Handpiece for integrated enhanced jet skin treatment

Abstract

The present invention provides an enhanced jet skin delivery handpiece.SOLUTION: A jet delivery handpiece 200 having an elongated housing terminating in one or more nozzles 230 for directing a therapeutic jet toward the subject's skin and therefrom along an axis at a desired jet application distance; and one or more elements of a handpiece for symbiotic therapy terminating in an operative end member having a skin contacting surface for delivering the therapy to the skin, comprising: And one or more symbiotic treatment handpiece elements whose treatment is symbiotic with the treatment provided by the therapeutic jet, wherein the operative end piece 320 and the contact surface 323 are laterally spaced from the axis, and wherein the operative end piece and the contact surface are axially offset from the one or more nozzles by a distance determined to limit the proximity of the one or more nozzles to the subject's skin down to a desired jet application distance.SELECTED DRAWING: Figure 2B

Description

[Technical Field]

[0001] The present disclosure relates to a handheld device for transdermal administration of therapeutic agents. [Background technology]

[0002] Various techniques for the therapeutic treatment of the skin of human subjects are well known in the art. One such skin care technique is described in applicant's WO 2005 / 065032, entitled "High Velocity Liquid Gas Mist Tissue Ablation Device," the contents of which are incorporated herein by reference.

[0003] The above references disclose skin abrasion devices that produce a high velocity liquid gas jet jet formed from droplets of a therapeutic agent in a liquid suspension, which is applied to a subject's skin as a continuous mist and is useful for transdermal delivery of the therapeutic agent to the subject's skin.

[0004] More particularly, with reference to prior art Figures 1A-1C, the aforementioned WO 2005 / 065032 discloses an apparatus, generally designated 200 (Figure 1A), for applying a high-velocity liquid gas mist to tissue. The integrated apparatus 200 has a generally tubular configuration and includes a sealed housing portion 202 having proximal and distal ends generally designated 210 and 212, respectively. The housing portion 202 is configured to withstand very high pressures, typically as high as 100 PSI. The proximal end 210 is provided with a gas inlet 1080 and a liquid inlet 1100, while the distal end 212 is provided with a mist jet delivery nozzle arrangement generally designated 230.

[0005] 1B and 1C, there is shown a schematic cross-sectional view of nozzle arrangement 230 of apparatus 200. Nozzle arrangement 230 includes a gas discharge nozzle, generally designated by reference numeral 1241. Disposed substantially concentrically within gas discharge nozzle 1241 is a liquid discharge nozzle 1160. Liquid inlet 1100 is connected in fluid flow communication with liquid discharge nozzle 1160 by liquid communication tube 24, which is disposed substantially concentrically within tubular housing portion 202.

[0006] Pressurized gas supplied from a pressurized gas source (not shown) enters the apparatus 200 through the gas inlet 1080 and passes along and through the tubular housing portion 202, as indicated by arrow 1340, to discharge through the gas discharge nozzle 1241. The gas discharge nozzle 1241 is generally configured to have, in flow order, a converging portion 1200, a throat portion 1220, and a diverging discharge portion 1240. As indicated by arrow 1260, the pressurized gas discharged from the nozzle 1241 is rapidly and significantly decompressed to atmospheric pressure and significantly accelerated to high velocities in the subsonic to supersonic range, particularly to supersonic velocities. The gas discharge nozzle 1241 is configured so that the discharged gas has a cone angle of less than 10 degrees, i.e., to provide a substantially parallel gas flow.

[0007] Liquid from a pressurized liquid source (not shown) enters device 200 through liquid inlet 1100 and passes through liquid communication tube 24, as indicated by arrow 1320. At distal end 212, the liquid is then ejected through opening 1280 at the distal end of liquid ejection nozzle 1160 into the ejection stream 1260 of gas, the flow of liquid being indicated by arrow 1300.

[0008] Those skilled in the art will appreciate that as the pressurized exhaled gas emerges from gas discharge nozzle 1241 into the atmosphere, the pressure of the exhaled gas rapidly drops to atmospheric pressure, as shown at 1260. The sudden pressure drop causes the velocity of the exhaled gas stream to greatly accelerate, approaching or even exceeding the speed of sound, generating a shock wave. The shock wave effect causes the liquid discharged from liquid discharge nozzle 1160 to atomize into the gas stream as a mist of droplets 1300, resulting in a relatively narrow jet of droplets in the high-velocity gas stream 1260.

[0009] Furthermore, by way of example, due to the relatively high gas pressure of approximately 689.5 KPa (100 psi) and the low liquid pressure of approximately 13.8 KPa (2 psi), as well as the relatively large inner diameter of gas discharge nozzle 1241 (approximately 0.8 mm) compared to the small inner diameter of liquid discharge nozzle 1160 (approximately 0.09 mm), the ratio of liquid flow rate to gas flow rate is extremely low.

[0010] In the field of skin care, various add-on techniques are known for their beneficial effects.

[0011] For example, electroporation uses electrical pulses to enhance cell permeability and aid in the deep penetration of skin care products. A detailed description of electroporation can be found in an article in Front.Bioeng.Biotechnol., January 16, 2023, Cell and Gene Therapy section, Vol. 10, 2022. Also, U.S. Patent No. 1,1291,836 to Broderick et al. discloses an electroporation device for skin treatment.

[0012] Ultrasound therapy, also known as phonophoresis and sonophoresis, is well known to aid in the transdermal administration of therapeutic agents, for example, https: / / en.wikipedia.org / wiki / Phonophoresis Summary of the Invention

[0013] The present invention aims to provide an enhanced jet projection skin delivery handpiece.

[0014] Thus, according to one embodiment: a jet jet delivery handpiece having an elongated housing terminating in one or more nozzles for directing a therapeutic jet along an axis toward the subject's skin a desired jet application distance therefrom; one or more symbiotic treatment handpiece elements terminating in an operating end member having a skin-contacting surface for delivering treatment to the skin, the treatment being symbiotic with the treatment delivered by the treatment jet; Including, the end member and the contact surface are laterally spaced apart from the axis; A multi-technology skin treatment integrated handpiece is provided in which the working end member and contact surface are axially offset from one or more nozzles by a distance determined to limit the proximity of the one or more nozzles to the subject's skin at a lower limit of a desired jet application distance.

[0015] Additionally, according to one embodiment, the working end of one or more of the co-treatment handpiece elements is axially adjustable relative to one or more nozzles, thereby adjusting the spray application distance accordingly.

[0016] Additionally, according to one embodiment, the one or more symbiotic treatment handpiece elements include first and second symbiotic treatment handpiece elements.

[0017] Furthermore, according to one embodiment, the working end member and the skin contact surface are curved and mounted to lie in a plane perpendicular to the axis.

[0018] Furthermore, according to one embodiment, the skin-contacting surface is arcuate and is mounted such that the center of curvature of the skin-contacting surface intersects the axis in a plane perpendicular to the axis.

[0019] Additionally, according to one embodiment, one or more of the symbiotic treatment handpiece elements also include: a cylindrical sheath having a proximal end and a distal end configured to fit at least partially around a housing of the jet delivery handpiece such that one or more nozzles of the jet delivery handpiece protrude through the distal end of the cylindrical sheath; a support for mounting the operating end member to the distal end of the cylindrical sheath so as to position the contact surface at a distance equal to a desired spray application distance from the one or more nozzles; Includes.

[0020] Further, according to one embodiment, the housing of the jet jet delivery handpiece has a proximal end and a distal end, and the jet jet delivery handpiece also includes a jet jet delivery head formed at the distal end of the housing terminating in one or more nozzles, the delivery head connected to a source of liquid suspension of therapeutic agent and to a source of pressurized gas for selectively mixing and supplying the liquid suspension and pressurized gas to the jet jet delivery head.

[0021] Furthermore, according to one embodiment, the working end member is electrically powered and the one or more co-treatment handpiece elements include electrical conducting elements for supplying electricity from the power source to the working end member.

[0022] Further, according to one embodiment, the jet delivery handpiece includes a liquid supply tube disposed within the housing for supplying a liquid suspension of a therapeutic agent, the housing operable to convey pressurized gas to the delivery head for mixing the liquid and pressurized gas at the delivery head into a jet for delivery through the one or more nozzles; The cylindrical sheath is fitted with an electrical conductor for supplying power to the operating end member in combination with the cylindrical sheath.

[0023] Further, according to one embodiment, the liquid supply tube terminates at a proximal end in a liquid connector to an external liquid source, the sealed housing terminates at a proximal end in a gas connector to an external pressurized gas source, and the electrical conductor terminates at a proximal end in an electrical connector to an external power source; The handpiece also includes a hollow coupling connected to the proximal end of the cylindrical sheath for accommodating a fluid connector, a gas connector, and an electrical connector.

[0024] Furthermore, according to one embodiment, the coupling and the cylindrical sheath are connected to each other by a clip.

[0025] Furthermore, according to one embodiment, the one or more symbiotic treatment handpiece elements are electroporation elements and the working end member is an electroporation probe.

[0026] Furthermore, according to one embodiment, the one or more symbiotic treatment handpiece elements are ultrasonic elements and the working end member is an ultrasonic transducer.

[0027] Further, according to one embodiment, the first symbiotic treatment handpiece element is an electroporation element, and the working end member of the first symbiotic treatment handpiece element is an electroporation probe, and the second symbiotic treatment handpiece element is an ultrasonic element, and the working end member of the second symbiotic treatment handpiece element is an ultrasonic transducer.

[0028] Alternatively, a jet jet delivery handpiece having an elongated housing terminating in one or more nozzles for directing the therapeutic jet along an axis toward the subject's skin a desired jet application distance therefrom; an adjustable rigid spacer element attached to the housing for adjustably limiting the proximity of one or more nozzles to the subject's skin to a selected jet application distance during treatment, a curved skin-contacting portion extending axially beyond the one or more nozzles so as to overhang the delivery head, the curved skin-contacting portion being configured to be pressed against the subject's skin during treatment; and a mounting portion configured to mount the skin-contacting portion on the housing at a known distance from the one or more nozzles, thereby determining the spray application distance; an adjustable rigid spacer element comprising: A skin treatment handpiece is provided, comprising:

[0029] therefore, A. An integrated jet jet delivery handpiece having an enclosed elongated housing with an axis of symmetry terminating in a delivery head having one or more therapeutic jet nozzles for directing a therapeutic jet along an axis toward a subject's skin at a desired jet application distance therefrom, each therapeutic jet nozzle comprising: (i) one or more gas discharge nozzles aligned with an axis of symmetry for receiving a high pressure gas flow and for delivering the gas flow into the atmosphere so as to create a shock wave upon exiting the one or more gas discharge nozzles, the one or more gas discharge nozzles having an inner diameter; (ii) one or more linear liquid discharge nozzles having a longitudinal axis and extending coaxially through the one or more gas discharge nozzles, the linear liquid discharge nozzles having an outer diameter smaller in size than the inner diameter of the one or more gas discharge nozzles, the linear liquid discharge nozzles discharging a stream of therapeutic liquid into a pressurized gas stream, the linear liquid discharge nozzles having an opening for exposing the stream of therapeutic liquid to shock waves to atomize the liquid into microdroplets, the atomized liquid mixing with the gas stream into a therapeutic jet of focused microdroplets at high velocity along the axis, the microdroplets having a predetermined quality to facilitate transdermal injection of the microdroplets into the subject at a predetermined jet application distance from the subject; an integrated jet delivery handpiece comprising: B. one or more electrically operable symbiotic treatment handpiece elements, each terminating in a working end member having a skin-contacting surface for delivering treatment to the skin, the treatment being symbiotic with the treatment delivered by the treatment jet; one or more electrically operable symbiotic treatment handpiece elements, the working end member and the contact surface being spaced laterally from the axis; C. A mechanism for positioning the operating end member and the contact surface beyond one or more treatment spray nozzles by a spray application distance having a size within a predetermined range. An integrated multi-technology skin treatment handpiece is provided, including:

[0030] definition In the following disclosure, the term "distal" refers to the portion of the disclosed device or handpiece that is furthest from the user operating the device, i.e., closest to the jet delivery end of the device. The term "proximal" refers to the portion of the device or handpiece that is closest or nearest to the user, i.e., farthest from the jet delivery end of the device.

[0031] The term "working medium" is used generically to include the air, liquid, and electrical flows necessary for the operation of the integrated handpiece of the present disclosure.

[0032] The present invention will be more fully understood and appreciated from the detailed description taken in conjunction with the drawings, in which: [Brief explanation of the drawings]

[0033] [Figure 1] FIG. 1A is a schematic side view of the prior art tissue ablation device of WO 2005 / 065032, and FIG. 1B is an enlarged schematic representation of the prior art device of FIG. 1A. [Figure 1C] 1B is a graphical representation of the prior art device of FIG. 1A. [Figure 2A] FIG. 1 is a diagram of a skin treatment system including a multi-technology skin treatment integrated handpiece constructed and operative in accordance with one embodiment of the present invention. [Figure 2B] 2B is an enlarged schematic representation showing the operation of the integrated multi-technology skin treatment handpiece seen in FIG. 2A, where the illustrated working end member is exemplified as an electroporation probe. [Figure 2C] FIG. 2C is a schematic plan view of the operating end member in the position shown in FIG. 2B. [Figure 3A] FIG. 2C is an exploded view of the handpiece of FIGS. 2A and 2B according to one embodiment before assembly. [Figure 3B] FIG. 3B is a view of the handpiece of FIG. 3A after assembly. [Figure 3C] FIG. 3B is another view of the handpiece of FIG. 3A after assembly. [Figure 4] FIG. 2 is an expanded cross-sectional view of the handpiece. [Figure 5A] FIG. 5 is an enlarged, partially cut-away side view of the coupling shown in FIG. 4. [Figure 5B] FIG. 5B is a perspective view of the coupling shown in FIG. 5A. [Figure 6] FIG. 5C is a view similar to that of FIGS. 5A and 5B, but with a snap-on coupling. [Figure 7A] FIG. 1 is a close-up view of the working end of the handpiece shown above, in accordance with one embodiment, in which the probe is slidably adjustable relative to the nozzle shown. [Figure 7B] FIG. 7B is a cross-sectional view of FIG. 7A, with the probe shown in an extended position relative to the nozzle. [Figure 7C] FIG. 7B is a cross-sectional view of FIG. 7A, in which the probe is shown in a retracted position relative to the nozzle. [Figure 8A] 1 is a close-up view of the working end of the handpiece shown above in an extended position, according to a second embodiment, the probe being threadably adjustable relative to the nozzle shown. [Figure 8B] 1 is a close-up view of the working end of the handpiece shown above in a retracted position, according to a second embodiment, the probe being threadably adjustable relative to the nozzle shown. [Figure 9]FIG. 2B is a perspective view of an integrated handpiece similar to the integrated handpiece of FIGS. 2A-8B, but the working end member shown is illustrated as a ring-shaped ultrasonic transducer. [Figure 10] Similar to FIG. 9, but with the transducer in a U-shape. [Figure 11] FIG. 11 is a perspective view of an integrated handpiece similar to the integrated handpieces of FIGS. 2A-10, but incorporating an electroporation probe and ultrasonic transducer into an integrated working end member. [Figure 12A] FIG. 12 is an enlarged view of the end of FIG. [Figure 12B] 12B is a view similar to FIG. 12A, but showing the integral end member in cross section. [Figure 13] FIG. 10 is an enlarged schematic diagram showing the operation of a jetting handpiece fitted with a spacer probe for precisely controlling the spacing of the nozzle from the subject's skin. DETAILED DESCRIPTION OF THE INVENTION

[0034] Referring now to FIG. 2A , the present invention relates to a multi-technology skin treatment system 10 for enhancing delivery of a therapeutic agent to a subject's dermis. System 10 uses one or more complementary skin treatment systems in symbiotic combination with a skin jet treatment system, such as that manufactured and sold by the present applicant, Tav-Tech Ltd., of Yehud, Israel, and available at https: / / jetpeel.com, to treat a subject using a multi-technology skin treatment integrated handpiece 100. Incorporating one or more technologies into the integrated handpiece, along with the jet technology described herein, improves epidermal porosity to enhance jet treatment in previously unavailable ways. As exemplified below, such symbiotic or complementary systems may use electroporation and / or ultrasound technologies, but may also use additional technologies instead of or in addition to these.

[0035] 2B-4, handpiece 100, as described above, incorporates jet delivery handpiece 200 and a companion treatment element 300 integrated into a single handheld skin treatment tool. Treatment element 300 extends generally along and encases jet delivery handpiece 200, terminating in a working end member 320 that appears to be generally coaxial with and protrude beyond nozzle 230 of handpiece 200, such that, in use, working end member 320 essentially defines and isolates the target treatment area. In the embodiment shown here, element 300 is an electroporation element, although other types of treatment technologies companion to the jet treatment delivered by handpiece 200 are also contemplated. For example, and by way of non-limiting example only, an alternative or additional companion technology is ultrasound, as shown and described below in conjunction with FIGS. 9-12B.

[0036] Also, as can be seen in the drawings, end member 320 and skin-contacting surface 323 are curved and lie in a plane indicated generally at 241 (FIGS. 2B and 3C) that is perpendicular to axis 240, typically perpendicular thereto.

[0037] 2A, system 10 includes an operating system 12 that may be substantially similar to any of the operating units that comprise applicant's JetPro™, JetProDuo™, JetProToGo™, or MyJet™ products. Operating system 12 includes sources of the various working media required for operation of the integrated handpiece of the present invention, and thus includes air compressor 14 for supplying compressed air to jet delivery handpiece 200 via air line 16, refrigeration unit 18, and power supply unit 20.

[0038] The power supply unit 20 incorporates the hardware and software necessary to operate the working end member 320, regardless of whether the working end member 320 is embodied as (i) an electroporation probe 320, as shown and described below in conjunction with Figures 2B-8B; (ii) an ultrasonic transducer 420 or 420', as shown and described below in conjunction with Figures 9 and 10, respectively; (iii) a combination of a probe 320 and a transducer 420, as shown and described below in conjunction with Figures 11-12B, as a combination member 520; or (iv) any other technology compatible with the jetting technology described herein. Such hardware and software as may be required to operate an electroporation probe, on the one hand, and an ultrasound therapy transducer or a phonophoresis transducer, on the other hand, is well known in the art and will therefore not be described in detail herein.

[0039] One or more therapeutic fluids, such as those advertised as JetCare products by the TavTech™ brand at https: / / jetpeel.com / jetcare / , may be supplied from various fluid containers 22 via fluid conduit 24. Electrical wires 26 are also provided for conducting electricity from power source 20 to additional symbiotic subsystems incorporated into handpiece 100, as needed. Air conduit 16, fluid conduit 24, and electrical wires 26 are all housed within a protective molded umbilical cord 28, which connects to handpiece 100 via coupling 120. A control panel, illustrated schematically in the drawings and designated by reference numeral 30, is also provided.

[0040] 3A , which shows the handpiece 100 prior to assembly, the jet delivery handpiece 200 has an elongated, enclosed housing 202 having proximal and distal ends, referenced 210 and 212, respectively. The distal end 212 is formed with a delivery head 220 having one or more nozzles 230. The jet delivery handpiece 200 may conform to that described in detail in the applicant's European Patent Application No. 1883447, as discussed above in the Background section, or that described on the applicant's web page https: / / tav-tech.com / jet-technology, or any suitable product available from Tav-Tech Ltd employing Tav-Tech Ltd's liquid mist / jet technology. Accordingly, the precise internal structure and operation of handpieces to achieve the referenced jets are well known in the art and, therefore, will not be fully illustrated or described herein.

[0041] Nozzle 230 operates to emit a therapeutic jet 242 toward the subject's skin 110, as seen in FIG. 2B. The jet is directed along axis 240 at a predetermined jet application distance "z" from the subject's skin 110, typically in the range of 5-15 mm. Axis 240 is typically the longitudinal axis of both jet jet delivery handpiece 200 and symbiotic treatment handpiece element 300.

[0042] The therapeutic jet is produced, as is well known in the art, by combining an inflow of a liquid suspension of therapeutic agent provided from a liquid source such as container 22 (FIG. 2A) with pressurized gas, such as may be provided by compressor 14 (FIG. 2A) operated by a suitable control panel 30. This method of producing a high-pressure, high-velocity jet jet is well known in the prior art, inter alia, in applicant's above-mentioned PCT Publication No. WO 2005 / 065032 and EP 1 883 447, which describe discharging a liquid into a high-velocity gas stream to form an accelerating mist or jet of liquid.

[0043] 3A, the symbiotic treatment handpiece element 300 is comprised of a cylindrical sheath 302 having proximal and distal ends, referenced 310 and 312, respectively. A working end member 320, exemplified herein as an electroporation probe, formed from any suitable conductive material, is attached to the distal end 312 by a support arm 314.

[0044] As can also be seen in Figures 3A-4 and 7A-8B, the sheath-like cylindrical sheath 302 is configured to fit onto the jet delivery handpiece 200 such that the nozzle 230 protrudes through the distal end 312 of the cylindrical sheath 302.

[0045] It can be seen that when the jet injection handpiece 200 and the symbiotic treatment handpiece element 300 are assembled, the nozzle 230 and the opening 321 of the working end member 320 are substantially coaxial. It can also be seen that the working end member 320 is offset distally from the nozzle 230 along the axis 240 so that the contact surface 323 contacts the skin and the nozzle 230 is spaced from the skin, thereby extending beyond the nozzle 230 to bring it closer to the skin 110 during treatment. As explained, the sheath 302 is formed to partially encase the jet injection housing 202 to form an integrated handpiece adapted to be held and operated in one hand of a user. Furthermore, the proximal ends 210 and 310 of the housing 202 and the sheath 302, respectively, are fastened together by a hollow coupling 120, which is shown and described in more detail below in conjunction with FIGS. 5A-6.

[0046] 5A-6, coupling 120 has a proximal end 142 and a distal end 144. Proximal end 142 has a proximal opening 143 through which umbilical cord 28 passes to facilitate the supply of working fluid to component handpieces 200 and 300, respectively. Distal end 144 has an opening 145 and is configured to connect with a proximal end 310 of sheath 302 of a symbiotic treatment element 300. Coupling 120 and sheath 302 may be connected by gluing or welding, for example, as seen in FIGS. 5A and 5B. Alternatively, as shown in FIGS. 3A and 6, coupling 120 and sheath 302 may be connected by a clip 345 to facilitate a snap connection therebetween. According to yet a further embodiment, clip 345 may be configured to be inwardly depressible by a push button, shown schematically as 347, thereby facilitating removal of coupling 120 from sheath 302 as needed for maintenance purposes. As mentioned above, the connection between the coupling 120 and the sheath 302, which is a simple mechanical connection between two polymeric members, can be achieved in any suitable manner known in the art, such as by adhesive bonding, and therefore will not be described in further detail herein.

[0047] The umbilical cord 28 has a distal end 282 attached just inside the coupling 120. Each of the air conduit 16, liquid conduit 24, and electrical wire 26 exits the distal end 282 of the umbilical cord 28 to supply working medium to a corresponding portion of the integrated handpiece 100, whereby the air conduit 16 is connected to a corresponding inlet conduit 216 extending inwardly within the jetting housing 202, the liquid conduit 24 carrying a mixture of water and a selected therapeutic agent is connected via suitable connectors 225 and 227 to a corresponding inlet conduit 224, and the electrical wire 26 is connected via a suitable pin connector 326 to a suitably positioned electrical conductor 327 for conducting an electrical charge to the end member 320.

[0048] As shown by way of schematic example only in FIG. 4, the conductor 327 may be embedded or otherwise formed within the wall of the sheath 302 so as to have a distal end 329 that overlaps and makes contact with the proximal portion 331 of the end member 320 within an overlap region generally designated 333.

[0049] 2B, the skin 110 is exposed to the jet spray 242 to deliver a predefined treatment, e.g., injection. The jet spray 242 delivers a focused jet having predefined qualities, such as pressure, flow rate, spray pattern, droplet size, droplet velocity, skin impact, reach, etc., to facilitate enabling transdermal injection as described above.

[0050] The jet spray 242 is comprised of high-velocity, high-pressure microdroplets that impact and impact the skin. The microdroplets possess kinetic energy that effectively causes them to act as solids upon impact, creating an injection effect on the skin depending on the angle at which the handpiece is held relative to the skin to inject the therapeutic fluid into the skin. As can be seen in the drawings, when the jet spray handpiece 200 is held perpendicular or nearly perpendicular to the skin, cavitation occurs, creating depressions or pits 111 in the skin 110. This stretches the skin where the depressions 111 are formed, opening up micropores in the skin for the injection of the jet spray components, and forming gas vesicles and vacuoles in the skin tissue.

[0051] At the same time, if element 300 is an electroporation handpiece and end element 320 is an electroporation probe, when the operating end member 320 of the symbiotic treatment handpiece element 300 is held in contact with the skin 110, the operation exposes a portion 113 of the epidermis surrounding and beneath the depression region 111 to an electrical charge, thereby improving the porosity of the epidermis and thereby facilitating more effective penetration by the jet treatment.

[0052] As will be explained below in conjunction with FIG. 9, a similar effect can be achieved, mutatis mutandis, when the symbiotic treatment handpiece element employs an ultrasonic transducer 420, in which case the energy to which the recessed region 111 is exposed is ultrasonic radiation.

[0053] 2C, end member 320 extends distally from integrated handpiece 100, as described below, and is illustrated herein as having a ring-shaped circular opening 321 with a radius "R." As further shown, end member 320 is typically mounted coaxially with and perpendicular to nozzle 230, with axis 240 passing through the geometric center of opening 321, as shown.

[0054] The probe 320 has a distal contact surface 323 that is held in contact with the subject's skin 110 during use so as to extend beyond the nozzle 230 a dimension therefrom equal to a preselected jet application distance "z" (FIG. 2B). As is known in the art, the distance at which the jet jet is directed to the subject's skin 110 can vary from treatment to treatment and even during different phases of a treatment. In the prior art, the handpiece is entirely handheld by the user, making it difficult to accurately measure this distance. The distance is approximate, and maintaining it is difficult, as its consistency within a single treatment depends on the steadiness of the administering person's hand. However, in the present invention, the distal contact surface 323 is pressed against the skin 110 such that the application distance "z" is known prior to treatment. Furthermore, as will be understood from the following description of FIGS. 7A-12B, the application distance "z" is adjustable. For example, according to one embodiment seen in Figures 7A-7C, member 320 is slidably adjustable, while in the embodiment of Figures 8A-8B, a screw mechanism is provided. These are merely examples, and other means by which member 320 may be adjustably attached are considered within the scope of this disclosure.

[0055] Thus, as seen in the embodiment of FIGS. 7A-7C where the symbiotic treatment element 300 is an electroporation element, the support arm 314 of the electroporation probe extends rearwardly through a channel 122 (FIGS. 7B and 7C) formed between the jet housing 202 and the sheath 302. A T-shaped slider element 124 is disposed within an elongated window 330 formed in a sidewall 332 of the sheath 302, typically parallel to the axis 240. The slider element 124 has an inwardly extending radial protrusion 126 that extends through the opening 334 in the support arm 314. In this manner, the position of the contact surface 323, and therefore the magnitude of the jet application distance "z," can be adjusted by sliding the slider element 124 within the window 330, to a maximum magnitude Z MAX and the minimum magnitude Z MIN 7B and 7C, respectively.

[0056] 8A-8B, an operating end member 320, embodied herein as an electroporation probe 320 by way of example, is threadably attached to the distal end 312 of the cylindrical sheath 302 by a proximal ring portion 340 having internal threads (not shown) that cooperate with external threads 342 formed on the distal end 312 of the sheath 302. As shown in FIG. MAX 8B, the probe 320 can be rotated in a first direction 344 along the thread 342 to increase the jet application distance "z" up to a minimum value Z MIN The screw thread 342 may be rotated in a second direction 346 opposite the first direction to decrease the jet application distance "z" until

[0057] Those skilled in the art will appreciate that the adjustment mechanisms shown in Figures 7A-8B are for example purposes only, and that any suitable mechanism for achieving the same purpose may be provided within the scope of the present invention.

[0058] 9, there is shown an integrated handpiece, generally designated 400, in which the coexisting treatment element is an ultrasonic element. In other respects, handpiece 400 is substantially similar to handpiece 100 shown and described above in conjunction with FIGS. 2A-7C. Portions of the illustrated device 400 previously shown and described are indicated by like reference numerals in this drawing, and device 400 will only be described with respect to its differences as compared to handpiece 100.

[0059] In this embodiment, the operating end member is illustrated as an ultrasonic transducer 420, shown to be arc-shaped in FIG. 9, and is illustrated herein as a complete circular ring. Thus, as shown and described above in conjunction with FIGS. 2B and 2C, the transducer 420 and nozzle 230 are coaxially aligned in a manner similar to that shown in FIG. 2B, such that the jet jet 242 (FIG. 2B) strikes the subject's skin 110 at the center of the ultrasound-exposed area 113. The exact configuration of ultrasonic transducers is well known in the art and is therefore beyond the scope of the present invention. An exemplary circular transducer may be manufactured by PZT Electronic Ceramic Co., Ltd., 15 Dezheng West Road, Changan Town, Dongguan City, Guangdong Province, China, and selected from their product listing at https: / / www.piezoelements.com / piezo-ceramic / piezo-ring / .

[0060] According to different embodiments, the shape of the end member does not necessarily have to be circular. For example, as illustrated in Fig. 10, the end member may be U-shaped, as shown by the U-shaped transducer 420'. The spatial positioning of the transducer 420' is generally similar to that shown and described above with reference to Fig. 2C, with the contact surface 423' of the transducer 420' mounted so as to surround the axis 240 in a plane perpendicular to the axis 240.

[0061] 11-12B, an integrated handpiece 500 is shown in which an exemplary symbiotic treatment element combines two end members implementing two different technologies. In this example, the symbiotic treatment element combines complementary skin treatment element components, referenced 320' and 420', formed as a combined end member 520. Outer member 320' is an electroporation probe, and inner member 420' is an ultrasound transducer.

[0062] Except as otherwise described below, handpiece 500 is substantially similar to handpiece 100 and handpiece 400 shown and described above in conjunction with Figures 2A-10. Portions of illustrated device 400 shown and described above are designated by like reference numerals in the drawings, and device 500 will be described only with respect to its differences as compared to handpiece 100 and handpiece 400.

[0063] As can be seen in the enlarged cross-sectional view of mating end member 520, the two parts are provided in the form of nested rings, so that their distal contact surfaces 323' and 423', respectively, are coplanar and synchronized in movement during adjustment.

[0064] Referring now to FIG. 13, there is shown a hard spacer element 620 formed of any suitable material, typically hard plastic, for accurately positioning the nozzle 230 of the delivery head 220 of the jet delivery handpiece 200 relative to the subject's skin 110.

[0065] The element 620 is attached to the distal end 212 of the hand piece 200 by a support arm 614 and an adjustable mount 615 that slidably or otherwise adjustably moves along the housing 202 of the hand piece 200. In practice, the adjustable mount can be replaced by any suitable sliding or threaded mounting means similar to those shown and described above in conjunction with FIGS. 7A-8B. Like the probe 320, the element 620 is illustrated herein as having a circular opening 621 that facilitates passage of the jet 242 therethrough. The element 620 has a contact portion 623 adapted to apply against the subject's skin 110. As shown, the element 620 defines a minimum dimension Z that limits the extent to which the nozzle 230 can be positioned from the skin 110 during treatment. MIN to the maximum magnitude Z MAX This limits the spray application distance "z" to a lower limit, typically Z MIN is about 5 mm, and Z MAX is 15 mm, but the actual range is determined by various treatment requirements.

[0066] Those skilled in the art will appreciate that the scope of the present invention is not limited by what has been shown and described above, merely by way of example, but rather is limited only by the claims. [Explanation of symbols]

[0067] 10...Multi-technology skin treatment system, 12...Operation system, 14...Air compressor, 16...Air tube, 18...Cooling unit, 20...Power supply unit, 22...Liquid container, 24...Liquid tube, liquid communication tube, 26...Electrical wire, 28...Umbilical cord, 30...Control panel, 100...Multi-technology skin treatment integrated handpiece, 110...Skin, 111...Dimple, recess, 113...Area, 120...Coupling, 122...Channel, 124...Slider element, 126...Protrusion, 142...Proximal end, 143...Proximal opening, 144...Distal end, 145 ...Opening, 200...Jet delivery handpiece, integrated device, 202...Housing, 210...Proximal end, 212...Distal end, 216...Inlet tube, 220...Delivery head, 224...Suction conduit, 225...Connector, 227...Connector, 230...Nozzle, nozzle arrangement, 240...Axis, 241...Flat surface, 242...Jet, therapeutic jet, 282...Distal end, 300...Symbiotic therapeutic handpiece element, 302...Sheath, 310...Proximal end, 312...Distal end, 314...Support arm, 320...Electroporation probe , operating end member, 320'... outer member, 321... opening, 323... distal contact surface, skin contact surface, 323'... distal contact surface, 326... pin connector, 327... electrical conductor, 329... distal end, 330... window, 331... proximal portion, 332... side wall, 333... overlap region, 334... opening, 340... proximal ring portion, 342... external thread, 344... first direction, 345... clip, 346... second direction, 347... push button, 400... integrated handpiece, 420... ultrasonic transducer, 420'... ultrasonic transducer Inducer, inner member, 423'...distal contact surface, 500...integral handpiece, 520...combined end member, 614...support arm, 615...adjustable mount, 620...rigid spacer element, 621...circular opening, 623...contact portion, 1080...gas inlet, 1100...liquid inlet, 1160...liquid outlet nozzle, 1200...focusing portion, 1220...throat portion, 1240...outlet portion, 1241...gas outlet nozzle, 1260...gas flow, outlet flow, 1280...opening, 1300...mist of droplets, 1320...arrow, 1340...arrow.

Claims

1. A. A sealed elongated housing having an axis of symmetry terminating in a delivery head having at least one therapeutic jet nozzle for directing a therapeutic jet along an axis toward a subject's skin a desired jet application distance therefrom, said at least one therapeutic jet nozzle comprising: (i) at least one gas discharge nozzle aligned with said axis of symmetry for receiving a high pressure gas flow and for delivering said gas flow into the atmosphere to create a shock wave upon exiting the at least one gas discharge nozzle, said at least one gas discharge nozzle having an inner diameter; (ii) at least one linear liquid delivery nozzle having a longitudinal axis, extending coaxially through said at least one gas delivery nozzle and having an outer diameter smaller in size than said inner diameter of said at least one gas delivery nozzle, said at least one linear liquid delivery nozzle having an opening for delivering a therapeutic liquid stream into said pressurized gas stream, thereby exposing said therapeutic liquid stream to said shock waves to atomize said liquid into microdroplets, said atomized liquid mixing with said gas stream to form a therapeutic jet of said microdroplets focused at high velocity along said axis, said microdroplets having a predetermined quality to facilitate transdermal injection of said microdroplets into said subject at a predetermined jet application distance from said subject; a housing comprising: B. at least one electrically operable symbiotic treatment handpiece element terminating in a working end member having a skin-contacting surface for delivering treatment to said skin, said treatment being symbiotic with the treatment delivered by said treatment jet; at least one electrically operable symbiotic treatment handpiece element, the working end member and the contact surface being spaced laterally from the axis; C. A mechanism for positioning the operating end member and the contact surface beyond the at least one treatment spray nozzle by a spray application distance having a size within a predetermined range.

1. An integrated handpiece for multi-technology skin treatment, including an integrated jet delivery handpiece comprising:

2. 2. The multi-technology skin treatment integrated handpiece of claim 1, wherein the operating end of the at least one co-treatment handpiece element is adjustable along the axis relative to the at least one treatment spray nozzle, thereby adjusting the spray application distance accordingly within the predetermined range.

3. The multi-technology integrated skin treatment handpiece of claim 1 , wherein the at least one symbiotic treatment handpiece element comprises first and second symbiotic treatment handpiece elements.

4. 10. The multi-technology skin treatment integrated handpiece of claim 1, wherein the working end member and the skin contacting surface are curved and mounted to lie in a plane perpendicular to the axis.

5. 5. The multi-technology skin treatment integrated handpiece of claim 4, wherein the skin contact surface is arcuate and is mounted such that the center of curvature of the skin contact surface intersects the axis in a plane perpendicular to the axis.

6. The at least one symbiotic treatment handpiece element also comprises: a cylindrical sheath having a proximal end and a distal end configured to at least partially fit around the housing of the jet delivery handpiece such that the at least one therapeutic jet nozzle of the jet delivery handpiece protrudes through the distal end of the cylindrical sheath; a support for mounting the operating end member to the distal end of the cylindrical sheath so as to position the contact surface at a distance from the at least one treatment spray nozzle equal to the desired spray application distance; 10. The integrated multi-technology skin treatment handpiece of claim 1, comprising:

7. 7. The multi-technology skin treatment integrated handpiece of claim 6, wherein the working end member is electrically powered, and the at least one co-treatment handpiece element includes an electrical conducting element for supplying electricity from a power source to the working end member.

8. the jet delivery handpiece includes a liquid supply tube disposed within the housing for supplying a liquid suspension of a therapeutic agent to the at least one linear liquid discharge nozzle, the housing being operable to deliver pressurized gas to the at least one gas discharge nozzle such that the liquid suspension atomizes into a therapeutic jet upon exiting the at least one linear liquid discharge nozzle; 8. The multi-technology skin treatment integrated handpiece of claim 7, wherein the cylindrical sheath is provided with an electrical conductor for supplying electrical power to the working end member in combination with the cylindrical sheath.

9. the liquid supply tube terminating at a proximal end in a liquid connector to an external liquid source, the sealed housing terminating at a proximal end in a gas connector to an external pressurized gas source, and the electrical conductor terminating at a proximal end in an electrical connector to an external power source; 9. The multi-technology skin treatment integrated handpiece of claim 8, wherein the handpiece also includes a hollow coupling connected to the proximal end of the cylindrical sheath for accommodating the liquid connector, the gas connector, and the electrical connector.

10. 10. The integrated multi-technology skin treatment handpiece of claim 9, wherein the coupling and the cylindrical sheath are coupled together by a clip.

11. 10. The multi-technology skin treatment integrated handpiece of claim 1, wherein the at least one co-treatment handpiece element is an electroporation element and the working end member is an electroporation probe.

12. 10. The multi-technology integrated skin treatment handpiece of claim 1, wherein the at least one co-treatment handpiece element is an ultrasonic element and the working end member is an ultrasonic transducer.

13. 4. The multi-technology skin treatment integrated handpiece of claim 3, wherein the first symbiotic treatment handpiece element is an electroporation element, the working end member of the first symbiotic treatment handpiece element is an electroporation probe, the second symbiotic treatment handpiece element is an ultrasound element, and the working end member of the second symbiotic treatment handpiece element is an ultrasound transducer.

14. a jet jet delivery handpiece having an elongated housing terminating in at least one nozzle for directing a therapeutic jet along an axis toward the subject's skin a desired jet application distance therefrom; a rigid spacer element attached to the housing for limiting the proximity of the at least one nozzle to the skin of the subject during treatment down to the desired jet application distance; a curved skin-contacting portion extending axially beyond the at least one nozzle to overhang the delivery head, the curved skin-contacting portion configured to be pressed against the skin of the subject during treatment; and a mounting portion configured to mount the skin contact portion on the housing at a known distance from the at least one nozzle, thereby determining the spray application distance; a rigid spacer element comprising: A skin treatment handpiece comprising:

15. 15. The skin treatment handpiece of claim 14, further comprising means for adjusting the position of the mounting portion relative to the at least one nozzle, thereby correspondingly adjusting the jet application distance.

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