WO1998001166A1 - Traitement de blessures - Google Patents

Traitement de blessures Download PDF

Info

Publication number
WO1998001166A1
WO1998001166A1 PCT/GB1997/001813 GB9701813W WO9801166A1 WO 1998001166 A1 WO1998001166 A1 WO 1998001166A1 GB 9701813 W GB9701813 W GB 9701813W WO 9801166 A1 WO9801166 A1 WO 9801166A1
Authority
WO
WIPO (PCT)
Prior art keywords
kit
wound
film
gel
agent
Prior art date
Application number
PCT/GB1997/001813
Other languages
English (en)
Inventor
Trisha Grocott
Simon Ashley Dixon
Martyn Edward Leat
Nada Walker
Duncan Gilding
Original Assignee
Innovative Technologies Limited
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 Innovative Technologies Limited filed Critical Innovative Technologies Limited
Priority to AU36266/97A priority Critical patent/AU3626697A/en
Publication of WO1998001166A1 publication Critical patent/WO1998001166A1/fr

Links

Classifications

    • 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
    • A61L15/44—Medicaments
    • 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
    • A61F13/02—Adhesive bandages or dressings
    • A61F13/023—Adhesive bandages or dressings wound covering film layers without a fluid retention layer
    • 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
    • A61L15/22—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
    • A61L15/28—Polysaccharides or their derivatives
    • 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
    • A61L15/38—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing enzymes
    • 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
    • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/20—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
    • A61L2300/252—Polypeptides, proteins, e.g. glycoproteins, lipoproteins, cytokines
    • A61L2300/254—Enzymes, proenzymes
    • 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
    • A61L2300/00—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40—Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/412—Tissue-regenerating or healing or proliferative agents

Definitions

  • the present invention relates to the treatment of chronic wounds of an irregular 3D nature.
  • the invention relates more particularly (but not exclusively) to the treatment of fungating carcinomas, i.e. cancers that erupt tluough the skin causing a continuous breakdown of surface tissues either by cancerous undermining or excess exudate levels eroding the periphery. All of these wounds are heavily colonised, predisposed to infections and malodorous. The wounds degrade the life of both the patient and the carer.
  • kits for the treatment of irregular 3D wounds comprising a breathable film which is of increased MVTR capability in the presence of liquid water as compared to moisture vapour only, and an agent for infection control.
  • the agent for infection control serves not only to control infection but also limit odour.
  • wounds to which the kit of the present invention is applicable include fungating carcinomas and diabetic ulcers.
  • the breathable film is preformed so as to be contoured to the portion of the body and/or the shape of the wound to which the dressing is to be applied.
  • contoured dressings may be formed, for example, by a dipping process using a former corresponding to the desired "shape" of the dressing and provide a convenient way of dressing an irregular 3D wound.
  • contoured dressings include two apertures (e.g. upper and lower apertures) such that exudate may be drained from one aperture and treatment agents introduced to the wound through the other aperture.
  • Exudate drainage may be by means of a tube attached to the film.
  • the tube may drain into a bag or the like.
  • a collar, flange or the like e./g. a (lal annular ring) located around the drainage aperture for the purpose of mounting the tube in position.
  • the bag may be mounted directly onto the film such that exudate passes through the aperture directly into the bag.
  • treatment agents which may be introduced through the other aperture (which may also be surrounded by a collar, flange or the like) include further infection control agent or iodine to clean the wound.
  • kit of the invention may include
  • the components (i)-(iii) may be used for filling or packing the wound so as to provide a more regular "structure" to which a flat breathable film may be applied. It is however also possible to incorporate one or more of components (i) to (iii) in a kit incorporating a pre-contoured film dressing.
  • Examples of (i) include absorbent fibrous materials such as alginates in any of a variety of formats, e.g. ropes, felt or wool.
  • Preferred examples of (I) comprise alginate fibres co-spun with at least one other polysaccharide as disclosed in WO-A- 96/10106 (Innovative Technologies).
  • a particular example of (ii) is an alginate gel.
  • Preferred examples of (ii) are compositions as disclosed in WO-A-96/13285 (Innovative Technologies) and our copending U.K. Patent Application No. 9609474.
  • examples of (iii) include foams and gels.
  • kit may incorporate a polysaccharide which may be applied as a spray (e.g. from an aerosol) to fill the wound.
  • a polysaccharide which may be applied as a spray (e.g. from an aerosol) to fill the wound.
  • the purpose of the film is lo cover the wound and block out odour.
  • the film also vents fluid from the wound, protects clothing from wound fluid and prevents ingress of dirt, bacteria and other micro-organisms into the wound.
  • the film may be provided with an adhesive (e.g. a patterned adhesive) which allows passage of moisture vapour tlirough the adhesive layer.
  • an adhesive e.g. a patterned adhesive
  • a relatively thick layer of adhesive may be required around the periphery of films to be used as dressings for fungating carcinomas in view of the very high levels of exudate.
  • the film is a breathable film which is increased MVTR capability in the presence of liquid water as compared to moisture vapour only.
  • MVTR in the presence of liquid water may be measured by ASTM E96BW whereas MVTR in the presence of moisture vapour alone may be measured by ASTM E96B (water method).
  • ASTM E96BW water method
  • the value of the breathability in the presence of liquid water is at least twice and preferably at least three times that in the presence of moisture vapour alone. The value may be up to 30 or 40 times that for moisture vapour alone.
  • the film will be of a material which has an MVTR in the presence of moisture vapour alone (ASTM E96B) of 2,000 to 2,500 g m "2 24hr ' ' and an MVTR in the presence of liquid water (ASTM E96BW) in the range 6,000 to 30,000 g m '2 24hr " ' (e.g. 600 to 10,000 g m "2 24hr " ').
  • the film will have a thickness of 30-70 microns more preferably 40-60 microns, e.g. about 50 microns.
  • the film may for example be of polyurethane. Suitable films are available from Alternative Technologies Limited under the designations B532. C542 and D562.
  • the agent for infection control comprises a solution or paste of a non-reducing sugar and iodine in a vehicle consisting essentially of a pharmacologically acceptable glycol and. optionally, water.
  • a composition is disclosed in WO-A-94/1781 1 ( cConn-Stern) and is referred to herein as a composition of the kind defined.
  • the principal use of the composition of the kind defined as disclosed in WO-A-94/1781 1 is in veterinary medicine, particularly the treatment of mastitis.
  • Other applications disclosed in WO-A-94/1781 1 include treatment of deep varicose vein ulcers, burns, and decubitus ulcers in human patients. All compositions disclosed in WO-A-94/1781 1 may be used in the present invention.
  • the agent for infection control may be a debride ent enzyme such as PHM-101 (ex Phairson Ltd.).
  • the infection control agenl may, for example, be provided in the form of an ointment, e.g. in a table. However, irrespective of its exact chemical formulation or physical form the agent is applied to the exposed surfaces ofthe wound.
  • the kit in accordance with the invention may be used, for example, for the treatment of diabetic ulcers but is particularly suitable for treatment of fungating carcinomas for which purpose it is particularly preferred that the agent for infection control is a composition of the kind defined.
  • the composition controls the infections and foul odour associated with fungating carcinomas without being toxic. Therefore according to a second aspect of the present invention there is provided the use of the composition of the kind defined for the manufacture of a medicament for the treatment of fungating carcinomas.
  • kits allow treatment to be tailored to the requirements of a particular patient and are substantially cheaper than conventionally used dressings which cost about £ 10- 100/patients/day and are not entirely effective.
  • the reason why the prior art dressings are not effective is that they tend to be flat rectangular sheets that do not have the conformability to fit the 3D structures of the fungating wound or the site, and leakage occurs around the edge. Disadvantages are overcome by the kits of the present invention.

Landscapes

  • Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Materials Engineering (AREA)
  • Epidemiology (AREA)
  • Chemical & Material Sciences (AREA)
  • Hematology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Medicinal Preparation (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

Abstract

Une trousse de traitement de blessures chroniques (par exemple un carcinome fongoïde) de forme tridimensionnelle irrégulière comprenant un film imper-respirant possède des qualités de perméabilité à l'humidité accrues en présence d'eau liquide, comparée à la vapeur d'eau uniquement, et un agent de contact infectieux.
PCT/GB1997/001813 1996-07-04 1997-07-04 Traitement de blessures WO1998001166A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU36266/97A AU3626697A (en) 1996-07-04 1997-07-04 Treatment of wounds

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB9614034.8A GB9614034D0 (en) 1996-07-04 1996-07-04 Treatment of wounds
GB9614034.8 1996-07-04

Publications (1)

Publication Number Publication Date
WO1998001166A1 true WO1998001166A1 (fr) 1998-01-15

Family

ID=10796343

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1997/001813 WO1998001166A1 (fr) 1996-07-04 1997-07-04 Traitement de blessures

Country Status (3)

Country Link
AU (1) AU3626697A (fr)
GB (1) GB9614034D0 (fr)
WO (1) WO1998001166A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0541251A1 (fr) * 1991-11-01 1993-05-12 Ferris Mfg., Corp. Pansement flexible
WO1996008223A1 (fr) * 1994-09-13 1996-03-21 Polymedica Industries, Inc. Pansements spirosorbants avec capacite de regulation des exsudats
WO1996013282A1 (fr) * 1994-10-27 1996-05-09 Innovative Technologies Limited Pansement
WO1996022753A1 (fr) * 1995-01-26 1996-08-01 Innovative Technologies Limited Pansement pour blessures
WO1997011658A1 (fr) * 1995-09-26 1997-04-03 Smith & Nephew Plc Pansement absorbant pouvant epouser diverses formes

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0541251A1 (fr) * 1991-11-01 1993-05-12 Ferris Mfg., Corp. Pansement flexible
WO1996008223A1 (fr) * 1994-09-13 1996-03-21 Polymedica Industries, Inc. Pansements spirosorbants avec capacite de regulation des exsudats
WO1996013282A1 (fr) * 1994-10-27 1996-05-09 Innovative Technologies Limited Pansement
WO1996022753A1 (fr) * 1995-01-26 1996-08-01 Innovative Technologies Limited Pansement pour blessures
WO1997011658A1 (fr) * 1995-09-26 1997-04-03 Smith & Nephew Plc Pansement absorbant pouvant epouser diverses formes

Also Published As

Publication number Publication date
GB9614034D0 (en) 1996-09-04
AU3626697A (en) 1998-02-02

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