Device for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure

Abstract

The present invention relates to a device (100) for reducing the retraction of the edges and / or for stretching the edges (112) of an opened tissue structure (114) of a patient with an open soft tissue defect, wherein the device (100) comprises at least one main body (102), at least one retraction element (104) for retraction and attachment at the edges of the opened tissue structure, and a tensioning element (106), wherein the tensioning element (106) is constituted and configured such that the at least one retraction element (104) is movable by means of the tensioning element (108), in such a way that the edges (112) of the opened tissue structure (114) are brought closer together at least in part as a result. The present invention also relates to a wound care system (108), comprising at least one such device (100) and a vacuum dressing system, wherein the vacuum dressing system comprises at least one foam-film dressing (110) and a vacuum pump.

Description

[0001] Device for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure

[0002] The present invention relates to a device for reducing the retraction of the edges and / or a device for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect.

[0003] The present invention further relates to a wound care system comprising a device for reducing the retraction of the edges and / or a device for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect and a vacuum dressing system.

[0004] After visceral surgery, closure of the abdominal wall may not be possible or even desirable after the actual procedure. This may be the case, for example, if the patient's abdominal cavity is heavily contaminated, as can occur with hollow organ perforations, among other things. In these cases, repeated abdominal lavage (especially peritoneal lavage) may be indicated.

[0005] It is also conceivable that in the case of hollow organ injuries that cannot be treated surgically, such as small bowel fistulas, the abdominal wall cannot or should not be closed initially.

[0006] Other indications include, for example, an ileus, where despite decompression the intestine requires so much space that the fascia in the abdominal wall area cannot be closed.

[0007] It is also conceivable that the abdominal cavity may not be closed again initially if there is a risk of abdominal compartment syndrome. Abdominal compartment syndrome is a life-threatening condition that develops as a result of a rapidly progressive increase in intra-abdominal pressure (especially IAP > 12 mm Hg) and results in severe impairment of intra- and extra-abdominal organ systems.

[0008] Further indications are conceivable, especially in the treatment of large hernias.

[0009] Retraction devices for treating open abdomens are already known from the prior art. These devices can be used to retract the wound edges of an opened abdominal cavity. One example of this is the wound care device according to WO2022074032A1, which comprises a device for reducing the retraction of the edges of an opened fascia after / during an open abdomen.

[0010] However, such devices are disadvantageous in that they only reduce the retraction of the edges of an opened tissue structure of a patient, whereas an actual approximation of the edges would be more favorable for re-closure of the tissue structure.

[0011] Furthermore, these devices require a very large amount of space, particularly a very large vertical space requirement (from the perspective of a patient lying down), which becomes particularly problematic when the patient requires intensive care. Patient repositioning is also significantly limited (up to 30° lateral tilt), which not only increases the risk of pressure ulcers but also complicates normal care routines and ensuring patient hygiene.

[0012] It is therefore the object of the present invention to advantageously further develop a device for reducing the retraction of the edges and / or for stretching the opened tissue structure of a patient of the type mentioned at the outset, in particular to the effect that a better closure of an opened tissue structure of a patient can be made possible.

[0013] This object is achieved according to the invention by a device having the features of claim 1. According to this, a device is provided for reducing the retraction of the edges and / or for stretching an opened tissue structure of a patient with an open soft tissue defect, wherein the device comprises at least one base body, at least one retraction element for retraction and attachment to the edges of the opened tissue structure and a tensioning element, wherein the tensioning element is designed and configured such that by means of the tensioning element the at least one retraction element can be moved, in particular continuously and / or with a predefined constant force, in such a way that the edges of the opened tissue structure are at least partially brought closer together.

[0014] The invention is based on the fundamental idea of ​​being able to bring the edges of an opened tissue structure closer together or pull them together. This pulling process should not be carried out abruptly or with excessive force. Rather, it becomes possible to pull the wound edges at least partially closer together comparatively slowly, possibly with a predefined and / or appropriate force. Accordingly, not only can the retraction of the edges of the opened tissue structure be reduced, but the aforementioned bringing of the edges closer together can also facilitate or improve closure of the opened tissue structure. An edge of an opened tissue structure refers to both the outermost boundary of a tissue (skin, muscles, fascia, tendon plates, fat, etc.) in front of an opened tissue structure, as well as a few centimeters laterally (away from the center of the body) from it.

[0015] The device can be designed and configured in such a way that, by means of the tensioning element, the at least one retraction element can be moved essentially in a plane with the opened tissue structure or essentially parallel to the opened tissue structure. In other words, the pulling movement can take place more or less at the level of or in the plane of the edges of the opened tissue structure. As a result, the device requires little space, in particular little vertical space (from the perspective of a patient lying down), which is particularly advantageous when a patient requires intensive care. This also makes it possible to reposition the patient, which on the one hand reduces the risk of pressure ulcers, and on the other hand also enables normal care routines and ensures the patient's personal hygiene.

[0016] The tensioning element can be designed and configured such that the at least one retraction element is moved by means of the tensioning element with a force of up to 10 N. Such a force not only makes it possible to reduce retraction of the edges of the opened tissue structure, but also allows the edges of the opened tissue structure to be at least partially brought closer together.

[0017] In particular, it can further be provided that the device comprises at least two retraction elements. Alternatively, it is conceivable that the device comprises a retraction element with several (at least two) subsections. Multiple retraction elements or multiple subsections of a retraction element can enable a better approximation of the edges of the opened tissue structure.

[0018] Furthermore, it can be provided that the base body is arranged essentially centrally between the at least two retraction elements. Thus, opposite edges of an opened tissue structure can be brought closer together.

[0019] In particular, it is conceivable that the base body is directly and / or indirectly connected at least one point to the at least one retraction element or to the at least two retraction elements. This enables a force to be transmitted from the tensioning element via the base body to the at least one or two retraction elements, and from there to the edges of the opened tissue structure. Alternatively and / or additionally, it is conceivable that the base body guides and / or redirects the at least one retraction element.

[0020] The base body can have a substantially elongated shape. Tissue openings are often substantially elongated due to a surgical incision. A base body with a substantially elongated shape is therefore largely compatible with an elongated tissue opening. This allows the edges of the tissue opening to be brought together along an axis, allowing only one (longitudinal) suture to close the tissue opening.

[0021] In particular, it is conceivable for the base body to be essentially in the shape of a cuboid, a cylinder, or a spindle. A base body in the shape of a cylinder or spindle has the advantage that a retraction element in the form of a thread can be easily wound around the cylinder or spindle.

[0022] Furthermore, the base body can comprise a winch. This allows the edges of the opened fabric structure to be pulled toward the center of the fabric opening. Alternatively, the tensioning element can comprise a winch.

[0023] It is also conceivable for the base body to comprise at least two sub-bodies that can be releasably connected to one another. The two sub-bodies can be releasably connected to one another, for example, by screwing, clamping, clicking, plugging, binding, and / or magnetism.

[0024] In particular, it is conceivable that the base body comprises two partial bodies which are detachably connected to one another, for example along their longitudinal axis.

[0025] Each partial body can be connected to at least one retraction element and / or be designed such that it is configured to deflect at least one retraction element.

[0026] In other words, each partial body can comprise at least one deflection element configured to deflect the at least one retraction element. Alternatively, it is possible for one or more deflection units to be attached to a partial body.

[0027] It is conceivable that at least one retraction element can be guided through the partial body and deflected therein via the deflection element. Each partial body can thus be connected to an edge of an opened tissue structure via at least one retraction element. By releasing the connection between the two partial bodies, the tension on the edges of the opened tissue structure can be reduced, while at the same time, access to the opened tissue structure (e.g., for wound cleansing processes and / or examinations) and / or to a vacuum dressing can be enabled.

[0028] In particular, the base body may be made of an autoclavable or sterilizable material or comprise an autoclavable or sterilizable material and remain on the patient throughout the entire therapy. Furthermore, it is conceivable for the tensioning element to comprise a spring and / or a motor. A spring offers the advantage of a mechanical drive and can be designed so that the tensioning element and the device are autoclavable. A motor can enable electrical control of the tensioning element. Furthermore, a hydraulic and / or pneumatic drive for the tensioning element would also be conceivable.

[0029] The clamping element can be at least partially mounted in or on the base body. This allows for a space-saving design of the device, especially the combination of clamping element and base body. Mounting the clamping element in the base body also allows for easy cleaning of the device, since only the base body needs to be cleaned.

[0030] Alternatively, it is possible that the tensioning element is not attached to the base body, but is connected or connectable to the base body via at least one retraction element.

[0031] It is possible for the clamping element to comprise a chamber, in particular a hydraulic and / or pneumatic chamber. The chamber can be connected directly or indirectly to a pump.

[0032] The presence of a pneumatic chamber allows a patient's coughing fits to be cushioned by briefly submerging the cylinders.

[0033] At least one pressure element can be connected to the chamber. At least one pressure element can also be embedded in the chamber. The pressure element can be configured, for example, in the shape of a cuboid or cylinder.

[0034] The pressure element can be connected to at least one retraction element, which is directly or indirectly connected to an edge of an opened tissue structure. A pump connected to the chamber can move the at least one pressure element in such a way that a tensile force is exerted on the edge of the opened tissue structure via the at least one retraction element connected to the pressure element.

[0035] If the device comprises a tensioning element with several pressure elements, each of which is connected to at least one retraction element, each retraction element can experience the same tensile force, possibly even continuously. By connecting the chamber to a pump (e.g. an electric pump or a manual pump), the pressure in the chamber and thus the tensile force of the at least one retraction element can be varied from outside as required. The connection can, for example, be a pneumatic or hydraulic connection, e.g. one or more tubes. This can enable flexible adaptation to different stages of wound healing, tissue properties, patient needs, etc. The chamber can be arranged outside the soft tissue defect or the opened tissue structure and / or away from a dressing located in the opened tissue structure.It is conceivable that the chamber is placed near the opened tissue structure under a sterile film.

[0036] The at least one retraction element can comprise at least one thread and / or suture material and / or at least one mesh and / or at least one mesh strip and / or at least one clamp and / or at least one hook and / or at least one tube, for example, a Bowden PTFE tube, and / or at least one wire. Several of the aforementioned elements can also be combined to form a retraction element. By selecting one of the aforementioned retraction elements or combining at least two of the aforementioned retraction elements, the device can be individually adapted to the nature of the tissue opening to be treated.

[0037] The device can comprise multiple retraction elements of different lengths and / or sizes. In particular, it is conceivable that, if the base body is located in the center of the tissue opening, the distance between the base body and the edges of the tissue opening varies. Retraction elements of different sizes and / or lengths can be used to enable uniform tension on the edges. In particular, the length of the retraction elements can be adapted to varying wound dehiscence. In the case of wound dehiscence, an undesirable separation of the wound edges occurs. The wound thus gapes apart, the extent and depth of which depends on the severity of the wound dehiscence.

[0038] In particular, it is conceivable for a retraction element to comprise at least one surgical thread and at least one mesh or mesh strip and / or at least one hook. The at least one mesh can be connected on one side to an edge of the opened tissue structure by numerous attachment points (e.g., by hooks, stitches, and / or clamps), and on the other side to a thread (thread pulled through the mesh mesh or secured with a hook or clip), which in turn is connected to the base body. This enables a very even distribution of force through the numerous attachment points at the edge of the opened tissue structure (fascia). Furthermore, significantly less resistance can result when the thread slides through the mesh mesh. By varying the number of stitches on the mesh (i.e., the connection points between the thread and the mesh), the total tensile force exerted by the device can be controlled.The more stitches there are (connections between the thread and the mesh), the greater the force. Furthermore, the mesh interposition (between the tissue and the thread) can be used as an additional suture bed for the definitive closure of the opened tissue structure at the end of the device's use on the patient.

[0039] The invention further encompasses a wound care system comprising at least one device according to the invention, wherein the wound care system further comprises a vacuum dressing system, wherein the vacuum dressing system comprises at least one foam film dressing and a vacuum pump. Vacuum dressing systems can be provided by various manufacturers and / or suppliers or can be custom-made. The combination of the device according to the invention with the vacuum dressing system can enable improved wound healing. The use of vacuum dressings in an open abdomen is associated with a reduced incidence of enteroatmospheric fistulas, which is why their use should be sought.

[0040] The vacuum dressing system can also be referred to as a vacuum-assisted wound conditioning and cleansing system. The principle of vacuum-assisted treatment is very simple: A foam (or other wound filler, e.g., a sponge) is cut to approximately the size of the tissue opening and inserted into the tissue opening. The wound area is covered with at least one film and connected to a vacuum via a drainage tube connected to the foam or similar device.

[0041] The combination of foam or other material and film can be referred to as a foam-film dressing. The foam ensures that the applied pressure is evenly distributed over the entire surface of the tissue opening. The suction provokes active wound cleansing by removing excess wound exudate, cellular debris, and bacteria from the wound. Wound edema is reduced, thus improving blood circulation in the wound area. Furthermore, the formation of granulation tissue is accelerated.

[0042] In particular, it is conceivable that the device according to the invention is at least partially integrated into the foam film dressing or at least partially applied to it. The device can then fully develop its effect. This has the advantage that the patient being treated with the wound care system is restricted as little as possible by the system. This, in turn, enables improved positioning and improved conditions for patient care.

[0043] Further details and advantages of the inventions will now be explained with reference to embodiments shown in more detail in the drawings.

[0044] 1 shows an exemplary representation of an embodiment of a device according to the invention for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect;

[0045] Fig. 2 shows a further exemplary representation of an embodiment of a device according to the invention for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect;

[0046] Fig. 3 is an exemplary representation of a wound care system according to the invention;

[0047] Fig. 4 is an exemplary representation of a further embodiment of a device according to the invention for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect (on an abdominal wall simulator);

[0048] Fig. 5 is a representation of an embodiment of a clamping element 106 with a chamber 118 and five pressure elements 120 in the form of cylinders 120;

[0049] Fig. 6 schematically shows another embodiment of a clamping element 106;

[0050] Fig. 7 shows exemplary different retraction elements 104;

[0051] Fig. 8 shows a schematic representation of a further embodiment of a

[0052] clamping element 106; and

[0053] Fig. 9 is a detailed view of an exemplary printing element 120. Fig. 1 shows an embodiment of a device 100 according to the invention in an opened fabric structure 114, specifically between the edges 112 of the opened fabric structure.

[0054] The opened tissue structure 114 here is an open abdomen.

[0055] The device 100 comprises a base body 102.

[0056] In this embodiment, the base body 102 has an elongated shape.

[0057] In this embodiment, the base body 102 has the shape of a cylinder; alternatively, the shape of a spindle would also be conceivable.

[0058] The device 100 further comprises a plurality of retraction elements 104, which are configured for retraction and attachment to the edges 112 of the opened tissue structure 114.

[0059] Alternatively, the device 100 could comprise only one retraction element 104 or a retraction element 104 with multiple subsections.

[0060] The base body 102 is arranged centrally, i.e. essentially centrally, between the retraction elements 104.

[0061] In this embodiment, the retraction elements 104 are threads, more precisely surgical threads. Alternatively, a different suture material or at least one mesh and / or at least one mesh strip and / or at least one staple or at least one hook or at least one tube or at least one wire would be conceivable. However, a combination of different retraction elements 104 would also be conceivable (see Fig. 2).

[0062] In this embodiment, the threads 104 are of equal length, but alternatively the threads 104 could also have different lengths.

[0063] The device also comprises a clamping element 106.

[0064] The tensioning element 106 here comprises a spring 106. Additionally or alternatively, the tensioning element 106 could also comprise a motor.

[0065] Here the spring 106 is attached to the base body 102.

[0066] This connects the spring 106 to the base body 102. In particular, the spring 106 can thus transmit force to the base body 102.

[0067] Alternatively, the spring 106 could be at least partially mounted in the base body 102.

[0068] The base body 102 is directly connected at one point to one end of each thread 104 (here by knotting). Alternatively, an indirect connection, e.g., via an intermediate element, would be conceivable. The threads 104 are each connected to an edge 112 of the open fabric structure 114 by the other end not connected to the base body 102.

[0069] In this embodiment, the threads 104 are knotted at / with the edges 112 of the opened fabric structure 114.

[0070] The spring 106 moves the base body 102 along its longitudinal axis (by tension force).

[0071] The base body 102 is thereby rotated along its longitudinal axis.

[0072] As a result, the spring 106 moves the threads 104 continuously and with a predefined constant force.

[0073] In this embodiment, the spring 106 moves the threads 104 with a force of 10 N.

[0074] Alternatively, the spring 106 can also move the threads 104 with a force of less than 10 N.

[0075] In this embodiment, the threads 104 are wound onto the cylinder 102.

[0076] As a result, the edges 112 of the opened tissue structure 114 are brought closer together, at least partially.

[0077] Retraction of the edges 112 is thus reduced.

[0078] In this embodiment, the spring 106 moves the threads 104 in a plane with the opened fabric structure 114. Alternatively, the spring 106 can move the threads 104 parallel to the fabric structure 114 (as is the case in Fig. 3).

[0079] Fig. 2 shows a further exemplary representation of an embodiment of a device according to the invention for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect.

[0080] Here, too, a device 100 according to the invention is shown in an opened fabric structure 114, specifically between the edges 112 of the opened fabric structure 114.

[0081] The device 100 comprises a base body 102 and a clamping element 106 (clamping element 106 not explicitly shown).

[0082] In this embodiment, the tensioning element 106 is a winch which is located in the base body 102.

[0083] The base body 102 thus comprises a winch.

[0084] In this embodiment, pulleys are attached to the base body 102. The device 100 further comprises a plurality of retraction elements 104, which are configured for retraction and attachment to the edges 112 of the opened tissue structure 114.

[0085] Here, there is a combination of different retraction elements 104, namely a combination of surgical threads 104 and meshes 104. In particular, there is a combination of two surgical threads 104 and two meshes 104.

[0086] The base body 102 is arranged centrally, i.e. essentially centrally, between the retraction elements 104.

[0087] Each mesh 10 is connected to an edge 112 of the opened fabric structure 114. In this exemplary embodiment, each mesh 104 is knotted on one side to / with an edge 112 of the opened fabric structure 114 using surgical threads. The other side of each mesh 104 is connected to a respective surgical thread 104.

[0088] A surgical thread 104 is pulled through the meshes of each net 104 (on the side opposite the fabric edge 112).

[0089] Each surgical thread 104 is also connected to the base body 102 via the pulleys. In other words, each surgical thread 104 is wound around pulleys on the base body 102.

[0090] The winch in the base body 102 moves the threads 104 (tractive force) continuously and with a constant force. The force exerted by the winch is transferred via the threads 104 to the nets 104, to the edges 112 of the opened fabric structure, so that the edges 112 of the opened fabric structure 114 are at least partially brought closer together.

[0091] Retraction of the edges 112 is thus reduced.

[0092] Fig. 3 shows an exemplary representation of a wound care system according to the invention.

[0093] The wound care system according to the invention comprises a device 100 according to the invention and a vacuum dressing system.

[0094] Shown is the embodiment of a device 100 according to the invention shown in Fig. 1.

[0095] Also shown is a foam film dressing 110 of a vacuum dressing system.

[0096] The vacuum dressing system further includes a vacuum pump (not shown).

[0097] In this embodiment, the device 100 is integrated into the foam film dressing 110. Alternatively, the device 100 could be applied to the foam film dressing 110. The function of the device 100 can essentially be derived from the description of Fig. 1. By means of the tensioning element 106, the retraction elements are moved essentially parallel to the opened tissue structure 114.

[0098] The combination of the vacuum dressing system and the device 100 results in a synergistic effect for the patient's wound healing.

[0099] Fig. 4 shows an exemplary representation of a further embodiment of a device 100 according to the invention for reducing the retraction of the edges and / or for stretching the edges of an opened tissue structure of a patient with an open soft tissue defect (on an abdominal wall simulator).

[0100] The abdominal wall simulator simulates both the opened tissue structure of a patient and the edges of the opened tissue structure.

[0101] The device 100 comprises a base body 102.

[0102] In this embodiment, the base body 102 comprises two partial bodies 116.

[0103] In other words: The base body 102 is divided into two partial bodies 116 along its longitudinal axis.

[0104] The partial bodies 116 are detachably connected to one another.

[0105] The device further comprises a plurality of retraction elements 104 for retraction and attachment to the edges of an opened tissue structure.

[0106] In this embodiment, the retraction elements 104 comprise threads 104 and tubes 104.

[0107] 18 threads 104 are shown.

[0108] Alternatively and / or additionally, nets, net strips, hooks, clamps or similar are conceivable.

[0109] Each thread 104 is connected to the abdominal wall simulator, thus simulating a connection of the threads to the edges of the opened tissue structure.

[0110] The threads 104 are connected laterally to the abdominal wall simulator, run towards the center of the simulator (corresponding to the center of the patient's body) through a partial body 116 (the 9 threads on the left side run through the left partial body 116, the 9 threads on the right side run through the right partial body 116, thus a separation of the connection of the partial bodies 116 is possible),

[0111] The threads 104 are redirected within the partial bodies 116 and exit the partial bodies 116 on a different side than they entered (here, the underside). After exiting the partial bodies 116, the threads 104 are sheathed by tubes 104.

[0112] The device further comprises a clamping element 106 (not shown).

[0113] The clamping element 106 comprises a chamber 118 (see Figures 5 and 6).

[0114] In this embodiment, the chamber 118 is a hydraulic chamber 118.

[0115] Alternatively and / or additionally, a pneumatic chamber 118 is conceivable.

[0116] 18 pressure elements 120 are embedded in the chamber 118.

[0117] The pressure elements 120 are designed as cylinders 120.

[0118] A different number of printing elements 120 is conceivable, but at least one printing element 120 is mandatory.

[0119] Alternatively, the pressure elements 120 may be connected to the hydraulic chamber 118.

[0120] Each pressure element 120 is connected to a thread 104 covered by a hose 104.

[0121] In other words, each of the 18 threads is connected at a first end to the abdominal wall simulator and can thus be connected to the edge of an opened tissue structure.

[0122] Each of the 18 threads is connected at a second end to a cylinder 120.

[0123] A pump is connected to the chamber 118, preferably via a hydraulic and / or pneumatic connection 122.

[0124] In this embodiment, the pump is a manual pump.

[0125] Alternatively, an electric pump could be used.

[0126] The pump may be part of the device 100, but it may also be an external part.

[0127] The force transmitted to the cylinders 120 via the pump via the chamber 118 moves the cylinders 120 in such a way that a tensile force is exerted on the abdominal wall simulator on the threads 104 connected to the cylinders 120 as a simulation of the edges of the opened tissue structure.

[0128] The tensioning element 106 (here, the chamber 118 and the cylinders 120) allows the retraction elements 104 (here, threads) to all be moved with the same force. This force can be predefined and continuous. The presence of a pneumatic chamber allows a patient's coughing fits to be cushioned by briefly submerging the cylinders. However, the force can also be controlled individually and / or as needed via the pump. This allows the opposing parts of the abdominal wall simulator (as a simulation for the edges of the opened tissue structure 114) to be at least partially brought closer together.

[0129] This embodiment comprises 18 threads, but a different number of threads is conceivable (e.g., 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, etc.). It is advantageous, but not absolutely necessary, for each partial body 116 to be connected with the same number of threads.

[0130] The device 100 described in Fig. 4 can be part of a wound care system 108 which, in addition to the device 100, comprises a vacuum dressing system 108 comprising a foam film dressing 110 and a vacuum pump.

[0131] The installation of an appropriate wound care system can be carried out as described below:

[0132] A mesh, for example in the form of a strip of mesh, is sewn to the edges of an opened tissue structure in a patient with an open soft tissue defect (e.g., after surgery). For example, it is conceivable that a mesh is sewn to the posterior rectus sheath, for example, a few centimeters lateral to the posterior side of the rectus sheath. One such mesh is sewn to the tissue edges on two opposite sides of an opened tissue structure.

[0133] It is advantageous to sew the mesh to the edges of the opened fabric structure with many stitches so that the force that will later be applied can be distributed as evenly as possible over the edges of the opened fabric structure, thus largely preventing it from tearing out of potentially brittle fabric.

[0134] A first foam or sponge (part of the vacuum dressing) can be inserted into the opened tissue structure. In particular, the first foam or sponge can be placed directly at the outermost edge of the opened tissue structure or beneath the outermost edge (a few centimeters lateral to the outermost tissue edge) to prevent contact of organs, such as the intestines, with the fascial edges.

[0135] Nine staples 104, each connected by a thread 104, are attached to each of the two meshes, preferably on the opposite side of the tissue edge. The nine threads 104 can then be connected to a partial body 116 of the base body 102 of the device 100 as described in Fig. 4.

[0136] Nine threads each are deflected in a partial body 116, leave the partial body 116 and are each covered with a hose after leaving.

[0137] The two partial bodies are then releasably connected and placed on the first foam or sponge, which has been inserted into the opened tissue structure. A second (subcutaneous) foam or sponge can then be placed on top. The tubes with the threads 104 can be routed out at one pole of the opened tissue structure.

[0138] A sterile film can now be applied to the second foam or sponge, which ultimately allows suction to be applied to the vacuum dressing.

[0139] The base body, the first and second foam and / or sponge are arranged in a sterile manner.

[0140] The clamping element 106 can be arranged sterilely under a second film, so that only the pneumatic / hydraulic connection between the clamping element 106 and the pump leaves the sterile space and is connected to the pump.

[0141] The pump builds up pressure, which ultimately leads to the pulling of the threads 104, so

[0142] The vacuum dressing can then be changed as follows:

[0143] The connection between the hydraulic chamber 118 and the pump is released.

[0144] Next, the second film, the first film and the second foam or sponge are removed.

[0145] Care is taken to ensure that the base body 102 remains sterile.

[0146] The detachable connection between the two partial bodies 116 is separated, so that the partial bodies 116 with their nine threads 104 each can be folded to the side without having to detach them from the respective connected net strip 104.

[0147] The first foam and / or sponge can now be removed and / or replaced. Furthermore, the opened tissue structure 114 can be examined.

[0148] The partial bodies 116 can be reconnected as described above, and the vacuum dressing can be completed as described above.

[0149] The base body 116 always remains sterile.

[0150] The tensioning element 106 can be connected to the pump using a new, sterile connecting tube. At the end of therapy, the dressing can be removed as described above.

[0151] The clips 104 are removed from the mesh strips 104.

[0152] The opened fabric structure can be closed primarily with sutures. The sewn-in mesh strip 104 can be used as a supplementary, stable suture support.

[0153] Fig. 5 shows an embodiment of a clamping element 106 with a hydraulic chamber 118 and five pressure elements 120 in the form of cylinders 120.

[0154] The functioning of the clamping element 106 is essentially described in Fig. 4, but unlike what is described in Fig. 4, there are only five cylinders 120 here.

[0155] Each thread 104 is fixed to a cylinder 120.

[0156] The hydraulic chamber 118 is connected to a pump via a hose 122.

[0157] The force transmitted to the cylinders 120 via the pump via the chamber 118 moves the cylinders 120 in such a way that a tensile force is exerted on the threads 104 connected to the cylinders 120, which makes it possible to bring the edges of an opened fabric structure closer together.

[0158] Fig. 6 shows schematically another embodiment of a clamping element 106.

[0159] In this embodiment, the clamping element 106 comprises a pneumatic chamber 118.

[0160] The clamping element 118 further comprises 11 pressure elements.

[0161] The operation of the clamping element 106 is analogous to the clamping elements described in Figures 4 and 5.

[0162] Fig. 7 shows examples of various retraction elements 104.

[0163] Shown are two different hooks 104 fixed to a thread device, which engage in a net 104.

[0164] Such a mesh can be connected (e.g. sewn) to the tissue edges of an opened tissue structure.

[0165] The net 104 can be connected to a tensioning element 106 via threads 104 attached to the hooks 104.

[0166] Two or more interconnected retraction elements 104 can also be understood as one retraction element 104.

[0167] Fig. 8 shows a schematic representation of another embodiment of a

[0168] Clamping element 106. The clamping element 106 comprises a hydraulic chamber 118 and a total of ten cylinders 120, with five cylinders 120 each protruding from the chamber on two opposite sides of the chamber 118.

[0169] A retraction element 104 can be attached to the head of each cylinder that protrudes from the chamber 118.

[0170] Alternatively, the chamber 118 may be a pneumatic chamber 118.

[0171] A different number of cylinders, 120, is also conceivable.

[0172] The operation of the clamping element 106 essentially corresponds to the operation of the clamping element 106 described in Fig. 4.

[0173] Fig. 9 shows a detailed view of an exemplary printing element 120.

[0174] Such a pressure element 120 can be used in a clamping element 106, as shown, for example, in Figures 5, 6 and 8.

[0175] The pressure element 120 essentially has the shape of a cylinder 120.

[0176] The head of the printing element 120 is shown on the left.

[0177] This protrudes from the chamber 118 (see Figures 5, 6) and is designed such that a retraction element 104, in particular in the form of a thread 104, can be fixed to it in a simple manner.

[0178] Reference symbol

[0179] device

[0180] Basic body

[0181] Retraction element

[0182] clamping element

[0183] Wound care system

[0184] Foam film dressing

[0185] Edge of an opened tissue structure

[0186] Tissue structure

[0187] Partial body

[0188] chamber

[0189] Pressure element / cylinder

[0190] connection, hose

Claims

Claims Device (100) for reducing the retraction of the edges and / or for stretching the edges (112) of an opened tissue structure (114) of a patient with an open soft tissue defect, wherein the device (100) comprises at least one base body (102), at least one retraction element (104) for retraction and attachment to the edges of the opened tissue structure and a tensioning element (106), wherein the tensioning element (106) is designed and configured such that by means of the tensioning element (108) the at least one retraction element (104) is movable such that the edges (112) of the opened tissue structure (114) are at least partially brought closer together.Device (100) according to claim 1, characterized in that the device (100) is designed and configured such that, by means of the tensioning element (106), the at least one retraction element (104) can be moved substantially in a plane with the opened tissue structure (114) or substantially parallel to the opened tissue structure (114). Device (100) according to claim 1 or claim 2, characterized in that the tensioning element (106) is designed and configured such that, by means of the tensioning element (106), the at least one retraction element (104) can be moved with a force of up to 10 N. Device (100) according to one of claims 1 to 3, characterized in that the device (100) comprises at least two retraction elements (104). Device (100) according to claim 4, characterized in that the base body (102) is arranged substantially centrally between the at least two retraction elements (104). Device (100) according to one of the preceding claims, characterized in that the base body (102) is directly and / or indirectly connected at least one point to the at least one retraction element (104) or to the at least two retraction elements (104). Device (100) according to one of the preceding claims, characterized in that the base body (102) comprises at least two partial bodies (116) which can be detachably connected to one another. Device (100) according to one of the preceding claims, characterized in that one partial body (116) comprises at least one deflection element which is designed to deflect the at least one retraction element (104). Device (100) according to one of the preceding claims, characterized in that the tensioning element (106) comprises a chamber (118), in particular a hydraulic chamber and / or a pneumatic chamber (118).Device (100) according to one of the preceding claims, characterized in that at least one pressure element (120) is connected to the chamber (118) or at least one pressure element (120) is embedded in the chamber (118), wherein the pressure element (120) is connected to the at least one retraction element (104) which is directly or indirectly connected to an edge of the opened tissue structure (114), wherein the at least one pressure element (120) can be moved via a pump which is connected to the chamber (118) in such a way that a tensile force is exerted on the edge of the opened tissue structure (114) via the at least one retraction element (104) connected to the pressure element (120). Device (100) according to one of the preceding claims, characterized in that the at least one retraction element (104) comprises at least one thread and / or suture material and / or at least one mesh and / or mesh strip and / or at least one clamp and / or at least one hook and / or at least one tube and / or at least one wire. Device (100) according to one of the preceding claims, characterized in that the device (100) comprises a plurality of retraction elements (104) of at least partially different lengths and / or sizes. Wound care system (108) comprising at least one device (100) according to one of claims 1-12, wherein the wound care system (108) further comprises a vacuum dressing system, wherein the vacuum dressing system comprises at least one foam film dressing (110) and a vacuum pump.Wound care system (108) according to claim 13, characterized in that the at least one device (100) according to one of claims 1-12 is at least partially integrated into the foam film dressing (110) or at least partially applied thereto.

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