WO2017016406A1 - 一种双向可逆医用皮肤减张闭合器 - Google Patents

一种双向可逆医用皮肤减张闭合器 Download PDF

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Publication number
WO2017016406A1
WO2017016406A1 PCT/CN2016/090372 CN2016090372W WO2017016406A1 WO 2017016406 A1 WO2017016406 A1 WO 2017016406A1 CN 2016090372 W CN2016090372 W CN 2016090372W WO 2017016406 A1 WO2017016406 A1 WO 2017016406A1
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WO
WIPO (PCT)
Prior art keywords
substrates
pawls
disposed
racks
medical skin
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PCT/CN2016/090372
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English (en)
French (fr)
Inventor
杨帅
朱天钢
刘尧
刘讯
周新钦
Original Assignee
河南汇博医疗股份有限公司
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Application filed by 河南汇博医疗股份有限公司 filed Critical 河南汇博医疗股份有限公司
Priority to DE212016000132.9U priority Critical patent/DE212016000132U1/de
Priority to JP2017509044A priority patent/JP2017527360A/ja
Priority to BR112017001398A priority patent/BR112017001398A2/pt
Priority to MX2017000944A priority patent/MX2017000944A/es
Priority to DE112016000075.8T priority patent/DE112016000075T5/de
Priority to KR2020177000004U priority patent/KR20170000896U/ko
Priority to US15/741,938 priority patent/US20180193019A1/en
Publication of WO2017016406A1 publication Critical patent/WO2017016406A1/zh
Priority to PH12017501840A priority patent/PH12017501840A1/en
Priority to AU2017101737A priority patent/AU2017101737A4/en

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    • 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
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • 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
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • 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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/02—Inorganic materials
    • A61L31/022—Metals or alloys
    • 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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/048—Macromolecular materials obtained by reactions only involving carbon-to-carbon unsaturated bonds
    • 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
    • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
    • A61L31/04—Macromolecular materials
    • A61L31/06—Macromolecular materials obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00407—Ratchet means
    • 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 present invention relates to a medical surgical instrument, and more particularly to a two-way reversible medical skin reduction and closure device for reducing the tension of the skin of the external surface of a surgical wound.
  • the lock can only be used for straight or nearly straight wounds, but most of the wounds in the clinic are irregular, and some wounds with curvature can not be used.
  • the object of the present invention is to provide a seam-free reducer which can adjust the degree of closure in any two-way manner and adapt to various skin wounds in view of the above-mentioned deficiencies of the prior art.
  • a bidirectional reversible medical skin reduction and closing device comprising two left and right substrates arranged horizontally symmetrically, respectively fixed to the left of the adjacent ends of the left and right substrates a right pawl, and left and right racks respectively fixed to the left and right pawls at one end of the method arranged side by side; the ratchet teeth of the left and right racks are inclined to the left and right substrates, respectively, and The other ends of the left and right racks respectively pass under the right and left pawls and are engaged with the ratchet teeth disposed at the lower portions of the right and left pawls; and the left and right substrates are fixed on the bottom surfaces of the left and right substrates.
  • An adhesive layer on the surface of human skin comprising two left and right substrates arranged horizontally symmetrically, respectively fixed to the left of the adjacent ends of the left and right substrates a right pawl, and left and right racks respectively fixed to the left and right pawls at one end of the method arranged side by side
  • the top surface of the left and right substrates of the present invention is provided with a plurality of venting holes, and the glue of the adhesive layer is a low-sensitivity glue, so that the skin of the human body covered by the substrate can be effectively maintained with a good ventilation effect. To prevent skin ulceration.
  • the left and right racks of the present invention are disposed at one end of the right and left substrate guide grooves, and the rack head is provided with a horizontal surface or a frosted surface, so that the rack is easier to pull when the rack is pulled. .
  • the outer ends of the left and right pawls of the present invention are fly-up structures that are tilted upward.
  • the material of the left and right substrates of the present invention is taken from one or a combination of two or more of a polymer material such as nylon, polyethylene, polypropylene, polyvinyl chloride or a metal material.
  • a bidirectional reversible medical skin reduction and closure device of the present invention is composed of two substrates having the same structure, the substrate has a vent hole, an adhesive layer, a pawl and a rack, and the adhesive layer is at the bottom of the substrate.
  • the pawl is at the head of the substrate.
  • the substrate is pasted on both sides of the wound, and then the rack head of the two sides of the rack is pulled to suture the skin under the substrate.
  • the rack is excessively stretched due to excessive force, the pawl above the rack can be pulled to flexibly adjust the degree of closure.
  • the invention can balance the force on both sides, and can also freely adjust the degree of closure of the reducer.
  • the present invention consists of two substrates of the same structure, which have vent holes, an adhesive layer, a pawl and a rack, the adhesive layer is at the bottom of the substrate, and the pawl is at the head of the substrate.
  • the two-way reversible medical skin reduction and closure device can not only be applied to the care of various wounds, but also can be applied to various scar treatment processes, and has great benefits.
  • Figure 1 is a schematic view of the structure of the present invention.
  • Figure 2 is a cross-sectional view of Figure 1.
  • Fig. 3 is an enlarged view of a portion A in Fig. 2;
  • Figure 4 is a schematic view of the pawl opening.
  • Figure 5 is a schematic view of the application of the invention in a linear wound.
  • Figure 6 is a schematic illustration of the application of the present invention in a curved wound.
  • Figure 7 is a schematic view of the application of the present invention for treating large-sized wounds (after removing the upper nonwoven adhesive layer).
  • a bidirectional reversible medical skin reducing and closing device of the present invention comprises two left and right substrates 3, 4 arranged horizontally symmetrically, respectively fixedly disposed on the adjacent ends of the left and right substrates.
  • the left and right pawls 5, 7 and the left and right racks 2, 1 respectively fixed to the left and right pawls at the ends of the upper and lower sides; the ratchets 9 of the left and right racks respectively
  • the left and right substrate directions are inclined, and the other ends of the left and right racks respectively pass under the right and left pawls and are engaged with the ratchet teeth 11 disposed at the lower portions of the right and left pawls; on the bottom surfaces of the left and right substrates
  • An adhesive layer 10 for fixing the left and right substrates to the surface of the human skin is provided.
  • venting holes 6 are disposed on the upper surfaces of the left and right substrates 3 and 4 of the present invention; the glue of the adhesive layer is a low-sensitivity glue, so that the human skin of the substrate covered by the substrate can be effectively maintained. Good ventilation effect to prevent skin ulceration; meanwhile, when the wound in the injured part is large and cannot be pasted, it can be fixed by intrusion: directly attach the closure to both sides of the wound, and use the skin stapler or surgical suture to fix the substrate. The vent hole 6 is sewed on both sides of the wound to achieve a firm fixation.
  • the left and right racks of the present invention are provided with a rack head 8 at one end of the right and left substrate guide grooves, and the upper surface of the rack head is a striated surface or a frosted surface.
  • the outer end of the pawl of the present invention is a fly-up structure that is tilted upward.
  • the materials of the left and right substrates of the present invention are taken from one or a combination of two or more of nylon, polyethylene, polypropylene, polyvinyl chloride or metal materials.
  • the use state of the linear wound and the curved wound in the present invention is shown in FIG. 5-6, and the method is as follows: the substrate is pasted on both sides of the wound during use, and then the racks on both sides are pulled to suture the skin under the substrate. If the rack is too stretched due to excessive force, the pawl above the rack can be pulled to flexibly adjust the degree of closure.
  • the invention can balance the force on both sides, and can also freely adjust the degree of closure of the reducer.
  • the closers of the present invention are symmetrically arranged and pasted on the above-mentioned non-woven adhesive layer, and then a layer of non-woven is pasted on the same side of the closure.
  • the adhesive layer of the cloth layer is used to connect the single occluders on the same side through the upper and lower non-woven layer adhesive layers to form an integral shape, thereby ensuring a stronger joint between the closers. stable.

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  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Chemical Kinetics & Catalysis (AREA)
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Abstract

一种双向可逆医用皮肤减张闭合器，包括水平对称设置的两个左、右基板（3，4），分别固定设置在左、右基板（3,4）相邻端上面的左、右棘爪（5,7），以及以上下并排设置的方式一端分别与左、右棘爪（5,7）相固接的左、右齿条（2,1）；所述左、右齿条的棘齿（9）分别向左、右基板（3,4）方向倾斜，且左、右齿条（2,1）的另一端分别穿过右、左棘爪（5,7）的下方并与右、左棘爪（5,7）下部设置的棘齿（11）相扣合；在位于左、右基板（3,4）的底面设置有用于左、右基板固定在人体皮肤表面的胶粘层；该皮肤减张闭合器能够两面均衡用力，同时还可以自由调节减张器的闭合程度。

Description

一种双向可逆医用皮肤减张闭合器
本申请要求于2015年07月26日提交中国专利局、申请号为201510441898.0、发明名称为“一种双向可逆医用皮肤减张闭合器”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本发明涉及一种医疗手术器具，具体说是一种用于手术伤口外表层皮肤减小张力的双向可逆医用皮肤减张闭合器。
背景技术
伤口闭合是外科最常见的问题，以前，一般使用缝合针和缝合线处理外科手术表层皮肤，不仅对皮肤造成新的创伤，而且还会造成伤口感染、异物残留、伤口愈合迟缓等问题，给临床医生带来很多问题。针对此问题，申报了大量专利。中国专利ZL03117364.0公开了一种《皮肤伤口锁合器》，其主要结构为在伤口两边埋植两条基带，上面分别设置有锁孔和棘条，棘条和锁孔配合可以将伤口锁紧，实现锁合的目的。但是此种结构具有不可忽视的问题：
(1)当一端拉动棘条，另一端胶条需要有一个反作用力，很难实现受力均匀，实际操作过程中，操作不便。
(2)该专利采用棘轮原理，只能单向调节锁扣的缝合力，无法实现逆转，一旦用力过猛，就会导致伤口闭合过度而凸起，此时只能重新换另外一个，大大增加医疗成本。
(3)该锁合器只能用于直线或近似直线的伤口，但是在临床中大部分伤口都不规整，有一些带有弧度的伤口便无法使用。
(4)该锁合器所使用的尼龙塑料，硬度大，给患者带来一些不适，这也是需要考虑的。其后，也有一些专利针对这些问题进行了解决，但是都未在根本上有大的改变。所以一款能够适应一些弯曲伤口，能够任意调节张力大小，使用方便的伤口减张器需求迫切。
发明内容
本发明的目的在于对上述现有技术的不足之处而提供一种可以双向用力，任意调节闭合程度，适应各种皮肤创面的免缝减张器。
本发明实现上述目的所采取的技术方案是：一种双向可逆医用皮肤减张闭合器，它包括水平对称设置的两个左、右基板，分别固定设置在左、右基板相邻端上面的左、右棘爪，以及以上下并排设置的方式一端分别与左、右棘爪相固接的左、右齿条；所述左、右齿条的棘齿分别向左、右基板方向倾斜，且左、右齿条的另一端分别穿过右、左棘爪的下方并与右、左棘爪下部设置的棘齿相扣合；在位于左、右基板的底面设置有用于左、右基板固定在人体皮肤表面的胶粘层。
本发明所述左、右基板的上面设置有若干个透气孔，所述胶粘层的胶质为低敏性胶，这样可有效的保持基板所粘贴覆盖处的人体皮肤有较好的透气效果，防止皮肤溃烂。
本发明所述左、右齿条位于右、左基板导槽内的一端均设置有齿条头，且所述齿条头的上面为横纹面或磨砂面，使得拉动齿条时较为容易方便。
本发明所述左、右棘爪的外端为向上翘起的飞檐式结构。
本发明所述左、右基板的材料取自尼龙、聚乙烯、聚丙烯、聚氯乙烯等高分子材料或金属材料中的一种或两种以上的组合。
具体的说：本发明的一种双向可逆医用皮肤减张闭合器，由结构相同的两个基板组成，基板上有透气孔、胶粘层、棘爪和齿条，胶粘层在基板底部，棘爪在基板的头部。使用时将基板粘贴在伤口两侧，然后牵拉两边齿条的齿条头就可以将基板下方的皮肤缝合。而且，如果因为用力过大，导致齿条拉伸过多，可以扣动齿条上方的棘爪，灵活调整闭合程度。本发明能够两面均衡用力，同时还可以自由调节减张器的闭合程度。
本发明的原理及有益效果是：本发明由结构相同的两个基板组成，基板上有透气孔、胶粘层、棘爪和齿条，胶粘层在基板底部，棘爪在基板头部。
(1)使用时将基板粘贴在伤口两侧，然后牵拉两边的拉条就可以将基板下方的皮肤缝合。
(2)而且在两个棘爪的外端存在一个向上翘起的飞檐式斜面，从而 使两个合并的棘爪与伤口之间形成一个缝隙，防止覆盖伤口。最重要的是，如果因为用力过大，导致拉条拉伸过多，可以方便扣动棘爪上方的扳钮，灵活调整闭合程度。该设计能够两面均衡用力，同时还可以自由调节减张器的闭合程度。
(3)同时，研究发现伤口缝合处两边的皮肤张力越大，则两边的对合越不容易紧密，身体就会收到“需要增生组织”的信号，就会长出比较多的疤痕组织来弥合伤口，时间较长后就会形成肉眼可见的“蜈蚣疤”，反之，如果缝合处两边的皮肤张力越小或者没有张力，皮肤对合紧密，身体接受的“需要增生组织”的信号不强烈，只需要增生较少的组织就可以愈合伤口，这样愈合的疤痕一般以线性居多。所以，应用该皮肤减张闭合器，可以有效减小皮肤两侧张力，达到形成线性伤口的目的。
(4)文献报道，减小皮肤两侧张力不仅对伤口愈合有作用，对新形成的疤痕也有很好的治疗作用，配合使用医用硅酮凝胶等缩小疤痕的敷料，可以有效缓解或减小疤痕组织。
综上所述，该双向可逆医用皮肤减张闭合器不仅能够应用于各种伤口的护理，同时还能够适用于各种疤痕的治疗过程中，产生了巨大的有益效益。
附图说明
图1为本发明的结构示意图。
图2为图1的剖视图。
图3为图2中A部的放大图。
图4为棘爪张开示意图。
图5为本发明在直线伤口中的应用示意图。
图6为本发明在弯曲伤口中的应用示意图。
图7为本发明处理大尺寸伤口中的应用示意图(去除上层无纺布胶粘层后)。
图中：1、右齿条；2、左齿条；3、左基板；4、右基板；5、左棘爪；6、透气孔；7、右棘爪；8、齿条头；9、棘齿；10、胶粘层；11、棘齿；12、伤口；13、无纺布胶粘层。
具体实施方式
本发明以下将结合附图进一步的描述。
如图1-3所示，本发明的一种双向可逆医用皮肤减张闭合器，它包括水平对称设置的两个左、右基板3、4，分别固定设置在左、右基板相邻端上面的左、右棘爪5、7，以及以上下并排的方式一端分别与左、右棘爪相固接的左、右齿条2、1；所述左、右齿条的棘齿9分别向左、右基板方向倾斜，且左、右齿条的另一端分别穿过右、左棘爪下方并与右、左棘爪下部设置的棘齿11相扣合；在位于左、右基板的底面设置有用于左、右基板固定在人体皮肤表面的胶粘层10。
本发明所述左、右基板3、4的上面设置有若干个透气孔6；所述胶粘层的胶质为低敏性胶，这样可有效的保持基板所粘贴覆盖处的人体皮肤有较好的透气效果，防止皮肤溃烂；同时当受伤部位的伤口较大，无法粘贴时，可以使用侵入的方式进行固定：直接将闭合器粘贴在伤口两边，使用皮肤吻合器或者手术缝合线，将基板通过上面的透气孔6缝合在伤口两边，达到牢固固定的目的。
本发明所述左、右齿条位于右、左基板导槽内的一端均设置有齿条头8，且所述齿条头的上面为横纹面或磨砂面。
本发明所述棘爪的外端为向上翘起的飞檐式结构。
本发明所述左、右基板的材料取自尼龙、聚乙烯、聚丙烯、聚氯乙烯或金属材料中的一种或两种以上的组合。
本发明在直线伤口和弯曲伤口的使用状态详见图5-6所示，其使用方法是：使用时将基板粘贴在伤口两侧，然后牵拉两边的齿条就可以将基板下方的皮肤缝合；如果因为用力过大，导致齿条拉伸过多，可以扣动齿条上方的棘爪，灵活调整闭合程度。本发明能够两面均衡用力，同时还可以自由调节减张器的闭合程度。
如图7所示，本实用新型在处理大尺寸创口时，将本实用新型的闭合器对称排列粘贴在上述无纺布胶粘层的上面，然后在同侧的闭合器上面粘贴一层无纺布层胶粘层，从而将同侧的单个闭合器通过上下两面无纺布层胶粘层连接成一体，做成整体的形状，从而保证了闭合器之间更为牢固和 稳定。

Claims (5)

  1. 一种双向可逆医用皮肤减张闭合器，其特征在于：它包括水平对称设置的两个左、右基板(3、4)，分别固定设置在左、右基板相邻端上面的左、右棘爪(5、7)，以及以上下并排设置的方式一端分别与左、右棘爪相固接的左、右齿条(2、1)；所述左、右齿条的棘齿(11)分别向左、右基板方向倾斜，且左、右齿条的另一端分别穿过右、左棘爪下方并与右、左棘爪下部设置的棘齿(9)相扣合；在位于左、右基板的底面设置有用于左、右基板固定在人体皮肤表面的胶粘层(10)。
  2. 根据权利要求1所述的双向可逆医用皮肤减张闭合器，其特征在于：所述左、右基板(3、4)的上面设置有若干个透气孔(6)。
  3. 根据权利要求1所述的双向可逆医用皮肤减张闭合器，其特征在于：所述左、右齿条位于右、左基板导槽内的一端均设置有齿条头(8)，且所述齿条头的上面为横纹面或磨砂面。
  4. 根据权利要求1所述的双向可逆医用皮肤减张闭合器，其特征在于：所述左、右棘爪的外端为向上翘起的飞檐式结构。
  5. 根据权利要求1所述的双向可逆医用皮肤减张闭合器，其特征在于：所述左、右基板的材料取自尼龙、聚乙烯、聚丙烯、聚氯乙烯或金属材料中的一种或两种以上的组合。
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