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TWI767911B - 負壓傷口敷料管理系統 - Google Patents

負壓傷口敷料管理系統 Download PDF

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TWI767911B
TWI767911B TW106115372A TW106115372A TWI767911B TW I767911 B TWI767911 B TW I767911B TW 106115372 A TW106115372 A TW 106115372A TW 106115372 A TW106115372 A TW 106115372A TW I767911 B TWI767911 B TW I767911B
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wound
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史蒂芬 比蕭
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康華特科技股份有限公司
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    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
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    • A61F13/05Bandages or dressings; Absorbent pads specially adapted for use with sub-pressure or over-pressure therapy, wound drainage or wound irrigation, e.g. for use with negative-pressure wound therapy [NPWT]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F13/00Bandages or dressings; Absorbent pads
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    • AHUMAN NECESSITIES
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    • A61F13/02Adhesive bandages or dressings
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    • A61F13/00Bandages or dressings; Absorbent pads
    • A61F13/02Adhesive bandages or dressings
    • A61F13/0203Adhesive bandages or dressings with fluid retention members
    • A61F13/022Adhesive bandages or dressings with fluid retention members having more than one layer with different fluid retention characteristics
    • 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
    • A61M1/71Suction drainage systems
    • A61M1/73Suction drainage systems comprising sensors or indicators for physical values
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A61M1/912Connectors between dressing and drainage tube
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
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    • 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
    • A61M1/982Containers specifically adapted for negative pressure wound therapy with means for detecting level of collected exudate
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    • 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
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    • 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
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    • A61M2205/00General characteristics of the apparatus
    • A61M2205/18General characteristics of the apparatus with alarm

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Abstract

本發明公開了一種傷口滲出物管理系統,所述傷口滲出物管理系統包括用於產生負壓的泵、用於覆蓋和保護使用者的傷口的敷料、包括內管腔的管,所述管子設置在泵和敷料之間,使得泵和敷料通過內管腔流體連通。敷料包括用於將敷料相鄰於傷口黏附的黏合劑層、傷口接觸層、壓力分散層、設置在傷口接觸層和壓力分散層之間的多層吸收材料、具有第一表面和第二表面的背襯層以及設置在背襯層的第二表面上的柔性連接器,其中背襯層的第一表面與壓力分散層和黏合劑層相鄰並接觸。

Description

負壓傷口敷料管理系統
本公開整體涉及傷口敷料系統,具體地涉及一種與負壓泵一起使用的傷口敷料系統。此外,本發明涉及敷料、用於通過敷料處理傷口的系統和成套工具,其中所述敷料可以與負壓源一起使用以輸送負壓力治療。敷料適用於處理包括慢性和急性類型的各種傷口,包括感染傷口、靜脉潰瘍、糖尿病性潰瘍、燒傷、外科傷口和類似傷口。
傷口敷料是已知的且通常適合於處理各種傷口,包括慢性和急性傷口類型,例如感染的傷口、靜脉潰瘍、糖尿病性潰瘍、燒傷和手術傷口。
已經使用負壓來處理一系列慢性和急性傷口。負壓可以通過許多機制促進傷口癒合,所述機制包括去除多餘的滲出物、减少周圍水腫和增加灌注。結合通過將傷口邊緣牽引在一起的負壓施加的物理力,這可能會產生改善的傷口結果。常規裝置通常很大,並且需要使用複雜的設備,所述設備可能包括產生負壓的抽吸泵、壓力調節器、用於收集傷口滲出物的罐和用於將治療遞送到傷口部位的傷口敷料。因此,這樣的裝置會體積龐大、昂貴並且將患者限制在床上,或者至少使病人不能移動且不能進行他們通常的活動。
最近,已經開發了便携式系統,所述便携式系統包括通過在傷口敷料內收集滲出物(通常在吸收材料中)以及通過經由敷料蒸發來管理由傷口產生的滲出物的裝置。這樣的系統意味著單獨的收集罐不是系統的重要部分。這樣的系統記載在EP 2021046中。不需要罐的優點在於所述裝置體積較小且更便携。這種裝置的缺點在於,如果敷料超過其流體處理能力,則滲出物會被從(多種)吸收材料中抽出並進入泵。泵中滲出物的存在將最終導致泵出現故障並需要更換。系統提供的治療也可能會由於在傷口分界面處聚集過量的滲出物的可能性而不太理想。為了防止滲出物使泵結垢,已知的是在吸收材料和泵之間提供液體不可滲透的阻擋層。然而,液體不可滲透的阻擋不會向裝置或護理者的使用者給出敷料已經達到其流體處理能力且需要更換的指示。
在存在罐的那些裝置中,給予使用者或護理人員通過在罐中存在滲出物的傷口產生多少滲出物的視覺指示。然而,只有在敷料達到其流體處理能力時才會在罐中存在滲出物。沒有需要更換敷料的預警。
存在對敷料達到其流體處理能力的指示的需求。
此外,現有的便携式負壓傷口敷料系統通常包括剛性敷料和連接部件,從而不利地影響系統效用和使用者舒適度。此外,現有的便携式負壓傷口敷料系統不使用布置成使敷料內的傷口滲出物的管理被最大化的吸收材料和額外的傷口敷料成分。因此,存在對包括這些特徵和其他特徵的便携式滲出物管理系統的需求。本公開尋求克服現有技術的限制和其他缺點,並提供迄今為止可用的新特徵。關於本公開的特徵和優點的全面討論被推遲到以下參照附圖進行的詳細說明。
在一個實施方式中,本發明提供了一種用於向傷口施加負壓的負壓傷口敷料,包括:吸收層,所述吸收層能夠吸收來自傷口的滲出物並允許流體流動通過所述吸收層;外覆蓋層,所述外覆蓋層覆蓋吸收層的離傷口最遠的一側部,覆蓋層適於能夠使負壓力被施加在傷口處並具有一端口;導管,所述導管具有連接到端口的近端、以及遠端,所述敷料設置有用於使來自傷口的流體通過吸收層、端口並到達導管的遠端的通路;和指示器裝置,所述指示器裝置在通路中被定位在吸收層和導管的遠端之間的位置處,所述指示器裝置能夠吸收滲出物以指示在吸收層的離傷口最遠的側部處存在滲出物。
在另一個實施方式中,本發明提供了一種用於向傷口施加負壓的負壓傷口敷料,包括:吸收層,所述吸收層能夠吸收來自傷口的滲出物並允許流體流動通過所述吸收層;外覆蓋層,所述外覆蓋層覆蓋吸收層的離傷口最遠的一側部,所述覆蓋層適於能夠使負壓被施加在傷口處並具有一端口;導管,所述導管具有連接到端口的近端、以及遠端,所述敷料設置有用於使來自傷口的流體通過吸收層、端口並到達導管的遠端的通路;指示器裝置,所述指示器裝置在通路中被定位在吸收層和導管的遠端之間的位置,所述指示器裝置能夠吸收滲出物以指示在吸收層的離傷口最遠的側部處存在滲出物;和負壓源,所述負壓源連接到導管的遠端。
優選地,負壓源能夠在傷口處產生75mmHg的最小值和125mmHg的最大值。
在所公開的主題技術的一些實施方式中,提供一種傷口滲出物管理系統。在一個實施例中,所述傷口滲出物管理系統包括:泵,所述泵用於產生負壓;用於覆蓋和保護傷口的敷料,所述敷料包括用於鄰近傷口黏附敷料的 黏合劑層、用於接觸傷口的傷口接觸層、壓力分散層、設置在傷口接觸層和壓力分散層之間的多層吸收材料以及具有第一表面和第二表面的背襯層,背襯層的第一表面與壓力分散層和黏合劑層相鄰並接觸;壓力管,所述壓力管具有內管腔,所述壓力管設置在泵和敷料之間,使得泵和敷料通過內管腔流體連通;和柔性連接器,所述柔性連接器連接到背襯層的第二表面。
在所公開的傷口滲出物管理系統中,所述敷料包括由所述壓力分散層和所述傷口接觸層的連結的周邊部分形成的內包封結構,所述內包封結構限定一腔體。
所公開的傷口滲出物管理系統還包括:熱塑性材料織成的網眼層,所述熱塑性材料織成的網眼層連接到所述壓力分散層;和無紡布織成的網眼層,所述無紡布織成的網眼層連接到所述傷口接觸層,以及其中內包封結構通過連結所述熱塑性材料織成的網眼層和所述無紡布織成的網眼層的周邊部分而形成,使得所述多層吸收材料大致設置在所述內包封結構的內腔體內。
在所公開的傷口滲出物管理系統中,所述吸收材料設置在所述內包封結構的所述腔體內。
所公開的技術還涉及一種用於覆蓋和保護傷口的敷料。所公開的技術還涉及一種傷口滲出物管理系統,包括:用於覆蓋和保護傷口的敷料,所述敷料包括:傷口接觸層,所述傷口接觸層具有第一表面和第二表面,所述傷口接觸層還具有周邊區域和中心區域,其中當敷料被黏附到與傷口相鄰的皮膚時,傷口接觸層的第一表面接觸傷口;壓力分散層,所述壓力分散層具有周邊區域和中心區域;多層吸收材料,所述多層吸收材料設置在傷口接觸層的第二表面和壓力分散層之間;和包封體,所述包封體通過將壓力分散層的周邊區域與傷口接觸層的第二表面的周邊區域連結而形成,多層吸收材料大致設置在包封體的內腔體內。可選地,包封體可以通過將連接到壓力分散層的熱塑性材料 織成的網眼層的周邊區域與連接到傷口接觸層的第二表面的無紡布織成的網眼層的周邊區域連結而形成,使得多層吸收材料大致設置在包封件的內腔體內。
所公開的技術還涉及一種傷口滲出物管理系統,所述系統還包括連接到壓力分散層的熱塑性材料織成的網眼層和連接到傷口接觸層的無紡布織成的網眼層,並且其中包封體通過將熱塑性材料織成的網眼層和無紡布織成的網眼層連結而形成,其中包封體的內腔體由無紡布織成的網眼層和熱塑性材料織成的網眼層形成,並且其中多層吸收材料大致設置在包封體的內腔體內。
所公開的技術還涉及一種傷口滲出物管理系統,包括:敷料,所述敷料用於覆蓋和保護傷口,所述敷料包括傷口接觸層、背襯層和在傷口接觸層和背襯層之間的至少一層吸收材料層;柔性連接器,所述柔性連接器具有內管腔,所述柔性連接器固定到敷料的背襯層;指示器,所述指示器在背襯層和柔性連接器之間;管,所述管具有內管腔,所述管連接到柔性連接器,其中柔性連接器的內管腔和管的內管腔流體連通;和壓力傳送構件,所述壓力傳送構件設置在管的內管腔內。
所公開的技術還涉及一種傷口滲出物管理系統,包括:泵,所述泵用於產生負壓;敷料,所述敷料用於覆蓋和保護傷口,所述敷料包括傷口接觸層、背襯層和在傷口接觸層和背襯層之間的至少一層吸收材料;管,所述管子連接泵和敷料,所述管子具有內管腔,以用於通過內管腔使泵和敷料流體連通;和單向閥,所述單向閥串聯在泵和敷料之間,以在泵與管斷開時在敷料內保持一負壓。
所公開的技術還涉及一種傷口滲出物管理系統,包括:泵,所述泵用於產生負壓;敷料,所述敷料用於覆蓋和保護傷口;管,所述管包括內管腔,所述管設置在泵和敷料之間,使得泵和敷料通過管的內管腔流體連通;和 多層吸收材料,所述多層吸收材料設置在敷料中,其中吸收材料具有在與傷口滲出物接觸時膨脹以管理傷口滲出物通過敷料的一部分的流動的纖維。
在所述傷口滲出物管理系統中的任一個中,所述系統可以適於允許傷口和負壓源(例如,泵)之間流體連通。典型地,流體連通通路被提供為從傷口穿過傷口接觸層以及穿過布置在敷料中的一層或多層吸收材料到達負壓源。流體連通通路可以可選地經由柔性連接器的內管腔或導管延伸通過背襯層中的開口到管的內管腔。在存在諸如吸收指示器構件的指示器時,流體連通通路還可以延伸通過指示器。
典型地,柔性連接器是細長的且具有平行於柔性連接器的縱向軸線延伸的內管腔或導管,其中柔性連接器可以以使柔性連接器的縱向軸線大致平行於背襯層的平面的取向連接到敷料的背襯層中的開口。柔性構件可以包括用於通過黏合劑或其他方式固定到背襯層的頭部。典型地,流體連通通路在大致垂直於柔性連接器的縱向軸線的方向上從柔性連接器的內管腔或導管延伸穿過背襯層中的開口。一旦被固定,則可以在柔性連接器和背襯層之間形成不透流體的密封。
在上述實施例中的任一個中,指示器裝置的存在可以具有以下優點,即給予使用者或護理者需要更換敷料的指示。指示器裝置允許使用者或護理者更換敷料並防止泵結垢。當吸收層已經吸收大量滲出物時,在吸收層的離傷口最遠的一個側部存在滲出物。如果指示器裝置位於敷料的導管中且被滲出物的吸收觸發,則滲出物不僅存在於吸收層的離傷口最遠的側部處,還被吸出超過覆蓋層並進入導管。所述指示器裝置預先警告使用者或護理者已經或不久將達到敷料的流體處理能力且需要敷料更換。指示器裝置可以指示敷料已經達到其流體處理能力,並且滲出物有可能被從敷料中抽出到導管中並最終進入泵中,這是不期望出現的。
指示器裝置可以是可視的或者可以產生聽覺報警或其他信號。優選地,指示器裝置是可視的並被定位成使得該指示器裝置對於敷料的使用者是可視的。例如,可視化指示器裝置可以位於覆蓋層中的端口中,或者可以位於導管中或端口和導管兩者中。類似地,在傷口滲出物管理系統中,視覺指示器裝置可以被定位成穿過背襯層中的開口和/或位於柔性連接器的內管腔或導管中。優選地,可視化指示器裝置為膠凝吸收劑,所述膠凝吸收劑在視覺上指示其通過形成凝膠而已經吸收了滲出物。如果滲出物帶有顏色,則凝膠也會帶有顏色並添加到可視化指示。可選地,可視化指示器裝置可以指示其通過改變顏色而吸收滲出物,例如通過在指示器裝置中激活染料。
優選地,指示器裝置由凝膠形成纖維提供。通過凝膠形成纖維是指在吸收傷口滲出物變得潮濕或凝膠狀時的吸濕纖維。凝膠形成纖維可以是在滲出物吸收時保持其結構完整性的類型,或者可以是失去其纖維形式並變成無定形或無結構的凝膠的類型。凝膠形成纖維優選為羧甲基纖維素鈉纖維、化學改性的纖維素纖維、例如WO2012/061225中所述的烷基磺酸酯改性的纖維素纖維、果膠纖維、藻酸鹽纖維、殼聚糖纖維、透明質酸纖維或其衍生自其的多糖纖維或纖維膠。纖維素纖維優選具有每個葡萄糖單元至少0.05個羧甲基的取代度。凝膠形成纖維優選具有每克纖維至少2克0.9%鹽水溶液的吸收性(通過自由溶脹法測量)。
凝膠形成纖維優選為織物形式的化學改性的纖維素纖維,具體為如Azko Nobel UK Ltd.的PCT WO00/01425中所述的羧甲基纖維素纖維。以這種方式,指示器裝置可以由優選位於覆蓋層的端口中的凝膠形成纖維層提供或者被提供作為導管中的纖維層。當導管中存在纖維層時,纖維層還可以用於在導管彎曲或者以其他方式通過使用者靠著或靠在其上而被限制的情况下使導管保持向流體的通道開口。羧甲基纖維素織物優選地具有通過IR光譜測定(如 WO00/01425中所限定)測量的在0.12至0.35之間的取代度,更優選地通過將編織或無紡布纖維素織物羧甲基化而具有在0.20和0.30之間的取代度,使得吸收性增加。特別優選地,織物具有在如上所限定的10g/g鈉/氯化鈣與通過BS EN 13726-1(2002)“Test methods for primary wound dressings”、第3.2節“Free swell absorptive capacity”所測量的30g/g鈉/氯化鈣之間的吸收性。特別優選地,織物具有15g/g至25g/g的吸收性,最優選地為通過如上所限定的方法測量的15g/g到20g/g的氯化鈉/氯化鈣。
纖維素織物優選地僅由纖維素纖維組成,但可以包含一定比例的非纖維素紡織纖維或凝膠形成纖維。纖維素纖維是已知類型的,並且可以包括連續長絲紗線和/或短纖維。羧甲基化通常是通過在水溶液中使織物與碱和羧甲基化劑(例如,氯乙酸)接觸來執行。織物優選為無紡布型,以减少切割敷料時傷口中的脫落。優選地,織物被水力纏結,並且因此在微觀尺度上包括一系列孔。
敷料的吸收層能夠吸收來自傷口的滲出物並允許流體流動通過所述吸收層。儘管吸收層可以包括能夠吸收滲出物同時允許流體流動通過該吸收層的任何吸收劑,例如泡沫、海綿或纖維基材料,優選地,吸收層由與指示器裝置中所使用的材料為相同類型或不同類型的凝膠形成纖維提供。凝膠形成纖維為吸濕纖維,其在吸收傷口滲出物時變得濕滑或為凝膠狀,因此降低周圍纖維黏附到傷口的趨勢。凝膠形成纖維優選為紡成的羧甲基纖維素鈉纖維、化學改性的纖維素纖維、例如WO2012/061225中所述的烷基磺酸鹽改性的纖維素纖維、果膠纖維、藻酸鹽纖維、殼聚糖纖維、透明質酸纖維或其他多糖纖維或從膠中衍生的纖維。纖維素纖維優選地具有每個葡萄糖單元至少0.05個羧甲基的取代度,更優選地被輕度取代,使得纖維的吸收性受到限制。凝膠形成纖維優選地具有每克纖維至少2克0.9%鹽水溶液的吸收性(通過上述方法測量)但每克纖 維少於30克0.9%鹽水溶液。凝膠形成纖維優選地為Azko Nobel UK Ltd的PCT WO00/01425中所述的羧甲基化纖維素纖維,其中所述專利文獻記載了輕度羧甲基化的纖維素織物且更優選地為指示器裝置中使用的類型。凝膠形成纖維優選地被輕度羧甲基化,以便减少吸收層出現凝膠阻滯的趨勢並阻塞流體從傷口通過吸收層、端口至導管遠端的通路。
優選地,吸收層設置有開窗,以幫助向傷口施加負壓並保持使來自傷口的流體通過吸收層的通路。然而,通常僅在內部吸收層中設置開窗。包括與傷口直接接觸的吸收層的外部吸收層通常不具有以機械方式加入的開窗,但是所述外部吸收層在纖維之間具有開口。
雖然吸收層可以與傷口直接接觸,但優選地敷料包括定位在傷口和吸收層之間的傷口接觸層。傷口接觸層能夠吸收來自傷口的滲出物並將所述滲出物傳送到吸收層。與吸收層相似,傷口接觸層能夠允許流體流動通過該傷口接觸層,使得可以對傷口施加負壓,並且可以保持使流體從傷口到導管遠端的通路。
優選地,傷口接觸層包括與包括吸收層的那些層為相同或相似類型的凝膠形成纖維,但傷口接觸層可以被加强以增加其完整性和敷料的完整性。例如,傷口接觸層可以為EP 1904011中所述的類型,並且包括為具有由纖維素或尼龍或聚烯烴紗線製成的縱向縫合線的墊形式的凝膠形成纖維以增加層的完整性。優選地,傷口接觸層是多孔的,以保持流體從傷口到導管遠端的通路。
敷料的外覆蓋層為細菌和病毒屏障層,其優選地抵抗液體和空氣的進入,但允許濕蒸汽透過。以這種方式,外覆蓋層通過允許濕蒸汽通過該覆蓋層逸出而增强敷料的整體流體處理能力,同時能夠對傷口施加負壓。外覆蓋層例如為具有通過BS EN 13726-2 2002的“Test methods for primary wound dressings Part 2 Moisture vapour transmission rate of permeable film dressings”中所述的方法測 量的每24小時為至少10,000gm-2或者在每24小時從10,000g/m2至50,000g/m2的範圍內的MVTR的層。覆蓋層可以是聚氨酯膜的形式,例如由Covestro製造的Epurex 912 T/129、或者由Coveris製造的Inspire 2350、或者由Mylan製造的Medifilm 426。
覆蓋層設置有用於連接到導管的端口。端口優選地位於覆蓋層的覆蓋吸收層但朝向吸收層的周邊的那部分中,使得所述端口不直接與敷料的中心(或在使用中與傷口)垂直對準。這有助於滲出物在吸收層的整個範圍內擴散。
敷料的導管優選地為一透明通道,所述透明通道在導管的近端處固定到覆蓋層的外側,以便從上方包圍覆蓋層中的端口。以這種方式,如果可視化指示器位於覆蓋層中的端口中和/或導管本身中,則使用者可以看到可視化指示器。類似地,在傷口滲出物管理系統包括柔性連接器的情况下,柔性連接器可以是部分地或全部為透明的,以便允許使用者看到可視化指示器。通常,柔性連接器的頭部是透明的。敷料的導管可以包括在其遠端處用於將敷料連接到負壓源(例如,泵)的連接器。優選地,連接器是魯爾鎖,以促進與泵的固定連接並在泵被暫時斷開時保持傷口上的負壓。連接器優選地包括單向鎖以幫助保持負壓。可視化指示器可以位於導管中,並且可以為凝膠形成纖維的針織筒或類似的形式。為了防止塌陷,導管可以包括由尼龍纖維支撑的內筒以保持導管對流體的開放性。
敷料還可以包括位於吸收層和外覆蓋層之間的分布層,例如壓力分布層,所述分布層是可滲透氣體和液體的,並且特別是可滲透濕蒸汽的,並用於通過允許滲出物在分布層下方擴散而幫助滲出物進入吸收層的更大區域。分布層還用於使在整個敷料上施加到傷口上的負壓力均勻。分布層優選地在敷料上分布滲出物和負壓力。以這種方式,在滲出物離開吸收層之前,吸收層吸收滲出物達到最大,並激活指示器裝置且優化向傷口傳遞負壓力。分布層優選 地為泡沫層,例如由Caligen製造的XD4200AS型的聚酯泡沫或者其他適當的網狀泡沫。
敷料還可以包括附加的可選層,例如用於將敷料黏附到傷口周圍的皮膚以形成不透流體的密封的黏合劑層。黏合劑層可以施加到敷料的最接近傷口的側面,並且可以設置有孔口以幫助滲出物和流體通過敷料運送。黏合劑層也可以施加到任何其他層以提供島狀結構例如到覆蓋層。
應當理解的是所述主題技術的其他實施例和結構從以下詳細說明中對本領域技術人員將變得顯而易見,其中通過示例示出和說明了本主題技術的各種結構。如將認識到的,本主題技術能夠為其他和不同的結構,並且在不脫離本主題技術的範圍的情况下其各個細節能夠在各種其他方面進行修改。因此,附圖和詳細說明在本質上被認為是說明性的而不是限制性的。
10:傷口滲出物管理系統
14:敷料
18:泵
22:壓力管
34a-c:指示器
36a-c:指示標記
38:泵連接器
40:遠端管部
44:可分離連接器
50:柔性連接器
53:格柵結構
54:柔性連接器管腔
60:柔性連接器孔
62:壓力輸送結構
66:下柔性連接器部分
67:上柔性連接器部分
70:指示器/上吸收指示器構件
74:上黏合劑
78:上黏合孔
82:背襯層
83:第一表面
84:第二表面
86:背襯層孔
90:背襯層黏合劑
94:背襯層黏合劑孔
100:包封體
104:壓力分散層/上包封層
108:周邊部/上周邊部
109:中心部/上中心部
112:傷口接觸層/下包封
113:第二表面
114:第一表面
116:周邊部/下周邊部
117:中心部/下中心部
118:加強縫合部
119、121:網眼層
120:包封腔
123:第一表面
125:第二表面
129:開窗/狹縫/開口
130、130a-h:吸收材料層
150:黏合劑層
154:中心孔
156:可移除蓋
156a、156b:部分
158a、158b:夾持部
170:遠端連接部
172:遠端花鍵
174:內部花鍵
176:扭轉構件
180:第一配合構件/螺紋
184:第二配合構件/螺紋
188:近端連接部
194:接口管
198:單向閥
200:指示器系統
為了理解本發明,現在將參照附圖通過示例來說明本發明,其中本發明的實施方式與下面的說明一起來說明、用於解釋本發明的原理。
圖1是根據本發明的示例性實施方式的傷口滲出物管理系統的俯視圖,具體地示出了泵、敷料和管以及其它特徵;圖2是根據本發明的示例性實施方式的傷口滲出物管理系統的俯視圖,具體地示出了傷口滲出物管理系統的敷料和柔性連接器的一部分;圖3是關於根據本發明的示例性實施方式的傷口滲出物管理系統的圖2的線3-3的橫截面圖,具體地示出敷料、柔性連接器的一部分和敷料的各種構成元件; 圖3A是關於傷口滲出物管理系統的圖2的線3-3的橫截面視圖的一個替代實施例,顯示了敷料、柔性連接器的一部分和敷料的各種構成元件;圖4是圖3的傷口滲出物管理系統的放大橫截面圖,具體地示出了箭頭4-4所標示的區域;圖5是根據本發明的示例性實施方式的傷口滲出物管理系統的分解立體圖;圖5A是本發明的傷口滲出物管理系統的分解立體圖的一個可選實施例;圖6是根據本發明的示例性實施方式的傷口滲出物管理系統的仰視圖,具體地示出了傷口滲出物管理系統的可移除蓋和柔性連接器的一部分;圖7是根據本發明的示例性實施方式的傷口滲出物管理系統的可釋放連接器的俯視圖,具體地示出處於連接狀態的可釋放連接器;以及圖8是圖7的可釋放連接器的俯視圖,具體地示出處於拆卸狀態的可釋放連接器。
雖然在此討論的傷口滲出物管理系統可以以許多不同的形式實施,但是在附圖中示出並且在此將詳細說明優選的實施方式,但應理解本說明將被視為傷口滲出物管理系統的原理的示例而不意在將所公開的廣泛方面限制於所示的實施方案。
現在參照附圖,具體地參照圖1,示出傷口滲出物管理系統10的一個實施例。本實施例的傷口滲出物管理系統10具有傷口敷料14、泵18和管22(也稱為壓力管22)。通常,傷口滲出物管理系統10有助於傷口癒合和傷口保 護。敷料14被施加到使用者的皮膚上,如下所述,並且系統10利用由泵18產生的負壓來幫助傷口癒合。敷料14和泵18通過管22流體連接。由泵18產生的負壓通過管22與敷料14連通,從而能使敷料14採用負壓來增强傷口癒合。
在各種實施例中,泵18響應於各種使用者輸入操作以產生負壓。在一個實施例中,用於泵18的使用者控制器30設置在泵18上和/或遠離泵18。使用者控制裝置30可以是按鈕、開關、控制桿、感測器或任何其他控制裝置中的一個或多個。應當理解的是任何普通的使用者控制裝置30都在本公開的保護範圍內。泵18還可以具有一個或多個指示器34a、34b、34c,所述指示器設置在泵18上以用於向泵使用者通知泵18的當前操作狀態、條件、電池壽命等。指示器34a-c可以是包括發光二極管(LED)的燈,然而也可以使用任何其他類型的指示器,例如用於產生可聽見的聲音的揚聲器或者具有用於產生振動的徑向不對稱飛輪的電動機。指示標記36a、36b、36c可以與指示器34a-c中的一個或多個相關聯,以向使用者通知特定指示器34a-c的操作的重要性。然而,在一些實施方式中,泵18在沒有使用者輸入的情况下操作,並且響應於定時器、遠程信號、感測器讀數或其他刺激而產生負壓。
在一個實施例中,在泵18的操作之前,用於泵18的指示器34a-c優選地不被點亮。在這種狀態下,泵18通常不產生負壓,這可以對應於處於關閉狀態的泵18。此外,在一個實施例中,當所有指示器34a-c轉變到點亮狀態時,泵18優選地處於就緒狀態並準備使用。此外,在一個實施例中,當一個指示器34a保持在點亮狀態而其餘指示器34b和34c轉變到非點亮狀態時,這表示泵18處於操作狀態。泵18的正常操作可以包括負壓的產生、負壓產生的交替周期和/或不產生負壓。作為操縱使用者控制裝置30的結果,泵18可以在關閉狀態、就緒狀態和操作狀態中的一個或多個之間轉換。操縱使用者控制裝置30以改變泵狀態可以包括和/或要求操縱使用者控制裝置30持續預定的時間量。
在操作狀態下,在一個優選實施例中,泵18在傷口處產生75mmHg的最小壓力和在傷口處產生125mmHg的最大壓力,然而,泵18也可產生交替壓力。在一個實施例中,泵18產生負壓直到達到第一壓力閾值為止。第一壓力閾值可以是例如在75mmHg至125mmHg之間的值,包括端值。然後,泵18可以避免產生負壓直到達到第二閾值壓力為止,此時泵18可以產生負壓,直到再次達到第一壓力閾值為止。泵的交替操作是可允許的。
在一個實施例中,如圖1所示,泵18通過泵連接器38連接到壓力管22。泵連接器38可以允許泵18和管22的選擇性分離。
在一個實施例中,管22包括遠端管部40和近端管狀部42。近端管狀部42可以是柔性連接器50的延伸部。可分離連接器44可以連結遠端管部40和近端管狀部42,如圖7和圖8所示。泵連接器38將管22的一端(優選地,管22的遠端管部40)連接到泵18。然而,在一個未示出的替代實施例中,泵連接器38可以將近端管狀部42連接到泵18。在一個實施例中,遠端管部40形成壓力管22的一部分,並且可以是柔性的、透明的、部分透明的和/或由聚合物、金屬、金屬合金或任何其他合適的材料形成。
轉到圖3和圖4,在一個實施例中,柔性連接器50在結構上連接到敷料14,並且還包括柔性連接器管腔54。柔性連接器管腔54沿著柔性連接器50的一部分或全部設置在柔性連接器50內,並且使得在泵18和敷料14之間能夠流體連通。柔性連接器孔60能夠使柔性連接器管腔54和敷料14之間流體連通。柔性連接器50可以包括下柔性連接器部分66和上柔性連接器部分67。下柔性連接器部分66和上柔性連接器部分67可以通過焊接、黏合劑或者任何其他連結技術連結以形成柔性連接器50。柔性連接器50可以優選地由聚氯乙烯、聚氨酯或任何其他合適的材料形成。在一個實施例中,柔性連接器50具有基本上平坦的外表面。
在一個實施例中,壓力輸送結構62設置在柔性連接器管腔54內。壓力輸送結構62使柔性連接器50能夠在柔性連接器管腔54內輸送流體流和/或壓力,而在柔性連接器50由薄壁柔性材料製成時不會塌陷,從而使敷料14能夠經受或表現出由泵18產生的負壓。壓力輸送結構62可以包括各種材料,包括但不限於尼龍。此外,壓力輸送結構62可以由格柵結構53構成。壓力輸送結構62的形狀、材料和布置使得能夠獲得沿著柔性連接器50的持續流體流動,否則考慮到由泵18產生的負壓力以及考慮到一般的傷口滲出物管理系統10的使用和定位可能受到柔性連接器50的形狀、柔性、材料或布置的限制。
如圖3-5中最佳所示,敷料14優選地包括指示器70,在一個實施例中,所述指示器是由吸收材料形成的上吸收指示器構件70。指示器70可以產生諸如視覺、聽覺、振動等信號的信號。當指示器70由吸收材料製成時,吸收材料可以包括凝膠形成纖維,所述凝膠形成纖維可以是在吸入傷口滲出物或其他流體時變濕、滑溜或凝膠狀的吸濕纖維。凝膠形成纖維可以在吸收滲出物時保持其結構完整性,或者它們可能失去其纖維形式並變成無定形或無結構的凝膠。在一些實施方式中,凝膠形成纖維為羧甲基纖維素鈉纖維、化學改性的纖維素纖維、例如WO2012/061225中所述的烷基磺酸鹽改性的纖維素纖維、果膠纖維、藻酸鹽纖維、殼聚糖纖維、透明質酸纖維、其他多糖纖維或衍生自膠紙的纖維。
纖維素纖維示例性地具有每個葡萄糖單元至少0.05個羧甲基的取代度。凝膠形成纖維可以具有每克纖維至少2克0.9%鹽溶液的吸收率(通過自由溶脹法測得),但每克纖維的吸收率小於30克0.9%鹽溶液。
凝膠形成纖維優選為織物形式的化學改性的纖維素纖維,特別是如Azko Nobel UK Ltd.的PCT WO00/01425中所述的羧甲基化纖維素纖維。羧甲基化的纖維素織物示例性地具有在通過IR光譜法(如WO00/01425中所限定)測 量的0.12至0.35之間的取代度,並且還可以具有在0.20至0.30之間的取代度。羧甲基化蜂窩織物可以通過將編織或非編織纖維素織物羧甲基化而形成,使得吸收率增加。通過BS EN 13726-1(2002)“Test methods for primary wound dressings”、第3.2部分“Free swell absorptive capacity”中所述的方法測量,織物可以具有在10g/g的鈉/氯化鈣與30g/g的鈉/鈣氯化物之間的吸收率。一些織物具有15g/g至25g/g或15g/g至20g/g的鈉/鈣氯化物的吸收率。凝膠形成纖維可以被輕度羧甲基化,以减少吸收材料凝膠阻滯和阻止流體路徑從傷口通過敷料14的趨勢。
纖維素織物可以僅由纖維素纖維組成,但也可以包含非纖維素紡織纖維或凝膠形成纖維。纖維素纖維可以是已知類型,並且可以包括連續長絲紗和/或短纖維。羧甲基化可以通過使織物與碱和羧甲基化試劑(例如,水系統中的氯乙酸)接觸來進行。織物可以是無紡布類型,並且可以進一步水力纏絡,並且因此在微觀尺度上包括一系列孔。吸收材料還可以包括能夠吸收滲出物同時允許流體流動通過的任何吸收材料,例如泡沫、海綿或纖維基材料。
上吸收指示器構件70優選地位於背襯層82的上方,並且可以與柔性連接器50相鄰、連結和/或接觸,並且還可以與柔性連接器孔60相鄰。如圖4最佳顯示,在一個實施例中,上黏合劑74的第一側面黏附到上吸收指示器構件70和柔性連接器50的下柔性連接器部分66。下柔性連接器部分66優選地黏附到上黏合劑74的第一側面的從黏附有上黏合劑74的黏附有上吸收指示器構件70的一部分徑向向外的一部分。上黏合劑74還具有從上黏合劑74的第一側面延伸到上黏合劑74的第二側面的上黏合孔78,並且布置成與上吸收示器構件70相鄰,以限制與通過上吸收指示器構件70引起的負壓的真空效應的干擾。
在一個實施例中,背襯層82設置在上吸收指示器構件70與柔性連接器50之間以及敷料14的多個吸收層之間。在一個實施例中,背襯層82設置在 上黏合劑74的下方。背襯層82優選地具有穿過背襯層82設置並從背襯層82的第一表面83延伸到背襯層的第二表面84的背襯層孔86。因此,在一個實施例中,上黏合劑74相鄰於背襯層82的第二表面84設置。在組裝中,背襯層82的孔86相鄰於上黏合劑74中的上黏合孔78設置。在一些實施方式中,背襯層82是細菌和病毒的屏障層,所述屏障層抵抗液體和空氣的進入,同時允許濕蒸汽穿過。以這種方式,背襯層82通過能夠對傷口或敷料14施加負壓的同時允許濕蒸汽通過背襯層82逸出而增强敷料14的整體流體處理能力。背襯層82可以具有通過BS EN 13726-2 2002“Test methods for primary wound dressings Part 2 Moisture vapour transmission rate of permeable film dressings”中所述的方法測量的每24小時至少為10,000g/m2或者每24小時在10,000g/m2至50,000g/m2的範圍內的濕蒸汽透過率(MVTR)。背襯層82可以部分或完全透明。背襯層82可以是聚氨酯的層或膜,例如由Covestro製造的Epurex 912 T/129或者由Coveris製造的Inspire 2350或者由Mylan製造的Medifilm 426。
如圖4和圖5所示,在一個實施例中,稱為背襯層黏合劑90的黏合劑層90相鄰於背襯層82的第一表面83設置。背襯層黏合劑90包括背襯層黏合劑孔94,所述背襯層黏合劑孔優選地從背襯層黏合劑90的第一表面穿過背襯層黏合劑90延伸到背襯層黏合劑90的第二表面。背襯層黏合劑90中的孔94優選地定位成與上黏合劑74中的上黏合孔78相鄰。應當理解的是在一個優選實施例中,柔性連接器孔60、上吸收指示器構件70、上黏合孔78、背襯層孔86和背襯層黏合劑孔94都基本上同心地布置,使得流體流能夠從柔性連接器孔60、橫過上吸收指示器構件70並穿過上黏合孔78、背襯層孔86和背襯層黏合劑孔94。此外,還應當理解的是,在一個優選實施例中,上柔性連接器部分67、下柔性連接器部分66、上吸收指示器構件70、上黏合劑74、背襯層82和背襯層黏合劑90依次布置在傷口滲出物管理系統10中。
參照圖3,在一些實施方式中,敷料14包括包封體100。包封體100優選地容納多層吸收材料以輔助滲出物管理。如圖3-5清楚地所示,在一個實施例中,包封體100由上包封層和下包封層限定。上包封層可以具有周邊部108和中心部109。上包封層的周邊部108也可以被稱為上周邊部108,而上包封層的中心部109也可以被稱為上中心部109。類似地,下包封層可以具有周邊部116和中心部117。下包封層的周邊部116可以被稱為下周邊部116,而下包封層的中心部117可以被稱為下中心部117。
傷口管理系統10的敷料14的一個替代實施例在圖3A和圖5A中示出。在該替代實施例中,無紡布織成的網眼層119優選地被縫合到傷口接觸層112的第二表面113。在一個實施例中,再生纖維素紗線用於縫合接合。此外,在一個實施例中,無紡布織成的網眼層119可以由包括基本相等的膠黏纖維和聚酯纖維的80gsm非織物層構成,優選小於5%的丙烯酸共聚物黏合劑。此外,可以在壓力分散層104和多個吸收材料層130之間設置熱塑性材料織成的網眼層121,例如聚醯胺層。熱塑性材料織成的網眼層121具有第一表面123和第二表面125,所述第一表面可以在其周邊熱黏合到壓力分散層104,所述第二表面可以在其周邊圍繞多個吸收材料層130類似地熱黏合到無紡布織成的網眼層119。因此,熱塑性材料織成的網眼層121和無紡布織成的網眼層119圍繞吸收材料層130形成內殼體或包封體。該實施例的內包封體或殼體由上包封層和下包封層限定。該實施例的上包封層包括熱塑性材料織成的網眼層121,並且該實施例的下包封層包括無紡布織成的網眼層119。
因此,在一個實施例中,如圖3所示,上包封層為壓力分散層104,下包封層為傷口接觸層112。在另一實施例中,如圖3A所示,上包封層為熱塑性材料織成的網眼層121,下包封層為無紡布織成的網眼層119。
在一些實施方式中,也稱為壓力分布層的壓力分散層104用於橫過壓力分散層104橫向地分布壓力或負壓。壓力分散層104可以滲透氣體、液體和濕蒸汽,並且用於通過在敷料14上橫向分布負壓來幫助滲出物進入敷料14的較大部分。以這種方式,敷料14的滲出物吸收被最大化,並且負壓到傷口或敷料14的更均勻的傳遞被優化。壓力分配層104可以由例如為由Caligen製造的類型XD4200AS的聚酯泡沫的泡沫、另一種適當的網狀泡沫或聚氨酯泡沫形成。
在一些實施方式中,傷口接觸層112可以由吸收材料形成。此外,傷口接觸層112可以由結構增强的材料或增强下包封層112的强度和物理特性的結構構成。例如,傷口接觸層112可以由羧甲基纖維素纖維形成。傷口接觸層112的結構增强材料可以包括加强縫合部118。在一些實施方式中,傷口接觸層112由具有加强縫合部118的吸收材料形成,包括由尼龍製成的加强縫合部118。還應當理解的是壓力分散層104和傷口接觸層112可以由上述吸收材料中的任何一種形成。
傷口接觸層112具有第一表面114和第二表面113。在一個實施例中,傷口接觸層112的第一表面114是用於在敷料14相鄰於傷口黏附到使用者的皮膚時接觸使用者的傷口的外層。此外,在一個實施例中,傷口接觸層112的第二表面113與第一表面114相對,並且第二表面113為與敷料14內的多個吸收材料層相鄰的內層,如下所述。
上包封層104(即,在一個實施例中為壓力分散層104)的周邊部108和下包封層112(即,在一個實施例中為傷口接觸層112)的周邊部116可以被連結,如圖3中最佳顯示。上周邊部108和下周邊部116可以通過黏合劑、焊接、縫合或任何其他常用的連結方法連結。上周邊部108和下周邊部116的連結基本上形成包封體100,並進一步限定設置在包封體100內的包封腔120。
在一個優選實施例中,多個吸收材料層130a、130b、130c、130d、130e、130f、130c、130d、130e、130f、130g、130h、130h等在一些實施方式中相鄰於彼此設置且基本上設置在包封腔120內。在一些實施例中,包封腔120內具有八層吸收材料。在一些實施方式中,吸收材料層130a-h包括凝膠形成纖維,例如上述那些纖維,並且凝膠形成纖維可以是羧甲基纖維素鈉纖維。此外,吸收材料層130a-h可以包括如上所述的吸收材料、水溶脹性纖維或凝膠形成纖維中的任何一種。例如,吸收材料層130a-h可以由羧甲基化纖維素纖維形成。
在一些實施方式中,吸收材料層130a-h中的一個或多個包括一個或多個開窗129,如圖5所示。開窗129可以是在吸收材料層130a-h上的一個或多個方向上的狹縫或開口129,所述狹縫或開口優選地在與縱向軸線在一個平面上且橫交於吸收材料的縱向軸線的方向上,這有助於管理滲出物流過敷料14的各層130a-h。具體地,開窗129促使或使得傷口滲出物在優選的方向上移動或被吸收。在一些實施方式中,開窗129促使或使傷口滲出物相對於從一個層到另一個層的軸向吸收材料層中的每一層橫向移動。開窗129可以機械地形成,例如通過切割。開窗129優選為長度為約10mm的狹縫,所述狹縫可以優選地橫過每個吸收材料層以行和列垂直和水平地交替。開窗全部充分利用吸收材料層的吸收能力,還可以幫助通過這些層進行負壓傳遞。
在各種實施例中,敷料14包括黏合劑層150。黏合劑層150可以有助於將敷料14固定到患者的皮膚。在一個實施例中,黏合劑層150還可以幫助形成具有背襯層82的外殼或包封體,其中包封體100位於所述背襯層82內。如圖3所示,在一個實施例中,黏合劑層150連接到背襯層82和傷口接觸層112兩者。具體地,在這種實施例中,背襯層82從黏合劑層150的黏附有傷口接觸層112的內部徑向向外黏附到黏合劑層150的外部。如圖5最清楚地所示,在一個實施例中,黏合劑層150具有帶有中心孔154的周邊形狀。黏合劑層150中的中心孔154 使得使用者的皮膚在敷料14被施加到使用者的皮膚上時能夠與傷口接觸層112接觸或流體連通。
如圖4中最清楚地顯示,在一個實施例中,背襯層的第一表面83優選地與壓力分散層104和黏合劑層150相鄰並接觸,同時柔性連接器50設置在背襯層的第二表面84上。
可移除蓋156可以黏附到黏合劑層150的外表面。如圖3和圖5所示,在一個實施例中,可移除蓋156可以黏附到黏合劑層150的外表面,從而位於黏合劑層150的黏附有傷口接觸層112和背襯層82的相反側上。可以包括具有折叠的夾持部158a、158b的多個部分156a、156b的可拆卸蓋156可從黏合劑層150移除。因此,在一個優選實施例中,當可移除蓋156被黏附到黏合劑層150時,可移除蓋156保護黏合劑層150,但是當可移除蓋156被從黏合劑層150移除以用於敷料14時,黏合劑層150的外表面露出且能夠將敷料14可釋放地固定到使用者的皮膚。
轉到圖7和圖8,可分離連接器44與壓力管22的遠端管40和柔性連接器50一起被詳細地示出。在一個實施例中,遠端管40包括遠端連接部170且優選地在一個端部處以所述遠端連接部終止。遠端連接部170可以包括圍繞遠端連接部170徑向布置的一個或多個遠端花鍵172。遠端花鍵172與圍繞遠端管40的一部分設置的扭轉構件176的對應內部花鍵174接合。扭轉構件176幫助旋轉遠端連接部170,以將遠端連接部170固定到近端連接部188。
遠端連接部170還優選地包括第一配合構件180,例如螺紋180,所述螺紋可以是螺旋形螺紋。相應的第二配合構件184(例如,螺紋184)可以設置在近端連接部188中,使得遠端連接部170可以通過第一配合構件180與第二配合構件184的接合而可釋放地連接到近端連接部188。
扭轉構件176的能夠與遠端連接部170的相應遠端花鍵172接合的內部花鍵174的組合使得使用者能夠更容易地相對於近端連接部188操縱和旋轉遠端連接部170,以選擇性地將遠端連接部170連接到近端連接部188和將所述遠端連接部從所述近端連接部上拆卸。圖7示出了處於連接狀態的遠端連接部170和近端連接部188,而圖8示出了處於拆卸狀態的遠端連接部170和近端連接部188。
如圖7和圖8所示,在一個實施例中,近端連接部188連接到接口管194並與所述接口管流體連通,所述接口管大致設置在近端連接部188和柔性連接器50之間。要理解的是遠端管40、遠端連接部170、近端連接部188、接口管194和柔性連接器50都沿著管22彼此流體連通,因此使泵18和敷料14之間能夠流體連通。
在一個優選實施例中,近端連接部188包括單向閥198。單向閥198允許流體在第一方向上移動通過單向閥198,同時基本上或完全地防止流體在第二方向上移動通過單向閥198。作為示例,單向閥198允許流體朝向泵18而遠離敷料14流動通過近端連接部188,同時防止流體遠離泵18而朝向敷料14流動。這種布置使得當遠端連接部170和近端連接部188被可釋放地拆開時能夠使敷料14繼續經歷或呈現負壓,如圖8所示,從而即使在與泵18拆分時也能增加敷料14的使用者舒適性、柔性和效用。
傷口滲出物管理系統10優選地還包括指示器系統200,所述指示器系統指示已經或不久將達到的敷料14的流體處理能力,以及敷料14應當被更換以避免滲出物從敷料14中泄漏或者進入泵18。指示器系統200可以產生信號,例如視覺、聽覺、振動等的信號。作為示例,指示器系統200包括設置在上吸收指示器構件70、背襯層82、壓力分散層104、傷口接觸層112、吸收材料層130a-h或柔性連接器50中的一個或多個內的膠凝吸收劑中的一個或多個。膠凝吸收劑 可以包括上述的吸收材料。指示器系統200可以在視覺上指示通過形成凝膠已經吸收滲出物。指示器系統200還可以在視覺上指示由於傷口滲出物進入指示器而由於顏色變化而已經被吸收,這是因為傷口滲出物接觸敷料內的一些成分或材料以及由於顏色變化模具由於滲出物或另一種液體或者通過其他方法被激活。
在一些實施方式中,傷口滲出物管理系統10,特別是敷料14可以以多種狀態設置。例如,敷料14可以處於第一狀態,敷料14在所述第一狀態下基本上沒有滲出物和流體。第一狀態可以對應於敷料14的吸收材料中的具有第一體積或尺寸的纖維。另外,在第一狀態下,纖維之間的通道具有第一容積。敷料14也可以處於第二狀態,敷料14的吸收材料中的纖維在所述第二狀態下已經被吸收並部分和完全充滿滲出物。第二狀態可以對應於敷料14的吸收材料中的具有第二體積或尺寸的纖維。第一體積或尺寸相對地小於第二體積或尺寸。因此,纖維之間的通道或開口相對較大。類似地,在第二狀態下,其中纖維在與傷口滲出液接觸時膨脹之後,纖維之間的通道的容積或尺寸减小,並且纖維之間的通道或開口相對較小或者纖維封閉通道或開口。在持續施加負壓時,滲出物id通過吸收材料的飽和纖維抽出到指示器系統200。
換句話說,圖1示出包括完全覆蓋敷料的其他層的外覆蓋層以及導管或管的傷口敷料。在覆蓋層下方是在覆蓋層的下方形成中心凸起島的吸收墊。在一個實施例中,吸收墊包括多個吸收材料層。
吸收層能夠從傷口吸收滲出物。外覆蓋層覆蓋吸收層的距離傷口最遠的側部,如圖3-5所示,還稱為背襯層的覆蓋層適於使負壓力能夠施加在傷口處並具有與吸收層流體連通的端口。導管或管道允許所述端口和負壓源之間流體連通,導管通過黏合環連接到外層。在端口中設置指示器裝置或上吸收指示器構件。在一個實施例中,指示器裝置包括凝膠形成纖維層。可選地,指示器裝置也可以仍然設置在端口中,但是在覆蓋層的上方。敷料還包括通過由聚 醯胺網眼層組成的可熱封網眼層黏附到吸收層的傷口接觸層。敷料還包括滲出物和壓力分布層,也稱為壓力分散層,優選為聚酯泡沫,所述聚酯泡沫用於將滲出物橫過吸收層擴散並橫過敷料平穩地施加負壓。可以在分布層和覆蓋層之間設置另外的可熱封網眼層。可熱封層有助於將各個層黏合在一起。吸收層、傷口接觸層和指示器裝置包括為一層或多層羧甲基化纖維素織物形式的凝膠形成纖維。
在一個實施例中,吸收層的面積小於覆蓋層,如圖5所示,使得所述吸收層在覆蓋層的框架內形成島狀部。矽黏合劑可以被施加到覆蓋層的面向傷口的一個側面上的框架,以便將敷料密封到傷口周圍的皮膚。可選地,敷料可以通過覆蓋敷料的面向傷口的具有或不具有在黏合墊上的窗口的表面的帶孔黏合劑固定到傷口,和/或通過施加到覆蓋層的外表面上和敷料周圍的皮膚的敷料條帶固定到傷口。
在使用中,敷料可以固定到傷口周圍的皮膚和導管,該導管通過位於導管的遠端處的連接器連接到負壓源。經由用於從傷口引導的流體的通路施加負壓、經由吸收層、端口將負壓施加到導管的遠端,而將負壓施加到傷口。滲出物被傷口接觸層吸收並通過緊密接觸傳送到吸收層。可能存在於吸收層中的窗孔有助於滲出物的吸收和負壓的施加。當滲出物被吸收層吸收時,所述滲出物在分布層下方擴散,使得更大面積的吸收層被滲出物接近,並且使用更大容量的吸收層。一旦已經達到吸收層的吸收能力,滲出物向端口擴散並被形成膠體的指示器裝置吸收。凝膠的形成和指示器裝置的可能的顏色變化對於敷料的使用者是可見的,並且指示需要更換敷料。指示器裝置也可以或者可選地存在於導管中或其鎖中,其中所述指示器裝置也可以被使用者看到並可以在滲出物被吸入泵或其他負壓源之前為敷料變化提供額外的時間。
雖然已經示出和說明了一些實施方式,但在不背離本公開的精神的情况下會想到許多修改,並且保護範圍僅受所附申請專利範圍的保護範圍的限制。此外,本公開提供具有增加的結構强度、改進的美學設計的標記基部和標記組件、便於柔性標記基座放置的占地面積以及允許容易的標記組裝運輸的輪子裝置。
已公開的系統和方法很好地適用於獲得所提及的目的和優點以及其中固有的目的和優點。以上公開的具體實施方式僅是說明性的,這是因為本公開的教導可以以具有在此教示的益處的對於本領域技術人員顯而易見的不同但等效的方式進行修改和實施。此外,除了如以下申請專利範圍中所述的以外,對在此所示的結構或設計的細節不作任何限制。因此,顯而易見的是以上公開的特定說明性實施方式可以被改變、組合或修改,並且所有這些變化被認為在本公開的保護範圍內。在此示例性公開的系統和方法可以適當地在沒有本文具體公開的任何元件和/或本文公開的任何可選元件的情况下實施。雖然組合和方法用“包含”、“含有”或“包括”的各種組合或步驟來說明,但是組合和方法也可以“主要由各種部件或步驟組成”或者“由各種部件或步驟組成”。以上公開的所有數字和範圍可以變化一些量。每當公開具有下限和上限的數值範圍時,具體公開了落在該範圍內的任何數量和任何包括的範圍。具體地,在此公開的每個範圍的值(形式為“從約a至約b”、或者等效地“從大約a到b”或者等效地“從近似a到b”)被理解為列出更廣泛的數值範圍內的每個數字和範圍。此外,除非專利權人明確且清楚地限定,否則申請專利範圍中的各項具有其明確的、普遍的含義。此外,申請專利範圍中使用的不定冠詞“一個”或“一”在本文中被限定為表示其引入的一個或多於一個的元素。如果本說明書中的單詞或術語的用法有任何衝突以及可以通過引用並入本文的一個或多個專利或其他文獻,則應該採用與本說明書一致的限定。
如在此所使用的,在一系列項目之前的術語“至少一個”以及用於分開任何一個項目的術語“和”或者“或”將整個列表修改為列表的每個項目(即,每個項目)。短語“至少一個”允許包括項目中的任一個、和/或項目的任何組合中的至少一個和/或每個項目中的至少一個中的至少一個的含義。作為示例,短語“A、B和C中的至少一個”或者“A、B或C中的至少一個”每一個僅表示A、B或C;A、B和C的任一個組合;和/或A、B和C中的每一個的至少一個。
14:敷料
50:柔性連接器
70:上吸收指示器構件
74:上黏合劑
78:上黏合孔
82:背襯層
83:第一表面
84:第二表面
86:背襯層孔
90:背襯層黏合劑
94:背襯層黏合劑孔
104:壓力分散層/上包封層
108:周邊部/上周邊部
109:中心部/上中心部
112:傷口接觸層/下包封
116:周邊部/下周邊部
117:中心部/下中心部
118:加強縫合部
129:開窗/狹縫/開口
130a-h:吸收材料層
150:黏合劑層
154:中心孔
156:可移除蓋

Claims (26)

  1. 一種傷口滲出物管理系統,包括:泵,所述泵用於產生負壓;敷料,所述敷料用於覆蓋和保護傷口,所述敷料包括:黏合劑層,所述黏合劑層用於鄰近傷口黏附所述敷料;傷口接觸層,所述傷口接觸層用於接觸傷口;壓力分散層;多層吸收材料,所述多層吸收材料設置在所述傷口接觸層和所述壓力分散層之間;和背襯層,所述背襯層具有第一表面和第二表面,所述背襯層的所述第一表面與所述壓力分散層和所述黏合劑層相鄰並接觸;壓力管,所述壓力管具有內管腔,所述壓力管設置在所述泵和所述敷料之間,使得所述泵和所述敷料通過所述內管腔流體連通;和柔性連接器,所述柔性連接器連接到所述背襯層的所述第二表面。
  2. 根據請求項1所述的傷口滲出物管理系統,其中,所述敷料包括由所述壓力分散層和所述傷口接觸層的連結的周邊部分形成的內包封結構,所述內包封結構限定一腔體。
  3. 根據請求項1所述的傷口滲出物管理系統,還包括:熱塑性材料織成的網眼層,所述熱塑性材料織成的網眼層連接到所述壓力分散層;和無紡布織成的網眼層,所述無紡布織成的網眼層連接到所述傷口接觸層,以及 其中內包封結構通過連結所述熱塑性材料織成的網眼層和所述無紡布織成的網眼層的周邊部分而形成,使得所述多層吸收材料大致設置在所述內包封結構的內腔體內。
  4. 根據請求項2所述的傷口滲出物管理系統,其中,所述吸收材料設置在所述內包封結構的所述腔體內。
  5. 根據請求項1所述的傷口滲出物管理系統,其中,所述吸收材料包括羧甲基纖維素纖維。
  6. 根據請求項1所述的傷口滲出物管理系統,其中,所述傷口接觸層包括羧甲基纖維素纖維。
  7. 根據請求項1所述的傷口滲出物管理系統,其中,所述傷口接觸層具有加强尼龍縫合部。
  8. 根據請求項1所述的傷口滲出物管理系統,其中,所述壓力分散層包括網狀泡沫。
  9. 根據請求項1所述的傷口滲出物管理系統,還包括在所述多層吸收材料中的一層或多層中的開窗。
  10. 根據請求項1所述的傷口滲出物管理系統,還包括:壓力傳送構件,所述壓力傳送構件設置在所述柔性連接器內。
  11. 根據請求項1所述的傷口滲出物管理系統,還包括上吸收指示器構件和上黏合構件,並且其中所述上黏合構件將所述柔性連接器和所述上吸收指示器構件黏附到所述背襯層。
  12. 一種傷口滲出物管理系統,包括:敷料,所述敷料用於覆蓋和保護傷口,所述敷料包括: 傷口接觸層,所述傷口接觸層具有第一表面和第二表面,所述傷口接觸層還具有周邊區域和中心區域,其中當所述敷料被黏附到與傷口相鄰的皮膚時,所述傷口接觸層的所述第一表面接觸所述傷口;壓力分散層,所述壓力分散層具有周邊區域和中心區域;多層吸收材料,所述多層吸收材料設置在所述傷口接觸層的所述第二表面和所述壓力分散層之間;和包封體,所述包封體通過將所述壓力分散層的所述周邊區域與所述傷口接觸層的所述第二表面的所述周邊區域連結而形成,所述多層吸收材料大致設置在所述包封體的內腔體內。
  13. 根據請求項12所述的傷口滲出物管理系統,還包括:熱塑性材料織成的網眼層,所述熱塑性材料織成的網眼層連接到所述壓力分散層;和無紡布織成的網眼層,所述無紡布織成的網眼層連接到所述傷口接觸層,以及其中所述包封體將所述熱塑性材料織成的網眼層和所述無紡布織成的網眼層的周邊部分連結而形成,其中所述包封體的所述內腔由所述無紡布織成的網眼層和所述熱塑性材料織成的網眼層形成,以及其中所述多層吸收材料大致設置在所述包封體的內腔內。
  14. 根據請求項12所述的傷口滲出物管理系統,其中,所述吸收材料包括羧甲基纖維素纖維。
  15. 根據請求項12所述的傷口滲出物管理系統,其中,所述傷口接觸層包括羧甲基纖維素纖維。
  16. 一種傷口滲出物管理系統,包括:敷料,所述敷料用於覆蓋和保護傷口,所述敷料包括傷口接觸層、背襯層和在所述傷口接觸層和所述背襯層之間的至少一層吸收材料層;柔性連接器,所述柔性連接器具有內管腔,所述柔性連接器固定到所述敷料的背襯層;指示器,所述指示器在所述背襯層和所述柔性連接器之間;管,所述管具有內管腔,所述管連接到所述柔性連接器,其中所述柔性連接器的所述內管腔和所述管的所述內管腔流體連通;和壓力傳送構件,所述壓力傳送構件設置在所述管的所述內管腔內。
  17. 根據請求項16所述的傷口滲出物管理系統,其中,所述壓力傳送構件包括柔性格柵結構。
  18. 據請求項16所述的傷口滲出物管理系統,其中,所述壓力傳送構件設置在所述柔性連接器內。
  19. 根據請求項16所述的傷口滲出物管理系統,其中,所述柔性連接器具有大致平坦的外表面。
  20. 一種傷口滲出物管理系統,包括:泵,所述泵用於產生負壓;敷料,所述敷料用於覆蓋和保護傷口,所述敷料包括傷口接觸層、背襯層和在所述傷口接觸層和所述背襯層之間的至少一層吸收材料; 管,所述管連接所述泵和所述敷料,所述管具有內管腔,以用於通過所述內管腔使所述泵和所述敷料流體連通;和單向閥,所述單向閥串聯在所述泵和所述敷料之間,以在所述泵與所述管斷開時在所述敷料內保持一負壓。
  21. 根據請求項20所述的傷口滲出物管理系統,其中,所述單向閥連接到所述泵和所述管中的一個。
  22. 一種傷口滲出物管理系統,包括:泵,所述泵用於產生負壓;敷料,所述敷料用於覆蓋和保護傷口;壓力管,所述壓力管包括內管腔,所述壓力管設置在所述泵和所述敷料之間,使得所述泵和所述敷料通過所述壓力管的所述內管腔流體連通;和多層吸收材料,所述多層吸收材料設置在所述敷料中,其中所述吸收材料具有在與傷口滲出物接觸時膨脹以管理傷口滲出物通過所述敷料的一部分的流動的纖維。
  23. 根據請求項22所述的傷口滲出物管理系統,其中,所述吸收材料中的纖維包括羧甲基纖維素纖維。
  24. 根據請求項22所述的傷口滲出物管理系統,其中,所述吸收材料中的纖維在傷口滲出物被引入到所述吸收材料之前具有第一體積,其中所述吸收材料中的纖維在傷口滲出物被引入到所述吸收材料之後具有第二體積,並且其中所述第二體積大於所述第一體積。
  25. 根據請求項22所述的傷口滲出物管理系統,其中,當纖維在與所述傷口滲出物接觸時膨脹之後,所述纖維之間的通道的容積减小。
  26. 一種用於向傷口施加負壓的負壓傷口敷料,包括:吸收層,所述吸收層能夠吸收來自傷口的滲出物並允許流體流動通過所述吸收層;外覆蓋層,所述外覆蓋層覆蓋所述吸收層的距離傷口最遠的一側部,所述覆蓋層適於將負壓力施加在傷口處並具有一端口;導管,所述導管具有連接到所述端口的近端、以及一遠端,所述敷料設置有用於使來自傷口的流體通過所述吸收層、所述端口並到達所述導管的所述遠端的通路;和指示器,所述指示器在所述通路中被定位在所述吸收層和所述導管的所述遠端之間的位置處,所述指示器能夠吸收滲出物以指示在所述吸收層的距離傷口最遠的所述側部處存在滲出物。
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