Apparatus and method for contacting biological tissue - Patent Application 20070122997

Abstract

The present invention provides materials and methods for forming an interface between a device and biological tissue using a foamed elastomeric material that contacts tissue or a similar surface. The elastomeric material is a durable, washable form of material that, when applied to or implanted in biological tissue or a similar surface, migrates or flows into non-conforming areas, thereby forming an air- and / or water-tight seal, and substantially recovers to its original shape when removed from its contact surface. The device may also include structural elements designed to optimize comfort, compliance, and seal, which is achieved through minimizing pressure fluctuations along the contact surface of the treatment device.

Description

[Technical Field]

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 62 / 817,522, filed March 12, 2019, which is incorporated by reference in its entirety, including all tables, figures, and claims, and this application claims priority to each of these patent applications. [Background technology]

[0002] The following discussion of the background of the invention is provided solely to aid the reader in understanding the invention and is not admitted to describe or constitute prior art to the invention.

[0003] U.S. Patent Nos. 5,343,878, 7,182,082, and 7,762,263 describe various devices intended to apply negative pressure to a patient's external neck surface. A therapeutic device is typically provided having a surface configured to enclose an external area of ​​the throat (the term "throat" is used herein to refer to the anterior portion of the neck overlying a portion of the upper respiratory passage, extending approximately from the chin to the top of the sternum and laterally to a point posterior to the external jugular vein). In certain embodiments, these devices may provide a chamber (e.g., a hollow space filled with air molecules) between the inner surface of the chamber and the throat. The therapeutic device is operably connected to a vacuum source configured to generate a partial negative pressure within the chamber. Applying a therapeutic level of negative pressure within the chamber may induce movement of the upper airway, alleviating symptoms such as snoring, sleep apnea, and complete or partial airway collapse (during sleep or during medical procedures requiring some level of sedation).

[0004] Achieving a proper and comfortable fit between such devices and the patient to create and maintain a negative pressure differential (e.g., relative to atmospheric pressure) at a desired location on the patient can be difficult. For devices intended for prolonged, daily use, any point experiencing high contact pressure due to the device's seal on the user's tissue quickly becomes significantly less comfortable for continued use. Furthermore, the success of these negative pressure therapies can be determined by their ability to accommodate (curve, flex, flow, etc.) varying anatomical features (i.e., device conformity). User compliance with treatment is maximized by a good comfort interface between the device and the user, and by an interface that minimizes or eliminates post-treatment redness that may be apparent when the device is removed, despite attempts to hide it. Finally, the device should optimally accommodate stubble growth and / or movement into different sleep positions without compromising the seal.

[0005] Similarly, masks adapted to infuse fluids (e.g., gases) into patients, particularly those suffering from obstructive sleep apnea (OSA), are preferably designed not only to deliver the fluid but also to maintain a good seal against the patient's face, adapt to any patient movements, and remain comfortable. A mask that is comfortable and compliant but does not provide an optimal seal is ineffective. If the frame for the mask is hard plastic, the seal and conformance must be provided by a face cushion. A very sensitive area of ​​the face where the seal is usually located is the nasal bridge area. Any increase in pressure can be transmitted directly to the nasal bridge area, causing a tight fit that can cause discomfort or even pain. Some masks have had a flowable gel at the skin interface. Such masks are heavy, and when the membrane ruptures, they can break, leaking gel into the airway, posing a potential health risk.

[0006] While encapsulated gels absorb pressure well (e.g., areas of high contact pressure are redistributed), they may not necessarily be a good sealing medium, especially if they lack "compliance" (e.g., by failing to remain in intimate contact with the patient's skin due to minor relative movements, such as those experienced with natural body movements). Compliance is the level of movement achievable between the patient's face and the cushion and / or the ability of the mask to maintain a comfortable seal. ResMed's Activa® cushion is an example of a cushion that provides very good compliance. Lack of compliance and resilience can affect seal performance and create localized pressure points, for example, at higher facial landmarks (especially in the nose bridge area).

[0007] Similarly, filtering facepiece respirators (FFRs) play an important role in everyday life. FFRs are available for purchase by the general public at many equipment retailers and are recommended or required for use in a variety of home, public, and occupational settings, particularly in health care settings. The primary function of FFRs is to provide respiratory protection against both non-biological and biological particles.

[0008] In practice, FFRs are generally used to protect the wearer. However, in healthcare and public health settings, FFRs must function both to protect the wearer from potentially harmful particulate matter (including biological pathogens) and / or to protect the patient and others from pathogens exhaled into the environment by the wearer. During surgical procedures, for example, smoke plumes generated from electrosurgery use have been shown to contain a wide range of vaporized viral organisms, including HIV and human papillomavirus (HPV). Thus, FFRs in such settings must both protect the surgeon and personnel in the operating room and protect the patient from contact with pathogens exhaled by the surgeon into the surgical field.

[0009] With regard to sealing the mask to the wearer's face, the primary reason for achieving such a seal is to avoid leakage around the mask's filtering portion rather than through the filtering portion. This applies to both inhaled and / or exhaled particulate matter. Face seal inner leakage (FSIL) and face seal outer leakage (FSOL) (collectively referred to as face seal leakage (FSL)) are difficult to reduce due to significant differences in human facial anatomy. Anthropometric studies have revealed substantial differences in many variables of human facial anatomy. These are most pronounced in three areas where face seal leakage is likely to occur: 1) the bridge of the nose and cheekbones, 2) from the cheekbones to the edge of the chin, and 3) around and below the area between the underside of the chin and back toward the angle of the jaw. The problem of face seal leakage can also be exacerbated by the fact that FFRs are made in generic "small, medium, large" sizes and often in a "one size fits all" design. Summary of the Invention [Problem to be solved by the invention]

[0010] It is an object of the present invention to provide a device designed to contact living tissue, where the tissue interface region of the device is adapted to form a conformal seal between the device and the tissue. In particular aspects, the device is configured to attach to and adhere to external or internal tissue of a patient, such as the face, neck, or area surrounding a wound.

[0011] As will be explained later, the tissue interface region may include inherent tacky or adhesive properties (referred to herein as "viscosity") to improve sealing and resistance to sliding against tissue and to expand the range of anatomical variations over which the treatment device may accommodate to ensure a proper seal and / or fit. Viscosity may be influenced, for example, by the mixing ratio of the "two-component" starting materials or by the addition of tackifiers. [Means for solving the problem]

[0012] In a first aspect, the present invention provides a device configured to contact the skin of an animal (preferably a mammal, and most preferably a human), comprising: (a) a tissue interface portion comprising a viscoelastic foam configured to provide a tissue-contacting surface of the device, the viscoelastic foam having the following properties: a Shore A durometer hardness of about 0 or less, and preferably about 30 or less, more preferably about 20 or less, and even more preferably about 10 or less, in each case measured using the Standard Test Method for Rubber Property—Durometer Hardness ASTM D2240-15; Approximately 0.9g / cm 3 The following density (specific gravity), and / or Approximately 9mJ / cm 2 Preferably less than about 7 mJ / cm 2 Below about 5 mJ / cm, most preferably 2 Viscosity levels measured using the Standard Test Method for Pressure-Sensitive Tack of Adhesives ASTM D2979-16: an elastic (storage) modulus in the range of about 0.3 kPa to about 30 kPa, and preferably in the range of about 1 kPa to about 15 kPa; a viscosity (loss) coefficient in the range of about 0.4 kPa to about 7 kPa, and preferably in the range of about 0.8 kPa to about 7 kPa; including one or more of: The tissue boundary portion, (b) a non-contact portion configured to support the tissue interface portion and to be spaced from the tissue by the tissue interface portion; The present invention provides an apparatus comprising:

[0013] The term "viscoelastic" is used herein to refer to a material that exhibits both viscous and elastic properties during deformation. Unlike purely elastic materials, viscoelastic materials have elastic and viscous components. The viscosity of a viscoelastic material gives the material a strain rate time dependence. Purely elastic materials do not release energy (heat) when a load is applied and then removed. Viscoelastic materials, however, lose energy when a load is applied and then removed.

[0014] The storage and loss moduli of a viscoelastic material indicate the energy stored (representing the elastic portion) and the energy dissipated as heat (representing the viscous portion). The storage (E') and loss (E') moduli are measured in kPa using Dynamic Mechanical Analysis (DMA) methods well known in the art. In particular embodiments, the viscoelastic foam comprises one or both of an elastic (storage) modulus in the range of 10 kPa to about 15 kPa and a viscous (loss) modulus in the range of about 2 kPa to about 7 kPa.

[0015] As used herein, the term "tissue" refers to a collection of cells. Tissues may, and in some embodiments preferably, include cells that grow and / or regenerate. Tissues may include layers of non-living cells, such as skin, including the stratum corneum, that overlie the living cells of the tissue. Tissues are preferably mammalian, most preferably human, body parts.

[0016] As used herein, the term "non-contact portion" refers to a portion of an appliance that does not directly contact a user's tissue. Such a portion may be, for example, internal to an appliance implanted within a user's body or external to an appliance worn on the body. The non-contact portion may be separate from or integral with the tissue interface portion. For example, if the entire appliance is made of viscoelastic foam, the portion of the viscoelastic foam that does not directly contact the user's tissue is non-contact. However, in preferred embodiments, the non-contact portion includes a material other than viscoelastic foam and thus may be conceptually considered to be a portion distinct from the tissue interface portion.

[0017] In particular embodiments, the viscoelastic foam exhibits a Shore A durometer hardness of about 10 or less, preferably about 5 or less, and even more preferably about 1 or less, or a Shore OO durometer hardness of about 30 or less, more preferably about 20 or less, and even more preferably about 10 or less, or a Shore OO durometer hardness of 50 or less, and most preferably 30 or less.

[0018] In particular embodiments, the viscoelastic foam has a viscosity of at least 0.1 mJ / cm 2 , preferably at least 0.3 mJ / cm 2 , most preferably at least mJ / cm 2 The viscosity is measured using the Standard Test Method for Pressure-Sensitive Tack of Adhesives ASTM D2979-16. Thus, in various embodiments, the viscosity is between 0.1 and 9 mJ / cm. 2 range, 0.3-7mJ / cm 2 and 0.5-5 mJ / cm 2 The range is.

[0019] "Inherent viscosity" means that the viscoelastic foam material itself is viscous, rather than a viscosity agent being added to the surface of the foam after production of the foam. In particular embodiments, the inherent viscosity is provided without the addition of a tackifier.

[0020] In particular embodiments, the viscoelastic foam comprises or is composed of a foamed silicone rubber, such as high consistency rubber ("HCR") or liquid silicone rubber ("LSR"). Such viscoelastic foams are formed from a silicone rubber and a blowing agent mixed together, which, after curing, produces a compliant and durable human interface layer. The viscoelastic foam may be provided as a single layer or as a component of a laminate of materials that is disposed over all or a portion of the tissue interface portion of the device. In the case of a laminate, the viscoelastic foam preferably provides the outermost layer of the laminate (and thus provides the tissue-contacting layer).

[0021] One substantial advantage of using foamed LSR as an interface material over other foam products is that the thermal conductivity of silicone is inherently higher than that of materials such as polyurethane "memory" foam. This makes foamed LSR cooler on the skin. Thermal conductivity can be further increased by adding various filler components such as Si3N4, Al2O3, and ZnO, as well as non-metallic fillers such as BN and graphite. In specific embodiments, the filler can be a reinforced vinyl-endblocked polymethylsiloxane using silicon nitride (Si3N4) particles alone or in combination with silicon carbide whiskers (SiCw), as described in Zhou et al., J. Composite Materials 42: 173-87, 2008. Thermal conductivity can also be increased by adding actual metal particles (e.g., copper nanowires, among others) or various composite materials (e.g., silver-coated copper or aluminum, nickel-coated graphite, etc.). Additionally, the intrinsic conductivity of silicone polymers can be increased through fabrication processes in which the polymer chains are better aligned within the cured material.

[0022] The thermal conductivity of silicone rubber is approximately 0.2 W / mK. Commercially available silicone rubbers with fillers, such as WACKER Semicosil, can have thermal conductivities as high as 1 W / mK to 4.3 W / mK. Addition of additives, such as Si3N4 particles, can increase thermal conductivities to as high as 1 W / mK to 1.8 W / mK. (Zhou et al., Composites Part A: Applied Science and Manufacturing 40: 830-836, 2009). In contrast, polyurethane foams have thermal conductivities as low as 0.022 W / mK, typically less than 0.060 W / mK. (WO2014 / 105690).

[0023] In certain embodiments, viscoelastic foams may contain tackifiers added during foam production. Tackifiers are chemical compounds used in forming elastomers to increase viscosity (adhesive surface stickiness). See U.S. Patent Nos. 4,073,776 and 7,772,345. Tackifiers have low molecular weights, glass transition temperatures above room temperature, and softening temperatures, thereby providing favorable viscoelastic properties. Tackifiers may comprise up to about 40% of the total mass. Examples of tackifiers include rosin and its derivatives, terpenes and modified terpenes, aliphatic resins, cycloaliphatic resins, and aromatic resins (C5 aliphatic resins, C9 aromatic resins, and C5 / C9 aliphatic / aromatic resins), hydrogenated hydrocarbon resins and mixtures thereof, and terpene phenolic resins (TPRs, often used with ethylene vinyl acetate adhesives). Silicone rubber-based pressure-sensitive adhesives may utilize special tackifiers based on "MQ" silicate resins, which generally consist of monofunctional trimethylsilane ("M") reacted with quadrafunctional silicon tetrachloride or silicon tetroxide ("Q"). In particular embodiments, the viscoelastic foam is tackifier- and adhesive-free.

[0024] Although tackifiers may be used in the present invention, in preferred embodiments the viscoelastic foam does not contain any tackifiers or adhesives. The viscous nature is an inherent property of the elastomer itself.

[0025] In a specific embodiment, the viscoelastic foam is formed using a silicone base, a blowing agent, and a catalyst. Examples of such blowing agents include ammonium, sodium, or potassium salts, although a variety of commercially available chemical blowing agents are known in the art. Typically, these blowing agents release a gas (e.g., N2, CO2) during the foaming process. The catalyst may be selected from the group consisting of an iron catalyst, a cobalt catalyst, a zinc catalyst, a titanate catalyst, a tin catalyst, a platinum catalyst, or an acid catalyst.

[0026] While it is preferred that the entire tissue interface portion of the device comprise viscoelastic foam, in certain embodiments, only a portion of the tissue interface portion comprises viscoelastic foam. In certain embodiments, the viscoelastic foam can be one concentric annular ring, or multiple abutting or continuous or discontinuous concentric annular rings separated by some pitch interval. In other embodiments, the viscoelastic foam can be one or multiple abutting or connected or disconnected spiral rings separated by some interval.

[0027] The weight percentage of the foaming agent additive to the elastomer component (e.g., silicone rubber) will preferably be 1-10%, more preferably 1-5%, and most preferably 1.5-3%. In various embodiments, the viscoelastic foaming material will be applied to the appliance and cured to "skin-coate" the viscoelastic foaming material, thereby providing a smooth, closed-cell surface to the tissue-contacting surface of the viscoelastic foam, thereby helping to mitigate potential leakage around the interface seal, mitigate absorption of moisture (e.g., perspiration) and / or particle contamination (e.g., skin, stubble, debris) to the foam substrate, and mitigate the growth of product-spoiling microorganisms (e.g., bacteria, fungi, algae) on or within the foam substrate. Alternatively, the thermal conductivity and breathability of foam interface materials can be increased by fabrication techniques such as reducing the "skin coverage" of the contact surface and / or increasing the porosity of the foam to create an open-cell rather than closed-cell foam structure. However, these approaches also increase the material's ability to absorb and retain moisture, which can have undesirable consequences in terms of washability.

[0028] In certain embodiments, the viscoelastic foam comprises reinforcing fillers such as silica, silica aerogel, silica xerogel, titanium dioxide, diatomaceous earth, iron oxide, aluminum oxide, zinc oxide, quartz, calcium carbonate, magnesium oxide, carbon black, graphite, glass fibers, glass microspheres, glass microballoons, glass beads, carbon fibers, silicon carbide, polystyrene beads, microcrystalline cellulose, nanoparticles (e.g., carbon nanotubes, layered silicates, etc.), and metal fibers.

[0029] In certain embodiments, the viscoelastic foam comprises an antimicrobial additive having an active ingredient that is metabolized by microbial cells to inhibit or prevent the growth of microorganisms such as bacteria, fungi, and viruses, such as silver, silver ions, silver ions encapsulated in glass particles, silver-sodium-zirconium hydrogen phosphate, 3-(trimethoxysilyl)propyldimethyloctadecyl ammonium chloride, benzalkonium chloride, benzethonium chloride, chloroxylenol, polyhexamethylene biguanide (PHMB), etc. These may be provided in the form of inorganic compounds or may comprise microsized (>100 nm) or nanosized (<100 nm) particles.

[0030] In a particular embodiment, the viscoelastic foam contains a leaching-resistant, non-flowing antimicrobial additive comprising a siloxane polymer that is not metabolized by microbial cells, but instead creates a network of electrically charged molecules on the surface of the viscoelastic foam substrate that destroys the microbial cell walls of bacteria, fungi, and algae.

[0031] In certain embodiments, the sealing element may include a viscous material inherent in or disposed over all or a portion of the contact area. For example, the viscous material may include room temperature vulcanizing or heat curing silicone rubber. The viscous material may be a single layer or may be a component of a stack of materials disposed over all or a portion of the contact area.

[0032] In particular embodiments, the viscoelastic foam provides a fluidly sealed surface.

[0033] Formation and curing of the viscoelastic foam can occur at room temperature, however, in certain embodiments, the viscoelastic foam is cured at a temperature in the range of at least about 50°C to 60°C, more preferably at least about 120°C, even more preferably at least about 150°C, and even more preferably at least about 170°C.

[0034] For examples of silicone foams and processes for making silicone foams, see, e.g., U.S. Patent Nos. 8,410,239, 8,173,717, 7,393,879, 6,022,904, and 5,436,274, which are incorporated herein by reference in their entireties. In certain embodiments, curing can occur in the range of about 100°C to about 250°C.

[0035] In certain embodiments, the viscoelastic foam has a viscosity of 0.9 g / cm 3 More preferably, 0.8 g / cm or less 3 More preferably, 0.7 g / cm or less 3 Below 0.5 g / cm, most preferably 3 It has the following density:

[0036] In various embodiments, the medical or cosmetic device may be an eye protection mask, a scuba mask, swim goggles, a medical device, a breathing mask, a negative pressure chamber configured to cover a body part (e.g., a negative pressure wound therapy device or a continuous negative external pressure (cNEP) therapy device), headphones, earplugs, earphones, a bra, swimwear, or the like.

[0037] As explained later, the devices described herein may be suitable for providing a pressure containment structure in the form of a sealed chamber configured to apply negative, neutral, or positive pressure to a targeted treatment area on an individual's external or internal tissue.

[0038] As used herein, the term "pressure containment structure" refers to an element of a treatment device that contains negative, positive, or neutral pressure during use. The pressure containment structure may include a rigid, semi-rigid, or flexible membrane that defines a dome-shaped chamber element, an aperture in the pressure containment structure through which a vacuum source may be secured or applied, and a sealing element secured to the dome-shaped chamber that forms a tissue interface between the chamber element and the individual.

[0039] Such pressure containment structures can be used to create a pressure differential between the internal space formed by the device when coupled to biological tissue (e.g., a location on a human) and external atmospheric pressure. Preferably, the viscoelastic foam creates a seal against the tissue that maintains the pressure differential. A certain amount of leakage at the seal can be tolerated as long as the desired pressure differential can be achieved and maintained. Preferably, leakage is no more than about 0.008 ml / min to about 8 ml / min, and most preferably, about 0.1 ml / min to about 1.6 ml / min. In the case of eye masks (e.g., scuba masks) for use underwater, the viscoelastic foam is preferably fluidly sealed such that a pressure differential of about 1 atm leaks no more than 10% of the internal volume, preferably no more than 5% of the internal volume, over 10, 20, or most preferably 30 minutes.

[0040] In certain embodiments, the device may be configured to provide a substantially constant and evenly distributed contact pressure across the tissue interface when the device is coupled to an individual and a therapeutic level of pressure (positive or negative) is applied within the device. For negative pressure devices, this approximate contact pressure may be in the range of 0.9 to 1.5 times, preferably about 1.1 to 1.3 times, the negative pressure within the treatment device.

[0041] In certain embodiments, when the treatment device is coupled to an individual and a therapeutic level of negative pressure is applied within the chamber, the approximate contact pressure applied to the tissue surface is approximately 1.2 times the negative pressure within the chamber. In various embodiments, treatment devices designed to maintain a neutral or negative pressure within the chamber can also be configured to distribute a constant and even contact pressure.

[0042] In a related aspect, the invention relates to a method of applying negative pressure therapy to an individual in need of such therapy, comprising coupling a therapeutic device as described herein to the individual and applying a therapeutic level of negative pressure within the chamber, thereby increasing the patency of the individual's airway. Such a method may be performed to treat sleep apnea, snoring, complete or partial upper airway collapse (during sleep or during medical procedures requiring some level of sedation), complete or partial upper airway obstruction, or negative pressure therapy of wounds, such as those caused by injury or surgery.

[0043] As used herein, the terms "external area" and "external surface" of an individual refer to a portion of an individual's external skin surface. As used herein, the terms "internal area" and "internal surface" of an individual refer to a portion of an internal or partial internal surface of an individual. For example, in various embodiments, a treatment device may be configured to be applied to and seal an ostomy or wound site, or to seal around a laryngeal tube in an airway. Other examples of internal applications would include application to the exterior of an implant to alleviate mechanical stiffness mismatches between the implant and adjacent tissue, or as all or part of a tissue filler material, such as cheek, breast, and buttock implants. In various embodiments, a treatment device is configured to provide optimized fit parameters (e.g., seal, comfort, and local device compliance) across all contact points. This can be achieved by preferably minimizing the contact pressure differential between one contact point on the patient's tissue and another through the design features of the compliant conformal interface and through the design features of the sealed chamber elements of the negative pressure therapy device.

[0044] In certain embodiments, the chamber element may be secured to the flange element as a unitary, unitary, or discontinuous structure. The flange element provides mechanical support for the interface between the device and the user's tissue. As used herein, a compliant conformal interface is defined as a flexible, shear-absorbent, and compressible surface that has the ability to stretch, flex, and / or curve such that a substantially airtight seal is formed between the chamber element and the user.

[0045] In certain embodiments, the compliant conformal interface varies in width and / or thickness around the circumferential dimension of the treatment device. The varying width and / or thickness of the conformal interface can result in different amounts of force being applied to the individual's tissue surface at different points around the periphery of the continuous contact surface. In this manner, it is possible to achieve a "constant" force applied to the individual's external surface at any point along the circumferential dimension of the sealing element. In this context, the term "constant" as used herein refers to maintaining the force within about 20%, more preferably within about 10%, of the average force along the entire circumferential dimension of the sealing element, where the force at each point along the circumferential dimension of the sealing element is measured at the location on the width dimension of the flange element where the sealing element contacts the user.

[0046] Any and all vacuum, gas, or fluid pump types may be used in the present invention, so long as the desired level of flow can be achieved with the selected pump. In certain embodiments, the pump may be connected to the device via a hose or tube. To maximize portability, it is preferred that the pump be wearable by the patient and battery-powered, and it is most preferred that the air pump be configured to be integrated into the device.

[0047] In certain embodiments, the vacuum pump may be a manually squeezed bulb or may be electrical and include a piezoelectric material configured to provide an oscillatory pumping action, most preferably operating at a frequency greater than 500 Hz.

[0048] In those embodiments in which the pump is integral to the device, it is preferred that a sealing component between the pump and the instrument form an airtight seal. For example, a compliant sealing ring or lip seal may be provided within the opening that the pump engages. Such a sealing component may be provided integrally with the chamber element, and is most preferably provided as a unitary structure with the chamber element. Alternatively, the compliant sealing ring and chamber element are separate structures.

[0049] In certain embodiments of the negative pressure device, the chamber element includes one or more apertures, resulting in a vent element that provides a controlled airflow to the chamber when the treatment device is coupled to an individual and a therapeutic level of negative pressure is applied. These apertures are located distal to the pump element's air inlet and provide airflow through the chamber. Such airflow can, first, facilitate hysteretic control of the vacuum treatment range and, second, assist in the exchange of air within the chamber. As used herein, hysteretic control is defined as the response of a control system within a range for changing the flow rate of a vacuum pump to sensed changes in absolute air pressure within the chamber element of the negative pressure device. This range provides two points: an "up" point at which the pump is activated, and a "down" point at which the pump is shut off. The aperture(s) preferably provide an air flow in the range of about 10 mL / min to about 300 mL / min, and most preferably in the range of about 20 mL / min to about 150 mL / min, and even more preferably in the range of about 40 mL / min to about 100 mL / min.

[0050] In some embodiments, the vent element can include an aperture and a filter element within the aperture, where the filter element has a pore size of about 1.0 μm or less (e.g., about 0.7 μm). The filter element can be configured as a replaceable element, and the size can be adjusted to provide an airflow preferably in the range of about 10 mL / min to about 300 mL / min, most preferably in the range of about 20 mL / min to about 150 mL / min, and even more preferably in the range of about 40 mL / min to about 100 mL / min.

[0051] In yet another embodiment, the vent element may include one or more holes. The holes are distal to the pump element inlet and small enough to prevent debris from entering the chamber. The number of holes and the diameter of the hole size preferably allow for a desired air flow in the range of about 10 mL / min to about 300 mL / min, most preferably in the range of about 20 mL / min to about 150 mL / min, and even more preferably in the range of about 40 mL / min to about 100 mL / min. The hole size ranges from about 25 μm to about 200 μm, and more preferably, a flow rate of about 40 mL / min with a hole size of about 73 μm to about 83 μm.

[0052] Alternatively, the level of airflow may vary. In certain embodiments, the level of airflow is related to the therapeutic level of vacuum. That is, higher levels of vacuum may result in higher levels of airflow due to the difference in pressure between the atmospheric side of the vent element and the interior of the chamber. In certain embodiments, the vacuum source may be used in various ways to maintain the therapeutic level of vacuum within a specific range rather than a single value, and the level of airflow may vary in response to the level of vacuum.

[0053] In a related aspect, the present invention relates to a method of applying negative, positive, or neutral pressure therapy to an individual in need of such therapy, comprising coupling a therapy device described herein to the individual and applying a therapeutic level of negative pressure within the chamber. In the case of a cNEP (continuous external negative pressure) airway support device, the therapy device may increase the patency of the individual's airway. Such methods may be implemented for the treatment of sleep apnea, snoring, complete or partial upper airway collapse (during sleep or medical procedures where full or partial sedation is administered), complete or partial upper airway obstruction, and negative pressure therapy for wounds, such as those caused by injury or surgery. [Brief explanation of the drawings]

[0054] [Figure 1]FIG. 1 shows a cross section of an open cavity coated foamed elastomer 100 including a viscoelastic foamed tissue interface surface 110, a non-contact substrate interface surface 120, and one or more gas pockets 130 within the foamed elastomer. [Figure 2] FIG. 1 illustrates a cNEP airway support device 140 showing the shaded area representing the tissue interface surface completely covered by the foamed elastomer 100. [Figure 3] FIG. 1 illustrates a cNEP airway support device 140 showing the shaded area representing the tissue interface surface partially covered with foamed elastomer 100 such that the foamed elastomer forms the majority of the skin contact area of ​​the device. [Figure 4] FIG. 1 shows a cNEP airway support device 140 having adjacent, continuous, concentric beads 150 of foamed elastomer spaced at regular intervals across the width of the viscoelastic foamed tissue interface surface 110. [Figure 5] A diagram showing the posterior surface of the partial face mask 140, including the viscoelastic foamed tissue interface 110, the aperture 115 for the air pump, the approximate location of the bridge of the nose 143, the approximate location of the cheekbones 147, and the approximate location of the jawbone 149. [Figure 6] FIG. 1 shows the posterior surface of the full face mask 150, including the perimeter face sealing surface 153, the face shield 125, the partial face mask 140 positioned inside the perimeter face sealing surface 153, the approximate location of the bridge of the nose 143, the approximate location of the cheekbone contact surface 147, and the approximate location of the jawbone contact surface 149 (which is obscured by the lower portion of the perimeter face sealing surface 153). [Figure 7] FIG. 1 is a rear view of a nasal cushion 160, including the nasal cups and outer tissue-contacting surface, a viscoelastic foamed tissue-interface surface 110. DETAILED DESCRIPTION OF THE INVENTION

[0055] The present invention and its various features and advantageous details will be explained in more detail with reference to non-limiting embodiments illustrated in the accompanying drawings and detailed in the following description. It should be noted that all features shown in these drawings are not necessarily drawn to scale. Descriptions of well-known components and processing techniques have been omitted to avoid unnecessarily obscuring the present invention. All examples used herein are merely intended to aid in the understanding of how the present invention may be implemented and to further enable those skilled in the art to practice the present invention. Therefore, these examples should not be construed as limiting the scope of the present invention. In these drawings, like reference numerals refer to corresponding parts throughout the several views.

[0056] In the present invention, devices comprising viscoelastic foams are configured to contact biological tissue or similar surfaces. Ideally, the device's contact surface provides an appropriate balance between viscoelastic properties that allow the material to adapt to anatomical variations between individuals and the changes that may occur as a result of movement by a given individual. The former refers to a low viscosity modulus that allows the material to flow / adapt, while the latter refers to a low elastic modulus that allows the material to recover. Of particular note in various embodiments are very low (tissue-like) durometer hardness extending into the Shore 000 scale range, inherent viscosity, closed cell surface, enhanced cleanability, and enhanced durability.

[0057] Additionally, the contact surface ideally includes a level of tackiness that prevents the instrument from sliding over biological tissue and resulting in abrasion or abrasion to the skin or implant migration that would otherwise occur, and that helps maintain an airtight seal between the instrument and biological tissue under both static and dynamic conditions. The contact surface should mimic tissue in hardness, exhibit minimal skin sensitivity or allergic reaction, and provide reasonable resistance to microbial growth. Finally, when used in repeated use applications (e.g., external applications such as skin contact), cleaning should not only not degrade the interface material, but should also aid in the removal of dirt, grime, stubble, makeup, and / or sweat while maintaining surface tackiness.

[0058] In achieving the objectives of the present invention (i.e., a compliant interface between the device and the living tissue), it has been determined that decreasing the durometer hardness of the elastomeric foam results in a corresponding decrease in the viscoelastic modulus (as measured by storage and loss modulus). Increasing the foaming agent concentration results in a decrease in the viscoelastic modulus, although to a lesser extent than the durometer hardness.

[0059] It is also recognized herein that foaming of elastomeric materials can be used to achieve surface tack without the addition of tackifiers. Low concentrations (e.g., less than 5%, and preferably less than 3%) of foaming agent provide compliant structures that, when loaded, have higher surface tack than unfoamed variants.

[0060] Thus, to enhance cleanability, elastomeric foam materials can be "skinned" during fabrication, which closes the normally open surface cellular structure and replaces the open surface structure with a continuous, integrally closed surface that exhibits stain resistance.

[0061] The following are suitable viscoelastic properties of viscoelastic foams for use in the present invention: [Table 1]

[0062] In certain embodiments, the viscoelastic foam contacts a tissue or similar surface and defines one or more surfaces of a positive, negative, or neutral pressure treatment device designed to maximize comfort and sealing efficiency, ultimately optimizing device efficacy and user compliance. In certain embodiments, the non-tissue-contacting portion of the device provides support for the viscoelastic foam element and the interface between the device and the tissue-contacting viscoelastic foam. In certain embodiments, the viscoelastic foam may be affixed to a negative pressure chamber configured to cover a portion of the body as described below for use in opening an individual's upper airway when placed over a subject's anterior neck region on a surface that roughly corresponds to the subject's upper airway.

[0063] Exemplary applications of this technology are not intended to be limiting. Viscoelastic foams can also be used to form tissue-contacting injection sites or sites for collecting biometric data, such as ECG and EKG electrodes, continuous glucose monitoring (CGM) systems, tracheal tubes, catheters, medical balloons, partial face masks (FIG. 5, which shows the posterior surface of a partial face mask 140, including a foam elastomer-tissue interface 110, an aperture 115 for an air pump, the approximate location of the bridge of the nose 143, the approximate location of the cheekbones 147, and the approximate location of the jawbone 149), full face masks (FIG. 6, which shows the posterior surface of a partial face mask 140, including a foam elastomer-tissue interface 110, an aperture 115 for an air pump, the approximate location of the bridge of the nose 143, the approximate location of the cheekbones 147, and the approximate location of the jawbone 149), and other applications. The perimeter face sealing surface 153, the face shield 125, the partial face mask 140 disposed within the perimeter face sealing surface 153, and the posterior surface of the full face mask 150, including the approximate location of the bridge of the nose 143, the approximate location of the cheekbone contact surface 147, and the approximate location of the jawbone contact surface 149 (shown obscured by the lower portion of the perimeter face sealing surface 153), may be used as one or more contact surfaces for additional devices for limited or prolonged contact with or treatment of a tissue site, including, but not limited to, medical devices such as: the perimeter face sealing surface 153, the face shield 125, the partial face mask 140 disposed within the perimeter face sealing surface 153, the posterior surface of the full face mask 150, including the approximate location of the bridge of the nose 143, the approximate location of the cheekbone contact surface 147, and the approximate location of the jawbone contact surface 149 (shown obscured by the lower portion of the perimeter face sealing surface 153). Note that the perimeter face sealing surface 153 and the sealing surfaces of the partial face mask 140 may be completely or partially covered with the elastomeric material 110.

[0064] Viscoelastic foams can also be used as one or more contact surfaces of additional devices for limited or long-term contact with or treatment of a tissue site, including, but not limited to, eye protection masks, colostomy bags, earplugs, earbuds, headphones, goggles, sports equipment, bras, and others. Viscoelastic foams provide omnidirectional compliance, including compressive and shear properties that closely mimic the biological tissue they contact to provide a tissue-friendly interface. Furthermore, viscoelastic foam elements are durable, abrasion-resistant, shear-absorbent, compressible, conformable, comfortable, and washable. Viscoelastic foams can also be used as scuba or other masks, where the viscoelastic foam is fluidly sealed against liquids such that only 10% of the mask is filled with liquid for at least 10 minutes at a pressure of approximately 1 atm. The liquid can be fresh water, seawater, oil, or any substance that is free-flowing but has a fixed volume.

[0065] In certain embodiments, the viscoelastic foam element comprises the following density, durometer, and probe viscosity characteristics: [Table 2]

[0066] (EFMFP) is an Elastomeric Foam Material Fabrication Process, defined by the manner in which the viscoelastic foam is cured. EFMFPs are classified as "open cavity" or "closed cavity" processes. As used herein, an open cavity viscoelastic foam material fabrication process is defined by applying a viscoelastic foam element onto a material to cure outside of a molding function. In an open cavity process, the viscoelastic foam is simply applied onto the material and allowed to cure in any desired manner (e.g., at room temperature, under the application of heat, UV light, or a combination thereof). As used herein, a closed cavity viscoelastic foam material fabrication process is defined by applying or injecting a viscoelastic foam element into a closed mold containing a material under near-vacuum (e.g., overmolding) to cure the viscoelastic foam element against the material in the mold. Curing in these processes can be achieved in any suitable manner (e.g., by applying a catalyst, heat, UV light, or a combination thereof).

[0067] Density is the degree of consistency measured by the mass of a substance per unit volume (e.g., grams per cubic centimeter (g / cm 3 In the open cavity viscoelastic foam material manufacturing process, the density of the viscoelastic foam material is preferably 0.1 to 0.8 g / cm 3 range, more preferably 0.2 to 0.7 g / cm 3 and most preferably 0.3 to 0.5 g / cm 3 In the closed cavity viscoelastic foam manufacturing process, the density of the viscoelastic foam is preferably in the range of 0.4 to 0.9 g / cm. 3 range, more preferably 0.5 to 0.8 g / cm 3 and most preferably 0.6 to 0.7 g / cm 3 The range is.

[0068] Durometer hardness is defined as a measurement of hardness as measured by the ASTM D2240 scale. For open cavity viscoelastic foam material manufacturing processes, the durometer hardness is less than about 10 Shore 00, more preferably less than about 50 Shore 000, and most preferably in the range of about 5-30 Shore 000. For closed cavity viscoelastic foam material manufacturing processes, the durometer hardness is less than about 10 Shore 00, more preferably less than about 80 Shore 000, and most preferably in the range of about 20-40 Shore 000.

[0069] Probe tack is defined as the force required to separate an adhesive element from an adhered probe, as measured by ASTM D2979 Standard Test Method for Pressure-Sensitive Tack of Adhesives. For open cavity viscoelastic foam material manufacturing processes, the probe tack is preferably about 9 mJ / cm. 2 less than 7 mJ / cm 2 less than, and most preferably about 5 mJ / cm 2 In a closed cavity viscoelastic foam material manufacturing process, the probe viscosity is preferably in the range of about 9 mJ / cm 2 less than 7 mJ / cm 2 less than, and most preferably about 5 mJ / cm 2 The range is.

[0070] In certain embodiments, the viscoelastic foamed material component is a foamed silicone rubber material produced by mixing a combination of silicone rubber and a foaming agent, which generates a foamed cellular structure that, upon curing, increases in thickness, preferably in the range of 50-300%, more preferably in the range of 75-250%, and most preferably in the range of 100-200%.

[0071] In certain embodiments, the compliant conformal interface includes a layer of viscoelastic foam material having a thickness preferably in the range of 0.030" to 0.375", more preferably in the range of 0.050" to 0.250", or most preferably in the range of 0.075" to 0.150".

[0072] Blowing agents are used to produce silicone foams at room temperature or thermosetting silicone elastomer systems. Foamed silicone rubber materials are designed to be conformable. The addition of a catalyst (e.g., iron, cobalt, zinc, titanate, tin, platinum, or acid catalyst) allows rapid production of silicone rubber foams in a chamber. Foam cellular structures can be created by releasing gases during the curing process. Foams can also be created by using certain additives (e.g., ammonium bicarbonate). Such additives can create cellular foams from high-viscosity rubber (HCR) or liquid silicone rubber (LSR) via the application of heat.

[0073] In certain embodiments, viscoelastic foams can be treated to promote a denser, open-cell or closed-cell matrix on a surface than is found throughout the entire body of the foam. For example, sheeting produces a denser film coating on surfaces exposed to the open atmosphere than would be produced on a surface coated on its continuous polymeric sheet film carrier. Such a denser matrix can be desirable to mitigate moisture absorption, particle or moisture contamination, and / or microbial growth. Additionally, if the surface exhibits impermeability, cleaning is easier and less detrimental.

[0074] In particular embodiments, the viscoelastic foam may be coated with an additional film coating layer having a lower durometer to produce a viscoelastic foam that is impervious to fluid intrusion and resistant to contamination or microbial growth. The film coating layer on the viscoelastic foam creates an overall dual durometer structure. However, the overall durometer is dominated by the viscoelastic foam when the ratio of viscoelastic foam to film coating layer exceeds 10:1.

[0075] In a specific embodiment, either the silicone rubber component of the viscoelastic foam or the film coating layer, or both, are selected from the group of silicone medical-grade soft skin adhesives (SSAs) commonly used in wound care therapy. Silicone SSAs offer the advantages of no traumatic skin removal, no skin peeling, and no painful pulling of skin or hair. Another advantage is that, unlike alternatives, SSAs have low viscosity components. As a result, the flowability of SSAs is limited, thereby limiting the absorption of stratum corneum cells and lipids on the surface of the skin. The adhesive surface of SSAs remains relatively clean and can be repeatedly removed, reused, and cleaned without compromising its integrity.

[0076] High viscosity rubbers consist of high molecular weight silicone polymers, optionally mixed with fillers (such as silica) to produce materials that can be molded, extruded, or calendered into useful final products. Liquid silicone rubbers (LSRs), like HCRs, can be silica reinforced, but typically use lower molecular weight polymers. LSRs are often pumped through injection molding machines and cured to form finished parts.

[0077] In certain embodiments, the viscoelastic foam may further comprise a reinforcing filler. The addition of the reinforcing filler can significantly improve the elastic mechanical properties of the viscoelastic foam, such as hardness, tensile strength, tear strength, and bending fatigue. The reinforcing filler may be selected from the group including acidic fillers such as fumed silica, silica, silica aerogel, silica xerogel, titanium dioxide, diatomaceous earth, iron oxide, aluminum oxide, zinc oxide, quartz, calcium carbonate, magnesium oxide, carbon black, graphite, glass fiber, glass microspheres, glass microballoons, glass beads, carbon fiber, silicon carbide, polystyrene beads, and metal fibers.

[0078] In certain embodiments, the tissue interface portion may be combined or partially comprised of a silicone rubber material, preferably an HCR material, and more preferably an LSR material. The durometer hardness of the silicone rubber is preferably in the range of approximately 1 to 20 Shore A durometer, and more preferably in the range of approximately 1 to 10 Shore A durometer. Furthermore, foaming the silicone rubber can create a three-dimensional network of hydrophobic polymer chains that can be physically or chemically crosslinked. The significant gas content of the foamed LSR material allows the foamed LSR to closely resemble natural soft tissue. The foaming properties can be achieved by adding a foaming agent (e.g., ammonium bicarbonate dispersed in a vinyldimethyl-terminated polydimethylsiloxane polymer) to the silicone rubber material. In these cases, the weight ratio of foaming agent to silicone rubber is preferably in the range of approximately 0.1% to 10%, more preferably in the range of approximately 0.5% to 5%, and most preferably in the range of approximately 1.5% to 3%. Additional agents used in forming the foamed LSR may include, but are not limited to, platinum catalysts and organotin compound catalysts.

[0079] In certain embodiments, the compliant interface element comprises a viscoelastic foam having a tissue interface with a sufficiently high surface tension to reduce or eliminate sliding between the patient's tissue and the compliant interface. The viscosity of the tissue interface further contributes to accommodating larger cross-sectional anatomical variations and creating the necessary interface seal.

[0080] Further desirable attributes or aspects of the device may be determined through additional material properties including, but not limited to, specific gravity, tensile strength, elongation, tensile modulus, tear strength, durometer hardness, and probe viscosity.

[0081] Specific gravity is defined as the ratio of the density of a material to the density of a reference material (e.g., the ratio of the densities of an elastomeric material to water). In various embodiments of the present device, the specific gravity of the viscoelastic foam material ranges from about 0.49 g / cm to about 0.72 g / cm.

[0082] Tensile properties (measured, for example, using ASTM D412) can be obtained for, for example, tensile strength, elongation, and tensile modulus.

[0083] Tensile strength is defined as the ability of a material to withstand a stretching load. Tensile strength (maximum tensile strength force) is measured by the maximum stress that a stretched material can withstand before bursting. In various embodiments of the present invention, the tensile strength of the viscoelastic foam material is preferably in the range of about 31 psi to about 114 psi, and more preferably in the range of about 31 psi to about 62 psi.

[0084] Elongation is defined as the increase in length of the viscoelastic foam measured after rupture and expressed as a percentage of the original gauge length, where the gauge length is defined as the distance along the specimen over which the elongation calculation is performed. In various embodiments of the present invention, the elongation of the viscoelastic foam ranges from about 438% to about 817%, and more preferably from about 438% to about 747%.

[0085] Tensile modulus is defined as a measure of stiffness that defines the relationship between stress and strain. In various embodiments of the present invention, the tensile modulus of the viscoelastic foam material ranges from about 5 MPa to about 10 MPa, and more preferably from about 6 MPa to about 7 MPa.

[0086] Tear strength (e.g., as determined using ASTM D624) is a measure of the force per unit thickness (pounds per inch, Ppi) required to break or tear a sample. In various embodiments of the present invention, the viscoelastic foamed material has a tear strength in the range of about 8 Ppi to about 32 Ppi, and more preferably in the range of about 9 Ppi to about 14 Ppi.

[0087] In various aspects of the invention, additional attributes of the viscoelastic foamed material may include a tackiness characteristic that is maintained over time (e.g., over time of cure), including storage, use, and / or cleaning. In certain embodiments, the viscoelastic foamed material has a probe tack value of about 0.43 mJ / cm for one week or more of cure, with about 65% or more of the probe tack maintained for a time period of about four weeks or more, preferably about 73% or more of the probe tack maintained for a time period of about four weeks or more, and most preferably about 83% or more of the probe tack maintained. 2 ~Approx. 2.52mJ / cm 2 is maintained within the range.

[0088] In certain embodiments, an antimicrobial composition is added to the viscoelastic foam element. Antibacterial, antifungal, and antiviral properties can be imparted by the addition of silver salts in any suitable material, for example, in the form of silver sulfate, silver citrate, silver acetate, silver carbonate, silver lactate, and silver phosphate. In addition, zeolites containing approximately 15% by weight of silver ions can also be used. Suitable materials (e.g., polyhexamethylene biguanide) are also well known in the art. Alternatively, bacteriostatic, fungistatic, and antistatic properties can be imparted by the addition of siloxane polymers, for example, incorporated into the coating in the form of powder, solvent, or solution, or synthesized in powder form with the uncured viscoelastic foam polymer.

[0089] In certain embodiments, the compliant interface element comprises a viscoelastic foam that is preferably mechanically secured, or more preferably adhered by an intervening adhesive layer, or most preferably directly dispensed or cured without any mechanical means or additional adhesive, to the tissue interface portion of the device to form a leak-tight tissue interface. In certain embodiments, overmolding may be used to provide mechanical features for attachment and retention of the foam to the device.

[0090] In certain embodiments, the compliant conformal interface element comprises a viscoelastic foam that is sheet-formed, cured, and then cut to shape and mechanically or adhesively bonded to the tissue interface portion of the device using an interleaving adhesive layer (e.g., RTV (room temperature vulcanizing) silicone rubber) to form a leak-tight tissue interface.

[0091] In certain embodiments, the compliant conformal interface element comprises a multi-layered sheet-formed and cured foamed silicone rubber material that can be coated with a thin, non-vulcanized, ground or calendered HCR material that serves as an adhesive layer that is heat-bonded onto the tissue interface of the device to create a leak-free interface.

[0092] In certain embodiments, the compliant interface element comprises a viscoelastic foam that may be laminated with a thin adhesive film (e.g., a silicone pressure-sensitive adhesive film) that serves as an adhesive layer that is pressure-bonded onto the tissue interface of the device to form a leak-tight interface.

[0093] In certain embodiments, the conformable interface element comprises a viscoelastic foam material that can be overmolded and cured directly onto the flange element (FIG. 2, 110) of the annular component to form a leak-tight tissue interface. As used herein, overmolding refers to the process of adding material to an already molded shape, thereby creating a final product that is partially or completely covered by the added material and that is slightly larger than or overlaps the edge of the original component that corresponds to the skin-contacting surface.

[0094] In certain embodiments, the present invention comprises a viscoelastic foamed material that is continuously dispensed across the width of the non-contact surface 120 of the device (the width of the foamed silicone rubber may be constant or may vary across the surface of the device substrate) and cured to form a non-exposed tissue interface. As can be seen in Figure 2, which shows a cNEP airway support device 140, the shaded area represents the tissue interface surface that is partially covered by the foamed elastomer 100.

[0095] In certain embodiments, the viscoelastic foam material is continuously dispensed and hardened in one or more discrete concentric annular rings and / or ribbons corresponding to the shape of the tissue interface portion of the device ( FIG. 4 , 150). An annular ring is defined as a pattern encompassing and encompassing the area or shape between two concentric rings. These discrete concentric annular rings or ribbons may have uniform or varying thicknesses and / or uniform or varying widths, or combinations thereof, on the non-contact portion of the device. The rings or ribbons may be dispensed with a pitch spacing between them that is preferably independent and self-supporting upon heat curing, or more preferably, with a sufficiently narrow pitch spacing between them that the rings and / or ribbons expand and coalesce upon heat curing to form a leak-tight tissue interface. Coalescence, as used herein, is defined as the outer edges of one or more of the rings or buttons meeting or flowing together, resulting in the formation of the uniform and / or peak and valley characteristics of the rings or ribbons. Note that peaks are defined as thicker areas of a ring or ribbon compared to valleys, which are thinner areas of a ring or button. As used herein, pitch separation is defined as the dimensional difference between two repeating features (e.g., the dimensional separation between the centerlines of concentric annular rings of viscoelastic foamed material).

[0096] In certain embodiments, the tissue interface comprises a viscoelastic foam material that is successively dispensed and cured in successive spiral rings and / or ribbons that correspond to the shape of the tissue interface of the device. The successive spiral rings or ribbons may be dispensed with a pitch spacing between the successively dispensed rings / ribbons that allows them to be independent and self-supporting upon heat curing, or more preferably, with a pitch spacing between such successive rings or ribbons that is sufficiently close that such successive rings and / or ribbons expand and coalesce upon heat curing to form a leak-tight tissue interface.

[0097] In certain embodiments, the tissue interface portion comprises a viscoelastic foam material dispensed in a two-dimensional array pattern of dots (e.g., with a sufficiently narrow pitch spacing that they expand and coalesce upon heat curing to form a continuous, leak-tight tissue interface).

[0098] In certain embodiments, the viscoelastic foams of the present invention will be sufficiently flexible and conformable to support the nocturnal growth of pre-existing stubble or stubble without compromising the necessary therapeutic interface seal. In the viscoelastic foaming material, preferred silicone rubber durometer and foaming agent concentrations range from 1 to 10 Shore A and 1.5 to 3%, respectively. The resulting viscoelastic foams have a final durometer of 10 Shore 00 or less, and preferably have a final durometer range of approximately 1 to 40 Shore 000.

[0099] In certain embodiments, the compliant conformal interface element comprises a foamed silicone rubber material, the foam cellular structure of which is preferably produced by a removal process, in which a salt of a given particle size and concentration is uniformly mixed with the LSR formulation and then washed (i.e., dissolved or removed) to leave the cellular structure, and more preferably by a gas expansion process, in which a blowing agent of a given particle size and concentration is uniformly mixed with the LSR formulation and then expanded by the application of heat to create the cellular structure.

[0100] Optionally, an adhesive layer or gel is disposed on the surface of the compliant interface element that contacts the user. Silicone gels, for example, are designed to be soft and conformable. These silicone gels achieve their gel-like consistency by having fewer cross-linking bonds than is typical for elastomers and are generally not silica-reinforced. The uncured gel is easily pourable, can be mixed by hand, and can be molded into finished parts. The adhesive or gel layer is intended to reduce device movement on the wearer and enhance sealing and cushioning for the wearer. These elements are configured to maintain a substantially uniform contact pressure, with pressure fluctuations minimized across all contact points of the treatment device with the patient along the individual's tissue. "Minimized pressure fluctuation" means that the pressure at any point between the contact surface of the sealing element and the patient's tissue varies by no more than about 20%, and preferably no more than about 10% or about 5%, from the average pressure across the entire contact surface. As used herein, an outer contact surface is a surface of a sealing element of a treatment device that contacts an individual's tissue, thereby forming a contact point and sealing the tissue interface of the device.

[0101] In certain embodiments, a treatment device comprising a chamber and a sealing element is configured to provide a contact surface between the chamber and a user, and the sealing element is configured to provide a contact surface between the chamber and a user, as described herein, to equalize loads in this region across the interface between the negative pressure treatment device and the user's three-dimensionally varying tissue surface, thereby maintaining a substantially uniform contact pressure across this non-uniform surface.

[0102] In particular, but not exclusively, the therapeutic devices described herein relate to external therapeutic devices for relieving upper airway obstruction. U.S. Patent Application Serial No. 12 / 002,515, U.S. Patent Application Serial No. 12 / 993,311, and U.S. Patent Application Serial No. 13 / 881,836, which are incorporated by reference in their entirety, including all tables, figures, and claims, describe therapeutic devices for relieving airway obstruction. Increasing the patency of an individual's upper airway alleviates symptoms such as snoring, sleep apnea, and complete or partial upper airway collapse (during sleep or medical procedures requiring some level of sedation). As described herein, the device is configured to fit externally at a location corresponding to the soft tissue overlying the upper respiratory passages in the neck below the user's chin.

[0103] In various embodiments, viscoelastic foam material features may include the ability to maintain desired material properties over a range of temperatures. These properties further enable the tissue-contacting surface of the viscoelastic foam material of the device to conform to moving and curving tissue interface surfaces, tissue-like interface surfaces, and non-tissue-contacting surfaces (e.g., surfaces of rigid or flexible wearable instruments or components of such instruments, which may or may not be moving or curving surfaces).

[0104] As described herein, viscoelastic foams can be used as interfaces between biological tissue surfaces and tissue-like and / or non-tissue surfaces of rigid or flexible wearable appliances or components of such appliances. The viscoelastic foams provide a compliant and comfortable mating interface that enables and supports periodic or long-term use of the device. While the duration of use may depend on the application, length of treatment required, protection, etc., the viscoelastic foams can alleviate the adverse fit and feel limitations of appliances that do not include the viscoelastic foam.

[0105] Devices that benefit from viscoelastic foam interfaces may be defined and required by a Chemical Hygiene Plan (CHP) and may include, but are not limited to, interfaces between medical and / or therapeutic devices (prosthetic devices, positive or negative pressure therapy devices, CPAP devices, cNEP devices, laryngeal mask airways (LMAs), nasal cannulae, nasal pillows (FIG. 7), airway insertion devices, catheter protection / sealing systems, etc.) and users. Additional applications may include, but are not limited to, interfaces between personal protective equipment or military protective equipment (PPE) and users. Applications may further include interface surfaces of respiratory protection, particle and / or gas masks, and / or interface surfaces of protective clothing or barriers used to seal areas between devices and tissue, tissue-like surfaces, and / or non-tissue surfaces. Uses may also include Level A, Level B, Level C, and / or Level D Occupational Safety and Health Administration rated protection, including, but not limited to, pressure-demand self-contained breathing apparatus (SCBA), gloves, leg and eye protection, earplugs, earmuffs (for noise attenuation and protection), knee pads, elbow pads, and / or wrist pads, helmets, hats, full or partial facepiece positive or negative pressure breathing apparatus, and / or theatrical equipment including full body suits, masks, wigs, ear, nose, forehead, cheek, chin, eyebrow devices, and small makeup FX props, etc.

[0106] In various embodiments, the foamed elastic material can be in the form of an injectable or preformed material, for example, to fill wrinkles, deep lines, acne scars, or to add volume to the lips and cheeks, or in larger structures, such as the breasts or buttocks. Silicone rubber is less expensive and easier to process than fillers such as collagen and Restylane, and side effects occur in less than 1% of patients. Furthermore, fillers such as collagen and Restylane can be absorbed by the body within approximately six months, making silicone a more permanent option. Uncontrolled or free silicones are generally not well tolerated by the body, making cured coatings, cured injections, or pre-cured implants preferred. As used herein, a cured coating is defined as a layer of a viscoelastic foamed material that is applied to a desired surface in its uncured state (which may be liquid or gel-like) and then cured, for example, via heat, UV, or chemical catalyst, to its final viscoelastic, foamed form. As used herein, a cured injection is defined as the injection of an uncured viscoelastic foamed material and catalyst into a desired location. The viscoelastic foam material is capable of hardening to its final viscoelastic foamed form at the location where it is placed via injection. As used herein, a pre-hardened implant is defined as a viscoelastic foam material that has hardened to a desired shape and then applied or implanted at a desired location.

[0107] In certain embodiments, viscoelastic foams can be used as coatings for catheters, guidewires, stents, grafts, and / or stent-grafts by protecting the vessel wall during insertion, reducing device deployment or expansion forces, and providing a tissue-like interface between all, partial, or selected portions of the device. Furthermore, viscoelastic foams can be mixed with antiproliferative agents to reduce restenosis for improved clinical outcomes. As used herein, deployment force is defined as the outward force (measured in a glass tube with a precise inner diameter) exerted by a device such as a stent as it expands from its initial diameter to its working diameter. A suitable testing machine (WL2100; Withlab, Gunpo, Gyeonggi-do, Korea) is well known in the art.

[0108] In further embodiments, the viscoelastic foam may be used as a ureteral stent or as a coating for a ureteral stent by protecting the ureteral wall, kidney, bladder, and urethra and providing a tissue-like structure and / or interface between all, partial, or selected portions of the stent.

[0109] In certain embodiments, viscoelastic foams can be used in the treatment of unruptured aortoiliac aneurysms (AAAs) or similar conditions. For example, a stent-graft, including a stent portion for anchoring to the aortic wall and a graft portion comprising a network of ducts, is used to treat the aneurysm. The stent-graft is delivered within a catheter in a compressed state. Upon release, the stent engages the vessel wall and the graft expands to guide blood flow. The aneurysm is then sealed by filling the space between the graft and the vessel wall by directly injecting a filling substance or by inflating a sealing chamber, endobag, and / or other support-type structure (e.g., ring-shaped ribs) with a suitable filling substance (e.g., a viscoelastic foam). When the components of the viscoelastic foam are mixed, cross-linking is initiated, forming a viscoelastic foam filling. These components may be mixed prior to filling the graft or may be mixed within the graft during filling. After mixing, the viscosity is maintained low to aid in filling, and then thickens and changes from a liquid to form a soft, compliant, yet firm solid. The mixed viscoelastic foam material may further contain a contrast material to aid the physician in visualizing proper deployment. Such a contrast material is injected into the inflatable sealing chamber of the graft.

[0110] In certain embodiments, viscoelastic foams can be used as an interface between biological tissue and a prosthetic device. Viscoelastic foams can satisfy key requirements for tissue structural support, tissue maintenance, and tissue healing, while providing a more optimal functional relationship between the prosthetic device and the biological tissue. Viscoelastic foams can be designed to replicate complex tissue structural hierarchies by modifying the physical properties of the viscoelastic foam to provide a more optimal interface between all or part of the biological tissue and the prosthesis. Viscoelastic foams can be used to form layers between the biological tissue and the prosthesis with uniform or varying thicknesses and durometers to accommodate variations in the biological tissue and the prosthesis. Furthermore, the probe viscosity of the viscoelastic foam favors adhesion of the viscoelastic foam to the biological tissue and favors adhesion of the viscoelastic foam to the prosthesis, thereby providing a more optimal interface between the prosthesis and the user. Additionally, the air pockets inherent in the viscoelastic foam material may provide a good bond between the prosthesis and the user upon water saturation due to sweating or other instances resulting from contact with water by trapping or removing moisture between the living tissue and the viscoelastic foam material while substantially maintaining the probe viscosity of the viscoelastic foam material.

[0111] For the purposes of this patent application, the term "about" refers to + / - 10% of a given value.

[0112] The negative pressure therapy device of the present invention includes a flexible membrane element, an aperture through the flexible membrane element, and a tissue interface disposed along the edge or surface of the flexible membrane element along a circumferential dimension of the tissue interface to form an airtight connection between the compliant tissue interface and the flexible membrane element. The connection between the non-contact portion of the chamber element and the chamber element is referred to herein as the "base" of the connection. As used herein, a compliant element is defined as an element (e.g., a compliant tissue interface) that is flexible to accommodate variations in the general shape of the contact surface and the target treatment area.

[0113] The term "peripheral dimension" as used herein refers to continuous locations along the width of a tissue interface portion, and in some cases, for example, where a chamber element continuously contacts a non-contact portion of an instrument. The term "base" as used herein refers to the location where the chamber element contacts a non-contact portion of an instrument, having a width bounded by the thickness of the chamber element. The chamber element may be secured to the non-contact portion of the tissue interface element as a unitary, monolithic, or discrete structure. A "monolithic structure" refers to a structure that is an integral entity constructed by joining two or more components together, such that once joined, they form a single piece that cannot be separated without destroying the device. A "monolithic structure" refers to a structure that is a unitary structure formed or molded as a single piece. Two (or more) structures are "discrete structures" when they form a single working structure but retain individual characteristics and are separable during natural use of the single working structure and reassembled after separation.

[0114] Surface variations in the treatment area, both permanent and temporary (i.e., jaw shape, neck-to-jaw transition point, tissue type, scarring, facial hair, and / or tissue imperfections, differential forces applied to different parts of the seal caused by wearer movement, etc.), can disrupt the seal between the negative pressure therapy device and the user. The present invention provides devices, systems, and methods of use that can accommodate varying facial contours / features and accommodate movement, thereby resulting in greater comfort, reduced vacuum leakage, and improved therapeutic efficacy.

[0115] The flexible membrane element and sealing element of the device comprise a cantilever-like structure, a hoop load-like structure, and / or a combination of the two, adapted to have stiffness, flexibility, and zonal properties that allow for uniform zonal compliance and / or force loading on an individual's tissue surface. As used herein, "zonal compliance" refers to a property of the device that allows it to "mold" itself to the surface and / or surface variations on the contact surface against the wearer. As will be explained later, uniform zonal compliance is provided in part by zonal properties or structural features associated with the area on the chamber element, the sealing element, or both.

[0116] The sealing element may be in the form of a flange comprising a flexible, resilient material that may be uniform in thickness and width, or may vary in thickness and width to achieve desired structural characteristics at locations along the contact surface of the treatment device. Additionally, the location of the chamber element at the base of the sealing element flange may be varied to adjust and equalize the contact pressure of the treatment device when a therapeutic level of negative pressure is applied. U.S. Provisional Patent Application No. 62 / 281,063, entitled "Device and Method for Opening an Airway," filed January 20, 2016, and incorporated herein by reference, describes varying flange and chamber characteristics to equalize contact pressure.

[0117] In certain embodiments, the sealing element can be a compliant tissue boundary element that includes a layer or series of layers that include foamed silicone rubber to provide a cushioned surface. The inner surface of the flange contacts the flexible membrane element, and the outer surface of the compliant tissue boundary element contacts the user's tissue. Such cushioned sealing elements are discussed in U.S. Provisional Patent Application No. 62 / 260,211, filed November 25, 2015, entitled "Chamber Cushion, Seal and Use Thereof," which is incorporated herein by reference.

[0118] The tissue boundary portion of the device is adapted to have zonal characteristics that allow for flexibility and uniform zonal compliance. As used herein, "uniform zonal compliance" refers to a characteristic of a compliant tissue boundary element that allows the compliant tissue boundary element to "mold" itself to the surface and / or surface variations on the contact surface against the wearer. As explained later in this specification, this uniform zonal compliance is provided in part by zonal characteristics or features associated with the regions on the compliant tissue boundary element.

[0119] The compliant tissue boundary element includes a foamed silicone rubber layer that is fluid-tight. The term "fluid-tight" refers to a foamed silicone rubber layer that prevents air from passing through the compliant tissue boundary element for the time period required for normal use of the chamber. For example, a latex balloon is "fluid-tight" over a 6-hour period of normal use, despite the fact that helium may eventually leak out of the balloon over time and despite the fact that the balloon may burst if subjected to the above conditions.

[0120] In certain embodiments, the sealing element of the present invention provides a contact interface for a negative pressure therapy device configured to conform to a continuous contact surface on an individual in an external area of ​​the neck that generally corresponds to the anterior cervical triangle of the neck. The term "generally corresponds to" an anatomical location refers to close contact, but perhaps not necessarily complete, precise, or accurate contact, relative to an actual location, shape, or size.

[0121] Most preferably, the sealing element is configured to follow the contours of a treatment device designed to generally conform to an individual from a first location corresponding to a first angle point of the jaw on one side of the individual's mandibular body, to a second location corresponding to the individual's mental protuberance, to a third location corresponding to a second angle point of the jaw on the other side of the individual's mandibular body, and to a fourth location corresponding to the individual's thyroid cartilage, and further configured to return to the general first location corresponding to the first angle point of the jaw.

[0122] As used herein, the term "jaw angle point" describes the approximate location on each side of an individual's lower jaw at the mandibular angle. As used herein, the term "mandibular prominence" describes the approximate location of the jaw, which may be depressed in the center but elevated on either side to form the mental tubercle. As used herein, the term "thyroid cartilage" describes the approximate location of the large cartilage of the human larynx.

[0123] The sealing element and chamber element are designed to create a uniform contact pressure against the wearer's tissue when a therapeutic level of pressure is applied. The sealing element preferably has a vertical width (wide and narrow) and thickness to achieve the desired contact pressure characteristics. The vertical width component is the overall width of the seal from the tip of the sealing element's outer edge, through the base, to the tip of the sealing element's inner edge. The width of the sealing element, including the chamber having an oval shape, further includes a central curvature to accommodate an engagement surface on the patient's neck that generally corresponds to the upper airway, and may vary along the circumferential axis of the sealing element's contact area to accommodate point load variations due to the uneven shape of the treatment device, maintaining a constant contact pressure of the negative pressure treatment device.

[0124] In various embodiments of the sealing element, locations on the flange element of the device may be substantially wider than other locations. In one aspect, the overall flange width may vary from approximately 28.0 millimeters to approximately 17.0 millimeters. As used herein, "substantially wider" refers to an increase in width from one location to another of at least about 10%, more preferably at least about 20%, and even more preferably at least about 30% or more. For example, in one embodiment of the present invention, the width of the flange element at the fourth location, which generally corresponds to the center of the user's neck, is approximately 39% wider than the first and third locations, which correspond to the user's mandibular and angle-of-jaw regions. Wider areas may be found in areas where greater load transfer is required (e.g., the second and fourth locations), and narrower areas may be found in areas where less load transfer is required (e.g., the first and third locations on the user).

[0125] The thickness of the flange element may also vary along the vertical width along the periphery of the contact surface of the treatment device to accommodate anatomical variations and varying vacuum cross-sectional areas. As used herein, thick or narrow describes the distance between the surface of the flange that contacts the individual and the (distal) surface of the flange element that contacts the chamber element of the vacuum chamber of the negative pressure treatment device. The thickness of the flange element at the base may vary from approximately 4.5 millimeters to 1.0 millimeter at the inside of the base and from approximately 3.0 millimeters to 1.2 millimeters at the outside of the base. For example, the thickness of the flange element at the junction of the first and third locations on the user may be approximately 1.6 millimeters at the inside of the base and 2.10 millimeters at the outside of the base.

[0126] In certain aspects, locations of flange elements on a device may vary in thickness such that some locations are substantially thicker than others. For example, locations of flange elements may vary in thickness such that one location is substantially thicker than another. As used herein, "substantially thicker" refers to an increase in thickness of at least about 20%, more preferably at least about 30%, and even more preferably at least about 50% or more. For example, in one embodiment of the present invention, the thickness at approximately the second location is approximately 64% thicker than the first and third locations, and the first and third locations are approximately 30% thicker than the fourth location.

[0127] The thickness of the flange element may further taper outward from the base location to a final flange thickness of approximately 0.7 millimeters to approximately 0.1 millimeters. The taper may begin at the base and continue to the inner or outer edge of the flange, or the taper may begin approximately 10%, 15%, 20%, 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, or 95% from the tip of the flange element and continue to the inner or outer edge of the flange element to the desired final thickness of approximately 0.7 to 0.1 millimeters. Tapering the flange at its inner or outer edge helps eliminate edge effects, thereby minimizing tissue irritation and injury. As used herein, "edge effect" refers to tissue irritation (redness, swelling) caused by prolonged contact pressure of a sharp edge against tissue. The tapered edge provides the flange edge with greater flexibility and pliability.

[0128] The chamber element is rigid along its length and the flange will not appreciably flex longitudinally. Thus, in accommodating the dynamic shape of the target treatment area, regions of the treatment device include accommodative design features (e.g., variations in width and thickness of the flange element and / or the addition of compliant, conforming interfaces designed to minimize high pressure points and eliminate pressure fluctuations of the treatment device along its contact surface when placed on a user and subjected to therapeutic levels of negative pressure).

[0129] In areas where the flange contacts a substantially flat surface of the user, the chamber and flange elements may act as an "I-beam." Here, the force presented by the flange to the user is more of a linear downward force and is cantilevered. The inner and outer flange elements at the base of the chamber element bend according to the thickness of the material, with the tapered ends of the flange elements bending most, resulting in a gentle transition against the user's tissue and eliminating edge effects as described above. As used herein, cantilevered force is the measurement of the chamber's downward force divided by the area of ​​the flange at a given point. For example, in areas where the flange elements lie flat across the tissue, the cantilevered force can be balanced by varying the width and thickness of the flange. For example, where a high vacuum cross-section exists and greater load distribution is desired (i.e., lower contact pressure), a flange with a larger vertical width may be utilized; similarly, where less load distribution is desired (i.e., higher contact pressure), a flange with a smaller vertical width may be utilized.

[0130] The thickness dimension of the flange element may impart flange element characteristics such that if the flange element is too thin, it may have great flexibility, but it may have little or no load-sharing properties and bottom out, creating a point or points of high contact pressure from the base of the chamber element, resulting in leakage and / or discomfort. If the flange element is too thick, it may affect the flange element's ability to change direction, for example, making it unable to conform to the sudden change from the cervical surface above the mandible to the ear, and may also cause undesirable levels of shear or lateral movement. Similarly, if the flange element is too small in width, it may create a high-pressure point or points, and if it is too large in width, it may unnecessarily increase the volume, which may affect fit and effective treatment area. The transition in width is tapered and the aspect ratio minimizes positional instability and optimizes flexibility.

[0131] In areas where the flanges contact curved surfaces of the user (e.g., around the chin and above the mandible), the observed forces include an additional hoop force component as the flanges curve around these features. As used herein, "hoop force" describes the distribution of forces exerted in a circumferential direction. For example, as the flange elements move around the user's location 4, the curvature adds additional stiffness to the underlying inner and outer flanges of the chamber element. In these areas where an additional hoop load force component exists, the thickness of the flange elements may be reduced and the vertical width of the flange elements may be reduced to effectively distribute the chamber load and minimize location-to-location contact pressure variations when therapeutic levels of negative pressure are applied.

[0132] As used herein, the term "contact pressure" refers to the pressure exerted by the contact surface of the device on the surface of the tissue. The value of the contact pressure may depend on the structural characteristics of the flange, such as the vertical width and surface area of ​​the contact surface, as well as the vacuum present, and may vary at different locations on the flange.

[0133] A contact surface with a larger "vertical width" (meaning the direction perpendicular to the longest axis of the contact surface, which may be curved) will have a lower overall contact pressure under the same vacuum pressure compared to a contact surface with a smaller vertical width due to the increased surface area of ​​the contact surface at that particular location. Thus, in areas with low dome location pressure, the flange contact surface can be designed with a smaller vertical width to effectively increase and "balance" the contact pressure, and in areas with high dome location pressure, the flange contact surface can be designed with a larger vertical width to effectively decrease and balance the contact pressure at locations with high dome location loads.

[0134] In certain embodiments, the position of the chamber element on the flange element (the root position) can be varied inward or outward from the midpoint to further help equalize the contact pressure of the treatment device against the user and maintain the equilibrium point of the flange element against the user when a therapeutic level of negative pressure is applied. For example, if the root of the chamber element edge is moved outward from the midpoint of the flange element on the flange element, the cross-sectional vacuum area and therefore the effective contact pressure of the treatment device at that point is effectively increased when a therapeutic level of negative pressure is applied. If the chamber edge is moved inward, the opposite effect occurs: a larger portion of the flange is exposed outside the root position, and the treatment device reduces the cross-sectional vacuum area. In areas where higher contact pressure is required (e.g., where the device is close to the user's ear), shifting the chamber position toward the outer edge on the flange can increase the cross-sectional vacuum area and the effective contact pressure at that point.

[0135] The chamber is operably connected to an air pump for generating a therapeutic level of negative pressure within the chamber element. The air pump may be of any suitable type for generating a therapeutic level of negative pressure, such as a positive displacement pump, a pulsating pump, a velocity pump, etc., which may include a hand-squeezed bulb, a rotary pump, a lobe pump, an oscillatory pump, etc. In certain embodiments, the air pump includes a piezoelectric material configured to provide an oscillatory pumping action, the oscillatory pumping action operating at a frequency greater than 500 Hz.

[0136] The air pump may be a separate component connected to the chamber via a hose or tube, or may be configured to be integrated into the chamber. The air pump may be connected to the chamber element in any suitable manner. For example, the air pump may be externally disposed outside the chamber element and connected via a hose or tube (e.g., a stationary clinical pump), or may be integrated into the chamber, battery-powered, and worn by the patient. In certain wearable embodiments, the air pump is configured to be integrated into the chamber. For example, the air pump may be configured to be inserted into a sealable aperture on the chamber, where the air pump fits tightly through the aperture to form a seal. As used herein, a sealable aperture is an opening through an element of a device that can be closed and sealed from one side to the other, with other elements of the device creating an airtight or watertight seal.

[0137] In certain embodiments, in conjunction with or in conjunction with one or more of the foregoing, a material is applied to the outer contact surface of the flange element that acts as an adhesive layer between the flange element material of the treatment device and the user. The purpose of the adhesive layer is to provide sealing, cushioning, and / or shear absorption (i.e., wear resistance) to the flange element. As used herein, shear refers to shear strain, which is a deformation of a material that allows parallel surfaces (e.g., the contact surfaces of the flange element and the user's tissue) to slide past each other.

[0138] The adhesive layer should also preferably adhere to the outer contact surface and provide a sufficient level of "stickiness" so that releasable mechanical fixation of the treatment device to the user's tissue is achieved. As used herein, "stickiness" refers to the mechanical properties at the interface created between the adhesive layer and the device and the user's tissue at the other interface created between the user and the device.

[0139] The adhesive layer may be applied to the contact surface of the negative pressure therapy device in any suitable manner, including, but not limited to, spraying, painting, placing, etc., in single or multiple layers, to achieve the desired cushioning and sealing properties, including, but not limited to, thickness, hardness, and viscosity. In additional embodiments, the adhesive layer may be a single layer of uniform thickness or a single layer of non-uniform thickness covering the contact surface of the negative pressure therapy device. In further embodiments, the adhesive layer may include a series of parallel adhesive beads around the periphery of the contact surface of the negative pressure therapy device. These adhesive beads may be uniform or non-uniform in thickness, may have the same or different adhesive properties, and / or may be a gel-like substance, to achieve the desired cushioning and sealing properties.

[0140] In certain embodiments, the adhesive layer is present on the contact surface of the negative pressure therapy device to a thickness generally in the range of 0.005 to 0.060 inches. In certain embodiments, the adhesive layer is present on the contact surface of the negative pressure therapy device to a thickness generally in the range of 0.010 to 0.050 inches. In further embodiments, the adhesive layer is present on the contact surface of the negative pressure therapy device to a thickness generally in the range of 0.020 to 0.040 inches.

[0141] The adhesive layer can be achieved using a variety of materials, including, but not limited to, gels, elastomers, viscous solutions, foams, and similar materials. These materials can be of any chemical composition that provides the required end-use properties (e.g., viscosity, hardness, medical clearance, etc.). These materials include, but are not limited to, polyurethane, silicone, acrylonitrile butadiene styrene (ABS), hydrogels, and others. In preferred embodiments, the adhesive layer should have a hardness, as measured by ASTM-D2240-00 (American Society for Testing and Materials), ranging from 0 to 50, more preferably from 5 to 30, and most preferably from 5 to 15. In certain embodiments, the adhesive layer is made from a silicone gel material. The silicone can be any organosilicone that provides the desired properties, but polydimethylsiloxane (PDMS) is often chosen.

[0142] The adhesive layer may be applied directly to the outer contact surface of the flange element to the desired thickness, or may be applied in combination with one or more primer layers and / or one or more primer layers combined with one or more adhesive or bonding layers to create a laminate of materials to the desired thickness. As used herein, a "primer" is a material used as a preparatory coating that serves as a bonding surface between the contact surface of the negative pressure therapy device and the adhesive or adhesion-promoting layer and the adhesive layer. Additionally, an adhesion-promoting layer is a material used as a coating to favorably adhere the adhesive layer to the contact surface of the negative pressure therapy device and / or to a primer layer applied to the outer surface of the negative pressure therapy device.

[0143] For example, a primer layer may be applied to the contact surface of the negative pressure therapy device to a thickness of approximately 0.005 inches, followed by an adhesion promoter layer to a thickness of approximately 0.005 inches, followed by an adhesive layer to a thickness of approximately 0.040 inches, to achieve a final thickness of approximately 0.050 inches. A primer layer may be applied directly to the outer contact surface of the negative pressure therapy device, followed by an adhesive layer to a desired thickness of approximately 0.050 inches directly to the primer. In additional embodiments, an adhesion promoter may be applied to the contact surface of the negative pressure therapy device, followed by an adhesive layer to a desired thickness of approximately 0.050 inches.

[0144] In certain embodiments, the adhesive layer is a gel layer. As used herein, a gel layer is a layer of material that is mostly liquid but may have the property of behaving like a solid due to the cross-linked nature of its structure. The material selected for the gel layer may have a specific cohesive, flexible consistency to mold and conform to complex shapes (e.g., imperfections in tissue). As used herein, the cohesive, flexible consistency, elasticity, or robustness of the gel layer is defined as the ability of the gel layer to flow, mold, stretch, and substantially recover to its original shape when not attached to a surface. The material selected for the gel layer may also have a specific viscosity to mechanically fix the contact area. As used herein, viscosity is defined as the "stickiness" of the gel, a property that allows for the immediate formation of a bond when it comes into contact with another surface.

[0145] The adhesive layer material must adhere sufficiently to the treatment device so that it remains adhered to the device when removed from the user's tissue, and must also have a viscosity level selected for proper performance at the user's tissue interface. That is, excessive viscosity can make removal of the device from the tissue difficult, potentially causing pain or trauma. On the other hand, insufficient viscosity can cause the device to move during use or open the seal against the tissue, thereby compromising the vacuum. Viscosity levels can be measured with a texture analyzer. For example, using a TA.XT plus with a 7 mm radius and 1-inch diameter spherical head, peak adhesion values ​​can range from 200 to 400 grams peak force, more preferably 250 to 350 grams peak force, and most preferably 275 to 325 grams peak force.

[0146] As mentioned above, the viscosity of the adhesive layer is optimized to achieve a releasable, yet mechanical, fixation of the therapy device to the patient. In certain embodiments, the contact surface of the flange element is coated with a primer to suitably fix the adhesive layer to the negative pressure therapy device over the user's contact area.

[0147] In certain embodiments, the adhesive layer is formed from a washable silicone gel so that the adhesive layer regains its original viscosity when dried after washing. In certain embodiments, the silicone gel is selected from a group having controllable properties, including, but not limited to, cross-sectional thickness, degree of cross-linking (and the resulting toughness and viscosity), and viscosity (to allow for processability under desired conditions). As used herein, viscosity is measured in centipoise (cps), where 1 cps = 0.01 g / cm / s.

[0148] In one embodiment of the present invention, the gel layer is prepared from a two-part platinum-cured organosilicone mixture with properties equivalent to a silicone gel base with an uncatalyzed viscosity of approximately 31,000 cps and a crosslinker with an uncatalyzed viscosity of approximately 30,500 cps. The final toughness (cps) of the cured gel can be increased by increasing the proportion of crosslinker in the mixture or decreased by decreasing the proportion of crosslinker in the mixture. The viscosity of the material can be increased by decreasing the proportion of crosslinker in the mixture or decreased by increasing the proportion of crosslinker in the mixture. To achieve the desired properties using a 31,000 cps silicone gel base and a 0,500 cps crosslinker, the ratio of silicone gel base to crosslinker can range from about 0.8:1 to about 1:0.8 (parts by weight).

[0149] In various embodiments of the present invention, the ratio of 31,000 cps silicone gel base to 30,500 cps crosslinker may further range from about 1:0.8 to about 1:1. In other embodiments of the present invention, the ratio of 31,000 cps silicone gel base to 30,500 cps crosslinker may further range from about 0.8:1 to about 1:1. In further embodiments of the present invention, the ratio of 31,000 cps silicone gel base to 30,500 cps crosslinker may further range from about 0.88:1 to about 1:0.88.

[0150] According to the present invention, the silicone gel base and crosslinker are mixed in a desired ratio and placed under vacuum to remove air bubbles from the mixed solution (degassing). After degassing, the silicone gel solution is applied to the contact surface of the flange element and allowed to cure. This mixture can achieve full cure in approximately 24 hours at room temperature. However, in some embodiments, full cure of the silicone gel can be achieved in approximately 5 minutes by placing the treatment device including the silicone gel layer at approximately 150°C. The cure temperature can be adjusted to accommodate limitations of the treatment device (e.g., the lower melting point of other treatment device components).

[0151] In certain embodiments, the adhesive layer is made of a hydrogel. A hydrogel is a three-dimensional network of cross-linked hydrophilic polymer chains that can be physically or chemically cross-linked. In further embodiments, the hydrogel layer can be found as a hydrocolloid, which is a hydrophilic polymer in which colloid particles are dispersed in water.

[0152] In certain embodiments, the adhesive layer is made from a combination of materials with different mechanical properties (e.g., different durometer hardness) applied in parallel on the outer contact surface of the fluidly sealed chamber, or a combination of similar materials. For example, a hydrogel material can be applied to the periphery of the central portion of the outer contact surface of the fluidly sealed chamber, and a silicone gel material can be applied on both sides of the periphery of the hydrogel material. In a further embodiment in which a combination of materials is applied in parallel on the outer contact surface of the flange element, a silicone gel layer can be applied to the periphery of the central portion of the outer contact surface of the fluidly sealed chamber, and a hydrogel material can be applied to both sides of the periphery of the silicone gel material, and then a silicone gel material can be finally applied to the periphery of the hydrogel material.

[0153] In certain embodiments, the compliant contact layer is made from a combination of materials applied in parallel on the outer contact surface of the fluidly sealed chamber. For example, a hydrogel material can be applied to the periphery of a central portion of the outer contact surface of the fluidly sealed chamber, and a silicone gel material can be applied on both sides of the periphery of the hydrogel material. In a further embodiment in which a combination of materials is applied in parallel on the outer contact surface of the flange element, a silicone gel layer can be applied to the periphery of a central portion of the outer contact surface of the fluidly sealed chamber, a hydrogel material can be applied to both sides of the periphery of the silicone gel material, and then a silicone gel material can be finally applied to the periphery of the hydrogel material.

[0154] As used herein, "user compliance" refers to a user's adherence to prescribed usage of a therapeutic device (eg, adherence to device usage throughout a sleep cycle).

[0155] As used herein, "device compliance" refers to the ability of a device or device element to accommodate variations, including anatomical variations and / or movements of the patient (e.g., bending, twisting, compressing, and / or expanding the device in response to application and use of the device).

[0156] Various aspects of the device may be made from generally rigid materials. As used herein, the term "generally rigid" refers to materials that exhibit sufficient rigidity to maintain the integrity of the particular element of interest. Those skilled in the art will appreciate that numerous polymers may be used, including thermoplastics, some thermosets, and elastomers. Thermoplastics become flowable liquids when heated and solid when cooled, often possessing the ability to undergo multiple heating / cooling cycles without losing mechanical properties. Thermosets are made from prepolymers that react and irreversibly harden into a solid polymer network. Elastomers are viscoelastic materials that exhibit both elastic and viscous properties and may be either thermoplastic or thermoset. Common thermoplastics include PMMA, cyclic olefin copolymers, ethylene vinyl acetate, polyacrylate, polyaryletherketone, polybutadiene, polycarbonate, polyester, polyetherimide, polysulfone, nylon, polyethylene, and polystyrene. Common thermosets include polyester, polyurethane, duroplast, epoxy resin, and polyimide. This list is not intended to be limiting. Functional filler materials such as talc and carbon fiber may be included for purposes of improving stiffness, working temperature, and part shrinkage.

[0157] Various aspects of the device can be formed using several methods well known to those skilled in the art, including, but not limited to, casting, injection molding, transfer molding, compression molding, coating, machining, etching, 3D printing, and others. In a preferred embodiment, the test fixture base is injection molded. Injection molding is a process for forming thermoplastic and thermoset materials into complex shaped molded products at high production rates and with good dimensional accuracy. The process typically involves injecting a metered amount of heated and plasticized material under high pressure into a relatively cold mold, where the plastic material solidifies. Resin pellets are fed under high pressure through a heated screw and barrel. The liquefied material travels through a runner system into the mold. The mold cavity determines the external shape of the product, while the core forms the interior. As the material enters the cooled cavity, it replasticizes, returning to a solid state and the configuration of the finished part. A machine then ejects the finished part or product.

[0158] The following represents a preferred embodiment of the present invention.

[0159] Embodiment 1 1. An instrument configured to contact tissue, comprising: (a) a tissue interface portion comprising a viscoelastic foam configured to provide a tissue-contacting surface of the device, the viscoelastic foam having the following properties: a Shore A durometer of about 10 or less, and preferably about 30 or less, more preferably about 20 or less, and even more preferably about 10 or less, as measured using the Standard Test Method for Rubber Property-Durometer Hardness ASTM D2240-15; Approximately 0.9g / cm 3 The following density (specific gravity), and / or Approximately 9mJ / cm 2 Preferably less than about 7 mJ / cm 2 Below about 5 mJ / cm, most preferably 2Viscosity levels measured using the Standard Test Method for Pressure-Sensitive Tack of Adhesives ASTM D2979-16: an elastic (storage) modulus in the range of about 0.3 kPa to about 30 kPa, and preferably in the range of about 1 kPa to about 15 kPa; a viscosity (loss) coefficient in the range of about 0.4 kPa to about 7 kPa, and preferably in the range of about 0.8 kPa to about 7 kPa; including one or more of: The tissue boundary portion, (b) a non-contact portion configured to support the tissue interface portion and to be spaced from the tissue by the tissue interface portion; Item (i) the tissue interface portion comprises a siloxane antimicrobial material coated on or molded into the viscoelastic foam; Item (ii) the tissue interface portion is overmolded onto the non-contact portion; Item (iii) the tissue interface portion is attached to the non-contact portion using a silicone pressure sensitive adhesive; and Item (iv) the tissue interface portion includes one filling material among a plurality of filling materials, the filling material having a higher thermal conductivity than the viscoelastic foam material; One or more of the four items in Equipment.

[0160] Embodiment 2 2. The device of embodiment 1, wherein the viscoelastic foam comprises one or both of an elastic (storage) modulus in the range of 10 kPa to about 15 kPa and a viscous (loss) modulus in the range of about 2 kPa to about 7 kPa.

[0161] Embodiment 3 3. The device of embodiment 1 or embodiment 2, further comprising a second tissue-contacting surface that is not a viscoelastic foam.

[0162] Embodiment 4 The viscoelastic foam has a Shore A of about 10 or less and a viscosity of about 0.9 g / cm 3 Density (specific gravity) of approximately 9 mJ / cm 2 4. The device of any one of embodiments 1 to 3, comprising the following viscosity levels:

[0163] Embodiment 5 5. The device of any one of embodiments 1 to 4, wherein the foam comprises a Shore A of about 5 or less.

[0164] Embodiment 6 5. The device of any one of embodiments 1 to 4, wherein the foam comprises a Shore A of about 1 or less.

[0165] Embodiment 7 7. The device of any one of claims 1 to 6, wherein the viscoelastic foam does not contain a tackifier or adhesive, and the viscosity is an inherent property of the viscoelastic foam.

[0166] Embodiment 8 The viscoelastic foam has a viscosity of at least about 0.1 mJ / cm 2 , at least about 0.3 mJ / cm 2 , or at least about 0.5 mJ / cm 2 The device according to any one of embodiments 1 to 7, which exhibits a viscosity of

[0167] Embodiment 9 9. The device of any one of the preceding claims, wherein the viscoelastic foam provides an air leakage past the sealing surface of no more than about 8 mL / min at atmospheric pressure.

[0168] Embodiment 10 9. The device of any one of the preceding claims, wherein the viscoelastic foam provides an air leakage across the sealing surface of no more than about 0.8 mL / min at atmospheric pressure.

[0169] Embodiment 11 9. The device of any one of claims 1 to 8, wherein the viscoelastic foam provides a seal against the tissue and provides an air leakage past the seal of no more than about 0.008 mL / min at atmospheric pressure.

[0170] Embodiment 12 The viscoelastic foam is about 0.5 g / cm 3 The device according to any one of embodiments 1 to 11, having the following density:

[0171] Embodiment 13 13. The device of any one of claims 1 to 12, wherein the viscoelastic foam is a foamed silicone rubber, and optionally the silicone rubber component of the viscoelastic foam is a medical-grade soft skin adhesive (SSA) silicone.

[0172] Embodiment 14 14. The device of any one of embodiments 1 to 13, wherein the viscoelastic foam comprises a reinforcing filler.

[0173] Embodiment 15 15. The device of embodiment 14, wherein the reinforcing filler is selected from the group consisting of silica, silica aerogel, silica xerogel, titanium dioxide, diatomaceous earth, iron oxide, aluminum oxide, zinc oxide, quartz, calcium, carbonate, magnesium oxide, carbon black, graphite, glass fiber, glass microspheres, glass microballoons, glass beads, carbon fiber, silicon carbide, polystyrene beads, microcrystalline cellulose, nanoparticles, and metal fibers.

[0174] Embodiment 16 16. The device of any one of embodiments 1 to 15, wherein the viscoelastic foam comprises an antimicrobial agent.

[0175] Embodiment 17 17. The device of embodiment 16, wherein the antimicrobial agent comprises one or more agents selected from the group consisting of silver salts, silver ions, silver ions encapsulated in glass particles, silver-sodium-zirconium hydrogen phosphate, 3-(trimethoxysilyl)propyldimethyloctadecyl ammonium chloride, benzalkonium chloride, benzethonium chloride, and chloroxylenol, polyhexamethylene biguanide (PHMB), and chlorhexidine.

[0176] Embodiment 18 The device of any one of embodiments 1 to 17, wherein item (i) is true.

[0177] Embodiment 19 The device of any one of embodiments 1 to 18, wherein item (ii) is true.

[0178] Embodiment 20 The device of any one of embodiments 1 to 19, wherein item (iii) is true.

[0179] Embodiment 21 The device of any one of embodiments 1 to 20, wherein item (iv) is true.

[0180] Embodiment 22 The device according to any one of embodiments 1 to 21, wherein the device is an eye protection mask.

[0181] Embodiment 23 The device according to any one of embodiments 1 to 21, wherein the device is a scuba mask.

[0182] Embodiment 24 The device according to any one of embodiments 1 to 21, wherein the device is a pair of swimming goggles.

[0183] Embodiment 25 25. The device of embodiment 23 or embodiment 24, wherein the viscoelastic foam provides a seal against the tissue and provides water leakage past the seal such that at a pressure of 1 atm, the device leaks no more than 10% of the internal volume of the device in 10 minutes.

[0184] Embodiment 26 The device according to any one of embodiments 1 to 21, wherein the device is a medical device.

[0185] Embodiment 27 The device according to any one of embodiments 1 to 21, wherein the device is a respiratory mask.

[0186] Embodiment 28 The medical device according to any one of the preceding embodiments, wherein the medical device is a negative pressure chamber configured to cover tissue of a human or animal body.

[0187] Embodiment 29 29. The device of embodiment 28, wherein the medical device is a negative pressure wound therapy device.

[0188] Embodiment 30 29. The device of embodiment 28, wherein the negative pressure chamber is a continuous negative external pressure (cNEP) therapy device for maintaining airway patency by applying external negative pressure to tissue overlying a portion of a human airway.

[0189] Embodiment 31 The device of any one of embodiments 1 to 21, wherein the device is a pair of headphones, earplugs, earbuds, or earphones.

[0190] Embodiment 32 The device according to any one of embodiments 1 to 21, wherein the device is a catheter, a vascular stent, a vascular graft, a vascular stent graft, or a component thereof.

[0191] Embodiment 33 32. A method of forming a viscoelastic foam that provides the tissue-contacting surface of the device of any one of claims 1 to 32, comprising: combining a silicone base, a blowing agent, and a catalyst to provide a formulation; curing the formulation under selected conditions to provide the viscoelastic foam, the viscoelastic foam having the following properties: a Shore A durometer hardness of about 10 or less, and preferably about 30 or less, more preferably about 20 or less, and even more preferably about 10 or less, in each case measured using the Standard Test Method for Rubber Property—Durometer Hardness ASTM D2240-15; Approximately 0.9g / cm 3 The following density (specific gravity), and / or Approximately 9mJ / cm 2 Preferably less than about 7 mJ / cm 2 Below about 5 mJ / cm, most preferably 2 Viscosity levels measured using the Standard Test Method for Pressure-Sensitive Tack of Adhesives ASTM D2979-16: an elastic (storage) modulus in the range of about 0.3 kPa to about 30 kPa, and preferably in the range of about 1 kPa to about 15 kPa; a viscosity (loss) coefficient in the range of about 0.4 kPa to about 7 kPa, and preferably in the range of about 0.8 kPa to about 7 kPa; Hardening and A method comprising:

[0192] Embodiment 34 34. The method of embodiment 33, wherein the curing step comprises curing at a temperature ranging from about 100°C to about 250°C.

[0193] Embodiment 35 35. The method of embodiment 34, wherein the curing step comprises curing at a temperature of at least about 120°C.

[0194] Embodiment 36 35. The method of embodiment 34, wherein the curing step comprises curing at a temperature of at least about 150°C.

[0195] Embodiment 37 35. The method of embodiment 34, wherein the curing step comprises curing at a temperature of at least about 170°C.

[0196] Embodiment 38 38. The method of any one of embodiments 33 to 37, wherein the effervescent agent comprises an ammonium salt, a sodium salt, or a potassium salt.

[0197] Embodiment 39 39. The method of any one of embodiments 33 to 38, wherein the catalyst is selected from the group consisting of an iron catalyst, a cobalt catalyst, a zinc catalyst, a titanate catalyst, a tin catalyst, a platinum catalyst, or an acid catalyst.

[0198] Embodiment 40 39. The method of any one of claims 33 to 39, wherein the viscoelastic foam comprises one or both of an elastic (storage) modulus in the range of 10 kPa to about 15 kPa and a viscous (loss) modulus in the range of about 2 kPa to about 7 kPa.

[0199] Embodiment 41 The viscoelastic foam has a Shore A of about 10 or less and a viscosity of about 0.9 g / cm 3 Density (specific gravity) of approximately 9 mJ / cm 2 41. The method of embodiment 40, comprising the following viscosity levels:

[0200] Embodiment 42 42. The method of embodiment 41, wherein the foam comprises a Shore A of about 5 or less.

[0201] Embodiment 43 42. The method of embodiment 41, wherein the foam comprises a Shore A of about 1 or less.

[0202] EMBODIMENT 44 44. The method of any one of embodiments 33 to 43, wherein the viscoelastic foam does not comprise a tackifier or adhesive.

[0203] Embodiment 45 The viscoelastic foam has a viscosity of at least about 0.1 mJ / cm 2 , at least about 0.3 mJ / cm 2 , or at least about 0.5 mJ / cm 2 The method according to any one of embodiments 33 to 44, wherein the viscosity of the emulsion is 0.01 to 0.01 MPa.

[0204] Embodiment 46 46. ​​The method of any one of embodiments 33 to 45, wherein the outer surface of the viscoelastic foam is coated with a coating to form closed-cell regions of the viscoelastic foam.

[0205] Embodiment 47 47. The device of embodiment 46, wherein the viscoelastic foam is coated with a thin elastomer of less than 40 durometer at a ratio of less than 1:10 to create a dual durometer structure.

[0206] Embodiment 48 47. The device of embodiment 46, wherein the viscoelastic foam is coated with medical grade SSA silicone of less than 40 durometer at a ratio of less than 1:10 to create a dual durometer structure.

[0207] Embodiment 49 The method of any one of embodiments 33 to 48, wherein the silicone base is an LSR.

[0208] Embodiment 50 The method of any one of embodiments 33 to 48, wherein the silicone base is HCR.

[0209] Embodiment 51 Item (i) the tissue interface portion comprises a siloxane antimicrobial material coated on or molded into the viscoelastic foam; Item (ii) the tissue interface portion is overmolded onto the non-contact portion; Item (iii) the tissue interface portion is attached to the non-contact portion using a silicone pressure sensitive adhesive; and Item (iv) the tissue interface portion includes one filling material among a plurality of filling materials, the filling material having a higher thermal conductivity than the viscoelastic foam material; The method of any one of embodiments 33 to 50, wherein one or more of the following four items are true:

[0210] Embodiment 52 52. The apparatus of embodiment 51, wherein item (i) is true.

[0211] Embodiment 53 53. The device of embodiment 51 or embodiment 52, wherein item (ii) is true.

[0212] EMBODIMENT 54 An apparatus according to any one of embodiments 51 to 53, wherein item (iii) is true.

[0213] Embodiment 55 The device of any one of embodiments 51 to 54, wherein item (iv) is true.

[0214] Example 1 - Liquid Silicone Rubber and Blowing Agent The material was prepared using a 10 Shore A durometer liquid silicone rubber (Silbione® LSR4310, Elkem Silicones, USA) and an ammonium bicarbonate blowing agent (Med4-4900, Nusil Technology LLC). The liquid silicone rubber used was a two-component platinum-catalyzed silicone elastomer hand-mixed in a 1:1 ratio. Ammonium bicarbonate was weighed out at 1.5 wt % from the liquid silicone rubber mixture, then combined with it and hand-mixed.

[0215] Example 2 - Liquid Silicone Rubber and Foaming Agent with Antibacterial Additives The material was prepared using a 5 Shore A durometer liquid silicone rubber (Silbione® LSR 4305, Elkem Silicones USA), an ammonium bicarbonate blowing agent (Med4-4900, Nusil Technology LLC), and a silicone-based antimicrobial additive (BIOSAFE® HM 4001, Gelest, Inc.). The liquid silicone rubber used was a two-component platinum-catalyzed silicone elastomer hand-mixed in a 1:1 ratio. The ammonium bicarbonate and organosilane antimicrobial agents were weighed out at 1.5% and 0.5% of the liquid silicone rubber mixture weight, respectively. These were combined and hand-mixed with the liquid silicone rubber mixture.

[0216] Whether the material was compounded without an antimicrobial additive as described in Example 1 or with an antimicrobial additive as described in Example 2, the material was formed using a knife coater. Knife coating is a process in which a thin liquid coating is formed on a continuous polymeric web substrate by applying an excess of coating liquid and then measuring it with a rigid knife held in close proximity to a stationary supported web as the web advances. The thickness of the coating depends primarily on the gap or gap between the knife and the web and the geometry of the gap (bevel angle, length, etc.). In this embodiment, an excess of the liquid silicone rubber and ammonium bicarbonate mixture described above was applied to the advancing web on the upstream side of the knife, which was set at a gap of 2.16 mm. As the web advanced, a measured 2.16 mm thick portion of the web was exposed to heat at 150°C, which was intended to simultaneously activate foaming and cure the liquid silicone rubber. Heating was maintained for a minimum period of 5 minutes. During that period, the material expanded in thickness due to ammonium bicarbonate foaming. After the 5 minute heating period, the cured elastomeric foam was allowed to return to room temperature, at which point the thickness of the resulting foam settled to a nominal 3.05 mm.

[0217] Material application was achieved by die-cutting an elastomeric foam sheet into a suitable two-dimensional shape corresponding to the three-dimensional shape of the tissue-contacting flange of the vacuum device (i.e., a 114 mm x 190 mm oval donut shape with an approximately 25 mm wide annulus). After die-cutting to the specific shape, the polymer web backing was removed from the back of the elastomeric foam donut, and a uniform, thin coating of silicone rubber adhesive (Sil-Poxy®, Smooth-On, Inc.) was manually applied in place along the entire annulus. A uniform, thin coating of silicone rubber adhesive was also manually applied onto the flange of the vacuum device. The coated elastomeric foam donut was manually manipulated to align and pressed into place onto the flange of the vacuum device. The silicone rubber adhesive was allowed to cure at room temperature for at least 12 minutes.

[0218] The end result was a vacuum device that was continuously conformed to its tissue-contacting flange.

[0219] Those skilled in the art will appreciate that the conception underlying the present disclosure may readily be utilized as a basis for the designing of other structures, methods, and systems for carrying out the several purposes of the present invention. It is important, therefore, that the claims be regarded as including such equivalent constructions insofar as they do not depart from the spirit and scope of the present invention.

[0220] Those skilled in the art will readily appreciate that the present invention is well adapted to carry out the objects and attain the ends and advantages that are not only inherent but also described herein. The examples provided herein represent preferred embodiments and are illustrative and are not intended to limit the scope of the invention.

[0221] It will be readily apparent to those skilled in the art that various modifications and variations can be made in the invention disclosed herein without departing from the spirit and scope of the invention.

[0222] All patents and publications mentioned in this specification are indicative of the level of those skilled in the art to which the invention pertains. All patents and publications are herein incorporated by reference to the same extent as if each individual publication was specifically and individually indicated to be incorporated by reference.

[0223] The present invention as preferably exemplified herein may be practiced in the absence of any element(s) or limitation(s) not specifically disclosed herein. Thus, for example, in each instance herein, any of the terms "comprising," "consisting essentially of," and "consisting of" may be replaced with either of the other two terms. The terms and expressions used are used as terms of description rather than terms of limitation, and the use of such terms and expressions is not intended to exclude any equivalents of the features shown and described or portions thereof, but it is recognized that various modifications are possible within the scope of the invention as claimed. Thus, while the present invention has been particularly disclosed with preferred embodiments and desired features, it should be understood that modifications and variations of the concepts disclosed herein may be employed by those skilled in the art, and that such modifications and variations are considered to be within the scope of the invention as defined by the appended claims.

[0224] Other embodiments are set forth within the following claims.

Claims

1. 1. An instrument configured to contact tissue, comprising: (a) a tissue interface portion comprising a viscoelastic foam configured to provide a tissue-contacting surface of the device, the viscoelastic foam comprising foamed silicone rubber, the viscoelastic foam comprising: Shore 000 in the range of 1 to 40, measured using Standard Test Method for Rubber Property - Durometer Hardness ASTM D2240-15; 0.2~0.7g / cm ３ Density (specific gravity) in the range 0.3~7mJ / cm ２ a level of viscosity measured using the Standard Test Method for Pressure-Sensitive Tack of Adhesives ASTM D2979-16 in the range of an elastic (storage) modulus in the range of 1 kPa to 15 kPa; and a viscous (loss) coefficient in the range of 0.8 kPa to 7 kPa; Including, The tissue boundary portion, (b) a non-contact portion configured to support the tissue interface portion and to be spaced from the tissue by the tissue interface portion; Including, The device, wherein the tissue interface portion comprises one of a plurality of filler materials that enhances thermal conductivity over a viscoelastic foam material compared to the same viscoelastic foam material in the absence of the filler material.

2. The device of claim 1 , wherein the tissue interface portion comprises a siloxane antimicrobial material coated on or molded into the viscoelastic foam.

3. 3. The device of claim 1 or claim 2, wherein the tissue interface portion is overmolded onto the non-contact portion by directly curing and adhering the tissue interface portion to the non-contact portion, or the tissue interface portion is attached to the non-contact portion using a silicone compatible adhesive layer.

4. The device of any one of claims 1 to 3, further comprising a second tissue contacting surface that is not a viscoelastic foam.

5. The device of any one of claims 1 to 4, wherein the viscoelastic foam does not contain a tackifier or adhesive, and the viscosity is an inherent property of the viscoelastic foam.

6. 6. The device of claim 1, wherein the viscoelastic foam provides a seal against the tissue to maintain a pressure differential between the interior space of the device and atmospheric pressure outside the interior space, and provides an air leakage past the seal of no more than 0.008 mL / min.

7. 7. The device of claim 1, wherein the viscoelastic foam is a foamed silicone rubber, and the silicone rubber component of the viscoelastic foam is a medical-grade soft skin adhesive (SSA) silicone.

8. The device of any one of claims 1 to 7, wherein the viscoelastic foam comprises a reinforcing filler.

9. The device of any one of claims 1 to 8, wherein the viscoelastic foam comprises an antimicrobial agent.

10. 10. The device of any one of claims 1 to 9, wherein the device is an eye protection mask, a scuba mask, swimming goggles, a pair of headphones, a pair of earplugs, a pair of earbuds, or a pair of earphones.

11. The device according to any one of claims 1 to 9, wherein the device is a medical device.

12. 12. The device of claim 11, wherein the device is a respiratory mask, a negative pressure wound therapy device, a continuous negative external pressure (cNEP) therapy device for maintaining airway patency by applying external negative pressure to tissue overlying a portion of a human airway, a catheter, a vascular stent, a vascular graft, a vascular stent graft, or one or more components thereof.

13. 1. A method for forming a viscoelastic foam comprising foamed silicone rubber, comprising: combining a silicone base, a blowing agent, and a catalyst to provide a formulation; curing the formulation under selected conditions to provide the viscoelastic foam, the viscoelastic foam comprising: Shore 000 in the range of 1 to 40, measured using Standard Test Method for Rubber Property - Durometer Hardness ASTM D2240-15; 0.2~0.7g / cm ３ Density (specific gravity) in the range 0.3~7mJ / cm ２ a level of viscosity measured using the Standard Test Method for Pressure-Sensitive Tack of Adhesives ASTM D2979-16 in the range of an elastic (storage) modulus in the range of 1 kPa to 15 kPa; and a viscous (loss) coefficient in the range of 0.8 kPa to 7 kPa; Including, Hardening and Including, The method, wherein the viscoelastic foam comprises one of a plurality of filler materials that enhances thermal conductivity of the viscoelastic foam material compared to the same viscoelastic foam material in the absence of the filler material.

14. 14. The method of claim 13, wherein the viscoelastic foam is tackifier-free or adhesive-free, and the viscosity is an inherent property of the viscoelastic foam.

15. 15. The method of any one of claims 13 to 14, wherein the viscoelastic foam is a foamed silicone rubber, and the silicone rubber component of the viscoelastic foam is a medical-grade soft skin adhesive (SSA) silicone.

16. The method of any one of claims 13 to 15, wherein the viscoelastic foam comprises a reinforcing filler.

17. The method of any one of claims 13 to 16, wherein the viscoelastic foam comprises an antimicrobial agent.

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