Of Minnesota Septal defect closure device
US6077281A (en) * 1992-01-21 2000-06-20 Regents Of The University Of Minnesota Septal defect closure device
US5743917A (en) * 1993-01-13 1998-04-28 Saxon; Allen Prosthesis for the repair of soft tissue defects
US8469996B2 (en) 2000-09-05 2013-06-25 Dietmar H. Wittmann Prosthesis and method for lowering abdominal pressure
US6991643B2 (en) * 2000-12-20 2006-01-31 Usgi Medical Inc. Multi-barbed device for retaining tissue in apposition and methods of use
US8926603B2 (en) 2004-03-05 2015-01-06 Hansen Medical, Inc. System and method for denaturing and fixing collagenous tissue
US7837706B2 (en) 2006-05-31 2010-11-23 Boston Scientific Scimed, Inc. Tissue attachment device, system, and method

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