SYSTEM FOR TREATING A WOUND
The invention relates to a system for treating a wound of a patient by suctioning wound fluid and/or rinsing the wound with a fluid, comprising a substantially airtight wound cover and fixing means provided on the wound cover, which extend on at least two sides of the wound cover.
Such a system is known from WO 03/070135. According to the system disclosed therein, an open wound is covered with an airtight foil, and wound fluid is removed by suctioning, or the wound is rinsed with water or a healing medium. To that end, the known wound cover is provided with one or more openings for supplying or discharging a fluid. This speeds up the healing process of the wound. The known wound cover is attached to the skin surrounding the wound by means of a double-sided adhesive tape. A drawback of this manner of attachment is that the adhesive tape may come loose after some time, so that air can find its way under the cover or rinsing medium can leak out.
Consequently it is an object of the invention to provide an improved manner of attaching the wound cover to the skin, which, in addition, is easy to apply.
Another object of the invention is to provide a system for treating a wound that further speeds up the healing process of the wound.
In order to accomplish that object, the fixing means comprise cords and/or straps, whose ends can be fastened together without any further means being required, or the fixing means
comprise engagement members provided on the wound cover, to which said cords and/or straps can be connected. Preferably, said straps at least partially consist of Velcro.
In a first implementation, the wound cover can be firmly attached to the skin by means of the cord and/or straps by arranging them round the part of the body with the wound and fastening them together.
In a second implementation, edges of the wound cover are attached to the skin near opposed edges of the wound, in particular to the fasci, and the cords and/or straps are used for pulling the opposed edges of the wound towards each other. This leads to an accelerated closure of the wound, whilst the treatment of the wound by rinsing or the removal of wound fluid by suctioning can be continued.
Consequently, the invention also relates to a method for closing an open wound of a patient, using fixing means comprising a fixing edge and cords and/or straps extending in a direction away from the fixing edge, wherein said fixing edge is attached to the skin at or near the edge of the wound on two sides by means of sutures, after which said cords and/or straps are interconnected and subsequently pulled tighter and tighter, after which the opposed edges of the wound are united by means of sutures.
Preferably, the fixing means furthermore comprise outwardly extending fixing edges that can be attached to the patient's body, in particular at or near the edge of the wound, by means of sutures. By providing the wound cover with a separate fixing edge, no holes through which fluid might leak are formed in the wound cover when the wound cover is being
attached to the skin. In addition, this edge can be made extra strong, so that it will not tear.
Preferably, engagement members and a fixing edge are made up of one fixing strip which is or which can be provided with several holes through which said cords and/or straps can be passed. Preferably, the fixing strip is connected to the wound cover between the holes. In this way a flexible system is obtained which can be used in several ways, depending on the use and the nature, the size and the shape of the wound. The fixing strip is preferably connected to the wound cover by means of welds.
The wound cover and/or the fixing strip is (are) preferably made of a plastic material that does not easily adhere to the wound. The fixing strip is preferably less flexible than the wound cover, and preferably it is provided with a strengthened part near its circumferential edge.
The invention further relates to a system for treating a wound of a patient, comprising fixing means provided with a fixing edge, which can be attached to the skin at or near the edge of the wound on two sides by means of sutures, wherein said fixing means furthermore comprise cords and/or straps extending in a direction away from the fixing edge, or wherein the fixing means comprise engagement members attached to the fixing edge, to which cords and/or straps can be connected. Said fixing means may be used in the manner as described above for closing a wound. In a preferred embodiment, 'the fixing means are connected to a wound cover, with fixing means being provided on at least two sides of the wound cover. In an especially preferred embodiment, the wound cover is made of a biodegradable material. In another
preferred embodiment, the wound cover is made of an air- permeable material. Within the framework of the invention, the term "suture" is understood to mean any conceivable form of uniting besides the traditional form of suturing by means of a surgical needle and thread.
The invention will now be explained in more detail by means of embodiments illustrated in the figures, in which like aspects are indicated by the same numerals, and in which:
Fig. 1 is a top plan view of an embodiment of a device for treating a wound/
Fig. 2 is a sectional view along the line II-II of the device for treating a wound that is shown in Fig. 1/ and
Fig. 3 shows a detail of the longitudinal sectional view of Fig. 2.
According to Figs. 1, 2 and 3, a wound treatment device 1 that can be placed on the skin 2 and over a wound 3 in a patient's skin 2 comprises a transparent wall 4 made of a flexible PVC foil. The size and the shape of the flexible wall 4 can readily be adapted by means of scissors. The surface of the foil that comes into contact with the wound 2 has a surface structure imprinted therein, so that it is not completely smooth, which helps to prevent the foil from adhering to or being sucked or pressed down onto the wound 2. A central portion 6 of the device 1, which is substantially oval in shape in this embodiment, is made of a double layer of such a flexible PVC foil, with the surfaces of two respective sides being partially bonded together. The bonded- together areas of the PVC foils are configured in such a
manner as to form an internal and inflatable continuous compartment comprising air cushions 5. The wall 4 that is formed in this manner is quite similar to an inflatable air mattress. In order to make it possible to fill this "mattress" with air, the compartment is provided with a valve 10, which is in communication with the air cushions 5. In an alternative preferred embodiment, the device comprises several separate compartments, which can each be filled separately. The wall 4 is furthermore provided with supply and discharge openings 8, 9 in the form of a plastic inlet and a plastic outlet, which may be identical. The openings 8, 9 are positioned between two sub-compartments 5, so that in principle an open communication between the environment and the space 13 between the wound the 3 and the wall 4 is created.
Fixing means are provided on the wall 4, around the central portion 6. Said fixing means comprise arcuate fixing strips 7, which are bonded to the wall 4 by means of circular welds 71. The fixing strips 7 are provided with holes 72 between said welds 71, so that fixing loops 74 are formed. In this way a fixing strip 7 has a fixing edge 73 that can be attached to 2 the patient's skin, and fixing loops 74 through which or under which the fastening cords or fastening straps, a for example Velcro, can be passed. The edges of the fixing strips 7, both the outer edges and the edges of the holes 72, are strengthened by means of a thickened portion so as to prevent tearing.
In a first application, the wound treatment device 1, and in particular the central portion 6, is laid over the wound. The foil 4 can be cut to size, if necessary. Fastening straps 75
provided with Velcro are passed through the holes 72 of the fixing strips 7, under the welds 74. Either the inner or the outer fixing strips 7 may be used, depending on the -size of the wound, the dimension of the part of the body in question, etc. The fastening straps 75 are passed round the part of the body in which the wound is present and fastened together. The compartment is filled with air and closed by means of the valve 10, so that the air cushions 5 are inflated. The advantages of such inflatable spacer elements are described in WO 03/070135.
A first treatment method consists of rinsing with a healing medium that is supplied via inlets 8 and discharged via outlets 9. Another treatment method, which can be used separately or in combination therewith, consists of removing wound fluid through the outlets 9 by suctioning. Both treatment methods are described in International patent publication WO 03/070135, the content of which is considered to be incorporated herein.
In a second application, for example in the case of open abdominal wounds, the central portion 6 of the wound treatment device 1 is laid in the wound after the foil 4 has been cut to size. The edges of the foil 4 are slid the abdominal wall. The fixing edges 73 of two opposed fixing strips 7 are attached to two opposed walls of the opening in the abdominal wall, in particular to the fasci, by means of sutures. Fastening straps 75 provided with Velcro are pulled through the holes 72 of two opposed fixing strips 7 and under the inner loops. Subsequently, the straps 75 are secured, with a pulling force being exerted on the opposed fixing strips 7. In this way the edges of the open wound are pulled towards each other. After some time, the straps 75 can be
pulled tighter and tighter, until the wound can be closed completely.
This manner of closing wounds may be combined with the methods of treating wounds that have been described above. It may be advantageous so use a biodegradable foil, so that the foil can remain behind in the abdominal cavity when the wound is closed. The foil 4 may also be left out, however, in situations in which the use of a foil is not necessary. In that case the system only consists of loose fixing strips 7.