Device for instillation in wound treatment with alternating negative pressure

Abstract

FIELD: medical equipment.SUBSTANCE: device for instillation during wound treatment with alternating negative pressure. The device contains a vacuum source in the form of a housing with a screen designed to display information about the operating parameters of the device for instillation during wound treatment with alternating negative pressure and controls. The device has a wound dressing consisting of a protective incisional film and a sponge located under the protective incisional film. The device includes a submersible drain located under the protective incisional film of the wound dressing, or an overhead drain located on the protective incisional film. The device has a container for collecting pathological discharge. The device has a system of sealed tubes; a means for supplying a medicinal solution, a sealed circuit of tubes and a tube for supplying a medicinal solution, designed with the possibility of placement on the wound bed. The device contains controls including a controller that allows setting and implementing a basic wound treatment program with alternating negative pressure of 120 mmHg for 5 minutes, then 60 mmHg for 2 minutes, instillation of 40 ml of a therapeutic solution every 6 hours, an exposure of 90 seconds, and subsequent evacuation of the therapeutic solution. An immersion drain located under the protective incisional film of a wound dressing, or an overhead drain located on the protective incisional film, is connected to a container collecting pathological discharge and a vacuum source through a system of sealed tubes, and a tube for supplying a medicinal solution is connected to a means for supplying a medicinal solution by means of a sealed circuit through a shut-off means.EFFECT: development of a device that provides local treatment of a wound, in which a liquid medicine is introduced directly into its cavity.4 cl, 1 dwg

Description

[0001] Field of technology to which the invention relates

[0002] The invention relates to the field of medicine and to devices for treating the wounded and sick with wounds of various origins, used to remove air, blood, exudate and other substances from a given area of ​​therapy in combination with the possibility of washing (instillation, disinfection, treatment, irrigation) of the wound without removing the medical dressing, which makes it possible to avoid unnecessary trauma to the wound.

[0003] Technology Level

[0004] A device is known for vacuum therapy of purulent wounds, containing a fine-mesh porous material, a drainage system for wound discharge, an insulating film and a vacuum source, wherein, depending on the parameters of the wound, a fine-mesh porous material with a thickness of 5 to 50 mm is used, the shape and dimensions of which are individually modeled according to the dimensions of the wound, its walls and bottom [RU 70627 U1, IPC A61M 1 / 00, published 2008].

[0005] A device is known for vacuum drainage of wounds using alternating negative pressure, consisting of a covering material covering a porous pad; the covering material contains a port, and the pad is connected via a vacuum line to a container for collecting wound discharge via the port, and a vacuum source is connected to the container via a vacuum line, and the pad has a corrugated surface in its lower part [RU 174957 U1, IPC A61M 1 / 00, published 2017].

[0006] A device is known for vacuum drainage of wounds using alternating negative pressure, designed with the possibility of placement in the wound and hermetically sealing with a covering material, consisting of a porous sponge with a vacuum wire introduced into its thickness using a trocar along its entire length, which has side holes with a diameter of 0.3-0.5 cm, located only in the part of the vacuum wire inserted into the sponge, the sponge is covered with a film made of synthetic material, which is perforated with a 21 G injection needle along its entire length, from 6 to 9 holes per 1 cm 2 , a vacuum line passing through the covering material is designed with the possibility of connection to a container for collecting wound discharge and a vacuum source [RU 183866 U1, IPC A61M 1 / 00, published 2018].

[0007] Known devices do not provide the ability to wash a wound without removing the wound dressing, that is, they work only on the principle of evacuating wound discharge.

[0008] In known devices, the medicinal solution is introduced through a drain located at the top of the dressing or another drain also located at the top. However, the medicinal solution does not reach the wound bed, or reaches it in insufficient quantities. In the process, the pathogenic medium remaining on the sponge during the vacuum phase of treatment is washed away from above downwards, i.e., back into the wound bed. This nullifies the treatment result and can lead to a deterioration in the patient's condition. Furthermore, rinsing (treating) the wound according to the known scheme requires a larger amount of medicinal solution, which leads to the dressing becoming wet, peeling off, and losing its seal. This can lead to serious health risks for the patient due to wound reinfection and the development of pathogenic processes in a closed (medical personnel may not notice this situation due to the presence of a closed dressing on the wound), moist environment.

[0009] Considering that when the solution is instilled into a wound during vacuum therapy, performed automatically without the presence of medical personnel, the situation described above can lead to serious adverse consequences for the patient's health, especially when the patient is asleep or unable to objectively assess their condition. In some cases, this situation necessitates secondary surgical debridement. An additional negative factor is the faster filling of the container for pathological discharge due to the larger volume of medicinal solution injected into the wound, which leads to unnecessary costs for more frequent replacement (emptying, if using a reusable container).

[0010] Disclosure of the essence of the invention

[0011] The problem to be solved by the invention is the development of a device that provides local treatment of a wound, in which a liquid medicine (medicinal rinsing solution) is introduced directly into its cavity.

[0012] When using the device, the task is solved by achieving a technical result, which consists in ensuring the possibility of effective action on the wound during wound treatment with a vacuum.

[0013] The specified technical result is achieved in that the device using alternating negative pressure contains a wound dressing consisting of a protective incisional film, a sponge located underneath it, a tube for feeding a medicinal solution, which is located on the wound bed, connected to a means for feeding the medicinal solution by means of a sealed circuit consisting of tubes connecting the feeding means with the tube for feeding the medicinal solution through a shut-off means, wherein under the protective film of the wound dressing there is an immersion drain connected to a vacuum source having a housing with a screen displaying information about the operating parameters, and control elements including a controller in which a program for treating a wound with alternating negative pressure is recorded, wherein the specified vacuum source is connected to the immersion drain through a container-collector of pathological discharge.

[0014] Brief description of drawings

[0015] Fig. 1 schematically shows a device for instillation in the treatment of a wound with alternating negative pressure.

[0016] Vacuum source 5 is designed as a housing with a screen displaying information about the operating parameters of the device for instillation during wound treatment with alternating negative pressure, and controls. Vacuum source 5 creates and maintains preset stable vacuum values ​​and alternates between them in accordance with the wound treatment program with alternating negative pressure, integrated into the controller, using an integrated pump motor, bypass valve, control boards, power supply, and an internal or external pneumatic system. Vacuum is delivered directly to the wound treatment area through a system of sealed tubes 6 (typically connected to a collection container 7 for pathological discharge).

[0017] A medical (wound) dressing is a structure consisting of an overlay or submersible drain 1, which is located in the upper part of the dressing; a protective (usually incisive) film 2, which serves to create a sealed contour around the wound; a sponge 3, made, for example, of foam material or other medical material that does not allow the edges of the wound to close and is not prone to sticking; a tube for delivering a medical (rinsing) solution 4 directly to the wound bed 12. Various underlying coverings can be used variably, designed to reduce trauma to the wound or adhesion of the dressing to the wound.

[0018] The introduction of the medicinal (irrigation) solution into the closed wound dressing occurs through a separate, sealed circuit of tubes 8 through tube 4, located in the wound bed area 12, for delivering the medicinal solution. The circuit of tubes 8 can be either parts of the tubes for delivering the medicinal solution 4 or separate connecting tubes; the main criterion is ensuring a tight seal. The introduction of the medicinal (rinsing) solution into the sealed circuit of tubes 8 can be carried out in various ways - either mechanically using a syringe or dropper 9, or using a pump 10, which can be separately carried out as a block or be part of the device, to ensure tightness and treatment phases, as a rule, a shut-off valve or clamp 11 is provided on the sealed circuit 8. The method of supplying the medicinal solution to the wound - using a syringe (dropper, etc.) or using a pump, does not affect the essence of the process of supplying the medicinal solution and treatment.

[0019] Implementation of the invention

[0020] To perform vacuum drainage, a tube for supplying a medicinal solution 4 is installed into a pre-treated wound, which is covered on top with a sponge 3 and a protective incisional film 2, under which an immersion drain 1 is placed.

[0021] Set vacuum source 5 to a specific wound treatment program using alternating negative pressure, selected based on the wound's characteristics. A therapeutic solution is applied directly to the wound bed 12 in the minimum required quantities, and this solution is removed through submersible drain 1, located at the top of the therapeutic dressing, ensuring the removal of pathogenic fluid from the wound in an upward direction (indicated by arrows in the figure). Pathogenic discharge and therapeutic solution are removed into collection container 7 for collecting pathological discharge under the action of the vacuum created by the device.

[0022] When treating purulent wounds, one of the following algorithms can be used. After preliminary necrectomy of the wound, a tube for delivering a medicinal solution (4) is placed at the bottom of the wound. A sponge (3) of the required porosity is placed on top, pre-shaped to a wound shape 15-20% smaller than the wound volume. The tube for delivering the medicinal solution (4) is connected to a sealed circuit of tubes (8) and an instillation device for wound treatment using alternating negative pressure, either mechanically using a syringe or dropper (9) or using a pump (10).

[0023] A protective incisional film 2 is glued onto the pre-prepared skin around the wound with an indentation from the edge of the wound of less than 5 cm along the perimeter, in the center with the help of scissors an opening up to 2 cm in diameter is made, onto which an overhead drainage 1 is glued or a drainage 1 is placed on a sponge 3, the free end of which (without perforation holes) is brought out through a counter-aperture away from the wound, and a protective incisional film 2 is glued onto the pre-prepared skin. Through a system of sealed 6 tubes it is connected to a container-collector 7 of pathological discharge and a vacuum source 5.

[0024] The positive effect of the claimed technical solution consists in ensuring a unidirectional flow of the rinsing solution from the bottom of the bed 12 and the walls of the wound in the direction of the collection container.

[0025] Clinical example

[0026] Patient N., 66 years old, diagnosed with phlegmon of the left leg due to diabetic angiopathy. Type 2 diabetes mellitus.

[0027] Completed: Opening and drainage of phlegmon of the left leg, necrectomy.

[0028] The device for instillation during wound treatment with alternating negative pressure has been installed: a tube for delivering medicinal solution 4 is placed at the bottom of the wound, a sponge 3 is formed along the contour and volume of the wound 20% smaller than the wound itself. A protective incisional film 2 is applied to the pre-prepared skin, and a hole approximately 2 cm in diameter is made in the center of the protective incisional film. A drainage 1 is installed into this hole, which is connected via a system of sealed tubes 6 to a collection container 7 for pathological discharge and a vacuum source 5. Tube for delivering medicinal solution 4, located in the wound bed 12, is connected to a sealed circuit of tubes 8 and a syringe 9.

[0029] The following cyclic mode of the wound treatment program with alternating negative pressure was selected for wound treatment: vacuum - 120 mmHg for 5 minutes, then 60 mmHg for 2 minutes, every 6 hours instillation of 40 ml of the medicinal solution of dioxidine with an exposure of 90 seconds, followed by an evacuation mode.

[0030] The device for instillation during wound treatment with alternating negative pressure was dismantled on the 5th day; the wound showed pronounced positive dynamics in the form of cleansing of the bottom and walls of the wound, the appearance of pink granulation on them, and a reduction in the size of the wound.

[0031] Thus, the proposed device for instillation during wound treatment with alternating negative pressure ensures uniform, more effective drainage of the wound, unidirectional flow of wound exudate and instillation of the medicinal solution, the absence of ingrowth of granulation tissue of the sponge 3 eliminates the risk of bleeding, including when removing the sponge 3 from the wound cavity.

[0032] Alternating negative pressure wound instillation device provides:

[0033] - cleaning the wound and subsequent evacuation of the pathogenic environment and medicinal solution from it;

[0034] - minimizing the amount of medicinal solution used due to its precise delivery to the wound bed through the supply of medicinal solution 4, which eliminates the risk of soaking, peeling off and loss of tightness of the medicinal dressing and, as a result, risks to the health and life of the patient.

[0035] - elimination of the complex procedure of calculating the required volume of medicinal solution introduced into the wound for administration (instillation) from above (taking into account the porosity of the sponge, its residual patency, taking into account contamination, etc.).

Claims

1. A device for instillation during wound treatment with alternating negative pressure, comprising a vacuum source in the form of a housing with a screen configured to display information on the operating parameters of the instillation device during wound treatment with alternating negative pressure and control elements; a wound dressing consisting of a protective incisional film and a sponge located under the protective incisional film; an immersion drain located under the protective incisional film of the wound dressing, or an overhead drain located on the protective incisional film; a container for collecting pathological discharge; a system of sealed tubes; a means for delivering a medicinal solution; a sealed circuit of tubes; a tube for delivering a medicinal solution, configured to be positioned on the wound bed; control elements including a controller that allows setting and implementing a basic program for wound treatment with alternating negative pressure with a vacuum of 120 mm Hg.for 5 minutes, then 60 mm Hg for 2 minutes, instilling 40 ml of the medicinal solution every 6 hours, holding for 90 seconds and then evacuating the medicinal solution; in this case, the immersion drain located under the protective incisional film of the wound dressing, or the overhead drain located on the protective incisional film, is connected to the container-collector of pathological discharge and the vacuum source through a system of sealed tubes, and the tube for supplying the medicinal solution is connected to the means for supplying the medicinal solution by means of a sealed circuit through a shut-off means.

2. The device for instillation according to paragraph 1, characterized in that the means for delivering the medicinal solution is made in the form of a pump.

3. The device for instillation according to paragraph 1, characterized in that the means for delivering the medicinal solution is made in the form of a dropper.

4. The device for instillation according to paragraph 1, characterized in that the means for delivering the medicinal solution is made in the form of a syringe.

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