CN103480080A - 伤口渗出物清除和隔离系统 - Google Patents
伤口渗出物清除和隔离系统 Download PDFInfo
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Abstract
一种伤口渗出物清除和隔离系统,其包括多孔敷料、与敷料流体相通的罐和设置在敷料和罐之间的第一阀。第一阀可定位在打开位置和关闭位置之间。处理线流体地连接到罐,并包括可定位在打开位置和关闭位置之间的第二阀。泵流体地连接到罐,并配置成当第一阀打开且第二阀关闭时将伤口渗出物从敷料吸到罐中。泵配置成当第一阀关闭且第二阀打开时迫使伤口渗出物从罐进入处理线内。
Description
本申请是申请日为2006年12月6日,申请号为200680045483.0,发明名称为“伤口渗出物清除和隔离系统”的申请的分案申请。
相关申请的交叉引用
本申请要求2005年12月6日提交的美国临时申请第60/742,755号的利益,其由此以引用方式并入。
发明背景
1.发明领域
本发明涉及伤口处理。更具体地说,本发明涉及伤口处理系统,其使用减小的压力清除伤口渗出物,并使用包含和隔离伤口的敷料,其中敷料必须保留在伤口上一段延长的时间。
2.相关技术的描述
与美国武装部队参与的其它冲突如在越南的战斗军事行动相比,最近美国武装部队在阿富汗和伊拉克的长时间战斗军事行动中相当低水平的伤亡方面是值得注意的。相当低水平的伤亡的原因是由于在保护性身体装甲和医疗护理方面获得的显著提高。对用于稳定受伤人员并将受伤人员从战场转移到设施的程序和技术进行了重大改进,有适当装备的人员可在设施上施行医疗护理。虽然显著降低了生命的损失,但是在受伤的服务成员的数量方面还是有相应的增加。如在很多战斗情况中的,对在地面战斗军事行动中人员的频繁伤害是深的外伤性伤口。很多军事外伤伤口被内在地污染,并可能由于与战场上地面的长时间接触或过长时间没有处理而变得严重感染。战地医生被教导如何冲洗和/或清洁深伤口,并接着用某种类型的伤口敷料覆盖伤口。伤口敷料执行几种功能。敷料通常包括散剂、药膏或软膏,其可杀死进入伤口的一些有毒细菌。第二,敷料覆盖伤口,以帮助阻止另外的有毒细菌的进入。第三,敷料降低了交叉污染患者身体上的其它伤口的机会。第四,敷料从伤口吸收流体或渗出物。
然而,当伤口大或深时,出现了若干处理问题。因为医疗撤离路线可能延伸数千英里,受伤军人在医疗撤离过程中经历若干天很常见。当受伤人员在输送过程中时,通常不可能提供在医院中可得到的类型的伤口处理。纱布敷料可能没有足够的流体滞留能力来充分吸收来自一些伤口的所有渗出物,所以可能变得充满渗出物。在通过飞机或地面/水运输车辆的医疗撤离和输送期间,可能不容易用不饱和的敷料更换饱和的敷料。在医疗输送/撤离车辆中典型的安装布置包括通常靠着墙或隔壁堆置三个或四个高的患者盖尼式床。盖尼式床的这样的堆置可能限制接近盖尼式床上的那些患者的渗出性伤口,使得医疗人员通常不易照管敷料或用于保护伤口的任何其它装备。
在医疗撤离过程的所有部分期间,需要给包含在封闭的保护性环境中的伤口提供伤口渗出物处理以及伤口隔离。进一步,需要清除并隔离伤口渗出物,以便可收集并正确丢弃伤口渗出物,一种生物危险物质。伤口渗出物的这样的清除和隔离将减少交叉污染,减小感染的风险,并便于在输送受伤军人期间进行有效的伤口处理。需要提供一种系统,该系统紧凑,以便它可容易携带,并且不依赖于任何外部能源进行操作。最后,需要提供一种系统,该系统是美国军事飞行鉴定的非资本级资产(non-capital levelasset),并且是一次性的。
发明内容
由现有的伤口隔离系统和方法提出的问题通过本发明的系统和方法来解决。根据本发明的一个实施方式的伤口渗出物清除和隔离系统包括多孔敷料、与多孔敷料流体相通的罐以及设置在多孔敷料和罐之间的第一阀。第一阀可定位在打开位置,以允许流体流动,并可定位在关闭位置,以阻止流体在多孔敷料和罐之间流动。处理线(disposal line)流体地连接到罐,且第二阀可操作地设置在处理线内。第二阀可定位在打开位置,以允许流体流动,并可定位在关闭位置,以阻止流体通过处理线流动。泵设置成与罐流体相通,并在第一阀打开而第二阀关闭时可操作来将伤口渗出物从多孔敷料吸到罐中。泵进一步可操作来在第一阀关闭而第二阀打开时,迫使伤口渗出物从罐进入到处理线内。
根据本发明的另一实施方式,伤口处理设备包括用于敷伤口的装置、用于将渗出物从伤口吸到罐中的装置、用于隔离伤口的装置以及用于迫使渗出物从罐中出来的装置。
根据本发明的另一实施方式,伤口淤滞和隔离设备包括平均孔径尺寸小于约200微米的开孔型网状泡沫敷料。提供消毒盖布来覆盖泡沫敷料和伤口。泵设置成与泡沫敷料流体相通,来以小于约125mmHg的压力将伤口渗出物从伤口吸出,以维持伤口处的伤口引流和湿度控制,但最小化组织在泡沫敷料内的内部生长。
根据本发明的另一实施方式,提供了一种对伤口提供淤滞和隔离的方法。该方法包括靠近伤口放置开孔型网状泡沫敷料,该泡沫敷料具有小于约200微米的平均孔径尺寸。消毒盖布放置在泡沫敷料和伤口上,且小于约100mmHg的减小的压力施加到泡沫敷料。
本发明提供了一种伤口处理设备,包括:
多孔敷料;
罐,其与所述多孔敷料流体相通;
第一阀,其设置在所述多孔敷料和所述罐之间,并可定位在打开位置,以允许流体流动,以及可定位在关闭位置,以阻止流体在所述多孔敷料和所述罐之间流动;
处理线,其流体地连接到所述罐;
第二阀,其可操作地设置在所述处理线内,并可定位在打开位置,以允许流体流动,以及可定位在关闭位置,以阻止流体通过所述处理线流动;以及
泵,其与所述罐流体相通,并可操作来在所述第一阀打开和所述第二阀关闭时,将伤口渗出物从所述多孔敷料吸到所述罐中,所述泵进一步可操作来在所述第一阀关闭和所述第二阀打开时,迫使伤口渗出物从所述罐进入到所述处理线内。
所述多孔敷料可以是开孔型网状泡沫。
所述多孔敷料的平均孔径尺寸可小于约200微米。
所述多孔敷料的平均孔径尺寸可小于或等于约100微米。
所述多孔敷料可由最小化所述多孔敷料内组织生长的材料组成。
所述多孔敷料可包括抗菌剂。
所述伤口处理设备进一步可包括:
第三阀,其设置在所述罐和所述泵的进口之间,所述第三阀可定位在所述罐与所述泵的所述进口流体相通的有效位置以及定位在所述泵的所述进口通风的通风位置;以及
第四阀,其设置在所述罐和所述泵的出口之间,所述第四阀可定位在所述罐与所述泵的所述出口流体相通的有效位置以及定位在所述泵的所述出口通风的通风位置。
所述泵可配置成在所述第三阀处于所述有效位置和所述第四阀处于所述通风位置时,将伤口渗出物从所述多孔敷料吸到所述罐中;以及
所述泵可配置成在所述第三阀处于所述通风位置和所述第四阀处于所述有效位置时,迫使伤口渗出物从所述罐进入所述处理线内。
所述伤口处理设备进一步可包括一次性容器,所述一次性容器可连接到所述处理线,以当所述第一阀关闭和所述第二阀打开时从所述罐收集伤口渗出物。
所述伤口处理设备进一步可包括传感器,所述传感器可操作地连接到所述罐以及所述第一阀和所述第二阀,以在所述罐中的伤口渗出物达到预定水平时关闭所述第一阀并打开所述第二阀。
所述伤口处理设备进一步可包括止回阀,所述止回阀可设置在所述多孔敷料和所述罐之间,以阻止伤口渗出物从所述罐回流到所述多孔敷料。
所述伤口处理设备进一步可包括安全警报器,如果检测到包括泄露检测事件、阻塞事件、满罐事件、低压事件、高压事件和弱电池事件中的至少一个事件,则所述安全警报器可向操作员报警。
所述伤口处理设备进一步可包括血液检测传感器。
本发明还提供了一种伤口处理设备,包括:
用于敷伤口的装置;
用于将渗出物从伤口吸到罐中的装置;
用于隔离伤口的装置;以及
用于迫使渗出物从所述罐出来的装置。
所述伤口处理设备进一步可包括用于阻止渗出物回流到所述用于敷伤口的装置的装置。
所述伤口处理设备进一步可包括用于感测从伤口吸出的渗出物的水平,并在所述水平达到预定水平时操作所述用于迫使渗出物进入处理容器内的装置的装置。
所述伤口处理设备进一步可包括如果检测到包括泄露检测事件、阻塞事件、满罐事件、低压事件、高压事件和弱电池事件中的至少一个事件就向操作员报警的装置。
所述伤口处理设备进一步可包括用于防止放血的装置。
所述伤口处理设备进一步可包括:
用于阻止渗出物回流到所述用于敷伤口的装置的装置;
用于感测从伤口吸出的渗出物的水平并在所述水平达到预定水平时操作所述用于迫使渗出物进入处理容器内的装置的装置;
用于在所述设备不运行时向操作员报警的装置;以及
用于防止放血的装置。
本发明另外提供了一种伤口淤滞和隔离设备,包括:
开孔型网状泡沫敷料,其具有小于约200微米的平均孔径尺寸,所述泡沫敷料靠近伤口放置;
消毒盖布,其覆盖所述泡沫敷料和伤口;以及
泵,其与所述泡沫敷料流体相通,来以小于约125mmHg的压力将伤口渗出物从伤口吸出,以维持伤口处的伤口引流和湿度控制,但最小化组织在所述泡沫敷料内的内部生长。
所述泡沫敷料的平均孔径尺寸可小于或等于约100微米。
所述泡沫敷料的孔径尺寸可最小化组织内部生长,但允许流体从伤口引流。
所述压力可在约25mmHg和75mmHg之间。
所述伤口淤滞和隔离设备进一步可包括:
罐,其设置在所述泡沫敷料和所述泵之间,以收集伤口渗出物,所述罐可具有排流出口;以及
其中所述泵可选择性地操作来通过所述排流出口迫使伤口渗出物从所述罐出来。
所述伤口淤滞和隔离设备进一步可包括一次性容器,所述一次性容器可定位成与所述排流出口流体相通,以从所述罐收集伤口渗出物。
本发明提供了一种对伤口提供淤滞和隔离的方法,包括:
将开孔型网状泡沫敷料靠近伤口放置,所述泡沫敷料具有小于约200微米的平均孔径尺寸;
将消毒盖布放置在所述泡沫敷料和伤口上,以及
将小于约100mmHg的减小的压力施加到所述泡沫敷料。
所述泡沫敷料的平均孔径尺寸可小于或等于约100微米。
所述泡沫敷料的孔径尺寸可最小化组织内部生长,但允许流体从伤口排出。
所述压力可在约25mmHg和75mmHg之间。
参考附图和接下来的详细说明,本发明的其它目的、特征和优点将变得明显。
附图说明
图1是所公开的紧凑、自加电的伤口渗出物清除和隔离系统的一个实施方式的简单图示;
图2是根据图1伤口渗出物清除和隔离系统的示意图;以及
图3是伤口渗出物清除和隔离系统的可选实施方式的示意图,其中通过旋转罐来启动阀。
具体实施方式
在优选实施方式的下列详细说明中,对形成其一部分的附图进行参考,其中作为例子示出可实践本发明的特定优选实施方式。这些实施方式被足够详细地描述,以使本领域的技术人员能够实践本发明,且应理解,可利用其它实施方式,并且可进行逻辑结构、机械、电和化学变化,而不偏离本发明的主旨或范围。为了避免使本领域的技术人员能够实践本发明不必要的细节,本说明可省略本领域的技术人员所公知的某些信息。因此,下列详细说明不应理解为限制意义的,且本发明的范围仅由所附权利要求限定。
图1是本发明所公开的紧凑、自加电的伤口渗出物清除和隔离系统100的一个实施方式的简单图示。如图1所示,系统100通过敷料提供伤口渗出物的收集和处理,该敷料可保留在伤口上,并在大大超过一般的敷料更换间隔之后和在整个医疗撤离过程期间都是有效的。因此,所公开的系统100保护有伤口的人、照顾有伤口的人的那些人以及非常接近的其他人。
伤口渗出物清除和隔离系统100在伤口上提供了敷料和覆盖物110,敷料和覆盖物110从伤口吸出渗出物,并通过应用真空或减小的压力来将渗出物移到渗出物收集系统120。用传统的减小压力的输送系统,减小的压力在伤口部位的分布用于促进新组织生长。伤口渗出物清除和隔离系统100优选地用于隔离、保护和提供对伤口部位的淤滞,直到患者到达伤口可被适当处理的医疗设施。因此,系统100配置成提供充分的伤口引流和湿度控制能力,同时最小化新组织在敷料内的内部生长。
图2是根据本发明的实施方式的伤口渗出物清除和隔离系统100的示意图。如图2所示,多孔敷料1.0用于在伤口上创建保护性环境。敷料1.0优选地由开孔型网状泡沫形成。可选地,敷料可由适合于向伤口增加压力的其它材料形成。例如,在一侧有突出部分的固体片材(例如,聚硅酮片),可允许通过在突出部分之间形成的流动通道来在伤口处分布压力。代替或除了突出部分以外,小孔可设置在片材中,以允许压力的增加。不管使用什么类型的敷料,敷料1.0都应具有分布减小的压力的能力,以从伤口适当地吸出伤口渗出物。虽然系统100没有设计成促进肉芽组织生长,但是研究发现,暴露于减小的压力的伤口可在少至48个小时内大量生长肉芽。为了有助于敷料的最终去除和替换,敷料1.0的伤口接触表面设计成最小化组织生长,因而便于在大大超过一般的48-72个小时敷料更换间隔之后进行伤口接触。
当使用泡沫敷料时,敷料1.0包括一种尺寸的小孔,其允许伤口渗出物从伤口通到管子1.2中,但最小化组织在小孔内的内部生长。平均孔径尺寸一般在约40μm和200μm之间,且优选为约100μm。与敷料1.0相关的孔径尺寸一般小于与用于促进伤口愈合的敷料相关的孔径尺寸。多孔敷料1.0还可具有抗菌特性。在一个实施方式中,敷料可被涂上或充满抗菌剂,例如银。
消毒盖布1.1放置在泡沫敷料1.0上,以隔离伤口,并允许减小的压力通过管子1.2施加到伤口1.0。在一个实施方式中,管子1.2是塑料管子。敷料1.0、消毒盖布1.1以及管子1.2可包括在小的重量轻的工具包中,该工具包可容易被前方军事医疗小组采用和储藏。
施加到敷料1.0的减小的压力强到足以通过管子1.2将渗出物从伤口连续地吸出。与用于促进伤口处肉芽组织生长的减小的压力系统不同,系统100的主要目的是隔离和遏制伤口,并清除渗出物。虽然可根据伤口的大小和敷料1.0的多孔性来调节通过敷料1.0施加到伤口的减小的压力,但是优选地,施加到伤口的压力小于约125mmHg。此特定的压力一般被考虑为加速伤口内新组织生长的最小压力;因此,期望保持低于该压力,以最小化新组织生长。更优选地,通过敷料施加到伤口的压力在约25mmHg和75mmHg之间。
再次参考用于例证的图2,止回阀2阻止渗出物回流到伤口中。推动而打开的内嵌阀3与设置在伤口下游的止回阀2流体相通。来自推动而打开的内嵌阀3下游的是与阀3流体相通的不可拆装的可排流的罐8。在一个实施方式中,罐8是可排流的,且由刚性材料构成。处理线14流体地连接到罐8的排流出口。阀4设置在与罐8流体相通的处理线14上。阀3、4都可选择性地定位在打开位置或关闭位置,以允许或阻止流体通过阀3、4流动。优选地,阀3在打开位置的放置导致阀4被放置在关闭位置。类似地,阀3在关闭位置的放置导致阀4被放置在打开位置。凸轮5可以可操作地连接到两个阀3、4,以机械地调整阀3、4的同时定位。
因为系统100在患者输送期间可放置在伤口处一段延长的时间,所以可能期望排流罐8,同时将系统100的剩余部分留在适当的位置。阀3、4设置成当罐8充满时或护理伤口的人期望时允许排流罐8。在减小的压力施加到伤口期间,阀3打开,以提供敷料1.0和罐8之间的流体相通。在本结构中,关闭阀4,以阻止罐8排流。为了排流罐8,关闭阀3,并打开阀4。阀3的关闭阻止减小的压力施加到伤口,而阀4的打开允许罐8中的伤口渗出物通过处理线14排出。任选地,一次性容器7可连接到处理线14,以收集从罐8排出的伤口渗出物。一次性容器7可为柔性的敞开式处理袋。当一次性容器7充满时,它可被去除,并用空的容器取代。
减小的压力借助于流体地连接到罐的泵11通过罐被提供到敷料1.0。在一个实施方式中,泵11是电池操纵的真空/压力泵。可选地,泵11可手工操作,或可为适合于引导暴露在其中的压力的任何其它泵。当泵11通过罐8将减小的压力施加到敷料1.0时,伤口渗出物从伤口被吸出,并沉积在罐8中。当阀3在打开位置,且阀4在关闭位置时,该操作出现。
如前所述,通过将阀3定位在关闭位置并将阀4定位在打开位置,可排流罐8。虽然重力可促进排出操作,但是泵11可以可选地迫使伤口渗出物从罐8出来进入处理线14内。为了便于罐8的强迫排流,三通阀9流体地连接在罐8和泵11的进口之间。阀9可选择性地定位在有效位置和通风位置之间。在有效位置,阀9允许在罐和泵11的进口之间流体相通。在通风位置,泵11的进口被通风。另一个三通阀10流体地连接在罐8和泵11的出口之间。阀10选择性地定位在有效位置和通风位置之间。在有效位置,阀10允许罐和泵11的出口之间流体相通。在通风位置,泵11的出口被通风。阀9、10的定位是相联系的,使得阀9在有效位置的定位导致阀10在通风位置的定位。类似地,阀9在通风位置的定位导致阀10在有效位置的定位。
当阀9定位在有效位置而阀10定位在通风位置时,泵11配置成将伤口渗出物从敷料1.0吸到罐8中。在此减小的压力配置中,阀3定位在打开位置,而阀4定位在关闭位置。当阀9定位在通风位置而阀10定位在有效位置时,泵11配置成向罐提供正压力,以便迫使伤口渗出物从罐8进入处理线14内。在此正压力配置中,阀3定位在关闭位置,而阀4定位在打开位置。
也可包括与罐8流体相通的疏水过滤器8.1,以阻止流体进入连接到泵11和阀9、10的管子中。
在一个实施方式中,传感器可以可操作地与罐8关联,以检测罐8何时充满伤口渗出物。传感器可以可操作地连接到阀3、4、9、10,以将系统100的运行从减小的压力系统自动调节到正压力系统,使得当罐8充满时,渗出物从罐8移到一次性容器7。
系统可进一步包括安全警报系统,如果系统没有正确地运行,该警报系统就提供音频信号或视觉信号。安全警报系统配置成避免响应于在医疗撤离过程期间可能出现的典型患者情况而产生假警报。然而,可通过安全警报系统来检测到的一些事件包括,但不限于,泄露检测事件、阻塞事件、满罐事件、低压事件、高压事件和弱电池事件。
系统还可包括阻止大量的或有害健康数量的血液从患者体内放血或去除的血液检测传感器。
如图3所示,引导渗出物流动的阀可通过旋转罐8而手动启动。
从前述内容应很明显,提供了具有重大优点的发明。虽然本发明仅以其形式中的几种示出,但是它并不只是限制的,而是容许各种变化和更改,而不偏离其主旨。
Claims (6)
1.一种伤口淤滞和隔离设备,包括:
开孔型网状泡沫敷料,其具有小于200微米的平均孔径尺寸,所述泡沫敷料靠近伤口放置;
消毒盖布,其覆盖所述泡沫敷料和伤口;以及
泵,其与所述泡沫敷料流体相通,来以小于125mmHg的压力将伤口渗出物从伤口吸出,以维持伤口处的伤口引流和湿度控制,但最小化组织在所述泡沫敷料内的内部生长。
2.如权利要求1所述的设备,其中所述泡沫敷料的平均孔径尺寸小于或等于100微米。
3.如权利要求1所述的设备,其中所述泡沫敷料的孔径尺寸最小化组织内部生长,但允许流体从伤口引流。
4.如权利要求1所述的设备,其中所述压力在25mmHg和75mmHg之间。
5.如权利要求1所述的设备,进一步包括:
罐,其设置在所述泡沫敷料和所述泵之间,以收集伤口渗出物,所述罐具有排流出口;以及
其中所述泵可选择性地操作来通过所述排流出口迫使伤口渗出物从所述罐出来。
6.如权利要求5所述的设备,进一步包括一次性容器,所述一次性容器可定位成与所述排流出口流体相通,以从所述罐收集伤口渗出物。
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- 2006-12-06 RU RU2008120329/14A patent/RU2404823C2/ru active
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- 2006-12-06 UA UAA200805313A patent/UA91241C2/ru unknown
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- 2006-12-06 WO PCT/US2006/046667 patent/WO2007067685A2/en active Application Filing
- 2006-12-06 JP JP2008544505A patent/JP4864979B2/ja active Active
- 2006-12-06 BR BRPI0620533-0A patent/BRPI0620533A2/pt not_active Application Discontinuation
- 2006-12-06 EP EP06844946.1A patent/EP1957018B2/en active Active
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2014
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