CN103384538B - 用于负压伤口治疗的设备和方法 - Google Patents
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Abstract
本文公开了减小压力器械的若干实施例及其在伤口治疗时的使用方法。某些实施例涉及用于连接到伤口部位的改进的流体连接器或抽吸适配器,例如使用较软的无结舒适抽吸适配器。某些实施例涉及连接器,该连接器用于将在传送负压中使用的流体沟道管连接到在抽吸适配器中使用的织物沟道。
Description
相关申请的交叉引用
本申请要求2010年12月22日提交的美国临时申请序号61/426,432的优先权,其内容被整体地结合到本文中。
技术领域
本发明的实施例一般地涉及使用负压伤口治疗法的伤口治疗,并且更具体地涉及其改进的设备和方法。
背景技术
过大而不能自发闭合或未能通过向伤口部位施加负压而愈合的开放或慢性伤口的治疗在本领域中是众所周知的。本领域中当前已知的负压伤口治疗系统一般地涉及使用各种手段在伤口上放置不透液体的盖以针对伤口周围的病人组织将伤口密封,并以使得在伤口区域中的盖下面产生负压区域的方式将负压的源(诸如真空泵)连接到该盖。
发明内容
本文公开的本发明的实施例针对降低压力器械和使用该降低压力器械的治疗方法,并且可能在使用降低压力的伤口治疗中有用。
本发明的某些实施例采用流体连接器和/或抽吸适配器以便将负压的源连接到位于伤口部位上的衣物。这些流体连接器和/或抽吸适配器相比于现有技术而言提供优点。例如且仅仅出于说明性目的,某些实施例可以提供用于将伤口部位连接到负压源以用于治疗的较软的无结流体连接器。此类流体连接器和/或抽吸适配器施加起来更快,与现有技术连接器相比要求较少的步骤,并且通过软且舒适而提供更大的病人舒适性和安全性,从而避免了由较硬的连接器引起的压疮及其他并发症。
在本文中还公开了用于向伤口部位提供负压的设备的实施例,包括由不透液体材料构成的顶层和底层,其具有位于这些顶层和底层之间并形成细长沟道的3D编织或3D织物材料。
在抽吸适配器的另一实施例中,此适配器具有施加器,施加器具有上和下表面,上表面被连接到桥的远端。该桥具有近端和远端,并且具有被连接到气漏的上流体通道和与负压源流体连通的下流体通道,下流体通道包括3D编织或3D织物材料。
在抽吸适配器的某些实施例中,上流体通道可以包括泡沫。桥部分还可以包括顶层、底层和中间层,每个层具有近端和远端以及在其之间延伸的细长部分,其中,上流体通道在顶层与中间层之间延伸,并且下流体通道在中间与底层之间延伸。桥的远端还可以具有扩大形状。此气漏可以设置在桥的近端处。3D编织或3D织物材料可以包括顶部编织层、底部编织层以及具有垂直延伸纤维的中间区域,并且其可以为约1.5至6 mm厚。可以将3D编织或3D织物材料构造成在经受15 psi的负荷时抵抗压缩到小于其原始厚度的一半。
以上抽吸适配器实施例可以在负压伤口治疗系统的实施例中使用,包括构造成位于伤口上且被相对于伤口周围的皮肤密封的柔性盖布,并且其中,抽吸适配器构造成被附接到该盖布,从而围绕在盖布中形成的至少一个孔口。真空泵优选地被至少一个导管连接到抽吸适配器。
在本文中还公开了用负压来治疗伤口的方法。用负压来治疗伤口部位的方法可以包括在伤口部位上施加柔性盖布,在柔性盖布中的开口上施加柔性抽吸适配器,其中,柔性抽吸适配器包括由不透液体材料构成的顶层和底层、位于顶层与底层之间的3D编织或3D织物材料、通过开口和3D编织或3D织物材料与伤口部位流体连通的底层中的孔口,并向伤口施加负压,该负压通过连接在负压源与柔性抽吸适配器之间的至少一个导管被传送到伤口并经由底层中的孔口通过3D编织或织物材料并进入柔性盖布中的开口中。
在某些实施例中,负压到伤口的施加可以促使空气经由设置在柔性抽吸适配器上的气漏而流入伤口中。在某些实施例中,空气的流速在负压被施加于抽吸适配器时可以为至少0.08升/分钟,并且可以在重量被置于抽吸适配器上的同时保持此流速,例如4.75 kg重量。当将适配器粘附于盖布时可以将粘合剂放置在抽吸适配器上,或者可以供应被预先附接到盖布的适配器。另外,上述方法可以包括向盖布中切割开口。还可以在施加盖布之前将伤口接触材料放置到伤口部位中。类似方法可以通过连接在负压源与柔性抽吸适配器之间的至少一个导管将负压传送到伤口,并且该负压通过3D编织材料进入柔性盖布中的开口中。
在另一实施例中,负压伤口治疗系统包括导管、抽吸适配器和连接器。该导管构造成将负压从负压源传送到伤口。抽吸适配器构造成向伤口输送负压,其中,抽吸适配器包括具有近端和远端的细长流体通道和在近端与远端之间延伸的细长3D编织或3D织物材料。连接器构造成牢固地附接到3D编织或3D织物材料的近侧部分,该连接器还构造成在细长流体沟道中的3D编织材料与导管之间产生流体连接。在某些实施例中,连接器构造成当经受小于20 kg的拉力时保持被附接到3D编织或3D织物材料。
在某些实施例中,连接器包括两个远侧延伸突出体,每个突出体还包括位于其上的至少一个倒钩,该倒钩构造成被推入并保持在3D编织或3D织物材料的近侧部分内。连接器还可以包括两个远侧延伸突出体,每个突出体还包括位于其上的至少一个倒钩,该倒钩构造成附接到3D编织或3D织物材料的上部分和下部分。
在其他实施例中,连接器包括构造成延伸到3D编织或3D织物材料的中心远侧延伸突出体。中心突出体还可以包括至少一个倒钩。
在另一实施例中,连接器包括构造成接收销或其他锁定设备的至少一个开口,并且其中,该销被推动通过3D编织或3D织物材料的至少一部分。
在另一实施例中,连接器包括中心沟道和构造成被推入并固定在3D编织或3D织物材料的近侧部分内部的至少一个凸缘。
在另一实施例中,连接器包括至少一个柔性线路和构造成接收所述至少一个线路的一个相应腔体,所述线路构造成形成环路并进入3D编织或3D织物材料的近侧部分中。该线路还可以包括至少一个倒钩。
在另一实施例中,提供了用于将流体通道管连接到织物沟道的连接器。连接器包括空心圆柱形主体,其包括在空心主体的近端与远端之间延伸的中心沟道。多个突出体从空心主体向远侧延伸。在每个突出体上提供了多个倒钩,其中,该倒钩向近侧倾斜,该倒钩构造成接合织物沟道。空心主体的近端处的截头圆锥形凸缘构造成压配合到流体通道管中。连接器构造成在脱离织物沟道之前耐受多达20 kg的拉力。
在另一实施例中,用于将流体通道管连接到织物沟道的连接器包括具有近端和远端的主体。至少一个构件从主体向远侧延伸,所述至少一个构件构造成延伸到织物沟道中。主体的近端构造成与流体通道管的内或外表面压配合。
在某些实施例中,主体可以是圆柱形和/或空心的。所述至少一个构件可以包括多个突出体,所述突出体可以另外包括沿近侧方向延伸的一个或多个倒钩。该构件可以替代地包括至少一个柔性线路,并且其中该线路包括锥形尖端,其构造成形成环路穿过织物沟道并被接收且牢固地连接到形成于连接器内的腔体。主体的近端可以包括截头圆锥形凸缘。
在另一实施例中,提供了流体连接,包括任何上述连接器。织物沟道与连接器的近端接合。管与连接器的远端接合。
在另一实施例中,一种运输流体的方法。该方法包括提供包括3D编织或3D织物材料的细长流体沟道。连接器被附接到3D编织或3D织物材料,其中,连接器的远端接合3D编织或3D织物材料。电路被附接到连接器的近端。流体被通过3D编织或3D织物材料、通过连接器和通过导管运输。
在某些实施例中,流体的运输包括向导管、连接器和3D编织或3D织物材料施加负压。可以将3D编织或3D织物材料放置成与伤口流体连通,其中,施加负压包括通过导管、连接器和3D编织或3D织物材料向伤口传送负压。在一个实施例中,用小于20 kg的力在连接器上拉动不会将连接器从3D编织或3D织物材料移开。
附图说明
图1示出可以在伤口的治疗中使用的负压系统。
图2A示出包括泵的负压伤口治疗系统的实施例,并且示出被施加于伤口的柔性抽吸适配器。
图2B示出图2A的实施例,柔性抽吸适配器已被放置在伤口上。
图2C示出可以在负压伤口治疗系统中使用的柔性抽吸适配器的等角视图。
图2D示出图2C的柔性抽吸适配器的分解图。
图2E示出图2D的柔性抽吸适配器的近端的近视图。
图2F示出图2C的柔性抽吸适配器的近端的近视剖视图。
图2G示出图2C的柔性抽吸适配器的顶视图。
图2H示出图2C的柔性抽吸适配器的侧视图。
图2I示出图2C的柔性抽吸适配器的底视图。
图2J示出替代的柔性抽吸适配器的分解图。
图3A示出可以在负压伤口治疗系统中使用的3D织物的顶视图。
图3B示出图3A的3D织物的底视图。
图3C示出图3A的3D织物的侧面剖视图。
图4A-B示出具有两个或更多突出体且可以连接到图2中所示的抽吸适配器的连接器的实施例。
图4C-D示出具有远侧延伸倒钩的连接器的实施例。
图4E示出具有中心杆的连接器的实施例。
图4F示出具有固定销的连接器的实施例。
图4G示出提供有突出体的与图4F类似的实施例。
图4H示出提供钩状倒钩的连接器的实施例。
图4I示出提供有设置在中心沟道周围的倒钩的连接器的实施例。
图4J-L示出连接器的实施例,该连接器包括构造成被接收到相应腔体中的一个或多个连接器。
图5A-G分别示出具有两个或更多突出体的连接器的实施例的正面透视图、前视图、后视图、左侧视图、右侧视图、顶视图和底视图。
图5H示出图5A-5G的实施例的横截面。
图5I示出图5A-5H的连接器被连接到如图2A中所示的抽吸适配器的视图。
具体实施方式
在本文中公开的优选实施例涉及用于人或动物体的伤口治疗。因此,在本文中对伤口的任何参考可以指的是人或动物体上的伤口,并且在本文中对主体的任何参考可以指的是人或动物体。本文中所使用的术语“伤口”除具有其宽泛的普通意义之外,还包括可以使用减小的压力来治疗的病人的任何身体部分。伤口包括但不限于开放伤口、压疮、溃疡和灼伤。此类伤口的治疗可以使用负压伤口治疗来执行,其中,可以将减小的压力或负压施加于伤口以帮助和促进伤口的愈合。还将认识到的是可以将在本文中公开的负压系统和方法应用于身体的其他部分,并且不一定局限于伤口的治疗。
最初参考图1,本申请的某些实施例中的用负压进行的伤口的治疗使用如示意性地示出的系统。在一个实施例中,可以部分地或完全用伤口填塞材料102来填充伤口101,诸如泡沫、纱布或任何其他适当材料。替代地,可以不利用伤口填塞材料。然后可以将至少部分地不透流体且优选地不透液体的柔性盖布103覆盖在伤口填塞材料102上且优选地到围绕伤口的周围健康皮肤的至少一部分上。可以经由诸如柔性管的导管104将盖布103连接到诸如泵的负压源106。在某些实施例中,导管104可以包括一个或多个管。用于负压的适当源包括诸如真空泵的电动负压源和诸如抽吸球的手动负压源。负压通过导管104且通过伤口填塞材料102被施加于伤口,并且伤口分泌液及其他分泌物被从伤口抽走,通过伤口填塞材料并进入罐子或其他收集单元105。收集单元105可以在负压源之前沿着导管定位,或者可以相对于负压源位于别处。在某些实施例中,可以沿着真空通道提供一个或多个过滤器107,例如在泵的出口处。此过滤器107可以对吸收臭味有用,或者可以是细菌过滤器。用于以上述方式来治疗伤口的适当系统包括可从Smith & Nephew获得的RENASYS-F、RENASYS-G、RENASYS EZ和RENASYS GO系统。
以上述方式向伤口施加减小的压力或负压可以特别地用来促进更快的愈合,增加血流,减少细菌负担,增加肉芽组织形成的速率,从伤口去除分泌液和腐肉,减轻间质性水肿,刺激纤维原细胞的增殖,刺激内皮细胞的增殖,使慢性开放伤口闭合,抑制灼烧穿透,并增强瓣片(flap)和移植物附着。还已报告已通过负压的施加而表现出对治疗的正面响应的伤口包括被感染的开放伤口、褥疮、裂开切口、部分厚度灼伤以及已附着有瓣片或移植物的各种损伤。
诸如在本文所述的实施例中使用的那些适当盖布优选地是不透液体的,使得可以在伤口部位处保持至少部分负压。盖布可以由例如诸如聚氨基甲酸酯的透明柔性塑料构成。其他适当材料在没有限制的情况下包括不吸收水流体的合成聚合物材料,包括聚烯烃,诸如聚乙烯和聚丙烯、聚硅氧烷、聚酰胺、聚酯及其他共聚物及其混合物。在盖布中使用的材料可以是疏水的或亲水的。适当材料的示例包括可从DeRoyal获得的Transeal®和可从Smith & Nephew获得的OpSite®。为了帮助病人舒适并避免皮肤浸渍,在某些实施例中,盖布是至少部分地可呼吸的,使得水蒸气能够通过而不是保持被俘获在敷料下面。最后,虽然本文所示的多个实施例示出手动地向盖布中切割孔口的操作员,但在这里公开的实施例中所使用的盖布还可以提供有一个或多个预切孔口。
伤口任选地被填充伤口填塞材料。优选地,此伤口填塞材料对于伤口床而言是舒适的。此材料优选地是柔软的且是弹性地柔性的。此类伤口填料的适当形式的示例是由例如弹性热塑塑料的适当材料形成的泡沫。用于本伤口敷料的优选材料包括具有小孔口或孔隙的网状聚氨酯泡沫体和开孔泡沫。其他适当材料可以包括纱布。优选地,此类伤口填塞材料将能够在负压被施加于伤口时引导伤口分泌液及其他流体通过其本身。某些伤口填塞材料可以包括出于此类目的预先形成的沟道或开口。
通常,操作负压伤口治疗系统直至伤口已达到对于医生而言可接受的愈合水平为止。优选地使用从约40至200 mmHg范围内的负压或减小的压力来操作治疗系统,虽然该量可以根据医生偏好而较低或较高。用于在伤口上使用伤口治疗设备的时间段由医生选择。在施加负压的时间段期间,可以发生敷料更换和对治疗的其他临时中断。优选地,负压伤口治疗系统能够每天处理至少1升的伤口分泌液或其他流体,或者0.694毫升/分钟。某些实施例可以每天处理超过10升的伤口分泌液。
在用本文所述的实施例来使伤口部位准备好治疗时,通常以医学上可接受的方式对伤口进行清洁、清除和干燥。任选地,可以部分地或完全用如图1中所示的伤口填塞材料102来填充伤口部位,包括例如但不限于纱布或泡沫。可以将此伤口填塞材料修整至适合于伤口空间。接下来,盖布103被放置成在重叠到伤口周围的健康皮肤上的同时覆盖伤口部位;在某些情况下,可能需要将盖布修整至适当尺寸。根据盖布的类型,可能需要在放置盖布之前向伤口周围的皮肤施加皮肤密封剂,使得可以将盖布粘附于皮肤。优选地,盖布103在其面对伤口侧具有粘合层。一旦被粘附于皮肤,则盖布应针对皮肤形成气密密封。为了使用负压来治疗伤口,本文公开的某些实施例可以要求将盖布刺穿(例如插入导管或与抽吸适配器连通,如下所述)以产生通向伤口部位的孔口。明显地,某些盖布可以具有被预切或预成形至盖布中的一个或多个孔口,并且本文公开的某些实施例可以不要求产生孔口(如图1中所示)。在向伤口部位施加负压之后,可以将伤口分泌液及其他流体从伤口部位抽离并使其进入适当接受器105中,优选地设置在伤口部位与负压源106之间。负压的施加持续(必要时,插入敷料更换)直至伤口已达到期望的愈合水平。
图2A-J示出负压伤口治疗系统5501的实施例。在这里,系统5501可以包括具有近端5503和远端5505的桥5502以及位于桥5502的远端5505处的施加器5520,形成柔性抽吸适配器。优选地,系统5501包括桥5502。连接器5504优选地设置在桥5502的近端5503处,从而连接到沟道5512和/或5516中的至少一个,如图2D中所示。可以为系统5501提供盖帽5536(并且在某些情况下,如所示,可以附接到连接器5504)。盖帽5536可以在防止流体从近端5503漏出时有用。在某些实施例中,连接器5504可以是由Value Plastics(科罗拉多州FortCollins)出售的MQC Series™快速连接器。系统5501可以包括负压源,诸如泵或负压单元5534,其能够供应负压。该泵还优选地包括用于储存可以从伤口去除的伤口分泌液及其他流体的罐子及其他容器。在某些实施例中,此泵5534可以是由Smith & Nephew出售的RENASYS GO泵。泵5534可以经由管5540连接到连接器5504。在使用中,施加器5520被放置在形成于盖布5531中的孔口5535,盖布5531被放置在适当准备的伤口5530上,其在某些情况下被填充诸如泡沫或纱布的伤口填塞材料。随后,在泵534经由管5540连接到连接器5504的情况下,泵被激活,从而向伤口供应负压。可以施加负压的施加直至实现伤口5530的期望愈合水平。
在这里,并且特别地参考图2C-D,系统5501可以包括具有近端5503和远端5505的桥5502及在桥5502的近端5505处的施加器5520。在某些实施例中,桥5520可以包括位于上层5510与中间层5514之间的上沟道层5512,下沟道层5516位于中间层5514与底层5518之间。优选地,层5510、5514和5518具有在近端与远端之间延伸的细长部分,并且可以由不透流体的材料、例如诸如聚氨酯的聚合物组成。当然将认识到的是层5510、5514和5518每个可以由不同的材料构成,包括半渗透材料。如图2D中所示,上和下层5510和5518可以是曲线的、圆形的或者在其大部分长度内向外凸起。在组装期间,例如可以将层5510、5514和5518捏在一起以将层焊接或粘附在一起。在这样做时,沟道5512和5516的近端被夹在这些层之间,因此部分地使沟道5512、5516的近端压缩并使这些上述近端上的层5510、5514、5518伸展。当然,在桥段5502中所使用的材料的近端不一定是圆形或曲线的;如图2J中所示,其可以保持基本上摆好姿势并是直线的。
上和下沟道层5512和5516优选地是从近端5503延伸至远端5505的细长层,并且每个可以优选地包括多孔材料,例如包括诸如聚乙烯或聚氨酯的开孔泡沫。在某些实施例中,上和下沟道层5512和5516中的一个或多个可以由织物组成,例如编织或织造隔离织物(诸如编织聚酯3D织物、Baltex 7970®或Gehring 879®)或无纺材料。适当材料还可以包括厚绒布织造或毛圈材料。纤维可以不一定是织造的,并且可以包括粘制和植绒(包括诸如Flotex®的材料)纤维材料。所选的材料优选地适合于引导伤口分泌液远离伤口,并且用于将负压和/或通风传送至伤口部位,并且还可以向沟道层5512和5516传送一定程度的抗打结或堵塞性,如下所述。在一个实施例中,上沟道层5512可以包括诸如聚氨酯的开孔泡沫,并且下沟道层可以包括如下文所述的织物。在另一实施例中,上沟道层是任选的,并且该系统可以替代地提供有开放上沟道。在图2D中所示的实施例中,上沟道层5512可以具有曲线的、圆形或向上突起的上表面和基本上扁平的下表面,并且下沟道层5516可以具有曲线的、圆形或向下突起的下表面和基本上平坦的上表面。
在某些实施例中,织物可以具有三维结构,其中,一个或多个类型的纤维形成其中纤维在全部的三个维度上延伸的结构。此类织物在某些情况下可以帮助芯吸、输送流体和/或传送负压。为了防止沟道5512和/或5516在被装入系统5501中的同时移位或扭绞(这可削弱在负压下的各沟道的性能),在某些实施例中可优选将沟道5512和/或5516粘附或固定到层5510、5514和5518中的一个或多个。在某些实施例中,这些材料保持打开且能够在负压治疗中所使用的典型压力下向伤口区域传送负压,所述典型压力例如在40至150 mmHg之间,不过也可以有较高和较低值。在某些实施例中,织物可以包括被相互堆叠或分层的多个材料层,这在某些情况下可以在防止沟道5516在负压的施加下皱缩时有用。在其他实施例中,在沟道5516中使用的织物可以在1.5 mm与6 mm之间;更优选地,织物可以在3 mm与6 mm厚之间,并且可以由一个或多个单独的织物层组成。在其他实施例中,沟道5512在1.2-3 mm厚之间,并且优选地厚于1.5 mm。另外,并且如前所述,在系统5501中所使用的材料优选地是舒适且柔软的,这可以帮助避免可能由伤口治疗系统挤压病人的皮肤而引起的压疮及其他并发症。下面在图3A-C中讨论3D织物的其他示例。
优选地,层5510、5514和5518的远端和沟道层5512和5516在其远端处被扩大(以放置在伤口部位上),并且可以形成“泪珠”或其他扩大形状。至少该层5512、5514、5516和5518的远端还可以提供有一个或多个通孔。此孔口不仅在对伤口分泌液的排出和对向伤口施加负压有用,而且在设备的制造期间有用,因为这些孔口可以用来使这些各层适当地对准。
另外参考图2D-E和J,在桥5502的近端5503处提供有沟道连接器5506,沟道连接器5506优选地构造成被嵌入下沟道层5516中,从而创建牢固的流体连接。在某些实施例中,可以将沟道连接器5506插入被形成到沟道5516中的预制腔体中,如图2J中所示,此腔体可以是切割出的,或者可以采取槽口接头的形式。在某些实施例中,沟道连接器5506可以是下面在图4A-L中描述的连接器中的一个。在沟道连接器5506的一端被嵌入下沟道层5516中的情况下,沟道连接器5506的另一端可以被连接到连接管5507或者在一个实施例中与之连通,虽然在某些实施例中,可以将沟道连接器5506直接连接到连接器5504,或者直接连接到被连接到负压源的管5540。当使用连接管5507时,所得到的组件可以允许向其附接连接器5504。盖帽5536,其可以例如经由盖帽皮条5527被固定到抽吸适配器,盖帽皮条5527被用设置在连接管5507的外表面上的环固定。盖帽5536可以用来例如在连接器5504处覆盖抽吸适配器的端部,从而防止分泌液及其他伤口流体漏出。连接器5504优选地构造成与被连接到负压源的管5540相连。连接器5504可以例如包括凸缘或其他类似结构以帮助将连接器5504固定到管5540和/或盖帽5536,不过将理解的是可以有其他连接器,包括快速断开耦合件、路厄锁、圣诞树及其他此类连接器。
上层5510可以包括向下延伸的附加材料,优选地至少具有桥5502的厚度;此材料然后可以用来结合或焊接到其他层,从而形成流体不透的密封。更具体地,在组装期间,可以例如通过熔融、焊接或用粘合剂将上层5510附接到下层5518,从而形成流体不透的密封(除远端和近端处的孔口之外)。优选地,中间层5514被附接到顶层5510和底层5518。在某些实施例中,将连接器5504和/或5506以及管5507附接或结合到层5510、5514、551中的至少一个从而创建流体不透的连接可以是优选的。为了提供更牢固的连接,某些实施例还可以提供有被实现到底层5518上的焊接点5532。下沟道5516可以具有穿过它的孔或孔口,其可以用来经由焊接点5532将其焊接到下层5518。下沟道5516经由通过孔5533实现的焊接点5532到下层5518的此焊接因此可以帮助防止各种层和沟道移动或被移位。明显地,将理解的是可以使用其他固定手段,例如粘合剂等,并且此类装置还可以在上沟道5512中使用。
在某些实施例中,例如,如图2C-J中所示,可以在桥部分5502上设置受控气漏5524,例如在其近端处。此气漏5524可以包括延伸通过上层5510的开口或沟道,使得气漏5524与上沟道5512进行流体连通。在对系统5501进行抽吸时,空气将通过气漏5524进入,并沿着上沟道5512从近端5503移动至远端5505。然后空气将通过经由层5512、5514、5516和5518的远端穿过孔口而被吸入下沟道5516中。气漏5524优选地包括过滤器5525。优选地,气漏5524位于桥部分5502的近端处,从而使伤口分泌液或其他流体进行接触且可能堵塞气漏5524或其过滤器5525或与之相干扰的可能性最小化。在某些实施例中,此过滤器5525是能够将微生物和细菌排除在外的微孔膜,并且该微孔膜可以能够滤出大于45 μm的颗粒。优选地,过滤器5525可以将大于1.0 μm的颗粒且更优选地大于0.2 μm的颗粒排除在外。有利地,某些实施例可以提供至少部分地对例如水、诸如洗发液的常见家庭液体及其他表面活性剂具有化学抵抗性的过滤器5525。在某些实施例中,向系统5501重新施加真空和/或擦净过滤器5525的暴露外部可能足以清除堵塞过滤器5525的任何外来物质。过滤器5525可以由诸如丙烯酸、聚醚砜或聚四氟乙烯的适当抵抗性聚合物,并且可以是疏油的和/或疏水的。在某些实施例中,过滤器5525还可以包括支撑衬里层,例如无纺聚酯支撑体。优选地,气漏5524将供应相对恒定的气流,其不会随着向系统5501施加附加负压而略微增加。在其中通过气漏5524的气流随着施加附加负压而增加的系统5501的实施例中,优选地,此增加气流将被最小化,并且不会与向其施加的负压成比例地增加。
在某些实施例中在受控气漏5524中提供的过滤器5525可以在供更多走动和活动的病人使用的系统5501中有用。例如,耐化学过滤器可以允许病人在不会在过滤器被重新连接到负压源时损坏过滤器的功能的情况下进行沐浴或淋浴。然后可以例如通过擦拭过滤器5525或向系统5501重新施加负压来清除阻塞气漏5524的任何堵塞物或流体。此类系统还将具有优点,即将不需要去除系统5501和任何分类的伤口敷料材料(如果存在的话)并然后重新施加,如果需要将病人从负压源断开连接的话,例如伴随着沐浴。浙江导致改善本治疗系统的成本有效性和容易使用方面的显著优点。
系统5501优选地构造成提供一致的流体流动,即使系统5501扭结或承受过大重量。例如,在病人身上使用时,桥部分5502可以变得自己折叠,否则病人可能翻身,因此将他或她的体重放置在系统5501的至少一部分上。通常,现有技术敷料和流体连接器在这种情况下被阻塞或变得无效,并且在某些情况下可能对诸如压疮的并发症有所贡献。然而,在这里,某些实施例在扭结或承受过大重量的情况下提供改善的阻塞抵抗力。优选地,通过采用如上所述的沟道层5512和5516,并且更优选地通过采用泡沫沟道层5512和织物沟道层5516,系统5501能够在通过负压源施加负压的同时保持至少0.08升/分钟且优选地0.12升/分钟的通过气漏5524的流速。其他实施例还将系统5501提供成能够处理至少10升/天或6.9毫升/分钟的通过下沟道5516的来自伤口部位的流体分泌液排放。某些实施例将系统5501提供成通过具有1英寸直径的杆在例如12 kg重量的重量压在桥部分上时保持这些流速。在某些实施例中,在具有相同重量的情况下或者例如在直接被放置在折叠区上的4.75 kg重量的情况下,在桥部分5502本身扭结的同时,也保持这些流速。优选的是系统5501能够耐受甚至在延长时间段期间、例如40小时内被折叠或扭结,并且与被折叠或扭结之前的其性能相比,不显示出性能(例如,流速)方面的任何退化。优选地,系统5501的实施例还能够在伤口处传送并保持接近于负压源处的负压水平的负压。例如,在伤口处保持的可接受压力水平可以在已在负压源处设定的负压的±25 mmHg内,此压力优选地在系统5501具有向其施加的负压的95%的时间内被保持在此水平。可接受压力水平可以包括在40-120 mmHg之间的压力范围,然而已成功地使用了200 mmHg的水平。
另外参考图2A-D、G-J,系统5501还包括被设计成用于放置在伤口部位上的施加器5520。优选地,施加器5520包括柔性层5550,例如聚乙烯或聚氨酯,在其下(面对伤口)侧具有一层粘合剂。任选地,可以将保护性释放层5529放置在粘合剂层上,其在使用之前可去除。在某些实施例中个,可以在施加器5520的上侧上提供更加刚性的可去除衬里层5552以由于层5550的柔性而促进施加器5520的操作。施加器5520优选地包括在远端5505处包括用于桥5502的附接点,例如使用一段双面胶带5528。可以用在将桥5502粘附于施加器5520之前被去除的附加保护释放层来保护双面胶带5528。将理解的是还可设想不同的附接方法,例如热密封、焊接或适当的粘合剂。某些实施例还可以允许桥5502和施加器5520作为单个单元的制造,该单个单元不要求单独的附接装置。施加器55520优选地包括通过其本身的至少一个孔口5526,并且被设计成放置在伤口部位上,并且其可以用于将伤口部位流体连接到负压源和气漏,同时还充当导管以从伤口部位抽出伤口分泌液。
在使用中,并且参考图2A-B,可以以与先前在本文中公开的其他实施例类似的方式来使用系统5501。优选地以适当的方式清洁和准备伤口部位5530,并且在必要时,将伤口填塞材料放置到伤口部位中,后面是盖布5531。然后产生通过盖布到达伤口部位的孔口5535,虽然某些实施例可以具有预制孔口5535。随后,操作员可以将施加器部分5520放置在孔口5535上。在从施加器部分5520的下侧上的粘合层去除衬里层5520(如果存在的话)之后,针对盖布5531将施加器密封,并且还从施加器部分5520去除衬里层5552(如果存在的话)。然后可以将诸如管5540的流体导管连接到连接器5504。还可以在向伤口部位施加所述施加器之前将管5540连接到连接器5504。流体导管被连接到负压源5534,优选地在其之间插入适合于包含伤口分泌液的容器。然后可以向伤口部位5530执行负压的施加直至伤口部位进展至期望的愈合水平。
在系统5501的使用期间,来自伤口部位5530的伤口分泌液通过下沟道层5516被负压抽出。气漏5524允许空气经由层5512、5514、5516和5518的远端穿过上沟道层5512至孔口中。负压向后朝着负压源或泵将通过上沟道层的空气抽入下沟道层5516中。在某些实施例中,受控气漏5524通过系统5501提供恒定的气流,其然后可以用来确定是否存在阻塞或泄漏。阻塞的原因可以包括例如其中下沟道5516被伤口碎屑堵塞的情况。泄漏原因可以包括例如伤口部位上的盖布的不适当密封或者对系统5501的物理损坏,导致过量空气泄漏到系统中。在某些实施例中,可以通过在泵工作以保持恒定负压的同时测量泵的速度来确定阻塞或泄漏。还可以通过测量被发送到泵的电压或信号的量来间接地测量泵速度。
图3A-C示出可以在本文所述的各种实施例中使用的3D织物的视图,例如图2A-J中所示的抽吸适配器的桥5502。虽然在本文所述的实施例中可以使用诸如泡沫的其他多孔材料,例如在图2A-C中所示的上和下沟道5512和/或5516中,在某些情况下,3D织物的使用可能是有利的。已经发现某些3D织物在向流体抽吸适配器传送负压和从流体抽吸适配器传送伤口分泌液方面变小很好,即使在处于负压下的同时(例如,当病人的体重被直接放置在抽吸适配器上时,或者和施加负压时)和/或当流体抽吸适配器扭结或折叠时。已经被发现表现可以接受的某些3D织物包括编织聚酯3D织物、Baltex 7970®、Gehring 879®或Coolmax®。当然,可以部分地或完全使用其他纤维和织物类型以制造3D织物,并且在没有限制的情况下包括诸如尼龙、纤维胶、棉花以及其他合成微纤维的聚酰胺。3D织物还可以至少部分地由诸如Nomex®和Kevlar®的纤维构成。还可以使用在本文中的其他地方公开的其他类型的织物和材料。
在一个实施例中,如图3A-C中所示,3D织物可以包括底侧5603、顶侧5605以及开放中间区域5607。图3A示出3D织物的底(面对伤口)的一侧5603,其可以被织造成从而产生跨织物纵向地延伸的长方形或卵形开口5611。在一个实施例中,长方形或卵形开口5611表示或提供在底层的表面面积的10和45%(或者约10%至约45%)、更优选地10%至30%(或约10%至约30%)之间的开放区域。在这里,纤维被编织(例如通过经编)成也包括这些较大开口或孔隙,其允许除通过纤维的毛细作用沿着纤维载送的伤口流体之外的伤口流体的大量运输。任选地形成在3D织物(如图2D和J所示)的远端中的孔口也可以帮助伤口碎屑和流体的大量排出。
图3B示出如本文所述的可以使用的3D织物的顶侧5605。在一个实施例中,此顶侧5605不具有底侧5603的较大卵形孔口5611,但是具有由纵长地且大体上横向地或者跨织物的宽度成一定角度延伸的纤维限定的开口5613。如所示,这些开口可以是大体上菱形形状的。在一个实施例中,这些开口5613可以表示或提供大于底层的面积、例如在30%与50%(或约30%与约50%)之间的开放区域。当然,将理解的是在这里提出的织物是非限制性示例,并且可以有不同的织物构造和取向,例如顶层5605被朝向放置,从而面对伤口,并且底层5603面朝上。
图3示出3D织物的横截面(织物中的竖直纤维上的球茎状突出体是切割过程的人为现象)。可以将竖直延伸纤维5609织造成从而在也被连接到底层和顶层5603和5605的同时延伸通过中间开放区域5607。优选地,存在于开放中间层5607中的纤维5609将具有足够的硬度从而帮助防止织物的压缩。如此图中所示,并且在不希望被理论束缚的情况下,已被发现表现很好的3D织物将常常在中间部分中包括较大开放区域5607,其可以在处于负压施加下的同时允许有效地将分泌液及其他流体从伤口部位输送走,而更稠密地织造的外层5603、5606可以帮助提供附加的拉伸强度和毛细芯吸动作。例如,中间层可以包括大于50%(或大于约50%)的开放体积。明显地,所得到的织物不能太厚或者由太硬的纤维组成,因为所得到的抽吸适配器和系统可能不会保持足够的柔性以供病人舒适地使用。
通常有利的是,在使用的同时修整3D织物的性能特性以解决抽吸适配器的各种要求。特别地,通过考虑织物的多孔性,可以简化通过分泌液通过织物的流速,例如当受压缩时。在这种情况下,并且再次地不希望被理论束缚,织物的多孔性和因此的将可用于流体穿过的空间可以部分地由在产生3D织物中所使用的纤维的编织图案、在其中所使用的纤维的厚度及其各自的刚性和硬度(尤其是当受压缩时)确定。还可以按照表面性质(纤维可以是平坦的或有纹理的)和在所得到的织物中使用的纤维或线丝的数目来修改纤维。抗压缩性可以收到在织物的竖直轴中使用的纤维或单丝的选择的影响,并且一般地,较硬的材料将改善此轴上的抗压缩性。诸如疏水性的其他材料性质可以起到作用。在某些情况下,将织物处理成是亲水的可能是有益的,例如用亲水聚合物,从而改善流体的芯吸。供某些抽吸适配器使用的3D织物的优选实施例已被发现当以这种方式来处理Baltex®织物时很适用。其他可能的处理可以包括亲脂性涂层以防止蛋白质在使用期间粘附和累积,这可能引起伤口部位的堵塞和压力损失。
可以通过将每个开口视为在处于层流下的同时服从伯努利原理的单独孔板,可以近似在处于负压施加下的同时通过3D织物的流速。为了简化计算,可以使用用于3D织物的给定区域的开口的面积。因此,可以使3D织物最优化以实现诸如所需抗压缩性和所得到的负压施加下的流速的因素之间的良好平衡。在3D织物的刚度和流速适合于在本文所述的实施例中的应用的情况下,还将发生进一步的最优化。3D织物的性质和尺寸的最优化还将优选地考虑到流速与织物的所需刚度和舒适性之间的平衡,因为过硬的织物可能不会适当地弯曲,并且还可能在病人身上是不舒适的。3D织物应优选地被设计成从而在针对组织被压缩时屈服,从而防止组织压缩(例如针对病人体内的骨隆起)和可能随之而来的不舒适和损坏,诸如压疮。例如,可以修整织物的尺寸以用于抽吸适配器的最终使用,在诸如手指的远侧肢端的情况下较小,并且对于腹部和灼伤伤口而言较大。过硬的织物还可能引起压疮及其他此类并发症,虽然其在其较大尺寸形式可以可接受地起作用。
在实践中,并且同样如前文所述,通过使用3D织物的抽吸适配器的实施例的流速在负压的施加期间为至少0.08升/分钟,优选地达到10升/分钟,并且应能够处理至少10升/天的流体分泌液排出。可以将抽吸适配器的某些实施例构造成处理大得多的伤口,包括腹部伤口,并且其在某些情况下可以流出至少0.5升/小时或12升/天。在更极端的情况下,所使用的泵(例如,RENASYS EZ)可以能够排放高达16升/分钟,从而在小于1分钟内将大的伤口抽空至120 mmHg的负压。由于3D织物而造成的压降应当是最小的,并且在伤口部位处测量的负压水平优选地处于在负压源处测量的压力水平的25 mmHg内。虽然压降随着施加负压的增加而增加(因此使得更难以达到25 mmHg的目标),但伤口治疗系统的实施例优选地能够将此目标压力保持到至少200 mmHg的负压。抽吸适配器和系统优选地能够在负压所需的压力范围内起作用,该压力范围估计为从约40 mmHg至200 mmHg。大于200 mmHg的压力范围是可能的,但是这些在某些情况下可能引起病人不适。该设备还可以在较低压力范围下起作用,诸如20 mmHg,不过在此类低压水平下,可能会减少由负压引起的治疗效果,而该设备更多地充当排出设备。优选地,负压治疗系统的实施例能够在向伤口施加负压的95%的时间内在伤口部位处保持这些目标压力。在某些实施例中,织物可以包括被相互堆叠或分层的多个材料层,这在某些情况下可以在防止沟道5516在负压的施加下皱缩时有用。在其他实施例中,在沟道5516中使用的织物可以在1.5 mm与6 mm之间;更优选地,织物可以在3 mm与6 mm厚之间,并且可以由一个或多个单独的织物层组成。在其他实施例中,沟道5512在1.2-3 mm厚之间,并且优选地比1.5 mm更厚。优选地,3D织物能够在不超过织物原始厚度的10%的压缩的情况下耐受至少5.3 psi的负荷。此外,3D织物还可以能够在经受15 psi的负荷时抵抗压缩到小于其原始厚度的一半。
在优选实施例中,可以使用150和225丹尼尔的纱线由100%聚酯来制造3D织物,以得到重量为每平方码约23至25盎斯的织物。在这些情况下,织物可以为约5.8-6.8 mm厚。织物的底部还可以具有与图3A中所示的那些类似的若干开口或孔隙5611,其在形状方面可以是细长的、矩形的或卵形,并且以其长轴纵向地沿着织物而定向。可以将开口5611布置成跨织物纵向地延伸的多个行,例如2至5行,或者更优选地3行,如图3A中所示。开口5611可以在每行中相互等距地间隔开,并且可以形成从一行到另一行的交错图案。在一个实施例中,每行可以具有每2英寸(或约50 mm)约6-10个开口,更优选地8个开口。沿着织物的给定宽度或横向维度,由开口形成的横向行可以具有每2又1/8英寸(或约54 mm)约6-10个开口、更优选地8个开口的间距。在一个实施例中,开口可以具有纵向地在约1/16"至约1"之间的长度和横向地在约1/32"与1/2"之间的宽度。在一个示例中,开口纵向地测量为约1/8"(或约3.2mm)并且横向地测量为约1/32"(或约0.79 mm)。在一个实施例中,3D织物可以具有在约50和100 mm之间、更优选地约60 mm的总长度,在约5和15 mm之间、更优选地约9 mm的宽度以及约6 mm的厚度。
本文所述的系统的实施例已被测试并被发现表现令人满意。通过由本文所述的实施例构造抽吸适配器来执行此类测试。抽吸适配器的远端然后被放置于盖布上产生的孔口上,该盖布被放置在提供有模拟伤口流体源的模拟伤口腔体上,所述模拟伤口流体源是可控的且其可以改变伤口流体的流速。在某些情况下,模拟伤口腔体还被填塞泡沫或某种其他伤口填塞材料。在某些测试中,模拟伤口流体是5:1水与甘油混合物,并且在其他测试中使用已过滤马血清(可从英国Oxoid获得)。抽吸适配器的近端然后被连接到负压源,在这种情况下为泵。然后在各种负压范围和模拟分泌液流速和漏气速率下执行流速测试及其他测量。
图4A-L示出连接器5704的实施例,类似于先前所述的连接器1504和5506,并且其可以用来将负压源牢固地连接到抽吸适配器的沟道5716,诸如本文所述的那个。例如,此沟道5716可以是图2-3中的沟道5512和5516。一般地,此类连接器5704可以在提供从负压源到负压治疗系统的更牢固连接时有用。这些连接器5704的使用是任选的,并且可能并不是在本文所述的所有实施例中都是必需的。在使用中,被连接到连接器5704的管5740可以拉动,或者其他外部源可以以某种方式使连接器5704从其被附接到的沟道5716脱离。在这种情况下,可以减少或停止负压到伤口的施加。如上所述,将连接器5704固定到系统的其余部分的其他手段包括将治疗系统的其他层(如果存在的话)结合或附接到连接器5704。例如,这可以包括将层1510、1514、1518中的至少一个结合到连接器5704。可以将连接器5704设计成从而产生与在沟道中使用的织物或材料的牢固连接;当使用3D织物或3D编织材料时,连接器5704的某些实施例构造成与材料的一部分或材料的纤维接合或附接到材料的一部分或材料的纤维以产生更牢固的连接。优选地,连接器5704的实施例能够在连接器的分离和/或故障发生之前耐受达到20 kg的拉力,优选地使得连接器从其被连接到的沟道脱离。将理解的是可以将其他实施例构造成耐受较低拉力,并且可以对其进行修整至释放从而防止对病人的损伤(例如肢体周围的抽吸适配器和/或引流管的收缩)。
图4A-B示出连接器5704a的实施例,连接器5704a包括从连接器5704a的优选圆柱形主体纵向地向远侧延伸的两个或更多突出体5752。该主体还包括纵向地延伸通过连接器5704a的主体的中心沟道5755。突出体5752可以另外包括被与之附接的一个或多个倒钩5754。优选地,这些倒钩5754向近侧倾斜,从而在被推入或插入沟道5716时充当锚定物。在某些实施例中,倒钩5754可以与突出体5752形成60°的角。当沟道5716是3D织物或编织材料时,倒钩5754构造成接合到其中的纤维,产生更牢固的连接。在连接器5704的近端处,还可以提供可以以截头圆锥形式提供的凸缘5756以用于到管5740的连接。可以通过压配合将管5740连接到连接器5704a(以及本文所述的其他连接器),虽然可以用其他连接手段。管5740可以与图2J中的管5507相同,或者其可以是用来提供与负压源的流体连通的任何其他管。
在图4C-D中,连接器5704b具有构造成配合在管5740的外部周围的近侧部分,由此,该近侧部分是近似圆柱形的,并具有构造成接收管5740,管5740可以通过压配合被固定。在大约连接器5704b的中心处,可以提供远侧延伸倒钩5744以附接到沟道5716。沟道5745优选地在位于中心的倒钩5744周围模制而成并通过连接器5704b的主体,从而允许流体通过连接器5704b并进入管5740的流动。
图4E示出连接器5704c的另一实施例,其中,连接器5704c包括构造成被推入沟道5716的内部区域的中心、远侧延伸杆5746。连接器5704c在其远端处是近似圆柱形的,并且逐渐缩减而在其近端处形成较小圆柱。其被至少部分地挖空并具有构造成将流体从材料5716朝着管5740传送的内部沟道。在其近端处,连接器5704c包括与下面在图4H中描述的凸缘5742类似的凸缘5765,其中,凸缘5765构造成帮助保持到被推到连接器5704c的近端上的管5740的连接。在某些构造中,凸缘5765可以由橡胶制成。
图4F示出连接器5704d的实施例,连接器5704d包括被设计成将沟道5716固定到连接器5704d的销5747。在这里,可以将连接器5704d推入沟道5716中。替代地,沟道5716可以部分地纵向地分裂,使得沟道5716的外部在连接器5704d被插入其中时围绕连接器5704d。然后通过沟道5716且通过连接器5704d中的孔口(未示出)插入销5747。在某些实施例中,销5747可以具有向外展开的端部或其他固定方法以防止销5747移位。
图4G示出图4F中所示的实施例的变化。在这里,连接器5704e可以包括在沟道5716的一部分上延伸并构造成接收销5747的远侧延伸突出体5748。在这两个实施例中,还可以通过向管中产生用于销5747的孔(并任选地通过在必要时切掉管)来形成连接器5704d、5704e,例如先前所示的管5740,使得不需要单独的连接器件。因此,经修改的管5740可以替代连接器5704d。
在图4H中,连接器5704f包括在沟道5716的端部附近附接到上部分和下部分的远侧延伸钩状倒钩5741。倒钩5741优选地由弹性或弹簧状材料制成,其提供足以使倒钩5741下沉到并保持在沟道5716的材料中的力。连接器5704f的主体优选地是空心的,从而充当流体导管。当然,其还可以在内部被划分成延伸通过连接器5704f的主体的多个流体沟道。在连接器5704f的另一端处,可以提供凸缘5742以帮助连接器5704保持被连接到管5740,使得可以从负压治疗系统排出流体。
图4I示出与图4A-B中所示的实施例类似的圆柱形空心连接器5704g的实施例,这次提供有在连接器5704g的中心沟道5749周围模制而成的远侧、截头圆锥形尖端5744。如其他实施例一样,可以提供近侧截头圆锥形凸缘5750从而提供到管5740的更牢固的连接。
图4J-L示出连接器5704h的实施例,连接器5704h包括柔性线路5760,柔性线路5760从连接器5704h的扩大远端或凸缘5763向远侧延伸并形成回到扩大远端5763的环路。线路5760构造成被接收在形成于连接器5704h的扩大远端5763上的相应腔体5762中。在某些实施例中,线路5760可以具有构造成牢固地锁定到腔体5762中的锥形或倒钩尖端5761。还可以为线路5760提供一个或多个倒钩5764。连接器5704h的主体优选地是管状的,从而允许液体从伤口流出。在使用中,线路5760可以被推入沟道5716中并绕着某些或所有材料循环,后面是将尖端5761推入腔体5762中。倒钩5764可以在将连接器5704h固定到沟道5716时有用。当沟道5716由3D编织或3D织物材料构成时,线路760可以用来形成环路围绕并穿过纤维,所述纤维可以延伸通过沟道5716的中间部分,倒钩5764帮助接合这些纤维。一旦被固定到沟道5716,可以将连接器5704h连接到管或其他连接器5740。
图5A-I均示出与图4A-B中所示的连接器5704a类似的连接器5800的实施例。在所示的实施例中,连接器5800包括圆柱形主体5804、近侧尖端5856和远侧突出体5852。中心沟道5855纵向地延伸通过近侧尖端5856并通过圆柱形主体。如图5H中所示,中心沟道可以具有至少通过近侧尖端5856和圆柱形主体5804的基本上恒定的内腔。
远侧突出体5852可以包括从连接器5800的优选圆柱形主体5804纵向地向远侧延伸的两个或更多突出体5852。这些突出体5852可以另外包括被与之附接的一个或多个倒钩5854。例如,在图5A-I中的每个突出体上示出了两个倒钩5854。倒钩5854可以具有锋利尖端,或者该尖端可以具有如图5H中所示的圆形或钝端部。优选地,倒钩5854向近侧倾斜(例如相对于突出体5852成60°的角),从而在被推入或插入抽吸适配器(图5I中所示)的沟道5816中时充当锚定物。沟道5816可以与图4I的沟道5716相同,或者与图2-3中的沟道5512和5516相同。当沟道5816是3D织物或编织材料时,倒钩5854构造成接合到其中的纤维,产生更牢固的连接。
突出体5852的近侧部分还可以包括将突出体5852连接到主体5804的加强部分5858,并且其可以构造成提供附加强度。如图5B、5C、5G和5H中所示,加强部分5858可以在突出体5852的近端处为突出体5852提供增加的厚度。此加强部分5858还可以提供附加抵抗力以使突出体5852变得弯曲或扭曲的可能性最小化,例如当其被插入沟道5816中时。如图5H中所示,在一个实施例中,相对突出体5852之间的距离可以大于中心沟道5855的直径。在本实施例中,加强部分5858充当沿着突出体5852的内表面的过渡以使突出体5852的相对距离逐渐缩减至中心沟道5855的直径。
在某些实施例中,可以为圆柱形主体5804沿着其外表面的远端提供扩大台肩,当在图5B-E中在剖面上看时其优选地是圆形的。从底部看(如图5G中所示),可以使台肩5859的一部分变平以减小其沿着某些轴的宽度。如果这样提供,则此台肩5859可以帮助将连接器580以及倒钩5854固定到沟道5816。台肩5859的外径优选地小于相对的倒钩5854之间的距离。
在连接器5800的近端处,可以以截头圆锥形是提供的凸缘5856还可以用于到管5840的连接。在某些实施例中,凸缘5856可以具有可以促进连接到管5840的原型近侧边缘。如所示,在一个实施例中,凸缘5856在为尺寸方面从其近端朝着其远端增加。在尖端5856的远端处,在外尺寸方面存在到圆柱形主体5804的递减。可以通过压配合将管5840连接到连接器5800(以及本文所述的其他连接器),虽然可以用其他连接手段。
参考图5H,中心沟道5855优选地在连接器5804的近端与在突出体5852之前的台肩5859的远端之间具有恒定的内径。在某些实施例中,中心沟道的内径在0.07-0.25英寸之间范围内,例如0.12英寸。相对突出体5852的内表面之间的距离通常可以较大,优选地在0.1-0.2英寸之间,例如0.126英寸。连接器5800的主圆柱形部分5804的外径优选地在0.1-0.55英寸之间的范围,例如0.19英寸。如前所述,尖端5856优选地在直径方面较大,并且可以在其远端或底座处测量在0.2-0.3英寸之间,例如0.25英寸。在某些实施例中,包括突出体5852的整个连接器5800的长度可以测量在0.5-1英寸之间,例如0.77英寸。连接器5804的主体、包括近侧凸缘5856和台肩5859可以在长度方面测量在0.25和0.75英寸之间,例如0.52英寸。凸缘5856可以在长度方面测量在0.1和0.3英寸之间,例如0.2英寸。台肩5859可以在长度方面测量在0.05和0.15英寸之间,例如0.08英寸。突出体5852可以在长度方面测量在0.15-0.3英寸之间,例如0.25英寸,而倒钩5854可以在长度方面测量在0.05-0.08英寸之间,例如0.068英寸。
虽然已经为连接器580的一个实施例提供了优选尺寸,但将认识到的是还可设想具有其他尺寸的供在负压中使用的连接器。这包括具有在0.5至3英寸之间(或在约0.5至约3英寸之间)的长度(包括突出体)和在0.05至1英寸之间的(中心沟道5855的)内径。用于连接器5800的适当材料可以包括聚合物,例如但在没有限制的情况下诸如聚丙烯、聚乙烯、聚苯乙烯及其混合物的聚合物。
再次参考图5I,可以基于许多因素来构造将连接器5800(或本文所述的其他连接器中的任何一个)从沟道5816移开所需的拉力。例如,使用诸如上述的材料和构造,可以特别地选择在沟道5816中使用的材料的类型和构造。另外,可以将连接器5800中的多个特征构造成容易地确定如何将连接器5800从沟道5816移开。例如,可以特别地构造突出体5852的长度和数目以及倒钩5854的长度和数目。此外,扣住、降服或拉断倒钩5854所需的力也影响移开连接器5800所需的拉力。因此可以修整诸如材料选择、材料的后处理或连接器5800、沟道5815的其他特性和/或负压治疗系统的其他方面的附加因素,以修改将连接器5800从沟道5816断开连接所需的拉力。在某些实施例中,足以将连接器5800从沟道5816移开的拉力可以被调整至落在例如约1 kg至100 kg之间的范围内、优选地10 kg至50 kg之间的范围内、更优选地20 kg或更大的范围内,如上所述。
在某些实施例中,以使将上述的任何连接器移开或断开连接所需的拉力最优化以提供安全特征。例如,如果负压治疗系统5502的实施例在被应用于病人的同时被缠住或困住,则可以修整该拉力,使得诸如连接器5800的连接器在此类力的作用下从沟道5516断开连接。当连接器5800从沟道5516断开连接时,可以在连接器与沟道层之间形成间隔。来自图2D中所示的实施例的层5514和5518然后可以由于正在施加的负压而会合在一起以形成部分或完整密封。可以用传感器来检测结果产生的部分或完全阻塞并激活警报以警告用户系统存在的问题。在某些实施例中,还可以在检测到阻塞时停止负压的施加。在其他实施例中,还可以用邻近于连接器5800放置的传感器来直接感测连接器5800的分离,该传感器然后可以取消警报。相应地,可以通过降低系统5502缠住病人的一部分(例如,病人肢体,引起止血带效应)或勒住病人的可能性来提高病人安全性。
图4A-L和5A-I中所示的前述实施例全部共享使得其适合于被结合到前述类型的柔性抽吸适配器系统中且特别地适合于固定到诸如3D织物的沟道材料的元件。可以将以倒钩为特征的连接器的实施例(诸如图4A-D、H、J-L;5A-I)的元件与以销为特征的连接器的其他实施例(诸如4F-G)组合以形成到沟道材料的甚至更牢固的连接。还将认识到的是可以将这些连接器的特征(特别是在远端处)结合到用来传送负压的管的端部上,使得可以将那些管直接连接到抽吸适配器系统。
虽然以上详细描述已示出、描述并指出了应用于各种实施例的新型特征,但将理解的是在不脱离本公开的精神的情况下可以进行所示的设备或过程的形式和细节方面的各种省略、替代以及变更。另外,可以相互独立地使用上述各种特征和过程,或者可以以各种方式将其组合。所有可能的组合和子组合意图落在本公开的范围内。上述许多实施例包括类似部件,并且同样地,在不同的实施例中可以将这些类似部件互换。
虽然在某些实施例和示例的上下文中已公开了本发明,但本领域的技术人员将理解的是本发明超过所具体公开的实施例而扩展至其他替代实施例和/或使用以及其明显的修改及等同物。相应地,本发明并不意图受到本文的优选实施例的特定公开内容的限制。
Claims (13)
1.一种负压伤口治疗系统,包括:
导管,所述导管构造成从负压源向伤口输送负压;
抽吸适配器,所述抽吸适配器构造成向所述伤口输送负压,其中,所述抽吸适配器包括细长流体沟道,所述细长流体沟道具有近端和远端以及在所述近端与所述远端之间延伸的细长3D编织或3D织物材料;以及
连接器,所述连接器构造成牢固地附接到所述3D编织或3D织物材料的近侧部分,所述连接器包括:
空心圆柱形主体,
延伸穿过所述主体的中心沟道,以及
两个远侧延伸的突出体,每个突出体还包括位于其上的至少一个倒钩,所述倒钩构造成被推入并保持在所述3D编织或3D织物材料的近侧部分内,
其中所述主体的近端构造成压配合到所述导管的内表面或外表面,以产生所述3D编织或3D织物材料与所述导管之间的流体连接。
2.权利要求1的系统,其中,所述倒钩构造成附接到所述3D编织或3D织物材料的上部分和下部分。
3.权利要求1的系统,其中,所述连接器包括构造成延伸到所述3D编织或3D织物材料中的中心远侧延伸突出体。
4.权利要求3的系统,其中,所述中心远侧延伸突出体还包括至少一个倒钩。
5.权利要求1的系统,其中,所述连接器包括构造成接收销的至少一个开口,并且其中,所述销被推动通过所述3D编织或3D织物材料的至少一部分。
6.权利要求1的系统,其中,所述连接器包括至少一个凸缘,所述至少一个凸缘构造成被推入并被固定在所述导管内。
7.权利要求1的系统,其中,所述连接器包括至少一个柔性线路和构造成接收所述至少一个柔性线路的一个相应腔体,所述至少一个柔性线路构造成形成环路并进入所述3D编织或3D织物材料的近侧部分中。
8.权利要求7的系统,其中,所述至少一个柔性线路还包括至少一个倒钩。
9.权利要求1的系统,其中,所述连接器构造成在经受小于20 kg的拉力时保持被附接到所述3D编织或3D织物材料。
10.权利要求1的系统,其中,所述抽吸适配器包括被设置在所述细长流体沟道上面和下面的由不透液体的材料制成的顶层和底层,并且其中,所述顶层和底层被与所述连接器密封在一起,从而在所述连接器被连接到所述导管时产生流体不透密封。
11.一种用于将流体通道管连接到织物沟道的连接器,包括:
主体,所述主体具有近端和远端;
从所述主体向远侧延伸的至少一个构件,所述至少一个构件构造成延伸到所述织物沟道中;其中,所述主体的近端构造成与所述流体通道管的内表面或外表面压配合,以及
所述至少一个构件包括至少一个柔性线路,所述至少一个柔性线路包括锥形尖端,所述锥形尖端构造成形成环路穿过所述织物沟道,并被接收在形成于所述连接器内的腔体中并且牢固地连接到所述腔体。
12.一种负压伤口治疗系统,包括:
导管,所述导管构造成从负压源向伤口输送负压;
抽吸适配器,所述抽吸适配器构造成向所述伤口输送负压,其中,所述抽吸适配器包括细长流体沟道,所述细长流体沟道具有近端和远端以及在所述近端与所述远端之间延伸的细长3D编织或3D织物材料;以及
连接器,所述连接器构造成产生所述3D编织或3D织物材料与所述导管之间的流体连接,所述连接器包括相互隔开的两个远侧延伸的突出体,每个突出体还包括位于其上的至少一个倒钩,所述倒钩构造成被推入并保持在所述3D编织或3D织物材料的近侧部分内。
13.权利要求12的负压伤口治疗系统,其中,所述连接器包括空心圆柱形主体和延伸穿过所述主体的中心沟道,所述主体的近端构造成压配合到所述导管的内表面,所述两个远侧延伸的突出体从所述主体的远端延伸。
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RU2582866C2 (ru) | 2016-04-27 |
EP2654821B1 (en) | 2019-05-08 |
JP2014506164A (ja) | 2014-03-13 |
ZA201304140B (en) | 2014-03-26 |
RU2013133169A (ru) | 2015-01-27 |
CA2821681C (en) | 2023-05-16 |
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AU2011345328B2 (en) | 2016-03-10 |
EP2654821A1 (en) | 2013-10-30 |
US9050398B2 (en) | 2015-06-09 |
RU2016111981A (ru) | 2018-11-27 |
AU2011345328A1 (en) | 2013-07-04 |
JP5881735B2 (ja) | 2016-03-09 |
WO2012087376A1 (en) | 2012-06-28 |
BR112013018320A2 (pt) | 2018-09-11 |
US9956389B2 (en) | 2018-05-01 |
US11247034B2 (en) | 2022-02-15 |
CA2821681A1 (en) | 2012-06-28 |
CN103384538A (zh) | 2013-11-06 |
CN106901900B (zh) | 2020-06-05 |
CN106901900A (zh) | 2017-06-30 |
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