阅读说明：本技术 一种取皮器及其使用方法 (Skin taking device and using method thereof ) 是由 潘孙峰 朱世辉 王振君 方高丰 邱祥 朱敏达 于 2019-12-26 设计创作，主要内容包括：本发明公开了一种取皮器及其使用方法。它包括供手握住的取皮器的外壳,外壳中安装有给取皮器提供动力的干电池,在干电池的下面安装有直流电机和变速器,直流电机和变速器的底部伸出有连接轴,连接轴插在空心转轴中,在空心转轴的端面与连接轴的台阶面之间安装有一个或两个连接平键,在空心转轴的前端安装有取皮刀,所述的取皮刀是由空心刀杆和连接在刀杆前端的环钻刀头组成,在环钻刀头的端面上制有以空心管口为中心呈放射状的导气槽,在空心转轴中的连接轴端与刀杆端之间设有一空腔,空腔与外面的导气管连通,导气管的另一端连接一空气压缩机,且在导气管上连接有正压、负压和常压三个状态的转换开关,在取皮器外壳的顶端安装有按钮开关。(The invention discloses a skin taking device and a using method thereof. The skin-picking knife comprises a shell of a skin-picking device held by a hand, a dry battery for providing power for the skin-picking device is arranged in the shell, a direct current motor and a speed changer are arranged below the dry battery, a connecting shaft extends out of the bottoms of the direct current motor and the speed changer, the connecting shaft is inserted in a hollow rotating shaft, one or two connecting flat keys are arranged between the end surface of the hollow rotating shaft and the step surface of the connecting shaft, a skin-picking knife is arranged at the front end of the hollow rotating shaft, the skin-picking knife consists of a hollow knife bar and a trephine bit head connected to the front end of the knife bar, a radial air guide groove with a hollow tube opening as the center is arranged on the end surface of the trephine bit head, a cavity is arranged between the connecting shaft end in the hollow rotating shaft and the knife bar end, the cavity is communicated with an air guide tube outside, the other end of the air guide tube, the top end of the skin taking device shell is provided with a button switch.)

1. A skin taking device is characterized by comprising a shell of the skin taking device held by a hand, a dry battery for providing power for the skin taking device is arranged in the shell, a direct current motor and a speed changer are arranged below the dry battery, a connecting shaft extends out of the bottoms of the direct current motor and the speed changer, the connecting shaft is inserted in a hollow rotating shaft, one or two connecting flat keys are arranged between the end surface of the hollow rotating shaft and the step surface of the connecting shaft, a skin taking knife is arranged at the front end of the hollow rotating shaft, the skin taking knife comprises a knife bar and a trephine bit head connected to the front end of the knife bar, the knife bar is a hollow pipe, the knife bar is inserted in the hollow rotating shaft and is fixed in the hollow rotating shaft through a set screw on the hollow rotating shaft, the trephine bit is disc-shaped, the periphery of the disc is provided with a forward extending knife edge, and the end surface of the trephine bit head is provided with a, be equipped with a cavity between the connecting axle head in hollow rotating shaft and the cutter arbor end, be connected with the air duct on the shell, the air duct passes through air guide hole and the epaxial air vent of hollow rotating and cavity intercommunication, an air compressor is connected to the other end of air duct, and is connected with the change over switch of malleation, negative pressure and the three state of ordinary pressure on the air duct, is fixed with the end cover on the top of getting skin ware shell, installs button switch on the end cover, and whether button switch is controlling the dry battery and is switched on with direct current motor, all installs the sealing washer between each fitting surface relevant with the cavity to guarantee not to leak gas in the cavity.

2. The dermatome of claim 1, wherein the diameter of the trephine bit is the diameter D of the skin piece to be removed, and the length B of the blade of the trephine bit is equal to the thickness of the skin piece to be removed.

3. The dermatome of claim 1, wherein a sliding bearing is installed between the housing and the hollow rotating shaft.

4. The dermatome of claim 1, wherein the air vent of the hollow shaft is communicated with the cavity, and a circumferential air guide groove is formed on the outer surface of the hollow shaft at the position of the air vent, so that air in the air guide pipe is always communicated with the air vent and the cavity through the air guide hole and the air guide groove.

5. The dermatome of claim 1, wherein the end cap is threaded onto the top of the dermatome housing.

6. The dermatome of claim 1, wherein the locking position of the set screw of the knife bar is provided with an annular locking groove.

7. The dermatome of claim 1, wherein said switch is controlled by foot pedal.

8. The use method of the skin taking device is characterized by comprising the following steps in sequence:

A. preparation before skin taking: a skinning knife with a proper diameter D is installed on the skinning device according to the size of the skinning area and is fixed by a set screw; after disinfection and anesthesia of the skin-feeding area; starting the air compressor;

B. skin taking: the skin taking device is held by hand, the change-over switch is placed in a normal pressure state, the button switch is pressed, the trephine bit is rotated, the trephine bit is pressed to a skin supplying position, and a skin supplying area and a non-skin supplying area are separated by the aid of the cutting edge; the button switch is released, the trephine bit stops rotating, the foot pedal controls the change-over switch to be in a negative pressure state, the skin in the trephine bit is tightly attached to the trephine bit due to negative pressure, the skin taking device is slightly lifted, and the skin piece which is cut is separated from the supply area by the operation knife which is tightly attached to the blade of the trephine bit;

C. skin placing: the trephine bit is stretched into a vessel filled with normal saline, a foot pedal controls a change-over switch to be in a positive pressure state, and a skin piece adhered to the inside of the trephine bit is blown off into the vessel;

D. changing a skin supplying position, and continuously circulating the actions B, C until all the skin taking operations are completed.

Technical Field

The invention relates to a surgical instrument for skin grafting, in particular to a skin taking device and a using method thereof.

Background

The microskin transplantation is applied to large-area burn at first, the problem of wound surface coverage of large-area burn patients is solved through a smaller skin supply area, and the cure success rate of the large-area burn patients is greatly improved; it is characterized by that a small piece of skin is uniformly covered on the wound surface, and the wound surface can be repaired by means of self-expansion of microsomes, and its maximum area can be expanded to 100 times of its own area. The advantage of the microparticulate skin transplantation is high expansion rate of autologous skin. The histological study shows that the structure of the new skin after operation is similar to that of normal skin, but has no accessory. Its advantages are simple operation, easy mastering and popularization, and wide operation time. The expansion rate of the general skin grafting can reach 13: 1 or even 18: 1, average expansion ratio is more than 10: 1. can rapidly seal large-area deep wound surface, reduce complication incidence of patients, obviously reduce sepsis incidence, reduce fatality rate, save cost, soften skin texture of the transplanted part after 2 years, and improve functions. The microparticulate skin transplantation has been widely applied nationwide, has obvious effect, once becomes the mainstream method of the domestic large-area burn wound repair operation, is still long and still has no decline until now, and is also applied abroad. The long-term follow-up effect after the microskin transplantation is good, except for large-area burn patients, the chronic refractory wound surface is treated by autologous microskin transplantation in China, and a certain curative effect is achieved.

The traditional microskin is made manually by scissors, which wastes time and labor, has slow speed, often lags behind the scab of the wound surface, leads the wound surface not to be covered in time, delays the operation time and has large bleeding amount. Therefore, a skin planer has been designed, a large piece of epidermis is planed on a skin supply area and then is beaten into a small size by a skin crusher, although the skin making speed is increased, the skin grafting effect is not ideal, for example, a roll skin taking device for general surgery of patent CN201820084186.7 is generally similar to the skin planer in the form, but for patients with more basic diseases, old and weak people, diabetic foot ulcer and the like, the healing of the skin taking area is greatly influenced by the large-area skin taking. Therefore, there is a limit to autologous microsomal skin transplantation. An SFS79-1A type three-purpose skin pricking machine is also improved into a cross pricking and cutting machine; also taiwan scholars use a net skin binding machine to assist the skin sheets on the non-groove surface of the skin carrying plate, coat the disinfected olive oil on the roller, and tie and cut the skin sheets in a cross shape or from 6 different angles, but still can not thoroughly solve the problems of fixing, cutting, sticking a knife and the like of the skin sheets.

Disclosure of Invention

The invention aims to provide a skin taking device which is simple in structure, convenient to manufacture and use and enables a skin supply area to heal in time and a using method thereof.

In order to meet the requirements, the invention is realized by the following technical scheme: the skin-picking knife is characterized by comprising a shell of a skin-picking device held by a hand, a dry battery for providing power for the skin-picking device is arranged in the shell, a direct current motor and a speed changer are arranged below the dry battery, a connecting shaft extends out of the bottoms of the direct current motor and the speed changer, the connecting shaft is inserted in a hollow rotating shaft, one or two connecting flat keys are arranged between the end surface of the hollow rotating shaft and the step surface of the connecting shaft, a skin-picking knife is arranged at the front end of the hollow rotating shaft, the skin-picking knife comprises a knife bar and a trephine bit connected to the front end of the knife bar, the knife bar is a hollow pipe and is inserted in the hollow rotating shaft, the knife bar is fixed in the hollow rotating shaft through a set screw on the hollow rotating shaft, the trephine bit is disc-shaped, the periphery of the disc is a forward-extending knife edge, a radial air guide groove taking a hollow pipe opening as the center is arranged on the end surface of the, be connected with the air duct on the shell, the air duct passes through air guide hole and the last air vent of hollow rotating shaft and cavity intercommunication, an air compressor is connected to the other end of air duct, and is connected with the change over switch of malleation, negative pressure and the three state of ordinary pressure on the air duct, is fixed with the end cover on the top of getting skin ware shell, installs button switch on the end cover, and button switch is controlling whether the dry battery switches on with DC motor, all installs the sealing washer between each fitting surface relevant with the cavity to guarantee not leak gaseously in the cavity.

The diameter of the trephine bit is the diameter D of the skin piece to be taken, and the extending length B of the upper cutting edge of the trephine bit is equal to the thickness of the skin piece to be taken.

A sliding bearing is arranged between the shell and the hollow rotating shaft.

The air guide hole and the air vent on the hollow rotating shaft are communicated with the cavity, and a circumferential air guide groove is formed in the outer surface of the hollow rotating shaft at the position of the air vent, so that air in the air guide pipe is always communicated with the air vent and the cavity through the air guide hole and the air guide groove.

The end cover is screwed on the top of the shell of the skin taking device through threads.

An annular locking groove is formed at the locking position of the set screw of the cutter bar.

The change-over switch is controlled by foot.

The use method of the skin taking device is characterized by comprising the following steps in sequence:

A. preparation before skin taking: a skinning knife with a proper diameter D is installed on the skinning device according to the size of the skinning area and is fixed by a set screw; after disinfection and anesthesia of the skin-feeding area; starting the air compressor;

B. skin taking: the skin taking device is held by hand, the change-over switch is placed in a normal pressure state, the button switch is pressed, the trephine bit is rotated, the trephine bit is pressed to a skin supplying position, and a skin supplying area and a non-skin supplying area are separated by the aid of the cutting edge; the button switch is released, the trephine bit stops rotating, the foot pedal controls the change-over switch to be in a negative pressure state, the skin in the trephine bit is tightly attached to the trephine bit due to negative pressure, the skin taking device is slightly lifted, and the skin piece which is cut is separated from the supply area by the operation knife which is tightly attached to the blade of the trephine bit;

C. skin placing: the trephine bit is stretched into a vessel filled with normal saline, a foot pedal controls a change-over switch to be in a positive pressure state, and a skin piece adhered to the inside of the trephine bit is blown off into the vessel;

D. changing a skin supplying position, and continuously circulating the actions B, C until all the skin taking operations are completed.

According to the designed skin taking device and the using method thereof, the dry battery is used as power, the power is output on the connecting shaft through the direct current motor and the speed changer, the power is transmitted through the end face key, the hollow rotating shaft and the trephine bit are driven to rotate, and the skin cutting effect is achieved. The main innovation points of the skin taking device are as follows:

1. in power transmission, the torque on the connecting shaft is transmitted by adopting a rare way of up-down involutive end surface key groove and key transmission in consideration of the sealing requirement of the cavity;

2. in the skin taking mode, the continuous large-piece skin taking mode of peeling is abandoned, and the discontinuous point-by-point skin taking mode is adopted, so that the wound surface at the skin supply position can be quickly healed;

3. the separation of the skin sheet and the falling of the skin sheet on the cutter adopt a cutter bar with a hollow middle part and different air inlet and outlet states, and three different states of negative pressure, positive pressure and normal pressure are formed on the end surface of the trephine head, so that the skin sheet in the cutter head realizes the actions of normal pressure skin cutting, negative pressure lifting and positive pressure skin blowing, the contact with other medical appliances is reduced, the pollution is reduced, and the skin taking efficiency is also improved;

4. when the skin taking device is used, a skin taking doctor holds the skin taking device with one hand to control the up-and-down action of the skin taking device, wherein the thumb presses the button switch to control whether the trephine bit rotates, and the other hand is responsible for separating a taken skin piece from a supply area by using a scalpel to cling to a knife edge of the trephine bit; the skin taking knife can be made into skin taking knives with various specifications according to the size and the thickness of the skin taking, and is connected in an inserting mode, so that the skin taking knife is convenient to assemble, disassemble and replace;

5. the skin-taking quality is good, the skin-taking problem in the prior art is better solved, the skin-taking speed is high, the size of the autologous skin taken down in the skin-supplying area is just suitable, and the cutting and manufacturing process of the microskin can be omitted. The particle skin manufactured by the design has uniform size and high skin taking speed, avoids excessive repeated cutting in the crushing process, and has small damage to skin cells; the traditional process of manufacturing the microskin by using scissors has the problems of blade contusion, repeated mechanical damage to the skin, heavy damage to skin cells, uneven skin grains and influence on the edge expansion of the microskin and the healing of a wound surface.

The whole skin taking device of the design has a simple structure and low manufacturing cost, is completely another skin taking form compared with the traditional skin taking device, is ideal equipment in skin taking instruments in burn surgery, and has wide popularization and application prospects.

Drawings

FIG. 1 is a front view of a dermatome;

FIG. 2 is an enlarged view of a portion of the area F in FIG. 1;

FIG. 3 is a K-view of the trephine bit of FIG. 2;

FIG. 4 is a front view of the hollow shaft;

FIG. 5 is a top view of FIG. 4;

FIG. 6 is a front view of the attachment stub shaft;

FIG. 7 is a right side view of FIG. 6;

fig. 8 is a view in direction E of fig. 6.

In the figure: 1. a housing; 2. dry batteries; 3. a DC motor and a transmission; 4. a connecting shaft; 5. a hollow rotating shaft; 6. flanging; 7. a sliding bearing; 8. a keyway; 9. a flat bond; 10. a skinning knife; 11. a cutter bar; 12. a trephine bit; 13. tightening the screw; 14. a locking groove; 15. a blade; 16. a hollow pipe orifice; 17. an air introducing groove; 18. a cavity; 19. an air duct; 20. an air vent; 21. a vent hole; 22. a gas guide groove; 23. an end cap; 24. a push button switch; 25. an O-shaped sealing ring.

Detailed Description

The invention is further described with reference to the following figures and specific embodiments.

Fig. 1, fig. 2 and fig. 3 are schematic structural views of a skin extractor. The skin taking device comprises a shell 1 of the skin taking device for being held by a hand, a dry battery 2 for providing power for the skin taking device is arranged in the shell 1, a direct current motor and a speed changer 3 are arranged below the dry battery 2, a connecting shaft 4 extends out of the bottoms of the direct current motor and the speed changer 3, the connecting shaft 4 is inserted into a hollow rotating shaft 5, an outward flange 6 is arranged on the upper end face of the hollow rotating shaft 5 as shown in figures 4 and 5, and a sliding bearing 7 is arranged between the shell 1 and the hollow rotating shaft 5. As shown in fig. 6, 7 and 8, a key groove 8 is formed between the end surface of the hollow rotating shaft 5 and the step surface of the connecting shaft 4, one or two connecting flat keys 9 are installed in the key groove 8, and the connecting flat key 9 is a C-shaped flat key. The skinning knife 10 is installed at the front end of the hollow rotating shaft 5, and the skinning knife 10 consists of a knife bar 11 and a trephine bit 12 connected to the front end of the knife bar 11. The cutter bar 11 is a hollow pipe, the cutter bar 11 is inserted in the hollow rotating shaft 5, the cutter bar 11 is fixed in the hollow rotating shaft 5 through a set screw 13 on the hollow rotating shaft 5, an annular locking groove 14 is formed in the locking position of the set screw 13 of the cutter bar 11, and the head of the set screw 13 is clamped in the locking groove 14. The trephine bit 12 is disc-shaped, and the periphery of the disc shape is provided with a forward extending blade 15. The diameter of the trephine bit 12 is the diameter D of the taken skin piece, and the extending length B of the upper cutting edge of the trephine bit 12 is equal to the thickness of the taken skin piece. The end face of the trephine bit 12 is provided with a radial air guide groove 17 with a hollow pipe orifice 16 as the center. A cavity 18 is arranged between the end of a connecting shaft 4 in the hollow rotating shaft 5 and the end of the cutter bar 11, an air guide pipe 19 is connected on the shell 1, the air guide pipe 19 is communicated with the cavity 18 through an air guide hole 20 and an air vent 21 on the hollow rotating shaft 5, the air vent 21 on the hollow rotating shaft 5 is communicated with the cavity 18, and a circumferential air guide groove 22 is formed in the outer surface of the hollow rotating shaft 5 at the position of the air vent 21, so that air in the air guide pipe 19 is always communicated with the air vent 21 and the cavity 19 through the air guide hole 20 and the air guide groove 22. The other end of the air duct 19 is connected with an air compressor (not shown in the figure), and the air duct 19 is connected with a change-over switch (not shown in the figure) with three states of positive pressure, negative pressure and normal pressure, and the change-over switch is controlled by a foot pedal. An end cover 23 is screwed on the top of the shell 1 of the skin taking device through threads, a button switch 24 is arranged on the end cover 23, the button switch 24 controls whether the dry battery 2 is conducted with the direct current motor, and O-shaped sealing rings 25 are arranged between matching surfaces related to the cavity 18 to ensure that the cavity 18 is airtight.

The use method of the skin taking device comprises the following steps:

A. preparation before skin taking: a skinning knife 10 with a proper diameter D is installed on the skinning device according to the size of the skinning area and is fixed by a set screw 13; after disinfection and anesthesia of the skin-feeding area; starting the air compressor;

B. skin taking: the skin taking device is held by hand, the change-over switch is placed in a normal pressure state, the button switch 24 is pressed, the trephine bit 12 rotates, the trephine bit 12 is pressed to a skin supplying position, and a skin supplying area and a non-skin supplying area are separated by the blade 15; the button switch 24 is loosened, the trephine bit 12 stops rotating, the foot pedal controls the change-over switch to be in a negative pressure state, the skin sheet in the trephine bit 12 is tightly attached to the interior of the trephine bit 12 due to negative pressure, the skin extractor is slightly lifted, and the scalpel is tightly attached to the blade 15 of the trephine bit 12 to separate the cut skin sheet from the supplied area;

C. skin placing: the head of the trephine bit 15 is inserted into a vessel filled with normal saline, a foot pedal controls a change-over switch to be in a positive pressure state, and a skin piece adhered to the inside of the trephine bit 15 is blown down into the vessel;

D. changing a skin supplying position, and continuously circulating the actions B, C until all the skin taking operations are completed.

The operation is convenient and simple, the wound is small, the bleeding amount of the wound surface after skin taking is less, the supply area is covered with the soft silicone foam dressing, the soft silicone foam dressing can be generally healed within 1 week, repeated dressing change is not needed, the skin-taking device is easy to accept by a patient, the effect is ideal, a common planer type skin-taking machine can be replaced, and the performance is more excellent.

However, the above embodiments are only for illustrating the technical concept and features of the present invention, and the purpose of the present invention is to enable those skilled in the art to understand the content of the present invention and implement the present invention, and not to limit the protection scope of the present invention. All equivalent changes and modifications made according to the spirit of the present invention should be covered within the protection scope of the present invention.