Surgery – Instruments – Sutureless closure
Patent
1996-06-13
1998-03-31
Buiz, Michael
Surgery
Instruments
Sutureless closure
606215, 606216, A61B 1708
Patent
active
057333050
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention concerns a process and a device for stimulation of the formation of new tissues in large surface area wounds and deep tissue defects according to the introductory portion of the independent patent claims.
2. Description of the Related Art
Large surface area wounds caused by open fractures or external influences are to a greater extent liable to disease causing agents, since the deepest tissue layers down to the damaged bone are exposed to the environment.
Even an infection by staphylo- or streptococci can be life threatening for the injured. The contamination of the large surface area wound by Proteus, Pseutonmas or Klebsiella leads as a rule to a life threatening septic condition. Further the healing process is burdened by the dying off of damaged tissue components. This highly toxic albumin decomposition product is discharged from the organism as a fluidized wound excrement. According to the degree of injury the injured may require more or less frequent extremely painful follow-up treatments of the wound.
For the operative care of large surface area wounds there has, in recent times, been employed a technique of vacuum sealing (for example 0093/09727). In accordance therewith, after the first operative care of the wound, the tissue defect or skin section and various tissue pockets are filled in with a layer of polyvinyl foam material, wherein in adjacent foam material layers so called Redon-drainages are incorporated directly into the foam material. Therein attention must be paid, that the drainage perforation does not come into contact with the soft parts, since they would form a tight suction seal upon application of a vacuum and their drainage function would be lost. The so applied layers of polyvinyl foam material are thereafter sealed with a transparent, water vapor permeable but bacterial non-transmissive polyurethane foil, such that the polyurethane foil covers the wound as well as the undamaged skin surrounding the edge of the wound. After connection of the Redon-drainages to a vacuum system the wound discharge is suctioned off and at the same time a more intensive contact between the wound and the foam material is achieved, which, as has been shown through experience--substantially improves the cleansing of the wound and the new formation of granulation tissues.
It has however been shown, that the atmospheric pressure resting upon the tissue worsens the perfusion of blood in the boarder area of the wound and in many cases leads to muscle atrophy and to devitalization of the tissue regions. In the damaged tissue frequently chambers are formed, in which toxic albumen decomposition products collect, which can lead to a life threatening septic condition in the injured patient. The recovery can--if at all--be achieved with difficult, with operative measures associated with prolonged, cost intensive and painful wound therapy which supplementally burdens the organism.
It is further known (for example from U.S. Pat. No. 4,896,680 and U.S. Pat. No. 5,263,971), to draw the peripheries of the wound of a large surface area wound together by means of a so-called skin-distractor, in order to be able to suture the wound peripheries to each other. The skin-distractor engages in the cutis or dermis with two distractor segments on respectively opposing wound peripheries. The distractor segments are drawn together via a spiral spindle. The drawing together is accomplished in successive steps, whereby the skin is stretched to the limits of its viscoelastic extensibility. The known skin distractor accomplishes pulling forces only in the plane of the wound field, in order to pull the peripheries of the wound together utilizing the viscoelastic properties of the skin. A formation of new tissues is not possible herewith and not intended.
SUMMARY OF THE INVENTION
The object of the invention is comprised therein, to improve the treatment of a tissue defect by insuring the tissue vitality and advancing the formation of new tissues, to avoid the compli
REFERENCES:
patent: 2371978 (1945-03-01), Perham
patent: 4702251 (1987-10-01), Sheehan
patent: 5556428 (1996-09-01), Shah
Buiz Michael
Pham Tina T. D.
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