Medically applicable placeholder and method for gassing a surface of a medical placeholder

Abstract

Medical placeholder comprising at least one hollow body (1, 21, 41, 61, 81, 101) which is expandable and which defines an interior space within the hollow body (1, 21, 41, 61, 81, 101), a gas inlet tube (2, 22, 42, 62, 82, 102) which is connected or connectable to the interior space of the hollow body (1, 21, 41, 61, 81, 101) in a gas-permeable manner, a gas outlet tube (3, 23, 43, 63, 83, 103) which is connected or connectable to the interior space of the hollow body (1, 21, 41, 61, 81, 101) in a gas-permeable manner, wherein the hollow body (1, 21, 41, 61, 81, 101) consists at least partially or completely of at least one plastic that is permeable to oxygen and carbon dioxide, wherein a one-way valve (4, 24, 44) is arranged in the gas inlet hose (2, 22, 42, 62, 82, 102) and a pressure relief valve (5, 25, 45) is arranged in the gas outlet hose (3, 23, 43, 63, 83, 103).

Description

[0001] The invention relates to a medical spacer for the treatment of bone defects. The invention also relates to a method for gassing a surface of a medical spacer.

[0002] The invention relates to an expandable medical spacer for temporary implantation in bone cavities. In addition to its space-maintaining function, the medical spacer is also designed for gas exchange with the surrounding tissue, wherein oxygen or an oxygen-containing flushing gas mixture or an oxygen-enriched flushing fluid flows continuously or discontinuously through the interior of the spacer and oxygen can be supplied to the tissue and carbon dioxide simultaneously removed via the permeable outer wall of the spacer.

[0003] Large segmental defects of long bones still pose a significant challenge for surgeons. These defects can be caused by trauma, infected pseudoarthroses, and chronic osteitis, among other factors. These bone defects are frequently treated using the Illizarov technique. For large diaphyseal and metaphyseal bone defects larger than 3 cm, the Masquelet technique is another treatment option. In this procedure, the bone defect is extensively debrided in the first operation, and a bone cement spacer is inserted into the medullary canal. The bone cement spacer is then covered with soft tissue. Adequate soft tissue coverage is essential for successful treatment. Mechanical stabilization of the bone defect is achieved using an external fixator. Over a period of four to six weeks, a vascularized connective tissue membrane forms around the bone cement spacer.This process regenerates the periosteum. The bone cement spacer is then removed in a second operation. This typically involves at least one longitudinal incision. Every effort is made to preserve the newly formed connective tissue membrane as much as possible, which is challenging because the bone cement spacer has a diameter equal to that of the medullary cavity. The medullary cavity is then filled with autologous cancellous bone, bone substitute materials, or mixtures of autologous cancellous bone and bone substitute materials. In most cases, membrane-guided ossification then occurs along the connective tissue membrane.

[0004] A disadvantage is that removing the bone cement spacer or placeholder disrupts the connective tissue membrane, which is subsequently needed for ossification. Furthermore, it would be desirable for the connective tissue membrane to regenerate quickly and stably to support the subsequent healing process.

[0005] At the same time, the placeholder should be variably adaptable to different treatment situations.

[0006] The invention aims to develop a medical spacer that can be implanted as a temporary implant in bone cavities or bone defects. The spacer's volume and shape should be variable as much as possible. It should be removable from the bone cavities or defects in such a way that minimal damage to the adjacent tissue occurs. The connective tissue membrane surrounding the spacer should remain as intact as possible. Furthermore, the spacer should allow gas exchange with the human tissue that is in contact with the spacer immediately after implantation or that forms there during the implantation period. The tissue should be supplied with oxygen, and at the same time, the carbon dioxide produced during tissue metabolism should be removed continuously or discontinuously.The spacer is intended to be suitable as a temporary implant for the Masquele technique in the treatment of large bone defects.

[0007] The objects of the invention are solved by a medical placeholder comprising at least one hollow body which is expandable and which defines an interior space within the hollow body, a gas inlet hose which is connected or connectable to the interior space of the hollow body in a gas-permeable manner, a gas outlet hose which is connected or connectable to the interior space of the hollow body in a gas-permeable manner, wherein the hollow body consists at least partially or completely of at least one plastic which is permeable to oxygen and carbon dioxide.

[0008] Preferably, the medical placeholder may be designed to be suitable for temporary implantation in bone cavities.

[0009] It is also preferable that the hollow body be made of a plastic that is permeable to oxygen and carbon dioxide.

[0010] Furthermore, it can be provided that the hollow body is expandable to such an extent that the volume of the hollow body can be increased by at least 50%, preferably by at least 100%, and most preferably by at least 200%.

[0011] Furthermore, it can be provided that the hollow body is elastically expandable to such an extent that the volume of the hollow body can be increased reversibly and non-destructively by at least 50%, preferably by at least 100%, and particularly preferably by at least 200%.

[0012] It may also be preferable to provide that the interior space is closed off from the surroundings of the medical placeholder.

[0013] According to a preferred further development, it can be provided that at least one plastic is impermeable to liquids.

[0014] The hollow body, or the plastic hollow body, forms a common interior space with the gas inlet and outlet hoses, preferably sealed from the environment, so that the hollow body can expand when pressurized rinsing gas (or a rinsing gas mixture) or an oxygen-containing rinsing fluid is introduced. It is advantageous if the wall of the hollow body is made of a rubber-elastic plastic or a plastically deformable plastic, allowing the hollow body to be inflated or expanded. This makes it possible to adapt the shape of the hollow body, and thus of the medical spacer, to the shape of the bone defect or cavity to be temporarily filled.

[0015] The at least one plastic preferably forms a continuous wall of the hollow body, at least in certain areas. This means that there are areas of the hollow body's wall where, apart from the at least one plastic, no other additional material is present. Highly permeable meshes and wires, especially those made of metal, do not interfere with this. This is intended to ensure that the permeability of the plastic to oxygen and carbon dioxide can be used to make the wall of the hollow body permeable to oxygen and carbon dioxide, at least in these areas.

[0016] It is therefore preferable to provide that a wall bounding the interior of the hollow body is permeable to oxygen and carbon dioxide.

[0017] According to a preferred embodiment of the present invention, the hollow body can be tubular in shape, with the gas inlet hose and the gas outlet hose preferably being connected to the interior of the hollow body at one end face or at two opposite end faces. Tubular hollow bodies are particularly well suited as spacers, especially in cases of bone defects in long bones.

[0018] The hollow body can also have any other shape, depending on the size and shape of the bone defect to be temporarily filled.

[0019] In the present invention, it can also be provided that the hollow body or at least one plastic of the hollow body has a permeability coefficient for oxygen of greater than or equal to 0.5 cm. 3 / (m 2*d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar) has, preferably a permeability coefficient for oxygen of greater than or equal to 1 cm 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 1 cm 3 / (m 2 *d*bar).

[0020] This allows for a good supply of oxygen to the connective tissue membrane and a good removal of carbon dioxide from the connective tissue membrane, taking place from the inside of the connective tissue membrane.

[0021] The permeability coefficient is determined according to DIN 53380-4 (11 / 2006). This standard specifically addresses the testing of plastics, particularly the determination of gas permeability. Part 4 of DIN 53380 standardizes a carbon dioxide-specific infrared absorption method for measuring permeability on plastic films and molded plastic parts, which is also applicable to oxygen. Such measurements are performed and offered, for example, by Mecadi GmbH (Bexbach, Germany).

[0022] It may therefore be preferable that the hollow body, or at least one plastic component of the hollow body, has a permeability coefficient for oxygen of greater than or equal to 0.5 cm. 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of equal to or greater than 0.5 cm 3 / (m 2*d*bar) according to DIN 53380-4 (11 / 2006), preferably has a permeability coefficient for oxygen of greater than or equal to 1 cm 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 1 cm 3 / (m 2 *d*bar) according to DIN 53380-4 (11 / 2006).

[0023] Permeability generally refers to the property of solids to allow gases and / or liquids to pass through. In this context, it refers to the permeability of the walls of the hollow body, specifically to molecular oxygen and molecular carbon dioxide in gaseous form. The permeability coefficient is a material-specific constant and is a measure of the permeability to liquids and gases.

[0024] The unit d stands for one day.

[0025] Furthermore, it may be provided that an inlet opening of the gas inlet hose, through which the gas inlet hose opens into the interior, is spatially separated from an outlet opening of the gas outlet hose, the outlet opening forming the inlet of the interior into the gas outlet hose.

[0026] This ensures that, when flowing through the hollow body, the purging gas or purging liquid has sufficiently long contact with the inner wall of the hollow body or of at least one plastic, thereby promoting a gas exchange of oxygen and carbon dioxide through the wall of the hollow body or of at least one plastic.

[0027] The inlet opening is the opening in the gas inlet hose through which the purge gas or purge liquid flows from the gas inlet hose into the interior of the hollow body. Similarly, the outlet opening is the opening in the gas outlet hose through which the purge gas or purge liquid flows out of the interior of the hollow body into the gas outlet hose.

[0028] It may be provided that the inlet opening of the gas inlet hose is located at a first end of the hollow body and the outlet opening is located at a second end of the hollow body opposite the first end.

[0029] This increases the residence time of the flowing purge gas or purge liquid on the inner wall of the hollow body or on the inner wall of the at least one plastic and improves the gas exchange through the hollow body or the at least one plastic.

[0030] Furthermore, it can be provided that the gas inlet hose and the gas outlet hose are arranged coaxially to each other in certain areas, preferably both being guided together through a feedthrough from the hollow body.

[0031] This results in only one access point to the cavity and only one shared passage to the treatment area, thus reducing the risk of microbial contamination at the junction of the coaxial gas inlet and outlet tubes from the outside of the body to the inside. As an alternative to coaxial tubes, it is possible to use a tube divided into two by a partition, for example, two crescent-shaped or semicircular tubes.

[0032] It can also be provided that the gas inlet hose and the gas outlet hose are connected to each other, wherein preferably the gas inlet hose and the gas outlet hose have a common outer hose and wherein the common outer hose is particularly preferably divided by a partition wall that limits the gas inlet hose on one side and limits the gas outlet hose on the other side.

[0033] A partition wall is also particularly preferred for dividing the common outer hose into two hoses with a crescent or semicircular cross-section, forming the gas inlet hose and the gas outlet hose.

[0034] This also reduces the risk of microbial contamination.

[0035] According to a preferred embodiment of the present invention, it can also be provided that a germ-impermeable but gas-permeable sterile filter is arranged in the gas inlet hose and / or the gas outlet hose.

[0036] This reduces the risk of infection for both the patient being treated and the staff providing treatment.

[0037] Furthermore, it may be provided that a valve is arranged in the gas inlet hose and / or the gas outlet hose, wherein preferably the gas inlet hose and / or the gas outlet hose can be shut off with the valve.

[0038] This allows the expanded state (the inflated state) of the hollow body to be maintained and, if necessary, preserved even when the purge gas supply or purge liquid supply is removed.

[0039] It is also preferably provided that the sterile filter is arranged in the gas inlet hose or the gas outlet hose downstream of the valve in the direction of flow, or that the sterile filters are arranged downstream of the valves in the gas inlet hose and in the gas outlet hose.

[0040] This can also reduce the risk of infection for the patient being treated and the staff providing treatment.

[0041] Furthermore, it can be provided that the valve is located in the gas inlet hose and is designed as a one-way valve.

[0042] This ensures an automatic, gas-tight seal of the gas inlet hose when the purge gas or purge fluid supply is disconnected, without the need for manual valve operation. This significantly improves the operational safety of the medical placeholder.

[0043] According to a preferred embodiment, the valve can be arranged in the gas discharge hose and be designed as a pressure relief valve, preferably with the opening pressure of the pressure relief valve being adjustable.

[0044] This ensures that the expanded state of the hollow body can be reliably achieved.

[0045] It can also be provided that the gas inlet hose and the gas outlet hose are made of a material that is impermeable to oxygen and carbon dioxide, preferably of a plastic that is impermeable to oxygen and carbon dioxide.

[0046] This prevents the oxygen from escaping the purge gas or purge liquid too early. Furthermore, the gas inlet hose and the gas outlet hose can then be manufactured from a more cost-effective plastic.

[0047] Furthermore, it may be provided that the hollow body or at least one plastic of the hollow body contains at least one antiseptic agent or is coated with at least one antiseptic agent.

[0048] This allows the surface of the medical placeholder and the area surrounding it within the patient's body to be disinfected with at least one antiseptic agent. This helps prevent complications during treatment.

[0049] Furthermore, it can be provided that in at least one wall of the hollow body or of the at least one plastic of the hollow body, feedthroughs are arranged which have openings pointing towards the outside of the hollow body and which connect at least one channel to the environment of the hollow body permeably for liquids and gases, wherein the at least one channel is provided for introducing liquids into the hollow body to the feedthroughs, wherein preferably the at least one channel is connected to a supply hose for pharmaceutical active ingredient solutions, wherein a connection adapter, in particular a Luer-Lock adapter, is particularly preferably arranged on the supply hose.

[0050] This allows the feedthroughs to be connected to the supply tube, through which antiseptic or antibiotic solutions can be forced into the feedthroughs. The feedthroughs provide antimicrobial protection to the surface of the hollow body. It is also possible to introduce liquid or gel-like antibiotic or antiseptic pharmaceutical preparations into the feedthroughs, which can migrate into the surrounding area by diffusion and thus be used to treat the patient in the area of ​​the medical device.

[0051] Furthermore, it can be provided that hollow bodies in the uninflated state rest against the gas inlet hose and / or the gas outlet hose, wherein preferably the hollow body or at least one plastic part is inflatable in the manner of a balloon.

[0052] This makes the medical placeholder compact in its uninflated (unexpanded) state, allowing it to be more easily inserted into and removed from the bone defect.

[0053] The problems underlying the present invention are also solved by a method for gassing a surface of a medical placeholder, in particular a medical placeholder according to the invention, characterized by the following steps: A) Expanding a hollow body by introducing a purging liquid or a purging gas containing oxygen into an interior of the hollow body, so that the interior of the hollow body is enlarged; B) Release of gaseous oxygen from the purge liquid or purge gas through a plastic material enclosing the interior to the surroundings of the hollow body; C) Absorption of gaseous carbon dioxide from the environment of the hollow body through the plastic enclosing the interior into the rinsing liquid or rinsing gas; D) Passing the purging liquid or purging gas through the interior of the hollow body and draining the purging liquid or purging gas from the interior.

[0054] Steps B) and C) preferably occur simultaneously. Furthermore, gas exchange in steps B) and C) preferably begins during step A) and continues throughout step D).

[0055] Air or oxygen can be used as the purge gas. Within the scope of the invention, it is also possible to introduce oxygen-saturated purge fluids, such as physiological saline solution, Ringer's solution, or Ringer's lactate solution, into the expandable medical placeholder instead of air or oxygen as the purge gas, particularly through the gas inlet tube. Furthermore, it is also possible to use perfluorinated decalin or other perfluorinated purge fluids in which oxygen is soluble as the oxygen carrier. These purge fluids can be drained from the hollow body through the gas outlet tube.

[0056] It may be intended that the procedure is not performed for the medical treatment of a human or animal body.

[0057] It may be preferable that the procedure be carried out outside of a human or animal body.

[0058] It may also be provided that the method according to the invention is not carried out by a doctor or a medical professional.

[0059] Preferably, it may also be provided that before step A) the hollow body is inserted into a cavity, wherein during step A) the shape of the inflated hollow body adapts at least partially to the shape of the cavity and during steps B) and C) is in contact with the cavity at least partially.

[0060] The cavity is preferably not a cavity of a human or animal body.

[0061] By inserting the device into the cavity, the advantages of the method are fully realized. The gas exchange between the cavity and the interior of the hollow body brings about the advantages according to the invention.

[0062] Furthermore, it may be provided that in step A) the hollow body is inflated until a minimum pressure is reached, whereby when the minimum pressure is reached a valve opens through which the purging liquid or purging gas is discharged from the interior of the hollow body during step D).

[0063] This allows the shape of the hollow body to be adapted to a surrounding shape, so that the environment of the hollow body can be mechanically stabilized by the hollow body.

[0064] The invention is based on the surprising finding that the expandable medical spacer successfully supports the formation of a connective tissue membrane by adapting to the shape of the bone defect, ensuring oxygen supply to the connective tissue membrane, and preventing acidification of the membrane by carbon dioxide or carbonic acid. Simultaneously, the medical spacer can be more easily removed after volume contraction through a small incision in the connective tissue membrane. For these reasons, faster and more effective ossification can be achieved, thus accelerating the healing process.The particular advantage lies in the fact that the inner surface of the connective tissue layer, which is away from the bloodstream and is normally poorly supplied with oxygen by the bloodstream, can be better supplied with the medical spacer according to the invention, since it is directly adjacent to the connective tissue layer. This is not possible with conventional solid spacers.

[0065] The advantage of the medical spacer according to the invention is that the hollow body can be adapted in shape to the bone defect to be filled by expansion (for example, by inflation). Furthermore, it is advantageous that after completion of the implantation phase, the hollow body can reduce its volume by applying negative pressure, thereby allowing its removal through a small opening in the formed connective tissue membrane, so that the connective tissue membrane remains largely undamaged. A significant advantage of the medical spacer according to the invention is the supply of oxygen to the cells of the developing connective tissue membrane and the removal of the accumulating carbon dioxide. This enables oxygen deficiency even when covering a previously damaged soft tissue. The removal of carbon dioxide prevents acidification of the cells of the developing connective tissue membrane.These two processes support the formation of a vital connective tissue membrane.

[0066] Essential for ossification is that the vascularized connective tissue membrane is sufficiently vital and is supplied with oxygen and nutrients by the overlying soft tissue.

[0067] Within the scope of the present invention, it was recognized that during the implantation period of conventional bone cement spacers, the developing connective tissue membrane is primarily supplied with oxygen and nutrients by the overlying soft tissue. The removal of carbon dioxide produced during metabolism also occurs via the overlying soft tissue. If the soft tissue is only present in a thin layer or if pre-existing soft tissue damage has occurred due to the bone defect, delayed formation of the connective tissue membrane is to be expected as a result of insufficient oxygen and nutrient supply as well as inadequate carbon dioxide removal. It is desirable to reliably generate a connective tissue membrane even with minimal soft tissue coverage or with pre-existing soft tissue coverage.For optimal oxygen supply to occur, the cells located directly on the spacer surface should be ensured. Furthermore, any carbon dioxide produced should be removed to prevent a drop in the local pH value. A decrease in pH can cause cell damage.

[0068] An exemplary expandable medical placeholder according to the invention may, for example, have: a) at least one expandable plastic hollow body with an interior space, b) at least one gas inlet hose which is connected to the interior of the plastic hollow body in a gas-permeable manner, c) at least one gas vent hose which is connected to the interior of the plastic hollow body in a gas-permeable manner, and d) wherein the plastic hollow body has a permeability coefficient for oxygen of 0.5 cm³ or greater 3 / (m 2* d * bar) and a permeability coefficient for carbon dioxide of equal to / greater than 0.5 cm 3 / (m 2 * d * bar) owns.

[0069] Six further embodiments of the invention are explained below with reference to nineteen schematically represented figures, without, however, limiting the invention. These figures show: Fig. 1: a schematic top view of a first exemplary medical placeholder according to the invention in the compressed state; Fig. 2: A schematic cross-sectional view of the first exemplary medical placeholder according to Fig. 1 in the compressed state, where the cutting plane lies in the image plane of the Fig. 1 lies; Fig. 3: A schematic overview of the first exemplary medical placeholder according to the Fig. 1 and Fig. 2 in the expanded state; Fig. 4: A schematic cross-sectional view of the medical placeholder according to the Fig. 1 to Fig. 3 in the expanded state, with the cutting plane in the image plane of the Fig. 3 lies; Fig. 5: the schematic cross-sectional view according to Fig. 4, where the flow conditions are indicated by arrows; Fig. 6: a schematic top view of a second exemplary medical placeholder according to the invention in the compressed state; Fig. 7: A schematic cross-sectional view of the second exemplary medical placeholder according to Fig. 6 in the compressed state, with the cutting plane in the image plane of the Fig. 6 lies; Fig. 8: A schematic cross-sectional view of the second exemplary medical placeholder according to the Fig. 6 and Fig. 7 in the expanded state; Fig. 9: A schematic perspective partial cross-sectional view of the second exemplary medical placeholder according to the Fig. 6 to Fig. 8 in the expanded state, with the cutting plane in the image plane of the Fig. 6 lies; Fig. 10: a schematic cross-sectional view of a third exemplary medical placeholder according to the invention in the compressed state; Fig. 11: A schematic cross-sectional view of the third exemplary medical placeholder according to Fig. 10 in the expanded state; Fig. 12: A schematic perspective partial cross-sectional view of the third exemplary medical placeholder according to the Fig. 10 and Fig. 11 in the expanded state; Fig. 13: a schematic cross-sectional view of a fourth exemplary medical placeholder according to the invention in the compressed state; Fig. 14: A schematic cross-sectional view of the fourth exemplary medical placeholder according to Fig. 13 in the expanded state; Fig. 15: A schematic perspective partial cross-sectional view of the fourth exemplary medical placeholder according to the Fig. 13 and Fig. 14 in the expanded state; Fig. 16: a schematic cross-sectional view of a fifth exemplary medical placeholder according to the invention in the compressed state; Fig. 17: A schematic cross-sectional view of the fifth exemplary medical placeholder according to Fig. 16 in the expanded state; Fig. 18: a schematic cross-sectional view of a sixth exemplary medical placeholder according to the invention in the compressed state; and Fig. 19: A schematic cross-sectional view of the sixth exemplary medical placeholder according to Fig. 18 in the expanded state.

[0070] In the Fig. 1 to Fig. 17 is the front of the respective medical placeholder facing downwards and the back facing upwards.

[0071] In the Fig. 1 to Fig. Figure 5 shows illustrations of a first medical placeholder according to the invention. Fig. 1 and Fig. Figure 2 shows the placeholder in its compressed state and the Fig. 3 to Fig. Figure 5 shows the placeholder in the expanded state.

[0072] The first medical placeholder according to the invention can be a hollow body 1 made of an elastically or plastically deformable plastic. The hollow body 1 It can be expandable by being inflated with a purging gas or by having a purging liquid forced into the hollow body under pressure. 1 is pressed in. The hollow body 1 It can, for example, be made of rubber.

[0073] The one for the hollow body 1 The material used can be permeable to gaseous molecular oxygen and gaseous carbon dioxide. The hollow body 1 or the material from which the hollow body is made 1 If manufactured, a permeability coefficient for oxygen of greater than or equal to 0.5 cm can be used for this purpose. 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar). The permeability coefficient is determined according to DIN 53380-4 (11 / 2006).

[0074] To introduce a purging fluid (a purging gas or a purging liquid), an interior of the hollow body can be used. 1 with a gas inlet hose 2 They must be made of plastic. They are used to drain the purge fluid (purge gas or purge liquid) from the hollow body. 1 The interior of the hollow body can be accessed from within.1 with a gas vent hose 3 The gas inlet hose must be made of plastic. 2 and the gas vent hose 3 They can be flexible and movable, at least in certain areas. In the gas inlet hose 2 can a valve 4 be arranged in the form of a lip valve that allows a flow of the rinsing fluid towards the hollow body 1 However, it allows the flushing fluid to flow in the direction away from the hollow body. 1 prevented from doing so. In the gas vent hose. 3 can a valve 5 be arranged in the form of a lip valve that allows a flow of the rinsing fluid towards the hollow body 1 However, it prevents the flow of the flushing fluid in the direction away from the hollow body. 1 Way allowed. The valve 5 It can be designed to open at a minimum pressure of the flushing fluid. Preferably, the minimum pressure is at the valve. 5Adjustable. The minimum pressure can be selected so that the pressure of the flushing fluid is sufficient to fill the hollow body. 1 from the compressed state (see Fig. 1 and Fig. 2) to transform into the expanded state (see Fig. 3 to Fig. 5).

[0075] The valves 4 , 5 can be connected via connecting sleeves 6 , 7 with the gas inlet hose 2 and the gas vent hose 3 be connected. The gas inlet hose can be used for this purpose. 2 on the connecting sleeve 6 be inserted and secured there with a crimp sleeve 14 be attached.

[0076] The gas vent hose can also be used 3 on the connecting sleeve 7 be inserted and secured there with a crimp sleeve 15 be attached.

[0077] The gas inlet hose 2 can be attached to its back in an adapter 8It can end in the form of a Luer-lock adapter. The gas vent hose can also be... 3 on its back in an adapter 9 They end in the form of a Luer-lock adapter. Through the adapters 8 , 9 The flushing fluid can be fed in and discharged.

[0078] The gas inlet hose 2 can be accessed via an inlet opening 10 into the front part of the interior of the hollow body 1 discharge, while the gas discharge hose 3 via an outlet opening 11 on the opposite rear side of the interior of the hollow body 1 with the interior of the hollow body 1 This ensures that the rinsing fluid flows along the surface of the wall of the entire hollow body. 1 can flow, thereby allowing a gas exchange of oxygen and carbon dioxide through the wall along the entire length of the hollow body. 1 can be done.

[0079] The valve 4 can a valve housing 12 exhibit the valve housing 12 can be connected via internal threads to external threads of the connecting sleeves 6 be connected. The valve 5 can a valve housing 13 exhibit the valve housing 13 can be connected via internal threads to external threads of the connecting sleeves 7 They must be connected. All connections can be gas-tight and pressure-tight.

[0080] The gas inlet hose 2 can be attached to a port of the adapter 8 be attached and secured there with a crimp sleeve 16 The gas vent hose must be attached in a pressure-tight and gas-tight manner. 3 can be attached to a port of the adapter 9 be attached and secured there with a crimp sleeve 17 They must be fastened in a pressure-tight and gas-tight manner.

[0081] The hollow body 1In its compressed state, it can also be inserted into a cavity through a small opening. There, the hollow body can... 1 to be expanded and thus change the outer shape of the hollow body 1 to be adapted to the cavity. The expanded hollow body 1 The placeholder, or rather the spacer in its expanded state, can thus mechanically support and stabilize the cavity. When the placeholder is no longer needed, the hollow body can 1 to be returned to its compressed state, for example by evacuation. The hollow body 1 It can then be removed from the cavity through a narrow opening. This is a particularly gentle way to treat bone defects, especially if the cavity is a hollow in a bone.

[0082] During operation, the rinsing fluid can pass through the adapter. 8 The flushing fluid is fed into the medical placeholder. It can be introduced through the gas inlet hose.2 flow and, at sufficient pressure, the valve 4 open. Then the rinsing fluid can pass through the inlet opening. 10 into the hollow body 1 and through the hollow body 1 The flushing fluid can flow through the gas vent hose. 3 until the initially closed valve 5 flow. This can occur inside the hollow body. 1 build up pressure with which the hollow body 1 is transformed into the expanded state (see Fig. 5) As soon as the pressure at the valve 5 in the gas discharge hose 3 If that is sufficient, the valve opens. 5 and the flushing fluid flows through the gas vent hose. 3 and the adapter 9 away.

[0083] The rinsing fluid contains oxygen. The rinsing fluid can pass through the wall of the hollow body. 1 Oxygen to the surroundings of the hollow body 1Release. At the same time, the flowing flushing fluid can release carbon dioxide from the surroundings of the hollow body. 1 , which passes through the wall of the hollow body 1 diffused into the interior, absorbed, and from the medical placeholder through the adapter 9 derive this. This allows the surroundings of the hollow body to be analyzed. 1 They are supplied with oxygen and, through the absorption of carbon dioxide, an acidification of the environment of the hollow body occurs. 1 be prevented.

[0084] In the gas inlet hose 2 and / or in the gas discharge hose 3 Sterile filters (not shown), preferably impermeable to germs but permeable to gases, can be arranged. The rinsing fluid can be freed from germs by the sterile filter, which would otherwise enter the hollow body. 1 could get in and / or the hollow body 1 through the adapter 9This could be derived. This reduces the risk of infection for the treated patient and the treating staff.

[0085] Preferably, the sterile filter can be placed in the gas inlet hose. 2 or the gas vent hose 3 in the direction of flow behind the valve 4 or the valve 5 be arranged or the sterile filters in the gas inlet hose 2 and in the gas vent hose 3 behind the valves 4 , 5 be arranged.

[0086] It may also be intended that the hollow body 1 as well as the adjacent areas of the hoses 2 , 3 is coated with an antiseptic substance or contains a soluble antiseptic substance in the material of the hollow body 1 It is included to prevent infection.

[0087] For treating the area surrounding the hollow body 1It may also be provided that in at least one wall of the hollow body 1 or at least one plastic component of the hollow body 1 Feedthroughs (not shown) are arranged that point towards the outside of the hollow body. 1 have openings that provide at least one channel (not shown) to the surroundings of the hollow body 1 Connect channels that are permeable to liquids and gases. At least one channel can be used to introduce liquids into the hollow body. 1 The channels are designed for various applications. Furthermore, at least one channel can be connected to a supply tube (not shown) for pharmaceutical solutions. This allows a pharmaceutical solution to be applied to the surface of the hollow body. 1 to be handed in.

[0088] In the Fig. 6 to Fig. Figure 9 shows illustrations of a second medical placeholder according to the invention. Fig. 6 and Fig. Figure 7 shows the placeholder in its compressed state and the Fig. 8 and Fig. Figure 9 shows the placeholder in its expanded state.

[0089] The second medical placeholder according to the invention can be a hollow body 21 made of an elastically or plastically deformable plastic. The hollow body 21 It can be expandable by being inflated with a purging gas or by having a purging liquid forced into the hollow body under pressure. 21 is pressed in. The hollow body 21 It can, for example, be made of rubber.

[0090] The one for the hollow body 21 The material used can be permeable to gaseous molecular oxygen and gaseous carbon dioxide. The hollow body 21 or the material from which the hollow body is made 21 If manufactured, a permeability coefficient for oxygen of greater than or equal to 0.5 cm can be used for this purpose. 3 / (m2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar). The permeability coefficient is determined according to DIN 53380-4 (11 / 2006).

[0091] To introduce a purging fluid (a purging gas or a purging liquid), an interior of the hollow body can be used. 21 with a gas inlet hose 22 They must be made of plastic. They are used to drain the purge fluid (purge gas or purge liquid) from the hollow body. 21 The interior of the hollow body can be accessed from within. 21 with a gas vent hose 23 The gas inlet hose must be made of plastic. 22 and the gas vent hose 23 They can be flexible and movable, at least in certain areas. In the gas inlet hose 22 can a valve 24be arranged in the form of a lip valve that allows a flow of the rinsing fluid towards the hollow body 21 However, it allows the flushing fluid to flow in the direction away from the hollow body. 21 prevented from doing so. In the gas vent hose. 23 can a valve 25 be arranged in the form of a lip valve that allows a flow of the rinsing fluid towards the hollow body 21 However, it prevents the flow of the flushing fluid in the direction away from the hollow body. 21 Way allowed. The valve 25 It can be designed to open at a minimum pressure of the flushing fluid. Preferably, the minimum pressure is at the valve. 25 Adjustable. The minimum pressure can be selected so that the pressure of the flushing fluid is sufficient to fill the hollow body. 21 from the compressed state (see Fig. 6 and Fig. 7) to transform into the expanded state (see Fig. 8 and Fig. 9).

[0092] The valves 24 , 25 can be connected via connecting sleeves 26 , 27 with the gas inlet hose 22 and the gas vent hose 23 be connected. The gas inlet hose can be used for this purpose. 22 on the connecting sleeve 26 be inserted and secured there with a crimp sleeve 34 be secured. The gas vent hose can also be attached. 23 on the connecting sleeve 27 be inserted and secured there with a crimp sleeve 35 be attached.

[0093] The gas inlet hose 22 can be attached to its back in an adapter 28 It can end in the form of a Luer-lock adapter. The gas vent hose can also be... 23 on its back in an adapter 29 They end in the form of a Luer-lock adapter. Through the adapters 28 , 29 The flushing fluid can be fed in and discharged.

[0094] The gas inlet hose22 can be accessed via an inlet opening 30 into the front part of the interior of the hollow body 21 discharge, while the gas discharge hose 23 via an outlet opening 31 on the opposite rear side of the interior of the hollow body 21 with the interior of the hollow body 21 This ensures that the rinsing fluid flows along the surface of the wall of the entire hollow body. 21 can flow, thereby allowing a gas exchange of oxygen and carbon dioxide through the wall along the entire length of the hollow body. 21 can be done.

[0095] The valve 24 can a valve housing 32 exhibit the valve housing 32 can be connected via internal threads to external threads of the connecting sleeves 26 be connected. The valve 25 can a valve housing 33 exhibit the valve housing 33can be connected via internal threads to external threads of the connecting sleeves 27 They must be connected. All connections can be gas-tight and pressure-tight.

[0096] The gas inlet hose 22 can be attached to a port of the adapter 28 be attached and secured there with a crimp sleeve 36 The gas vent hose must be attached in a pressure-tight and gas-tight manner. 23 can be attached to a port of the adapter 29 be attached and secured there with a crimp sleeve 37 They must be fastened in a pressure-tight and gas-tight manner.

[0097] The gas inlet hose 22 and the gas vent hose 23 In the second embodiment, unlike the first embodiment, the hollow body is already present before the hollow body. 21 They are joined together and form a coaxial tube there. 38 The gas vent hose can be used in this process. 23 inside the gas inlet hose 22be arranged (as in the Fig. 6 to Fig. 9 shown) or the gas inlet hose 22 can occur within the gas vent hose 23 It should be arranged in this way. The advantage is that there is only one connection, making the passage easier to close and reducing the risk of germs passing through. In addition, the outflow opening leads to... 31 around the gas inlet hose 22 around into the interior of the hollow body 21 (or alternatively the inlet opening) 30 around the gas vent hose into the interior of the hollow body 21 This allows the entire surface of the hollow body to be... 21 They can be coated even more directly and easily with the rinsing fluid, thus improving gas exchange.

[0098] During operation, the rinsing fluid can pass through the adapter. 28The flushing fluid is fed into the medical placeholder. It can be introduced through the gas inlet hose. 22 flow and, at sufficient pressure, the valve 24 open. Then the rinsing fluid can pass through the inlet opening. 30 into the hollow body 21 and through the hollow body 21 The flushing fluid can flow through the gas vent hose. 23 up to the initially closed valve 25 flow. This can occur inside the hollow body. 21 build up pressure with which the hollow body 21 is converted into the expanded state. As soon as the pressure at the valve 25 in the gas discharge hose 23 If that is sufficient, the valve opens. 25 and the flushing fluid flows through the gas vent hose. 23 and the adapter 29 away.

[0099] The hollow body 21In its compressed state, it can also be inserted into a cavity through a small opening. There, the hollow body can... 21 to be expanded and thus change the outer shape of the hollow body 21 to be adapted to the cavity. The expanded hollow body 21 The placeholder, or rather the spacer in its expanded state, can thus mechanically support and stabilize the cavity. When the placeholder is no longer needed, the hollow body can 21 to be returned to its compressed state, for example by evacuation. The hollow body 21 It can then be removed from the cavity through a narrow opening. This is a particularly gentle way to treat bone defects, especially if the cavity is a hollow in a bone.

[0100] The rinsing fluid contains oxygen. The rinsing fluid can pass through the wall of the hollow body. 21 Oxygen to the surroundings of the hollow body 21Release. At the same time, the flowing flushing fluid can release carbon dioxide from the surroundings of the hollow body. 21 , which passes through the wall of the hollow body 21 diffused into the interior, absorbed, and from the medical placeholder through the adapter 29 derive this. This allows the surroundings of the hollow body to be analyzed. 21 They are supplied with oxygen and, through the absorption of carbon dioxide, an acidification of the environment of the hollow body occurs. 21 be prevented.

[0101] In the gas inlet hose 22 and / or in the gas discharge hose 23 Sterile filters (not shown), preferably impermeable to germs but permeable to gases, can be arranged. The rinsing fluid can be freed from germs by the sterile filter, which would otherwise enter the hollow body. 21 could get in and / or the hollow body 21 through the adapter 29This could be derived. This reduces the risk of infection for the treated patient and the treating staff.

[0102] Preferably, the sterile filter can be placed in the gas inlet hose. 22 or the gas vent hose 23 in the direction of flow behind the valve 24 or the valve 25 be arranged or the sterile filters in the gas inlet hose 22 and in the gas vent hose 23 behind the valves 24 , 25 be arranged.

[0103] It may also be intended that the hollow body 21 and / or the coaxial hose 38 is coated with an antiseptic substance or contains a soluble antiseptic substance in the material of the hollow body 21 It is included to prevent infection.

[0104] For treating the area surrounding the hollow body 21It may also be provided that in at least one wall of the hollow body 21 or at least one plastic component of the hollow body 21 Feedthroughs (not shown) are arranged that point towards the outside of the hollow body. 21 have openings that provide at least one channel (not shown) to the surroundings of the hollow body 21 Connect channels that are permeable to liquids and gases. At least one channel can be used to introduce liquids into the hollow body. 21 The channels are designed for various applications. Furthermore, at least one channel can be connected to a supply tube (not shown) for pharmaceutical solutions. This allows a pharmaceutical solution to be applied to the surface of the hollow body. 21 to be handed in.

[0105] In the Fig. 10 to Fig. Figure 12 shows illustrations of a third medical placeholder according to the invention. Fig. Figure 10 shows the placeholder in its compressed state and the Fig. 11 and Fig. Figure 12 shows the placeholder in the expanded state.

[0106] The third medical placeholder according to the invention can be a hollow body 41 made of an elastically or plastically deformable plastic. The hollow body 41 It can be expandable by being inflated with a purging gas or by having a purging liquid forced into the hollow body under pressure. 41 is pressed in. The hollow body 41 It can, for example, be made of rubber.

[0107] The one for the hollow body 41 The material used can be permeable to gaseous molecular oxygen and gaseous carbon dioxide. The hollow body 41 or the material from which the hollow body is made 41 If manufactured, a permeability coefficient for oxygen of greater than or equal to 0.5 cm can be used for this purpose. 3 / (m2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar). The permeability coefficient is determined according to DIN 53380-4 (11 / 2006).

[0108] To introduce a purging fluid (a purging gas or a purging liquid), an interior of the hollow body can be used. 41 with a gas inlet hose 42 They must be made of plastic. They are used to drain the purge fluid (purge gas or purge liquid) from the hollow body. 41 The interior of the hollow body can be accessed from within. 41 with a gas vent hose 43 The gas inlet hose must be made of plastic. 42 and the gas vent hose 43 They can be flexible and movable, at least in certain areas. In the gas inlet hose 42 can a valve 44be arranged in the form of a lip valve that allows a flow of the rinsing fluid towards the hollow body 41 However, it allows the flushing fluid to flow in the direction away from the hollow body. 41 prevented from doing so. In the gas vent hose. 43 can a valve 45 be arranged in the form of a lip valve that allows a flow of the rinsing fluid towards the hollow body 41 However, it prevents the flow of the flushing fluid in the direction away from the hollow body. 41 Way allowed. The valve 45 It can be designed to open at a minimum pressure of the flushing fluid. Preferably, the minimum pressure is at the valve. 45 Adjustable. The minimum pressure can be selected so that the pressure of the flushing fluid is sufficient to fill the hollow body. 41 from the compressed state (see Fig. 10) to transform into the expanded state (see Fig. 11 and Fig. 12).

[0109] The valves44 , 45 can be connected via connecting sleeves 46 , 47 with the gas inlet hose 42 and the gas vent hose 43 be connected. The gas inlet hose can be used for this purpose. 42 on the connecting sleeve 46 be inserted and secured there with a crimp sleeve 54 be secured. The gas vent hose can also be attached. 43 on the connecting sleeve 47 be inserted and secured there with a crimp sleeve 55 be attached.

[0110] The gas inlet hose 42 can be attached to its back in an adapter 48 It can end in the form of a Luer-lock adapter. The gas vent hose can also be... 43 on its back in an adapter 49 They end in the form of a Luer-lock adapter. Through the adapters 48 , 49 The flushing fluid can be fed in and discharged.

[0111] The gas inlet hose 42can be accessed via an inlet opening 50 into the front part of the interior of the hollow body 41 discharge, while the gas discharge hose 43 via an outlet opening 51 on the opposite rear side of the interior of the hollow body 41 with the interior of the hollow body 41 This ensures that the rinsing fluid flows along the surface of the wall of the entire hollow body. 41 can flow, thereby allowing a gas exchange of oxygen and carbon dioxide through the wall along the entire length of the hollow body. 41 can be done.

[0112] The valve 44 can a valve housing 52 exhibit the valve housing 52 can be connected via an internal thread to external threads of the connecting sleeves 46 be connected. The valve 45 can a valve housing 53 exhibit the valve housing 53can be connected via internal threads to external threads of the connecting sleeves 47 They must be connected. All connections can be gas-tight and pressure-tight.

[0113] The gas inlet hose 42 can be attached to a port of the adapter 48 be attached and secured there with a crimp sleeve 56 The gas vent hose must be attached in a pressure-tight and gas-tight manner. 43 can be attached to a port of the adapter 49 be attached and secured there with a crimp sleeve 57 They must be fastened in a pressure-tight and gas-tight manner.

[0114] The gas inlet hose 42 and the gas vent hose 43 In the third embodiment, unlike the first embodiment, the hollow body is already present before the hollow body. 41 they merge and form a double hose there 58 with two adjacent pipes that form part of the gas inlet hose 42and the gas vent hose 43 are. The gas vent hose can be used in this process. 43 next to the gas inlet hose 42 be arranged (as in the Fig. 10 to Fig. (shown in Figure 12). The advantage is that there is only one connection, making it easier to close and reducing the risk of germs passing through. The gas vent hose 43 and the gas inlet hose 42 have in the area of ​​the double hose 58 a crescent-shaped or semicircular conductor cross-section.

[0115] During operation, the rinsing fluid can pass through the adapter. 48 The flushing fluid is fed into the medical placeholder. It can be introduced through the gas inlet hose. 42 flow and, at sufficient pressure, the valve 44 open. Then the rinsing fluid can pass through the inlet opening. 50 into the hollow body 41 and through the hollow body41 The flushing fluid can flow through the gas vent hose. 43 up to the initially closed valve 45 flow. This can occur inside the hollow body. 41 build up pressure with which the hollow body 41 is converted into the expanded state. As soon as the pressure at the valve 45 in the gas discharge hose 43 If that is sufficient, the valve opens. 45 and the flushing fluid flows through the gas vent hose. 43 and the adapter 49 away.

[0116] The hollow body 41 In its compressed state, it can also be inserted into a cavity through a small opening. There, the hollow body can... 41 to be expanded and thus change the outer shape of the hollow body 41 to be adapted to the cavity. The expanded hollow body 41The placeholder, or rather the spacer in its expanded state, can thus mechanically support and stabilize the cavity. When the placeholder is no longer needed, the hollow body can 41 to be returned to its compressed state, for example by evacuation. The hollow body 41 It can then be removed from the cavity through a narrow opening. This is a particularly gentle way to treat bone defects, especially if the cavity is a hollow in a bone.

[0117] The rinsing fluid contains oxygen. The rinsing fluid can pass through the wall of the hollow body. 41 Oxygen to the surroundings of the hollow body 41 Release. At the same time, the flowing flushing fluid can release carbon dioxide from the surroundings of the hollow body. 41 , which passes through the wall of the hollow body 41 diffused into the interior, absorbed, and from the medical placeholder through the adapter 29derive this. This allows the surroundings of the hollow body to be analyzed. 41 They are supplied with oxygen and, through the absorption of carbon dioxide, an acidification of the environment of the hollow body occurs. 41 be prevented.

[0118] In the gas inlet hose 42 and / or in the gas discharge hose 43 Sterile filters (not shown), preferably impermeable to germs but permeable to gases, can be arranged. The rinsing fluid can be freed from germs by the sterile filter, which would otherwise enter the hollow body. 41 could get in and / or the hollow body 41 through the adapter 49 This could be derived. This reduces the risk of infection for the treated patient and the treating staff.

[0119] Preferably, the sterile filter can be placed in the gas inlet hose. 42 or the gas vent hose 43 in the direction of flow behind the valve 44or the valve 45 be arranged or the sterile filters in the gas inlet hose 42 and in the gas vent hose 43 behind the valves 44 , 45 be arranged.

[0120] It may also be intended that the hollow body 41 and / or the double hose 58 is coated with an antiseptic substance or contains a soluble antiseptic substance in the material of the hollow body 41 It is included to prevent infection.

[0121] For treating the area surrounding the hollow body 41 It may also be provided that in at least one wall of the hollow body 41 or at least one plastic component of the hollow body 41 Feedthroughs (not shown) are arranged that point towards the outside of the hollow body. 41 have openings that provide at least one channel (not shown) to the surroundings of the hollow body41 Connect channels that are permeable to liquids and gases. At least one channel can be used to introduce liquids into the hollow body. 41 The channels are designed for various applications. Furthermore, at least one channel can be connected to a supply tube (not shown) for pharmaceutical solutions. This allows a pharmaceutical solution to be applied to the surface of the hollow body. 41 to be handed in.

[0122] In the Fig. 13 to Fig. Figure 15 shows illustrations of a fourth medical placeholder according to the invention. Fig. Figure 13 shows the placeholder in its compressed state and the Fig. 14 and Fig. Figure 15 shows the placeholder in the expanded state.

[0123] The fourth medical placeholder according to the invention can be a hollow body 61 made of an elastically or plastically deformable plastic. The hollow body 61It can be expandable by being inflated with a purging gas or by having a purging liquid forced into the hollow body under pressure. 61 is pressed in. The hollow body 61 It can, for example, be made of rubber.

[0124] The one for the hollow body 61 The material used can be permeable to gaseous molecular oxygen and gaseous carbon dioxide. The hollow body 61 or the material from which the hollow body is made 61 If manufactured, a permeability coefficient for oxygen of greater than or equal to 0.5 cm can be used for this purpose. 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar). The permeability coefficient is determined according to DIN 53380-4 (11 / 2006).

[0125] To introduce a purging fluid (a purging gas or a purging liquid), an interior of the hollow body can be used.61 with a gas inlet hose 62 They must be made of plastic. They are used to drain the purge fluid (purge gas or purge liquid) from the hollow body. 61 The interior of the hollow body can be accessed from within. 61 with a gas vent hose 63 The gas inlet hose must be made of plastic. 62 and the gas vent hose 63 They can be flexible and movable, at least in certain areas. In the gas inlet hose 62 and in the gas vent hose 63 can a valve 64 be arranged in the form of a manually operated rotary valve, which is operated via a valve handle 65 It is operable. With the valve 64 can the gas inlet hose 62 and the gas vent hose 63 It can be manually closed and opened. It may also be provided that the gas inlet hose 62 and the gas vent hose 63They can be opened and closed manually, individually and independently of each other. A cross-section of the gas vent hose 63 A specific back pressure can be chosen so that the pressure of the flushing fluid is sufficient to fill the hollow body. 61 with the valve open 64 from the compressed state (see Fig. 13) to transform into the expanded state (see Fig. 14 and Fig. 15).

[0126] The valve 64 can be done via connecting sleeves 66 , 67 with the gas inlet hose 62 and the gas vent hose 63 be connected. The gas inlet hose can be used for this purpose. 62 on the connecting sleeve 66 be inserted and secured there with a crimp sleeve 74 be secured. The gas vent hose can also be attached. 63 on the connecting sleeve 67 be inserted and secured there with a crimp sleeve 75 be attached.

[0127] The gas inlet hose 62 can be attached to its back in an adapter 68 It can end in the form of a Luer-lock adapter. The gas vent hose can also be... 63 on its back in an adapter 69 They end in the form of a Luer-lock adapter. Through the adapters 68 , 69 The flushing fluid can be fed in and discharged.

[0128] The gas inlet hose 62 can be accessed via an inlet opening 70 into the front part of the interior of the hollow body 61 discharge, while the gas discharge hose 63 via an outlet opening 71 on the opposite rear side of the interior of the hollow body 61 with the interior of the hollow body 61 This ensures that the rinsing fluid flows along the surface of the wall of the entire hollow body. 61can flow, thereby allowing a gas exchange of oxygen and carbon dioxide through the wall along the entire length of the hollow body. 61 can be done.

[0129] The valve 64 can a valve housing 72 exhibit the valve housing 72 can be connected via an internal thread to external threads of the connecting sleeves 66 and the connecting sleeves 67 They must be connected. All connections can be gas-tight and pressure-tight.

[0130] The gas inlet hose 62 can be attached to a port of the adapter 68 be attached and secured there with a crimp sleeve 76 The gas vent hose must be attached in a pressure-tight and gas-tight manner. 63 can be attached to a port of the adapter 69 be attached and secured there with a crimp sleeve 77 They must be fastened in a pressure-tight and gas-tight manner.

[0131] During operation, the rinsing fluid can pass through the adapter. 68The flushing fluid can be fed into the medical placeholder. 64 through the gas inlet hose 62 flow. Then the flushing fluid can flow through the inlet opening. 70 into the hollow body 61 and through the hollow body 61 flow. This can occur inside the hollow body. 61 build up pressure with which the hollow body 61 is transformed into the expanded state.

[0132] The hollow body 61 can be in a compressed state with the valve closed 64 It can also be inserted into a cavity through a small opening. There the hollow body can 61 to be expanded and thus change the outer shape of the hollow body 61 to be adapted to the cavity. The expanded hollow body 61The placeholder, or rather the spacer in its expanded state, can thus mechanically support and stabilize the cavity. When the placeholder is no longer needed, the hollow body can 61 to be returned to its compressed state, for example by evacuation. The hollow body 61 It can then be removed from the cavity through a narrow opening. This is a particularly gentle way to treat bone defects, especially if the cavity is a hollow in a bone.

[0133] The rinsing fluid contains oxygen. The rinsing fluid can pass through the wall of the hollow body. 61 Oxygen to the surroundings of the hollow body 61 Release. At the same time, the flowing flushing fluid can release carbon dioxide from the surroundings of the hollow body. 61 , which passes through the wall of the hollow body 61 diffused into the interior, absorbed, and from the medical placeholder through the adapter 69derive this. This allows the surroundings of the hollow body to be analyzed. 61 They are supplied with oxygen and, through the absorption of carbon dioxide, an acidification of the environment of the hollow body occurs. 61 be prevented.

[0134] In the gas inlet hose 62 and / or in the gas discharge hose 63 Sterile filters (not shown), preferably impermeable to germs but permeable to gases, can be arranged. The rinsing fluid can be freed from germs by the sterile filter, which would otherwise enter the hollow body. 61 could get in and / or the hollow body 61 through the adapter 69 This could be derived. This reduces the risk of infection for the treated patient and the treating staff.

[0135] Preferably, the sterile filter can be placed in the gas inlet hose. 62 or the gas vent hose 63 in the direction of flow behind the valve 64be arranged or the sterile filters in the gas inlet hose 62 and in the gas vent hose 63 behind the valves 64 be arranged.

[0136] It may also be intended that the hollow body 61 and / or the hoses 62 , 63 in the area of ​​the hollow body 61 is coated with an antiseptic substance or contains a soluble antiseptic substance in the material of the hollow body 61 It is included to prevent infection.

[0137] For treating the area surrounding the hollow body 61 It may also be provided that in at least one wall of the hollow body 61 or at least one plastic of the hollow body 61 Feedthroughs (not shown) are arranged that point towards the outside of the hollow body. 61have openings that provide at least one channel (not shown) to the surroundings of the hollow body 61 Connect channels that are permeable to liquids and gases. At least one channel can be used to introduce liquids into the hollow body. 61 The channels are designed for various applications. Furthermore, at least one channel can be connected to a supply tube (not shown) for pharmaceutical solutions. This allows a pharmaceutical solution to be applied to the surface of the hollow body. 61 to be handed in.

[0138] In the Fig. 16 and Fig. Figure 17 shows illustrations of a very simply constructed fifth medical placeholder according to the invention. Fig. Figure 16 shows the placeholder in its compressed state and the Fig. Figure 17 shows the placeholder in the expanded state.

[0139] The fifth medical placeholder according to the invention can be a hollow body 81made of an elastically or plastically deformable plastic. The hollow body 81 It can be expandable by being inflated with a purging gas or by having a purging liquid forced into the hollow body under pressure. 81 is pressed in. The hollow body 81 It can, for example, be made of rubber.

[0140] The one for the hollow body 81 The material used can be permeable to gaseous molecular oxygen and gaseous carbon dioxide. The hollow body 81 or the material from which the hollow body is made 81 If manufactured, a permeability coefficient for oxygen of greater than or equal to 0.5 cm can be used for this purpose. 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar). The permeability coefficient is determined according to DIN 53380-4 (11 / 2006).

[0141] To introduce a purging fluid (a purging gas or a purging liquid), an interior of the hollow body can be used. 81 with a gas inlet hose 82 They must be made of plastic. They are used to drain the purge fluid (purge gas or purge liquid) from the hollow body. 81 The interior of the hollow body can be accessed from within. 81 with a gas vent hose 83 The gas inlet hose must be made of plastic. 82 and the gas vent hose 83 They can be flexible and movable, at least in certain areas. A cross-section of the gas vent hose 83 A specific back pressure can be chosen so that the pressure of the flushing fluid is sufficient to fill the hollow body. 81 from the compressed state (see Fig. 16) to transform into the expanded state (see Fig. 17).

[0142] The gas inlet hose 82 can be accessed via an inlet opening90 into the front part of the interior of the hollow body 81 discharge, while the gas discharge hose 83 via an outlet opening 91 on the opposite rear side of the interior of the hollow body 81 with the interior of the hollow body 81 This ensures that the rinsing fluid flows along the surface of the wall of the entire hollow body. 81 can flow, thereby allowing a gas exchange of oxygen and carbon dioxide through the wall along the entire length of the hollow body. 81 can be done.

[0143] During operation, the purging fluid can pass through the gas inlet hose. 82 The flushing fluid is fed into the medical placeholder. 90 into the hollow body 81 and through the hollow body 81 flow. This can occur inside the hollow body. 81build up pressure with which the hollow body 81 is transformed into the expanded state.

[0144] The hollow body 81 In its compressed state, it can also be inserted into a cavity through a small opening. There, the hollow body can... 81 to be expanded and thus change the outer shape of the hollow body 81 to be adapted to the cavity. The expanded hollow body 81 The placeholder, or rather the spacer in its expanded state, can thus mechanically support and stabilize the cavity. When the placeholder is no longer needed, the hollow body can 81 to be returned to its compressed state, for example by evacuation. The hollow body 81 It can then be removed from the cavity through a narrow opening. This is a particularly gentle way to treat bone defects, especially if the cavity is a hollow in a bone.

[0145] The rinsing fluid contains oxygen. The rinsing fluid can pass through the wall of the hollow body. 81 Oxygen to the surroundings of the hollow body 81 Release. At the same time, the flowing flushing fluid can release carbon dioxide from the surroundings of the hollow body. 81 , which passes through the wall of the hollow body 81 diffused into the interior, absorbed, and out of the medical placeholder through the gas venting hose 83 derive this. This allows the surroundings of the hollow body to be analyzed. 81 They are supplied with oxygen and, through the absorption of carbon dioxide, an acidification of the environment of the hollow body occurs. 81 be prevented.

[0146] In the gas inlet hose 82 and / or in the gas discharge hose 83Sterile filters (not shown), preferably impermeable to germs but permeable to gases, can be arranged. The rinsing fluid can be freed from germs by the sterile filter, which would otherwise enter the hollow body. 81 could get in and / or the hollow body 81 through the gas vent hose 83 This could be derived. This reduces the risk of infection for the treated patient and the treating staff.

[0147] It may also be intended that the hollow body 81 and / or the hoses 82 , 83 in the area of ​​the hollow body 81 is coated with an antiseptic substance or contains a soluble antiseptic substance in the material of the hollow body 81 It is included to prevent infection.

[0148] For treating the area surrounding the hollow body 81It may also be provided that in at least one wall of the hollow body 81 or of at least one plastic of the hollow body 81 Feedthroughs (not shown) are arranged that point towards the outside of the hollow body. 81 have openings that provide at least one channel (not shown) to the surroundings of the hollow body 81 Connect channels that are permeable to liquids and gases. At least one channel can be used to introduce liquids into the hollow body. 81 The channels are designed for various applications. Furthermore, at least one channel can be connected to a supply tube (not shown) for pharmaceutical solutions. This allows a pharmaceutical solution to be applied to the surface of the hollow body. 81 to be handed in.

[0149] In the Fig. 18 and Fig. Figure 19 shows illustrations of a very simply constructed sixth medical placeholder according to the invention. Fig. Figure 18 shows the placeholder in its compressed state and the Fig. Figure 19 shows the placeholder in its expanded state.

[0150] The sixth medical placeholder according to the invention can be a hollow body 101 made of an elastically or plastically deformable plastic. The hollow body 101 It can be expandable by being inflated with a purging gas or by having a purging liquid forced into the hollow body under pressure. 101 is pressed in. The hollow body 81 It can, for example, be made of rubber.

[0151] The one for the hollow body 101 The material used can be permeable to gaseous molecular oxygen and gaseous carbon dioxide. The hollow body 101 or the material from which the hollow body is made 101 If manufactured, a permeability coefficient for oxygen of greater than or equal to 0.5 cm can be used for this purpose. 3 / (m 2*d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar). The permeability coefficient is determined according to DIN 53380-4 (11 / 2006).

[0152] To introduce a purging fluid (a purging gas or a purging liquid), an interior of the hollow body can be used. 101 with a gas inlet hose 102 They must be made of plastic. They are used to drain the purge fluid (purge gas or purge liquid) from the hollow body. 101 The interior of the hollow body can be accessed from within. 101 with a gas vent hose 103 The gas inlet hose must be made of plastic. 102 and the gas vent hose 103 They can be flexible and movable, at least in certain areas. A cross-section of the gas vent hose 103A specific back pressure can be chosen so that the pressure of the flushing fluid is sufficient to fill the hollow body. 101 from the compressed state (see Fig. 18) to transform into the expanded state (see Fig. 19).

[0153] The gas inlet hose 102 can be accessed via an inlet opening 110 into the front part of the interior of the hollow body 101 discharge, while the gas discharge hose 103 via an outlet opening 111 on the opposite rear side of the interior of the hollow body 101 with the interior of the hollow body 101 This ensures that the rinsing fluid flows along the surface of the wall of the entire hollow body. 101 can flow, thereby allowing a gas exchange of oxygen and carbon dioxide through the wall along the entire length of the hollow body. 101 can be done.

[0154] During operation, the purging fluid can pass through the gas inlet hose. 102 The flushing fluid is fed into the medical placeholder. 110 into the hollow body 101 and through the hollow body 101 flow. This can occur inside the hollow body. 101 build up pressure with which the hollow body 101 is transformed into the expanded state.

[0155] The hollow body 101 In its compressed state, it can also be inserted into a cavity through a small opening. There, the hollow body can... 101 to be expanded and thus change the outer shape of the hollow body 101 to be adapted to the cavity. The expanded hollow body 101 The placeholder, or rather the spacer in its expanded state, can thus mechanically support and stabilize the cavity. When the placeholder is no longer needed, the hollow body can 101to be returned to its compressed state, for example by evacuation. The hollow body 101 It can then be removed from the cavity through a narrow opening. This is a particularly gentle way to treat bone defects, especially if the cavity is a hollow in a bone.

[0156] The rinsing fluid contains oxygen. The rinsing fluid can pass through the wall of the hollow body. 101 Oxygen to the surroundings of the hollow body 101 Release. At the same time, the flowing flushing fluid can release carbon dioxide from the surroundings of the hollow body. 101 , which passes through the wall of the hollow body 101 diffused into the interior, absorbed, and out of the medical placeholder through the gas venting hose 103 derive this. This allows the surroundings of the hollow body to be analyzed. 101 They are supplied with oxygen and, through the absorption of carbon dioxide, an acidification of the environment of the hollow body occurs. 101be prevented.

[0157] In the gas inlet hose 102 and / or in the gas discharge hose 103 Sterile filters (not shown), preferably impermeable to germs but permeable to gases, can be arranged. The rinsing fluid can be freed from germs by the sterile filter, which would otherwise enter the hollow body. 101 could get in and / or the hollow body 101 through the gas vent hose 103 This could be derived. This reduces the risk of infection for the treated patient and the treating staff.

[0158] It may also be intended that the hollow body 101 and / or the hoses 102 , 103 in the area of ​​the hollow body 101 is coated with an antiseptic substance or contains a soluble antiseptic substance in the material of the hollow body 101 It is included to prevent infection.

[0159] For treating the area surrounding the hollow body 101 It may also be provided that in at least one wall of the hollow body 101 or at least one plastic component of the hollow body 101 Feedthroughs (not shown) are arranged that point towards the outside of the hollow body. 101 have openings that provide at least one channel (not shown) to the surroundings of the hollow body 101 Connect channels that are permeable to liquids and gases. At least one channel can be used to introduce liquids into the hollow body. 101 The channels are designed for various applications. Furthermore, at least one channel can be connected to a supply tube (not shown) for pharmaceutical solutions. This allows a pharmaceutical solution to be applied to the surface of the hollow body. 101 to be handed in.

[0160] The features of the invention disclosed in the preceding description, as well as in the claims, figures and embodiments, can be essential for the realization of the invention in its various embodiments, both individually and in any combination. Reference symbol list 1, 21, 41, 61, 81, 101 Hollow bodies 2, 22, 42, 62, 82, 102 Gas inlet hose 3, 23, 43, 63, 83, 103 Gas vent hose 4, 5, 24, 25, 44, 45 Valve / Lip valve 6, 26, 46, 66 Connecting sleeve 7, 27, 47, 67 Connecting sleeve 8, 28, 48, 68 adapters 9, 29, 49, 69 adapters 10, 30, 50, 70, 90, 110 Inlet opening 11, 31, 51, 71, 91, 111 Outlet 12, 32, 52, 72 Valve housing 13, 33, 53 Valve housing 14, 34, 54, 74 crimp sleeve 15, 35, 55, 75 crimp sleeve 16, 36, 56, 76 crimp sleeve 17, 37, 57, 77 crimp sleeve 38 Coaxial hose 58 Double hose 64 valve 65 Valve handle

Claims

[1] Medical placeholder at least one hollow body (1, 21, 41, 61, 81, 101) that is expandable and that defines an interior space within the hollow body (1, 21, 41, 61, 81, 101), a gas inlet hose (2, 22, 42, 62, 82, 102) which is connected or connectable to the interior of the hollow body (1, 21, 41, 61, 81, 101) in a gas-permeable manner, a gas outlet hose (3, 23, 43, 63, 83, 103) which is connected or connectable to the interior of the hollow body (1, 21, 41, 61, 81, 101) in a gas-permeable manner, wherein the hollow body (1, 21, 41, 61, 81, 101) consists at least partially or completely of at least one plastic which is permeable to oxygen and carbon dioxide. [2] Medical placeholder according to claim 1, characterized by, that the hollow body (1, 21, 41, 61, 81, 101) or at least one plastic of the hollow body (1, 21, 41, 61, 81, 101) has a permeability coefficient for oxygen of greater than or equal to 0.5 cm 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 0.5 cm 3 / (m 2 *d*bar) has, preferably a permeability coefficient for oxygen of greater than or equal to 1 cm 3 / (m 2 *d*bar) and a permeability coefficient for carbon dioxide of greater than or equal to 1 cm 3 / (m 2 *d*bar). [3] Medical placeholder according to claim 1 or 2, characterized by, that an inlet opening (10, 30, 50, 70, 90, 110) of the gas inlet hose (2, 22, 42, 62, 82, 102), through which the gas inlet hose (2, 22, 42, 62, 82, 102) opens into the interior, is spatially separated from an outlet opening (11, 31, 51, 71, 91, 111) of the gas outlet hose (3, 23, 43, 63, 83, 103), wherein the outlet opening (11, 31, 51, 71, 91, 111) forms the inlet of the interior into the gas outlet hose (3, 23, 43, 63, 83, 103). [4] Medical placeholder according to claim 3, characterized by , that the inlet opening (10, 30, 50, 70, 90, 110) of the gas inlet hose (2, 22, 42, 62, 82, 102) is arranged at a first end of the hollow body (1, 21, 41, 61, 81, 101) and the outlet opening (11, 31, 51, 71, 91, 111) is arranged at a second end of the hollow body (1, 21, 41, 61, 81, 101) opposite the first end. [5] Medical placeholder according to any of the preceding claims, characterized by, that the gas inlet hose (22) and the gas outlet hose (23) are arranged coaxially to each other in certain areas, preferably both being guided together through a passage from the hollow body (21). [6] Medical placeholder according to any of the preceding claims, characterized by , that the gas inlet hose (2, 22, 42, 62, 82, 102) and the gas outlet hose (3, 23, 43, 63, 83, 103) are connected to each other, wherein preferably the gas inlet hose (22, 42) and the gas outlet hose (23, 43) have a common outer hose (38, 58) and wherein the common outer hose (38, 58) is particularly preferably divided by a partition wall that limits the gas inlet hose (22, 42) on one side and limits the gas outlet hose (23, 43) on the other side. [7] Medical placeholder according to any of the preceding claims, characterized by, that a sterile filter which is impermeable to germs but permeable to gases is arranged in the gas inlet hose (2, 22, 42, 62, 82, 102) and / or the gas outlet hose (3, 23, 43, 63, 83, 103). [8] Medical placeholder according to any of the preceding claims, characterized by , that a valve (4, 5, 24, 25, 44, 45, 64) is arranged in the gas inlet hose (2, 22, 42, 62, 82, 102) and / or the gas outlet hose (3, 23, 43, 63, 83, 103), wherein preferably the gas inlet hose (2, 22, 42, 62, 82, 102) and / or the gas outlet hose (3, 23, 43, 63, 83, 103) can be shut off with the valve (4, 5, 24, 25, 44, 45, 64). [9] Medical placeholder according to claims 7 and 8, characterized by, that the sterile filter is arranged in the gas inlet hose (2, 22, 42, 62, 82, 102) or the gas outlet hose (3, 23, 43, 63, 83, 103) in the direction of flow behind the valve (4, 5, 24, 25, 44, 45, 64) or the sterile filters are arranged in the gas inlet hose (2, 22, 42, 62, 82, 102) and in the gas outlet hose (3, 23, 43, 63, 83, 103) behind the valves (4, 5, 24, 25, 44, 45, 64). [10] Medical placeholder according to one of claims 8 or 9, characterized by , that the valve (4, 24, 44) is arranged in the gas inlet hose (2, 22, 42, 62, 82, 102) and is designed as a one-way valve. [11] Medical placeholder according to any one of claims 8 to 10, characterized by , that the valve (5, 25, 45) is arranged in the gas discharge hose (3, 23, 43, 63, 83, 103) and is designed as a pressure relief valve, preferably with the opening pressure of the pressure relief valve being adjustable. [12] Medical placeholder according to any of the preceding claims, characterized by , that the gas inlet hose (2, 22, 42, 62, 82, 102) and the gas outlet hose (3, 23, 43, 63, 83, 103) are made of a material that is impermeable to oxygen and carbon dioxide, preferably of a plastic that is impermeable to oxygen and carbon dioxide. [13] Medical placeholder according to any of the preceding claims, characterized by , that the hollow body (1, 21, 41, 61, 81, 101) or at least one plastic of the hollow body (1, 21, 41, 61, 81, 101) contains at least one antiseptic agent or is coated with at least one antiseptic agent. [14] Medical placeholder according to any of the preceding claims, characterized by, that in at least one wall of the hollow body (1, 21, 41, 61, 81, 101) or of the at least one plastic of the hollow body (1, 21, 41, 61, 81, 101) passages are arranged which have openings pointing towards the outside of the hollow body (1, 21, 41, 61, 81, 101) and which connect at least one channel to the surroundings of the hollow body (1, 21, 41, 61, 81, 101) in a way that allows liquids and gases to pass through, wherein the at least one channel is provided for introducing liquids into the hollow body (1, 21, 41, 61, 81, 101) to the passages, wherein preferably the at least one channel is connected to a supply hose for pharmaceutical active ingredient solutions, wherein a connection adapter, in particular a Luer-lock adapter is arranged. [15] Medical placeholder according to any of the preceding claims, characterized by, that the hollow body (1, 21, 41, 61, 81, 101) in the uninflated state rests against the gas inlet hose (2, 22, 42, 62, 82, 102) and / or against the gas outlet hose (3, 23, 43, 63, 83, 103), wherein preferably the hollow body (1, 21, 41, 61, 81, 101) or the at least one plastic is inflatable in the manner of a balloon. [16] Method for gassing a surface of a medical placeholder, in particular a medical placeholder according to one of the preceding claims, characterized by the following steps: A) Expanding a hollow body (1, 21, 41, 61, 81, 101) by introducing a purging liquid or a purging gas containing oxygen into an interior of the hollow body (1, 21, 41, 61, 81, 101), so that the interior of the hollow body (1, 21, 41, 61, 81, 101) is enlarged; B) Release of gaseous oxygen from the purge liquid or purge gas through a plastic forming the interior to the surroundings of the hollow body (1, 21, 41, 61, 81, 101); C) Absorption of gaseous carbon dioxide from the environment of the hollow body (1, 21, 41, 61, 81, 101) through the plastic enclosing the interior into the rinsing liquid or rinsing gas; D) Passing the purging liquid or purging gas through the interior of the hollow body (1, 21, 41, 61, 81, 101) and draining the purging liquid or purging gas from the interior. [17] Method according to claim 16, characterized by that the procedure is not performed for the medical treatment of a human or animal body. [18] Method according to claim 16 or 17, characterized by, that before step A) the hollow body (1, 21, 41, 61, 81, 101) is inserted into a cavity, wherein during step A) the shape of the inflated hollow body (1, 21, 41, 61, 81, 101) adapts at least partially to the shape of the cavity and during steps B) and C) is in contact with the cavity at least partially. [19] Method according to any one of claims 14 to 16, characterized by , that in step A) the hollow body (1, 21, 41, 61, 81, 101) is inflated until a minimum pressure is reached, whereby when the minimum pressure is reached a valve (5, 25, 45) opens through which the purging liquid or purging gas is discharged from the interior of the hollow body (1, 21, 41, 61, 81, 101) during step D).

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