Device for reducing shrinkage of edge of open tissue structure and / or for stretching said edge

Abstract

The present invention relates to a device (100) for reducing contraction of an edge of an open tissue structure (114) of a patient having an open soft tissue defect and / or for stretching the edge (112), wherein the device (100) comprises: at least one body (102); at least one constriction element (104) for constricting and attaching the edge of the open tissue structure at the edge; and a tensioning element (106), in which the tensioning element (106) is configured and configured such that the at least one contracting element (104) is movable by the tensioning element (108) in such a way that the edges (112) of the open tissue structure (114) are thus at least partially more closely gathered together. The invention also relates to a wound care system (108) comprising at least one such device (100) and a vacuum dressing system wherein the vacuum dressing system comprises at least one foam film dressing (110) and a vacuum pump.

Description

Technical Field

[0001] The present invention relates to a device for reducing the retraction of the edges of an opened tissue structure in a patient having an open soft tissue defect and / or a device for stretching said edges.

[0002] The present invention also relates to a wound care system comprising a device for reducing the retraction of the edges of an opened tissue structure of a patient having an open soft tissue defect and / or a device for stretching said edges and a vacuum dressing system. Background Art

[0003] After visceral surgery, it is possible that it may not be possible or even desirable to close the abdominal wall after the actual procedure is complete. This may be the case, for example, if the patient's abdominal cavity is severely contaminated, such as may be the case in the case of a perforated hollow organ. In such cases, repeated lavage of the abdominal cavity (particularly peritoneal lavage) may be indicated.

[0004] It is also conceivable that in the case of a surgically untreatable hollow organ injury, such as a small bowel fistula, the abdominal wall may not or should not be initially closed.

[0005] Other indications include, for example, intestinal obstruction, in which the intestine requires so much space that the fascia in the abdominal wall region cannot be closed despite decompression.

[0006] It is also conceivable that the abdomen is also not initially closed in cases where there is a risk of abdominal compartment syndrome, a life-threatening condition that occurs due to a rapidly progressive increase in intra-abdominal pressure (especially IAP>12 mm Hg) and can lead to severe damage to intra- and extra-abdominal organ systems.

[0007] Additional indications are conceivable, in particular for the treatment of giant hernias.

[0008] Retraction devices for treating the open abdomen are already known from the prior art, by means of which the wound edges of the opened abdominal cavity can be retracted.

[0009] An example of this is a wound care device according to WO 2022074032A1, which comprises a device for reducing the retraction of the edges of the opened fascia after / during open abdomen.

[0010] However, such devices have the disadvantage that they only reduce the contraction of the edges of the patient's open tissue structure, whereas actual closing of the edges would be more conducive to reclosing the tissue structure.

[0011] Furthermore, these devices require a lot of space, in particular a lot of vertical space (from the perspective of the patient lying down), which is particularly problematic in cases where the patient requires intensive care. Moreover, the patient's position change is significantly limited (up to 30° lateral tilt), which on the one hand increases the risk of pressure sores and on the other hand makes normal care routines and ensuring the patient's personal hygiene more difficult. Summary of the invention

[0012] The object of the present invention is to advantageously further develop a device for reducing the shrinkage of the edges of an open tissue structure of a patient of the type mentioned at the outset and / or for stretching the open tissue structure, in particular to achieve an effect of better closing of the open tissue structure of the patient.

[0013] Therefore, a device is provided for reducing the contraction of the edges of an open tissue structure of a patient with an open soft tissue defect and / or for stretching the open tissue structure, whereby the device comprises at least one base body, at least one contraction element for contracting the edges of the open tissue structure and attaching to the edges, and a tensioning element, wherein the tensioning element is designed and configured such that the at least one contraction element can be moved by the tensioning element, specifically continuously and / or under a predetermined constant force, so that the edges of the open tissue structure can be at least partially brought together.

[0014] The invention is based on the basic idea that the edges of an open tissue structure can be brought closer together or can be pulled together. This pulling together should not be sudden and should not be done with excessive force. Instead, it is possible to bring together at least part of the edges of the wound relatively slowly with a predetermined and / or appropriate force. Therefore, this can not only reduce the shrinkage of the edges of the open tissue structure, but also promote or improve the closure of the open tissue structure by the approach of the edges.

[0015] The edge of the opened tissue structure refers to the outermost boundary of the tissue (skin, muscle, fascia, tendon plate, fat, etc.) located in front of the opened tissue structure and a few centimeters laterally (from the center of the body) to the opened tissue structure.

[0016] The device can be designed and configured so that the at least one contraction element can be moved by the tensioning element substantially in the same plane as the open tissue structure or substantially parallel to the open tissue structure. In other words, the pulling movement can be performed more or less at the level or in the plane of the edge of the open tissue structure. Therefore, the device requires very little space, especially vertically (from the perspective of the patient lying down), which is particularly advantageous in cases where the patient requires intensive care. It is also possible to change the position of the patient, which on the one hand reduces the risk of pressure sores and on the other hand also enables the normal care routine to be carried out and ensure the patient's personal hygiene.

[0017] The tensioning element may be designed and configured such that the at least one contraction element is moved by the tensioning element at a force of at most 10 N. A force of this magnitude may not only reduce the retraction of the edges of the open tissue structure but may also bring the edges of the open tissue structure at least partially closer together.

[0018] In particular, it can be further provided that the device comprises at least two contraction elements. Alternatively, it is conceivable that the device comprises a contraction element having several (at least two) segments. Several contraction elements or several segments of a contraction element can allow the edges of the opened tissue structure to be better approximated.

[0019] Furthermore, it can be provided that the basic body is arranged substantially in the middle between the at least two contraction elements. As a result, the opposite edges of the opened tissue structure can be brought closer together.

[0020] In particular, it is conceivable that the base body is directly and / or indirectly connected to the at least one contraction element or the at least two contraction elements at at least one point. This allows forces to be transmitted from the tensioning element through the base body to the at least one or the at least two contraction elements and from the contraction elements to the edge of the opened tissue structure. Alternatively and / or in addition, it is conceivable that the base body guides the at least one contraction element and / or deflects the at least one contraction element.

[0021] The basic body may have a substantially elongated shape. The tissue opening is generally elongated due to the surgical incision. Therefore, a basic body having a substantially elongated shape is compatible with an elongated tissue opening to a large extent. This allows the edges of the tissue opening to be brought together along an axis so that only one suture (longitudinal) is required to close the tissue opening.

[0022] In particular, it is conceivable that the basic body is substantially in the form of a cube, a cylinder or a spindle. The advantage of a basic body in the form of a cylinder or a spindle is that a contraction element in the form of a suture can easily be wound around the cylinder or the spindle.

[0023] Furthermore, the basic body may also comprise a winding mechanism. This makes it possible to pull the edge of the opened tissue structure towards the center of the tissue opening. Alternatively, the tensioning element may comprise a winding mechanism.

[0024] It is also conceivable that the basic body comprises at least two partial bodies, which can be detachably connected to each other. The two partial bodies can be releasably connected to each other, for example, by screws, clips, buckles, plugs, straps and / or magnetism.

[0025] In particular, it is conceivable that the basic body comprises two partial bodies which are detachably connected to one another, for example along their longitudinal axis.

[0026] Each partial body may be connected to at least one contraction element and / or may be designed and configured to deflect at least one contraction element.

[0027] In other words, each partial body may comprise at least one deflection element, which is arranged to deflect the at least one contraction element. Alternatively, one or more deflection units may be connected to a partial body.

[0028] It is conceivable that at least one contraction element can be guided through the partial body and deflected in the partial body by the deflection element. Thus, each partial body can be connected to the edge of the open tissue structure by at least one contraction element. By loosening the connection of the two partial bodies, on the one hand, the tension on the edge of the open tissue structure can be reduced, and on the other hand, the open tissue structure can be accessed (for example, to carry out a wound cleaning process and / or to perform an inspection) and / or to a vacuum dressing.

[0029] In particular, it is envisaged that the base body is made of or comprises an autoclavable or sterilizable material and remains on the patient throughout the therapeutic treatment.

[0030] Furthermore, it is conceivable that the tensioning element comprises a spring and / or a motor. A spring offers the advantages of a mechanical drive and can be designed in such a way that the tensioning element and the device can be autoclaved. A motor can enable electrical control of the tensioning element. Furthermore, a hydraulic and / or pneumatic drive of the tensioning element is also conceivable.

[0031] The tensioning element can be at least partially attached in or on the base body. This enables a space-saving design of the device, in particular the combination of a tensioning element with a base body. Attaching the tensioning element in the base body also makes it easier to clean the device, since only the base body needs to be cleaned.

[0032] Alternatively, the tensioning element may not be connected directly to the base body, but may be connected or connectable to the base body via at least one contraction element.

[0033] It is possible that the tensioning element contains a chamber, in particular a hydraulic chamber and / or a pneumatic chamber. The chamber can be directly or indirectly connected to a pump.

[0034] The presence of the pneumatic chamber allows the patient's cough shocks to be dampened by briefly immersing the cylinder.

[0035] At least one pressure element may be connected to the chamber. At least one pressure element may also be present in the chamber. For example, the pressure element may be in the form of a cube or a cylinder.

[0036] The pressure element may be connected to at least one contraction element, which is directly or indirectly connected to an edge of the opened tissue structure. By means of a pump connected to the chamber, the at least one pressure element may be moved in such a way that a pulling force is applied to the edge of the opened tissue structure by means of the at least one contraction element connected to the pressure element.

[0037] In case the device comprises a tensioning element with several pressure elements, each of which is connected to at least one contraction element, each contraction element can be subjected to the same tension, possibly also continuously. By connecting the chamber to a pump (e.g. an electric pump or a manual pump), the pressure in the chamber and thereby the tension of the at least one contraction element can be changed from the outside as required. The connection can be, for example, a pneumatic connection or a hydraulic connection, for example one or more tubes. This allows a flexible adaptation to different wound healing stages, tissue properties, patient needs, etc.

[0038] The chamber may be arranged outside the soft tissue defect or the open tissue structure and / or away from a dressing located in the open tissue structure. It is conceivable that the chamber is attached under a sterile film near the open tissue structure.

[0039] The at least one contraction element may comprise at least one suture and / or suture material and / or at least one net and / or at least one mesh band and / or at least one clip and / or at least one hook and / or at least one tube, for example a Bowden-PTFE tube and / or at least one silk thread. Several of the mentioned elements may also be combined to form a contraction element. By selecting one of the mentioned contraction elements or combining at least two of the mentioned contraction elements together, an individual adaptation of the device to the properties of the tissue opening to be processed is achieved.

[0040] The device may comprise several contraction elements of different lengths and / or sizes. In particular, it is conceivable that when the base body is located in the center of the tissue opening, the distance between the base body and the edge of the tissue opening is different. Contraction elements of different sizes and / or lengths may be used to achieve uniform traction on the edge. In particular, the length of the contraction element may be adapted to different wound dehiscences. Wound dehiscence is the undesirable separation of the wound edges. The extent and depth of wound dehiscence depends on the severity of the wound dehiscence.

[0041] Specifically, it is conceivable that the contraction element comprises at least one surgical suture and at least one net or mesh belt and / or at least one hook. The at least one net can be connected to the edge of the tissue structure opened on one side by many attachment points (e.g., by hooks, sutures and / or clips), and on the other side is connected to a suture (a suture pulled through the mesh of the net or fixed with a hook or clip), which in turn is connected to the base body. This enables the force to be distributed very evenly on the edge of the tissue structure (fascia) opened by many attachment points. In addition, when the suture slides through the net, there may be significantly less resistance. The total pulling force applied by the device can also be controlled by changing the number of stitches on the net (i.e., the point where the suture is connected to the net). The more stitches (the position where the suture is attached to the net), the greater the force. In addition, the net insertion (between the tissue and the suture) can also be used as a carrier for carrying another seam for permanently closing the open tissue structure at the end of the use of the device on the patient.

[0042] The present invention further comprises a wound care system comprising at least one device as described above, wherein the wound care system further comprises a vacuum dressing system, wherein the vacuum dressing system comprises at least one foam film dressing and a vacuum pump. The vacuum dressing system can be provided by different manufacturers and / or suppliers, or can be manufactured separately. Combining the above-mentioned device with the vacuum dressing system can improve wound healing. The use of vacuum dressings in open abdomen is associated with a reduced incidence of entero-air fistulas, which is also the purpose of using vacuum dressings.

[0043] The vacuum dressing system may also be referred to as a vacuum-assisted wound conditioning and cleaning system. The principle of vacuum-assisted therapy is very simple: the foam (or other wound filler, e.g., sponge) is cut to the approximate size of the tissue opening and placed in the tissue opening. The wound area is covered with at least one film and connected to the vacuum via a drainage tube, which is connected to the foam or the like.

[0044] The combination of foam or the like with a film may be referred to as a foam film dressing. The foam ensures that the applied vacuum is evenly distributed over the entire surface of the tissue opening. The suction device stimulates effective wound cleaning by removing excess wound exudate, cell debris and bacteria from the wound. Wound edema is reduced, and the blood flow in the wound area is thereby improved. In addition, the formation of granulation tissue is accelerated.

[0045] In particular, it is conceivable to integrate the above-mentioned device at least partially into a foam film dressing or to apply it at least partially to the foam film dressing. The device can fully exert its effect. This has the advantage that the patient treated with the wound care system is restricted as little as possible by the wound care system. This in turn improves the patient's position and the care situation. BRIEF DESCRIPTION OF THE DRAWINGS

[0046] Further details and advantages of the invention will now be explained on the basis of the example shown in the drawing.

[0047] In the attached picture:

[0048] Figure 1 An exemplary representation of an embodiment of a device according to the invention for reducing the shrinkage of the edges of an opened tissue structure of a patient having an open soft tissue defect and / or for stretching said edges;

[0049] Figure 2 Another exemplary representation of an apparatus for reducing shrinkage and / or stretching edges of an open tissue structure in a patient having an open soft tissue defect;

[0050] Figure 3 An exemplary representation of a wound care system according to the present invention;

[0051] Figure 4 An exemplary representation of a further embodiment of an apparatus for reducing contraction and / or stretching the edges of an open tissue structure in a patient having an open soft tissue defect (on an abdominal wall simulator);

[0052] Figure 5 Representation of an exemplary embodiment of a tensioning element 106 having a chamber 118 and five pressure elements 120 in the form of cylinders 120 ;

[0053] Figure 6 A further embodiment of the tensioning element 106 is schematically shown;

[0054] Figure 7 Exemplary individual constriction elements 104;

[0055] Figure 8 Schematically, another embodiment of the tensioning element 106; and

[0056] Fig. 9 A detailed view of the pressure element 120 is illustrated.

[0057] The reference numerals are as follows:

[0058] 100 Installations

[0059] 102 Basic Subject

[0060] 104 Contraction element

[0061] 106 tensioning element

[0062] 108 Wound Care System

[0063] 110 Foam Film Dressing

[0064] 112 The edge of the open organizational structure

[0065] 114 Organizational Structure

[0066] 116 Partial subject

[0067] Room 118

[0068] 120 pressure element / cylinder

[0069] 122 connecting pipe DETAILED DESCRIPTION

[0070] Figure 1 An embodiment is shown in which a device 100 according to the invention is located in an open tissue structure 114, ie between the edges 112 of the open tissue structure.

[0071] The opened tissue structure 114 is an open abdomen.

[0072] The device 100 includes a base body 102 .

[0073] In the present embodiment, the base body 102 has an elongated shape.

[0074] In the present embodiment, the base body 102 has a cylindrical shape, but it may alternatively have a spindle shape, for example.

[0075] The device 100 also includes a number of contraction elements 104 configured to contract and attach to edges 112 of an opened tissue structure 114 .

[0076] Alternatively, the device 100 may include only one constriction element 104 or a constriction element 104 having several segments.

[0077] In this case, the basic body 102 is arranged centrally, ie approximately in the middle between the constriction elements 104 .

[0078] In the present embodiment, the contraction element 104 is a suture, more particularly a surgical suture. Alternatively, another suture material or at least one mesh and / or at least one mesh band and / or at least one clip or at least one hook or at least one tube or at least one thread are conceivable. However, combinations of different types of contraction elements 104 are also conceivable, see Figure 2 .

[0079] In the present embodiment, the sutures 104 have equal lengths, but alternatively, the sutures 104 may have different lengths.

[0080] Furthermore, the device comprises a tensioning element 106 .

[0081] Here, the tensioning element 106 comprises a spring 106. Additionally or alternatively, the tensioning element 106 may also comprise a motor.

[0082] Here, the spring 106 is connected to the base body 102 .

[0083] This connects the spring 106 to the base body 102. Specifically, the spring 106 can thereby transfer force to the base body 102.

[0084] Alternatively, the spring 106 may be at least partially mounted in the base body 102 .

[0085] The base body 102 is directly connected at one point to one end of the suture 104 (here by entanglement). Alternatively, an indirect connection, for example via an intermediate element, would be conceivable.

[0086] Each suture 104 is not connected to one end of the base body 102 but is connected to an edge 112 of an opened tissue structure 114 .

[0087] In this embodiment, the suture 104 is entangled to and / or with the edge 112 of the opened tissue structure 114.

[0088] The spring 106 moves the base body 102 along its longitudinal axis (via tension).

[0089] The base body 102 is thereby rotated along its longitudinal axis.

[0090] Thus, the spring 106 moves the suture 104 continuously and at a predetermined constant force.

[0091] In this embodiment, the spring 106 moves the suture 104 with a force of 10N.

[0092] Alternatively, the spring 106 may also move the suture 104 with a force less than 10N.

[0093] In this embodiment, suture 104 is wrapped around cylinder 102 .

[0094] This causes the edges 112 of the opened tissue structure 114 to at least partially come closer together.

[0095] As a result, the shrinkage of the edge 112 is reduced.

[0096] In this embodiment, the spring 106 moves the suture 104 in the same plane as the opened tissue structure 114. Alternatively, the spring 106 can move the suture 104 parallel to the tissue structure 114 (e.g., Figure 3 situation shown).

[0097] Figure 2 Another exemplary representation of an embodiment of an apparatus for reducing the shrinkage and / or stretching of edges of an opened tissue structure in a patient having an open soft tissue defect is shown.

[0098] Here also the device 100 according to the invention is shown in an open tissue structure 114 , ie between the edges 112 of the open tissue structure 114 .

[0099] The device 100 comprises a base body 102 and a tensioning element 106 (the tensioning element 106 is not explicitly shown).

[0100] In the present exemplary embodiment, the tensioning element 106 is a winch which is arranged in the base body 102 .

[0101] Thus, the base body 102 comprises a winch.

[0102] In this embodiment, the pulley is connected to the base body 102 .

[0103] The device 100 further comprises a plurality of contraction elements 104 adapted to contract and attach to the edges 112 of the opened tissue structure 114 .

[0104] Here, there is a combination of different contraction elements 104, namely a combination of a surgical suture 104 and a mesh 104. Specifically, there is a combination of two surgical sutures 104 and two meshes 104.

[0105] In this case, the basic body 102 is arranged centrally, ie approximately in the middle between the constriction elements 104 .

[0106] In each case, one mesh 104 is connected to one edge 112 of an open tissue structure 114. In this embodiment, one mesh 104 is entangled on one side by a surgical suture to / or with one edge 112 of an open tissue structure 114. The other side of each of the meshes 104 is connected to the surgical suture 104.

[0107] The surgical suture 104 is passed through the mesh of each of the meshes 104 (on the side away from the tissue edge 112 ).

[0108] In addition, the surgical suture 104 is connected to the base body 102 via the deflection roller. In other words: the surgical suture 104 is wound on the base body 102 around the deflection roller.

[0109] The capstan in the base body 102 moves the suture 104 (tension) continuously and under constant force. The force applied by the capstan is transmitted through the suture 104 to the mesh 104, to the edges 112 of the open tissue structure, so that the edges 112 of the open tissue structure 114 are at least partially gathered together.

[0110] As a result, the shrinkage of the edge 112 is reduced.

[0111] Figure 3 An exemplary representation of a wound care system according to the present invention is shown.

[0112] The wound care system according to the invention comprises the device 100 according to the invention and a vacuum dressing system.

[0113] Shows Figure 1 An embodiment of a device 100 according to the invention is shown.

[0114] Additionally, a foam film dressing 110 of a vacuum dressing system is shown.

[0115] The vacuum dressing system further comprises a vacuum pump (not shown).

[0116] In this embodiment, the device 100 is integrated into the foam sheet dressing 110. Alternatively, the device 100 can also be applied to the foam sheet dressing 110.

[0117] The functionality of the device 100 can generally be found in Figure 1By means of the tensioning element 106 , the contraction element is moved here substantially parallel to the opened tissue structure 114 .

[0118] The combination of the vacuum dressing system and the device 100 creates a synergistic effect on wound healing for the patient.

[0119] Figure 4 An example of a further embodiment of a device 100 according to the invention for reducing the retraction of the edges of an opened tissue structure and / or for stretching the edges of a patient with an open soft tissue defect is shown (on an abdominal wall simulator).

[0120] Here, the abdominal wall simulator simulates the opened tissue structure and the edges of the opened tissue structure of the patient.

[0121] The device 100 includes a base body 102 .

[0122] In this embodiment, the basic body 102 includes two partial bodies 116 .

[0123] In other words, the base body 102 is divided into two partial bodies 116 along its longitudinal axis.

[0124] The partial bodies 116 are detachably connected to each other.

[0125] The device further comprises a plurality of contraction elements 104 for contracting and attaching to the edges of the opened tissue structure.

[0126] In this embodiment, the constriction element 104 comprises a suture 104 and a tube 104 .

[0127] Eighteen sutures 104 are shown.

[0128] Alternatively and / or additionally, nets, netting strips, hooks, clips or the like are also conceivable.

[0129] Each suture 104 is connected to an abdominal wall simulator, thereby simulating the connection of the suture to the edges of an opened tissue structure.

[0130] Sutures 104 are laterally connected to the abdominal wall simulator, extending through the partial body 116 toward the center of the simulator (corresponding to the center of the patient's body) (nine sutures on the left side extend through the left partial body 116, and nine sutures on the right side extend through the right partial body 116, thereby allowing the connection of the partial body 116 to be separated).

[0131] The suture 104 is deflected in the partial body 116 and exits the partial body 116 on a side different from the side on which it entered (here, the lower side).

[0132] After exiting portion body 116 , suture 104 is encased in tube 104 .

[0133] The device further comprises a tensioning element 106 (not shown).

[0134] The tensioning element 106 includes a chamber 118 (see Figure 5 and 6 ).

[0135] In this example, chamber 118 is a hydraulic chamber 118 .

[0136] Alternatively and / or additionally, a pneumatic chamber 118 is conceivable.

[0137] Eighteen pressure elements 120 are inserted into the chamber 118 .

[0138] The pressure element 120 is designed as a cylinder 120 .

[0139] A different number of pressure elements 120 is conceivable, but at least one pressure element 120 is necessary.

[0140] Alternatively, the pressure element 120 may be connected to the hydraulic chamber 118 .

[0141] Each pressure element 120 is connected to a suture 104 encased in the tube 104 .

[0142] In other words, each of the 18 sutures is connected at a first end to the abdominal wall simulator and thereby may be connected to the edge of the opened tissue structure.

[0143] Each of the 18 sutures is connected to cylinder 120 at a second end.

[0144] The pump is preferably connected to the chamber 118 via a hydraulic and / or pneumatic connection 122 .

[0145] In this embodiment, the pump is a manual pump.

[0146] Alternatively, for example, an electric pump would be conceivable.

[0147] The pump may be a component of the device 100 , but it may also be an external component.

[0148] The force transmitted by the pump through the chamber 118 to the cylinder 120 causes the cylinder 120 to move so that tension is applied to the suture 104 connected to the cylinder 120 on the abdominal wall simulator to simulate the edges of an opened tissue structure.

[0149] Thus, the contraction element 104 (here: suture) can be moved by the tensioning element 106 (here: chamber 118 and cylinder 120) with the same force. The force can be predetermined and continuous. The presence of the pneumatic chamber means that the coughing shock of the patient can be dampened by briefly contracting the cylinder. The force can also be controlled individually and / or as needed using a pump. This allows the opposing parts of the abdominal wall simulator (simulating the edges of the opened tissue structure 114) to be at least partially brought together.

[0150] The present embodiment includes 18 sutures, but alternatively, different numbers of sutures are contemplated (e.g., 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, etc.) It is advantageous, but not necessary, to connect each portion of the body to the same number of sutures.

[0151] Figure 4 The described device 100 may be part of a wound care system 108 that, in addition to the device 100 , also includes a vacuum dressing system 108 that includes a foam film dressing 110 and a vacuum pump.

[0152] The corresponding wound care system can be applied as follows:

[0153] A mesh (e.g., in the form of a mesh strip) is sutured to each of the edges of an open tissue structure of a patient with an open soft tissue defect (e.g., after surgery). It is conceivable, for example, to suture the mesh to the posterior rectus sheath, for example, transversely to a few centimeters posterior to the rectus sheath. This type of mesh is sutured to the edges of tissue located on two opposite sides of the open tissue structure.

[0154] Advantageously, the mesh is sewn to the edge of the open tissue structure using a plurality of stitches so that the forces acting thereon can be distributed as evenly as possible over the edge of the open tissue structure, thereby largely preventing the mesh from being torn off the possibly fragile tissue.

[0155] A first foam or sponge (part of a vacuum dressing) can be placed in the open tissue structure. Specifically, the first foam or sponge can be placed directly at or below the outermost edge of the open tissue structure (a few centimeters laterally from the outermost edge tissue) to avoid contact between organs (e.g., intestines) and fascia edges.

[0156] Nine clips 104 (each clip connected to a suture 104) are connected to each of the two meshes, preferably attached on opposite sides of the tissue edge. Then, the nine sutures 104 can be connected to the Figure 4 A partial body 116 of the base body 102 of the device 100 is depicted.

[0157] Each of the nine sutures is deflected within the portion body 116, exits the portion body 116, and is each encased within a tube after exiting.

[0158] The two partial bodies are then detachably connected to each other and placed on the first foam or sponge introduced into the opened tissue structure.

[0159] Now, a second (subcutaneous) foam or sponge can be placed on top of the two part bodies. A tube with sutures 104 can be introduced out of the open tissue structure at one pole.

[0160] A sterile film may now be applied to the second foam or sponge, which ultimately enables the suction device to be attached to the vacuum dressing.

[0161] The base body, first and second foam materials and / or sponges are arranged in a sterile manner.

[0162] The tensioning element 106 can be arranged in a sterile manner below the second film, so that only the pneumatic / hydraulic connection between the tensioning element 106 and the pump leaves the sterile space and is connected to the pump.

[0163] The pump causes pressure to build up, which ultimately results in pulling of the suture 104, see above.

[0164] The vacuum dressing can then be changed as follows:

[0165] The connection between the hydraulic chamber 118 and the pump is released.

[0166] Next, the second film, the first film, and the second foam or sponge are removed.

[0167] Care is taken to ensure that base body 102 remains sterile.

[0168] The detachable connection between the two partial bodies 116 is broken so that the partial bodies 116 (each with its nine seams 104 ) can be folded to one side without having to detach them from the respective connected web strips 104 .

[0169] The first foam and / or sponge may now be removed and / or replaced.In addition, the opened tissue structure 114 may be inspected.

[0170] Portion body 116 may be reattached as above, and the vacuum dressing may also be completed as above.

[0171] The base body 116 remains sterile at all times.

[0172] New sterile connecting tubing may be used to complete the connection of the tensioning element 106 to the pump.

[0173] When therapy is complete, the dressing can be removed as above.

[0174] The clip 104 is removed from the web belt 104 .

[0175] Sutures can be used to initially sew up the tissue structure that is opened. In addition, the mesh belt 104 that is sewed in the inside can be used as a stable suture site.

[0176] Figure 5 An example of a tensioning element 106 is shown which has a hydraulic chamber 118 and five pressure elements 120 in the form of cylinders 120 .

[0177] The operating mode of the tensioning element 106 is Figure 4 is generally described in Figure 4 In contrast, here only five cylinders 120 are present.

[0178] Suture 104 is connected to each cylinder 120 .

[0179] The hydraulic chamber 118 is connected to a pump via a pipe 122 .

[0180] The force transmitted by the pump through the chamber 118 to the cylinder 120 causes the cylinder 120 to move, so that a tensile force is applied to the suture 104 connected to the cylinder 120, which makes it possible to bring the edges of the opened tissue structure closer together.

[0181] Figure 6 A further exemplary embodiment of a tensioning element 106 is schematically shown.

[0182] In the present exemplary embodiment, the tensioning element 106 includes a pneumatic chamber 118 .

[0183] The tensioning element 118 further includes 11 pressure elements.

[0184] The function of the tensioning element 106 is Figure 4 and 5 The function of the tensioning element described in is similar.

[0185] Figure 7 Various examples of contraction elements 104 are shown.

[0186] Two different hooks 104 are shown secured to a suture device, which is engaged in the mesh 104 .

[0187] This type of mesh can be attached (eg, sutured) to the tissue edges of the open tissue structure.

[0188] The mesh 104 may be connected to the tensioning element 106 by sutures 104 attached to the hooks 104 .

[0189] Two or more mutually connected contraction elements 104 may also be regarded as one contraction element 104 .

[0190] Figure 8 A further exemplary embodiment of a tensioning element 106 is schematically shown.

[0191] The tensioning element 106 comprises a hydraulic chamber 118 and a total of ten cylinders 120 , of which five cylinders 120 protrude out of the chamber 118 on two opposite sides.

[0192] The constriction element 104 may be connected to the head of each cylinder protruding from the chamber 118 .

[0193] Alternatively, the chamber 118 may also be a pneumatic chamber 118 .

[0194] Another number of cylinders 120 is also conceivable.

[0195] The mode of operation of the tensioning element 106 corresponds generally to Figure 4 The operating mode of the tensioning element 106 is described in .

[0196] Fig. 9 A detailed view of an exemplary pressure element 120 is shown.

[0197] A pressure element 120 of this type can be used for a tensioning element 106, for example Figure 5 , 6 and 8.

[0198] The pressure element 120 is substantially in the form of a cylindrical body 120 .

[0199] The head of the pressure element 120 is shown on the left.

[0200] The pressure element is drawn from chamber 118 (see Figure 5 , 6 ) protrudes and is designed so that a contraction element 104, in particular in the form of a suture 104, can be easily attached to the pressure element.

Claims

1. A device (100) for reducing the shrinkage of the edge of an open tissue structure (114) of a patient with an open soft tissue defect and / or for stretching the edge (112), characterized in that The device (100) comprises: at least one base body (102); at least one contracting element (104) for contracting and fastening said edge of said opened tissue structure to said edge; and a tensioning element (106), The tensioning element (106) is designed and configured such that at least one of the contraction elements (104) can be moved by the tensioning element (108), thereby causing the edges (112) of the open tissue structure (114) to at least partially come together.

2. The device (100) according to claim 1, characterized in that The device (100) is designed and configured such that at least one of the contraction elements (104) can be moved substantially in the same plane as the opened tissue structure (114) or substantially parallel to the opened tissue structure (114) by the tensioning element (106).

3. The device (100) according to claim 1 or claim 2, characterized in that The tensioning element (106) is designed and configured such that the at least one contraction element (104) can be moved by the tensioning element (106) at a force of at most 10N.

4. The device (100) according to any one of claims 1 to 3, characterized in that The device (100) comprises at least two constriction elements (104).

5. The device (100) according to claim 4, characterized in that The base body (102) is arranged substantially in the middle of at least two of the constriction elements (104).

6. The device (100) according to any one of the preceding claims, characterized in that The base body (102) is directly and / or indirectly connected at least at one point to at least one of the constriction elements (104) or at least two of the constriction elements (104).

7. The device (100) according to any one of the preceding claims, characterized in that The basic body (102) includes at least two partial bodies (116), and the at least two partial bodies are detachably connectable.

8. The device (100) according to any one of the preceding claims, characterized in that The partial body (116) includes at least one deflection element configured to deflect the at least one constriction element (104).

9. The device (100) according to any one of the preceding claims, characterized in that The tensioning element (106) contains a chamber (118), in particular a hydraulic chamber and / or a pneumatic chamber (118).

10. The device (100) according to any one of the preceding claims, characterized in that At least one pressure element (120) is connected to the chamber (118), or at least one pressure element (120) is embedded in the chamber (118), the pressure element (120) is connected to at least one contraction element (104), at least one contraction element is directly or indirectly connected to the edge of the open tissue structure (114), wherein at least one pressure element (120) can be moved by a pump connected to the chamber (118), so that tension is applied to the edge of the open tissue structure (114) by at least one contraction element (104) connected to the pressure element (120).

11. The device (100) according to any one of the preceding claims, characterized in that The at least one contracting element (104) comprises at least one suture and / or suture material and / or at least one mesh and / or mesh tape and / or at least one clip and / or at least one hook and / or at least one tube and / or at least one thread.

12. The device (100) according to any one of the preceding claims, characterized in that The device (100) comprises a plurality of constriction elements (104) of at least partially different lengths and / or sizes.

13. A wound care system (108), comprising at least one device (100) according to any one of claims 1 to 12, wherein the wound care system (108) further comprises a vacuum dressing system, wherein the vacuum dressing system comprises at least one foam sheet dressing (110) and a vacuum pump.

14. The wound care system (108) according to claim 13, characterized in that At least part of at least one device (100) according to any one of claims 1 to 12 is integrated into the foam sheet dressing (110) or at least partly applied to the foam sheet dressing.

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