Device for reducing retraction of and / or stretching edges of opened tissue structures - Patent Application 20070122999

Abstract

The present invention relates to a device (100) for reducing retraction and / or stretching edges (112) of an open tissue structure (114) in a patient having an open soft tissue defect, the device (100) having at least one base body portion (102), at least one retraction element (104) for retracting and attaching to the edges of the open tissue structure, and a clamping element (106), the clamping element (106) designed and arranged such that the at least one retraction element (104) can be moved by the clamping element (108) so that the edges (112) of the open tissue structure (114) are at least partially brought together. The present invention further relates to a wound care system (108) including at least one such device (100) and a vacuum dressing system, the vacuum dressing system including at least one foam sheet dressing (110) and a vacuum pump.

Description

[Technical Field]

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

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

[0003] After visceral surgery, it may be impossible or even undesirable to close the abdominal wall after the actual procedure is completed. This may be the case in some cases, such as in the case of a perforation of a hollow organ, where the patient has a severely contaminated abdominal cavity. In such cases, repeated irrigation of the abdominal cavity (particularly peritoneal cavity irrigation) may be indicated.

[0004] It is also possible that in cases of hollow viscus injuries that cannot be treated surgically, such as small bowel fistulas, the abdominal wall cannot or should not be closed early.

[0005] Other conditions include, for example, ileus, in which the intestines require so much space despite decompression that the fascia in the abdominal wall area cannot close.

[0006] It is also possible that the abdominal cavity does not reclose early if there is a risk of abdominal compartment syndrome, a life-threatening condition that occurs as a result of a sudden increase in intra-abdominal pressure (especially IAP > 12 mmHg) resulting in significant damage to intra- and extra-abdominal organ systems.

[0007] In particular, additional symptoms may be expected due to the treatment of large hernias.

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

[0009] An example of this is a wound care device according to WO2022074032, which includes a device for reducing retraction of opened fascial edges after / during abdominal opening.

[0010] However, such devices are undesirable in that they only reduce the retraction of the edges of the patient's opened tissue structures, while actual approximation of the edges would be more favorable for reclosure of the tissue structures.

[0011] Moreover, these devices require a lot of space, especially vertical space (from the point of view of the reclining patient), which is particularly problematic when the patient requires intensive care. Also, patient repositioning is significantly limited (maximum lateral tilt of 30°), which, on the one hand, increases the risk of bedsores and, on the other hand, makes it more difficult to ensure normal care routines and personal hygiene of the patient. Summary of the Invention

[0012] The object of the present invention is therefore to advantageously further develop a device for reducing and / or stretching the edges of an opened tissue structure of a patient of the type mentioned at the outset, with the effect, inter alia, that a better closure of the opened tissue structure of the patient can be achieved.

[0013] This problem is solved according to the invention by a device with the features of claim 1. Thus, there is provided a device for reducing retraction of and / or stretching edges of an opened tissue structure in a patient with an open soft tissue defect, whereby the device comprises at least one base body part, at least one retraction element for retracting and attaching to the edges of the opened tissue structure, and a clamping element, the clamping element being designed and arranged such that the at least one retraction element can be moved by the clamping element, in particular continuously and / or with a predefined constant force, so that the edges of the opened tissue structure are at least partially brought together.

[0014] The present invention is based on the basic idea that the edges of an opened tissue structure can be brought closer together or drawn together. This drawing process should not be sudden or carried out with too much force. Rather, the edges of the wound can be pulled relatively slowly, possibly with a predefined and / or appropriate force, thereby at least partially drawing the edges of the wound closer together. Thus, not only can retraction of the edges of the opened tissue structure be reduced, but said approximation of the edges can also facilitate or improve closure of the opened tissue structure.

[0015] The edge of the opened tissue construct refers to both the outermost boundary of the tissue (skin, muscle, fascia, rotator cuff, fat, etc.) positioned in front of the opened tissue construct and several centimeters lateral to it (away from the center of the body).

[0016] The device can be designed and set up so that at least one retraction element can be moved by the clamping element essentially in a plane with or essentially parallel to the opened tissue structure. In other words, the pulling movement can be performed more or less at the level of or in the plane of the edge of the opened tissue structure. As a result, the device requires little space, especially in the vertical direction (from the point of view of the lying patient), which is particularly advantageous when the patient requires intensive care. It also allows for repositioning the patient, which, on the one hand, reduces the risk of bedsores and, on the other hand, allows for normal care routines and the patient's personal hygiene.

[0017] The clamping element can be designed and set up such that at least one retraction element is moved by the clamping element with a force of at most 10 N. This magnitude of force not only makes it possible to reduce the edges of the opened tissue structure, but also makes it possible to at least partially bring the edges of the opened tissue structure closer together.

[0018] In particular, it can be further provided that the device comprises at least two retraction elements. Alternatively, it is also conceivable that the device comprises a retraction element with several (at least two) sections. Several retraction elements or several sections of a retraction element can allow better approximation of the edges of the opened tissue structure.

[0019] Furthermore, it can be provided that the base body is essentially centrally disposed between the at least two retraction elements, so that the opposite edges of the opened tissue structure can be brought closer together.

[0020] It is particularly conceivable that the base body is directly and / or indirectly connected at least at one point to the at least one retraction element or to the at least two retraction elements. This allows forces to be transmitted from the clamping element via the base body to the at least one or at least two retraction elements and from there to the edge of the released tissue structure. Alternatively and / or additionally, it is conceivable that the base body guides and / or deflects the at least one retraction element.

[0021] The base body can have a substantially elongated shape. Tissue openings are often substantially elongated due to surgical incisions. Therefore, a base body having a substantially elongated shape is highly compatible with elongated tissue openings. This allows the edges of the tissue opening to be brought together along an axis, such that only one (longitudinal) suture is required to close the tissue opening.

[0022] It is especially conceivable for the base body to be essentially in the form of a cuboid, a cylinder or a spindle. A base body in the form of a cylinder or spindle has the advantage that the retraction element in the form of a thread can easily be wound around the cylinder or spindle.

[0023] Additionally, the base body portion can include a retraction mechanism that allows the edges of the opened tissue structure to be pulled toward the center of the tissue opening. Alternatively, the clamping element can include the retraction mechanism.

[0024] It is also conceivable that the base body comprises at least two partial body parts that can be releasably connected to one another, for example by screws, clips, clicks, plugs, ties, and / or magnetism.

[0025] It is especially conceivable that the base body comprises two partial body parts, which are detachably connected to one another, for example along their longitudinal axes.

[0026] Each partial body portion can be connected to at least one retraction element and / or designed such that it is set up to deflect at least one retraction element.

[0027] In other words, each partial body can include at least one deflection element that is set up to deflect at least one retraction element. Alternatively, it is also possible that one or more deflection units are attached to the partial body.

[0028] It is conceivable that at least one retraction element can be guided through the partial body parts and deflected therein via the deflection element. Thus, each partial body part can be connected to an edge of the opened tissue structure by at least one retraction element. By loosening the connection between the two partial body parts, on the one hand, the tension on the edge of the opened tissue structure can be reduced, and on the other hand, access to the opened tissue structure (e.g., for wound cleansing processes and / or investigations) and / or access to the vacuum dressing can be made possible.

[0029] In particular, it may be envisioned that the base body portion is made from or includes an autoclavable or sterilizable material and remains on the patient throughout treatment.

[0030] Furthermore, it is conceivable that the clamping element includes a spring and / or a motor. The spring provides the advantage of a mechanical drive and can be designed so that the clamping element and the device can be autoclaved. The motor can allow electrical control of the clamping element. Furthermore, hydraulic and / or pneumatic drives of the clamping element are also conceivable.

[0031] 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, and in particular of the combination of the clamping element and the base body. Mounting the clamping element in the base body also makes it easier to clean the device, since only the base body needs to be cleaned.

[0032] Alternatively, it is also possible that the clamping element is not attached to the base body part but is or can be connected to the base body part via at least one retraction element.

[0033] The clamping element may comprise a chamber, in particular a hydraulic and / or pneumatic chamber, which may be directly or indirectly connected to a pump.

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

[0035] At least one pressure element may be connected to the chamber and may be present in the chamber, and the pressure element may be in the form of, for example, a rectangular parallelepiped or a cylinder.

[0036] The pressure element can be connected to at least one retraction element, which is directly or indirectly connected to an edge of the opened tissue structure, and via a pump connected to the chamber, the at least one pressure element can be moved such that tension is exerted on the edge of the opened tissue structure via the at least one retraction element connected to the pressure element.

[0037] If the device includes a clamping element with several pressure elements, each connected to at least one retraction element, each retraction element is subjected to the same tension, possibly even sequentially. By connecting the chamber to a pump (e.g., an electric or manual pump), the pressure in the chamber, and thus the tension of the at least one retraction element, can be varied externally as needed. The connection can be, for example, a pneumatic or hydraulic connection, e.g., one or more tubes. This can allow for flexible adaptation to different wound healing stages, tissue characteristics, patient needs, etc.

[0038] The chamber can be positioned outside the soft tissue defect or open tissue structure and / or away from a dressing positioned within the open tissue structure. It is contemplated that the chamber may be attached under a sterile film adjacent to the open tissue structure.

[0039] 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 clip 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 mentioned elements can also be combined to form a retraction element. By selecting one of the mentioned retraction elements or by combining at least two of the mentioned retraction elements, an individual adaptation of the device to the nature of the tissue opening to be treated is achieved.

[0040] The device can include several retraction elements of different lengths and / or sizes. It is particularly contemplated that when the base body is centered in the tissue opening, the distance between the base body and the edges of the tissue opening will vary. Retraction elements of different sizes and / or lengths can be used to allow uniform traction at the edges. In particular, the length of the retraction elements can be adapted to varying wound dehiscence. Wound dehiscence is the undesirable separation of wound edges. The extent and depth of wound dehiscence depend on the severity of the wound dehiscence.

[0041] Specifically, it is conceivable that the retraction element includes 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 to the edge of the opened tissue structure on one side by multiple attachment points (e.g., by hooks, sutures, and / or clips), and on the other side by a thread (pulled through the mesh or secured by hooks or clips), which is then connected to the base body. This allows for very uniform distribution of force through the multiple attachment points at the edge of the opened tissue structure (fascia). Furthermore, there can be significantly less resistance as the thread slides through the mesh. The total tension exerted by the device can also be controlled by varying the number of stitches on the mesh (i.e., the points where the thread connects to the mesh). The more stitches there are (if the thread is attached to the mesh), the greater the force. Additionally, the interposition of the mesh (between the tissue and the thread) can be used as an additional seam bearing for permanent closure of the opened tissue structure upon completion of the device's use on the patient.

[0042] The present invention further includes a wound care system comprising at least one device according to the present invention, the wound care system further comprising a vacuum dressing system, the vacuum dressing system comprising at least one foam film dressing and a vacuum pump. The vacuum dressing system can be provided by a different manufacturer and / or supplier or can be manufactured separately. Combining a device according to the present invention with a vacuum dressing system can enable improved wound healing. The use of vacuum dressings in open abdomens is associated with a reduced incidence of enteroatmospheric fistulas, which is why their use should be targeted.

[0043] A vacuum dressing system can also be referred to as a vacuum-assisted wound preparation and cleansing system. The principle of vacuum-assisted treatment is very simple: foam (or other wound filler, e.g., sponge) is cut to the approximate size of the tissue opening and placed into the tissue opening. The wound area is covered with at least one film and connected to a vacuum by a drainage tube attached to the foam or similar.

[0044] The combination of foam or the like and film can be referred to as a foam film dressing. The foam ensures that the applied vacuum is evenly distributed over the entire surface of the tissue opening. The suction causes active wound cleansing by removing excess wound exudate, cellular debris, and bacteria from the wound. Wound edema is reduced, thus improving blood flow conditions in the wound area. In addition, granulation tissue formation is accelerated.

[0045] It is particularly conceivable that the device according to the invention is at least partially integrated into or at least partially applied to a foam film dressing, allowing the device to exert its full effect, which has the advantage that the patient treated by the wound care system is thereby restricted as little as possible, which allows for improved positioning conditions and improved conditions for patient care.

[0046] Further details and advantages of the invention will now be explained on the basis of examples shown in the drawings. [Brief explanation of the drawings]

[0047] [Figure 1] 1 is an exemplary illustration of an embodiment of a device according to the present invention for reducing retraction of the edges of an open tissue structure and / or stretching the edges in a patient having an open soft tissue defect. [Figure 2] FIG. 10 is another exemplary illustration of a device for reducing edge retraction and / or stretching edges of an open tissue structure in a patient having an open soft tissue defect. [Figure 3] 1 is an exemplary diagram of a wound care system according to the present invention. [Figure 4] 10A-10C are exemplary illustrations of further embodiments of devices for reducing retraction of the edges of open tissue structures in patients with open soft tissue defects and / or for stretching the edges (on an abdominal wall simulator). [Figure 5] 1 is a diagram of an embodiment of a clamping element 106 with five pressure elements 120 in the form of chambers 118 and cylinders 120. FIG. [Figure 6] 10A and 10B are diagrams illustrating a further embodiment of a clamping element 106. [Figure 7] 1A-1C illustrate various exemplary retraction elements 104. [Figure 8] 10A and 10B are diagrams illustrating a further embodiment of a clamping element 106. [Figure 9] 1 is an exemplary detailed view of a pressure element 120. FIG. DETAILED DESCRIPTION OF THE INVENTION

[0048] FIG. 1 illustrates an embodiment of a device 100 according to the present invention within an open tissue structure 114, ie, between edges 112 of the open tissue structure.

[0049] The open tissue structure 114 is the open abdomen.

[0050] The device 100 includes a base body portion 102 .

[0051] In this embodiment, the base body portion 102 has an elongated shape.

[0052] In this embodiment, the base body 102 has the shape of a cylinder, but it could alternatively have the shape of a spindle, for example.

[0053] The device 100 also includes several retraction elements 104 that are designed for retraction and attachment to the edges 112 of the opened tissue structure 114 .

[0054] Alternatively, the device 100 may include only one retraction element 104 or a retraction element 104 with several sections.

[0055] The base body portion 102 is here centrally located between the setback elements 104, ie, essentially in the middle.

[0056] In this embodiment, the retraction element 104 is a thread, more specifically a surgical thread. Alternatively, another suture material or at least one mesh and / or at least one mesh strip and / or at least one clamp or at least one hook or at least one tube or at least one wire would be considered. However, combinations of different retraction elements 104 would also be considered (see FIG. 2).

[0057] In this embodiment, the threads 104 are of equal length, although alternatively, the threads 104 could have different lengths.

[0058] In addition, the device includes a clamping element 106 .

[0059] The clamping element 106 here includes a spring 106. Additionally or alternatively, the clamping element 106 may include a motor.

[0060] Here, the spring 106 is attached to the base body portion 102 .

[0061] This connects the spring 106 to the base body part 102. Among other things, the spring 106 is thus able to transmit a force to the base body part 102.

[0062] Alternatively, the spring 106 can be at least partially mounted within the base body portion 102 .

[0063] The base body 102 is directly connected (here by tying a knot) at one point to one end of the thread 104. Alternatively, an indirect connection (e.g., via an intermediate element) would also be conceivable.

[0064] The threads 104 are connected by their ends not connected to the base body 102 to edges 112 of an open tissue structure 114, respectively.

[0065] In this embodiment, the thread 104 is tied to / with the edge 112 of the open tissue structure 114 .

[0066] The spring 106 (by tension) moves the base body 102 along its longitudinal axis.

[0067] This causes the base body portion 102 to rotate along its longitudinal axis.

[0068] As a result, the spring 106 moves the sled 104 continuously and with a predefined constant force.

[0069] In this embodiment, the spring 106 moves the sled 104 with a force of 10N.

[0070] Alternatively, the spring 106 may move the sled 104 with a force of less than 10N.

[0071] In this embodiment, thread 104 is wound onto cylinder 102 .

[0072] This causes the edges 112 of the open tissue structure 114 to be at least partially brought closer together.

[0073] Thus, recession of the edge 112 is reduced.

[0074] In this embodiment, the spring 106 moves the sled 104 in a plane with the open tissue structure 114. Alternatively, the spring 106 can move the sled 104 parallel to the tissue structure 114 (as is the case in FIG. 3).

[0075] FIG. 2 shows another exemplary view of an embodiment of a device for reducing edge retraction and / or stretching the edges of an open tissue structure in a patient with an open soft tissue defect.

[0076] Also shown here is a device 100 according to the present invention within an open tissue structure 114, i.e., between edges 112 of the open tissue structure 114.

[0077] The device 100 includes a base body portion 102 and a clamping element 106 (clamping element 106 not explicitly shown).

[0078] In this embodiment, the clamping element 106 is a winch that is positioned within the base body portion 102 .

[0079] Thus, the base body portion 102 includes a winch.

[0080] In this embodiment, the pulley is attached to the base body portion 102 .

[0081] The device 100 further includes a plurality of retraction elements 104 adapted to retract and attach to the edge 112 of the open tissue structure 114 .

[0082] Here, there are different combinations of retraction elements 104, namely a combination of a surgical thread 104 and a mesh 104. In particular, there is a combination of two surgical threads 104 and two meshes 104.

[0083] The base body portion 102 is here centrally located between the setback elements 104, ie, essentially in the middle.

[0084] In each case, one mesh 104 is connected to one edge 112 of the opened tissue structure 114. In this embodiment, one mesh 104 is attached on one side to / with one edge 112 of the opened tissue structure 114 by a surgical thread. The other side of each one of the meshes 104 is connected to the surgical thread 104.

[0085] The surgical thread 104 is threaded through each one of the meshes 104 (on the side facing away from the tissue edge 112).

[0086] Additionally, the surgical thread 104 is connected to the base body portion 102 via a deflection roller. In other words, the surgical thread 104 is wound around the deflection roller on the base body portion 102.

[0087] A winch in the base body 102 moves the thread 104 (tension) continuously and with constant force. The force exerted by the winch is transmitted through the thread 104 to the net 104 and to the edges 112 of the open tissue structure 114, causing the edges 112 of the open tissue structure 114 to be at least partially brought together.

[0088] Thus, recession of the edge 112 is reduced.

[0089] FIG. 3 shows an exemplary diagram of a wound care system according to the present invention.

[0090] A wound care system according to the present invention includes a device 100 according to the present invention and a vacuum dressing system.

[0091] An embodiment of an apparatus 100 according to the present invention is shown in FIG.

[0092] Additionally, a foam film dressing 110 of the vacuum dressing system is shown.

[0093] The vacuum dressing system further includes a vacuum pump (not shown).

[0094] In this embodiment, the device 100 is integrated into the foam sheet dressing 110. Alternatively, the device 100 can be applied to the foam sheet dressing 110.

[0095] The function of the device 100 can essentially be found in the description of Figure 1. By means of the clamping element 106, the retraction element is now moved essentially parallel to the released tissue structure 114.

[0096] The combination of the vacuum dressing system and device 100 results in a synergistic effect for wound healing in a patient.

[0097] FIG. 4 shows an example of a further embodiment of a device 100 according to the present invention for reducing edge retraction and / or stretching the edges of open tissue structures in a patient with an open soft tissue defect (on an abdominal wall simulator).

[0098] Here, the abdominal wall simulator simulates both the open tissue structures of the patient and the edges of the open tissue structures.

[0099] The device 100 includes a base body portion 102 .

[0100] In this embodiment, the base body portion 102 includes two partial body portions 116 .

[0101] In other words, the base body portion 102 is divided into two partial body portions 116 along its longitudinal axis.

[0102] The partial body portions 116 are releasably connected to one another.

[0103] The device also includes a plurality of retraction elements 104 for retracting and attaching the edges of the released tissue structure.

[0104] In this embodiment, the retraction element 104 includes a thread 104 and a tube 104 .

[0105] Eighteen threads 104 are shown.

[0106] Alternatively and / or additionally, mesh, mesh strips, hooks, clips, or the like are contemplated.

[0107] Each thread 104 is connected to an abdominal wall simulator, thus simulating the connection of the thread to the edge of an open tissue structure.

[0108] The threads 104 are connected laterally to the abdominal wall simulator and run through the partial body parts 116 towards the centre of the simulator (corresponding to the centre of the patient's body) (the nine threads on the left side run through the left partial body part 116 and the nine threads on the right side run through the right partial body part 116, thus allowing the connections of the partial body parts 116 to be separated).

[0109] The threads 104 are deflected within the partial body 116 and leave the partial body 116 on a different side (here the lower side) than they entered.

[0110] After leaving the partial body portion 116 , the thread 104 is placed into a tube 104 .

[0111] The device also includes a clamping element 106 (not shown).

[0112] The clamping element 106 includes a chamber 118 (see FIGS. 5 and 6).

[0113] In this example, the chamber 118 is a hydraulic chamber 118 .

[0114] Alternatively and / or additionally, a pneumatic chamber 118 is contemplated.

[0115] Eighteen pressure elements 120 are inserted into the chamber 118 .

[0116] The pressure element 120 is designed as a cylinder 120 .

[0117] A different number of pressure elements 120 are possible, but at least one pressure element 120 is required.

[0118] Alternatively, the pressure element 120 can be connected to the hydraulic chamber 118 .

[0119] Each pressure element 120 is connected to a thread 104 encased within a tube 104 .

[0120] In other words, each of the 18 threads is connected at a first end to the abdominal wall simulator and is therefore capable of being connected to the edge of the open tissue structure.

[0121] Each of the 18 threads is connected at a second end to a cylinder 120 .

[0122] A pump is connected to the chamber 118, preferably via a hydraulic and / or pneumatic connection 122.

[0123] In this embodiment, the pump is a manual pump.

[0124] Alternatively, for example, an electric pump would also be conceivable.

[0125] The pump can be part of the device 100, but it can also be an external part.

[0126] The force transmitted by the pump through the chamber 118 to the cylinder 120 moves the cylinder 120 such that tension is applied to the thread 104 connected to the cylinder 120 on the abdominal wall simulator to simulate the edge of an open tissue structure.

[0127] Thus, the retraction elements 104 (here the sled) can all be moved by the same force through the clamping elements 106 (here the chamber 118 and cylinder 120). The force can be a predefined continuous force. The presence of the pneumatic chamber means that the impact of the patient's cough can be mitigated by a brief retraction of the cylinder. The force can also be controlled individually and / or as needed using a pump. This allows the opposing parts of the abdominal wall simulator (which simulate the edges of the open tissue structure 114) to be at least partially brought together.

[0128] This embodiment includes 18 threads, although alternatively, different numbers of threads are contemplated (e.g., 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, etc.) It is advantageous, but not necessary, for each partial body to be connected to the same number of threads.

[0129] The device 100 illustrated in FIG. 4 can be part of a wound care system 108, which in addition to the device 100 includes a vacuum dressing system 108 that includes a foam film dressing 110 and a vacuum pump.

[0130] A corresponding wound care system can be applied as described below.

[0131] A mesh (e.g., in the form of a mesh strip) is sutured to each edge of an open tissue construct in a patient having an open soft tissue defect (e.g., after surgery). For example, it is conceivable that the mesh is sutured to the posterior rectus sheath, e.g., a few centimeters lateral to the dorsal surface of the rectus sheath. This type of mesh is sutured to the tissue edges on two opposing sides of the open tissue construct.

[0132] It is advantageous to suture the mesh to the edges of the opened tissue structure with many stitches so that the forces acting on it can later be distributed as evenly as possible over the edges of the opened tissue structure, thus largely preventing it from tearing away from the potentially fragile tissue.

[0133] A first foam or sponge (part of the vacuum dressing) can be placed within the opened tissue structure, particularly at or directly below the outermost edge of the opened tissue structure (several centimeters lateral to the outermost tissue edge) to avoid contact of organs (e.g., bowel) with the fascial edge.

[0134] Nine clips 104 (each connected to a thread 104) are attached to each of the two meshes, preferably on opposite sides of the tissue edges. The nine threads 104 can then be connected to the partial body portion 116 of the base body portion 102 of the device 100, as illustrated in FIG.

[0135] Each of the nine threads is deflected within the partial body 116, leaves the partial body 116, and is then each placed into a tube after leaving it.

[0136] The two partial body portions are then removably connected to one another and placed over a first foam or sponge that is introduced into the open tissue structure.

[0137] A second (subcutaneous) foam or sponge can then be placed over this. A tube with threads 104 can be routed out at one pole of the open tissue structure.

[0138] A sterile film can now be applied to a second foam or sponge, which will ultimately allow for attachment of suction to the vacuum dressing.

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

[0140] The clamping element 106 can be placed in a sterile manner under the second film, such 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 a pulling on the thread 104 (see above).

[0142] The vacuum dressing can then be modified as follows.

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

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

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

[0146] The removable connection between the two partial body portions 116 is severed, allowing the partial body portions 116 (each with their nine threads 104) to be folded sideways without having to detach them from their respective connected mesh strips 104.

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

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

[0149] The base body portion 116 remains sterile at all times.

[0150] The connection of the clamping element 106 to the pump can be made using new sterile connecting tubing.

[0151] When treatment is completed, the dressing can be removed as described above.

[0152] The clips 104 are removed from the mesh strip 104 .

[0153] Primary closure of the opened tissue structure can be performed using sutures, with the sewn mesh strips 104 additionally being used as stable suture sites.

[0154] FIG. 5 shows an example of a clamping element 106 with five pressure elements 120 in the form of hydraulic chambers 118 and cylinders 120 .

[0155] The mode of operation of the clamping element 106 is essentially as described in FIG. 4, but unlike FIG. 4, here only five cylinders 120 are present.

[0156] A sled 104 is attached to each cylinder 120 .

[0157] Hydraulic chamber 118 is connected to the pump by tubing 122 .

[0158] The force transmitted by the pump through the chamber 118 to the cylinder 120 causes the cylinder 120 to move so that tension is exerted on the thread 104 connected to the cylinder 120, which allows the edges of the opened tissue structure to move closer together.

[0159] FIG. 6 shows a further embodiment of the clamping element 106 in a schematic manner.

[0160] In this embodiment, the clamping element 106 includes a pneumatic chamber 118 .

[0161] The clamping element 118 further includes eleven pressure elements.

[0162] The function of the clamping element 106 is similar to the clamping element described in FIGS.

[0163] FIG. 7 shows various examples of retraction elements 104.

[0164] Two different hooks 104 are shown secured to the thread device, which engage the mesh 104 .

[0165] This type of mesh can be connected (eg, stitched) to the tissue edges of the open tissue construct.

[0166] The mesh 104 can be connected to a clamping element 106 via a thread 104 attached to a hook 104 .

[0167] It is also possible that two or more interconnected retraction elements 104 may be considered to be one retraction element 104 .

[0168] FIG. 8 shows a further embodiment of the clamping element 106 in a schematic manner.

[0169] The clamping element 106 includes a hydraulic chamber 118 and a total of ten cylinders 120, five of which on two opposite sides of the chamber 118 protrude from the chamber.

[0170] The retraction elements 104 may be attached to the head of each cylinder that projects from the chamber 118 .

[0171] Alternatively, the chamber 118 can be a pneumatic chamber 118 .

[0172] Other numbers of cylinders 120 are contemplated.

[0173] The mode of operation of the clamping element 106 essentially corresponds to the mode of operation of the clamping element 106 illustrated in FIG.

[0174] FIG. 9 shows a detailed view of an exemplary pressure element 120.

[0175] This type of pressure element 120 can be used, for example, in the clamping element 106 as shown in FIGS.

[0176] The pressure element 120 is essentially in the form of a cylinder 120 .

[0177] The head of the pressure element 120 is shown on the left.

[0178] It projects from the chamber 118 (see Figures 5, 6) and is designed so that the retraction element 104 (notably in the form of a sled 104) can be easily attached to it. [Explanation of symbols]

[0179] 100 devices 102 Base body 104 Regression Elements 106 Clamping Elements 108 Wound Care System 110 Foam Film Dressing 112 Edge of Open Tissue Structure 114 Organizational Structure 116 Partial Body 118 Chamber 120 pressure elements / cylinder 122 Connection, Tube

Claims

1. 1. A device (100) for reducing retraction of and / or stretching edges (112) of an open tissue structure (114) in a patient having an open soft tissue defect, said device (100) comprising at least: One base body portion (102); at least one retraction element (104) for retracting and fastening to the edge of the opened tissue structure; A clamping element (106) and Including, The device (100) is designed and arranged such that the at least one retraction element (104) can be moved by the clamping element (108) so that the edges (112) of the released tissue structure (114) are at least partially brought together.

2. The device (100) of claim 1, characterized in that the device (100) is designed and arranged so that the at least one retraction element (104) can be moved by the clamping element (106) essentially in a plane with the opened tissue structure (114) or essentially parallel to the opened tissue structure (114).

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

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

5. 5. The device (100) according to claim 4, characterized in that said base body (102) is essentially centrally located between said at least two retraction elements (104).

6. 6. The device (100) according to any one of claims 1 to 5, characterized in that the base body portion (102) is connected at least at one point to the at least one retraction element (104) or to the at least two retraction elements (104), directly and / or indirectly.

7. 7. The device (100) according to any one of claims 1 to 6, characterized in that the base body (102) comprises at least two partial body portions (116) which can be releasably connected to each other.

8. 8. The device (100) of claim 1, wherein the partial body portion (116) includes at least one deflection element configured to deflect the at least one retraction element (104).

9. 9. The device (100) according to any one of claims 1 to 8, characterized in that the clamping element (106) comprises a chamber (118), in particular a hydraulic and / or pneumatic chamber (118).

10. 10. The device (100) of claim 1, wherein at least one pressure element (120) is connected to the chamber (118) or at least one pressure element (120) is placed in the chamber (118), the pressure element (120) is connected to the at least one retraction element (104), the at least one retraction element (104) is directly or indirectly connected to an edge of the opened tissue structure (114), and the at least one pressure element (120) can be moved by a pump connected to the chamber (118) so that tension 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).

11. 11. The device (100) according to any one of claims 1 to 10, 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 clip and / or at least one hook and / or at least one tube and / or at least one wire.

12. 12. The device (100) according to any one of claims 1 to 11, characterized in that said device (100) comprises a plurality of retraction elements (104) of at least partially different lengths and / or sizes.

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

14. 14. A wound care system (108) as claimed in claim 13, characterized in that the at least one device (100) as claimed in any one of claims 1 to 12 is at least partially integrated into the foam sheet dressing (110) or at least partially applied to the foam sheet dressing (110).

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