WO2004112666A1

WO2004112666A1 - Dressing

Info

Publication number: WO2004112666A1
Application number: PCT/DE2004/001207
Authority: WO
Inventors: Stefan Rüster; Klaus Peters
Original assignee: Ruester Stefan; Klaus Peters
Priority date: 2003-06-13
Filing date: 2004-06-14
Publication date: 2004-12-29
Also published as: DE10327153A1; DE112004000979D2

Abstract

The invention relates to a dressing comprising a swab that can be placed against the wound and absorbs secretion therefrom, a means for pressing the swab against a wound, and a fastening means for locally fixing the dressing. The invention is characterized in that the pressing means is embodied as an open-pore or closed-pore foam material which can be deformed in an elastically reversible and delayed manner and is accommodated within the dressing between the swab and an outer cover layer that overlaps the swab.

Description

wound dressing

The invention relates to a wound dressing with a wound swab which can be applied to a wound, a pressure swab for pressing the swab against a wound and a fastening means for local fixation of the wound dressing in the area of the wound in accordance with the preamble of claim 1.

The invention relates in particular to a rapid wound dressing, a fast wound plaster or a compression bandage for rapid wound care. For example, it is a compression plaster, which quickly stops bleeding through metered compression, without stopping the blood circulation in the tissue.

Such compression bandages are such. For example, venous catheter / Braunülen implant wounds are required for taking blood samples. Small wounds and cuts

In the following, individual areas of application and methods for using such compression bandages are listed:

To stop bleeding after taking blood, a wound must be taped slightly compressively. In addition, the formation of "bruises" should be prevented. For this purpose, for example, a gauze swab is glued to an approx. 7 x 7 cm fixomull blank. This unit is glued to the wound. As a support, the patient holds his thumb on the patch to support the light compression. If cannulas and tubes are placed on the patient, several individual components are used. A combination of a gauze swab and an inelastic adhesive carrier is usually used for permanent fixation.

In the primary emergency care of heavily bleeding wounds, strongly compressive bandages are also used. Wrapping these bandages is difficult for inexperienced people. The bandage must not be too tight but not too loose, and must be done quickly.

In venous therapy, pressure is also required to relieve the surrounding veins after the obliteration of individual sick vessels or after the surgical removal. This pressure is often achieved by elastic bandages that are wrapped around the treated areas and at the same time fix the wound fabric flat and firmly over the vulner ulcer. The metered pressure is intended to promote the circulation in the vessels and thus facilitate the work of the venous valves. Problems generally arise in areas around joints on the musculoskeletal system. There it is often not possible to guarantee the necessary pressure and maximum freedom of movement at the same time.

The applications listed above have in common that they are composed of two or more components and that the application is sometimes time-consuming and impractical. Furthermore, the combination of several components takes time and experience to create the associations professionally.

Wound plasters have already been developed and optimized in many forms and conceivable variations. There are also some publications on the use of, for example, reversibly deformable materials in medicine. In surgery, for example laparoscopy, the reversible expansion of a material can be used to fill the openings and cavities after the organ has been removed. Due to the deformable flexible It is possible to insert this material into the patient through the smallest surgical openings and to remove it again (US Pat. 6,080,168). This supports the tissue close to the surgical field and separates it from the surgical site. Another application uses a compressive sponge to absorb wound fluids. Applications of this type are particularly required for highly secreting wounds, such as burn victims

Elastic bandages are also used in venous therapy. After surgical removal or obliteration of diseased vessels, an elastic bandage is wrapped around the diseased areas. The compresses close and protect the operating area. An inventive development describes the use of an elastic bandage equipped on one side with an expandable hydrocolloid layer US Pat. 5,006,401. The compression is brought about by the elastic bandage. The hydrocolloid layer sticks to the skin, making it easier to apply the bandage and optimally caring for the wound. Skillful wrapping achieves the required compression through the elasticity of the bandage.

This often results in differently stressed parts of one leg. If the compression is too strong, it can also lead to impaired blood circulation. In highly flexible parts of the body, e.g. in the squat, winding is ineffective.

A wound dressing is known from DE 195 12 005 A1 which, as a wound dressing, generates mechanical pressure through strongly swelling absorber particles by absorbing wound exudate. The pressure generated therefore depends heavily on the presence of wound fluid.

DE 695 17 876 T2 describes a wound dressing which contains an elastically compressible moisture-absorbing foam which is designed as a layer separated from the wound dressing in order to prevent the drainage of to ease liquid secretions from the wound. The foam is designed as a hydrophilic polyether polyurethane foam. Its compression and decompression properties are essentially static.

DE 692 29 940 T2 shows a foam for wound treatment that can be cured by the user during the application to produce a foam cushion. The foam material is preferably used together with a plaster cast. Due to its use of synthetic resin, the cured foam has a remaining resilience, which gives the foam a certain flexibility. The application of this foam is difficult because the curing is done by adding moisture. Use on open wounds is therefore not possible. The hardening also requires a setting time of several minutes, so that this application is at best an alternative or supplement to a plaster cast.

From US Re 29,487 earplugs formed from a polymer foam are known, which are used for hearing protection and which have a delayed reset speed for better adaptation to the auditory canals of the outer ear. This is between 1 and 60 seconds, with the material expanding from 60% to 40% compression. There is a slight pressure on the ear, on the one hand to adapt comfortably to the ear canal and on the other hand to achieve a higher noise reduction.

A corresponding material is specified in US Pat. No. 6,659,103, which additionally has a stiffening agent.

The invention has for its object to provide a simple wound dressing which is designed as a compression dressing, is easy to use and ensures an application-specific targeted compression and / or decompression effect. The wound dressing is also intended to seal the wound permanently and germ-free and to stop bleeding by means of slight compression, so that subsequent bleeding can be prevented by appropriately dosed pressure, as well as circulatory disorders due to excessive pressure.

This object is achieved by the invention specified in claim 1. Embodiments further developing the invention are specified in subclaims.

According to the invention, the pressure means is designed as an open or closed-pore foam material which is elastically reversibly deformable with a time delay and which is accommodated in the wound dressing between the wound swab and an outer covering layer projecting beyond the wound swab.

A wound dressing according to the invention enables high product benefits with only a small amount of material used. The wound dressing is inexpensive to manufacture and can be used on the patient with a minimum of time.

The swab serves to absorb wound secretions, e.g. Blood. It can be made of different materials. Cotton fleece, plastic fabrics, knitted fabrics, polyurethane foam or hydrogel with superabsorbents are possible, which stick to dry skin but not on the wound. The wound swab used in the invention is applied directly to the wound.

The invention can be used as a sterile or as a non-sterile variant. The wound swab can also be omitted in a simplified form, e.g. if the function of the wound secretion is not necessary or is taken over by the pressure medium.

The pressure medium, which is made, for example, of a polymer foam, is either positively or adhesively bonded to the wound swab. There are also any other joining techniques, such as ultrasonic welding, stapling or melting can be used. The shape of the pressure means can be designed in any way three-dimensional, the surfaces can be adapted to that of the patient, for example. This way you meet the special requirements of a special body.

The invention describes a material which can be elastically and / or partially elastically deformed by manual compression and whose deformation is reversibly or partially reversibly reduced in time. The material is particularly characterized by good processability, good handling, inexpensive to manufacture, ecological compatibility and sterilizability.

A material suitable for the purposes of the invention can be found in the aforementioned US Re 29,487. Foamed polymer foam with a density of 170 kg / m ³ is preferably used in the invention.

However, the decompression data mentioned in the cited document are not transferable to the invention. In the invention, the pressure medium is to be compressed as much as possible before application, for. B. to 20 - 25% of the initial volume. The thickness should be about 2 mm in the compressed state, which results in a thickness in the decompressed state of about 8 mm.

At about 40% decompression, the state of equilibrium should occur. In relation to the applications of the wound dressing, the state of equilibrium corresponds to a pressure of up to 100,000 pascals, preferably 1,000-30,000 pascals. For example, in a healthy person with a blood pressure of 150 mm Hg, surface pressures of approx. 20,000 Pascal result.

A self-adhesive or non-adhesive carrier material is preferably used to fix the wound dressing in the patient's wound area. This carrier material fixes the pressure element with the wound swab arri place of action. Furthermore, this should be inelastic in at least one direction, so that it can convert the force that develops during the delayed decompression of the pressure element into a slight pressure on the wound. An example is a product with the brand name Fixomull, which has precisely these properties.

The delayed decompression of the wound dressing according to the invention allows the user enough time to stick the wound plaster properly onto a wound. After e.g. B. the blood draw 15 minutes are enough for wearing the patch.

The advantages of delayed decompression over conventional foams are as follows:

- The combined product is already ready for use and can be used immediately.

- Depending on the application (venous or arterial), a previously defined pressure can be set.

- The defined pressure prevents e.g. B. bruises that can result from incorrect printing.

- The set pressure is reproducible and almost unaffected by application errors caused by incorrect use, e.g. B. by laypersons.

- The combined product is easy to use. When applying with a standard foam, you need 3 hands to close the puncture channel (2 hands to hold the adhesive film and one to flatten the foam). In the application according to the invention, one-handed application is also conceivable.

- If the area of the pressure area is larger than the area that can be pressed with the index finger and thumb, a defined pressure cannot be achieved with regular foam. The foam will then expand laterally and create space. - By slowly building up pressure to the necessary maximum pressure, the tissue is spared and can also have an analgesic effect.

- Creating z. B. Pressure bandages with elastic bandages require practice and some experience. Too strong and uneven wrapping is counterproductive. The application of pressure bandages is made considerably easier and safer by generating a uniform and sufficient pressure.

- When applying a wound plaster after taking blood with a standard foam with rapid decompression, it would theoretically be conceivable to first stick on one side, then squeeze the foam and then stick on the other side. However, the human skin is not rigid, but flexible, so it will depend on the application how much pressure is then generated. In the worst case, the patch may be too loose, even though both sides are glued on.

In a further embodiment, provision can also be made to incorporate in the wound dressing a non-elastic, but deformable area made of any suitable material, which is adapted to the body structure by deforming ("kneading") before or during application. It can also be provided that that this area hardens after a short time, corresponding to a plaster cast or a bandage, as specified, for example, in DE 692 29 940.

The principle of the invention is explained in more detail with reference to the figures described below, without wishing to restrict the invention unnecessarily. Show it:

Figure 1a, b side views of an inventive

Wound dressing in compressed and relieved state Figure 2 shows an embodiment in plan view

Figure 3 shows an embodiment with outer packaging in plan view Figure 4 is a fixation of cannulas and tubes

The basic principle of the application of the invention is shown in FIG. The wound dressing consists of a self-adhesive covering layer 1 for fixation on a wound. This can e.g. be made of a fixomull carrier, but also consist of other suitable materials.

The pressure medium 2 is applied centrally to the cover layer 1. This consists of a compressive foam, e.g. B. a polymer foam, but also other materials with similar properties are conceivable.

The pressure medium is equipped with a wound swab 3, the wound secretions such. B. should soak up blood. The swab may e.g. B. consist of a fleece. However, other fabrics or materials with similar properties are also conceivable.

The wound dressing is preferably applied in the following order:

First, the wound dressing is removed from the packaging 4 (see also FIG. 3). Then the pressure medium together with the wound dressing is compressed in a maximum compressive manner. The delayed decompression leaves enough time to remove existing release papers 5 (see FIG. 2) in order to apply the wound dressing to the wound. Decompression then exerts a pre-defined pressure on the wound.

Figure 1 b shows the relieved condition of the wound dressing, in which the fixed cover layer exerts pressure on the wound via the pressure medium.

FIG. 2 shows a perspective view of the wound dressing with release paper 5 on the underside. Figure 3 shows a packaged wound dressing. In a preferred embodiment, the packaging is a vacuum packaging which on the one hand ensures sterility and on the other hand already produces a compressed state of the wound dressing, so that the wound dressing can be used immediately after opening the packaging. No release paper is required, nor is compression necessary before application if the application takes place before decompression begins. Such a wound dressing is therefore particularly suitable for emergency medicine.

FIG. 4 shows the use of the wound dressing for fixing cannulas and tubes 6, 7. In this embodiment, the wound swab can be dispensed with.

reference numeral

1. Cover layer

2. Pressure medium

3. Swab

4. Packaging

5. Release paper

6. Hose

7. Cannula

Claims

Expectations

1. Wound dressing with a wound swab which can be applied to a wound, a pressure pad for pressing the wound swab against a wound and a fastening means for local fixation of the wound dressing, characterized in that the pressure means is an open or closed-pore foam material which can be deformed elastically and reversibly with a time delay is formed, which is accommodated in the wound dressing between the swab and an outer covering layer projecting beyond the swab.

2. Wound dressing according to claim 1, characterized in that the foam material is a polymer foam.

3. Wound dressing according to claim 1, characterized in that the cover layer also forms a self-adhesive carrier for fixation on the skin.

4. Wound dressing according to claim 1, characterized in that the cover layer forms an area of a wound dressing.

5. Wound dressing according to claim 1, characterized in that the decompression time of the pressure medium from the time of compression to the essentially complete return to the initial state is 0.05-5 min.

6. Wound dressing according to claim 5, characterized in that the decompression time is 0.1-1 min.

7. wound dressing according to claim 5 or 6, characterized in that the elastic modulus and / or the decompression property of the flat pressure medium can be selected differently within the surface or in the volume.

8. Wound dressing according to claim 1, received in an airtight packaging, characterized in that the packaging is designed as a vacuum packaging in which the wound dressing is received in the compressed state of the pressure medium.

9. wound dressing according to claim 1, 5, 6 or 7, characterized in that the pressure means is formed from a matrix of individual elements.

10. Wound dressing according to claim 9, characterized in that the individual elements have different elasticity and / or decompression properties.

11. Wound dressing according to claim 9, characterized in that the individual elements have different sizes and / or thicknesses.

12. Wound dressing according to claim 7, characterized in that a non-elastic deformable partial area is provided which is deformable in accordance with the body structure before or during an application.