Surgical mesh fixation device for wound closure system

Abstract

A device includes a cannula defining a lumen and a wound closure device. The cannula may be coupled with an aspiration source to establish fluid communication between the aspiration source and the lumen. The cannula includes a distal portion defining at least one aperture such that the at least one aperture is in fluid communication with the lumen and an outer surface of the distal portion. The wound closure device may cover a wound in skin. The wound closure device may receive a layer of topical adhesive to adhere to skin and form a microbial barrier over the wound. The wound closure device includes a cannula housing defining a channel capable of receiving a distal portion of the cannula. The cannula may be inserted into the cannula housing to provide fluid communication between the suction source and the wound after the microbial barrier is formed.

Description

BACKGROUND OF THE INVENTION

[0001] A wound closure system (also referred to as a skin closure system) can be used at the end of a patient's surgical procedure to close a wound (e.g., a surgical incision) formed in the patient's skin for access to a target anatomical structure. By way of example, a wound closure system can include components such as sutures, substrates, and / or liquid topical skin adhesives that are applied by a surgeon to approximate the edges of the wound and, in some cases, form a stable and protective layer over the wound that promotes effective healing. In some cases, one or more components of the applied wound closure system can be absorbed by the patient during the healing process. After the wound has healed, the remaining components of the wound closure system can be removed from the skin by the surgeon and / or they can detach automatically from the skin such that they can be discarded by the patient.

[0002] Although a variety of wound closure systems and associated components and methods have been made and used, it is believed that the invention described in the appended claims has not been made or used prior to the present inventors. BRIEF DESCRIPTION OF THE DRAWINGS

[0003] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the description given below, serve to explain the principles of the invention.

[0004] Figure 1 A perspective view of an example of a wound closure system is shown that includes a wound closure device, an adhesive applicator, and an adhesive spreader;

[0005] Figure 2 Shows Figure 1 An exploded perspective view of the wound closure device of, showing a mesh layer, a pressure-sensitive adhesive layer, and a removable backing layer;

[0006] Figure 3A Shows the wound closure device of longitudinally aligned with a wound in a patient's skin, Figure 1 A perspective view of the wound closure device of, showing the central portion of the backing layer that has been removed;

[0007] Figure 3B Shows Figure 1 A perspective view of the wound closure device of, applying the wound closure device over a patient's skin wound to approximate the edges of the wound;

[0008] Figure 3C Shows the wound closure device of applied over a patient's skin wound, Figure 1 A perspective view of the wound closure device of, showing the remaining portion of the backing layer that has been removed such that the wound closure device is fully adhered to the skin;

[0009] Figure 3D Shows a perspective view of a wound closure device applied over a skin wound of a patient, showing a liquid topical skin adhesive being applied to a mesh layer with an adhesive applicator; Figure 1

[0010] Figure 3E Shows a perspective view of a wound closure device applied over a skin wound of a patient, Figure 1 showing an adhesive spreader positioned against the patient at the start of an adhesive spreading stroke for spreading the applied topical skin adhesive over and through the wound closure device;

[0011] Figure 3F Shows a perspective view of a wound closure device applied over a skin wound of a patient, Figure 1 showing the adhesive spreader during a subsequent portion of the adhesive spreading stroke;

[0012] Figure 4 Shows a perspective view of another exemplary wound closure device;

[0013] Figure 5 Shows a perspective view of a cannula that can be used with a wound closure device, Figure 4 ;

[0014] Figure 6A Shows a perspective view of a wound closure device longitudinally aligned with a wound in a patient's skin, Figure 4 ;

[0015] Figure 6B Shows a perspective view of a wound closure device, Figure 4 which is applied over a skin wound of a patient to be adjacent to the edge of the wound;

[0016] Figure 6C Shows a perspective view of a wound closure device applied over a skin wound of a patient, Figure 4 wherein a cannula is inserted into a cannula housing of the wound closure device such that the cannula is longitudinally aligned with a wound in the patient's skin; Figure 5

[0017] Figure 6D Shows a perspective view of a wound closure device applied over a skin wound of a patient and a cannula received in a cannula housing, Figure 4 showing a liquid topical skin adhesive being applied to a mesh layer with an adhesive applicator; Figure 6C Figure 5

[0018] Figure 6E Shows a perspective view of a wound closure device applied over a skin wound of a patient and a cannula received in a cannula housing, Figure 4 ​​​​​Figure 6C The cannula housing Figure 5 a perspective view of a cannula of showing a topical skin adhesive being spread over and through a wound closure device using an adhesive spreader;

[0019] Figure 7A Shown along Figure 6E The line 7-7 is applied to the patient's skin. Figure 4 Wound closure devices and Figure 5 A cross-sectional view of a cannula of the invention wherein a topical skin adhesive covers a wound closure device;

[0020] Figure 7B Shown along Figure 6E The line 7-7 is applied to the patient's skin. Figure 4 Wound closure devices and Figure 5 a cross-sectional view of a cannula of a wound closure device with a topical skin adhesive covering the wound closure device and secreted fluid accumulating within the wound;

[0021] Figure 7C Shown along Figure 6E The line 7-7 is applied to the patient's skin. Figure 4 Wound closure devices and Figure 5 a cross-sectional view of a cannula of a wound closure device, wherein a topical skin adhesive covers the wound closure device and secreted fluid is aspirated from the wound via the cannula;

[0022] Figure 8A shows a cross-sectional view of a base fabric mesh of another exemplary wound closure device applied to the skin of a patient;

[0023] Figure 8B Shown with Figure 8A The top fabric mesh and cannula of the wound closure device are aligned Figure 8A A cross-sectional view of a base fabric mesh;

[0024] Figure 8C Shown attached to Figure 8B The top fabric mesh forms a Figure 8B The cannula housing of the cannula Figure 8A a cross-sectional view of a base fabric mesh of a wound closure device wherein a topical skin adhesive is applied to the wound closure device;

[0025] Figure 9 Shows that Figure 5 A perspective view of an alternative wound closure device for use with a cannula;

[0026] Figure 10 Shows that Figure 5 A perspective view of an alternative wound closure device for use with a cannula;

[0027] Figure 11 shows a perspective view of an alternative wound closure device that can be used with the Figure 5 intubation tube;

[0028] Figure 12 shows a perspective view of an alternative wound closure device that can be used with the Figure 5 intubation tube;

[0029] Figure 13 shows a longitudinal cross-sectional view of a wound closure device coupled to an alternative intubation tube Figure 4 ;

[0030] Figure 14 shows a longitudinal cross-sectional view of an alternative intubation tube;

[0031] Figure 15 shows a longitudinal cross-sectional view of an alternative intubation tube;

[0032] Figure 16 shows a longitudinal cross-sectional view of an alternative intubation tube;

[0033] Figure 17 shows a longitudinal cross-sectional view of an alternative intubation tube; and

[0034] Figure 18 shows a longitudinal cross-sectional view of an alternative intubation tube.

[0035] The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the present invention may be carried out in many other ways, including those not necessarily shown in the drawings. The drawings incorporated in and forming a part of this specification illustrate several aspects of the present invention and, together with the description, serve to explain the principles of the present invention; however, it is to be understood that the present invention is not limited to the specific arrangements shown. DETAILED DESCRIPTION

[0036] The description of certain examples of the present technology should not be used to limit the scope of the present technology. From the following description, other examples, features, aspects, embodiments, and advantages of the present technology will become apparent to those skilled in the art. The following description is given by way of example, which is one of the best ways contemplated for carrying out the present technology. As will be appreciated, the technology described herein can have other different and obvious aspects, all of which do not depart from the present technology. Accordingly, the drawings and description are to be regarded as illustrative in nature and not restrictive.

[0037] For clarity of the disclosure, the terms "proximal" and "distal" are defined herein relative to the human or robotic operator of the surgical instrument. The term "proximal" refers to an element location that is closer to the human or robotic operator of the surgical instrument and farther from the surgical end effector of the surgical instrument. The term "distal" refers to an element location that is closer to the surgical end effector of the surgical instrument and farther from the human or robotic operator of the surgical instrument. It should also be understood that, for convenience and clarity, spatial terms such as "side", "upward", and "downward" are also used herein with reference to relative positions and orientations. For clarity, such terms are used below with reference to views and are not intended to limit the invention described herein.

[0038] In addition, as used herein, the terms "about" and "approximately" in connection with any numerical value or range are intended to cover the exact value recited, as well as a suitable tolerance that enables the recited feature or combination of features to be used for the intended purpose described herein.

[0039] I. Wound Closure System

[0040] Figure 1 An example of a wound closure system (10) is shown, which includes a wound closure device (20) (also referred to as a patch) configured to be applied to a wound (W) of a patient, an adhesive applicator (40) configured to apply a topical skin adhesive (54) (see Figure 3D ) to the applied wound closure device (20), and an adhesive spreader (60) configured to spread the applied topical skin adhesive (54) onto and through the wound closure device (20). Each of these components is described in more detail below.

[0041] Preferably as Figure 2 shown, the wound closure device (20) of this type has an elongated generally rectangular shape and a three-layer structure. More specifically, the wound closure device (20) includes a base layer in the form of a fabric mesh (22), a pressure-sensitive adhesive layer (24) formed as a continuous or discontinuous coating along the skin-facing lower side of the mesh (22), and a backing layer (26) removably applied to the lower side of the pressure-sensitive adhesive (24). It should be understood that, as used herein, the term "wound closure device" encompasses wound closure devices (20) with and without a backing (26), which backing can be removed and discarded during application of the wound closure device (20) to the patient, as described in more detail below.

[0042] The mesh (22) is configured to hold a liquid topical skin adhesive and can be formed of polyethylene (PET) or any other suitable surgical textile material. The pressure-sensitive adhesive (24) is configured to enable the wound closure device (20) to self-adhere to the patient's skin in response to pressure applied by a surgeon to the upper side of the mesh (22) during its application. The backing (26) is used to protect the pressure-sensitive adhesive (24) before the wound closure device (20) is applied to the patient. In this form, the backing (26) includes an elongated perforated array that extends longitudinally and defines an elongated central backing portion (28) and a pair of elongated side backing portions (30). Although each backing portion (28, 30) is shown as generally rectangular in this form, in other forms, the backing portions (28, 30) can be of various alternative shapes, sizes, and numbers.

[0043] As Figure 1 shown, the adhesive application device (40) includes an application device body (42), a plunger unit (44) slidably received within the proximal end of the opening in the application device body (42), and a static mixer (46) fixed to the distal end of the application device body (42). The application device body (42) includes a pair of barrels (48) arranged side by side, with each barrel (48) receiving a respective portion of a two-part liquid topical skin adhesive. The plunger unit (44) includes a pair of plungers (50) that are arranged side by side and interconnected at their proximal ends by a bridge (52). Each plunger (50) can be actuated distally through the respective barrel (48) of the application device body (42) to force the corresponding liquid adhesive portion distally into the static mixer (46). The static mixer (46) is configured to receive a first adhesive portion and a second adhesive portion and direct them around and through a series of static baffles and channels (not shown) that mix the two adhesive portions together into a homogeneous liquid adhesive (54), which is then dispensed through the open distal end of the static mixer (46) as described below Figure 3D shown.

[0044] In this form, the liquid topical skin adhesive (54) is in the form of a silicone-based topical skin adhesive that is configured to cure on the skin in less than two minutes at body temperature. Once cured, the topical skin adhesive (54) remains an elastomer such that a given portion of the cured adhesive (54) is configured to stretch up to 160% of its cured length and then fully recover to its cured length. Thus, the wound closure system (10) can be particularly effective for actuation body parts of a patient, such as, for example, the knee, wrist, elbow, or other joints.

[0045] Also as Figure 1As shown, the adhesive spreader (60) of this type has an integral body that includes a proximal body portion (62) configured to be grasped by a user, a distal body portion (64) terminating at an end configured to spread a topical skin adhesive (54) being applied, and an intermediate flexible body portion (66) interconnecting the proximal body portion (62) and the distal body portion (64). The flexible body portion (66) is configured to be elastically deformed such that the distal body portion (64) angularly deflects relative to the proximal body portion (62) to facilitate effective spreading of the topical skin adhesive (54) along the wound closure device (20) with a suitable normal force within a predetermined range.

[0046] Figures 3A to 3D An example of a wound closure system (10) for closing a wound (W) formed in a patient's skin (S) is shown. In some procedures, the wound (W) may be at least partially closed with one or more sutures prior to using the wound closure system (10), such as at a deeper portion of the wound (W). Additionally, the wound closure device (20) may be trimmed by a surgeon into any suitable shape desired prior to being applied to the patient.

[0047] As Figure 3A shown, the central backing portion (28) is removed from the wound closure device (20) to expose the central window of the mesh (22) and the pressure-sensitive adhesive (24), and the imaginary centerline of the wound closure device (20) is longitudinally aligned with the edges of the wound (W). The wound closure device (20) is then applied to the patient's skin (S) over the wound (W), and the surgeon applies pressure to the central portion of the mesh (22) to force the pressure-sensitive adhesive (24) to adhere to the skin (S), thereby fixing the edges of the wound (W) relative to each other. Prior to this step, the surgeon may hold the edges of the wound (W) in an approximated state. Alternatively, during this step, the central portion of the wound closure device (20) may be applied in a lateral alternating manner to approximate the edges of the wound (W) during application. For either method, the wound closure device (20) is configured to hold the edges of the wound (W) in an approximated state after this initial application step. Once the surgeon is satisfied with the position of the wound closure device (20) relative to the wound (W), the surgeon may remove the remaining side backing portions (30) to adhere the remaining portion of the wound closure device (20) to the skin (S).

[0048] As Figure 3DAs shown, a pattern of topical skin adhesive (54) is then applied to the upper side of the mesh (22) of the applied wound closure device (20) using an adhesive applicator (40). Although in this form the adhesive application device (40) is shown applying a linear bead of topical skin adhesive (54), it should be understood that in other forms various other patterns of topical skin adhesive (54) may be applied, such as the T-shaped pattern or the corrugated pattern disclosed in the following U.S. patent application: U.S. Patent Application No. [Attorney Docket No.: ETH6163USNP1], entitled "Application of Topical Skin Adhesiveto Surgical Mesh", filed on the same day as this application, the disclosure of which is incorporated herein by reference in its entirety.

[0049] As Figures 3E to 3F shown, the applied topical skin adhesive (54) is then evenly spread over the wound closure device (20) using an adhesive spreader (60) to force the topical skin adhesive (54) through the layers of the mesh (22) and the pressure-sensitive adhesive (24) and directly against the wound (W) and the surrounding skin (S). In this regard, the layers of the mesh (22) and the pressure-sensitive adhesive (24) may be at least partially permeable to allow the topical skin adhesive (54) to be forced therethrough. As Figure 3E shown, at the beginning stage of the adhesive spreading stroke, when the adhesive spreader (60) is first positioned against the wound closure device (20), the flexible body portion (66) of the adhesive spreader (60) may be in a non-deformed state. When the adhesive spreader (60) is longitudinally dragged along the wound closure device (20), the input force applied by the user may cause the flexible body portion (66) to elastically deform such that the distal body portion (64) deflects angularly relative to the proximal body portion (62), as Figure 3F shown. The degree of deformation of the flexible body portion (66) may be directly related to the viscosity of the topical skin adhesive (54). Specifically, a greater viscosity may require the user to apply a greater input force through the proximal body portion (62) to effectively spread the topical skin adhesive (54) over and through the wound closure device (20), such that the flexible body portion (66) deforms a relatively greater amount. Conversely, a smaller viscosity may require a smaller input force, such that the flexible body portion (66) deforms less or not at all.

[0050] Optionally, the topical skin adhesive (54) may also be spread over adjacent portions of the skin (S) not covered by the wound closure device (20) to ensure that the entire mesh (22) is encapsulated by the topical skin adhesive (54). By way of example and not limitation, the topical skin adhesive (54) may be spread around the entire outer periphery of the applied wound closure device (20) onto the skin (S) for at least 1 cm. Once the topical skin adhesive (54) has been fully spread over the wound closure device (20), any topical skin adhesive (54) on the skin (S) outside the perimeter of the device (20) may be wiped away, for example, with sterile gauze. Additionally, in some instances, a quantity of the topical skin adhesive (54) may be applied between the edges of the wound (W) prior to applying the wound closure device (20) to the skin (S). The applied topical skin adhesive (54) then cures within and over the wound closure device (20) to form a composite microbial barrier above the wound (W) that maintains a protective environment that promotes effective healing. After the wound (W) has healed, the wound closure device (20) may be manually removed (e.g., by a surgeon) from the skin (S), or it may automatically separate from the skin (S) such that it can be discarded by the patient.

[0051] The wound closure system (10) can also be constructed and operated according to at least some of the teachings of U.S. Patent Publication No. 2021 / 0369258, entitled "Systems, Devices and Methods for Dispensing and Curing Silicone Based Topical Skin Adhesives", published on December 2, 2021, the entire disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2021 / 0371190, entitled "Systems, Methods and Devices for Aerosol Spraying of Silicone Based Topical Skin Adhesives for Sealing Wounds", published on December 2, 2021, the entire disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2021 / 0371658, entitled "Novel Topical Skin Closure Compositions and Systems", published on December 2, 2021, the entire disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 20210369639, entitled "Novel Antimicrobial Topical Skin Closure Compositions and Systems", published on December 2, 2021, the entire disclosure of which is incorporated herein by reference; U.S. Patent Publication No. 2021 / 0369276, entitled "Anisotropic Wound Closure Systems", published on December 2, 2021, the entire disclosure of which is incorporated herein by reference; and / or U.S. Patent Application No. 17 / 667,950, entitled "Gas Sterilizable Syringes Having Apertures Covered By Gas Permeable Barriers For Enabling Ingress and Egress of Sterilization Gases While Preventing Leakage of Flowable Materials", filed on February 9, 2022, the entire disclosure of which is incorporated herein by reference.

[0052] II. Exemplary Wound Closure Device with Cannula Housing

[0053] As described above, after the wound closure device (20) is applied to the wound (W) according to the above description, the topical skin adhesive (54) is appropriately applied and spread within and over the wound closure device (20) to form a composite microbial barrier over the wound (W), thereby maintaining a protective environment that promotes effective healing. Such a microbial barrier can effectively seal the wound (W) from the external environment.

[0054] In some cases, after the wound closure device (20) and the topical adhesive (54) are appropriately applied to the wound (W), exudate and / or other substances may accumulate within the wound (W). In the case of effectively sealing the wound (W) from the external environment, the accumulation of exudate and / or other substances within the wound (W) may result in undesirable consequences such as infection, inhibition of wound closure, and / or other undesirable consequences, which will be apparent to those skilled in the art in light of the teachings herein. Accordingly, it may be desirable to have a wound closure device (20) that is capable of removing accumulated exudate and / or other substances after the wound closure device (20) and the topical adhesive (54) are appropriately applied.

[0055] Figure 4 An exemplary wound closure device (120) is shown, while Figure 5 an exemplary cannula (150) that can be used with the wound closure device (120) is shown. As will be described in more detail below, the cannula (150) can be inserted into the cannula housing (130) of the wound closure device (120) such that the cannula (150) can provide fluid communication between the effectively sealed wound (W) and a suitable fluid and / or suction source. In this example, the wound closure device (120) and the cannula (150) can be used with the topical adhesive (54) and a vacuum source (140) (see Figures 6C to 6E ) to provide a suitable negative pressure within the wound (W) to remove accumulated exudate and / or other substances while providing a suitable microbial barrier as described herein.

[0056] The wound closure device (120) can be substantially similar to the above-described wound closure device (20). Thus, the wound closure device (120) includes a fabric mesh (122), a pressure-sensitive adhesive (124), and a backing (126); they can be substantially similar to the above-described fabric mesh (22), pressure-sensitive adhesive (24), and backing (26), respectively, but with differences detailed below. Thus, the mesh (122) is configured to absorb the liquid topical skin adhesive (54); the backing (126) can be selectively removed to expose the pressure-sensitive adhesive (124); and the pressure-sensitive adhesive (124) is configured to enable the wound closure device (120) to self-adhere to the patient's skin in response to pressure applied by a surgeon to the upper side of the mesh (122) during its application.

[0057] Additionally, the fabric mesh (122) further includes an intubation housing (130) that longitudinally extends from an opening proximal end (130) toward a distal end (134). The intubation housing (130) is positioned on the wound closure device (120) such that once the wound closure device (120) is properly attached to the patient's skin (S), the intubation housing (130) is properly adjacent to the wound (W). In some cases, the intubation housing (130) is properly adjacent to the wound (W) such that it extends at least partially along the length of the wound (W).

[0058] The intubation housing (130) includes a housing structure (135) that defines a longitudinally extending channel (136) having an access opening at an opening proximal end (132). The intubation housing (130) is sized to receive a portion of the intubation tube (150) as shown Figure 5 . Specifically, the distal end (156) of the intubation tube (150) can be inserted through the opening proximal end (132) into the longitudinally extending channel (136) until the array of holes (154) is properly received within the intubation housing (130). As will be described in more detail below, the array of holes (154) can be oriented within the intubation housing (130) to provide fluid communication between the wound (W) and the lumen (158) defined by the intubation tube (150) (see Figures 7A to 7C ). Thus, the fabric mesh (122), the housing structure (135), and / or a suitable portion of the wound closure device (120) are configured to provide fluid communication between the channel (136) and the underside of the wound closure device such that, after the wound closure device (120), the intubation tube (150), and the topical adhesive (54) are properly applied as described herein, the array of holes (154) is in fluid communication with the wound (W).

[0059] The longitudinally extending channel (136) may extend from the proximal end (130) of the opening towards the distal end (134). In some cases, the longitudinally extending channel (136) terminates at the distal end (134). In other cases, the longitudinally extending channel (136) extends through the distal end (134) such that the distal end (134) is also open. In other cases, the longitudinally extending channel terminates before the distal end (134). Thus, the longitudinally extending channel (136) may have any suitable length relative to the remainder of the wound closure device (120), which will be apparent to those skilled in the art in light of the teachings herein.

[0060] In the present aspect of the disclosure, the housing structure (135) is formed of the same material as the fabric mesh (122) and extends above the top surface of the remainder of the fabric mesh (122). In some aspects of the disclosure, the housing structure (135) may be formed of a suitable different material compared to the fabric mesh (122), which will be apparent to those skilled in the art in light of the teachings herein. The housing structure (135) may be formed of any suitable material and may be positioned relative to the fabric mesh (122) in any suitable location, which will be apparent to those skilled in the art in light of the teachings herein.

[0061] Turning to Figure 5 , the cannula (150) includes a cannula body (155) that extends into a distal end (152) that terminates in a distal tip (156). As shown in the current example, the distal tip (156) is closed. In some aspects of the disclosure, the distal tip (156) may be open. The distal end (152) of the cannula body (155) is sized to be inserted into the channel (136) of the cannula housing (130). After being inserted into the cannula housing (130), the distal end (152) of the cannula body (154) may be configured to be able to remain substantially fixed relative to the cannula housing (130) such that the cannula (154) is not accidentally removed from the interior of the housing structure (135). As will be described in more detail below, the interior of the cannula (150) and / or the cannula housing (130) may have additional suitable features to ensure that the cannula (150) remains properly housed within the channel (136).

[0062] The distal end (152) of the cannula body (155) also defines an array of holes (154) that provide fluid communication between the exterior of the cannula body (155) and the lumen (158) defined by the cannula body (155) (see Figures 7A to 7C)。In the current aspect of the present disclosure, the holes (154) are aligned in a longitudinal array on the cannula body (155). The distal end (152) of the cannula body (155) can be oriented within the cannula housing (130) such that once the holes (154) are properly inserted into the cannula housing (130) of the wound closure device (120), the holes face the wound (W) (see Figures 7A to 7C ).

[0063] The cannula body (154) defines at least one lumen (158) that is in fluid communication with the holes (154) (see Figures 7A to 7C ). Preferably as Figures 6C to 6E shown, the cannula body (154) includes a suitable length such that the proximal end of the cannula (150) can be operatively attached to a fluid and / or suction source, such as a vacuum (140). The proximal end of the cannula (150) can include any suitable structure for operatively coupling to the vacuum (140) or any other suitable fluid and / or suction source, which will be apparent to those skilled in the art in light of the teachings herein.

[0064] The vacuum (140) can be configured to provide a suction source such that a suitable negative pressure can be generated within the wound (W). Thus, the negative pressure generated within the wound (W) can drive undesired substances out of the wound (W), through the orifice (154), and through the lumen (158) in order to remove any undesired accumulated exudate and / or other substances, which will be apparent to those skilled in the art.

[0065] In this example, the cannula (150) is in fluid communication with the vacuum (140). In some aspects of the present disclosure, the cannula (150) can be configured to be operatively attached to another fluid and / or suction source, such as a reservoir of a suitable fluid, including but not limited to a therapeutic agent, saline, etc. Additionally, although the cannula (150) is shown as having a single lumen (158) that is in fluid communication with the holes (154), the cannula (150) can include multiple lumens that are fluidly isolated from each other and in fluid communication with their own respective groups of holes (154). Thus, the cannula (150) can be configured to provide suction at the wound (W), as well as deliver a suitable fluid to the wound (W). In some other cases, more than one cannula (150) can be utilized and inserted into the cannula housing (130) or into one or more cannula housings (130).

[0066] Figures 6A to 6E An example is shown of the wound closure system (120) being used with the cannula (150) to close a wound (W) formed in a patient's skin; while Figures 7A to 7CAn exemplary use of a wound closure system (120), cannula (150), and vacuum (140) is shown to create a negative pressure within a wound (W) to remove accumulated exudate and / or other substances. As Figure 6A shown, the backing (126) is appropriately removed while the mesh (122) and pressure-sensitive adhesive (124) are properly aligned with the wound (W) such that the cannula housing (130) is directly adjacent to the wound (W). Next, as Figure 6B shown, the wound closure device (120) is then applied over the wound (W) in the patient's skin (S) in a manner similar to the wound closure device (20) described above. It should be understood that the backing (126) of the wound closure device (120) can be used in a manner similar to the backing (26) of the wound closure device described above. At the moment as Figure 6B shown, the pressure-sensitive adhesive (124) appropriately attaches the wound closure device (120) to the patient's skin (S) at least temporarily.

[0067] Next, as Figure 6C shown, the distal end (152) of the cannula (150) is inserted into the longitudinally extending channel (136) via the proximal opening (132). The distal end (152) can be inserted into the channel (136) any suitable distance, which will be apparent to those skilled in the art in light of the teachings herein. It should be understood that the cannula (150) is oriented within the channel (136) such that the orifice (154) faces the wound (W) (see Figures 7A to 7C ). The distal end (152) can be appropriately secured within the channel (136) after insertion such that the distal end (152) is not accidentally removed from the cannula housing (130) or otherwise inadvertently separated. Accordingly, the interior of the distal end (152) and / or the cannula housing (130) can include features that help facilitate such a connection between the two.

[0068] Also as Figure 6C shown, the proximal end of the cannula (150) is appropriately coupled to the vacuum (140). The vacuum (140) can be located in any suitable position, which will be apparent to those skilled in the art. The vacuum (140) is configured to selectively provide a negative pressure within the cannula (150). The camera (140) can include any suitable components, as will be apparent to those skilled in the art in light of the teachings herein.

[0069] In some cases, the cannula (150) can be a two-piece device where the distal end (152) terminates proximally beyond the opening proximal end (132) (and thus extends partially away from the channel (136)), and the other piece of the cannula (150) is longer and configured to selectively couple to the distal end (152) to provide selective fluid communication with the vacuum (140). In such cases, the open end of the distal end (152) can include a removable cap or seal to maintain a microbial seal when the distal end (152) is not coupled to the second piece of the cannula (150) and the vacuum (140); while also allowing the distal end (152) to selectively couple to the vacuum (140).

[0070] Next, as Figure 6D shown, a pattern of liquid topical skin adhesive (54) is then applied to the upper side of the mesh (122) of the applied wound closure device (120) using an adhesive applicator (40). As Figure 6E shown, the applied topical adhesive (54) is then evenly spread over the wound closure device (120), as well as over the portion of the cannula (150) that extends distally away from the opening proximal end (132) and over the surrounding skin (S) of this portion that is directly adjacent to the cannula (150). The applied topical adhesive (54) then cures within and over the wound closure device (120) (including the proximal opening (132) and the appropriate portion of the cannula (150)) to form a composite microbial barrier over the wound (W), thereby maintaining a protective environment that promotes effective healing.

[0071] As Figures 7A to 7B shown, after a microbial barrier is formed over the wound (W), exudate and / or other substances may tend to accumulate within the wound (W) such that the exudate may not flow out of the wound (W). In such cases, as Figure 7C shown, the vacuum (140) can be selectively activated to create a suitable negative pressure within the wound (W). The suitable negative pressure can create suction within the wound (W) such that the exudate (E) is drawn away from the wound (W), through the aperture (154) into the lumen (158), and towards the vacuum (140). Allowing removal of the exudate (E) can promote faster healing of the wound (W) or other benefits, which will be apparent to those skilled in the art in light of the teachings herein. Negative pressure can be induced within the wound (W) for any other suitable purpose, which will be apparent to those skilled in the art in light of the teachings herein.

[0072] As described above, the cannula housing (130) is formed from a single piece of fabric mesh (122) such that after the wound closure device (120) is properly attached to the skin (S), the cannula (150) can be inserted into the channel (136). However, in some cases, the cannula (150) can be attached simultaneously with the wound closure device (120). In other cases, the cannula (150) can be positioned between two wound closure devices (20). Figures 8A to 8C Another exemplary wound closure system (160) is shown formed by two wound closure devices (20) and a cannula (150) positioned between each wound closure device (20) and adjacent directly to the wound (W).

[0073] First, as Figure 8A shown, in accordance with the description above, the first wound closure device (20) can be attached to the skin (S) covering the wound (W). Next, as Figure 8B shown, the second wound closure device (20) can then be attached on top of the first wound closure device (20) such that the cannula (150) is positioned between each wound closure device (20) while the aperture (154) is adjacent to the wound (W). The pressure sensitive adhesive (24) of the second wound closure device (20) can be attached to the fabric mesh (22) of the first wound closure device (20). Additionally, the pressure sensitive adhesive (24) of the second wound closure device (20) can be attached to the cannula (150) to further facilitate secure placement of the cannula (150) relative to the two wound closure devices (20).

[0074] Once the second wound closure device (20) is positioned on top of the cannula (150) and the first wound closure device (20), the cannula (150) is received within a longitudinally extending channel (180) defined by both the wound closure device (20) and the cannula (150). Next, as Figure 8C shown, a topical adhesive (54) can be applied in accordance with the description herein to form a suitable microbial seal while also providing fluid communication between the cannula (150) and the wound (W). With the cannula (150) properly positioned adjacent to the wound (W), the cannula (150) can be attached to a vacuum (140) such that suction can be provided at the wound (W).

[0075] Figures 9 to 12 Alternative wound closure devices (200, 220, 240, 260) are shown which can be readily substituted for the wound closure device (120) described above. Turning to Figure 9, the wound closure device (200) is substantially similar to the above-described wound closure device (120), but has differences detailed below. Thus, the wound closure device (200) includes a fabric mesh (202), a pressure-sensitive adhesive (204), a backing (206), and an intubation housing (210); they are substantially similar to the above-described fabric mesh (122), pressure-sensitive adhesive (124), backing (126), and intubation housing (130), but have differences detailed below.

[0076] Specifically, the intubation housing (210) includes an intubation housing structure (215) that defines a longitudinally extending (216) channel. The intubation housing structure (215) extends from an open proximal end (212) to a distal end (214). Different from the above-described intubation housing (130), in the current aspect of the present disclosure, the distal end (214) terminates before the peripheral edge of the fabric mesh (202).

[0077] Turning to Figure 10 , the wound closure device (220) is substantially similar to the above-described wound closure device (120), but has differences detailed below. Thus, the wound closure device (220) includes a fabric mesh (222), a pressure-sensitive adhesive (224), a backing (226), and an intubation housing (230); they are substantially similar to the above-described fabric mesh (122), pressure-sensitive adhesive (124), backing (126), and intubation housing (130), but have differences detailed below.

[0078] Specifically, the intubation housing (230) includes a housing structure (235) that defines a longitudinally extending channel (236) and extends from an open proximal end (232) to a distal end (234). Different from the above-described intubation housing (130), in the current aspect of the present disclosure, the distal end (234) terminates before the peripheral edge of the fabric mesh (222). Additionally, the housing structure (235) is tapered such that the open proximal end (232) is wider than the distal end (234). This can help facilitate the easy insertion of the intubation (150) into the channel (236) of the housing structure (235).

[0079] Turning to Figure 11 , the wound closure device (240) is substantially similar to the above-described wound closure device (120), but has differences detailed below. Thus, the wound closure device (240) includes a fabric mesh (242), a pressure-sensitive adhesive (244), a backing (246), and an intubation housing (250); they are substantially similar to the above-described fabric mesh (122), pressure-sensitive adhesive (124), backing (126), and intubation housing (130), but have differences detailed below.

[0080] Specifically, the cannula housing (250) includes a housing structure (255) that defines a longitudinally extending channel (256) and extends from an opening proximal end (252) to a distal end (254). Different from the cannula housing (130) described above, in the current aspect of the present disclosure, both the proximal end (252) and the distal end (254) terminate before the peripheral edge of the fabric mesh (242).

[0081] Turning to Figure 12 , the wound closure device (260) is substantially similar to the wound closure device (120) described above, but has differences detailed below. Thus, the wound closure device (260) includes a fabric mesh (262), a pressure-sensitive adhesive (264), a backing (266), and a cannula housing (270); they are substantially similar to the fabric mesh (122), the pressure-sensitive adhesive (124), the backing (126), and the cannula housing (130) described above, but have differences detailed below.

[0082] Specifically, the cannula housing (270) includes a housing structure (275) that defines a longitudinally extending channel (276). The housing structure (275) extends from an opening proximal end (272) to a distal end (274). The housing structure (275) is formed of a material different from the fabric mesh (262) and also defines a hole (273) in the bottom of the cannula housing (270) to further facilitate fluid communication between the channel (276) and the wound (W) when the wound closure device (260) is properly attached to the skin (S). The hole (273) extends from the lower side of the wound closure device (260) and into the channel (276).

[0083] As described above, the cannula (150) may include features that assist in fixing the inserted cannula (150) relative to the cannula housing (130). Figure 13An exemplary alternative cannula (280) is shown, which is substantially similar to the above-described cannula (150), but has differences detailed below. The cannula (280) includes a distal end (282), an array of holes (284), a distal tip (286), and a lumen (288), which are substantially similar to the above-described distal end (152), array of holes (154), distal tip (156), and lumen (158), but have differences detailed below. Specifically, the cannula (280) includes a plurality of barbs (285) extending from the cannula body at the distal end (282). The barbs (285) extend from the cannula (280) in the proximal direction to engage the cannula housing (130). The barbs (285) are configured to engage the cannula housing (130) sufficiently to resist proximal movement of the cannula (280) relative to the wound closure device (120) after being properly inserted into the cannula housing (130). The proximally angled nature of the barbs (285) may assist in facilitating initial distal insertion of the cannula (280) while preventing proximal retraction. The barbs (285) are atraumatic such that during appropriate use as described herein, the barbs properly engage the cannula housing (130) without damaging and / or disturbing the skin (S) and / or the wound (W).

[0084] Figure 14 Another exemplary cannula (290) is shown, which is substantially similar to the above-described cannula (150), but has differences detailed below. The cannula (290) includes a distal end (292), an array of holes (294), a distal tip (296), and a lumen (298), which are substantially similar to the above-described distal end (152), array of holes (154), distal tip (156), and lumen (158), but have differences detailed below. Additionally, the cannula (290) includes a single barb (295), which is substantially similar to a single barb (285) among the above-described plurality of barbs (285). The single barb (295) is located directly adjacent to the distal tip (296).

[0085] Figure 15 Another exemplary cannula (300) is shown, which is substantially similar to the above-described cannula (150), but has differences detailed below. The cannula (300) includes a distal end (302), an array of holes (304), a distal tip (306), and a lumen (308), which are substantially similar to the above-described distal end (152), array of holes (154), distal tip (156), and lumen (158), but have differences detailed below. Additionally, the cannula (300) includes a single barb (305), which is substantially similar to the above-described single barb (295). In this example, the single barb (305) is positioned closer to the distal tip (306) compared to the above-described single barb (295).

[0086] Figure 16 Another exemplary cannula (310) is shown, which is substantially similar to the cannula (150) described above, but has differences detailed below. The cannula (310) includes a distal end (312), an array of holes (314), a distal tip (316), and a lumen (318), which are substantially similar to the distal end (152), the array of holes (154), the distal tip (156), and the lumen (158) described above, but have differences detailed below. The cannula (300) also includes a plurality of barbs (315), which are substantially similar to the barbs (285) described above, except that the barbs (315) are spaced farther apart from each other. In this example, a single barb (305) is positioned closer to the distal tip (306) compared to the single barb (295) described above.

[0087] Figure 17 Another exemplary cannula (320) is shown, which is substantially similar to the cannula (150) described above, but has differences detailed below. The cannula (320) includes a distal end (322), an array of holes (324), a distal tip (326), and a lumen (328), which are substantially similar to the distal end (152), the array of holes (154), the distal tip (156), and the lumen (158) described above, but have differences detailed below. The cannula (320) also includes a plurality of barbs (325), which are substantially similar to the barbs (285) described above, except that in the current example the barbs (325) are arranged in pairs and they extend in opposite directions. Thus, two barbs (325) extend away from the direction of the holes (334), while the other two barbs (325) extend in the same direction as the direction presented by the holes (334).

[0088] Figure 18 Another exemplary cannula (330) is shown, which is substantially similar to the cannula (150) described above, but has differences detailed below. The cannula (330) includes a distal end (332), an array of holes (334), a distal tip (336), and a lumen (338), which are substantially similar to the distal end (152), the array of holes (154), the distal tip (156), and the lumen (158) described above, but have differences detailed below. The cannula (330) also includes a plurality of barbs (325), which are substantially similar to the barbs (325) described above, but have differences detailed below. However, the barbs (335) are arranged in a proximal array and a distal array of barbs (335), rather than in pairs. In the distal array of barbs (335), two barbs (335) extend away from the direction of the holes (334), while the proximal array of barbs (325) extends in the same direction as the direction presented by the holes (334).

[0089] III. Combined Embodiments

[0090] The following embodiments relate to various non-exhaustive ways in which the teachings herein can be combined or applied. It should be understood that the following embodiments are not intended to limit the scope of any claims that may be provided at any time in the present patent application or in subsequent filings of the present patent application. There is no intention to disclaim. The following embodiments are provided merely for illustrative purposes. It is contemplated that the various teachings herein can be arranged and applied in many other ways. It is also contemplated that some variations may omit certain features mentioned in the following embodiments. Accordingly, none of the aspects or features mentioned below should be considered decisive, unless expressly so specified by the inventor or successors in interest to the inventor at a later date. If any claims presented in the present patent application or in subsequent filings related to the present patent application include additional features other than those mentioned below, such additional features should not be assumed to have been added for any reason related to patentability.

[0091] Embodiment 1

[0092] A device comprising: (a) a cannula defining a lumen, wherein the cannula is configured to be operatively coupled to a suction source to establish fluid communication between the suction source and the lumen, wherein the cannula further includes a distal portion defining at least one aperture, wherein the at least one aperture is in fluid communication with the lumen and the outer surface of the distal portion; and (b) a wound closure device sized to cover a wound in the skin, wherein the wound closure device is configured to receive a layer of topical adhesive to adhere to the skin and form a microbial barrier over the wound, wherein the wound closure device includes a cannula housing defining a channel sized to receive the distal portion of the cannula, wherein the cannula is configured to be inserted into the cannula housing to provide fluid communication between the suction source and the wound after the microbial barrier is formed.

[0093] Embodiment 2

[0094] The device according to any one or more of the preceding embodiments, wherein the wound closure device further includes a fabric mesh.

[0095] Embodiment 3

[0096] The device according to any one or more of the preceding embodiments, wherein the fabric mesh includes the cannula housing.

[0097] Embodiment 4

[0098] The device according to any one or more of the foregoing embodiments, wherein the wound closure device further comprises a pressure-sensitive adhesive configured to temporarily attach the fabric mesh to the wound.

[0099] Embodiment 5

[0100] The device according to any one or more of the foregoing embodiments, wherein the wound closure device further comprises a backing removably covering the pressure-sensitive adhesive.

[0101] Embodiment 6

[0102] The device according to any one or more of the foregoing embodiments, wherein the distal portion of the cannula further comprises a closed distal end.

[0103] Embodiment 7

[0104] The device according to any one or more of the foregoing embodiments, wherein the distal portion of the cannula further comprises at least one barb.

[0105] Embodiment 8

[0106] The device according to any one or more of the foregoing embodiments, wherein the at least one barb comprises a longitudinal array of barbs.

[0107] Embodiment 9

[0108] The device according to any one or more of the foregoing embodiments, wherein the longitudinal array of barbs extends away from at least one hole in the distal portion of the cannula.

[0109] Embodiment 10

[0110] The device according to any one or more of the foregoing embodiments, wherein the wound closure device comprises a first fabric mesh and a second fabric mesh, wherein the distal portion of the cannula is inserted between the first fabric mesh and the second fabric mesh.

[0111] Embodiment 11

[0112] The device according to any one or more of the foregoing embodiments, wherein the second fabric mesh comprises a pressure-sensitive adhesive, wherein the cannula is attached to the pressure-sensitive adhesive.

[0113] Embodiment 12

[0114] The device according to any one or more of the foregoing embodiments, wherein the wound closure device has a generally rectangular shape.

[0115] Embodiment 13

[0116] The device according to any one or more of the foregoing embodiments, wherein the cannula housing includes an open proximal end and a closed distal end.

[0117] Embodiment 14

[0118] The device according to any one or more of the foregoing embodiments, wherein the open proximal end is located at a first peripheral position of the wound closure device.

[0119] Embodiment 15

[0120] The device according to any one or more of the foregoing embodiments, wherein the distal end is located at a second peripheral position of the wound closure device.

[0121] Embodiment 16

[0122] A device comprising: (a) a cannula defining a lumen, wherein the cannula further includes a distal portion defining at least one hole, wherein the at least one hole is in fluid communication with the lumen and the outer surface of the distal portion; and (b) a wound closure device configured to be temporarily fixed relative to a wound and cover the wound, wherein the wound closure device is configured to receive a topical adhesive to form a microbial barrier over the wound, wherein the wound closure device includes a longitudinally extending cannula housing defining a channel sized to receive the distal portion of the cannula, wherein the cannula is configured to be inserted into the longitudinally extending cannula housing to provide fluid communication between a suction source and the wound after the microbial barrier is formed.

[0123] Embodiment 17

[0124] The device according to any one or more of the foregoing embodiments, wherein the cannula housing includes a proximal end and a distal end, wherein the cannula housing is tapered such that the proximal end is wider than the distal end.

[0125] Embodiment 18

[0126] The device according to any one or more of the foregoing embodiments, wherein both the proximal end and the distal end are located within the peripheral edge of the wound closure device.

[0127] Embodiment 19

[0128] A method of applying a wound closure device to a wound, the method comprising: (a) placing a fabric mesh on the patient's wound and temporarily securing the fabric mesh relative to the wound; (b) inserting a cannula defining at least one aperture into a cannula housing defined by the fabric mesh such that the at least one aperture is located within the cannula housing defined by the fabric mesh; (c) applying a topical adhesive to the fabric mesh; (d) spreading the topical adhesive over a portion of the cannula and the fabric mesh to form a microbial barrier over the wound; and (e) providing fluid communication between at least one aperture of the lumen and the wound after the topical adhesive has cured.

[0129] Embodiment 20

[0130] The method according to any one or more of the preceding embodiments, further comprising coupling the cannula to a suction source.

[0131] IV. Miscellaneous

[0132] It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Accordingly, the foregoing teachings, expressions, embodiments, examples, etc. should not be regarded as mutually exclusive. Various suitable ways in which the teachings herein may be combined will be apparent to those of ordinary skill in the art in light of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

[0133] In addition, any one or more of the teachings in the teachings of this document may be combined with any one or more of the teachings in the teachings disclosed in the following patent applications: Serial No. [Attorney Docket No.: ETH6161USPSP1], titled "Spreader Device for Applying Topical Skin Adhesive", filed on the same date as this application, the disclosure of which is incorporated herein by reference in its entirety; U.S. Patent Application No. [Attorney Docket No.: ETH6163USNP1], titled "Application of Topical Skin Adhesive to Surgical Mesh", filed on the same date as this application, the disclosure of which is incorporated herein by reference in its entirety; and / or Serial No. [Attorney Docket No.: ETH6166USNP1], titled "Wound Closure System Having Microfluidic Pathways", filed on the same date as this application, the disclosure of which is incorporated herein by reference in its entirety.

[0134] It should be understood that any patent, patent publication, or other published material purported to be incorporated herein by reference, whether in its entirety or in part, is incorporated herein only to the extent that such incorporated material does not conflict with the existing definitions, statements, or other published material set forth in this disclosure. Accordingly, and to the extent necessary, the disclosure set forth herein expressly supersedes any conflicting material incorporated herein by reference. Any material or portion thereof that is purported to be incorporated herein by reference but conflicts with the existing definitions, statements, or other published material set forth in this document will be incorporated only to the extent that there is no conflict between the incorporated material and the existing published material.

[0135] The types of the above-described devices can be applied to traditional medical treatments and surgeries performed by medical professionals, as well as robot-assisted medical treatments and surgeries. By way of example only, the various teachings herein can be readily incorporated into robotic surgical systems, such as the DAVINCI TM system.

[0136] Devices of the type described above can be designed to be discarded after single use, or they can be designed for multiple use. In either case or both cases, these types can be repaired for reuse after at least one use. Repair can include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts and subsequently reassembling. Specifically, some types of devices can be disassembled, and any number of specific parts or portions of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing specific components, some types of the device can be reassembled at a repair facility or by the user immediately prior to surgery for subsequent use. Those skilled in the art will appreciate that the repair of the device can be carried out for disassembly, cleaning / replacement, and reassembly using a variety of techniques. The use of such techniques and the resulting repaired device are all within the scope of this application.

[0137] By way of example only, the types described herein can be sterilized before and / or after a procedure. In one sterilization technique, the device is placed in a closed and sealed container such as a plastic bag or TYVEK bag. The container and device can then be placed in a radiation field that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation can kill bacteria on the device and in the container. The sterilized device can then be stored in a sterile container for later use. Any other technique known in the art can also be used to sterilize the device, including but not limited to beta radiation or gamma radiation, ethylene oxide, or steam.

[0138] Various embodiments of the invention have been shown and described, and further improvements to the methods and systems described herein can be achieved by appropriate modification by those of ordinary skill in the art without departing from the scope of the invention. Several such possible modifications have been mentioned, and other modifications will be obvious to those skilled in the art. For example, the embodiments, implementations, geometries, materials, dimensions, ratios, steps, etc. discussed above are illustrative and not essential. Therefore, the scope of the invention should be considered in light of the following claims and should be understood to be not limited to the details of the structures and operations shown and described in the specification and drawings.

Claims

1. An apparatus, comprising: (a) a cannula defining a lumen, wherein the cannula is configured to be operatively coupled to a suction source to establish fluid communication between the suction source and the lumen, wherein the cannula further includes a distal portion defining at least one aperture, wherein the at least one aperture is in fluid communication with the lumen and the outer surface of the distal portion; and (b) a wound closure device sized to cover a wound in the skin, wherein the wound closure device is configured to receive a layer of topical adhesive to adhere to the skin and form a microbial barrier over the wound, wherein the wound closure device includes a cannula housing defining a channel sized to receive the distal portion of the cannula, wherein the cannula is configured to be inserted into the cannula housing to provide fluid communication between the suction source and the wound after the microbial barrier is formed.

2. The device according to claim 1, wherein, The wound closure device further includes a fabric mesh.

3. The device according to claim 2, wherein, The fabric mesh includes the cannula housing.

4. The device according to any one of the preceding claims, wherein, The wound closure device further includes a pressure-sensitive adhesive configured to temporarily attach the fabric mesh to the wound.

5. The device according to claim 4, wherein, The wound closure device further includes a backing removably covering the pressure-sensitive adhesive.

6. The device according to any one of the preceding claims, wherein, The distal portion of the cannula further includes a closed distal end.

7. The apparatus according to any one of the preceding claims, wherein, The distal portion of the cannula further includes at least one barb.

8. The device according to claim 7, wherein, The at least one barb includes a longitudinal array of barbs.

9. The apparatus according to claim 8, wherein, The longitudinal array of barbs extends away from at least one aperture of the distal portion of the cannula.

10. The device according to any one of the preceding claims, wherein, The wound closure device includes a first fabric mesh and a second fabric mesh, wherein the distal portion of the cannula is interposed between the first fabric mesh and the second fabric mesh.

11. The apparatus according to claim 10, wherein, The second fabric mesh includes a pressure-sensitive adhesive, wherein the cannula is attached to the pressure-sensitive adhesive.

12. The device according to any one of the preceding claims, wherein, The wound closure device has a generally rectangular shape.

13. The apparatus according to any one of the preceding claims, wherein, The cannula housing includes an open proximal end and a closed distal end.

14. The apparatus according to claim 13, wherein, The open proximal end is located at a first peripheral position of the wound closure device.

15. The device according to claim 13 or 14, wherein, The distal end is located at a second peripheral position of the wound closure device.

16. An apparatus, comprising: (a) a cannula defining a lumen, wherein the cannula further includes a distal portion defining at least one aperture, wherein the at least one aperture is in fluid communication with the lumen and the outer surface of the distal portion; and (b) a wound closure device configured to be temporarily fixed relative to and cover a wound, wherein the wound closure device is configured to receive topical adhesive to form a microbial barrier over the wound, wherein the wound closure device includes a longitudinally extending cannula housing defining a channel sized to receive the distal portion of the cannula, wherein the cannula is configured to be inserted into the longitudinally extending cannula housing to provide fluid communication between a suction source and the wound after the microbial barrier is formed.

17. The apparatus according to claim 16, wherein, The cannula housing includes a proximal end and a distal end, wherein the cannula housing is tapered such that the proximal end is wider than the distal end.

18. The apparatus according to claim 17, wherein, Both the proximal end and the distal end are located within the peripheral edge of the wound closure device.

19. A method of applying a wound closure device to a wound, the method comprising: (a) placing a fabric mesh over a patient's wound and temporarily securing the fabric mesh relative to the wound; (b) inserting a cannula defining at least one hole into a cannula housing defined by the fabric mesh such that the at least one hole is located within the cannula housing defined by the fabric mesh; (c) applying a topical adhesive to the fabric mesh; (d) spreading the topical adhesive onto a portion of the cannula and the fabric mesh to form a microbial barrier over the wound; and (e) providing fluid communication between at least one hole of the lumen and the wound after the topical adhesive has cured.

20. The method of claim 19, further comprising coupling the cannula to a suction source.

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