CA2121509C - Closure for a skin wound or incision - Google Patents
Closure for a skin wound or incisionInfo
- Publication number
- CA2121509C CA2121509C CA002121509A CA2121509A CA2121509C CA 2121509 C CA2121509 C CA 2121509C CA 002121509 A CA002121509 A CA 002121509A CA 2121509 A CA2121509 A CA 2121509A CA 2121509 C CA2121509 C CA 2121509C
- Authority
- CA
- Canada
- Prior art keywords
- wound
- strip
- tapes
- tape
- filaments
- Prior art date
- Legal status (The legal status 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 status listed.)
- Expired - Fee Related
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/085—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound with adhesive layer
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0466—Suture bridges
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/085—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound with adhesive layer
- A61B2017/086—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound with adhesive layer having flexible threads, filaments, laces or wires, e.g. parallel threads, extending laterally from a strip, e.g. for tying to opposing threads extending from a similar strip
Abstract
A sutureless closure (10) for a skin wound or incision in which a plurality of f ilaments (48) are secured between the ends of opposing adhesive tapes (12, 16). A second substantially identical pair of adhes ive tapes (14, 18) has filaments (46) disposed therebetween with the filaments on the first and second pairs of tapes being alt ernately interwoven. Each of the lower tapes (12, 14) is adhered to skin adjacent either side of a wound. The upper tapes (16, 18) are adhered to the exposed surface of the lower tapes thereby stretching the filaments (46, 48) across the wound and drawing the wound together. In another embodiment, a pair of tapes (60, 62) having opposed hooks (72, 74, 76) are taped onto skin adjacent opposite sides of a wound (66). A filament (88, 90) is wound between the hooks (72, 74, 76) on the tapes (60, 66) to draw the wo und (66) together. Notches (82, 84), in the hooks 72, 74, 76) secure the filament (88, 90) at each hook and permit selecting diffe rent tensions in each filament run from hook-to-hook.
Description
W~ 93/0~74~ i . P~r/U~92/0~246 - 21~1~û9 , CLOS~E FOR A SKIN IJO~D OR ~NCISION
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13~A~rf~ ON
1. Fif~l~ of thP. lf~ nti~m S Th~ present illve~on ~el~es to a sutureless closure for a ~in wound or i~CiSiOIl and ~re particula~ly to such a closure ir~ which a plurality of p~allel fi~ ts disposed between opposirlg ends of tape strips coanpress and draw ~e ~n~ion or wo~d.
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13~A~rf~ ON
1. Fif~l~ of thP. lf~ nti~m S Th~ present illve~on ~el~es to a sutureless closure for a ~in wound or i~CiSiOIl and ~re particula~ly to such a closure ir~ which a plurality of p~allel fi~ ts disposed between opposirlg ends of tape strips coanpress and draw ~e ~n~ion or wo~d.
2. 1~.~ in.~ of t!h~ R~
0 Tbe~e ~e D~llmS~OUS p~or art d~i~s and ~ s ~or c1rs;n" s~5ic~1 .
~cisioDs or wou~ds. Tl~ terms ~si~ and wound are ~e~eEred t~ ein interchallgeably as the present invcn~on may bc r~ 7~d to close both sur~cal ~cisions and wounds.
In ~e prior a~ adhesi~e~bandages may be used to cover a wound as weU as 15 draw the~odges ~e~eof 'c.~ hP,r to t~de healing. Wo~ds ~d ~r~pc~1 :~ i~cisions:are ~o ~ PS s~il-ed toge~erosiDg -'~~ smd a Déedle. U.S. Patent No.~ S~ o Pietce disc1~e8 a wound closule device iJI wh~ch ~0 : ~ ~ttaching ~~ ~cd to eitlie~ side of a wound ~or drawi~g toh_~r ~nd .j ~ : :: secumlgtheopposi~e~sides:ofthewound. TI~K~deviced~otp~idgany 20 ~r~ agafinst ~e wound~whi~h is a reco~ echni~ue for prom~g .r~ U.S.~PateDt No. 4,423,731 1~ Roomi discloses ~a surg~cal d~essi~g ill wbich wo st~ips of a~ f plss~er lie~alo~ oi~er s;de and pa~1el to a wo~d. Each s~ip bas fil~ ecured at ~pa~ed i~ervals al~g otle side ~ ~f The ~
25 . -~ ends ~e filan~ts~ secured to:two;~udditional~ e~r s~ips which adh~ to ~e~:sldn a~a~gi~n fi~er~away:~om~e wound.~
e Roon~i dGvice suffers from a ~ , of disadv~ E;f ~. FIIst, ~e fi1 ~ use~ ill Roon~i ane a~p~ed ;to sldn both acro~s th~ ci~ ;~" and l~t~
i~ ~he plaster strips on each side of ~e ~1 ~ C;on. The l~ll~ds ~nd ~o ilTitate tbe sldn ~ ~ ; 30 wh~n p~ssed l~ r~ r~l Also, the threads in Roomi are ve~y widely sp~çed j, , . i . . .
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212150~3 ~pparently ~J~ . }lC-~ in the range of two to ~ee th~ per inch. The wound or i~ 5~ could be beffer drawn to~ll~r with more thread~ per inch. In ;~, a ~rr,~ "t n~r of ~eads would apply pr~ssur~ against ~e wound ~imilar to a gauze pad which promotes hr~
S The filament~ Ln the Roo~ ~essing a~e con~ected to ~e sides of el~gate plaster strip~. More tension ~d be ~pplied if the ~ads were con4ec~d to ~e end of the strips. In ~ d~;tiot~ nne~ing filaments to the end of the strips produc~s a much narrower bar~dage which would pernut using more band~ges per wsund. This would enable co~g each closure with dif~erent le~els of '' 10 ten~i~n. Thi8 mtly be desirable ~ the case where ~e wound or in~sioll depth v~ries or where vascubs co~cenb~tioDs n~ight r~qu~ e tension in Ihe fil~ for optimum bealing.
s~ rY 0~1~ INVEN~ION
In one aspect, a ~uDueless closwe for a generally elonga~e woL~nd or incision comp~isos:frst ~ ~d strips of adhesiYe tape ~h bei~g ada~d to adhe~e to a pu~on's ~kin adjs~e~t tb~ lengthwi~ ex~ding sdges of ~e wound.
Th~ londtudinal axes of ~e ta~es are oliellted substan~lly ~onn~l to the wo~nd.
A ~ird ~tdp of:Ddbosi~e ta~)e has a pIu~ity of filaments secu~d ~t spaoed in~ls along;~ne end a~d o~upled to ~ e~d of ~e S~st tape. A fou~ st~ip of bas a plur~lity of filC~ ~ .t~ SeCIIred at SpalCed i5iltel~alS along one s. elld ~d co ipled:to an:end of ~e ~econd tap~.: The ~ird and ~ou~ tapes each . ~; adher~ to ~e e~osed surf~of the fir~e and ~ d tapes wi~ dle l~gitudinal f su~nlly DOilllal to ~ wound so tha~ tbe filame t te sio between ~e tapes dr~w the edges o~the wound to~ e~ other aspect, ~e suhuebss clos~ ~.~ r~ ~ first and second st~ips of adhesiv~ tape each being :: - ~d to adhcle to a po~ s skin adjacent the len~ extending edges ~e wound. ~e lor~ ;r~l ax~s ~dle tapes are substan~ally p~~llel to ~ wound.
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A p~ y of hooks are ~ unt~d along the length of each tape. E~h h~k 30 ~~rludes ~n opening facing away from the wound when the closure is in use. The ,.
~ WO 93/0874~ Pcr/us92/os246 .
21~1~1)9 , i'.
o~ * is adapted to ~coiw a filament di~FosEd around ~e ~pp~;~ hook~ for drawing the edges of ~e wound tfi~ responsive to tension in ~e filam0nt. A
~l~d for clo~ing a generally elong~te wound o~ ~n~;C;~n iS also provided.
It is a general o~ject of the pr~ent inve~tion to ~.o~d~ a s.~ los~
.. Sfor a skin wound or i~cis~on which OY~ ~B the ~bove-enwnetated '1 ~diS&IdV~lt~ageS nssoci~ed ~th p~ior ~t closu~es. .
~ t is a~o~er ~bJect of ~e present i~ention to ~ .i~ such a closure which facilitates app~i~on to i~ lar wolmds itl ~ssues by ~pplying seve~l devices, each of which may be differently tensioned, thereto.
It is ano~aer db~ect of dle present i.. -~nlio~ to ~rovide such a closure which mi~n~i~s exposure of skin to ~e tensioned ial~ne~
It is s~l a~other object of ~e p~esent i~ve~tion to providc such a closure in which ~e wound is draw~ l~g~ lh~r and compressed to promo~e beali~g thereof.
;~ It is yet ano~er object of ~e plegODt illVel31tiOD to p U ~id~; 8UGh a cl~e in lSwhich gleater~e~sion ~ in pnor art ~ iCGB Illay be a~pplied to ~e fillG ~
~'?~' ' The ~g~j20~11g and ~er obj~, foahllss and adYa~ltages OI ~ i~ention mo~ readily npp~nt ~om the fo11Owing ~ s~p~io~ of a prefe~d ~;~,nt which ~/wccds wieh refe~snoe to ~e drawi~g~.
20~ RIEF D~ ON Ol~ l~ DlRAYV~GS
Figs. 1~ pc- .~;v~ views of a deYice ~1~Dhu ~d ill ~!ICCO~IIOe Y~th s ~ ~e pr~t inveDtioD ~ lU~i-~ ~ages of application ~o a wound or i~cision.
: Flg. S is a p~ e view of a s~ond d0~ice cong~ucted i~ acoordance with the presellt inv~.~tio~ applied to a wound or ;~ ;01 ~; 2~ t .~ ~Fig. 6 is a plan ~ w of a second ~ pplied to a wound or ,.,,~
Flg. ~ is a~ enl~ed view taken ~long lines 7-7 in Flg. 6.
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~' Flg. 8 is a view taken along lines 8-8 in Pig. ~O
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.~ F~g. 9 is an ~I~I&~ed cross-sec~i~n~1 view of one of ~e fi1~ in Fig. S.
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.. i i ;, ;, WO93/08748 ~ CI/U~g2/092~6 21215~9 ,, Fig. 10 is a pe.~ ;ve view of atlOtheF device ~u,~ ,~d in accordance with ~e prese~t in~e~ti~.
Pig. 11 i~ an enlarged ~riew of a portion of the view of ~ig. 10.
S
DET~ILEl) D~ ON OF l~IE rREF F~rFr~ E~MB~DD~T
Lndica~d generally at 10 il~ Flgs. 14 is a ~utureless CIOD constmcted in accordance with ~e prese~t ~ve~on. I~.Qs~l~ 10 is illustr~d in Flg. 1 pnor to for~ce of any of ~ eces~ary to apply ~u closure to a wound.
.. 10 Closur~ 10 is ~how~ ~ Fig. 4 applied to a wou~d. Inteiim~ediate ~igs. 24 i~ e tbe closure il~ p~ss;~ es of prpa~a~io~ for applying it to a w~und which i5 desaribed henei~ er ,; .
~! Closure ~ is first, second, ~rd and folllth strips of i~
12, 14, 16, 18, ~ ly, each of wP~ich i~ about one inch wide, a~l ou~
15 a~bodin~ ~g i~ width f~m much ~ , e.g., 1/16", ItO much l~e~, . ~ : e.g., 4n~ collltem~d a5 beiDg withh~ cope Qf ~e in~ion . E~
ip ;~ ve upper w~ e 20, ~, 24~ 26. E~h ~
illclDdes a~lower surface, not visible i~ ~e drawillgs~ wihich is coa~d i wi~ adl~si~e. Tbe~ e may b~ elas~ic. In Flg. 1, ~ lower sur~aces of tape , stlip~ 12~ 18, is C0~l acd by afir~t p~ive jpaper ~np 28 while the lowe~
sur~es of tap~; 14. 16 is ~.~.~d by a ~cond prolec ivo paper ~rip 30.
P~per stlip 28 i~ ~eoa~i!y ogu~1 to ~ width ~f tape ~trips 12, 18 a~d ~cludes a s~e 32 which is o~ ~ ~r si~b of ~e su~ tuck to ~e adhe~ive ~ t~pes 12, 18. St~ip Z8 is ~n~lly r~angular and i~cludes a pair of ., 2~ opp~se~ e~ds 31, 33. Tluee ~nsvenie creases 36, 38, 40 a~e fo~ in ~e paper s~ip. Cleases 36, 40 ~ gol~ in the s~e d~ cr~e 38 I:leiDg folded c ~ the oppo~; ili~Lion to pro~nde an ac~ordion-type fold in s~rip 28. That fion of strip 28 behveen clrase 40 and end 33 c~ nl~ ;ces a ~ab 42.
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WO 93/08748 PCT/~JSg2/0924~
212:1509 s :, s P~Q~tive paper strip 30 is subst~n~ally ide~cal to ~trip 28 a~d al~o ', illClUde5 a tab 44. Neither of tabs 42, 44 u ~uck to ~e adhesiw on tl~e tape ~p~.
A plurali~r of filamelats i~dic~d generslly at ~6 are co~n~ted betweeln an S ond of tape s~ip 18 and an ~d of t~e s~ip 14. The filamen~ nuy bc elastic or non~las~c and dther r~und or fl~t nbbon-li1ce s~ds of n~nofilament, mult;-filament or w~ven rna~erials and may be c~d wi~ a l~c!n ~ subs~ance k~own in the ~. Th~ fil~nts may bo molded integral with or attached ~ their associ~d ta~e strips by a scwi~g or ~V~Yi~ t c~ e, gluing or by bo~ding. In ~e present e ~ 1 of ~ invetltion, fil~er~e~ 46 are ~n su~an~ally parallel ~}ation a~d are ~d al,p~ ately 13 filame~ts per ~ch in the ~,-l e~iim~nt.
Indica~d generally at 48 a~ f~ametlts wbiçh ar~ eQ~ P~ between the ends o~ s~ips 16, 120 liloe iEilaJ~nts 46, fîlament~ ~ a~e in pa~allel ~la~n a~da~ y in~ oven wi~h filame~ts ~. The ~terwoven filaments ~u~ hav~
a densi~ OI ~ppn~inutely 26 filu~ per i~ch ~ ~e present en~
Polya~ e ~ S0, 52 are ~unted on ~p3~g- ~, e~ds of ~e ~trips 12, 14 The polyamide .~ circular in cross sec~on wi~ a .~ elo~c sid~ of each membcr b~g ~tuck t~ ~e adhesive on ~e lower side . 20 e~ch ~pgs adjaco~t ~ tapc ~d. E3ach of ~mbers SQ 52 i~ formed firom nn . elast~lDenc polya~ide. ~
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si~g ~ow~e o~o~ o~closure 10, ~itially one of tubs 42, 44 is pulled to expose the ~hesive on the lower ~Y f ~ of tape 12, ~or ~ab 42, or t~e .i ~ ; , ~ , , .
.; 14. for t~s 44. The exposed adhesive is p~sstd agai~s~ s~iaa adja~ t a wound or 25 ~ ~: iDcision 54, as i~ s~d in Flg. 4. ~ -Ii!e~t, ~e o~ t~b is pulld to e~pDse ~e adhesive on ~e l~wer side of the ~' :othe~ of tapes 12, 14 so ~at closur~ 10 IS config~ed as illust~ted ~ Fig. 2. T~
. o~r~YI~sed ~dhesi~e h taped to ~e slcin adjacent wou~d 54 as; ~ t~,d in Flg. 4 so ~ ~ f~ 50, 52 are ~ ly parallel with each o~er, ~nd with .~, Wo 93/08748 . Pcr/uss2~2~6 . 2121~Q9 ~
wound 54. ~ach ..~ is spaced away From ~e wouDd 8r'-stan~dally ~he wne ~ dist~nGe. .
'! Next, one of pro~ve pap~r strip~ 28, 30 is pl311ed un~ trip is ~nli~41y l~.w~t firom ~ ~dlhe~ive on the ~pe. By way of illustra~ion in Flgs. 3 and 4, 58trip 30 iS plllled o~f ondl tape s~ip 16 i~ 4 whe~eupo~ str;p 16 is t~ed onto t~le e.~ su~ace of ~ 14 ~d par~ally onto ~ ed sldn b~yond ~e end of ~trip 14. ~ strip 16 is p~ ;d onto the 81~-, it i~ o p~lled away from strip 12 in the ~: t~in ~ o~the fil~nents 80 as to tension t~e fil~nents and cause "~ 2 to mound ~p flesh betwee~ wound 54 ~nd member 52 as illu~trated in 10Fig. 4. ~ n~r 52 f~ on~lly ~-.g~g.~ s ~ skin ~urface and thus cau~ the flesh m~undi~g whe~ ion is applied to fik~ 48~ Similarly, when tape 18 ~s stuck onto tape 12, and to ~e sldn beyond tape 12, tension i8 applied to the t~lpe to ~rS2 to be pulled t~war~ wound 54 and thus mo~d flesh ~h.~.
509 52 as ill~st~d. The flesh i8 thus pwlagd up 80 ~at the wound ~' 1SlA;~;~r~S a very ~light }~ , f~m ~he f;l~n~s passing ~ . B~h ~e ~'! momldillg 0~ flesh and p~ess~e again st the wou~ i~ h~own iEa~ ~e ar~ to p~~
r. beaZ[illg Tu~ng DC~W to Flg. S indicated gcne~ally a~ S6 is a ~econd ~ W-nt of a suhuele~s closure oo~shucted in a~co~dance wi~ ~he p~nt i~ tion. Closure 20 S~i i$ SUbSta~ y i~cal to ClOSUI~ 1O except that ~e~ e no poly~de lx~ e .~ SQ 52 in Flg. 1. Thus, ~e filn~ one ~f wbich is , filament 5~ posed ver ~e worund be~ di~y ag~lu;t ît. While ~ere may be - some r~ effect by virtue of ~nsion irl tbe fil~nts which is ~ntained by the tapes ~;Ft ;4e to ~e skin on opposite ~ ~the wound, it is ~ot as~i ~ 25 ~ o~e~l as in closure 10. Closure 56 does, how~rer, coT~ ~ wound ~d d to pull t}ae OppOSillg edges ~ to promote h~
It should b~ ed that both c~u.~,s lQ 56 ~ac;lita~ wse of muJitdple . .
'~ : closu~ oll a sillgk wound or incision. When 80 ~plied, ~e ~ensioD in the fi~ 0~ one closu~e to al~oth~ may valy ss a result of Yarying tension in 30 ~ch closure when the adhesive is pressed down.
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WO 93/08748 PCr/USg2/Og246 2 ~ 0 9 ~ the present embodiment of ~e invention, the fil~nents, like fi1n~"~ 57 in Flg. 5, ~r~p~ -~ a ribbo~, ~s bes~ viewed i~ C~W8 SCC~i~ll ill enlarg~d ~ig~ 9, ha~ring substatl~ally flat upper and lower 811rfaCe~ witb the lower ~ ~e ~g ~aingt ~s skin. It ~hould be ~oted ~at a simihr ~ibbon~shaped filament may be equally well u~ in closure 10, in Figs. 1~. Th¢ fla~ ~urfacc of ~e fi~ament bea~ing a~st the sldn ~ GCB irrt~ n lelative to a ~ d r.lC ~ t Tun~1ng n~w to Figs. ~8, indi~ ~t~n~rPlly alt 58 in Flg 6 is a third erf~OdL~.lt of a sutu~eless closure co~ ..cted in acco~nce wi~ the p~nt eDtiOIl. CIOSD 58 i~cludes a ffrst and ~cond strip of adhesive tape 60, 62. In ~ ~ew of Fig. 6, tapcs 60, 62 are shown t~ped onto a ~ ~urface 64 having an i~a~io~ ~r wound 66 t?~-rrin A paar ~f sslbsb~lly iden~cal ngid polyamide . ~ "~ 68, 70 extend ~o~g ~ leng~ of e~h oi tapes 60, 62, .~ s~ . A }~ of hooks~ l;ke hoolcs 72, 74~ 76 ~ i~o~ i~ ally with mernber 68O Melribor 68 is s~
tape 60 adjace~t an edge ~ereo~ The adhosive o~ d3e u~ ide of t~ 60 s~icks ~o ~e upper su~fnce of .~ 68 as ~riewod in Flg. 7 ~ ecunng it ~ao ~
t~. At e~eh hoo~, a notch is cut in ~e:tape to pe~i~ a po~on 78 of ff~ e to be folded over one ~ge of, U~ ~r 68 and ad~d to ~e lower su~face ~ere~f.
E~h hook has an oponi~ e ~e o~e~ing indicated generally at 80 for hook 76. A pair of opposed notches 82~ 84 are lo ~-~ Ln hook 76. Notch 82 is f< ~d in a por~cD 86 Of ~ae hook having a redooed ~ ss In the ~ 3 . ~ at of ~e ~ve~tio~. ~ ~l~d tbichless of p~r~o~ 86 is e~ual to appn~ly: .01 ~ch adjacent ~e ed~es of ~otch 82. Notch 84 is similarly ~d in ~n oppo~ii g pO~tiOII of ~e ho~k. Each o~ ths o~er hooks o~ ~r 68 is suost~ly j~ ~ ~c~l to hook 76. Member 70 ~d its COll~S~Udil~g hooks ' are wbstan~ally identi~l to ~ r 68 a~ld ~e hooks as~ated ~.c~. ilL.
A surgical fil~nont 88 is~th~1ed int?~ ~e op~n;?llg~ ~hook 72 ~nd h~ok o~ ~ ~r~ nother ~ .~ .. ~t 90 is s nt 1?-~r1y th~e~ded ~to C~ d;.
of hooks on the other end of closure 58.
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W~ 93/08748 P~r/U592/09~
2121~;09 r~
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. , :, 8 Co~sidera~on will now be give~ ~o the ~3er ~ whi~h closure S8 iLS
applied. Flrst, p~ctive paper ~trips (llot shown) which are stucl~ against t~e ..;
si~e o~ the lower surface of ta~e 60, 62 are ~J~ ed and each o~ 60, 62 is t~ped onto sl~n surface 64 adjaaent wound 66 as shown in Flg. 6, ~,i S Ne~t, filan enS~ 88 is wow~d arowld the hoo~ a~ ~hown ~ Flg. 6. At each ho~lc, ~e filament is p~ d into a notch, lilc~ llotches 82, 84 in ho~lc 76, to secure it at the hook. PIior s~o secu~ing ~e ~ent in a notch on a hook on ~ o~her side of the wound, tension in the filament is adjus~d. When ~rl~ion is at the desiredleY~l, the f~ t ~s ~en ~ by winding it around ~ hook at the ope~ing and into one ~f ~e notches. The filament is ~en placed into tbe OppO~ g n~tch he same hook ~nd exten~ a~ss the woulld to ~o~ on the opposite side whe~e ~e p~ure is re~. It can ~us be s~e~ ~at selec~d diffe~nt leYels of tension may be placed on e~ch filament ~un bch~ opposed ho~
'rhis ~acili~ applyqng ~e desir~d lcvel of tension depe~dent upon ~e dep~h of the wound or va~cular concentratio~.
, ','~! . lt may ~so be de~ire~le to ~ e dfflerene filar~nts, like ~ gO, ~;, n, ~ ~E tha~l one coll~nuous fil~e~t a~ i~ lacing a boot. Op~mum wound closure ~! may be O~illed by lacing a fila~ment ill ~e ap~ ate middle ofthe wound ud-way betw~n ~e end~ of closure S8 alld Ih~ r~ ing o~e e~d wi~ a ,. . .
~co~d filaD~nt, li~e filam~ 88~ d ~e otlae~e~d with a ~ird filament, like ~a~ent gO. ~ ~fi1~q~nt may be sec~d to the last h~3k to ~h;ch it is co~d by wlappLng ~e fil~ert multipb dn~s around the op~siDg notches, ~ B2, 84,:to ~ it finr~y to dle hook.
Tunung ~w ~oFigs. 10 a~ld 11, uldi~d ~ne~ly at g2 u; ~ r embodiment-of a ~u~ ss clo~e co~t~ in a~ t on. L~cluded ~ao is a fi~st tape strip 949 a se~ond t~pe strip 96 alld a ird ta~ s~ip ~8. ~e previously ~ trips he~e~n, ea~h of t}~e StIipS
. ; , .~s ~ adhesiYe ~nd~de. Tape ~tIipS 94, 96 ar~ adap~ed to be s~c~d Oll .~ ol,~si~ sides of a wound or in~iC;or a~d tape 98 is ~rt~ to be ~u~d in part 30 to d~e upper surface of t:ape strip 94 ~nd in part to skin ext~ n~ beyond a distal ~ 1, -- .
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, WO g3/0~74f~ PCr/US92/09246 " .
~ '~ 212~509 end 100 of strip 94. Strips 94, 98 each i~ de ends lOQ, 104to which a plurality of filaments, indicated gener~ly at 106, are secured. The filaments are secured in the same manner as des~ibed in COMeCtiOII with the previous e~ ,nts.
~ach of tlle filaments~ like filaments 108, 110 inrl~lde a first end, like end ,"
112 on fil9~nt 108, and a second end, like end 1 14 on filament 108, which are secured to tape strips 94, 98, r~ Lr_ly.
~ach filament also includes a central por~on, some of which are.viewable in Flg. 11, which is received over an elongate relatively stiff ~ 1 ;r n~ c 116. In the present ~ nt of ~~ invention, member 116 com~isgs a monofilament line several times ~e diameter of ea~h of filaments 106 and e~tending transversely across ~ 96. An end 118 of ~e tape is folded upon itself so ~ adhesive ponions of tape 96 are stucl~ to one an~er. Openings, like opeDings 12Q 122 are cut into ~: end of the:tape to permit ~h fil~-nPnt~ lilce '.~ s~ ts 110,108.tobe~idably~ dover.~ hcr 116.
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!-, 15 Polyan~ide ,~ 124, 126 senre tl~e same function as descIibed in on wi~ ~e emb~iiment of Flg. 1 ~ can be elin~nn~d as in Flg. 5.
An elong~te p~ective paper st~ip (not shovm) I~;~g a tra.~ .~ crease can be applied to~t~s 98, ~ ame f~shion as :such strips are applied to o,Dposing sides of the cn~~ of Fig.~l. Similarly, a strip can be applied to 20 ~e adh~si~ e surfnce of t~pe 96 th ~, p~._n~ing ~e~ same from ~ , before In opffation~ ~e paper strips are ~enxned as prenou~ly ~es~ ~, ~ips 94, 96 are secllad to op~ ~A~ ;ides of ~ ~longa~ wound ~nd fore is applied to strip 98 in the di~ion of ~e anow 11~n~ As force is applied, fLIaments 106 : 25 ~ c~e:und~rtension~ b.,~eausing~efillunentsto~draw~ewourld tO~,f~ as p~iously ~escribed. ~en an app~ia4e lével:oft~inQinn is placed on the '~ ~ fil~ ~h .~ ~ 98 is se~ d,:using ~e adhesive on the r~er~i~le ~e~eof, to ~e : upper silrfi ce of tape 94 ~nd/or to sW~ n .~ P~t tape 94. This ~uc~ allows for a~speedy ~li~on and, with p~tice, application using only one hand.
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Wo 93/087~8 : PC~/US9210g246 'l 2121509 '~
' 10 Ha~ring illL~strated and deuYi~ t~ principle~ of my inv~n~;o~ in a pxefe~d ~m~;m~nt thf~reof, it ~hould be readily app~v"~ to those sl~lled in the att that ~e inve~tioll can be ~r d;r~P~ ~gement ~nd det~il without ~ng fiom such principles. I claim all modifi~A~ n~ coming within the 8piliYt ~nd scope S of the accompanying claims.
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0 Tbe~e ~e D~llmS~OUS p~or art d~i~s and ~ s ~or c1rs;n" s~5ic~1 .
~cisioDs or wou~ds. Tl~ terms ~si~ and wound are ~e~eEred t~ ein interchallgeably as the present invcn~on may bc r~ 7~d to close both sur~cal ~cisions and wounds.
In ~e prior a~ adhesi~e~bandages may be used to cover a wound as weU as 15 draw the~odges ~e~eof 'c.~ hP,r to t~de healing. Wo~ds ~d ~r~pc~1 :~ i~cisions:are ~o ~ PS s~il-ed toge~erosiDg -'~~ smd a Déedle. U.S. Patent No.~ S~ o Pietce disc1~e8 a wound closule device iJI wh~ch ~0 : ~ ~ttaching ~~ ~cd to eitlie~ side of a wound ~or drawi~g toh_~r ~nd .j ~ : :: secumlgtheopposi~e~sides:ofthewound. TI~K~deviced~otp~idgany 20 ~r~ agafinst ~e wound~whi~h is a reco~ echni~ue for prom~g .r~ U.S.~PateDt No. 4,423,731 1~ Roomi discloses ~a surg~cal d~essi~g ill wbich wo st~ips of a~ f plss~er lie~alo~ oi~er s;de and pa~1el to a wo~d. Each s~ip bas fil~ ecured at ~pa~ed i~ervals al~g otle side ~ ~f The ~
25 . -~ ends ~e filan~ts~ secured to:two;~udditional~ e~r s~ips which adh~ to ~e~:sldn a~a~gi~n fi~er~away:~om~e wound.~
e Roon~i dGvice suffers from a ~ , of disadv~ E;f ~. FIIst, ~e fi1 ~ use~ ill Roon~i ane a~p~ed ;to sldn both acro~s th~ ci~ ;~" and l~t~
i~ ~he plaster strips on each side of ~e ~1 ~ C;on. The l~ll~ds ~nd ~o ilTitate tbe sldn ~ ~ ; 30 wh~n p~ssed l~ r~ r~l Also, the threads in Roomi are ve~y widely sp~çed j, , . i . . .
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', r,J, , ,, . , .. ,, . ... -- . -, wo 93/~8748 i Pc~rruss2/os~
212150~3 ~pparently ~J~ . }lC-~ in the range of two to ~ee th~ per inch. The wound or i~ 5~ could be beffer drawn to~ll~r with more thread~ per inch. In ;~, a ~rr,~ "t n~r of ~eads would apply pr~ssur~ against ~e wound ~imilar to a gauze pad which promotes hr~
S The filament~ Ln the Roo~ ~essing a~e con~ected to ~e sides of el~gate plaster strip~. More tension ~d be ~pplied if the ~ads were con4ec~d to ~e end of the strips. In ~ d~;tiot~ nne~ing filaments to the end of the strips produc~s a much narrower bar~dage which would pernut using more band~ges per wsund. This would enable co~g each closure with dif~erent le~els of '' 10 ten~i~n. Thi8 mtly be desirable ~ the case where ~e wound or in~sioll depth v~ries or where vascubs co~cenb~tioDs n~ight r~qu~ e tension in Ihe fil~ for optimum bealing.
s~ rY 0~1~ INVEN~ION
In one aspect, a ~uDueless closwe for a generally elonga~e woL~nd or incision comp~isos:frst ~ ~d strips of adhesiYe tape ~h bei~g ada~d to adhe~e to a pu~on's ~kin adjs~e~t tb~ lengthwi~ ex~ding sdges of ~e wound.
Th~ londtudinal axes of ~e ta~es are oliellted substan~lly ~onn~l to the wo~nd.
A ~ird ~tdp of:Ddbosi~e ta~)e has a pIu~ity of filaments secu~d ~t spaoed in~ls along;~ne end a~d o~upled to ~ e~d of ~e S~st tape. A fou~ st~ip of bas a plur~lity of filC~ ~ .t~ SeCIIred at SpalCed i5iltel~alS along one s. elld ~d co ipled:to an:end of ~e ~econd tap~.: The ~ird and ~ou~ tapes each . ~; adher~ to ~e e~osed surf~of the fir~e and ~ d tapes wi~ dle l~gitudinal f su~nlly DOilllal to ~ wound so tha~ tbe filame t te sio between ~e tapes dr~w the edges o~the wound to~ e~ other aspect, ~e suhuebss clos~ ~.~ r~ ~ first and second st~ips of adhesiv~ tape each being :: - ~d to adhcle to a po~ s skin adjacent the len~ extending edges ~e wound. ~e lor~ ;r~l ax~s ~dle tapes are substan~ally p~~llel to ~ wound.
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A p~ y of hooks are ~ unt~d along the length of each tape. E~h h~k 30 ~~rludes ~n opening facing away from the wound when the closure is in use. The ,.
~ WO 93/0874~ Pcr/us92/os246 .
21~1~1)9 , i'.
o~ * is adapted to ~coiw a filament di~FosEd around ~e ~pp~;~ hook~ for drawing the edges of ~e wound tfi~ responsive to tension in ~e filam0nt. A
~l~d for clo~ing a generally elong~te wound o~ ~n~;C;~n iS also provided.
It is a general o~ject of the pr~ent inve~tion to ~.o~d~ a s.~ los~
.. Sfor a skin wound or i~cis~on which OY~ ~B the ~bove-enwnetated '1 ~diS&IdV~lt~ageS nssoci~ed ~th p~ior ~t closu~es. .
~ t is a~o~er ~bJect of ~e present i~ention to ~ .i~ such a closure which facilitates app~i~on to i~ lar wolmds itl ~ssues by ~pplying seve~l devices, each of which may be differently tensioned, thereto.
It is ano~aer db~ect of dle present i.. -~nlio~ to ~rovide such a closure which mi~n~i~s exposure of skin to ~e tensioned ial~ne~
It is s~l a~other object of ~e p~esent i~ve~tion to providc such a closure in which ~e wound is draw~ l~g~ lh~r and compressed to promo~e beali~g thereof.
;~ It is yet ano~er object of ~e plegODt illVel31tiOD to p U ~id~; 8UGh a cl~e in lSwhich gleater~e~sion ~ in pnor art ~ iCGB Illay be a~pplied to ~e fillG ~
~'?~' ' The ~g~j20~11g and ~er obj~, foahllss and adYa~ltages OI ~ i~ention mo~ readily npp~nt ~om the fo11Owing ~ s~p~io~ of a prefe~d ~;~,nt which ~/wccds wieh refe~snoe to ~e drawi~g~.
20~ RIEF D~ ON Ol~ l~ DlRAYV~GS
Figs. 1~ pc- .~;v~ views of a deYice ~1~Dhu ~d ill ~!ICCO~IIOe Y~th s ~ ~e pr~t inveDtioD ~ lU~i-~ ~ages of application ~o a wound or i~cision.
: Flg. S is a p~ e view of a s~ond d0~ice cong~ucted i~ acoordance with the presellt inv~.~tio~ applied to a wound or ;~ ;01 ~; 2~ t .~ ~Fig. 6 is a plan ~ w of a second ~ pplied to a wound or ,.,,~
Flg. ~ is a~ enl~ed view taken ~long lines 7-7 in Flg. 6.
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~' Flg. 8 is a view taken along lines 8-8 in Pig. ~O
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.~ F~g. 9 is an ~I~I&~ed cross-sec~i~n~1 view of one of ~e fi1~ in Fig. S.
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.. i i ;, ;, WO93/08748 ~ CI/U~g2/092~6 21215~9 ,, Fig. 10 is a pe.~ ;ve view of atlOtheF device ~u,~ ,~d in accordance with ~e prese~t in~e~ti~.
Pig. 11 i~ an enlarged ~riew of a portion of the view of ~ig. 10.
S
DET~ILEl) D~ ON OF l~IE rREF F~rFr~ E~MB~DD~T
Lndica~d generally at 10 il~ Flgs. 14 is a ~utureless CIOD constmcted in accordance with ~e prese~t ~ve~on. I~.Qs~l~ 10 is illustr~d in Flg. 1 pnor to for~ce of any of ~ eces~ary to apply ~u closure to a wound.
.. 10 Closur~ 10 is ~how~ ~ Fig. 4 applied to a wou~d. Inteiim~ediate ~igs. 24 i~ e tbe closure il~ p~ss;~ es of prpa~a~io~ for applying it to a w~und which i5 desaribed henei~ er ,; .
~! Closure ~ is first, second, ~rd and folllth strips of i~
12, 14, 16, 18, ~ ly, each of wP~ich i~ about one inch wide, a~l ou~
15 a~bodin~ ~g i~ width f~m much ~ , e.g., 1/16", ItO much l~e~, . ~ : e.g., 4n~ collltem~d a5 beiDg withh~ cope Qf ~e in~ion . E~
ip ;~ ve upper w~ e 20, ~, 24~ 26. E~h ~
illclDdes a~lower surface, not visible i~ ~e drawillgs~ wihich is coa~d i wi~ adl~si~e. Tbe~ e may b~ elas~ic. In Flg. 1, ~ lower sur~aces of tape , stlip~ 12~ 18, is C0~l acd by afir~t p~ive jpaper ~np 28 while the lowe~
sur~es of tap~; 14. 16 is ~.~.~d by a ~cond prolec ivo paper ~rip 30.
P~per stlip 28 i~ ~eoa~i!y ogu~1 to ~ width ~f tape ~trips 12, 18 a~d ~cludes a s~e 32 which is o~ ~ ~r si~b of ~e su~ tuck to ~e adhe~ive ~ t~pes 12, 18. St~ip Z8 is ~n~lly r~angular and i~cludes a pair of ., 2~ opp~se~ e~ds 31, 33. Tluee ~nsvenie creases 36, 38, 40 a~e fo~ in ~e paper s~ip. Cleases 36, 40 ~ gol~ in the s~e d~ cr~e 38 I:leiDg folded c ~ the oppo~; ili~Lion to pro~nde an ac~ordion-type fold in s~rip 28. That fion of strip 28 behveen clrase 40 and end 33 c~ nl~ ;ces a ~ab 42.
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WO 93/08748 PCT/~JSg2/0924~
212:1509 s :, s P~Q~tive paper strip 30 is subst~n~ally ide~cal to ~trip 28 a~d al~o ', illClUde5 a tab 44. Neither of tabs 42, 44 u ~uck to ~e adhesiw on tl~e tape ~p~.
A plurali~r of filamelats i~dic~d generslly at ~6 are co~n~ted betweeln an S ond of tape s~ip 18 and an ~d of t~e s~ip 14. The filamen~ nuy bc elastic or non~las~c and dther r~und or fl~t nbbon-li1ce s~ds of n~nofilament, mult;-filament or w~ven rna~erials and may be c~d wi~ a l~c!n ~ subs~ance k~own in the ~. Th~ fil~nts may bo molded integral with or attached ~ their associ~d ta~e strips by a scwi~g or ~V~Yi~ t c~ e, gluing or by bo~ding. In ~e present e ~ 1 of ~ invetltion, fil~er~e~ 46 are ~n su~an~ally parallel ~}ation a~d are ~d al,p~ ately 13 filame~ts per ~ch in the ~,-l e~iim~nt.
Indica~d generally at 48 a~ f~ametlts wbiçh ar~ eQ~ P~ between the ends o~ s~ips 16, 120 liloe iEilaJ~nts 46, fîlament~ ~ a~e in pa~allel ~la~n a~da~ y in~ oven wi~h filame~ts ~. The ~terwoven filaments ~u~ hav~
a densi~ OI ~ppn~inutely 26 filu~ per i~ch ~ ~e present en~
Polya~ e ~ S0, 52 are ~unted on ~p3~g- ~, e~ds of ~e ~trips 12, 14 The polyamide .~ circular in cross sec~on wi~ a .~ elo~c sid~ of each membcr b~g ~tuck t~ ~e adhesive on ~e lower side . 20 e~ch ~pgs adjaco~t ~ tapc ~d. E3ach of ~mbers SQ 52 i~ formed firom nn . elast~lDenc polya~ide. ~
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si~g ~ow~e o~o~ o~closure 10, ~itially one of tubs 42, 44 is pulled to expose the ~hesive on the lower ~Y f ~ of tape 12, ~or ~ab 42, or t~e .i ~ ; , ~ , , .
.; 14. for t~s 44. The exposed adhesive is p~sstd agai~s~ s~iaa adja~ t a wound or 25 ~ ~: iDcision 54, as i~ s~d in Flg. 4. ~ -Ii!e~t, ~e o~ t~b is pulld to e~pDse ~e adhesive on ~e l~wer side of the ~' :othe~ of tapes 12, 14 so ~at closur~ 10 IS config~ed as illust~ted ~ Fig. 2. T~
. o~r~YI~sed ~dhesi~e h taped to ~e slcin adjacent wou~d 54 as; ~ t~,d in Flg. 4 so ~ ~ f~ 50, 52 are ~ ly parallel with each o~er, ~nd with .~, Wo 93/08748 . Pcr/uss2~2~6 . 2121~Q9 ~
wound 54. ~ach ..~ is spaced away From ~e wouDd 8r'-stan~dally ~he wne ~ dist~nGe. .
'! Next, one of pro~ve pap~r strip~ 28, 30 is pl311ed un~ trip is ~nli~41y l~.w~t firom ~ ~dlhe~ive on the ~pe. By way of illustra~ion in Flgs. 3 and 4, 58trip 30 iS plllled o~f ondl tape s~ip 16 i~ 4 whe~eupo~ str;p 16 is t~ed onto t~le e.~ su~ace of ~ 14 ~d par~ally onto ~ ed sldn b~yond ~e end of ~trip 14. ~ strip 16 is p~ ;d onto the 81~-, it i~ o p~lled away from strip 12 in the ~: t~in ~ o~the fil~nents 80 as to tension t~e fil~nents and cause "~ 2 to mound ~p flesh betwee~ wound 54 ~nd member 52 as illu~trated in 10Fig. 4. ~ n~r 52 f~ on~lly ~-.g~g.~ s ~ skin ~urface and thus cau~ the flesh m~undi~g whe~ ion is applied to fik~ 48~ Similarly, when tape 18 ~s stuck onto tape 12, and to ~e sldn beyond tape 12, tension i8 applied to the t~lpe to ~rS2 to be pulled t~war~ wound 54 and thus mo~d flesh ~h.~.
509 52 as ill~st~d. The flesh i8 thus pwlagd up 80 ~at the wound ~' 1SlA;~;~r~S a very ~light }~ , f~m ~he f;l~n~s passing ~ . B~h ~e ~'! momldillg 0~ flesh and p~ess~e again st the wou~ i~ h~own iEa~ ~e ar~ to p~~
r. beaZ[illg Tu~ng DC~W to Flg. S indicated gcne~ally a~ S6 is a ~econd ~ W-nt of a suhuele~s closure oo~shucted in a~co~dance wi~ ~he p~nt i~ tion. Closure 20 S~i i$ SUbSta~ y i~cal to ClOSUI~ 1O except that ~e~ e no poly~de lx~ e .~ SQ 52 in Flg. 1. Thus, ~e filn~ one ~f wbich is , filament 5~ posed ver ~e worund be~ di~y ag~lu;t ît. While ~ere may be - some r~ effect by virtue of ~nsion irl tbe fil~nts which is ~ntained by the tapes ~;Ft ;4e to ~e skin on opposite ~ ~the wound, it is ~ot as~i ~ 25 ~ o~e~l as in closure 10. Closure 56 does, how~rer, coT~ ~ wound ~d d to pull t}ae OppOSillg edges ~ to promote h~
It should b~ ed that both c~u.~,s lQ 56 ~ac;lita~ wse of muJitdple . .
'~ : closu~ oll a sillgk wound or incision. When 80 ~plied, ~e ~ensioD in the fi~ 0~ one closu~e to al~oth~ may valy ss a result of Yarying tension in 30 ~ch closure when the adhesive is pressed down.
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WO 93/08748 PCr/USg2/Og246 2 ~ 0 9 ~ the present embodiment of ~e invention, the fil~nents, like fi1n~"~ 57 in Flg. 5, ~r~p~ -~ a ribbo~, ~s bes~ viewed i~ C~W8 SCC~i~ll ill enlarg~d ~ig~ 9, ha~ring substatl~ally flat upper and lower 811rfaCe~ witb the lower ~ ~e ~g ~aingt ~s skin. It ~hould be ~oted ~at a simihr ~ibbon~shaped filament may be equally well u~ in closure 10, in Figs. 1~. Th¢ fla~ ~urfacc of ~e fi~ament bea~ing a~st the sldn ~ GCB irrt~ n lelative to a ~ d r.lC ~ t Tun~1ng n~w to Figs. ~8, indi~ ~t~n~rPlly alt 58 in Flg 6 is a third erf~OdL~.lt of a sutu~eless closure co~ ..cted in acco~nce wi~ the p~nt eDtiOIl. CIOSD 58 i~cludes a ffrst and ~cond strip of adhesive tape 60, 62. In ~ ~ew of Fig. 6, tapcs 60, 62 are shown t~ped onto a ~ ~urface 64 having an i~a~io~ ~r wound 66 t?~-rrin A paar ~f sslbsb~lly iden~cal ngid polyamide . ~ "~ 68, 70 extend ~o~g ~ leng~ of e~h oi tapes 60, 62, .~ s~ . A }~ of hooks~ l;ke hoolcs 72, 74~ 76 ~ i~o~ i~ ally with mernber 68O Melribor 68 is s~
tape 60 adjace~t an edge ~ereo~ The adhosive o~ d3e u~ ide of t~ 60 s~icks ~o ~e upper su~fnce of .~ 68 as ~riewod in Flg. 7 ~ ecunng it ~ao ~
t~. At e~eh hoo~, a notch is cut in ~e:tape to pe~i~ a po~on 78 of ff~ e to be folded over one ~ge of, U~ ~r 68 and ad~d to ~e lower su~face ~ere~f.
E~h hook has an oponi~ e ~e o~e~ing indicated generally at 80 for hook 76. A pair of opposed notches 82~ 84 are lo ~-~ Ln hook 76. Notch 82 is f< ~d in a por~cD 86 Of ~ae hook having a redooed ~ ss In the ~ 3 . ~ at of ~e ~ve~tio~. ~ ~l~d tbichless of p~r~o~ 86 is e~ual to appn~ly: .01 ~ch adjacent ~e ed~es of ~otch 82. Notch 84 is similarly ~d in ~n oppo~ii g pO~tiOII of ~e ho~k. Each o~ ths o~er hooks o~ ~r 68 is suost~ly j~ ~ ~c~l to hook 76. Member 70 ~d its COll~S~Udil~g hooks ' are wbstan~ally identi~l to ~ r 68 a~ld ~e hooks as~ated ~.c~. ilL.
A surgical fil~nont 88 is~th~1ed int?~ ~e op~n;?llg~ ~hook 72 ~nd h~ok o~ ~ ~r~ nother ~ .~ .. ~t 90 is s nt 1?-~r1y th~e~ded ~to C~ d;.
of hooks on the other end of closure 58.
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W~ 93/08748 P~r/U592/09~
2121~;09 r~
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. , :, 8 Co~sidera~on will now be give~ ~o the ~3er ~ whi~h closure S8 iLS
applied. Flrst, p~ctive paper ~trips (llot shown) which are stucl~ against t~e ..;
si~e o~ the lower surface of ta~e 60, 62 are ~J~ ed and each o~ 60, 62 is t~ped onto sl~n surface 64 adjaaent wound 66 as shown in Flg. 6, ~,i S Ne~t, filan enS~ 88 is wow~d arowld the hoo~ a~ ~hown ~ Flg. 6. At each ho~lc, ~e filament is p~ d into a notch, lilc~ llotches 82, 84 in ho~lc 76, to secure it at the hook. PIior s~o secu~ing ~e ~ent in a notch on a hook on ~ o~her side of the wound, tension in the filament is adjus~d. When ~rl~ion is at the desiredleY~l, the f~ t ~s ~en ~ by winding it around ~ hook at the ope~ing and into one ~f ~e notches. The filament is ~en placed into tbe OppO~ g n~tch he same hook ~nd exten~ a~ss the woulld to ~o~ on the opposite side whe~e ~e p~ure is re~. It can ~us be s~e~ ~at selec~d diffe~nt leYels of tension may be placed on e~ch filament ~un bch~ opposed ho~
'rhis ~acili~ applyqng ~e desir~d lcvel of tension depe~dent upon ~e dep~h of the wound or va~cular concentratio~.
, ','~! . lt may ~so be de~ire~le to ~ e dfflerene filar~nts, like ~ gO, ~;, n, ~ ~E tha~l one coll~nuous fil~e~t a~ i~ lacing a boot. Op~mum wound closure ~! may be O~illed by lacing a fila~ment ill ~e ap~ ate middle ofthe wound ud-way betw~n ~e end~ of closure S8 alld Ih~ r~ ing o~e e~d wi~ a ,. . .
~co~d filaD~nt, li~e filam~ 88~ d ~e otlae~e~d with a ~ird filament, like ~a~ent gO. ~ ~fi1~q~nt may be sec~d to the last h~3k to ~h;ch it is co~d by wlappLng ~e fil~ert multipb dn~s around the op~siDg notches, ~ B2, 84,:to ~ it finr~y to dle hook.
Tunung ~w ~oFigs. 10 a~ld 11, uldi~d ~ne~ly at g2 u; ~ r embodiment-of a ~u~ ss clo~e co~t~ in a~ t on. L~cluded ~ao is a fi~st tape strip 949 a se~ond t~pe strip 96 alld a ird ta~ s~ip ~8. ~e previously ~ trips he~e~n, ea~h of t}~e StIipS
. ; , .~s ~ adhesiYe ~nd~de. Tape ~tIipS 94, 96 ar~ adap~ed to be s~c~d Oll .~ ol,~si~ sides of a wound or in~iC;or a~d tape 98 is ~rt~ to be ~u~d in part 30 to d~e upper surface of t:ape strip 94 ~nd in part to skin ext~ n~ beyond a distal ~ 1, -- .
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, WO g3/0~74f~ PCr/US92/09246 " .
~ '~ 212~509 end 100 of strip 94. Strips 94, 98 each i~ de ends lOQ, 104to which a plurality of filaments, indicated gener~ly at 106, are secured. The filaments are secured in the same manner as des~ibed in COMeCtiOII with the previous e~ ,nts.
~ach of tlle filaments~ like filaments 108, 110 inrl~lde a first end, like end ,"
112 on fil9~nt 108, and a second end, like end 1 14 on filament 108, which are secured to tape strips 94, 98, r~ Lr_ly.
~ach filament also includes a central por~on, some of which are.viewable in Flg. 11, which is received over an elongate relatively stiff ~ 1 ;r n~ c 116. In the present ~ nt of ~~ invention, member 116 com~isgs a monofilament line several times ~e diameter of ea~h of filaments 106 and e~tending transversely across ~ 96. An end 118 of ~e tape is folded upon itself so ~ adhesive ponions of tape 96 are stucl~ to one an~er. Openings, like opeDings 12Q 122 are cut into ~: end of the:tape to permit ~h fil~-nPnt~ lilce '.~ s~ ts 110,108.tobe~idably~ dover.~ hcr 116.
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!-, 15 Polyan~ide ,~ 124, 126 senre tl~e same function as descIibed in on wi~ ~e emb~iiment of Flg. 1 ~ can be elin~nn~d as in Flg. 5.
An elong~te p~ective paper st~ip (not shovm) I~;~g a tra.~ .~ crease can be applied to~t~s 98, ~ ame f~shion as :such strips are applied to o,Dposing sides of the cn~~ of Fig.~l. Similarly, a strip can be applied to 20 ~e adh~si~ e surfnce of t~pe 96 th ~, p~._n~ing ~e~ same from ~ , before In opffation~ ~e paper strips are ~enxned as prenou~ly ~es~ ~, ~ips 94, 96 are secllad to op~ ~A~ ;ides of ~ ~longa~ wound ~nd fore is applied to strip 98 in the di~ion of ~e anow 11~n~ As force is applied, fLIaments 106 : 25 ~ c~e:und~rtension~ b.,~eausing~efillunentsto~draw~ewourld tO~,f~ as p~iously ~escribed. ~en an app~ia4e lével:oft~inQinn is placed on the '~ ~ fil~ ~h .~ ~ 98 is se~ d,:using ~e adhesive on the r~er~i~le ~e~eof, to ~e : upper silrfi ce of tape 94 ~nd/or to sW~ n .~ P~t tape 94. This ~uc~ allows for a~speedy ~li~on and, with p~tice, application using only one hand.
;:'~ ~ ' :
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Wo 93/087~8 : PC~/US9210g246 'l 2121509 '~
' 10 Ha~ring illL~strated and deuYi~ t~ principle~ of my inv~n~;o~ in a pxefe~d ~m~;m~nt thf~reof, it ~hould be readily app~v"~ to those sl~lled in the att that ~e inve~tioll can be ~r d;r~P~ ~gement ~nd det~il without ~ng fiom such principles. I claim all modifi~A~ n~ coming within the 8piliYt ~nd scope S of the accompanying claims.
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Claims (11)
1. A sutureless closure for a generally elongate wound or incision comprising:
first and second strips of adhesive tape each being adapted to adhere to skin adjacent the lengthwise extending edges of the wound with the longitudinal axes thereof oriented substantially normal to the wound;
a third strip of tape having a plurality of filaments coupled thereto at spaced intervals along one end of said third strip, said filaments being also coupled to an end of said first tape;
a fourth strip of tape having a plurality of filaments coupled thereto at spaced intervals along one end of said fourth strip, said fourth strip filaments being also coupled to an end of said second taps, said third and fourth tapes each being adapted to adhere to the exposed surface of said first and second tapes with the longitudinal axes thereof oriented substantially normal to the wound so that the filaments tensioned between said tapes draw the edges of the wound together;
and means for frictionally engaging the skin closely adjacent the opposing ends of said first and second tapes when said closure is in use whereby tension in the filaments draws tissues between said engaging means into a slight mound, said engaging means comprising an elongate polyamide member mounted on each of said tapes normal to the longitudinal axis thereof.
first and second strips of adhesive tape each being adapted to adhere to skin adjacent the lengthwise extending edges of the wound with the longitudinal axes thereof oriented substantially normal to the wound;
a third strip of tape having a plurality of filaments coupled thereto at spaced intervals along one end of said third strip, said filaments being also coupled to an end of said first tape;
a fourth strip of tape having a plurality of filaments coupled thereto at spaced intervals along one end of said fourth strip, said fourth strip filaments being also coupled to an end of said second taps, said third and fourth tapes each being adapted to adhere to the exposed surface of said first and second tapes with the longitudinal axes thereof oriented substantially normal to the wound so that the filaments tensioned between said tapes draw the edges of the wound together;
and means for frictionally engaging the skin closely adjacent the opposing ends of said first and second tapes when said closure is in use whereby tension in the filaments draws tissues between said engaging means into a slight mound, said engaging means comprising an elongate polyamide member mounted on each of said tapes normal to the longitudinal axis thereof.
2. The sutureless closure of claim 1 wherein said polyamide member has a semicircular cross section with a rounded portion directed toward the skin when said closure is in use.
3. A sutureless closure for a generally elongate wound or incision comprising:
first and second strips of adhesive tape each being adapted to adhere to skin adjacent the lengthwise extending edges of the wound with the longitudinal axes thereof oriented substantially normal to the wound;
a third strip of tape having a plurality of filaments coupled thereto at spaced intervals along one end of said third strip, said filaments to being also coupled to an end of said first tape;
a fourth strip of tape having plurality of filaments coupled thereto at spaced intervals along one end of said fourth strip, said fourth strip filaments being also coupled to an end of said second tape, said third and fourth tapes each being adapted to adhere to the exposed surface of said first and second tapes with the longitudinal axes thereof oriented substantially normal to the wound so that the filaments tensioned between said tapes draw the edges of the wound together;
a first elongate protective strip for covering the adhesive on said first and fourth tapes; and a second elongate protective strip for covering the adhesive on said second and third tapes, said strips preventing said adhesive from sticking prior to use of said closure, said protective strips each including a pair of transverse creases to permit each of the adhesive tapes which the protective strip covers to be covered by the same side of said strip.
first and second strips of adhesive tape each being adapted to adhere to skin adjacent the lengthwise extending edges of the wound with the longitudinal axes thereof oriented substantially normal to the wound;
a third strip of tape having a plurality of filaments coupled thereto at spaced intervals along one end of said third strip, said filaments to being also coupled to an end of said first tape;
a fourth strip of tape having plurality of filaments coupled thereto at spaced intervals along one end of said fourth strip, said fourth strip filaments being also coupled to an end of said second tape, said third and fourth tapes each being adapted to adhere to the exposed surface of said first and second tapes with the longitudinal axes thereof oriented substantially normal to the wound so that the filaments tensioned between said tapes draw the edges of the wound together;
a first elongate protective strip for covering the adhesive on said first and fourth tapes; and a second elongate protective strip for covering the adhesive on said second and third tapes, said strips preventing said adhesive from sticking prior to use of said closure, said protective strips each including a pair of transverse creases to permit each of the adhesive tapes which the protective strip covers to be covered by the same side of said strip.
4. The sutureless closure of claim 3 wherein each of said protective strips includes a tab that does not cover any of said adhesive tapes and which when first pulled exposes the adhesive on only one of the tapes covered by the protective strip and when pulled further exposes the adhesive on the other tape covered by the protective strip.
5. A sutureless closure for a generally elongate wound or incision comprising:
first and second strips of tape each being adapted to adhere to skin adjacent the lengthwise extending edges of the wound with the longitudinal axes thereof substantially parallel to the wound; and a plurality of hooks mounted along the length of each tape, said hooks having openings facing away from said wound when said closure is in use and adapted to receive a filament disposed around opposing hooks for drawing the edges of said wound together responsive to tension in said filament said hooks further having notches cut therein for receiving and holding a filament received in said hook openings.
first and second strips of tape each being adapted to adhere to skin adjacent the lengthwise extending edges of the wound with the longitudinal axes thereof substantially parallel to the wound; and a plurality of hooks mounted along the length of each tape, said hooks having openings facing away from said wound when said closure is in use and adapted to receive a filament disposed around opposing hooks for drawing the edges of said wound together responsive to tension in said filament said hooks further having notches cut therein for receiving and holding a filament received in said hook openings.
6. The sutureless closure of claim 5 wherein the filament comprises a ribbon.
7. A method for closing a generally elongate wound or incision comprising the steps of:
providing a plurality of hooks adjacent the lengthwise extending edges of the wound;
wrapping a filament around opposing hooks;
placing the filament under tension thereby drawing the edges of said wound together;
wrapping a second filament around different opposing hooks; and placing the second filament under tension different from the tension in the other filament thereby drawing the edges of said wound together.
providing a plurality of hooks adjacent the lengthwise extending edges of the wound;
wrapping a filament around opposing hooks;
placing the filament under tension thereby drawing the edges of said wound together;
wrapping a second filament around different opposing hooks; and placing the second filament under tension different from the tension in the other filament thereby drawing the edges of said wound together.
8. The method of claim 7 wherein said method further comprises the step of applying different levels of tension to filament segments disposed between said hooks.
9. The method of claim 8 wherein the step of applying different levels of tension to filament segments disposed between said hooks comprises the steps of:
applying a selected level of tension to the filament; and fixing the filament to each of a pair of hook son oppose sides of said wound.
applying a selected level of tension to the filament; and fixing the filament to each of a pair of hook son oppose sides of said wound.
10. A sutureless closure for a generally elongate wound or incision comprising:
a first strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound;
a second strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound on the opposite side of said wound from said first strip;
a third strip of adhesive tape adapted to adhere to the exposed surface of said first adhesive tape;
a plurality of filaments having a first end coupled to an end of said first tape and a second end coupled to an end of said third tape, said filaments being slidingly received over structure defined on said second strip; and means for frictionally engaging the skin closely adjacent the opposing ends of said first and second tapes when said closure is in use whereby tension in the filaments draws tissue between said engaging means into a slight mound, said engaging means comprising an elongate polyamide member mounted on each of said tapes normal to the longitudinal axis thereof.
a first strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound;
a second strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound on the opposite side of said wound from said first strip;
a third strip of adhesive tape adapted to adhere to the exposed surface of said first adhesive tape;
a plurality of filaments having a first end coupled to an end of said first tape and a second end coupled to an end of said third tape, said filaments being slidingly received over structure defined on said second strip; and means for frictionally engaging the skin closely adjacent the opposing ends of said first and second tapes when said closure is in use whereby tension in the filaments draws tissue between said engaging means into a slight mound, said engaging means comprising an elongate polyamide member mounted on each of said tapes normal to the longitudinal axis thereof.
11. A sutureless closure for a generally elongate wound or incision comprising:
a first strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound;
a second strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound on the opposite side of said wound from said first strip;
a first strip of adhesive tape adapted to adhere to the exposed surface of said first adhesive tape;
a plurality of filaments having a first end coupled to an end of said first tape and a second end coupled to an end of said third tape, said filaments being slidingly received over structure defined on said second strip; and an elongate protective strip for covering the adhesive on said first and third tapes, said strips preventing said adhesive from sticking prior to use of said closure, said protective strips each including a pair of transverse creases to permit each of the adhesive tapes which the protective strip covers to be covered by the same side of said strip.
a first strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound;
a second strip of adhesive tape adapted to adhere to skin adjacent the lengthwise extending edges of the wound on the opposite side of said wound from said first strip;
a first strip of adhesive tape adapted to adhere to the exposed surface of said first adhesive tape;
a plurality of filaments having a first end coupled to an end of said first tape and a second end coupled to an end of said third tape, said filaments being slidingly received over structure defined on said second strip; and an elongate protective strip for covering the adhesive on said first and third tapes, said strips preventing said adhesive from sticking prior to use of said closure, said protective strips each including a pair of transverse creases to permit each of the adhesive tapes which the protective strip covers to be covered by the same side of said strip.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US07/784,974 | 1991-10-30 | ||
| US07/784,974 US5176703A (en) | 1991-10-30 | 1991-10-30 | Sutureless closure for a skin wound or incision |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2121509A1 CA2121509A1 (en) | 1993-05-13 |
| CA2121509C true CA2121509C (en) | 1998-06-30 |
Family
ID=25134101
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002121509A Expired - Fee Related CA2121509C (en) | 1991-10-30 | 1992-10-29 | Closure for a skin wound or incision |
Country Status (5)
| Country | Link |
|---|---|
| US (2) | US5176703A (en) |
| AU (1) | AU665219B2 (en) |
| CA (1) | CA2121509C (en) |
| GB (1) | GB2275423B (en) |
| WO (1) | WO1993008748A1 (en) |
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| US4141363A (en) * | 1975-11-20 | 1979-02-27 | James Jesse L | Interlocking suture |
| US4073298A (en) * | 1976-08-03 | 1978-02-14 | New Research & Development Lab., Inc. | Wound clip |
| US4201215A (en) * | 1977-09-06 | 1980-05-06 | Crossett E S | Apparatus and method for closing a severed sternum |
| US4222383A (en) * | 1978-08-07 | 1980-09-16 | Schossow George W | Surgical drape and suture |
| DE3020083C2 (en) * | 1980-05-27 | 1982-06-24 | Peter Dr.med. 6109 Mühltal Will | Splint for supporting joints for orthopedic or surgical purposes |
| US4423731A (en) * | 1980-09-09 | 1984-01-03 | Roomi Reyadh K | Surgical dressings |
| US4526173A (en) * | 1982-04-12 | 1985-07-02 | Kells Medical, Inc. | Skin closure device |
| US4605005A (en) * | 1982-04-12 | 1986-08-12 | Kells Medical, Inc. | Wound closure device and method for using same |
| US4702251A (en) * | 1982-04-12 | 1987-10-27 | Kells Medical, Incorporated | Wound closure device |
| US4512346A (en) * | 1983-04-25 | 1985-04-23 | Lemole Gerald M | Sternal closure method and means |
| US4696301A (en) * | 1986-07-16 | 1987-09-29 | Barabe David J | Wound closing method |
| US4815468A (en) * | 1987-01-09 | 1989-03-28 | Annand David S | Sutureless closure |
| US4825866A (en) * | 1987-08-27 | 1989-05-02 | Robert Pierce | Wound closure device |
-
1991
- 1991-10-30 US US07/784,974 patent/US5176703A/en not_active Expired - Lifetime
-
1992
- 1992-10-29 WO PCT/US1992/009246 patent/WO1993008748A1/en active Application Filing
- 1992-10-29 CA CA002121509A patent/CA2121509C/en not_active Expired - Fee Related
- 1992-10-29 AU AU30565/92A patent/AU665219B2/en not_active Ceased
- 1992-10-29 GB GB9407860A patent/GB2275423B/en not_active Expired - Fee Related
- 1992-10-29 US US08/302,711 patent/US5534010A/en not_active Expired - Fee Related
Also Published As
| Publication number | Publication date |
|---|---|
| AU3056592A (en) | 1993-06-07 |
| CA2121509A1 (en) | 1993-05-13 |
| US5534010A (en) | 1996-07-09 |
| GB2275423A (en) | 1994-08-31 |
| GB2275423B (en) | 1996-02-07 |
| US5176703A (en) | 1993-01-05 |
| AU665219B2 (en) | 1995-12-21 |
| GB9407860D0 (en) | 1994-06-29 |
| WO1993008748A1 (en) | 1993-05-13 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| MKLA | Lapsed |