WO2021080631A1 - Wound dressing containing a vacuum pump - Google Patents

Wound dressing containing a vacuum pump Download PDF

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Publication number
WO2021080631A1
WO2021080631A1 PCT/US2020/000041 US2020000041W WO2021080631A1 WO 2021080631 A1 WO2021080631 A1 WO 2021080631A1 US 2020000041 W US2020000041 W US 2020000041W WO 2021080631 A1 WO2021080631 A1 WO 2021080631A1
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WO
WIPO (PCT)
Prior art keywords
wound
dressing
negative pressure
porous
sponge material
Prior art date
Application number
PCT/US2020/000041
Other languages
French (fr)
Inventor
Thomas J. Drury
Christopher Hanson
John E. O'gara
Alysha De Silva
Original Assignee
Hydrofera, Llc
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 Hydrofera, Llc filed Critical Hydrofera, Llc
Publication of WO2021080631A1 publication Critical patent/WO2021080631A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/42Use of materials characterised by their function or physical properties
    • A61L15/46Deodorants or malodour counteractants, e.g. to inhibit the formation of ammonia or bacteria
    • A61F13/01017
    • A61F13/05
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/22Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing macromolecular materials
    • A61L15/24Macromolecular compounds obtained by reactions only involving carbon-to-carbon unsaturated bonds; Derivatives thereof
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/42Use of materials characterised by their function or physical properties
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L15/00Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/42Use of materials characterised by their function or physical properties
    • A61L15/425Porous materials, e.g. foams or sponges
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/90Negative pressure wound therapy devices, i.e. devices for applying suction to a wound to promote healing, e.g. including a vacuum dressing
    • A61M1/91Suction aspects of the dressing
    • A61M1/915Constructional details of the pressure distribution manifold
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/90Negative pressure wound therapy devices, i.e. devices for applying suction to a wound to promote healing, e.g. including a vacuum dressing
    • A61M1/96Suction control thereof
    • A61M1/962Suction control thereof having pumping means on the suction site, e.g. miniature pump on dressing or dressing capable of exerting suction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/90Negative pressure wound therapy devices, i.e. devices for applying suction to a wound to promote healing, e.g. including a vacuum dressing
    • A61M1/98Containers specifically adapted for negative pressure wound therapy
    • A61M1/984Containers specifically adapted for negative pressure wound therapy portable on the body
    • A61M1/985Containers specifically adapted for negative pressure wound therapy portable on the body the dressing itself forming the collection container
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/20Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices containing or releasing organic materials
    • A61L2300/252Polypeptides, proteins, e.g. glycoproteins, lipoproteins, cytokines
    • A61L2300/254Enzymes, proenzymes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/404Biocides, antimicrobial agents, antiseptic agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS 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
    • A61L2300/00Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices
    • A61L2300/40Biologically active materials used in bandages, wound dressings, absorbent pads or medical devices characterised by a specific therapeutic activity or mode of action
    • A61L2300/442Colorants, dyes

Definitions

  • Ths is a patent application claiming priority and benefit from U.S. Patent Application
  • the present invention is directed toward a PVA wound dressing for the treatment of wounds containing a pump which administers negative pressure to the wound site.
  • Negative pressure wound therapy has long been used in the treatment of wounds and improves the rate of wound healing while removing fluid, exudates, bacteria and other healing inhibiting substances from the wound site.
  • NGWT Negative pressure wound therapy
  • Extensive studies of both continuous l and intermittent treatment of wounds under negative pressure were conducted in the 1980’s and 1990’s in various Russian institutions. This testing demonstrated that slow healing wounds healed substantially faster with negative pressure. It was also shown that treatment of wounds with negative pressure produced an antibacterial effect. These studies are described in articles in the Russian medical journal Vestnik Khirurgil. It is presently believed that such negative pressure wound therapy hastens wound closure by speeding migration of epithelial and subcutaneous tissue adjacent the wound towards the center and away from the base of the wound until the wound closes.
  • Negative pressure therapy also known as suction or vacuum therapy has been used in treating and healing wounds.
  • Application of negative pressure e.g. reduced or subatmospheric pressure (pressure below normal atmospheric pressure)
  • pressure below normal atmospheric pressure e.g. reduced or subatmospheric pressure (pressure below normal atmospheric pressure)
  • This technique has proven particularly effective for chronic or healing-resistant wounds, and is also used for other purposes such as post-operative wound care.
  • negative pressure wound therapy assists in the closure and healing of many forms of "hard to heal" wounds by reducing tissue edema, encouraging blood flow and granular tissue formation, and/or removing excess exudate and can reduce bacterial load (and thus infection risk).
  • negative pressure therapy provides for a wound to be covered to facilitate suction at the wound area.
  • a conduit is introduced through the wound covering to provide fluid communication to an external vacuum source.
  • Atmospheric gas, wound exudates, or other fluids may thus be drawn from the reservoir through the fluid conduit to stimulate healing of the wound. Exudates drawn from the reservoir may be deposited in a collection canister or container.
  • Patent Number 3,572,340 issued March 23, 1971 discloses a pump in the form of an elastically compressible body made of an open celled foam material, preferably polyurethane foam which body also serves as a receptacle for fluid drained from a wound.
  • the pump is said to have a capacity to maintain a negative pressure of 15-80 mmHg for over 48 hours.
  • a drain is placed in the wound pocket and is connected to the pump by a tube.
  • U.S. Patent Number 4,525,166 issued June 25, 1985 which uses laminaria (kelp) instead of foam. Laminaria swells by absorption of liquid and does not release the liquid.
  • U.S. Patent Number 7,569,742 issued August 4, 2009 discloses a wound dressing apparatus using a micro pump system housed within or above a wound dressing member.
  • the micro-pump includes a miniature pump that applies a sub-atmospheric pressure to the wound to draw wound fluid or exudate away from the wound bed while allowing patient mobility.
  • U.S. Patent Number 9,084,845 issued July 21, 2015 discloses a number of pump assemblies for reduced pressure wound therapy which are battery powered.
  • the embodiments show a housing, a pump, a flow pathway through the pump, one or more valves in communication with the housing and a one way pressure sensor in communication with a fluid pathway.
  • U.S. Patent Number 9,974,890 issued May 22, 2018 discloses a portable system for sub-atmospheric pressure therapy in connection with healing a surgical wound, including a wound dressing dimensioned for positioning relative to a wound bed of a subject and a sub- atmospheric pressure mechanism carried or worn by the subject.
  • the sub-atmospheric pressure mechanism includes a housing having a control unit adapted to draw a vacuum and a canister associated with the housing.
  • the canister has a collection bag disposed therein, which is in fluid communication with the wound dressing to receive exudates from the wound bed.
  • the collection bag is adapted to expand upon receipt of the fluids and releases gas with operation of the control unit.
  • U.S. Patent Number 10,046,096 issued August 14, 2018 discloses a number of dressing embodiments, some of which have a pump assembly mounted to or supported by a dressing for reduced pressure wound therapy.
  • the dressing can have visual pressure, saturation, and/or temperature sensors to provide a visual indication of the level of pressure, saturation, and/or temperature within the dressing.
  • the pump assembly can have a controller supported within or by the housing, the controller being configured to control one or more operations of the pump.
  • the pump is configured to be sterilized.
  • U.S. Patent Application Publication Number 2010/0324510 published December 23, 2010 disclosed a number of embodiments for treating wounds with reduced pressure.
  • the preferred device is a sealing film which covers the wound as well as a tube which connects a space over the wound and a space beneath the sealing film to the negative pressure source which is preferably a pump.
  • An open foam hydrophilic material of polyurethane is cut to the shape of the wound to fill the wound pocket. See also U.S. Patent Application Publication Number 2011/0178451 published July 21, 2011 which is directed to foam wound inserts having high density and low density regions which are subjected to negative pressure.
  • NGWT Current negative pressure wound therapy
  • a wound dressing a canister to collect wound exudate
  • a pump or a vacuum source a vacuum source.
  • the SNAP system relies on a mechanical vacuum source and a canister to collect exudate (see U.S. Patent Application Publication Number 2011/0230849 published September 22, 2011), while the PICO system (see U.S. Patent Application Publication Number 2010/0160881 published June 24, 2010) relies on an electrical vacuum source and uses the dressing to collect the exudate.
  • a therapeutically useful reduced pressure i.e. vacuum or negative pressure
  • the vacuum source is far from the wound bed, creating a need for tubing that is uncomfortable and unsightly for the patient, leading to compliance issues.
  • Tubing can be crimped or clogged leading to failure. In subfreezing climates, the tubing can freeze and as a result, clog leading to failure.
  • the pump must reduce the pressure requiring large mechanical or electrical units that can be bulky and noisy. This is further exacerbated by long lengths of tubing that result in greater pressure drop over distance, in turn requiring a larger and more powerful pump.
  • a separate wound dressing is used with the prior art negative pressure pumps and the dressing itself is not actively used to treat the wound with natural capillary pressure or kill bacteria, prevent bacteria reproduction or inhibit or destroy biofilm forming within the wound.
  • the present invention describes a medical wound dressing device in the field of wound care treatment and is comprised of a porous PVA sponge material dressing having a natural capillary pressure.
  • the device is also provided with a biocide.
  • the device is also provided with a sealing drape covering the porous PVA sponge dressing material, an auxiliary vacuum generator mechanism such as a negative pressure pump connected to them porous PVA sponge dressing material and a fluid removal path with an optional fluid return path back to the dressing.
  • the device enables the application of negative pressure to the porous PVA dressing material and the adjacent wound while covering the wound. It is an object of the invention to provide a constant source of low negative pressure on the wound through the natural capillary pressure of the porous sponge dressing material while systematically providing a second higher negative pressure on the wound by applying a secondary negative pressure.
  • Figure 1 is a schematic cross section of the inventive negative pressure wound dressing device
  • Figure 2 is a schematic cross section of another embodiment of the negative pressure wound dressing device
  • Figure 3 is a schematic of the negative pressure provided to the wound dressing of Figures 1 and 2 using the inventive wound dressing device.
  • Figure 4 is a schematic of a detailed control circuit of the inventive wound dressing device.
  • the present invention is a negative pressure wound therapy (NPWT) system where the reduced atmospheric pressure on the wound is achieved by two sources, (1) a porous sponge dressing material and (2) an auxiliary vacuum unit, e.g. a pump.
  • the porous sponge dressing material is a PVA foam which provides a natural capillary pressure of about -20 mmHg to about -72 mmHg on the wound.
  • the auxiliary pump can further reduce the pressure to maintain a therapeutic benefit, e.g. down to about -120 mmHg.
  • the result is a NPWT system that is portable by the user and is significantly smaller than prior art devices and with minimal to no tubing required to connect the dressing to the auxiliary vacuum source.
  • reduced or negative pressure levels represent pressure levels relative to normal ambient atmospheric pressure, which corresponds to 760 mmHg (or 1 atm, 29.93 inHg, 101.325 kPa, 14.696 psi, etc.).
  • a negative pressure value of -X mmHg reflects absolute pressure that is X mmHg below normal ambient atmosphere pressure of 760 mmHg or, in other words, an absolute pressure of (760 mmHg -X mmHg).
  • negative pressure that is "less” or "smaller” than the X mmHg negative pressure corresponds to pressure that is closer to atmospheric pressure.
  • the present invention describes a medical dressing device for the field of wound care of patients and is comprised of a porous sponge dressing material 10, preferably PVA foam sponge material 12, a sealing drape or cover 20, a fluid removal path 30, and a vacuum producing mechanism 40 as seen in Figures 2 and 4.
  • the device enables the application of negative pressure to a wound with absorption of fluid to the porous sponge dressing material.
  • the porous sponge dressing material of the invention is preferably PVA foam sponge material 12 and acts as a source for negative pressure through its natural capillary action and as a wound exudate collection vehicle.
  • PVA foam refers to one or more of the following: Polyvinyl formal, Polyvinyl acetal, PVA copolymers of vinyl esters and PVA copolymers of ethylene-containing repeat units. Copolymers with PVA may be random, block, alternating, periodic or graft.
  • the acetal group may have one or two substituents such as aliphatic or aromatic groups which may be further substituted.
  • Foams may further be comprised of blends of above PVA based polymers with non-PVA polymers.
  • the porous PVA sponge 12 has a surface chemistry and porosity that create capillary flow properties, which in turn provide for a natural capillary pressure leading to exudate being drawn from the wound into the porous material.
  • the reduced pressure created by the capillary action of the porous material enables the auxiliary vacuum unit or vacuum producing mechanism 40 as shown in Figures 1 and 2 to do less work, thereby affording smaller and less energy consuming technologies to be employed over current commercial products.
  • porous sponge dressing material is generally referred to by the numeral 10 and the PVA sponge dressing material is referred to by the numeral 12, these numbers can be interchanged as necessary as both refer to the sponge dressing material.
  • the PVA porous dressing material 12 acts as a dressing to the wound surface 14.
  • This material is polymeric in composition where the polymer can be a synthetic substance, a natural substance or combinations thereof hi the preferred embodiment, the polymer is foamed PVA with positive and negative biocidal dyes which impregnate or bind to the sponge receptor sites.
  • the porous PVA sponge dressing material has a morphology characterized by an average pore throat diameter of 10 - 500 p , a fluid retention of 5.5 - 300 mL fluids/g porous material, a density of 0.05 - 0.15 g polymer/cm3 porous material, and a porosity of 60 - 99.5%.
  • the cell structure is characterized as open / interconnected with through-going pores that can be evaluated by techniques such as capillary flow porometry and liquid extrusion porosimetry.
  • the natural capillary pressure of the PVA sponge or foam dressing material ranges from about -20 mmHg to about -70 mmHg. This natural capillary pressure ranges and falls within the low to mid-range settings of presently used mechanical vacuum machines.
  • the porous PVA sponge dressing material has one or more material properties which in combination afford fluid flow through the material to create a natural capillary pressure.
  • Material properties may include the pore properties above, surface chemical structure, surface roughness and the resultant interfacial tensions arising from the porous PVA material surface and the fluid surface in contact with other.
  • the porous PVA sponge dressing material having natural capillary pressure has a simplified diffusion coefficient greater than 0.3 cm 2 / second; in a more preferred embodiment greater than 0.4 cm 2 / second, and in a most preferred embodiment greater than 0.5 cm 2 / second.
  • Table 1 dressings used in the field today have little to no natural capillary pressure as measured by their simplified diffusion coefficient whereas the porous PVA foam of the present invention surprisingly has an almost 4-5X ability.
  • the simplified diffusion coefficient may be determined to suspending a swatch of the dressing (0.5" x 0.25" x 3.0") in a normal saline solution to allow vertical wicking through the dressing material. Prior to evaluation, all materials are conditioned at ambient temperature for at least 24 hours. The test article is then attached to a suspension fixture and lowered into a test beaker containing saline solution such that one end is slightly submerged in the saline solution. The vertical wicking distance is recorded after 45 seconds. This wicking distance is then corrected to account for the initial height of saline, and the diffusion coefficient is calculated from the corrected wicking distance and wicking time period.
  • a biofilm enzymatic solution can also be incorporated into the porous sponge dressing material during the same manufacturing process that binds the antibacterial agents but after addition of the antibacterial agents. During this process, Methylene Blue, Crystal Violet, and biofilm prevention enzyme solution is introduced and allowed to uniformly impregnate or bind to the foam matrix. The product is then dried and processed to final specification and sterilization.
  • the porous sponge dressing material may further have agents that bind and/or eliminate toxins from the exudate, e.g. bacteria, mold, spores, endotoxins.
  • the present invention uses foamed polyvinyl alcohol which is treated to open up the binding sites of the foam. The washed foam is soaked with one or more gram positive dyes selected from a group of dyes consisting of
  • Gentian Violet dye also called Crystal Violet dye, Malachite Green dye, Brilliant Green dye, Quinacrine dye and Acriflavin dye and one or more gram negative dyes selected from a group of dyes consisting of Methylene Blue dye, Dimethyl Methylene Blue dye, New Methylene Blue dye.
  • the preferred dyes used in the invention are Methylene Blue dye and Gentian or Crystal Violet dye are attached to a finite number of the binding sites in the foam.
  • electronegative (acidic) dyes are more effective on Gram-negative bacteria and electropositive (basic) dyes are more effective on Gram positive bacteria such as Staphyloccus aureus.
  • the porous sponge dressing material may be shaped if desired to be conformable to the shape of the wound bed.
  • the porous sponge dressing material may have a surface porosity on the surface distal to the wound that allows for moisture transmission outwards but is impermeable to air (inwards).
  • the porous sponge dressing material can self- rejuvenate until it is fully loaded with exudate, up to 5x, lOx or even 15x its weight in exudate fluid, at which time the dressing would be replaced.
  • This sponge material of the invention may further be combined with clinically safe agents, e.g. saline, hydration fluids, antimicrobial agents, softening agents, stiffening agents, or wetting agents.
  • clinically safe agents e.g. saline, hydration fluids, antimicrobial agents, softening agents, stiffening agents, or wetting agents.
  • the agents may be preloaded prior to clinical use or may be loaded by a clinician at the time of clinical use.
  • the synthetic polymer can be polyvinyl formal.
  • the natural polymer material can be either animal or plant derived, for example, collagen, chitosan, or polyethylene terephthalate.
  • the sealing layer, drape or cover 20 acts to form a vacuum seal over the dressing 12 to the wound perimeter.
  • the sealing layer 20 may be polymeric in composition where the polymer can be a synthetic substance, a natural substance or combinations thereof.
  • the sealing layer may also be metallic in composition.
  • the sealing layer may be comprised of multiple polymeric and or metallic layers and may further have adhesives on its surfaces or between layers.
  • the vacuum connection assembly 30 acts to apply auxiliary vacuum through the sealing layer 20 to the sponge dressing 12 from the vacuum mechanism 40 via plastic conduits 82 and 80 as seen in Figure 4, or nipples 42 as seen in Figure 2, or nipple 30 as seen in Figure 1.
  • the fluid removal assembly (conduit, T-section, nipples) may be polymeric in composition where the polymer can be a synthetic substance, a natural substance or combinations thereof.
  • the vacuum connection assembly may also be metallic in composition or a combination of polymer and metal.
  • the vacuum connection path may be affixed external to the sealing layer or be imbedded within the sealing layer.
  • the vacuum mechanism 40 provides a clinically beneficial negative pressure (up to -120 mm Hg) to the wound site 14 through the porous foam dressing material 10/12.
  • the vacuum mechanism 40 may be affixed external to the sealing layer 20, positioned adjacent the sealing layer or be imbedded within the sealing layer and draws fluid away from the porous foam sponge material through one or more paths.
  • the vacuum or negative pressure is achieved and controlled through many methods known to those skilled in the art.
  • the vacuum is achieved through an energized device.
  • the vacuum is achieved through a manual process such as a syringe or squeeze bulb.
  • the device is a mechanical pump which is energized or powered by batteries.
  • the vacuum mechanism may allow for filtration of fluid prior to entering the fluid return path.
  • the vacuum mechanism may allow for the addition of clinically safe agents to the fluid prior to entering the fluid return path.
  • the medical device described in this invention may be single use and thus disposable or one or more of its components may be reusable. It is envisioned that all components will be disposable and that a whole unit will be disposable as medical waste.
  • the device may be fully assembled when received by the customer or may require assembly at the point of care.
  • the NPWT system of the invention may optionally have a sealing layer 20 as shown in Figure 2 on the porous material surface 10 that allows for vapor or moisture transmission outwards but is impermeable to air (inwards).
  • the layer 20 is both vapor permeable and an air barrier. As noted above, this would enable the porous sponge material to self-rejuvenate until it is fully loaded with exudate.
  • the sealing layer covers only the distal facing porous sponge material surface and abuts the auxiliaiy vacuum unit. In another embodiment, the sealing layer extends over the auxiliary vacuum unit, and the vacuum exhaust passes through the sealing layer. In yet another embodiment, the sealing layer runs under the auxiliary vacuum unit and the vacuum auxiliary units sits above the sealing layer. In a preferred embodiment, the sealing layer is translucent to aid in visualization of the porous sponge material by the clinician or patient.
  • the inventive assembly may have a vacuum connection component 30.
  • This component would be located between the auxiliary vacuum unit 40 and the foamed porous material dressing 10/12.
  • the vacuum connection component has baffles or channels that aid in equilibrating the vacuum from the auxiliary vacuum unit 40 to the porous material 10/12 or aid in distributing filtered exudate back to the porous material.
  • One or a plurality of fluid removal and/or fluid return chambers may be used where each chamber has one or more of the functions listed above.
  • the vacuum connection component may also be provided with a vacuum port/valve.
  • This port/valve component is gas permeable but not liquid permeable and acts to protect the auxiliary vacuum unit from being fouled by exudate.
  • the assembly may be provided with a check valve to prevent back flow of air into the vacuum connection component and/or the porous sponge material.
  • the vacuum connection component may have a length of tubing to separate the auxiliary vacuum unit from the porous sponge material.
  • One or a plurality of vacuum port/valves may be used where each unit has one or more of the functions listed above.
  • the auxiliary vacuum unit 40 of the invention supplements the negative pressure provided by the foam porous dressing material 12 so that the total negative pressure on the wound remains in a clinically beneficial range.
  • the porous material 12 alone provides negative pressure that is above the clinically beneficial threshold, and the auxiliary unit supplements that pressure by raising the pressure higher in the therapeutic range.
  • the pump can apply vacuum to maintain the therapeutic range.
  • the porous material gets filled, its contribution to maintenance of the therapeutically beneficial negative pressure decreases and the auxiliary vacuum unit’s contribution increases.
  • the NPWT system can be replaced with a new device.
  • the auxiliary vacuum unit can be powered by a mechanical action, e.g. a syringe force.
  • the auxiliary vacuum unit (pump) is preferably powered with an electrical supply, most preferably a battery. Examples of battery powered pumps that could be used in the auxiliary vacuum unit include Models Compact/OEM and KPV-14A available from Cole Parmer, Model NMP 03 KP DC-S available from KNF Neuberger, Inc. and Model SX-1 from Binaca Products.
  • auxiliary vacuum unit 40 can sit on the distal (outward) facing surface of the porous material 10/12, the auxiliary vacuum unit 40 can be embedded or encased in the porous material 10/12 to provide a low-profile system.
  • the auxiliary vacuum unit 40 may have addition features including:
  • the auxiliary vacuum unit 40 is provided with an integral motor 78 and can also be provided with a vacuum exhaust component that allows escape of air and moisture vapor that has traveled through the auxiliary vacuum unit.
  • the vacuum exhaust component may sit on the surface of the auxiliary vacuum unit or be attached to the auxiliary vacuum unit through a length of tubing. One or a plurality of vacuum exhausts may be used.
  • the auxiliary vacuum unit may also serve as a check valve to prevent back flow of air into the auxiliary vacuum unit.
  • the NPWT system may further have a sealing drape layer 20.
  • the sealing drape layer 20 acts to seal the wound bed in an airtight manner. It can also act as the moisture vapor transmission layer described above.
  • the sealing layer may cover the auxiliary vacuum unit, porous material and other components of the device.
  • the sealing drape layer is non-permeable. In this case it would run from the healthy skin to the moisture vapor transmission layer, or it would still cover the entire NPWT system where moisture transmission would be through the auxiliary vacuum unit or vacuum exhaust component.
  • the overall system is a single use, disposable product.
  • the system is supplied sterile and have a useful lifetime of approximately 1 day, more preferably 2-3 days, and most preferably up to 7 days depending upon the type and severity of the wound.
  • the control system 70 as schematically shown in Figure 4 comprises a low power microcontroller 71, a three LED indicators 72, one or more push button switches 74, ambient 76a and vacuum 76b pressure sensors, a vacuum motor 78, motor power control 79, one or more batteries 77 and a tactile feedback device 72a.
  • the vacuum pressure sensor has a “T” attachment 82 connecting it to the plastic conduit 80 (for vacuum connection component 30) which connects the vacuum motor to the wound dressing 10 placed on the patient wound 14.
  • the ambient pressure sensor 76a is open to the atmosphere.
  • the microcontroller implents the logic described herein with the C source code language compiled and downloaded for execution to the microcontroller.
  • the clinically therapeutic negative pressure range for the device is about -60 mmHg to about -120 mmHg which is shown in Figure 3 by the letter R.
  • a normal working cycle is shown in Figure 3.
  • the ramp up is shown by the letter A and the decay is shown by the letter D.
  • the negative pressure should fall within about -80 mmHg to about - 100 mmHg and most preferably about -85 mmHg to about -95 mmHg.
  • the negative pressure cut-off value for the device is about -120 mmHg. Beyond this value, the patient experiences discomfort.
  • the push button and three LED A s provide the device user interface.
  • the device starts up, performs an initial operational check and indicates it is ready for operation by illuminating a green LED.
  • the second time the push button is pushed the device initiates treatment and starts monitoring operational status.
  • Good status is indicated by an illuminated green light.
  • Warning status is indicated by an illuminated yellow light and a unique tactile feedback pattern.
  • Error status is indicated by an illuminated red light and a different unique tactile feedback pattern.
  • Differential pressure sensors require that the path to the ambient pressure be physically adjacent to the path to the vacuum pressure. Separate sensors allow the paths to be physically separated. Differential pressure sensors are bulky and difficult to mount, whereas absolute pressure sensors are small with a wide variety at mounting options.
  • the ambient pressure sensor provides barometric pressure, which can provide an input to the volume calculations to determine the operational status.
  • the device undergoes initial start-up.
  • the vacuum motor 78 will turn on and remain running until it reaches the upper therapy threshold, at which point the vacuum motor is turned off and the pressure control will start.
  • Pressure control consists of reading the ambient and vacuum pressure sensors periodically. Each time a sensor is read, the vacuum level is calculated as the difference between the ambient and vacuum pressure sensors. If the vacuum is at or below the lower therapy threshold, the vacuum motor is turned on. When the vacuum subsequently reaches the upper therapy threshold, the vacuum motor is turned off.
  • variable vacuum level may provide more effective therapy than a constant vacuum level.
  • the microcontroller may optionally change the upper and lower threshold values in a redetermined pattern over the course of several minutes to improve the therapy effectiveness.
  • the pressure is held constant.
  • Operational status monitoring will run continuously once the NPWT device is started with the first push of the button.
  • the status monitoring will include battery level, leak detection, microcontroller health, blockage detection, loss of volume capacity and device lifetime.
  • the battery level will be monitored using both coulomb counting methods, and voltage level measurements.
  • a warning level and error level will be established for battery monitoring based on battery characteristics. Leak rate will be calculated by summing the time of the ramp up (A in Figure 3) over a known time combined with the vacuum pump characteristics.
  • the warning level will be established based on a projection of the loss of 20% of the lifetime of the device.
  • the error level will be the point where the device is no longer able to maintain the pressure above the lower therapy threshold or the projected lifetime of the device due to the leak is less than 12 hours.
  • the microcontroller health will be monitored by a hardware watchdog, which will turn off the device if the microcontroller does not run the pressure control logic at the selected periodic rate.
  • the microprocessor will track the elapsed time that the NPWT has provided therapy. When the elapsed time is within 12 hours of a predetermined lifetime, the device will shut down the therapy, and turn off all the indicator LED’s.

Abstract

The present invention relates to a wound healing PVA sponge dressing using negative capillary pressure of the dressing material together with auxiliary negative pressure for wound treatment. The PVA sponge dressing is pretreated with gram positive and gram negative biocidal dyes for insertion into or over a wound. A negative pressure pump is mounted to the PVA sponge dressing to produce additional capillary pressure for withdrawing fluid or water vapor from the sponge dressing and a cover is mounted over the sponge material and negative pressure pump forming a unitary sealed package for placement over a wound.

Description

WOUND DRESSING CONTAINING A VACUUM PUMP
RELATED APPLICATIONS
Ths is a patent application claiming priority and benefit from U.S. Patent Application
Ser. No.16/602,517 filed October 24, 2019.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR
DEVELOPMENT
None
REFERENCE TO SEQUENCE LISTING. A TABLE OR A COMPUTER
PROGRAM LISTING COMPACT DISC APPENDIX
None.
BACKGROUND OF THE INVENTION
1. Field of Invention
The present invention is directed toward a PVA wound dressing for the treatment of wounds containing a pump which administers negative pressure to the wound site.
2. Background of the Invention
Negative pressure wound therapy (NPWT) has long been used in the treatment of wounds and improves the rate of wound healing while removing fluid, exudates, bacteria and other healing inhibiting substances from the wound site. Extensive studies of both continuous l and intermittent treatment of wounds under negative pressure were conducted in the 1980’s and 1990’s in various Russian institutions. This testing demonstrated that slow healing wounds healed substantially faster with negative pressure. It was also shown that treatment of wounds with negative pressure produced an antibacterial effect. These studies are described in articles in the Russian medical journal Vestnik Khirurgil. It is presently believed that such negative pressure wound therapy hastens wound closure by speeding migration of epithelial and subcutaneous tissue adjacent the wound towards the center and away from the base of the wound until the wound closes.
Negative pressure therapy also known as suction or vacuum therapy has been used in treating and healing wounds. Application of negative pressure, e.g. reduced or subatmospheric pressure (pressure below normal atmospheric pressure), to a localized reservoir over a wound has been found to assist in closing the wound by promoting blood flow to the area, stimulating the formation of granulation tissue, and encouraging the migration of healthy tissue over the wound. This technique has proven particularly effective for chronic or healing-resistant wounds, and is also used for other purposes such as post-operative wound care.
Thus it is known that negative pressure wound therapy assists in the closure and healing of many forms of "hard to heal" wounds by reducing tissue edema, encouraging blood flow and granular tissue formation, and/or removing excess exudate and can reduce bacterial load (and thus infection risk). Generally, negative pressure therapy provides for a wound to be covered to facilitate suction at the wound area. A conduit is introduced through the wound covering to provide fluid communication to an external vacuum source. Atmospheric gas, wound exudates, or other fluids may thus be drawn from the reservoir through the fluid conduit to stimulate healing of the wound. Exudates drawn from the reservoir may be deposited in a collection canister or container. U.S. Patent Number 3,572,340 issued March 23, 1971 discloses a pump in the form of an elastically compressible body made of an open celled foam material, preferably polyurethane foam which body also serves as a receptacle for fluid drained from a wound. The pump is said to have a capacity to maintain a negative pressure of 15-80 mmHg for over 48 hours. A drain is placed in the wound pocket and is connected to the pump by a tube. See also U.S. Patent Number 4,525,166 issued June 25, 1985 which uses laminaria (kelp) instead of foam. Laminaria swells by absorption of liquid and does not release the liquid.
U.S. Patent Number 7,569,742 issued August 4, 2009 discloses a wound dressing apparatus using a micro pump system housed within or above a wound dressing member. The micro-pump includes a miniature pump that applies a sub-atmospheric pressure to the wound to draw wound fluid or exudate away from the wound bed while allowing patient mobility.
U.S. Patent Number 9,084,845 issued July 21, 2015 discloses a number of pump assemblies for reduced pressure wound therapy which are battery powered. The embodiments show a housing, a pump, a flow pathway through the pump, one or more valves in communication with the housing and a one way pressure sensor in communication with a fluid pathway.
In U.S. Patent Number 9,974,890 issued May 22, 2018 discloses a portable system for sub-atmospheric pressure therapy in connection with healing a surgical wound, including a wound dressing dimensioned for positioning relative to a wound bed of a subject and a sub- atmospheric pressure mechanism carried or worn by the subject. The sub-atmospheric pressure mechanism includes a housing having a control unit adapted to draw a vacuum and a canister associated with the housing. The canister has a collection bag disposed therein, which is in fluid communication with the wound dressing to receive exudates from the wound bed. The collection bag is adapted to expand upon receipt of the fluids and releases gas with operation of the control unit.
U.S. Patent Number 10,046,096 issued August 14, 2018 discloses a number of dressing embodiments, some of which have a pump assembly mounted to or supported by a dressing for reduced pressure wound therapy. The dressing can have visual pressure, saturation, and/or temperature sensors to provide a visual indication of the level of pressure, saturation, and/or temperature within the dressing. The pump assembly can have a controller supported within or by the housing, the controller being configured to control one or more operations of the pump. The pump is configured to be sterilized.
U.S. Patent Application Publication Number 2010/0324510 published December 23, 2010 disclosed a number of embodiments for treating wounds with reduced pressure. The preferred device is a sealing film which covers the wound as well as a tube which connects a space over the wound and a space beneath the sealing film to the negative pressure source which is preferably a pump. An open foam hydrophilic material of polyurethane is cut to the shape of the wound to fill the wound pocket. See also U.S. Patent Application Publication Number 2011/0178451 published July 21, 2011 which is directed to foam wound inserts having high density and low density regions which are subjected to negative pressure.
Current negative pressure wound therapy (NPWT) systems are generally comprised of a wound dressing, a canister to collect wound exudate, and a pump or a vacuum source. The SNAP system relies on a mechanical vacuum source and a canister to collect exudate (see U.S. Patent Application Publication Number 2011/0230849 published September 22, 2011), while the PICO system (see U.S. Patent Application Publication Number 2010/0160881 published June 24, 2010) relies on an electrical vacuum source and uses the dressing to collect the exudate. In these cases, a therapeutically useful reduced pressure (i.e. vacuum or negative pressure) is achieved through the vacuum source.
There are numerous problems with the current prior art. The vacuum source is far from the wound bed, creating a need for tubing that is uncomfortable and unsightly for the patient, leading to compliance issues. Tubing can be crimped or clogged leading to failure. In subfreezing climates, the tubing can freeze and as a result, clog leading to failure. The pump must reduce the pressure requiring large mechanical or electrical units that can be bulky and noisy. This is further exacerbated by long lengths of tubing that result in greater pressure drop over distance, in turn requiring a larger and more powerful pump. A separate wound dressing is used with the prior art negative pressure pumps and the dressing itself is not actively used to treat the wound with natural capillary pressure or kill bacteria, prevent bacteria reproduction or inhibit or destroy biofilm forming within the wound. SUMMARY OF THE INVENTION
The present invention describes a medical wound dressing device in the field of wound care treatment and is comprised of a porous PVA sponge material dressing having a natural capillary pressure. The device is also provided with a biocide. The device is also provided with a sealing drape covering the porous PVA sponge dressing material, an auxiliary vacuum generator mechanism such as a negative pressure pump connected to them porous PVA sponge dressing material and a fluid removal path with an optional fluid return path back to the dressing. The device enables the application of negative pressure to the porous PVA dressing material and the adjacent wound while covering the wound. It is an object of the invention to provide a constant source of low negative pressure on the wound through the natural capillary pressure of the porous sponge dressing material while systematically providing a second higher negative pressure on the wound by applying a secondary negative pressure.
It is another object of the invention to provide a natural capillary pressure wound dressing material to a wound and applying additional negative pressure to the dressing material and to the wound by a vacuum mechanism which heals and closes a wound in quicker time than conventional wound dressings.
It is still another object of the invention to provide a wound dressing material having a natural capillary pressure and providing additional mechanical negative pressure to the wound dressing material which is superior to only mechanically produced negative pressure application to a wound. It is another object of the invention to provide a wound dressing device which is disposable;
It is yet another object of the invention to provide a wound dressing device which is easier to apply to the user; It is another object of the invention to provide a continuous operational status to the user and alert the user of any operational problem with the device with visual and tactile indicators; and
It is still another object of the invention to provide a self-contained wound dressing device that can be easily carried by the patient being treated.
BRIEF DESCRIPTION OF THE DRAWINGS
The present invention will be described with reference to the appended Figures, in which: Figure 1 is a schematic cross section of the inventive negative pressure wound dressing device; Figure 2 is a schematic cross section of another embodiment of the negative pressure wound dressing device;
Figure 3 is a schematic of the negative pressure provided to the wound dressing of Figures 1 and 2 using the inventive wound dressing device; and
Figure 4 is a schematic of a detailed control circuit of the inventive wound dressing device.
These and other objects, advantages, and novel features of the present invention will become apparent when considered with the teachings contained in the detailed disclosure along with the accompanying drawings.
DESCRIPTION OF THE INVENTION The present invention is a negative pressure wound therapy (NPWT) system where the reduced atmospheric pressure on the wound is achieved by two sources, (1) a porous sponge dressing material and (2) an auxiliary vacuum unit, e.g. a pump. The porous sponge dressing material is a PVA foam which provides a natural capillary pressure of about -20 mmHg to about -72 mmHg on the wound. The auxiliary pump can further reduce the pressure to maintain a therapeutic benefit, e.g. down to about -120 mmHg. The result is a NPWT system that is portable by the user and is significantly smaller than prior art devices and with minimal to no tubing required to connect the dressing to the auxiliary vacuum source.
As is used herein, reduced or negative pressure levels, such as -X mmHg, represent pressure levels relative to normal ambient atmospheric pressure, which corresponds to 760 mmHg (or 1 atm, 29.93 inHg, 101.325 kPa, 14.696 psi, etc.). Accordingly, a negative pressure value of -X mmHg reflects absolute pressure that is X mmHg below normal ambient atmosphere pressure of 760 mmHg or, in other words, an absolute pressure of (760 mmHg -X mmHg). In addition, negative pressure that is "less" or "smaller" than the X mmHg negative pressure corresponds to pressure that is closer to atmospheric pressure. The present invention describes a medical dressing device for the field of wound care of patients and is comprised of a porous sponge dressing material 10, preferably PVA foam sponge material 12, a sealing drape or cover 20, a fluid removal path 30, and a vacuum producing mechanism 40 as seen in Figures 2 and 4. The device enables the application of negative pressure to a wound with absorption of fluid to the porous sponge dressing material.
The porous sponge dressing material of the invention is preferably PVA foam sponge material 12 and acts as a source for negative pressure through its natural capillary action and as a wound exudate collection vehicle. The term PVA foam refers to one or more of the following: Polyvinyl formal, Polyvinyl acetal, PVA copolymers of vinyl esters and PVA copolymers of ethylene-containing repeat units. Copolymers with PVA may be random, block, alternating, periodic or graft. The acetal group may have one or two substituents such as aliphatic or aromatic groups which may be further substituted. Foams may further be comprised of blends of above PVA based polymers with non-PVA polymers. The porous PVA sponge 12 has a surface chemistry and porosity that create capillary flow properties, which in turn provide for a natural capillary pressure leading to exudate being drawn from the wound into the porous material. The reduced pressure created by the capillary action of the porous material enables the auxiliary vacuum unit or vacuum producing mechanism 40 as shown in Figures 1 and 2 to do less work, thereby affording smaller and less energy consuming technologies to be employed over current commercial products.
While the porous sponge dressing material is generally referred to by the numeral 10 and the PVA sponge dressing material is referred to by the numeral 12, these numbers can be interchanged as necessary as both refer to the sponge dressing material.
The PVA porous dressing material 12 acts as a dressing to the wound surface 14. This material is polymeric in composition where the polymer can be a synthetic substance, a natural substance or combinations thereof hi the preferred embodiment, the polymer is foamed PVA with positive and negative biocidal dyes which impregnate or bind to the sponge receptor sites. The porous PVA sponge dressing material has a morphology characterized by an average pore throat diameter of 10 - 500 p , a fluid retention of 5.5 - 300 mL fluids/g porous material, a density of 0.05 - 0.15 g polymer/cm3 porous material, and a porosity of 60 - 99.5%. The cell structure is characterized as open / interconnected with through-going pores that can be evaluated by techniques such as capillary flow porometry and liquid extrusion porosimetry. The natural capillary pressure of the PVA sponge or foam dressing material ranges from about -20 mmHg to about -70 mmHg. This natural capillary pressure ranges and falls within the low to mid-range settings of presently used mechanical vacuum machines.
Without wishing to be bound by theory, the porous PVA sponge dressing material has one or more material properties which in combination afford fluid flow through the material to create a natural capillary pressure. Material properties may include the pore properties above, surface chemical structure, surface roughness and the resultant interfacial tensions arising from the porous PVA material surface and the fluid surface in contact with other. Porous PVA materials with natural capillary pressure may be differentiated from porous materials without natural capillary flow by their simplified diffusion coefficient (D) which can be calculated from the general form of the Washburn equation: D = L2 t where (L) is the wicking distance of the liquid at time (t). In a preferred embodiment the porous PVA sponge dressing material having natural capillary pressure has a simplified diffusion coefficient greater than 0.3 cm2 / second; in a more preferred embodiment greater than 0.4 cm2 / second, and in a most preferred embodiment greater than 0.5 cm2 / second. As shown in Table 1, dressings used in the field today have little to no natural capillary pressure as measured by their simplified diffusion coefficient whereas the porous PVA foam of the present invention surprisingly has an almost 4-5X ability.
TABLE 1
Figure imgf000013_0001
The simplified diffusion coefficient may be determined to suspending a swatch of the dressing (0.5" x 0.25" x 3.0") in a normal saline solution to allow vertical wicking through the dressing material. Prior to evaluation, all materials are conditioned at ambient temperature for at least 24 hours. The test article is then attached to a suspension fixture and lowered into a test beaker containing saline solution such that one end is slightly submerged in the saline solution. The vertical wicking distance is recorded after 45 seconds. This wicking distance is then corrected to account for the initial height of saline, and the diffusion coefficient is calculated from the corrected wicking distance and wicking time period.
A biofilm enzymatic solution can also be incorporated into the porous sponge dressing material during the same manufacturing process that binds the antibacterial agents but after addition of the antibacterial agents. During this process, Methylene Blue, Crystal Violet, and biofilm prevention enzyme solution is introduced and allowed to uniformly impregnate or bind to the foam matrix. The product is then dried and processed to final specification and sterilization.
The porous sponge dressing material may further have agents that bind and/or eliminate toxins from the exudate, e.g. bacteria, mold, spores, endotoxins. The present invention uses foamed polyvinyl alcohol which is treated to open up the binding sites of the foam. The washed foam is soaked with one or more gram positive dyes selected from a group of dyes consisting of
Gentian Violet dye, also called Crystal Violet dye, Malachite Green dye, Brilliant Green dye, Quinacrine dye and Acriflavin dye and one or more gram negative dyes selected from a group of dyes consisting of Methylene Blue dye, Dimethyl Methylene Blue dye, New Methylene Blue dye. The preferred dyes used in the invention are Methylene Blue dye and Gentian or Crystal Violet dye are attached to a finite number of the binding sites in the foam. Generally, electronegative (acidic) dyes are more effective on Gram-negative bacteria and electropositive (basic) dyes are more effective on Gram positive bacteria such as Staphyloccus aureus.
The porous sponge dressing material may be shaped if desired to be conformable to the shape of the wound bed. The porous sponge dressing material may have a surface porosity on the surface distal to the wound that allows for moisture transmission outwards but is impermeable to air (inwards). As a result, the porous sponge dressing material can self- rejuvenate until it is fully loaded with exudate, up to 5x, lOx or even 15x its weight in exudate fluid, at which time the dressing would be replaced.
This sponge material of the invention may further be combined with clinically safe agents, e.g. saline, hydration fluids, antimicrobial agents, softening agents, stiffening agents, or wetting agents. The agents may be preloaded prior to clinical use or may be loaded by a clinician at the time of clinical use.
In another example, the synthetic polymer can be polyvinyl formal. The natural polymer material can be either animal or plant derived, for example, collagen, chitosan, or polyethylene terephthalate. The sealing layer, drape or cover 20 acts to form a vacuum seal over the dressing 12 to the wound perimeter. The sealing layer 20 may be polymeric in composition where the polymer can be a synthetic substance, a natural substance or combinations thereof. The sealing layer may also be metallic in composition. The sealing layer may be comprised of multiple polymeric and or metallic layers and may further have adhesives on its surfaces or between layers. The vacuum connection assembly 30 acts to apply auxiliary vacuum through the sealing layer 20 to the sponge dressing 12 from the vacuum mechanism 40 via plastic conduits 82 and 80 as seen in Figure 4, or nipples 42 as seen in Figure 2, or nipple 30 as seen in Figure 1. The fluid removal assembly (conduit, T-section, nipples) may be polymeric in composition where the polymer can be a synthetic substance, a natural substance or combinations thereof. The vacuum connection assembly may also be metallic in composition or a combination of polymer and metal. The vacuum connection path may be affixed external to the sealing layer or be imbedded within the sealing layer.
The vacuum mechanism 40 provides a clinically beneficial negative pressure (up to -120 mm Hg) to the wound site 14 through the porous foam dressing material 10/12. The vacuum mechanism 40 may be affixed external to the sealing layer 20, positioned adjacent the sealing layer or be imbedded within the sealing layer and draws fluid away from the porous foam sponge material through one or more paths. The vacuum or negative pressure is achieved and controlled through many methods known to those skilled in the art. In one embodiment, the vacuum is achieved through an energized device. In another embodiment, the vacuum is achieved through a manual process such as a syringe or squeeze bulb. Preferably, the device is a mechanical pump which is energized or powered by batteries. The vacuum mechanism may allow for filtration of fluid prior to entering the fluid return path. The vacuum mechanism may allow for the addition of clinically safe agents to the fluid prior to entering the fluid return path.
The medical device described in this invention may be single use and thus disposable or one or more of its components may be reusable. It is envisioned that all components will be disposable and that a whole unit will be disposable as medical waste. The device may be fully assembled when received by the customer or may require assembly at the point of care. The NPWT system of the invention may optionally have a sealing layer 20 as shown in Figure 2 on the porous material surface 10 that allows for vapor or moisture transmission outwards but is impermeable to air (inwards). In other words, the layer 20 is both vapor permeable and an air barrier. As noted above, this would enable the porous sponge material to self-rejuvenate until it is fully loaded with exudate. In one embodiment, the sealing layer covers only the distal facing porous sponge material surface and abuts the auxiliaiy vacuum unit. In another embodiment, the sealing layer extends over the auxiliary vacuum unit, and the vacuum exhaust passes through the sealing layer. In yet another embodiment, the sealing layer runs under the auxiliary vacuum unit and the vacuum auxiliary units sits above the sealing layer. In a preferred embodiment, the sealing layer is translucent to aid in visualization of the porous sponge material by the clinician or patient.
As previously noted, the inventive assembly may have a vacuum connection component 30. This component would be located between the auxiliary vacuum unit 40 and the foamed porous material dressing 10/12. In one embodiment of the invention, the vacuum connection component has baffles or channels that aid in equilibrating the vacuum from the auxiliary vacuum unit 40 to the porous material 10/12 or aid in distributing filtered exudate back to the porous material. One or a plurality of fluid removal and/or fluid return chambers may be used where each chamber has one or more of the functions listed above.
The vacuum connection component may also be provided with a vacuum port/valve. This port/valve component is gas permeable but not liquid permeable and acts to protect the auxiliary vacuum unit from being fouled by exudate. In another embodiment, the assembly may be provided with a check valve to prevent back flow of air into the vacuum connection component and/or the porous sponge material. In yet another embodiment, the vacuum connection component may have a length of tubing to separate the auxiliary vacuum unit from the porous sponge material. One or a plurality of vacuum port/valves may be used where each unit has one or more of the functions listed above.
The auxiliary vacuum unit 40 of the invention (see vacuum motor 78 in Figure 4) supplements the negative pressure provided by the foam porous dressing material 12 so that the total negative pressure on the wound remains in a clinically beneficial range. In one example (FIG 3), the porous material 12 alone provides negative pressure that is above the clinically beneficial threshold, and the auxiliary unit supplements that pressure by raising the pressure higher in the therapeutic range. As exudate is drawn into the foam porous dressing material 12, air or moisture exhaust from the system and/or leaks occur in the system, the pump can apply vacuum to maintain the therapeutic range. As the porous material gets filled, its contribution to maintenance of the therapeutically beneficial negative pressure decreases and the auxiliary vacuum unit’s contribution increases. When the porous material is fully saturated, and/or the auxiliary vacuum no longer has power sufficient to hold a therapeutic negative pressure, the NPWT system can be replaced with a new device. It should be recognized that the system’s design allows for different ratios of negative pressure contribution from the porous material and auxiliary vacuum unit, and that the ratio may vary over the course of the treatment period. As previously noted, the auxiliary vacuum unit can be powered by a mechanical action, e.g. a syringe force. The auxiliary vacuum unit (pump) is preferably powered with an electrical supply, most preferably a battery. Examples of battery powered pumps that could be used in the auxiliary vacuum unit include Models Compact/OEM and KPV-14A available from Cole Parmer, Model NMP 03 KP DC-S available from KNF Neuberger, Inc. and Model SX-1 from Binaca Products.
While the auxiliary vacuum unit 40 can sit on the distal (outward) facing surface of the porous material 10/12, the auxiliary vacuum unit 40 can be embedded or encased in the porous material 10/12 to provide a low-profile system.
The auxiliary vacuum unit 40 may have addition features including:
• Pressure feedback loop enabling constant pressure adjustment
• Pressure feedback loop enabling intermittent pressure adjustment (cycling)
• Pressure cut off detection when pressure is beyond therapeutic level
• Leak detection when pressure decay is too rapid
• Pressure ramp up detection when rate (mm Hg/sec) of pressure increase is too steep, indicating the porous material or fluid removal/fluid return chamber is saturated or exhausted
• Total pressure reduction in a cycle, which when above a threshold, indicates the porous material or fluid removal/fluid return chamber is saturated or exhausted
The auxiliary vacuum unit 40 is provided with an integral motor 78 and can also be provided with a vacuum exhaust component that allows escape of air and moisture vapor that has traveled through the auxiliary vacuum unit. The vacuum exhaust component may sit on the surface of the auxiliary vacuum unit or be attached to the auxiliary vacuum unit through a length of tubing. One or a plurality of vacuum exhausts may be used. The auxiliary vacuum unit may also serve as a check valve to prevent back flow of air into the auxiliary vacuum unit.
The NPWT system may further have a sealing drape layer 20. The sealing drape layer 20 acts to seal the wound bed in an airtight manner. It can also act as the moisture vapor transmission layer described above. In this case, the sealing layer may cover the auxiliary vacuum unit, porous material and other components of the device. In another modification, the sealing drape layer is non-permeable. In this case it would run from the healthy skin to the moisture vapor transmission layer, or it would still cover the entire NPWT system where moisture transmission would be through the auxiliary vacuum unit or vacuum exhaust component.
The overall system is a single use, disposable product. The system is supplied sterile and have a useful lifetime of approximately 1 day, more preferably 2-3 days, and most preferably up to 7 days depending upon the type and severity of the wound.
The control system 70 as schematically shown in Figure 4 comprises a low power microcontroller 71, a three LED indicators 72, one or more push button switches 74, ambient 76a and vacuum 76b pressure sensors, a vacuum motor 78, motor power control 79, one or more batteries 77 and a tactile feedback device 72a. The vacuum pressure sensor has a “T” attachment 82 connecting it to the plastic conduit 80 (for vacuum connection component 30) which connects the vacuum motor to the wound dressing 10 placed on the patient wound 14. The ambient pressure sensor 76a is open to the atmosphere. The microcontroller implents the logic described herein with the C source code language compiled and downloaded for execution to the microcontroller.
The clinically therapeutic negative pressure range for the device is about -60 mmHg to about -120 mmHg which is shown in Figure 3 by the letter R. A normal working cycle is shown in Figure 3. The ramp up is shown by the letter A and the decay is shown by the letter D. However, it is preferred that the negative pressure should fall within about -80 mmHg to about - 100 mmHg and most preferably about -85 mmHg to about -95 mmHg.
The negative pressure cut-off value for the device is about -120 mmHg. Beyond this value, the patient experiences discomfort.
The push button and three LEDAs provide the device user interface. When the push button is first pushed, the device starts up, performs an initial operational check and indicates it is ready for operation by illuminating a green LED. The second time the push button is pushed, the device initiates treatment and starts monitoring operational status. Good status is indicated by an illuminated green light. Warning status is indicated by an illuminated yellow light and a unique tactile feedback pattern. Error status is indicated by an illuminated red light and a different unique tactile feedback pattern.
Having separate ambient and vacuum absolute pressure sensors have advantages over a single differential sensor common the state of the art. Differential pressure sensors require that the path to the ambient pressure be physically adjacent to the path to the vacuum pressure. Separate sensors allow the paths to be physically separated. Differential pressure sensors are bulky and difficult to mount, whereas absolute pressure sensors are small with a wide variety at mounting options. The ambient pressure sensor provides barometric pressure, which can provide an input to the volume calculations to determine the operational status.
At the onset of treatment with the dressing properly secured with no leaks, the device undergoes initial start-up. The vacuum motor 78 will turn on and remain running until it reaches the upper therapy threshold, at which point the vacuum motor is turned off and the pressure control will start.
Pressure control consists of reading the ambient and vacuum pressure sensors periodically. Each time a sensor is read, the vacuum level is calculated as the difference between the ambient and vacuum pressure sensors. If the vacuum is at or below the lower therapy threshold, the vacuum motor is turned on. When the vacuum subsequently reaches the upper therapy threshold, the vacuum motor is turned off.
Research has shown that a variable vacuum level may provide more effective therapy than a constant vacuum level. During the course of therapy, the microcontroller may optionally change the upper and lower threshold values in a redetermined pattern over the course of several minutes to improve the therapy effectiveness. In another embodiment, the pressure is held constant.
Operational status monitoring will run continuously once the NPWT device is started with the first push of the button. The status monitoring will include battery level, leak detection, microcontroller health, blockage detection, loss of volume capacity and device lifetime. The battery level will be monitored using both coulomb counting methods, and voltage level measurements. A warning level and error level will be established for battery monitoring based on battery characteristics. Leak rate will be calculated by summing the time of the ramp up (A in Figure 3) over a known time combined with the vacuum pump characteristics. The warning level will be established based on a projection of the loss of 20% of the lifetime of the device. The error level will be the point where the device is no longer able to maintain the pressure above the lower therapy threshold or the projected lifetime of the device due to the leak is less than 12 hours. The microcontroller health will be monitored by a hardware watchdog, which will turn off the device if the microcontroller does not run the pressure control logic at the selected periodic rate. The microprocessor will track the elapsed time that the NPWT has provided therapy. When the elapsed time is within 12 hours of a predetermined lifetime, the device will shut down the therapy, and turn off all the indicator LED’s. The principles, preferred embodiments and modes of operation of the present invention have been described in the foregoing specification.. However, the invention should not be construed as limited to the particular embodiments which have been described above. Instead, the embodiments described here should be regarded as illustrative rather than restrictive. Variations and changes may be made by others without departing from the scope of the present invention as defined by the following claims:

Claims

What is claimed is:
1. A wound dressing using natural capillary pressure of the dressing material together with auxiliary negative pressure for wound treatment comprising: a porous PVA sponge dressing material which exerts a natural capillary pressure when moistened, said PVA sponge material being pretreated with gram positive and gram negative biocidal dyes for insertion into or over a wound; a negative pressure pump mounted to and connected with said PVA sponge material to produce additional negative pressure for withdrawing fluid and water vapor from said sponge material and a cover member mounted over said sponge material and said negative pressure pump forming a unitary package for placement over a wound.
2. A wound dressing as claimed in claim 1 wherein said cover member has an adhesive placed on said cover member allowing said cover member to be mounted on a patient.
3. A wound dressing as claimed in claim 1 wherein said sponge material has a natural capillary pressure with a simplified diffusion coefficient ranging from about 0.3 cm2 / second to about 0.5 cm2 / second.
4. A wound dressing as claimed in claim 1 wherein said cover member is impervious to moisture and forms an air barrier.
5. A wound dressing as claimed in claim 1 wherein said porous PVA sponge dressing material is pretreated with a biofilm inhibitor enzyme.
6. A wound dressing as claimed in claim 1 wherein said dyes are taken from a group of dyes consisting of one or more gram positive dyes consisting of Gentian Violet dye, Malachite
Green dye, Brilliant Green dye, Quinacrine dye and Acriflavin dye and one or more gram negative dyes consisting of Methylene Blue dye, Dimethyl Methylene Blue dye and New Methylene Blue dye.
7. A wound dressing as claimed in claim 1 wherein said negative pressure pump is embedded in said porous sponge material and said natural capillary pressure runs from about -20 mmHg to about -70 mmHg.
8. A wound dressing as claimed in claim 1 wherein said porous PVA sponge dressing material has a plurality of sensors mounted thereto, said sensors measuring ambient pressure and vacuum in said PVA sponge dressing material and activating or deactivating said negative pressure pump when predetermined levels of pressure are reached.
9. A wound dressing as claimed in claim 1 wherein said negative pressure pump creates negative pressure on saod sponge dressing material ranging from about -60 mmHg to about -120 mmHg.
10. A wound dressing using negative pressure of the dressing porous sponge material together with auxiliary negative wpressure from an outside source for wound treatment comprising of: a porous sponge material having natural capillary pressure when wetted for insertion into or over a wound, said porous sponge material being pretreated with biocidal materials; a negative pressure pump mounted to said porous sponge material having natural capillary pressure when wetted to produce additional negative pressure for withdrawing fluid or water vapor from said porous sponge material and an air barrier cover mounted over said sponge material and negative pressure pump forming a unitary package for placement over a wound.
11. A wound dressing as claimed in claim 10 wherein said natural capillary pressure runs from about -20 mmHg to about -70 mmHg.
12. A wound dressing as claimed in claim 10 wherein said biocidal materials are dyes are taken from a group of dyes consisting of one or more gram positive dyes consisting of Gentian Violet dye, also called Crystal Violet dye, Malachite Green dye, Brilliant Green dye, Quinacrine dye and Acriflavin dye and one or more gram negative dyes selected from a group of dyes consisting of Methylene Blue dye, Dimethyl Methylene Blue dye, New Methylene Blue dye.
13. A wound dressing as claimed in claim 10 wherein said porous sponge material is pretreated with a biofilm inhibitor.
14. A wound dressing as claimed in claim 10 wherein said porous sponge material is taken from one or more of a group consisting of: Polyvinyl formal, Polyvinyl acetal, PVA copolymers of vinyl esters and PVA copolymers of ethylene-containing repeat units.
15. A wound dressing as claimed in claim 10 wherein said porous sponge material has a plurality of sensors mounted thereto, said sensors measuring the specific negative pressure in said porous sponge material and activating or deactivating said negative pump when predetermined levels of negative pressure are reached.
16. A wound dressing as claimed in claim 10 wherein said dressing is disposable.
17. A wound healing dressing using natural capillary pressure of the dressing material together with auxiliary negative pressure from a pump for wound treatment comprising of: a porous PVA sponge material having a fluid retention ranging from about 5.0 to about 300 ml fluids/g porous material and exerting a natural capillary pressure when wetted, said PVA sponge material being pretreated with gram positive and gram negative biocidal dyes for insertion into or over a wound and exerting a natural capillary pressure on said wound; a negative pressure pump mounted to said porous PVA sponge material to produce additional negative pressure on said wound of up to -120 mmHg for withdrawing fluid or water vapor from said sponge material and a cover member mounted over said sponge material and said negative pressure pump forming a unitary package for placement over a wound; and a sealing member mounted over said dressing; and a plurality of sensors electrically connected to a microcontroller which operates said pump to change the upper and lower threshold valves placed in the wound dressing material in a predetermined pattern.
18. A wound healing dressing as claimed in claim 17 including a fluid removal assembly mounted to said dressing.
19. A wound healing dressing as claimed in claim 17 wherein said negative pressure pump is battery powered.
20. A wound healing dressing as claimed in claim 17 wherein said negative pressure pump has a filter means to filter exudate from said wound.
PCT/US2020/000041 2019-10-24 2020-10-23 Wound dressing containing a vacuum pump WO2021080631A1 (en)

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US201916602517A 2019-10-24 2019-10-24
US16/602,517 2019-10-24

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Citations (6)

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US20090264807A1 (en) * 2005-09-07 2009-10-22 Tyco Healthcare Group Lp Self contained wound dressing with micropump
US20130211318A1 (en) * 2012-02-11 2013-08-15 Paul Hartmann Ag Wound therapy device
US20140018654A1 (en) * 2012-07-12 2014-01-16 Tolland Development Company, Llc Color change wound dressing
US20150100008A1 (en) * 2013-10-04 2015-04-09 Dristi, LLC Methods for Using Polymer Foam Absorbent Materials in Wound Dressings
US20170266240A1 (en) * 2014-11-24 2017-09-21 Matoke Holdings Limited Prevention and treatment of microbial infections

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060149170A1 (en) * 2001-08-24 2006-07-06 Kci Licensing, Inc. Negative pressure assisted tissue treatment system
US20090264807A1 (en) * 2005-09-07 2009-10-22 Tyco Healthcare Group Lp Self contained wound dressing with micropump
US20130211318A1 (en) * 2012-02-11 2013-08-15 Paul Hartmann Ag Wound therapy device
US20140018654A1 (en) * 2012-07-12 2014-01-16 Tolland Development Company, Llc Color change wound dressing
US20150100008A1 (en) * 2013-10-04 2015-04-09 Dristi, LLC Methods for Using Polymer Foam Absorbent Materials in Wound Dressings
US20170266240A1 (en) * 2014-11-24 2017-09-21 Matoke Holdings Limited Prevention and treatment of microbial infections

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