WO2009066116A1 - Dispositif pour suture sous-cutanée de plaies chirurgicales - Google Patents

Dispositif pour suture sous-cutanée de plaies chirurgicales Download PDF

Info

Publication number
WO2009066116A1
WO2009066116A1 PCT/HR2008/000036 HR2008000036W WO2009066116A1 WO 2009066116 A1 WO2009066116 A1 WO 2009066116A1 HR 2008000036 W HR2008000036 W HR 2008000036W WO 2009066116 A1 WO2009066116 A1 WO 2009066116A1
Authority
WO
WIPO (PCT)
Prior art keywords
suture
wound
needle
wavy
stitching
Prior art date
Application number
PCT/HR2008/000036
Other languages
English (en)
Inventor
Zelimir Obradovic
Original Assignee
Zelimir Obradovic
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 Zelimir Obradovic filed Critical Zelimir Obradovic
Publication of WO2009066116A1 publication Critical patent/WO2009066116A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0466—Suture bridges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • 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
    • A61B2017/081—Tissue approximator
    • 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
    • A61B2017/086—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 having flexible threads, filaments, laces or wires, e.g. parallel threads, extending laterally from a strip, e.g. for tying to opposing threads extending from a similar strip

Definitions

  • the device is meant for the stitching of surgical wounds by subcutaneous technique and completely replaces classical way of surgical stitching.
  • interrupted suture is a suture that is cut after it goes through the skin and tightens.
  • interrupted sutures such as:, simple interrupted suture, few kinds of mattress sutures, vertical and horizontal suture and so on.
  • Running suture is a suture that closes the whole wound in continuity without interruption or suture cutting.
  • running suture combined with the interrupted sutures technique.
  • the act of stitching is executed on following way: the needle, which is inserted from one side of the wound edge is pulled out of the wound and inserted into other side of the wound; when it's point comes to the other side of the cutting line, the needle is pulled out and the suture fastened by the. ⁇ sp&cigl technique to get the wound edges closer, while the suture remains tied without possibility of loosening of the suture.
  • the especial attention should be paid to the distance between the entry and the exit of the needle from the edge of the wound, distances between individual sutures along the wound, the angle under which the needle entries and exits, quantity and depth of the elaborated tissue /that dictates the choice of size, curve and cross-section of the needle/.
  • the thickness of the suture very important is the choice of the thickness of the suture, the strength of the tightening and tying ofj the suture and, of course, the tying technique and kind of the knot and its place on the wound. All mentioned is necessary to leave correctly adapted edges of the wound after tensing and tying of the suture. In case that the step occurs, due to irregular position of the edges of the wound, the wound will ii heal more slowly and irregular scar will occur.
  • the closure by metal clips has its advantages because of the simplicity and speed of the implementation, lesser reactions of the tissue towards the metal
  • Closing of the wound with adhesive foil is similar as the closing with the strips, however, the wound remains completely closed which causes the sweating under the foil, so the skin seems like "cooked”; further it causes the accumulation of secretion, the possibility for the infection is bigger.
  • the problem in the wound-closure is alternately stitching of first one and then of other side of the wound in the layer of the skin, because of the determining of the distance of entry and exit of the needle, so that both sides will be symmetrical and not folded over, because of the direction of the needle, that must always be parallel with the upper edge of the skin, because of the depth of every individual suture which can not be bigger than 3 mm and finally because of equal tension of the suture.
  • the wound edges are not equally adapted, so there is danger of wrong healing, and, in case of the loosening of the suture, of the stretching of wound edges.
  • the closure consists of the thin nylon suture, special skin needle and two small clips in different colors for the fixating of the suture visible above the skin, to prevent stretching of the wound edges, after the suture is tightened. i ;
  • the primary aim of the invention is that it completely replaces classical surgical technique of subcutaneous stitching. ; ⁇ ;
  • the secondary aim is equal stitching of the wound with as small scar as possible, and improved, simplified and fastened act of subcutaneous closure technique.
  • the device is meant for subcutaneous closure of the wound and completely replaces classical surgical way of closure by subcutaneous technique.
  • I! closing and fixing of the device by the very edge of the wound it presses the edges of the wound and places the skin in the wavy line identical to the wavy inner surface of the device. Positioning by the very edge defines the depth through which enters the surgical needle.
  • Picture2b Enlarged survey of the opening for the guiding needle entrance on convex contour ;
  • Guiding parts 3 are, by a firm connection, fixated to the guiding part fixed holders 4b on the part Ib, while freely sliding through the guiding part shallow holders 4a on the part Ia.
  • Both parts of the device Ia and Ib have, on the inner side; wavy surface made of convex 2a and concave 2b contours, and are constructed so that convex contours 2a of one part enter the concave contours 2b placed on the other part of the device.
  • wavy contours make wavy space 7 which on the beginning of each side has two pairs of narrowly positioned needles that function as an intake for straight surgical needle 8a and 8b, when the device is in the closed position.
  • Wavy surface is defined by the number of convex and concave contours 2a and 2b. Number of convex and concave contours in the given length of the device can be bigger or smaller what understands bigger or smaller radius of them.
  • the closure is made so that the i! opened device is positioned on both sides of the cutting wound 13 distanced from the edges of the wound depending of the thickness of the skin.
  • the device is closed so that the device parts Ia and Ib simply get closer to each other by sliding oil; the guiding parts 3.
  • the pair of driving needles on concave contours placed by upper and lower part end of the contour together with the wavy surface, transforms the wavy space 7 into virtual straight line space 16 through which runs a straight surgical needle with suture 9.
  • the device is positioned closer to the edge of the wound, while by the thicker skin it is distanced just for the thickness of the skin. If the wound is larger than the device, the device is, after the pulling through of the needle and suture, opened and moved further, and, in the same way positioned along the wound, and the needle with the suture pulls through the device until the suture is positioned through the whole wound. . . ,
  • the device can be made in more sizes and thickness of the device out of the inox steel which is used by the production of surgical devices or of the special firm plastic material with metal needles. If the device is made out of the metal, it can be used repeatedly and if it is made of plastics it can be made
  • I 1 to be used only once or more times.
  • the idea is to pack the device into sterile sets together with the device for holding and pushing of the needle, clips for the prevention of the pulling of the suture and "steri - strip" strips.
  • the mentioned technique demands only short medical education.
  • the device can be used outside of surgical institutes, in places where there is no surgically educated doctor. It can be used in ambulances of general practice and emergency rooms.
  • the simplicity of the appliance of the device enables completely new approach and large applicability, and, thanks to the simplicity of, the performance, the economical production which includes improvements relating to the given idea and does not demand bigger investments.

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)
  • Surgical Instruments (AREA)

Abstract

Les principaux objectifs de tout traitement d'une plaie sont sa fermeture rapide et adéquate et la formation d'une cicatrice esthétiquement acceptable. Lors d'un traitement chirurgical, la fermeture de la plaie avec cicatrice aussi peu visible que possible constitue le problème le plus important. Le dispositif de suture sous-cutanée de la peau permet la fermeture de plaies chirurgicales par une technique sous-cutanée et remplace complètement la voie chirurgicale classique de suture. Le dispositif consiste en deux parties (Ia et Ib) reliées par des parties de guidage (3) sur lesquelles elles coulissent lors de la fermeture et de la fixation sur la plaie (13). Les parties comportent des surfaces ondulées du côté interne munies de contours convexe (2a) et concave (2b) et dotées d'aiguilles de guidage s'interpénétrant et réalisant des zones ondulées (7) sur lesquels les bords de la plaie sont pressés suivant une ligne identique à la surface ondulée. Après fermeture du dispositif, les aiguilles de guidage et la surface ondulée s'arrondissent et transforment l'espace ondulé en une ligne droite virtuelle étroite (16) par laquelle passe l'aiguille chirurgicale droite avec la suture, laissant derrière elle une suture positionnée de manière rectiligne. Après l'ouverture du dispositif, la plaie reprend la position droite et la suture est positionnée suivant un trajet ondulé de type serpent. En tendant les deux côtés de la suture, les bords des plaies sont fermés par traction et la suture est terminée.
PCT/HR2008/000036 2007-11-21 2008-11-19 Dispositif pour suture sous-cutanée de plaies chirurgicales WO2009066116A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
HR20070533 HRPK20070533B3 (en) 2007-11-21 2007-11-21 Instrument for intradermal suturing of surgical wounds
HRP20070533A 2007-11-21

Publications (1)

Publication Number Publication Date
WO2009066116A1 true WO2009066116A1 (fr) 2009-05-28

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/HR2008/000036 WO2009066116A1 (fr) 2007-11-21 2008-11-19 Dispositif pour suture sous-cutanée de plaies chirurgicales

Country Status (2)

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HR (1) HRPK20070533B3 (fr)
WO (1) WO2009066116A1 (fr)

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011150847A1 (fr) * 2010-06-02 2011-12-08 四川立辰医药科技有限责任公司 Appareil de fermeture de plaie cutanée
CN102599951A (zh) * 2012-04-13 2012-07-25 张立 皮肤伤口锁合器
CN102811671A (zh) * 2009-09-17 2012-12-05 锡普莱恩医疗有限公司 快速闭合用外科闭合装置
CN103654893A (zh) * 2013-12-27 2014-03-26 甘肃锦东生物科技有限公司 医用调节式伤口缝合器
WO2014070922A1 (fr) 2012-10-31 2014-05-08 Zipline Medical, Inc. Incision chirurgicale et appareil de fermeture
CN103919584A (zh) * 2014-04-23 2014-07-16 曾梓 伤口缝合器
CN103932745A (zh) * 2014-02-12 2014-07-23 平荧 桥式牵引瘢痕治疗器
CN103948407A (zh) * 2014-05-20 2014-07-30 重庆博维生物技术有限公司 一种创口闭合器
CN104127212A (zh) * 2014-06-26 2014-11-05 汪世琼 一种伤口缝合器
WO2015143477A1 (fr) * 2014-03-24 2015-10-01 Whalan Comus Appareil et procédé de suture sous-cutanée continue
WO2015164923A1 (fr) * 2014-04-29 2015-11-05 Roffe Medical Holdings Pty Ltd Procédé et appareil de fermeture de tissu
US9474529B2 (en) 2011-11-01 2016-10-25 Zipline Medical, Inc. Surgical incision and closure apparatus
US9561034B2 (en) 2011-11-01 2017-02-07 Zipline Medical, Inc. Surgical incision and closure apparatus
US10010710B2 (en) 2009-09-17 2018-07-03 Zipline Medical, Inc. Rapid closing surgical closure device
US10123801B2 (en) 2011-11-01 2018-11-13 Zipline Medical, Inc. Means to prevent wound dressings from adhering to closure device
CN109077767A (zh) * 2013-07-24 2018-12-25 奇普林医药公司 外科切口和闭合设备
CN109620327A (zh) * 2018-12-29 2019-04-16 李皓峰 扣式皮肤牵张器及皮肤牵张方法
CN109893185A (zh) * 2019-03-08 2019-06-18 中南大学湘雅三医院 缝合装置
WO2020057113A1 (fr) * 2018-09-20 2020-03-26 上海锦辰医药科技有限公司 Dispositif de fermeture de plaie
US10888269B2 (en) 2014-01-05 2021-01-12 Zipline Medical, Inc. Instrumented wound closure device
US10918332B2 (en) 2016-10-31 2021-02-16 Zipline Medical, Inc. Systems and methods for monitoring physical therapy of the knee and other joints
US11051988B2 (en) 2010-06-14 2021-07-06 Zipline Medical, Inc. Methods and apparatus for inhibiting scar formation
US11849415B2 (en) 2018-07-27 2023-12-19 Mclaren Applied Technologies Limited Time synchronisation
US11898874B2 (en) 2019-10-18 2024-02-13 Mclaren Applied Technologies Limited Gyroscope bias estimation

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4535772A (en) * 1983-03-10 1985-08-20 Kells Medical, Incorporated Skin closure device
US5127412A (en) * 1990-03-14 1992-07-07 Cosmetto Aristodeme J Skin tensioning
WO1994010916A1 (fr) * 1991-02-13 1994-05-26 Medchem Products, Inc. Appareil de fermeture de plaies larges par etirage de la peau
EP0598976A2 (fr) * 1992-10-27 1994-06-01 American Cyanamid Company Instrument chirurgical pour suture en cordon de bourse et méthode
US5534008A (en) * 1994-09-28 1996-07-09 Acksel; Ione Suturing guide and clamp
US20040133216A1 (en) * 2003-01-03 2004-07-08 Wulc Allan E. Surgical instrument for endoscopic suturing of deep subcutaneous tissue
WO2006047563A2 (fr) * 2004-10-25 2006-05-04 Deland Jonathan T Guide de suture
WO2007011039A1 (fr) * 2005-07-22 2007-01-25 Olympus Corporation Element de maintien, systeme de traitement par endoscope et appareil de suture pour une utilisation dans un endoscope

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4535772A (en) * 1983-03-10 1985-08-20 Kells Medical, Incorporated Skin closure device
US5127412A (en) * 1990-03-14 1992-07-07 Cosmetto Aristodeme J Skin tensioning
WO1994010916A1 (fr) * 1991-02-13 1994-05-26 Medchem Products, Inc. Appareil de fermeture de plaies larges par etirage de la peau
EP0598976A2 (fr) * 1992-10-27 1994-06-01 American Cyanamid Company Instrument chirurgical pour suture en cordon de bourse et méthode
US5534008A (en) * 1994-09-28 1996-07-09 Acksel; Ione Suturing guide and clamp
US20040133216A1 (en) * 2003-01-03 2004-07-08 Wulc Allan E. Surgical instrument for endoscopic suturing of deep subcutaneous tissue
WO2006047563A2 (fr) * 2004-10-25 2006-05-04 Deland Jonathan T Guide de suture
WO2007011039A1 (fr) * 2005-07-22 2007-01-25 Olympus Corporation Element de maintien, systeme de traitement par endoscope et appareil de suture pour une utilisation dans un endoscope
EP1908424A1 (fr) * 2005-07-22 2008-04-09 Olympus Corporation Element de maintien, systeme de traitement par endoscope et appareil de suture pour une utilisation dans un endoscope

Cited By (44)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10010710B2 (en) 2009-09-17 2018-07-03 Zipline Medical, Inc. Rapid closing surgical closure device
CN102811671A (zh) * 2009-09-17 2012-12-05 锡普莱恩医疗有限公司 快速闭合用外科闭合装置
JP2015013214A (ja) * 2009-09-17 2015-01-22 ジップライン メディカル， インコーポレイテッド 迅速閉鎖の外科的閉鎖デバイス
US10159825B2 (en) 2009-09-17 2018-12-25 Zipline Medical, Inc. Rapid closing surgical closure device
WO2011150847A1 (fr) * 2010-06-02 2011-12-08 四川立辰医药科技有限责任公司 Appareil de fermeture de plaie cutanée
US8915942B2 (en) 2010-06-02 2014-12-23 Sichuan Lichen Medical & Pharmaceutical Technology Co., Ltd. Skin wound closure apparatus
US11051988B2 (en) 2010-06-14 2021-07-06 Zipline Medical, Inc. Methods and apparatus for inhibiting scar formation
US10456136B2 (en) 2011-11-01 2019-10-29 Zipline Medical, Inc. Surgical incision and closure apparatus
US9642622B2 (en) 2011-11-01 2017-05-09 Zipline Medical, Inc. Surgical incision and closure apparatus
US10123801B2 (en) 2011-11-01 2018-11-13 Zipline Medical, Inc. Means to prevent wound dressings from adhering to closure device
US10123800B2 (en) 2011-11-01 2018-11-13 Zipline Medical, Inc. Surgical incision and closure apparatus with integrated force distribution
US11439395B2 (en) 2011-11-01 2022-09-13 Zipline Medical, Inc. Surgical incision and closure apparatus
US9642621B2 (en) 2011-11-01 2017-05-09 ZipLine Medical, Inc Surgical incision and closure apparatus
US9561034B2 (en) 2011-11-01 2017-02-07 Zipline Medical, Inc. Surgical incision and closure apparatus
US9554800B2 (en) 2011-11-01 2017-01-31 Zipline Medical, Inc. Surgical incision and closure apparatus
US9474529B2 (en) 2011-11-01 2016-10-25 Zipline Medical, Inc. Surgical incision and closure apparatus
US9554799B2 (en) 2011-11-01 2017-01-31 Zipline Medical, Inc. Surgical incision and closure apparatus
CN102599951A (zh) * 2012-04-13 2012-07-25 张立 皮肤伤口锁合器
EP2914183A4 (fr) * 2012-10-31 2016-08-10 Zipline Medical Inc Incision chirurgicale et appareil de fermeture
WO2014070922A1 (fr) 2012-10-31 2014-05-08 Zipline Medical, Inc. Incision chirurgicale et appareil de fermeture
EP3574848A1 (fr) * 2012-10-31 2019-12-04 Zipline Medical, Inc. Appareil d'incision et de fermeture chirurgicales
CN109077767A (zh) * 2013-07-24 2018-12-25 奇普林医药公司 外科切口和闭合设备
CN103654893B (zh) * 2013-12-27 2015-12-16 甘肃锦东生物科技有限公司 医用调节式伤口缝合器
CN103654893A (zh) * 2013-12-27 2014-03-26 甘肃锦东生物科技有限公司 医用调节式伤口缝合器
US10888269B2 (en) 2014-01-05 2021-01-12 Zipline Medical, Inc. Instrumented wound closure device
US11844625B2 (en) 2014-01-05 2023-12-19 Zipline Medical, Inc. Instrumented wound closure device
CN103932745A (zh) * 2014-02-12 2014-07-23 平荧 桥式牵引瘢痕治疗器
WO2015143477A1 (fr) * 2014-03-24 2015-10-01 Whalan Comus Appareil et procédé de suture sous-cutanée continue
CN103919584A (zh) * 2014-04-23 2014-07-16 曾梓 伤口缝合器
US10441261B2 (en) 2014-04-29 2019-10-15 Roffe Medical Holdings Pty Ltd. Tissue closing method and apparatus
WO2015164923A1 (fr) * 2014-04-29 2015-11-05 Roffe Medical Holdings Pty Ltd Procédé et appareil de fermeture de tissu
CN103948407A (zh) * 2014-05-20 2014-07-30 重庆博维生物技术有限公司 一种创口闭合器
CN104127212A (zh) * 2014-06-26 2014-11-05 汪世琼 一种伤口缝合器
US11033270B2 (en) 2015-08-07 2021-06-15 Zipline Medical, Inc. Means to prevent wound dressings from adhering to closure device
US11337649B2 (en) 2016-10-31 2022-05-24 Zipline Medical, Inc. Systems and methods for monitoring physical therapy of the knee and other joints
US10918332B2 (en) 2016-10-31 2021-02-16 Zipline Medical, Inc. Systems and methods for monitoring physical therapy of the knee and other joints
US11992334B2 (en) 2016-10-31 2024-05-28 Zipline Medical, Inc. Systems and methods for monitoring physical therapy of the knee and other joints
US11849415B2 (en) 2018-07-27 2023-12-19 Mclaren Applied Technologies Limited Time synchronisation
WO2020057113A1 (fr) * 2018-09-20 2020-03-26 上海锦辰医药科技有限公司 Dispositif de fermeture de plaie
CN109620327A (zh) * 2018-12-29 2019-04-16 李皓峰 扣式皮肤牵张器及皮肤牵张方法
CN109620327B (zh) * 2018-12-29 2024-04-30 李皓峰 扣式皮肤牵张器及皮肤牵张方法
CN109893185A (zh) * 2019-03-08 2019-06-18 中南大学湘雅三医院 缝合装置
CN109893185B (zh) * 2019-03-08 2024-04-02 中南大学湘雅三医院 缝合装置
US11898874B2 (en) 2019-10-18 2024-02-13 Mclaren Applied Technologies Limited Gyroscope bias estimation

Also Published As

Publication number Publication date
HRP20070533A2 (en) 2009-05-31
HRPK20070533B3 (en) 2011-01-31

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