Apparatus for the closure of wide skin defects by stretching of

Details Apparatus for the closure of wide skin defects by stretching of Apparatus for the closure of wide skin defects by stretching of

1995-07-12

1999-04-13

Jackson, Gary

Surgery

Instruments

Sutureless closure

606213, 606216, 606217, A61B 1704

Patent

active

058938796

DESCRIPTION:

BRIEF SUMMARY
BACKGROUND OF THE INVENTION

1. Field of the Invention
The invention relates to an apparatus for stretching skin to cover an open wound, and more particularly, to an apparatus for use before or during an operation for closure of skin defects or otherwise damaged skin areas.
2. Description of the Related Technology
U.S. Pat. No. 4,896,680 discloses a method and apparatus for stretching skin over a wound by load cycling. A force may be applied on opposite skin margins during several periods interrupted by relaxation periods, so skin may be stretched over a wide area. A surgical stretching apparatus according to that patent may include two pins for insertion into the skin along both edges of a wound.
The pins may be gradually pulled together by a flexible strap. The tension or pulling load on the pins may be applied in intervals to allow the collagen fibers of the skin to rearrange for further stretching. The pins may be substantially shaped as safety pins exhibiting a loop for attachment to a flexible strap. The strap may exhibit projections or apertures for engaging a ratchet-shaped device that may hold the pins in forceful apposition.
A disadvantage of the above-described apparatus is manifest when the pins have been drawn together, as no space or room is provided for suturing the approximated skin margins. Another drawback resides in the rather crude manner for approximating the pins, i.e., manually pulling on the flexible strap, as the pulling force cannot be minutely controlled. Another drawback is the two pins grip only relatively narrow strips of skin along both edges, therefore, it is not possible to close a wide wound in a single pulling operation.
There exists a need for a skin closing or skin stretching device that closes a wide skin defect in a single pulling operation. There further exists a need for a skin closing apparatus that provides a visual or auditory indication of the tension or force applied to the wound margins during a pulling operation, and may limit the amount of force applied to the wound margins by disengaging a clutch mechanism.


SUMMARY OF THE INVENTION

The present invention is directed to a skin stretching apparatus that approximates opposing margins of a wound in a single skin stretching operation, provides visual or auditory indication of the amount of force applied and limits the amount of force applied to the margins of the wound. A skin stretching apparatus having the features of the present invention may include two long interdermal needles for insertion under skin along the two edges of a wound to be closed; two retaining members exhibiting a top surface, a bottom surface configured for placement close to the skin, and a sharp hook at the end of each leg of the lower surface of the retaining member. A contracting mechanism may also be provided for pulling and approximating the two retaining members with their legs extending towards an open wound. The skin stretching apparatus may further include a clutch mechanism for preventing overtensioning of the device and a visual or auditory mechanism for indicating the force applied to the wound margins and also for indicating skin relaxation.
The retaining members may be placed behind the interdermal needles with respect to the wound location and in opposing alignment. The hooks of the retaining members may pierce the skin and engage an associated long interdermal needle in a position along the wound edges. The contracting mechanism may be designed to pull the retaining members slowly and gradually together so no damage to the skin area results. Each retaining member may exhibit a U-shaped profile which permits suturing of the skin edges, while the apparatus remains in position proximal to the wound due to the open spaces left between and on both sides of the two legs.
One embodiment of the contracting mechanism exhibits two contractor arms in parallel alignment and connected by a screw mechanism adapted to slowly bring together or approximate the two components by rotating the screw mechanism. One end of each contractor arm

REFERENCES:
patent: 376441 (1888-01-01), Hughes
patent: 4506669 (1985-03-01), Blake, III
patent: 4535772 (1985-08-01), Sheehan
patent: 5127412 (1992-07-01), Cosmetto et al.
patent: 5236973 (1993-08-01), Cook
patent: 5507775 (1996-04-01), Ger et al.

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