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Kafe 바로가기국가/구분 | United States(US) Patent 등록 |
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국제특허분류(IPC7판) |
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출원번호 | US-0224852 (2002-08-21) |
등록번호 | US-7381211 (2008-06-03) |
발명자 / 주소 |
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출원인 / 주소 |
|
인용정보 | 피인용 횟수 : 128 인용 특허 : 143 |
A medical closure screen device for a separation of first and second tissue portions is provided, which includes a mesh screen comprising tubular vertical risers, vertical strands with barbed filaments, and horizontal spacers connecting the risers and strands in a grid-like configuration. An optiona
A medical closure screen device for a separation of first and second tissue portions is provided, which includes a mesh screen comprising tubular vertical risers, vertical strands with barbed filaments, and horizontal spacers connecting the risers and strands in a grid-like configuration. An optional perimeter member partly surrounds the screen and can comprise a perimeter tube fluidically coupled with the vertical risers to form a tubing assembly. Various input/output devices can optionally be connected to the perimeter tube ends for irrigating and/or draining the separation according to methodologies of the present invention. Separation closure, irrigation and drainage methodologies are disclosed utilizing various combinations of closure screens, tubing, sutures, fluid transfer elements and gradient force sources. The use of mechanical forces associated with barbed strands for repositionably securing separated tissues together is disclosed. The use of same for eliminating or reducing the formation of subcutaneous voids or pockets, which can potentially form hematoma and seroma effects, is also disclosed.
Having thus described the invention, what is claimed as new and desired to be secured by Letters Patent is: 1. A device for primary intention closing a separation of first and second portions of body tissue presenting first and second tissue generally matching edges respectively, which device compr
Having thus described the invention, what is claimed as new and desired to be secured by Letters Patent is: 1. A device for primary intention closing a separation of first and second portions of body tissue presenting first and second tissue generally matching edges respectively, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first closure member edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple barbs associated with said first and second faces respectively and retaining same contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for releasing one of said tissue edges and sliding one of said tissue edges relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from each said face are generally parallel with the other barbs extending from said face; and all of said barbs associated with both of said faces are generally oriented towards said first closure member edge; a pressure differential source associated with said closure member and adapted for exerting a pressure differential at said separation for approximating said tissue edges with said tissue edges maintained in repositionable alignment with respect to each other by said closure member; and a tube connected to said closure member and said pressure differential source, said tube including an orifice adapted for placement at said separation in direct fluidic connection with the tissue edges for applying the pressure differential directly thereto, said tube having an external port for fluid input/output. 2. The device according to claim 1 wherein said closure member comprises a screen with proximate and distal margins, multiple strands extending between said margins and each strand including multiple barbs projecting outwardly therefrom. 3. The device according to claim 1, which includes: said tube comprising a perimeter tube attached to said closure member perimeter and having first and second tube ends; and said pressure differential source being connected to said perimeter tube first end and adapted for exerting said pressure differential in said separation through said perimeter tube. 4. The device according to claim 1, which includes: said tube comprising a perimeter tube attached to said closure member perimeter and having first and second tube ends; and first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation. 5. The device according to claim 1 wherein said closure member comprises a screen adapted to receive an ingrowth of tissue into said screen. 6. The device according to claim 1, which includes: said closure member having multiple risers adapted for extending within said separation. 7. The device according to claim 6 wherein each said riser has a monofilament construction and is adapted for communicating fluid therealong. 8. The device according to claim 6 wherein each said riser includes multiple barbs projecting outwardly in opposite directions from said first and second closure member faces. 9. The device according to claim 8 wherein each said barb includes a sharpened end and extends generally outwardly with respect to said separation. 10. The device according to claim 4 wherein one of said input/output devices comprises a fluid transfer subassembly. 11. The device according to claim 10 wherein said fluid transfer subassembly includes first and second sponges located on either side of said closure member on the skin surface and a bridge sponge placed over said first and second sponges. 12. The device according to claim 11 wherein said fluid transfer subassembly is connected to a vacuum source comprising said first input/output device. 13. The device according to claim 4 wherein said closure screen includes hollow risers, which fluidly communicate with said perimeter tube. 14. The device according to claim 13 wherein said risers include perforations. 15. The device according to claim 1, which includes a perimeter suture mounted on said closure member perimeter. 16. The device according to claim 15 wherein said perimeter suture includes first and second ends and first and second needles respectively mounted thereon. 17. The device according to claim 16 wherein said perimeter suture is separable from said closure member. 18. The device according to claim 2 wherein said strands comprise multi-filament, braided material. 19. The device according to claim 2 wherein said strands include filaments with free ends forming said barbs and projecting generally outwardly therefrom. 20. The device according to claim 19 wherein each barb includes a sharpened end and a notch spaced inwardly therefrom. 21. The device according to claim 6 wherein said risers comprise multiple members joined together and forming fluid passages therebetween. 22. The device according to claim 21 wherein said riser members are joined together at spaced intervals. 23. The device according to claim 22 wherein said risers are adapted for receiving fluid and pumping same in response to patient movements. 24. The device according to claim 21 wherein said risers comprise multiple, bundled tubes with multiple barbs projecting outwardly therefrom. 25. The device according to claim 4 wherein said perimeter tube comprises a fluted drain. 26. The device according to claim 1 wherein said closure member comprises a screen with a configuration adapted to admit tissue and body fluids. 27. The device according to claim 26 wherein said closure member screen consists of multiple strands forming a flexible panel. 28. The device according to claim 27 wherein each said strand has a respective barb. 29. The device according to claim 28, which includes said screen having multiple spacers connecting said strands and adapted for maintaining same in generally parallel, spaced relation. 30. The device according to claim 27 wherein: said closure member screen has proximate and distal margins; and each said strand includes multiple barbs extending therefrom in a direction generally outwardly and towards said distal margin. 31. The device according to claim 30 wherein said stands are integrally formed with said barbs. 32. The device according to claim 30 wherein: each said strand comprises multiple filaments; each said strand includes a longitudinally-extending axis; and each said barb comprises a filament with a free end located in spaced relation from said axis. 33. The device according to claim 32 wherein said filaments are twisted. 34. The device according to claim 32 wherein said filaments are braided. 35. The device according to claim 26 wherein said closure screen comprises a biodegradable material adapted for absorption within said tissue separation. 36. The device according to claim 4 wherein one of said input/output devices is a fluid transfer element, which comprises a sponge material and is connected to said pressure differential source. 37. The device according to claim 36 wherein said fluid transfer element is connected to a fluid supply source, which irrigates said tissue separation. 38. The device according to claim 3 wherein one of said perimeter tube ends is closed. 39. The device according to claim 38, which includes a clamp mounted on said one perimeter tube end and adapted for closing same. 40. The device according to claim 38 wherein said one perimeter tube end is knotted. 41. The device according to claim 38 wherein said one perimeter tube end terminates below the patient's dermis. 42. The device according to claim 2 wherein said closure screen includes a plurality of tubular risers, each said riser having a fluid passage and a fluid inlet/outlet orifice communicating with said separation. 43. The device according to claim 42 wherein said tube and said risers are fluidically interconnected to form a fluid distribution manifold at said screen perimeter and extending across an interior of said screen. 44. The device according to claim 4, which includes a Leur lock mounted on a respective perimeter tube end and comprising a respective input device. 45. The device according to claim 4, wherein said perimeter tube is secured to said closure member by dissolvable connectors. 46. The device according to claim 1, which includes a fluid transfer element connected to said closure member and comprising a hydrophobic material. 47. The device according to claim 1, which includes a fluid transfer element connected to said closure member and comprising a hydrophilic material. 48. The device according to claim 4, which includes a needle mounted on said perimeter tube and adapted for passing same through tissue, and said perimeter tube including multiple orifices. 49. The device according to claim 1, which includes a fluid receptacle fluidically connected to said pressure differential source. 50. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member being adapted for positioning at least partly within said separation; first and second retainers associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively; a perimeter tube attached to said closure member perimeter and having first and second tube ends; first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation; and said closure screen includes hollow risers, which fluidly communicate with said perimeter tube. 51. The device according to claim 50 wherein said risers include perforations. 52. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; a perimeter tube attached to said closure member perimeter and having first and second tube ends; first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation; one of said input/output devices comprising a fluid transfer subassembly; and said fluid transfer subassembly including first and second sponges located on either side of said closure member on the skin surface and a bridge sponge placed over said first and second sponges. 53. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; a perimeter tube attached to said closure member perimeter and having first and second tube ends; first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation; and said closure screen including hollow risers, which fluidly communicate with said perimeter tube. 54. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; said closure member having multiple risers adapted for extending within said separation; said risers comprising multiple riser members joined together and forming fluid passages; said riser members being joined together at spaced intervals; and said risers being adapted for receiving fluid and pumping same in response to patient movements. 55. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; said closure member having multiple risers adapted for extending within said separation; said risers comprise multiple members joined together and forming fluid passages; and said risers comprise multiple, bundled tubes with multiple barbs projecting outwardly therefrom. 56. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; and first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; a pressure gradient source connected to said perimeter tube first end; first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation; one of said input/output devices is a fluid transfer element, which comprises a sponge material and is connected to said pressure gradient source; and said fluid transfer element is connected to a fluid supply source, which irrigates said tissue separation. 57. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; one of said perimeter tube ends being closed; and said one perimeter tube end being knotted. 58. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; and said closure screen including a plurality of tubular risers, each said riser having a fluid passage and a fluid inlet/outlet orifice communicating with said separation. 59. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said perimeter having a first edge; said closure member being adapted for positioning at least partly within said separation; first and second groups of multiple retainers comprising barbs associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said Face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; a needle mounted on said perimeter tube and adapted for passing same through tissue; and said perimeter tube including multiple orifices. 60. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and generally planar first and second faces, said closure member being adapted for placement at least partly in said separation and said perimeter having a first edge; a tube connected to said closure member and including an orifice adapted for placement at said separation in fluidic connection with the patient, said tube having an external port for fluid input/output; first and second groups of multiple barbs associated with and extending from said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively, said barbs including a directional tissue-sliding construction adapted for sliding one of said tissue portions relative to the other in a predetermined direction, said construction comprising an acute angular orientation of said barbs and adapted for closing said tissue portions in response to an outwardly directed force on said closure member such that all of said barbs extending from said face are generally parallel with the other barbs extending from said face; and all of said barbs are generally oriented towards said first edge; said tube comprising a perimeter tube mounted on said closure member perimeter and including multiple input/output orifices; an external suction/supply source; said closure member including a plurality of risers each having multiple inlet/outlet orifices and connected to an external suction/supply source; and said perimeter tube external port being connected to said external suction/supply source. 61. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member being adapted for positioning at least partly within said separation; first arid second retainers associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively; a perimeter tube attached to said closure member perimeter and having first and second tube ends; first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation; one of said input/output devices comprising a fluid transfer subassembly; and said fluid transfer subassembly including first and second sponges located on either side of said closure member on the skin surface and a bridge sponge placed over said first and second sponges. 62. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member being adapted for positioning at least partly within said separation; first and second retainers associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively; said closure member having multiple risers adapted for extending within said separation; said risers comprising multiple members joined together and forming fluid passages therebetween; said risers being joined together at spaced intervals; and said risers being adapted for receiving fluid and pumping same in response to patient movements. 63. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member being adapted for positioning at least partly within said separation; first and second retainers associated with said first and second faces respectively and retaining same in contact with said first and second body tissue portions respectively; said closure member having multiple risers adapted for extending within said separation; said risers comprising multiple members joined together and forming fluid passages therebetween; and said risers comprising multiple, bundled tubes with multiple barbs projecting outwardly therefrom. 64. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member including a barb projecting outwardly from said first closure member face; said barb being adapted to penetrate the first portion of said tissue with said closure member positioned at least partly in said separation and with said separated tissue portions engaging said closure member; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; a pressure gradient source connected to said perimeter tube first end; first and second input/output devices connected to said perimeter tube first and second ends respectively and adapted for fluidically communicating with said separation; one of said input/output devices comprising a fluid transfer element, which comprises a sponge material and is connected to said pressure gradient source; and said fluid transfer element is connected to a fluid supply source, which irrigates said tissue separation. 65. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member including a barb projecting outwardly from said first closure member face; said barb being adapted to penetrate the first portion of said tissue with said closure member positioned at least partly in said separation and with said separated tissue portions engaging said closure member; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; one of said perimeter tube ends being closed; and said one perimeter tube end being knotted. 66. A device for closing a separation of first and second portions of body tissue, which device comprises: a closure member with a perimeter and first and second faces; said closure member including a barb projecting outwardly from said first closure member face; said barb being adapted to penetrate the first portion of said tissue with said closure member positioned at least partly in said separation and with said separated tissue portions engaging said closure member; a perimeter member attached to said closure member perimeter and having first and second ends; said perimeter member comprising a tube adapted for fluidically communicating with said tissue within said tissue separation; and said closure screen including a plurality of tubular risers, each said riser having a fluid passage and a fluid inlet/outlet orifice communicating with said separation.
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