Sensor positioning for performing sensor wound monitoring or treatment
阅读说明:本技术 实施传感器的伤口监测或治疗的传感器定位 (Sensor positioning for performing sensor wound monitoring or treatment ) 是由 伐楼尼·拉申德拉·布朗希尔 维多利亚·乔迪·哈蒙德 艾伦·肯尼士·弗雷泽·格鲁根·亨特 马库斯 于 2018-06-21 设计创作,主要内容包括:本发明公开了用于确定传感器在伤口敷料中的就位的设备和方法的实施例。在一些实施例中,伤口敷料包括被配置成测量伤口或患者特征的多个传感器。一个或多个处理器被配置成接收伤口或患者特征数据以及就位数据。所接收的数据可用于确定多个传感器、伤口敷料或伤口的就位。传感器可以包括一组纳米传感器。伤口敷料可以包括pH敏感油墨,其能够用于确定伤口敷料的放置并确定与伤口相关联的pH。伤口敷料可用于负压伤口治疗系统中。(Embodiments of an apparatus and method for determining the position of a sensor in a wound dressing are disclosed. In some embodiments, the wound dressing includes a plurality of sensors configured to measure characteristics of the wound or patient. The one or more processors are configured to receive wound or patient characteristic data and in-situ data. The received data may be used to determine the position of a plurality of sensors, wound dressings, or wounds. The sensor may comprise a set of nanosensors. The wound dressing may include a pH sensitive ink that can be used to determine the placement of the wound dressing and determine the pH associated with the wound. The wound dressing may be used in a negative pressure wound therapy system.)
1. A wound monitoring and/or treatment system comprising:
a wound dressing configured to be positioned in contact with a wound, the wound dressing comprising a plurality of sensors configured to measure a plurality of wound characteristics; and
a controller comprising one or more processors, the controller configured to communicate with at least some of the plurality of sensors and further configured to:
receiving in-situ data associated with a position or orientation of a reference point;
determining a position and/or orientation of at least one reference point relative to the wound based at least in part on the received in-situ data;
determining a position and/or orientation of a first sensor of the plurality of sensors in the wound based at least in part on the determined position and/or orientation of the at least one reference point;
comparing the position and/or orientation of a first sensor of the plurality of sensors to threshold in-situ data indicative of a correct position and/or orientation of the first sensor of the plurality of sensors in the wound; and
based at least on the comparison, providing an indication that a first sensor of the plurality of sensors is properly positioned in the wound.
2. The system of any one of the preceding claims, wherein the plurality of sensors comprises at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, impedance sensor, or electrode.
3. The system of claim 2, wherein the optical sensor comprises at least one of a red green blue transparent (RGBC) sensor or a Red Green Blue White (RGBW) sensor.
4. The system of any preceding claim, wherein the first sensor is a sensor other than a seat sensor configured to detect the seat data.
5. The system of any preceding claim, wherein the first sensor is a seat sensor configured to detect the seat data.
6. The system of any one of claims 3 or 4, further comprising a position sensor configured to detect the position data, wherein the position sensor comprises at least one of an external camera or a Radio Frequency (RF) sensor.
7. The system of any one of claims 3 or 4, further comprising a in-situ sensor configured to detect the in-situ data, wherein the in-situ sensor is embedded in the wound dressing.
8. The system of any preceding claim, wherein the reference point corresponds to a position or orientation of a seating sensor configured to detect the seating data.
9. The system of any one of the preceding claims, wherein the reference point corresponds to a location remote from the wound dressing.
10. The system of any one of the preceding claims, wherein the controller is further configured to determine a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on the received in-situ data and a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or the wound.
11. The system of claim 10, wherein the relationship comprises at least a known position and/or orientation offset between the first sensor and the second sensor.
12. The system of any preceding claim, wherein at least some of the plurality of sensors are configured to communicate with each other and/or co-register, and wherein the controller is configured to provide the indication also based on co-registration data.
13. The system of any of the preceding claims, wherein at least one sensor of the plurality of sensors is configured with an adjustable sensor setting, and wherein the adjustable sensor setting is configured to be adjusted based at least in part on the received seating data.
14. The system of any one of the preceding claims, wherein the wound dressing is configured to deliver negative pressure to the wound.
15. A kit comprising the wound dressing of claim 15 and a negative pressure source configured to be fluidly connected to the wound dressing.
16. A method of operating a wound monitoring and/or therapy system comprising a wound dressing comprising a plurality of sensors configured to measure a plurality of wound characteristics, the method comprising:
receiving in-situ data associated with at least one reference point;
determining a position and/or orientation of a first sensor of the plurality of sensors based at least in part on the received seating data;
comparing the position and/or orientation of a first sensor of the plurality of sensors to threshold in-situ data indicative of a correct position and/or orientation of the first sensor of the plurality of sensors in the wound; and
providing an indication that a first sensor of the plurality of sensors is properly positioned in the wound based at least in part on the comparison,
wherein the method is performed by a controller of the wound monitoring and/or therapy system.
17. The method of the preceding claim, wherein the plurality of sensors comprises at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, impedance sensor, in-situ sensor configured to detect the in-situ data, or electrode.
18. The method of any one of claims 16 to 17, wherein the first sensor is a sensor other than a position sensor.
19. The method of any of claims 16-18, wherein the first sensor is a seat sensor configured to detect the seat-in-data.
20. The method of any of claims 16-19, wherein the reference point corresponds to a position or an orientation of a position sensor configured to detect the position-in-place data.
21. The method of any one of claims 16 to 20, wherein the reference point corresponds to a location remote from the wound dressing.
22. The method of any of claims 16 to 21, further comprising:
determining a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on the received in-situ data and a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or the wound.
23. The method of claim 22, wherein the relationship comprises at least a known position and/or orientation offset between the first sensor and the second sensor.
24. The method of any one of claims 16 to 23, wherein at least some of the plurality of sensors are configured to communicate with each other and/or co-register, and the method further comprises providing the indication further based on co-registration data.
25. The method of any one of claims 16-24, wherein at least one sensor of the plurality of sensors is configured with an adjustable sensor setting, and the method further comprises adjusting the adjustable sensor setting based at least in part on the received seating data.
26. The method of any one of claims 16 to 25, further comprising delivering negative pressure to the wound.
27. A wound monitoring and/or treatment system comprising:
a wound dressing configured to be positioned in contact with a wound, the wound dressing comprising a plurality of sensors configured to measure a plurality of wound characteristics and at least one alignment feature associated with a position and/or orientation of the wound dressing;
a position sensing device comprising a sensor and a controller comprising one or more processors, the controller configured to communicate with the sensor and further configured to:
determining a position and/or orientation of the at least one alignment feature based, at least in part, on data received from the sensor;
determining a position and/or orientation of at least one sensor of a plurality of sensors of the wound dressing in the wound based at least in part on the determined position and/or orientation of the at least one alignment feature; and
providing an indication of a positional status of at least one sensor of the plurality of sensors relative to the wound.
28. The system of claim 27, wherein the at least one alignment feature comprises a marker.
29. The system of claim 28, wherein the marker is positioned on the wound dressing.
30. The system of claim 28, wherein the marker is positioned on or near the perimeter of the wound.
31. The system of any one of claims 28 to 30, wherein the indicia comprises a pH sensitive ink.
32. The system of claim 31, wherein the pH sensitive ink comprises at least one of a pH sensitive ink, dye, or pigment, and is configured to change color in response to a pH change in a wound environment.
33. The system of claim 32, wherein the controller of the position sensing device is further configured to measure a color change of the pH sensitive ink.
34. The system of any one of claims 27 to 33, wherein the sensor of the positioning sensing device comprises at least one of an optical pH sensor or a scanner.
35. The system of any one of claims 27 to 34, wherein the data received from the sensor of the positioning sensing device comprises at least one of: an angle of the at least one alignment feature relative to the positional sensing device, an angle of the at least one alignment feature relative to a trajectory of a scanning beam of the positional sensing device, a distance between the at least one alignment feature and the positional sensing device, a size corresponding to the at least one alignment feature, a tilt corresponding to the at least one alignment feature, or an angular amount corresponding to a parallax of the at least one alignment feature.
36. The system of any one of claims 27 to 35, wherein the at least one alignment feature comprises at least one of a bar code, a number, a letter, an alphanumeric code, a standard shape, an irregular shape, or a logo.
37. The system according to any one of claims 27 to 36, wherein the position and/or orientation of the at least one alignment feature relative to the wound comprises at least one of: a depth of at least one sensor of the plurality of sensors in the wound, a distance of the at least one sensor from a portion of the wound, an orientation of the at least one sensor, or a location of the at least one sensor on the wound.
38. The system of any one of claims 27 to 37, wherein the at least one alignment feature is associated with a value, and the value is capable of identifying a baseline position of the at least one alignment feature relative to a flat dressing.
39. The system of any one of claims 27 to 38, wherein the at least one alignment feature comprises two alignment features.
40. The system of any one of claims 27 to 39, wherein the status comprises an indication that the at least one sensor is properly positioned in the wound.
41. The system of any one of claims 27 to 40, wherein the status comprises an indication that the at least one sensor is not properly positioned in the wound.
42. A method of operating a wound monitoring and/or therapy system comprising a wound dressing comprising a plurality of sensors configured to measure a plurality of wound characteristics and markers positioned on the wound dressing, the method comprising:
receiving, from a positioning sensing device, in-situ data associated with a position or orientation of a reference point, and wherein the wound dressing is in contact with a wound of a patient and comprises a plurality of sensors configured to measure a plurality of wound characteristics;
determining a position and/or orientation of at least one reference point relative to the wound based at least in part on the received in-situ data;
determining a position and/or orientation of a first sensor of a plurality of sensors of the wound dressing in the wound based at least in part on the determined position and/or orientation of the at least one reference point; and
indicating a status of a position and/or orientation of the at least one sensor in the wound.
43. The method of claim 4241, wherein the plurality of sensors comprises at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, impedance sensor, or electrode.
44. The method of claim 43, wherein the optical sensor comprises at least one of a red, green, blue, transparent (RGBC) sensor or a red, green, blue, white (RGBW) sensor.
45. The method of any one of claims 42 to 44, wherein the first sensor is a sensor other than a seat sensor configured to detect the seat-in-data.
46. The method of any one of claims 42 to 44, wherein the first sensor is a seat sensor configured to detect the seat-in-data.
47. The method of any one of claims 45-46, wherein the in-situ sensor comprises at least one of an external camera or a Radio Frequency (RF) sensor.
48. The method of any one of claims 45 to 47, wherein the in-situ sensor is embedded in the wound dressing.
49. The method of any of claims 42 to 48, wherein the reference point corresponds to a position or orientation of a seating sensor configured to detect the seating data.
50. The method of any one of claims 42 to 49, wherein the reference point corresponds to a location remote from the wound dressing.
51. The method of any one of claims 42 to 50, further comprising:
determining a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or the wound.
52. The method of claim 51, wherein the relationship comprises at least a known position and/or orientation offset between the first sensor and the second sensor.
53. The method of any one of claims 42 to 52, wherein at least some of the plurality of sensors are configured to communicate with each other and/or co-register, wherein the method further comprises providing the indication further based on co-registration data.
54. The method of any one of claims 42-53, wherein at least one sensor of the plurality of sensors is configured with an adjustable sensor setting, and wherein the method further comprises adjusting the adjustable sensor setting based at least in part on the received seating data.
55. The method of any one of claims 42 to 54, wherein the wound dressing is configured to deliver negative pressure to the wound.
56. The method of any one of claims 42 to 55, wherein a sensor of the positioning sensing device comprises at least one of an optical pH sensor or a scanner.
57. The method of any one of claims 42 to 56, wherein at least one alignment feature is associated with a position and/or orientation of the wound dressing.
58. The method according to claim 57, wherein in-situ data received from said positioning sensing device comprises at least one among: an angle of the at least one alignment feature relative to the positional sensing device, an angle of the at least one alignment feature relative to a trajectory of a scanning beam of the positional sensing device, a distance between the at least one alignment feature and the positional sensing device, a size corresponding to the at least one alignment feature, a tilt corresponding to the at least one alignment feature, or an angular amount corresponding to a parallax of the at least one alignment feature.
59. The method of any one of claims 57 to 58, wherein the at least one alignment feature comprises at least one of a barcode, a number, a letter, an alphanumeric code, a standard shape, an irregular shape, or a logo.
60. The method according to any one of claims 57 to 59, wherein the position and/or orientation of the at least one alignment feature relative to the wound comprises at least one of: a depth of the at least one sensor in the wound, a distance of the at least one sensor from a portion of the wound, an orientation of the at least one sensor, or a location of the at least one sensor on the wound.
61. The method of any one of claims 57 to 60, wherein the at least one alignment feature is associated with a value, and the value is capable of identifying a baseline position of the alignment feature relative to a flat dressing.
62. The method of any one of claims 57 to 60, wherein the alignment features comprise a pH sensitive ink.
63. The method of claim 62, wherein the pH sensitive ink is configured to change color in response to a pH change in a wound environment.
64. The method of any one of claims 62 to 63, further comprising measuring a color change of the pH sensitive ink.
65. The method of any one of claims 57 to 64, wherein the at least one alignment feature comprises two markings.
66. The method of any one of claims 42-65, wherein indicating the status further comprises indicating that the at least one sensor is properly positioned in the wound.
67. The method of any one of claims 42 to 66, wherein indicating the status further comprises indicating that the at least one sensor is not properly positioned in the wound.
Technical Field
Embodiments of the present disclosure relate to devices, systems, and methods for treating tissue through monitoring of delivery sensors in communication with various treatment regions.
Background
Almost all fields of medicine may benefit from improved information about the state of the tissue, organ or system to be treated, especially if such information is collected in real time during the treatment. Many types of processing are still performed periodically without the use of sensor data collection; indeed, such processing relies on visual inspection or other limited means by the caregiver rather than quantitative sensor data. For example, in the case of wound treatment by dressing and/or negative pressure wound therapy, data acquisition is typically limited to visual inspection by the caregiver, and often the underlying wounded tissue may be obscured by bandages or other visual barriers. Even intact skin may render underlying lesions invisible to the naked eye, such as damaged blood vessels or deeper tissue lesions that may lead to ulceration. Similar to wound treatment, during orthopedic procedures that require the limb to be immobilized with a model or other encasement, only limited information is collected about the underlying tissue. In the case of internal tissue repair, such as bone plates, continuous direct sensor-driven data acquisition is not performed. Furthermore, braces and/or sleeves for supporting musculoskeletal function do not monitor the function of the underlying muscles or movement of the limb. In addition to direct treatment, common hospital room items such as beds and blankets may be improved by adding the ability to monitor patient parameters.
Accordingly, there is a need for improved sensor monitoring, particularly through the use of substrates implementing sensors that can be incorporated into existing processing schemes.
It is well known in the art to treat open or chronic wounds that are too large to spontaneously close or otherwise heal by applying negative pressure to the wound site. Negative Pressure Wound Therapy (NPWT) systems currently known in the art typically involve placing a cover that is impermeable or semi-permeable to fluids over the wound, sealing the cover to the patient tissue surrounding the wound using various means, and connecting a source of negative pressure (e.g., a vacuum pump) to the cover in a manner that causes negative pressure to be created and maintained under the cover. It is believed that such negative pressure promotes wound healing by promoting the formation of granulation tissue at the wound site and assisting the body's normal inflammatory process while removing excess fluid that may contain adverse cytokines and/or bacteria. However, further improvements in NPWT are needed to fully realize therapeutic benefits.
Many different types of wound dressings are known for assisting NPWT systems. These different types of wound dressings include many different types of materials and layers, for example, gauze, pads, foam pads, or multi-layer wound dressings. One example of a multilayer wound dressing is the PICO dressing available from Smith & Nephew, which includes a wound contact layer and a superabsorbent layer beneath a backing layer to provide a can-less system for treating wounds with NPWT. The wound dressing may be sealed to a suction port that provides a connection to a length of tubing that may be used to pump fluid out of the dressing and/or to transfer negative pressure from the pump to the wound dressing. Additionally, RENASYS-F, RENASYS-G, RENASYS-AB and RENASYS-F/AB, available from Smith & Nephew, are additional examples of NPWT wound dressings and systems. Another example of a multilayer wound dressing is the allwynlife dressing available from Smith & Nephew, which includes a moist wound environment dressing for treating a wound without the use of negative pressure.
However, prior art dressings for negative pressure wound therapy or other wound therapy provide little visualization or information of the state of the wound under the dressing. This may require premature dressing changes before a desired level of wound healing has occurred, or for an absorbent dressing, before the full absorbent capacity of the dressing is reached to allow the clinician to check the healing and status of the wound. Some current dressings have limited and/or unsatisfactory methods or features for providing wound status information.
Disclosure of Invention
The present disclosure provides improved apparatus and methods for determining the position of a sensor in a wound dressing. A wound monitoring and/or treatment system may include a wound dressing and a controller. The wound dressing may be configured to be positioned in contact with a wound. The wound dressing may include a plurality of sensors configured to measure a plurality of wound characteristics. The controller may include one or more processors. The controller may be configured to communicate with at least some of the plurality of sensors. The controller may be configured to receive seating data associated with a position or orientation of a reference point. The controller may be configured to determine a position and/or orientation of the at least one reference point relative to the wound based at least in part on the received in-situ data. The controller may be configured to determine a position and/or orientation of a first sensor of the plurality of sensors in the wound based at least in part on the determined position and/or orientation of the at least one reference point. The controller may be configured to compare the position and/or orientation of a first sensor of the plurality of sensors to threshold in-situ data indicative of a correct position and/or orientation of the first sensor of the plurality of sensors in the wound. The controller may be configured to provide an indication that a first sensor of the plurality of sensors is properly positioned in the wound based at least on the comparison.
The system of the previous paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. The plurality of sensors may include at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, impedance sensor, or electrode. The optical sensor may include at least one of a red green blue transparent (RGBC) sensor or a Red Green Blue White (RGBW) sensor. The first sensor may be a sensor other than a seated sensor configured to detect the seated data. The first sensor may be a seated sensor configured to detect the seated data. The system may include a seating sensor configured to detect the seating data. The in-position sensor may include at least one of an external camera or a Radio Frequency (RF) sensor. The in-situ sensor may be embedded in the wound dressing. The reference point may correspond to a position or an orientation of a seating sensor configured to detect the seating data. The reference point may correspond to a location remote from the wound dressing.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. The controller may be configured to determine a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on the received seating data and a relationship between positions and/or orientations of the first and second sensors in the wound dressing and/or wound. The relationship may include at least known positions and/or orientations, which may be configured to communicate and/or co-register with each other. The controller may be configured to provide the indication also based on co-registration data. At least one of the plurality of sensors may be configured with an adjustable sensor setting. The adjustable sensor settings may be configured to be adjusted based at least in part on the received seating data. The wound dressing may be configured to deliver negative pressure to the wound.
The kit may include any of the features described in this paragraph or in any of the preceding paragraphs, as well as other features described herein. The kit may include a wound dressing and a negative pressure source configured to be fluidly connected to the wound dressing.
The present disclosure also provides a method of operating a wound monitoring and/or therapy system. The system may include a wound dressing including a plurality of sensors configured to measure a plurality of wound characteristics. The method may comprise: receiving in-situ data associated with at least one reference point; and determining a position and/or orientation of a first sensor of the plurality of sensors based at least in part on the received seating data. The method may further include comparing the position and/or orientation of a first sensor of the plurality of sensors to threshold in-situ data indicative of a correct position and/or orientation of the first sensor of the plurality of sensors in the wound. The method may further include providing an indication that a first sensor of the plurality of sensors is properly positioned in the wound based at least in part on the comparison. The method may be performed by a controller of the wound monitoring and/or therapy system.
The method of the previous paragraph can also include any combination of the following features or steps described in this paragraph, as well as other features or steps described herein. The plurality of sensors may include at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, impedance sensor, in-situ sensor configured to detect the in-situ data, or electrode. The first sensor may comprise a sensor other than a seated sensor. The first sensor may be a seated sensor configured to detect the seated data. The reference point may correspond to a position or an orientation of a seating sensor configured to detect the seating data. The reference point may correspond to a location remote from the wound dressing.
The method of any preceding paragraph can also include any combination of the following features or steps described in this paragraph, as well as other features or steps described herein. The method may further comprise determining a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on the received in-situ data and a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or wound. The relationship may include at least a known position and/or orientation offset between the first sensor and the second sensor. At least some of the plurality of sensors may be configured to communicate with and/or co-register with each other. The method may further comprise providing the indication further based on co-registration data. At least one of the plurality of sensors may be configured with an adjustable sensor setting. The method may also include adjusting the adjustable sensor settings based at least in part on the received seating data. The method may further comprise delivering negative pressure to the wound.
The present disclosure also provides wound monitoring and/or treatment systems. The system may include a wound dressing and a position sensing device. The wound dressing may be configured to be positioned in contact with a wound, the wound dressing including a plurality of sensors configured to measure a plurality of wound characteristics and at least one alignment feature associated with a position and/or orientation of the wound dressing. The positioning sensing device may include a sensor and a controller including one or more processors. The controller may be configured to communicate with the sensor. The controller may also be configured to determine a position and/or orientation of the at least one alignment feature based at least in part on data received from the sensor. The controller may be further configured to determine a position and/or orientation of at least one sensor of the plurality of sensors of the wound dressing in the wound based at least in part on the determined position and/or orientation of the at least one alignment feature. The controller may be further configured to provide an indication of a positional status of at least one of the plurality of sensors relative to the wound.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. The at least one alignment feature may comprise a marker. The indicia may be positioned on the wound dressing. The marker may be positioned on or near the perimeter of the wound. The indicia may comprise a pH sensitive ink. The pH sensitive ink may include at least one of a pH sensitive ink, dye, or pigment, and may be configured to change color in response to a pH change in the wound environment. The controller of the positioning sensing device may also be configured to measure a color change of the pH sensitive ink. The sensor of the positioning sensing device may comprise at least one of an optical pH sensor or a scanner. The data received from the sensors of the positioning sensing device may comprise at least one of: an angle of the at least one alignment feature relative to the positional sensing device, an angle of the at least one alignment feature relative to a trajectory of a scanning beam of the positional sensing device, a distance between the at least one alignment feature and the positional sensing device, a size corresponding to the at least one alignment feature, a tilt corresponding to the at least one alignment feature, or an angular amount corresponding to a parallax of the at least one alignment feature.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. The at least one alignment feature may comprise at least one of a bar code, a number, a letter, an alphanumeric code, a standard shape, an irregular shape, or a logo. The position and/or orientation of the at least one alignment feature relative to the wound comprises at least one of: a depth of at least one sensor of the plurality of sensors in the wound, a distance of the at least one sensor from a portion of the wound, an orientation of the at least one sensor, or a location of the at least one sensor on the wound. The at least one alignment feature may be associated with a value, and the value may identify a baseline position of the at least one alignment feature relative to the flat dressing. The at least one alignment feature may comprise two alignment features. The status may include an indication that the at least one sensor is properly positioned in the wound. The status may include an indication that the at least one sensor is not properly positioned in the wound.
The present disclosure also provides a method of operating a wound monitoring and/or therapy system. The system may include a wound dressing including a plurality of sensors configured to measure a plurality of wound characteristics. The method may include receiving, from a position sensing device, in-situ data associated with a position or orientation of a reference point. The wound dressing may be in contact with a wound of a patient and include a plurality of sensors configured to measure a plurality of wound characteristics. The method may include determining a position and/or orientation of the at least one reference point relative to the wound based at least in part on the received in-situ data. The method may include determining a position and/or orientation of a first sensor of a plurality of sensors of the wound dressing in the wound based at least in part on the determined position and/or orientation of the at least one reference point. The method may comprise indicating a status of a position and/or orientation of the at least one sensor in the wound.
The method of any preceding paragraph can also include any combination of the following features or steps described in this paragraph, as well as other features or steps described herein. The plurality of sensors may include at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, impedance sensor, or electrode. The optical sensor may include at least one of a red green blue transparent (RGBC) sensor or a Red Green Blue White (RGBW) sensor. The first sensor may include a sensor other than a seated sensor configured to detect the seated data. The first sensor is a seated sensor configured to detect the seated data. The in-position sensor may include at least one of an external camera or a Radio Frequency (RF) sensor. The in-situ sensor may be embedded in the wound dressing. The reference point may correspond to a position or an orientation of a seating sensor configured to detect the seating data. The reference point may correspond to a location remote from the wound dressing.
The method of any preceding paragraph can also include any combination of the following features or steps described in this paragraph, as well as other features or steps described herein. The method may comprise determining the position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or wound. The relationship may include at least a known position and/or orientation offset between the first sensor and the second sensor. At least some of the plurality of sensors may be configured to communicate with and/or co-register with each other. The method may comprise providing the indication further based on co-registration data. At least one of the plurality of sensors may be configured with an adjustable sensor setting. The method may include adjusting the adjustable sensor settings based at least in part on the received seating data. The wound dressing may be configured to deliver negative pressure to the wound. The sensor of the positioning sensing device may comprise at least one of an optical pH sensor or a scanner. The at least one alignment feature may be associated with a position and/or orientation of the wound dressing.
The method of any preceding paragraph can also include any combination of the following features or steps described in this paragraph, as well as other features or steps described herein. The in-situ data received from the positioning sensing device may comprise at least one of: an angle of the at least one alignment feature relative to the positional sensing device, an angle of the at least one alignment feature relative to a trajectory of a scanning beam of the positional sensing device, a distance between the at least one alignment feature and the positional sensing device, a size corresponding to the at least one alignment feature, a tilt corresponding to the at least one alignment feature, or an angular amount corresponding to a parallax of the at least one alignment feature. The at least one alignment feature may comprise at least one of a bar code, a number, a letter, an alphanumeric code, a standard shape, an irregular shape, or a logo. The position and/or orientation of the at least one alignment feature relative to the wound may comprise at least one of: a depth of the at least one sensor in the wound, a distance of the at least one sensor from a portion of the wound, an orientation of the at least one sensor, or a location of the at least one sensor on the wound. The at least one alignment feature may be associated with a value, and the value may identify a baseline position of the alignment feature relative to the flat dressing.
The method of any preceding paragraph can also include any combination of the following features or steps described in this paragraph, as well as other features or steps described herein. The alignment feature may comprise a pH sensitive ink. The pH sensitive ink may be configured to change color in response to a pH change in the wound environment. The method may include measuring a color change of the pH sensitive ink. The at least one alignment feature may comprise two markings. Indicating the status may also include indicating that the at least one sensor is properly positioned in the wound. Indicating the status may also include indicating that the at least one sensor is not properly positioned in the wound.
In some embodiments, a wound monitoring system includes a wound dressing and a controller. The wound dressing is configured to be positioned in contact with a wound, the wound dressing including a plurality of sensors. The plurality of sensors is configured to measure a plurality of wound characteristics. The plurality of sensors includes at least one in-situ sensor configured to determine a position and/or orientation of a first sensor of the plurality of sensors in the wound. The controller includes one or more processors. The controller is configured to be communicatively coupled to at least some of the plurality of sensors. The controller is further configured to receive in-situ data from the at least one in-situ sensor, wherein the in-situ data is indicative of a position and/or orientation of a first sensor of the plurality of sensors in the wound. The controller is further configured to compare the received in-situ data to threshold in-situ data indicative of a correct position and/or orientation of a first sensor of the plurality of sensors in the wound. The controller is further configured to provide an indication that a first sensor of the plurality of sensors is properly positioned in the wound based at least on the comparison.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. In some embodiments, the plurality of sensors includes at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, or electrode. In some embodiments, the first sensor is a sensor other than a seated sensor. In some embodiments, the first sensor is the in-position sensor.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. In some embodiments, the controller is further configured to determine a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on the received in-situ data and a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or wound. In some embodiments, the relationship comprises at least a known position and/or orientation offset between the first sensor and the second sensor.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. In some embodiments, at least some of the plurality of sensors are configured to communicate with each other and/or co-register, and wherein the controller is configured to provide the indication also based on co-registration data. In some embodiments, at least one of the plurality of sensors comprises an adjustable sensor setting, and wherein the adjustable sensor setting is configured to be adjusted based at least in part on the received seating data. In some embodiments, the wound dressing is configured to deliver negative pressure to the wound.
In some embodiments, there is provided a kit comprising a wound dressing of the features of any of the preceding paragraphs and a negative pressure source configured to fluidly connect to the wound dressing.
In some embodiments, a method of operating a wound monitoring system includes a wound dressing including a plurality of sensors configured to measure a plurality of wound characteristics. The method includes receiving in-situ data from at least one in-situ sensor positioned in the wound dressing. The in-situ data is indicative of a position and/or orientation of a first sensor of the plurality of sensors in the wound. The method further includes comparing the received in-situ data to threshold in-situ data indicative of a correct position and/or orientation of a first sensor of the plurality of sensors in the wound. The method further includes providing an indication that a first sensor of the plurality of sensors is properly positioned in the wound based at least on the comparison. In some embodiments, the controller of the wound monitoring system performs the method.
The method of any preceding paragraph can also include any combination of the following steps or features described in this paragraph, as well as other steps or features described herein. In some embodiments, the plurality of sensors includes at least one nanosensor, thermistor, conductivity sensor, Sp02 sensor, pH sensor, color sensor, optical sensor, or electrode. In some embodiments, the first sensor is a sensor other than a seated sensor. In some embodiments, the first sensor is the in-position sensor.
The method of any preceding paragraph can also include any combination of the following steps or features described in this paragraph, as well as other steps or features described herein. In some embodiments, the method may further comprise determining a position and/or orientation of a second sensor of the plurality of sensors in the wound based at least on the received in-situ data and a relationship between the position and/or orientation of the first and second sensors in the wound dressing and/or wound. In some embodiments, the relationship comprises at least a known position and/or orientation offset between the first sensor and the second sensor. In some embodiments, at least some of the plurality of sensors are configured to communicate and/or co-register with each other, the method further comprising providing the indication further based on co-registration data.
The method of any preceding paragraph can also include any combination of the following steps or features described in this paragraph, as well as other steps or features described herein. In some embodiments, at least one of the plurality of sensors includes an adjustable sensor setting, and the method further comprises adjusting the adjustable sensor setting based at least in part on the received seating data. In some embodiments, the method further comprises delivering negative pressure to the wound.
In some embodiments, a wound monitoring system includes a wound dressing and a positioning sensing device. The wound dressing is configured to be positioned in contact with a wound. The wound dressing includes a plurality of sensors configured to measure a plurality of wound characteristics. The wound dressing further includes at least one marker positioned on the wound dressing. The at least one marking comprises a pH sensitive ink. The positioning sensing device includes a sensor and a controller. The controller includes one or more processors. The controller is configured to be communicatively coupled to the sensor and is further configured to determine a position and/or orientation of the at least one marker relative to the wound based at least in part on data received from the sensor. The controller is further configured to determine a position and/or orientation of at least one sensor of a plurality of sensors of the wound dressing in the wound based at least in part on the determined position and/or orientation of the at least one marker. The controller is also configured to provide an indication of a positional status of the at least one sensor relative to the wound.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. In some embodiments, the sensor of the positioning sensing device comprises at least one of an optical pH sensor or a scanner. In some embodiments, the data received from the sensor comprises at least one of: an angle of the at least one mark relative to the position sensing device, an angle of the at least one mark relative to a trajectory of a scanning beam of the position sensing device, a distance between the at least one mark and the position sensing device, a size corresponding to the at least one mark, a tilt corresponding to the at least one mark, or an angular amount corresponding to a parallax of the at least one mark.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. In some embodiments, the at least one indicia comprises at least one of a bar code, a number, a letter, an alphanumeric code, a standard shape, an irregular shape, or a logo. In some embodiments, the position and/or orientation of the at least one marker relative to the wound comprises at least one of: a depth of the at least one sensor in the wound, a distance of the at least one sensor from a portion of the wound, an orientation of the at least one sensor, or a location of the at least one sensor on the wound. In some embodiments, the at least one marker is associated with a value, and the value is capable of identifying a baseline position of the marker relative to a flat dressing.
The system of any preceding paragraph can also include any combination of the following features described in this paragraph, as well as other features described herein. In some embodiments, the pH sensitive ink comprises at least one of a pH sensitive ink, dye, or pigment and is configured to change color in response to a change in pH in the wound environment. In some embodiments, the controller of the position sensing device is further configured to measure a color change of the pH sensitive ink. In some embodiments, the at least one marker comprises two markers. In some embodiments, the status comprises an indication that the at least one sensor is properly positioned in the wound. In some embodiments, the status comprises an indication that the at least one sensor is not properly positioned in the wound.
In some embodiments, a method of operating a wound monitoring system includes a wound dressing. The wound dressing includes a plurality of sensors configured to measure a plurality of wound characteristics, and the wound dressing further includes indicia positioned on the wound dressing. The method includes receiving, from a positioning sensing device, in-situ data corresponding to at least one marker positioned on a wound dressing. The at least one marking comprises a pH sensitive ink. The wound dressing is in contact with a wound of a patient and includes a plurality of sensors configured to measure a plurality of wound characteristics. The method further includes determining a position and/or orientation of the at least one marker relative to the wound based at least in part on the received seating data. The method further includes determining a position and/or orientation of at least one sensor of a plurality of sensors of the wound dressing in the wound based at least in part on the determined position and/or orientation of the at least one marker. The method further comprises indicating a status of a position and/or orientation of the at least one sensor in the wound.
The method of any preceding paragraph can also include any combination of the following steps or features described in this paragraph, as well as other steps or features described herein. In some embodiments, the sensor of the positioning sensing device comprises at least one of an optical pH sensor or a scanner. In some embodiments, the data received from the sensor comprises at least one of: an angle of the at least one mark relative to the position sensing device, an angle of the at least one mark relative to a trajectory of a scanning beam of the position sensing device, a distance between the at least one mark and the position sensing device, a size corresponding to the at least one mark, a tilt corresponding to the at least one mark, or an angular amount corresponding to a parallax of the at least one mark.
The method of any preceding paragraph can also include any combination of the following steps or features described in this paragraph, as well as other steps or features described herein. In some embodiments, the at least one indicia comprises at least one of a bar code, a number, a letter, an alphanumeric code, a standard shape, an irregular shape, or a logo. In some embodiments, the position and/or orientation of the at least one marker relative to the wound comprises at least one of: a depth of the at least one sensor in the wound, a distance of the at least one sensor from a portion of the wound, an orientation of the at least one sensor, or a location of the at least one sensor on the wound. In some embodiments, the at least one marker is associated with a value, and the value is capable of identifying a baseline position of the marker relative to a flat dressing.
The method of any preceding paragraph can also include any combination of the following steps or features described in this paragraph, as well as other steps or features described herein. In some embodiments, the pH sensitive ink is configured to change color in response to a pH change in the wound environment. In some embodiments, the method further comprises measuring a color change of the pH sensitive ink. In some embodiments, the at least one marker comprises two markers. In some embodiments, the method further comprises indicating that the at least one sensor is properly positioned in the wound. In some embodiments, the method further comprises indicating that the at least one sensor is not properly positioned in the wound.
Any features, components, or details of any arrangement or embodiment disclosed in the present application, including but not limited to any pump embodiment and any negative pressure wound therapy embodiment disclosed below, may be interchangeably combined with any other feature, component, or detail of any arrangement or embodiment disclosed herein to form new arrangements and embodiments.
Drawings
Fig. 1A illustrates a negative pressure wound therapy system according to some embodiments;
fig. 1B illustrates a wound dressing according to some embodiments;
fig. 1C illustrates a negative pressure wound therapy system employing a flexible fluid connector and a wound dressing capable of absorbing and storing wound exudate, according to some embodiments;
fig. 1D illustrates a negative pressure wound therapy system employing a flexible fluid connector and a wound dressing capable of absorbing and storing wound exudate, according to some embodiments;
fig. 1E illustrates a negative pressure wound therapy system employing a flexible fluid connector and a wound dressing capable of absorbing and storing wound exudate, according to some embodiments;
fig. 1F illustrates a negative pressure wound therapy system according to some embodiments;
fig. 1G illustrates a wound treatment system for use without negative pressure, employing a wound dressing capable of absorbing and storing wound exudate, according to some embodiments;
FIG. 2 illustrates a sensor array showing sensor placement incorporated into a wound dressing, according to some embodiments;
FIG. 3A illustrates a flexible sensor array including a sensor array portion, a tail portion, and connector pad end portions, according to some embodiments;
FIG. 3B illustrates a flexible circuit board with different sensor array geometries according to some embodiments;
FIG. 3C shows a
fig. 3D illustrates a flexible sensor array incorporated into a perforated wound contact layer, in accordance with some embodiments;
FIG. 3E illustrates a control module according to some embodiments;
4A-C illustrate an embodiment of a monitoring or therapy system having a plurality of alignment features for assisting in the proper placement of a wound dressing on a wound;
fig. 5 illustrates a cross-section of a wound dressed with a wound filler material having a plurality of incorporated sensors or sensor packs according to some embodiments;
FIG. 6A illustrates a system having a sensor strip positioned within a wound, according to some embodiments;
FIG. 6B illustrates a system having a sensor strip positioned within a wound, according to some embodiments; and
fig. 7 illustrates a monitoring or treatment system utilizing pH sensitive inks on a wound dressing according to some embodiments.
Detailed Description
Embodiments disclosed herein relate to apparatuses and methods for monitoring and treating biological tissue with a substrate implementing a sensor. The embodiments disclosed herein are not limited to treating or monitoring a particular type of tissue or lesion, and indeed, the techniques of implementing sensors disclosed herein are broadly applicable to any type of therapy that may benefit from implementing the substrate of the sensor. Some embodiments utilize healthcare provider dependent sensors and data acquisition to make diagnostic and patient management decisions.
Some embodiments disclosed herein relate to the use of sensors mounted on or embedded within a substrate, the sensors being configured for treating intact and damaged human or animal tissue. Such sensors may collect information about surrounding tissue and transmit such information to a computing device or caregiver for further processing. In certain embodiments, such sensors may be attached to the skin anywhere on the body, including areas that monitor arthritis, temperature, or other areas that may be prone to problems and require monitoring. The sensors disclosed herein may also incorporate markers, such as radiopaque markers, to indicate the presence of the device, for example, prior to performing MRI or other techniques.
The sensor embodiments disclosed herein may be used in conjunction with apparel. Non-limiting examples of apparel for use with embodiments of the sensors disclosed herein include shirts, pants, trousers, skirts, undergarments, coats, gloves, shoes, hats, and other suitable clothing. In certain embodiments, the sensor embodiments disclosed herein may be welded into or laminated into a particular garment. The sensor embodiments may be printed directly onto the garment and/or embedded into the fabric. Breathable printable materials, such as microporous films, may also be suitable.
The sensor embodiments disclosed herein may be incorporated into, for example, a cushion or mattress within a hospital bed to monitor patient characteristics, such as any of the characteristics disclosed herein. In certain embodiments, disposable membranes containing such sensors may be placed on hospital bedding and removed/replaced as needed.
In some implementations, the sensor embodiments disclosed herein can incorporate energy harvesting such that the sensor embodiments are self-sustaining. For example, energy may be harvested from a thermal energy source, a kinetic energy source, a chemical gradient, or any suitable energy source.
The sensor embodiments disclosed herein may be used in rehabilitation devices and treatments, including sports medicine. For example, the sensor embodiments disclosed herein may be used with stents, sleeves, wraps, supports, and other suitable items. Similarly, the sensor embodiments disclosed herein may be incorporated into sporting equipment, such as helmets, sleeves, and/or pads. For example, such sensor embodiments may be incorporated into protective helmets to monitor characteristics such as acceleration, which may be used for concussion diagnostics.
The sensor embodiments disclosed herein may be used with surgical devices (e.g., the NAVIO surgical system manufactured by Smith & Nephew). In embodiments, sensor embodiments disclosed herein may communicate with such surgical devices to guide the placement of the surgical devices. In some embodiments, sensor embodiments disclosed herein may monitor blood flow to or from a potential surgical site or ensure that there is no blood flow to the surgical site. Additional surgical data may be acquired to help prevent scarring and monitor areas away from the affected area.
To further assist in surgical techniques, the sensors disclosed herein may be incorporated into surgical drapes to provide information about the tissue under the drape that may not be immediately visible to the naked eye. For example, a sensor-embedded flexible drape may have sensors advantageously positioned to provide improved area-focused data acquisition. In certain embodiments, the sensor embodiments disclosed herein may be incorporated into the boundary or interior of a drape to create a fence to limit/control the surgical field.
Sensor embodiments as disclosed herein may also be used for pre-operative assessment. For example, such sensor embodiments may be used to gather information about potential surgical sites, for example, by monitoring possible incision sites of the skin and underlying tissue. For example, the level of perfusion or other suitable characteristic may be monitored at the surface of the skin and deeper within the tissue to assess whether an individual patient is likely to be at risk for surgical complications. Sensor embodiments, such as those disclosed herein, may be used to assess the presence of a microbial infection and provide an indication of the use of an antimicrobial agent. In addition, the sensor embodiments disclosed herein may collect further information in deeper tissues, such as identifying pressure sore lesions and/or adipose tissue levels.
The sensor embodiments disclosed herein may be used for cardiovascular monitoring. For example, such sensor embodiments may be incorporated into a flexible cardiovascular monitor that may be placed against the skin to monitor characteristics of the cardiovascular system and communicate such information to another device and/or caregiver. For example, such devices may monitor pulse rate, blood oxygenation, and/or electrical activity of the heart. Similarly, the sensor embodiments disclosed herein may be used in neurophysiological applications, for example, monitoring electrical activity of neurons.
The sensor embodiments disclosed herein may be incorporated into implantable devices, such as implantable orthopedic implants, including flexible implants. Such sensor embodiments may be configured to gather information about the implant site and transmit that information to an external source. In some embodiments, an internal source may also power such implants.
The sensor embodiments disclosed herein may also be used to monitor biochemical activity on or below the surface of the skin, such as lactose accumulation in muscle or sweat production on the surface of the skin. In some embodiments, other characteristics may be monitored, such as glucose concentration, urine concentration, tissue pressure, skin temperature, skin surface conductivity, skin surface resistivity, skin hydration, skin maceration, and/or skin tearing.
The sensor embodiments disclosed herein may be incorporated into an ear-nose-throat (ENT) application. For example, such sensor embodiments may be used to monitor recovery from ENT-related procedures, e.g., wound monitoring within the sinus tract.
As described in more detail below, sensor embodiments disclosed herein can encompass sensor printing techniques with encapsulation (e.g., encapsulation with a polymer film). Such membranes may be constructed using any of the polymers (e.g., polyurethanes) described herein. The packaging of the sensor embodiments may provide water resistance to the electronics and protection from localized tissue, localized fluids, and other potential sources of damage.
In certain embodiments, the sensors disclosed herein may be incorporated into an organ protection layer, as disclosed below. The sensor-embedded organ protection layer can protect the organ of interest and confirm that the organ protection layer is in place and provide protection. Furthermore, the organ protection layer of the embedded sensor may be used to monitor the underlying organ, for example by monitoring blood flow, oxygenation and other suitable markers of organ health. In some embodiments, the organ protection layer implementing the sensor may be used to monitor the transplanted organ, for example, by monitoring the fat and muscle content of the organ. Furthermore, the organ protection layer implementing the sensor may be used to monitor the organ during and after transplantation (e.g., during rehabilitation of the organ).
The sensor embodiments disclosed herein may be incorporated into a wound treatment (disclosed in more detail below) or various other applications. Non-limiting examples of additional applications of the sensor embodiments disclosed herein include: monitoring and treatment of intact skin, cardiovascular applications (e.g., monitoring blood flow), orthopedic applications (e.g., monitoring limb movement and bone repair), neurophysiological applications (e.g., monitoring electrical impulses), and any other tissue, organ, system, or condition that may benefit from improved monitoring of an implemented sensor.
Wound treatment
Some embodiments disclosed herein relate to wound therapy for the human or animal body. Thus, any reference herein to a wound may refer to a wound on a human or animal body, and any reference herein to a body may refer to a human or animal body. Embodiments of the disclosed technology may relate to preventing or minimizing damage to physiological or living tissue, or to treating a damaged tissue wound (such as a wound described herein) with or without reduced pressure, including, for example, negative pressure sources and wound dressing components and devices. Devices and components comprising the wound covering and filler material or inner layer (if present) are sometimes referred to herein collectively as dressings. In some embodiments, the wound dressing may be provided for use without reducing pressure.
Some embodiments disclosed herein relate to wound therapy for the human or animal body. Thus, any reference herein to a wound may refer to a wound on a human or animal body, and any reference herein to a body may refer to a human or animal body. Embodiments of the disclosed technology may relate to preventing or minimizing damage to physiological or living tissue, or to the treatment of damaged tissue (e.g., wounds as described herein).
As used herein, the expression "wound" may include damage to living tissue, typically skin that is cut or ruptured, that may result from cutting, pounding, or other impact. The wound may be a chronic or acute injury. Acute wounds occur as a result of surgery or trauma. They undergo various stages of healing within a predicted time frame. Chronic wounds usually begin with acute wounds. Acute wounds may become chronic wounds when they do not follow the healing phase leading to prolonged recovery. It is believed that the transition from acute to chronic wounds may be due to an impaired immune system of the patient.
Chronic wounds may include, for example: venous ulcers (such as those present in the legs), which account for a large portion of chronic wounds and primarily affect the elderly; diabetic ulcers (e.g., foot or ankle ulcers); peripheral arterial disease; pressure ulcers, or Epidermolysis Bullosa (EB).
Examples of such wounds include, but are not limited to, abdominal wounds or other large or incised wounds that result from either surgery, trauma, sternotomy, fasciotomy, or other conditions, dehiscent wounds, acute wounds, chronic wounds, subacute and dehiscent wounds, traumatic wounds, flap and skin grafts, lacerations, abrasions, contusions, burns, diabetic ulcers, pressure ulcers, stoma, surgical wounds, traumatic ulcers, venous ulcers, and the like.
Wounds may also include deep tissue damage. Deep tissue damage is a term proposed by the national pressure sore advisor group (NPUAP) to describe a unique form of pressure ulcers. Clinicians have used these terms to describe these ulcers for many years, such as purple pressure sores, ulcers that may worsen and contused in the bony prominence.
Wounds may also include tissue at risk of becoming a wound as discussed herein. For example, the at-risk tissue may include tissue on a bony protrusion (with risk of deep tissue damage/invasion) or possibly preoperative tissue (e.g., knee tissue) that may be resected (e.g., for joint replacement/surgical alteration/reconstruction).
Some embodiments relate to methods of treating wounds using the techniques disclosed herein in combination with one or more of: advanced footwear, turning the patient, debriding (e.g., debriding a diabetic foot ulcer), treating infection, systemic mixing (systemix), antimicrobial, antibiotic, surgery, removing tissue, affecting blood flow, physiotherapy, exercise, bathing, nutrition, hydration, nerve stimulation, ultrasound, electrical stimulation, oxygen therapy, microwave therapy, the active agent ozone, antibiotic, antimicrobial, and the like.
Alternatively or additionally, the wound may be treated with topical negative pressure and/or traditional advanced wound care, which is not assisted with applied negative pressure (also referred to as non-negative pressure therapy).
Advanced wound care may include the use of absorbent dressings, occlusive dressings, the use of antimicrobial and/or debriding agents in wound dressings or appendages, pads (e.g., cushioning or compression therapy, such as padding or bandages), and the like.
In some embodiments, the treatment of these wounds may be performed using traditional wound care, wherein a dressing may be applied to the wound to facilitate and promote wound healing.
Some embodiments relate to a method of manufacturing a wound dressing, comprising providing a wound dressing as disclosed herein.
Wound dressings that may be used in conjunction with the disclosed techniques include any known in the art. The technique is applicable to negative pressure therapy treatment as well as non-negative pressure therapy treatment.
In some embodiments, the wound dressing includes one or more absorbent layers. The absorbent layer may be a foam or a superabsorbent.
In some embodiments, the wound dressing may include a dressing layer comprising a polysaccharide or modified polysaccharide, polyvinylpyrrolidone, polyvinyl alcohol, polyvinyl ether, polyurethane, polyacrylate, polyacrylamide, collagen, or gelatin or mixtures thereof. Dressing layers comprising the listed polymers are known in the art as being useful for forming wound dressing layers for negative pressure therapy or non-negative pressure therapy.
In some embodiments, the polymer matrix may be a polysaccharide or a modified polysaccharide.
In some embodiments, the polymer matrix may be cellulose. The cellulosic material may comprise a hydrophilically modified cellulose, such as methyl cellulose, carboxymethyl cellulose (CMC), carboxymethyl cellulose (CEC), ethyl cellulose, propyl cellulose, hydroxyethyl cellulose, hydroxypropyl methyl cellulose, carboxyethyl cellulose sulfate, cellulose alkyl sulfonic acid, or mixtures thereof.
In some embodiments, the cellulosic material may be a cellulose alkyl sulfonate. The alkyl moiety of the alkyl sulfonate substituent may have an alkyl group having 1 to 6 carbon atoms, such as methyl, ethyl, propyl, or butyl. The alkyl moiety may be branched or unbranched and thus a suitable propyl sulfonate substituent may be 1-or 2-methyl-ethyl sulfonate. The butyl sulfonate substituent may be 2-ethyl sulfonate, 2, 2-dimethyl-ethyl sulfonate, or 1, 2-dimethyl-ethyl sulfonate. The alkyl sulfonate substituent may be ethyl sulfonate. Cellulose alkyl sulfonates are described in WO10061225, US2016/114074, US2006/0142560 or US 5,703,225, the disclosures of which are hereby incorporated by reference in their entirety.
The cellulose alkyl sulfonate may have varying degrees of substitution, chain length of the cellulose backbone structure, and structure of the alkyl sulfonate substituent. Solubility and absorption depend strongly on the degree of substituents: as the degree of substituents increases, the cellulose alkyl sulfonate becomes more and more soluble. It follows that as the solubility increases, the absorption increases.
In some embodiments, the wound dressing further comprises a top layer or cover layer.
The thickness of the wound dressing disclosed herein may be between 1mm to 20mm, or 2mm to 10mm, or 3mm to 7 mm.
In some embodiments, the disclosed techniques may be used in conjunction with non-negative pressure dressings. A non-negative pressure wound dressing suitable for providing protection at a wound site may comprise:
an absorbent layer for absorbing wound exudate and
a masking element for at least partially masking the view of wound exudate absorbed by the absorbent layer in use.
The shading element may be partially translucent.
The masking element may be a masking layer.
The non-negative pressure wound dressing may also include an area in or near the masking element for viewing the absorbent layer. For example, the shading element layer may be disposed over a central region of the absorbing layer and not over a border region of the absorbing layer. In some embodiments, the masking element is provided with or coated with a hydrophilic material.
The shading elements may comprise a three-dimensional knitted spacer fabric. Spacer fabrics are known in the art and may include a knitted spacer fabric layer.
The shading element may further comprise an indicator for indicating that the dressing needs to be changed.
In some embodiments, the shading element is provided as a layer at least partially over the absorbent layer, which layer is further away from the wound site than the absorbent layer in use.
The non-negative pressure wound dressing may also include a plurality of openings in the masking element for movement of fluid therethrough. The masking element may comprise or may be coated with a material having size exclusion properties for selectively allowing or preventing passage of molecules of a predetermined size or weight.
The shading elements may be configured to at least partially mask optical radiation having wavelengths of 600nm and less.
The shading elements may be configured to reduce light absorption by 50% or more.
The shading elements may be configured to produce CIE L values of 50 or more and optionally 70 or more. In some embodiments, the shading elements may be configured to produce CIE L values of 70 or greater.
In some embodiments, the non-negative pressure wound dressing may further comprise at least one of a wound contact layer, a foam layer, an odor control element, a pressure resistant layer, and a cover layer.
In some embodiments, a cover layer is present, and the cover layer is a translucent film. Typically, the translucent film has a moisture vapor transmission rate of 500g/m2/24 hours or greater.
The translucent film may be a bacterial barrier.
In some embodiments, a non-negative pressure wound dressing as disclosed herein comprises a wound contact layer, and an absorbent layer covers the wound contact layer. The wound contact layer carries an adhesive portion for forming a substantially fluid tight seal over the wound site.
A non-negative pressure wound dressing as disclosed herein may comprise a masking element and an absorbent layer, the absorbent layer being provided as a single layer.
In some embodiments, the non-negative pressure wound dressings disclosed herein comprise a foam layer and the masking element is of a material that includes a component that may be displaced or damaged by movement of the masking element.
In some embodiments, the non-negative pressure wound dressing includes an odor control element, and in another embodiment, the dressing does not include an odor control element. When present, the odor control element can be dispersed within or adjacent to the absorbent layer or the masking element. Alternatively, when present, the odour control element may be provided as a layer sandwiched between the foam layer and the absorbent layer.
In some embodiments, the disclosed techniques for a non-negative pressure wound dressing include a method of manufacturing a wound dressing comprising: providing an absorbent layer for absorbing wound exudate; and providing a masking element for at least partially masking the view of wound exudate absorbed by the absorbent layer in use.
In some embodiments, a non-negative pressure wound dressing may be suitable for providing protection at a wound site, including: an absorbent layer for absorbing wound exudate; and a barrier layer disposed over the absorbent layer and further from the wound-facing side of the wound dressing than the absorbent layer. The shielding layer may be disposed directly over the absorbing layer. In some embodiments, the shielding layer comprises a three-dimensional spacer fabric layer.
The barrier layer increases the area of pressure transmission applied to the dressing by 25% or more or the initial area of application. For example, the barrier layer increases the area of pressure transmission applied to the dressing by 50% or more, and optionally by 100% or more, and optionally by 200% or more.
The shielding layer may include 2 or more sub-layers, wherein a first sub-layer includes a via and another sub-layer includes a via, and the via of the first sub-layer is offset from the via of the other sub-layer.
The non-negative pressure wound dressing as disclosed herein may further comprise a permeable cover layer for allowing gas and vapor transmission therethrough, the cover layer being disposed over the barrier layer, wherein the through holes of the cover layer are offset from the through holes of the barrier layer.
Non-negative pressure wound dressings may be suitable for treating pressure sores.
A more detailed description of the non-negative pressure dressing disclosed above is provided in WO2013007973, the entire content of which is hereby incorporated by reference.
In some embodiments, the non-negative pressure wound dressing may be a multi-layer wound dressing comprising: a fibrous absorbent layer for absorbing exudate from the wound site; and a support layer configured to reduce shrinkage of at least a portion of the wound dressing.
In some embodiments, the multilayer wound dressings disclosed herein further comprise a liquid impermeable film layer, wherein the support layer is positioned between the absorbent layer and the film layer.
The support layer disclosed herein may comprise a mesh. The web may include a geometric structure having a plurality of generally geometric apertures extending therethrough. The geometric structures may, for example, include a plurality of bosses substantially evenly spaced and joined by the polymeric strands to form generally geometric pores between the polymeric strands.
The mesh may be formed of high density polyethylene.
The apertures may have an area of 0.005mm2 to 0.32mm 2.
The support layer may have a tensile strength of 0.05Nm to 0.06 Nm.
The support layer may have a thickness of 50 μm to 150 μm.
In some embodiments, the support layer is located immediately adjacent to the absorbent layer. Typically, the support layer is bonded to the fibers in the top surface of the absorbent layer. The support layer may further comprise a tie layer, wherein the support layer is thermally laminated to the fibers in the absorbent layer through the tie layer. The tie layer may comprise a low melting point adhesive, such as an ethylene vinyl acetate adhesive.
In some embodiments, the multilayer wound dressings disclosed herein further comprise an adhesive layer attaching the film layer to the support layer.
In some embodiments, the multilayer wound dressings disclosed herein further comprise a wound contact layer positioned adjacent to the absorbent layer to be positioned adjacent to the wound. The multilayer wound dressing may further comprise a fluid transport layer between the wound contact layer and the absorbent layer for transporting exudate away from the wound into the absorbent layer.
A more detailed description of the multi-layer wound dressing disclosed above is provided in uk patent application no GB1618298.2 filed on 28/10/2016, the entire contents of which are hereby incorporated by reference.
In some embodiments, the disclosed techniques may be included in a wound dressing comprising a vertically overlapping material comprising: a first layer of material comprising an absorbent layer and a second layer of material, wherein the first layer is comprised of at least one layer of nonwoven textile fibers folded into a plurality of folds to form a pleated structure. In some embodiments, the wound dressing further comprises a second layer of material that is temporarily or permanently attached to the first layer of material.
Typically, the vertically overlapping material has been cut.
In some embodiments, the first layer has a pleating structure with a depth determined by the pleat depth or by the cut width. The first layer material may be a moldable lightweight fiber-based material, a blend of materials or composite layers.
The first layer material may comprise one or more of fibres made from synthetic, natural or inorganic polymers, natural fibres of cellulose, proteins or mineral sources.
The wound dressing may comprise two or more vertically overlapping material absorbent layers of material stacked one on top of the other, wherein the two or more layers have the same or different densities or compositions.
In some embodiments, the wound dressing may include only one absorbent layer of material that vertically overlaps the material.
The layer of absorbent material is a blend of natural or synthetic, organic or inorganic fibers and binder fibers, or bicomponent fibers, typically PET, having a low melt temperature PET coating to soften at a particular temperature and act as a binder throughout the blend.
In some embodiments, the absorbent material layer may be a blend of 5 to 95% thermoplastic polymer, and 5 to 95% by weight cellulose or a derivative thereof.
In some embodiments, the wound dressings disclosed herein have a second layer comprising a foam or dressing fixture.
The foam may be a polyurethane foam. The polyurethane foam may have an open or closed cell structure.
The dressing fixture may include a bandage, tape, gauze, or backing layer.
In some embodiments, a wound dressing as disclosed herein comprises a layer of absorbent material directly connected to a second layer by lamination or by an adhesive, and the second layer is connected to a dressing anchor layer. The adhesive may be an acrylic adhesive or a silicone adhesive.
In some embodiments, a wound dressing as disclosed herein further comprises a layer of superabsorbent fibers or viscose fibers or polyester fibers.
In some embodiments, a wound dressing as disclosed herein further comprises a backing layer. The backing layer may be a transparent or opaque film. Typically, the backing layer comprises a polyurethane film (typically a transparent polyurethane film).
A more detailed description of the multi-layer wound dressing disclosed above is provided in uk patent applications with application number GB1621057.7 filed on 12.12.2016 and application number GB1709987.0 filed on 22.6.2017, the entire contents of which are hereby incorporated by reference.
In some embodiments, a non-negative pressure wound dressing may include an absorbent component for a wound dressing, the component including a wound contact layer comprising gel-forming fibers bonded to a foam layer, wherein the foam layer is directly bonded to the wound contact layer by an adhesive, a polymer-based melt layer, by flame lamination, or by ultrasound.
The absorbent member may be in the form of a sheet.
The wound contact layer may comprise a woven or non-woven or knitted gel-forming fibrous layer.
The foam layer may be an open cell foam or a closed cell foam, typically an open cell foam. The foam layer is a hydrophilic foam.
The wound dressing may include features forming islands in direct contact with the wound surrounded by a perimeter of adhesive adhering the dressing to the wound. The adhesive may be a silicone or acrylic adhesive, typically a silicone adhesive.
The wound dressing may be covered by a film layer on the surface of the dressing furthest from the wound.
A more detailed description of a wound dressing of this type above is provided in EP2498829, the entire content of which is hereby incorporated by reference.
In some embodiments, a non-negative pressure wound dressing may comprise a multi-layer wound dressing for use on a wound that produces high levels of exudate, wherein the dressing comprises: a transmission layer having an MVTR of at least 300gm2/24 hours; an absorbent core comprising gel-forming fibers capable of absorbing and retaining exudates; a wound contact layer comprising gel-forming fibres which transport exudate to an absorbent core and a bonding layer positioned on the absorbent core, the absorbent core and wound contact layer limiting lateral diffusion of exudate from the dressing to the wound area.
The wound dressing may be capable of handling at least 6g (or 8g and 15g) of fluid per 10cm2 of dressing over a 24 hour period.
The wound dressing may comprise gel-forming fibres, which are chemically modified cellulose fibres in the form of a fabric. The fibers may include carboxymethyl cellulose fibers, typically sodium carboxymethyl cellulose fibers.
The wound dressing may comprise a wound contact layer, wherein the lateral wicking rate is from 5 mm/min to 40 mm/min. The wound contact layer may have a fibre density of between 25gm2 and 55gm2, for example 35gm 2.
The absorbent core may have an exudate absorbency of at least 10g/g, and typically a lateral wicking rate of less than 20 mm/min.
The absorbent core may have a blend in the range of up to 25% by weight of cellulosic fibers and 75% to 100% by weight of gel-forming fibers.
Alternatively, the absorbent core may have a blend in the range of up to 50% by weight of cellulosic fibres and from 50% to 100% by weight of gel-forming fibres. For example, the blend is in the range of 50% by weight of cellulosic fibers and 50% by weight of gel-forming fibers.
The density of the fibers in the absorbent core may be between 150gm2 and 250gm2, or about 200gm 2.
The wound dressing may have a shrinkage when wetted of less than 25% or 15% of its original size/dimension.
The wound dressing may include a transmission layer, and the layer is a foam. The transfer layer may be a polyurethane foam laminated to a polyurethane film.
The wound dressing may comprise one or more layers selected from the group comprising a dissolvable drug film layer, an odour absorbing layer, a diffusion layer and an additional adhesive layer.
The wound dressing may be 2mm and 4mm thick.
The wound dressing may be characterized by a bonding layer bonding the absorbent core to an adjacent layer. In some embodiments, the bonding layer may be positioned on the wound-facing side of the absorbent core or the non-wound-facing side of the absorbent core. In some embodiments, the bonding layer is positioned between the absorbent core and the wound contact layer. The bonding layer is a polyamide web.
A more detailed description of a wound dressing of this type above is provided in EP1718257, the entire content of which is hereby incorporated by reference.
In some embodiments, the non-negative pressure wound dressing may be a compression bandage. Compression bandages are known for the treatment of edema and other venous and lymphatic disorders such as the lower limbs.
Compression bandage systems typically employ multiple layers, including a filler layer between the skin and one or several compression layers. Compression bandages are useful, for example, in treating wounds such as venous leg ulcers.
In some embodiments, the compression bandage may include a bandage system comprising a skin-facing inner layer comprising a first foam layer and a second layer of an absorbent nonwoven web, and an elastic outer layer, the inner and outer layers being sufficiently long to be capable of wrapping around a limb of a patient. WO99/58090, the entire contents of which are hereby incorporated by reference, discloses a compression bandage of this type.
In some embodiments, a compression bandage system comprises: a) an inner elongated skin-facing elastic bandage comprising: (i) an elongated elastomeric substrate, and
(ii) an elongate foam layer adhered to one face of the substrate and extending 33% or more across the face of the substrate in a transverse direction and 67% or more across the face of the substrate in a longitudinal direction; and b) an outer elongate self-adhesive elastic bandage; the bandage having a compressive force when extended; wherein, in use, the foam layer of the inner bandage faces the skin and the outer bandage covers the inner bandage. WO2006/110527 discloses a compression bandage of this type, the entire content of which is hereby incorporated by reference.
In some embodiments, other compression bandage systems, such as those disclosed in US 6,759,566 and US2002/0099318, the entire contents of each of which are hereby incorporated by reference.
Negative pressure wound dressing
In some embodiments, such wounds may be treated using negative pressure wound therapy, wherein reduced or negative pressure may be applied to the wound to facilitate and promote healing of the wound. It will also be appreciated that the wound dressings and methods as described herein may be applied to other parts of the body and are not necessarily limited to wound treatment.
It should be understood that embodiments of the present disclosure are generally suitable for use in a topical negative pressure ("TNP") therapy system. Briefly, negative pressure wound therapy helps to close and heal "difficult to heal" wounds of various morphologies by reducing tissue edema, promoting blood flow and granulation tissue formation, removing excess exudate, and may reduce bacterial load (thereby reducing infection risk). In addition, the therapy allows the wound to be less disturbed, resulting in faster healing. TNP therapy systems may also assist in the healing of surgically closed wounds by removing fluid and by helping to stabilize the tissue in close proximity to the closure site. Additional beneficial uses of TNP therapy may be found in grafts and flaps where removal of excess fluid is important and where close proximity of the graft to the tissue is required to ensure tissue viability.
Negative pressure therapy may be used to treat open or chronic wounds that are too large to spontaneously close or otherwise heal by applying negative pressure to the wound site. Topical Negative Pressure (TNP) therapy or Negative Pressure Wound Therapy (NPWT) involves placing a cover that is impermeable or semi-permeable to fluids over the wound, sealing the cover to the patient tissue surrounding the wound using various means, and connecting a source of negative pressure (such as a vacuum pump) to the cover in a manner that causes negative pressure to be created and maintained under the cover. It is believed that this negative pressure promotes wound healing by promoting the formation of granulation tissue at the wound site and assisting the body's normal inflammatory process while removing excess fluid that may contain adverse cytokines or bacteria.
Some of the dressings used in NPWT may include many different types of materials and layers, for example, gauze, pads, foam pads, or multi-layer wound dressings. One example of a multilayer wound dressing is the PICO dressing available from Smith & Nephew, which includes a wound contact layer and a superabsorbent layer beneath a backing layer to provide a can-less system for treating wounds with NPWT. The wound dressing may be sealed to a suction port that provides a connection to a length of tubing that may be used to pump fluid out of the dressing or to transfer negative pressure from the pump to the wound dressing. Additionally, RENASYS-F, RENASYS-G, RENASYS-AB and RENASYS-F/AB, available from Smith & Nephew, are additional examples of NPWT wound dressings and systems. Another example of a multilayer wound dressing is the ALLEVYN Life dressing available from Smith & Nephew, which includes a moist wound environment dressing for treating the wound without the use of negative pressure.
As used herein, a reduced or negative pressure level (e.g., -X mmHg) represents a pressure level relative to normal ambient atmospheric pressure, which may correspond to 760mmHg (or 1atm, 29.93inHg, 101.325kPa, 14.696psi, etc.). Therefore, the negative pressure value-X mmHg reflects an absolute pressure lower than 760mmHg by X mmHg, or in other words, reflects an absolute pressure (760-X) mmHg. Further, a negative pressure "lower" or "less" than X mmHg corresponds to a pressure closer to atmospheric pressure (e.g., -40mmHg is less than-60 mmHg). A negative pressure "higher" or "greater" than-X mmHg corresponds to a pressure further away from atmospheric pressure (e.g., -80mmHg is greater than-60 mmHg). In some embodiments, local ambient atmospheric pressure is used as a reference point, and such local atmospheric pressure may not necessarily be, for example, 760 mmHg.
The negative pressure range of some embodiments of the present disclosure may be about-80 mmHg, or between about-20 mmHg and-200 mmHg. It should be noted that these pressures are based on normal ambient atmospheric pressure (which may be 760 mmHg). Therefore, in practice, about 560mmHg would be about-200 mmHg. In some embodiments, the pressure range may be between about-40 mmHg and-150 mmHg. Alternatively, pressure ranges of up to-75 mmHg, up to-80 mmHg, or above-80 mmHg may be used. In still other embodiments, a pressure range of less than-75 mmHg may be used. Alternatively, the negative pressure device may supply a pressure range in excess of about-100 mmHg, or even-150 mmHg.
In some embodiments of the wound closure devices described herein, increased wound contraction may result in increased tissue expansion in the surrounding wound tissue. This effect may be enhanced by varying the force applied to the tissue (e.g., by varying the negative pressure applied to the wound over time), possibly in combination with increased tension applied to the wound via various embodiments of the wound closure device. In some embodiments, for example, the negative pressure may be varied over time using a sine wave, a square wave, or synchronized with one or more patient physiological indicators (e.g., heart beat). Examples of such applications in which additional disclosure related to the foregoing may be found include U.S. patent No. 8,235,955 entitled "wound treatment apparatus and method" (published 2012, 8, 7); and U.S. patent No. 7,753,894 entitled "Wound cleansing apparatus with stress" published on 7/13/2010. The disclosures of both of these patents are hereby incorporated by reference in their entirety.
Embodiments OF the WOUND dressing, WOUND dressing components, WOUND TREATMENT apparatus AND METHODS described herein may also be used in combination with or in addition to those described in international application No. PCT/IB2013/001469 entitled "apparatus AND METHOD FOR NEGATIVE PRESSURE WOUND TREATMENT" (apparatus AND METHODS FOR achieving PRESSURE in WOUND TREATMENT) "filed on day 11/28 OF 2013,
Furthermore, some embodiments relating to TNP wound therapy including a wound dressing in combination with a pump or associated electronics as described herein may also be used in combination with or in addition to those described in international application PCT/EP2016/059329 entitled "PRESSURE reduction device AND method" (redended PRESSURE APPARATUS AND METHODS) "filed on 3/11/2016 at 26/2016, the disclosure of which is hereby incorporated by reference in its entirety.
NPWT System overview
Fig. 1A illustrates one embodiment of a negative or reduced pressure wound therapy (or TNP)
The
Some embodiments of
The
The
Some embodiments of the system are designed to operate without the use of a bleed liquid tank. Some embodiments may be configured to support an exudate canister. In some embodiments, configuring the
In some embodiments, the
In operation, wound
Wound dressings that may be used with the pump assembly and other embodiments of the present application include Renasys-F, Renasys-G, Renasys AB, and Pico dressings available from Smith & Nephew. Other descriptions of such wound dressings and other components of negative pressure wound therapy systems that may be used with pump assemblies and other embodiments of the present application may be found in U.S. patent publication nos. 2011/0213287, 2011/0282309, 2012/0116334, 2012/0136325, and 2013/0110058, which are incorporated by reference herein in their entirety. In other embodiments, other suitable wound dressings may be used.
Overview of wound dressing
Fig. 1B illustrates a cross-section through a wound dressing 155 according to some embodiments. Fig. 1B also illustrates a
As used herein, an upper, top or upper layer refers to the layer that is furthest from the skin or surface of the wound when the dressing is in use and positioned over the wound. Thus, a lower surface, layer, sub-layer or layer refers to the layer closest to the skin or surface of the wound when the dressing is in use and positioned over the wound.
The
Some embodiments of
A
In some embodiments, the
Although reference is made throughout this disclosure to monofilament fibers, it should be understood that multiple strand alternatives may of course be used. Thus, the top spacer fabric has a greater number of filaments in the yarns used to form it than the number of filaments that make up the yarns used to form the bottom spacer fabric layer.
This difference between the number of filaments in the spaced apart layers helps to control the flow of moisture through the transfer layer. In particular, by having a greater number of filaments in the top layer, i.e., the top layer is made of yarns having more filaments than the yarns used for the bottom layer, liquid tends to wick more along the top layer than the bottom layer. In use, this difference tends to wick liquid away from the wound bed and into the central region of the dressing where the
In some embodiments, to improve the flow of liquid through the transmission layer 226 (that is, perpendicular to the channel region formed between the top and bottom spacer layers), the 3D fabric may be treated with a dry cleaning agent (e.g., without limitation, perchloroethylene) to help remove any manufactured products, such as previously used mineral oils, fats, or waxes, that may interfere with the hydrophilic ability of the transmission layer. Subsequently, an additional manufacturing step may be performed in which the 3D spacer fabric is washed in a hydrophilic agent (such as, but not limited to, Feran Ice 30g/l available from Rudolph Group). This process step helps to ensure that the surface tension on the material is very low so that liquids such as water can enter the 3D knitted fabric once they contact the fabric. This also helps to control the flow of the liquid fouling component of any exudate.
The absorbing
The material of the
In some embodiments, the
An orifice, hole, or
In some embodiments, the
As shown in fig. 1B, an aperture or via 228 may be provided in the
The
The
As shown in fig. 1B, one embodiment of the wound dressing 155 includes an
For example, in embodiments having a
Turning now to the
Some embodiments may also include an optional second fluid passageway positioned above the
In some embodiments, the
In some embodiments, the
In some embodiments, the
It should be understood that other types of materials may be used for the
The MHM blocks liquid while allowing air to flow through the membrane. They are also highly efficient air filters that eliminate potentially infectious aerosols or particles. It is well known that a single piece MHM is an alternative to mechanical valves or vents. Accordingly, configuring the MHM may reduce product assembly costs to improve patient profits and cost/benefit ratios.
The
Wound dressing 155 may include a spacer element 215 in combination with
Similar to the embodiments of the wound dressings described above, some wound dressings include a perforated wound contact layer having a silicone adhesive on the skin-contacting side and an acrylic adhesive on the back side. A transmission layer or 3D spacer fabric mat is located above the boundary layer. The absorption layer is located above the transmission layer. The absorbent layer may comprise a super absorbent Nonwoven (NW) mat. The absorbent layer may be about 5mm across the transmission layer at the perimeter. The absorbent layer may have an aperture or through hole towards one end. The orifice may be about 10mm in diameter. The backing layer is positioned over the transmission layer and the absorbent layer. The backing layer may be a high Moisture Vapor Transmission Rate (MVTR) film coated with a pattern of acrylic adhesive. The high MVTR film and wound contact layer encapsulate the transmission layer and the absorbent layer, creating a peripheral boundary of about 20 mm. The backing layer may have a 10mm aperture overlying the aperture in the absorbent layer. A fluid connector may be attached over the well, the fluid connector including a liquid impermeable, gas permeable semi-permeable membrane (SPM) overlying the orifice.
Fig. 1C-1D illustrate an embodiment of a negative pressure
As shown in fig. 1E, the
Turning to fig. 1F, in certain embodiments, negative
In the case of wounds, in particular in the abdomen, there is a need to manage the possible complications related to the exposure of the organs and the peritoneal space, whether the wound is kept open or closed. Treatment, preferably applied using negative pressure, may be targeted to minimize the risk of infection, while promoting tissue viability and removal of harmful substances from the wound. It has been found that the application of reduced or negative pressure to a wound generally promotes faster healing, increased blood flow, decreased bacterial load, increased rate of granulation tissue formation, stimulation of fibroblast proliferation, stimulation of endothelial cell proliferation, closure of chronic open wounds, inhibition of burn penetration, and/or enhanced flap and graft attachment, among other things. Wounds that exhibit a positive response to treatment by the application of negative pressure have also been reported to include infected open wounds, decubitus ulcers, dehisced incisions, partial thickness burns, and various lesions of attached valves or grafts. Thus, applying negative pressure to the
Accordingly, certain embodiments provide for placing the
Certain embodiments of the negative
Preferably, the
The
In many applications, a container or other storage unit 115 may be interposed between the
Fig. 1G illustrates various embodiments of a wound dressing that may be used to heal a wound without negative pressure. As shown in the dressing in fig. 1G, the wound dressing may have multiple layers similar to the dressing described with reference to fig. 1C-1F, except that the dressing of fig. 1G does not include ports or fluid connectors. The wound dressing of fig. 1G may include a cover layer and a wound contact layer as described herein. The wound dressing may include various layers positioned between the wound contact layer and the cover layer. For example, the dressing may include one or more absorbent layers and/or one or more transmission layers, as described herein with reference to fig. 1C-1F. In addition, some embodiments related to WOUND therapy including WOUND dressings described herein may also be used in combination with or in addition to those described in U.S. application publication No. 2014/0249495 entitled "WOUND dressing and METHOD OF TREATMENT" (WOUND DRESSING AND METHOD OF healing) "filed on 21/5/2014, the disclosure OF which is incorporated herein by reference in its entirety, including more details related to embodiments OF WOUND dressings, WOUND dressing components and principles, and materials for WOUND dressings.
Wound dressing with sensor
A wound dressing comprising a plurality of sensors may be utilized in order to monitor the characteristics of the wound as it heals. Collecting data from both well-healed and non-well-healed wounds may provide useful insight to identify the measured object to indicate whether the wound is on the healing track.
In some embodiments, a number of sensor technologies may be used for the wound dressing or one or more components forming part of the overall wound dressing assembly. For example, as shown in fig. 2 and 3D, which describe wound
The sensor-integrated wound contact layer may be placed in contact with the wound and will allow fluid to pass through the contact layer while causing little or no damage to the tissue in the wound. The sensor-integrated wound contact layer may be made of a flexible material such as silicone and may contain antimicrobial agents or other therapeutic agents known in the art. In some embodiments, the sensor-integrated wound contact layer may comprise an adhesive that adheres to wet or dry tissue. In some embodiments, the sensor or sensor array may be incorporated into or encapsulated in other components of the wound dressing (e.g., the absorbent or spacer layer described above).
As shown in fig. 2 and 3D, five sensors may be used, including, for example, sensors for: temperature (e.g., 25 thermistor sensors in a 5 x5 array, 20mm pitch), oxygen saturation or SpO2 (e.g., 4 or 5 SpO2 sensors in a single line from the center of the wound contact layer to its edge, 10mm pitch), tissue color (e.g., 10 optical sensors in a2 x5 array, 20mm pitch; not all 5 sensors in each row of the array need to be aligned), pH (e.g., by optionally measuring the color of a pH sensitive pad using the same optical sensor as the tissue color), and conductivity (e.g., 9 conductive contacts, in a 3 x3 array, 40mm pitch). As shown in fig. 3A, the SpO2 sensors may be arranged in a single column from the center or near the center of the wound contact layer to the edge of the wound contact layer. The SpO2 sensor column may allow the sensor to measure changes between regions in the middle of a wound, at the edge or wound, or on the intact skin. In some embodiments, the wound contact layer or sensor array may be larger than the size of the wound to cover the entire surface area of the wound as well as the surrounding intact skin. The larger size of the wound contact layer and/or sensor array and plurality of sensors may provide more information about the wound area than if the sensors were placed only in the center of the wound or only in one area at a time.
The sensor may be incorporated onto a flexible circuit board formed from flexible polymers including polyamides, Polyimides (PI), polyesters, polyethylene naphthalate (PEN), Polyetherimides (PEI), along with various Fluoropolymers (FEP) and copolymers, or any material known in the art. The sensor array may be incorporated into a two-layer flex circuit. In some embodiments, the circuit board may be a multilayer flexible printed circuit. In some embodiments, these flexible circuits may be incorporated into any layer of the wound dressing. In some embodiments, the flexible circuit may be incorporated into the wound contact layer. For example, the flexible circuit may be incorporated into a wound contact layer similar to that described with reference to fig. 1B. The wound contact layer may have cuts or slits that allow one or more sensors to protrude from the lower surface of the wound contact layer and directly contact the wound area.
In some embodiments, the sensor-integrated wound contact layer may include a first wound contact layer and a second wound contact layer, with the flexible circuit board sandwiched between the two layers of wound contact layer material. The first wound contact layer has a lower surface intended to be in contact with a wound and an upper surface intended to be in contact with a flexible circuit board. The second wound contact layer has a lower surface intended to be in contact with the flexible circuit board and an upper surface intended to be in contact with the wound dressing or one or more components forming part of the overall wound dressing assembly. The upper surface of the first wound contact layer and the lower surface of the second wound contact layer may be adhered together by a flexible circuit board sandwiched between the two layers.
In some embodiments, the one or more sensors of the flexible circuit board may be completely encapsulated or covered by the wound contact layer to prevent contact with moisture or fluids in the wound. In some embodiments, the first wound contact layer may have a cut or slit that allows the one or more sensors to protrude from the lower surface and directly contact the wound area. For example, one or more SpO2 sensors as shown in fig. 3D are shown protruding from the bottom surface of the wound contact layer. In some embodiments, the SpO2 sensor may be mounted directly on the lower surface of the first wound contact layer. Some or all of the sensors and electrical or electronic components may be potted or encapsulated (e.g., rendered waterproof or liquidproof) with a polymer (e.g., a silicon or epoxy-based polymer). Encapsulation with a polymer can prevent fluid ingress and leaching of chemicals from the component. In some embodiments, the wound contact layer material may seal the component to prevent water from entering and leaching out chemicals.
In some embodiments, collecting and processing information related to a wound may use three components, including a sensor array, a control or processing module, and software. These components are described in more detail herein.
Fig. 3A illustrates a flexible sensor
FIG. 3B illustrates an embodiment of a flexible circuit board having four different
FIG. 3C illustrates in more detail the
Fig. 3D illustrates a flexible sensor array incorporated into a perforated
The connections of the sensor array may vary depending on the various sensors and sensor array designs used. In some embodiments, for example, as shown in fig. 3B, a total of 79 connections may be used to connect the components of the sensor array. The sensor array may terminate in two parallel 40-way 0.5mm pitch Flat Flex Cable (FFC) contact surfaces with terminals on the top surface designed to connect to an FFC connector, such as Molex 54104-4031.
In some embodiments, one or more of a thermistor, conductivity sensor, SpO2 sensor, or color sensor may be used on the sensor array to provide information related to the status of the wound. The sensor array and individual sensors may assist the clinician in monitoring the healing of the wound. One or more sensors may operate individually or in coordination with one another to provide data relating to the wound and wound healing characteristics.
The temperature sensor may use a thermocouple or a thermistor to measure the temperature. The thermistor may be used to measure or track the temperature of the underlying wound or the thermal environment within the wound dressing. The thermometric sensors may be calibrated, and data obtained from the sensors may be processed to provide information about the wound environment. In some embodiments, an ambient sensor that measures the ambient air temperature may also be used to help eliminate problems associated with ambient temperature excursions.
The optical sensor may be used to measure wound appearance using an RGB sensor with an illumination source, such as a red green blue transparent (RGBC) sensor or a Red Green Blue White (RGBW) sensor. In some embodiments, both the RGB sensor and the illumination source may be pressed against the skin such that the light will penetrate into the tissue and present the spectral characteristics of the tissue itself.
Light propagation in tissue can be dominated by two main phenomena (scattering and attenuation). For attenuation, as light passes through tissue, its intensity may be lost due to absorption by various components of the tissue. Blue light tends to be severely attenuated, while light at the red end of the spectrum tends to be minimally attenuated.
The scattering process may be more complex and may have various "regions" (regions) that must be considered. A first aspect of scattering is based on a comparison of the size of the scattering center with the wavelength of the incident light. If the scattering center is much smaller than the wavelength of light, Rayleigh (Rayleigh) scattering can be assumed. If the scattering center is around the wavelength of light, then a more detailed Mie scattering formula must be considered. Another factor involved in scattering light is the distance between the input and output of the scattering medium. Ballistic photon transmission is assumed if the mean free path of light (the distance between scattering events) is much greater than the distance traveled. In the case of tissue, the scattering events are about 100 microns apart, so a path distance of 1mm will effectively randomize the photon direction and the system will enter the diffuse region.
Ultra bright Light Emitting Diodes (LEDs), RGB sensors and polyester optical filters can be used as components of optical sensors to measure by tissue color differentiation. For example, since the surface color can be measured from reflected light, the color can be measured from light that first passes through the tissue for a given geometry. This may include color sensing of diffusely scattered light from an LED in contact with the skin. In some embodiments, LEDs may be used with nearby RGB sensors to detect light that has diffused through tissue. The optical sensor may be imaged with diffuse internal light or surface reflected light.
In addition, optical sensors may be used to measure autofluorescence. Autofluorescence is used because tissue absorbs light at one wavelength and emits light at another wavelength. In addition, dead tissue may not auto-fluoresce, and thus this may be a very strong indication of whether the tissue is healthy or not. Because of the blue light (or even UV light) with such a short penetration depth, UV light with, for example, a red sensitive photodiode (or some other wavelength shift band) in the vicinity can be very useful as a binary test for healthy tissue, which will auto-fluoresce at very specific wavelengths.
Conductivity sensors can be used to determine the difference between live and dead tissue, or to indicate changes in impedance due to opening a wound in diseased tissue. The conductivity sensor may include an Ag/AgCl electrode and an impedance analyzer. The conductivity sensor may be used to measure impedance changes in the wound growth area by measuring the impedance of the surrounding tissue/area. In some embodiments, the sensor array may utilize conductivity sensors to measure changes in conductivity across the peripheral electrodes due to changes in wound size or wound shape. In some embodiments, the conductivity sensor may be used in the wound bed or on the wound periphery.
In some embodiments, a pH change pad may be used as a pH sensor. A spectrometer and a broadband white light source can be used to measure the spectral response of the pH dye. Illumination and imaging may be provided on the surface of the wound dressing in contact with the wound and on the same side as the fluid application (bottom surface). Alternatively, in some embodiments, the illumination and imaging sources may be disposed on the top surface of the dressing opposite the bottom surface and away from the surface to which the fluid is applied.
In some embodiments, a pulse oximetry SpO2 sensor may be used. To measure the degree of oxidation of blood, pulsatile blood flow was observed. Pulse oximetry works by time-resolved measurements of light absorption/transmission in tissue at two different wavelengths of light. When hemoglobin is oxidized, its absorption spectrum changes relative to non-oxygenated blood. By making measurements at two different wavelengths, a ratiometric measure of the degree of blood oxygenation can be obtained.
The components in the sensor array may be connected by a plurality of connections. In some embodiments, the thermistors may be arranged in groups of five. Each thermistor has a nominal value of 10k omega and each group of five has a common ground. There are five groups of thermistors, for a total of 30 connections. In some embodiments, there may be nine conductive terminals. One connection is required for each conductive terminal, providing a total of 9 connections. In some embodiments, there may be five SpO2 sensors. Each SpO2 sensor required three connections, plus power and ground (these were independently covered), for a total of 15 connections. In some embodiments, there may be 10 color sensors. Each color sensor includes an RGB LED and an RGB photodiode. Six connections are required for each color sensor, but five of them are common to each sensor, providing a total of 15 connections. Power and ground are considered separately. In some embodiments, there may be 5 pH sensors. The pH sensor may be a color changing disk and may be sensed using the color sensor described above. Therefore, no additional connections are required for the pH sensor. There may be three power rails and seven ground return signals, providing a total of 10 common connections. In some embodiments, the sensor array may include 25 thermistors (Murata NCP15WB473E03RC), 9 conductive terminals, 5 SpO2(ADPD144RI), 10 RGB LEDs (e.g., KPTF-1616RGBC-13), 10 RGB color sensors, 10 FETs, a Printed Circuit Board (PCB), and components.
The control module may be configured to interface with the sensor array. In some embodiments, the control module may contain a power source, such as a battery, and electronics for driving the sensors. The control module may also record data at appropriate intervals and allow the data to be transferred to an external computing device, such as a Personal Computer (PC). Depending on the sensors used in the sensor array and the data collected by the sensors, the control module may be customized to have various characteristics. In some embodiments, the control module may be comfortable enough and small enough to be worn for several weeks in succession. In some embodiments, the control module may be positioned adjacent to or on the wound dressing. In some embodiments, the control module may be located at a remote location from the wound dressing and accompanying sensor array. The control module may communicate with the sensor array and the wound dressing, whether located on, near, or remote from the wound dressing, via wires or via wireless communication. In some embodiments, the control module may be adapted for use with different sensor arrays, and may enable easy replacement of the sensor arrays.
In some embodiments, the control module may include various combinations of requirements and features including, but not limited to, the features listed in table 1 below.
TABLE 1 optional features of the control Module
FIG. 3E illustrates a block diagram 330 of a control module according to some embodiments. The block diagram of the control module includes a
In some embodiments, the microprocessor may have one or more of the following features: 2.4GHz or another suitable frequency radio (integrated or external); a provided Bluetooth software stack; an SPI interface; USB (or UART for external USB drivers); I2C; 3, channel PWM; 32 GPIO; or a 6-channel ADC. In some embodiments, the device may require at least 48I/O pins or possibly more due to stack limitations. The bluetooth stack typically requires-20 kB of onboard flash memory, and thus would require at least 32 kB. In some embodiments, 64kB may be required if complex data processing is considered. The processor core may be an ARMCortex M4 or similar processor core. In some embodiments, the components may include STM32L433LC or STM32F302R8 of ST, which may require external radio, or the Kinetis KW family of NXP that includes integrated radio.
In some embodiments, the control module may include a memory component, wherein the amount of local memory depends on the sampling rate and resolution of the sensor. For example, a serial flash memory device using many manufacturers (Micron, spread) may meet an estimated data requirement of 256Mb (32 Mb).
The control module may use one or more analog switches. In some embodiments, analog switches with good on-resistance and reasonable bandwidth may be used. For example, ADG72 from Analog Device or NX3L4051HR from NXP may be used. Based on the initial system architecture, 8 of these would be needed.
The control module may include a power source, such as a battery. For example, a 300 mWh/day cell may be used. This was 2100mWh for 7 days. This may be provided by: 10 days, non-rechargeable, ER14250(14.5mm diameter × 25mm) LiSOCl2 cell; or 7 days, rechargeable, Li 14500(14.5mm diameter × 500mm) lithium ion battery.
The control module may comprise a Real Time Clock (RTC). The RTC may be selected from any RTC device with a crystal. The control module may also include various resistors, capacitors, connectors, charge controllers, and other power sources.
The PCB of the control module may be 4-layer board, approximately 50mm by 20mm, or 25mm by 40 mm. The type of PCB used depends largely on the connection requirements for the sensor array.
The housing of the control module may be a two-part moulding with a clip feature to allow easy access for replacement of the sensor array or battery.
Data collected by the sensor array may be passed through the control module and processed by host software. The software may be executed on a processing device. The processing device may be a PC, tablet, smartphone or other computer capable of running host software. The processing device executing the software may communicate with the control module via wires or via wireless communication. In some embodiments, the software may be configured to provide access to data stored on the control module, but not to perform big data analysis. The host software may include an interface to the control module via bluetooth or USB. In some embodiments, the host software may read the state of the control module, download logged data from the control module, upload sample rate control to the control module, convert data from the control module into a format suitable for processing by a big data analysis engine, or upload data to the cloud for processing by the analysis engine.
The software may be developed for PCs (Windows/Linux), tablets or smart phones (Android/iOS) or multiple platforms.
In some embodiments, a negative pressure source (e.g., a pump) and some or all of the other components of the local negative pressure system, e.g., power sources, sensors, connectors, user interface components (e.g., buttons, switches, speakers, screens, etc.), etc., may be integral with the wound dressing. In some embodiments, the component may be integrated below, within, on top of, or near the backing layer. In some embodiments, the wound dressing may include a second cover layer or second filter layer for positioning over the layers and any integrated components of the wound dressing. The second cover layer may be the uppermost layer of the dressing or may be a separate envelope enclosing the integrated components of the local negative pressure system.
As used herein, an upper, top or upper layer refers to the layer that is furthest from the skin or surface of the wound when the dressing is in use and positioned over the wound. Thus, a lower surface, layer, sub-layer or layer refers to the layer closest to the skin or surface of the wound when the dressing is in use and positioned over the wound.
Nano sensor
In some embodiments, the wound dressing assembly may incorporate or include one or more nanotechnology-supported sensors (also referred to as nanosensors). The nanosensor can be used to measure any one or more of the following: volume, concentration, displacement and velocity, gravity, electric and magnetic forces, pressure, or temperature of cells in the body. The nanosensors are capable of distinguishing or identifying certain cells at the molecular level in order to deliver drugs to specific places in the body or to monitor development. The nanosensor can detect characteristics of the wound, for example, it can be used to monitor the wound and recommend a treatment plan based on the extent of wound healing. A set of nanosensors may operate as an ensemble. For example, the nanosensors may communicate as a network and may be formulated into a substrate (e.g., foam or wound filler that may be placed within a wound cavity).
As described herein with respect to other sensors, the nanosensors can be incorporated into an array, string, flexible circuit board, matrix, chip, or the like. In some embodiments, the nanosensors may be electronically printed on, for example, a thin, lightweight, disposable or flexible material. In some embodiments, the nanosensor is biocompatible.
As the wound heals, it may generate an electric field. In some embodiments, the nanosensor can interpret and analyze electrical signals released by the wound. Thus, the nanosensor can detect or accurately measure these fields over time, thereby non-invasively tracking the healing process of the wound. In some embodiments, the nanosensor can track the rate or extent of wound healing. In some embodiments, the nanosensor can accelerate wound healing. In some embodiments, the wound dressing assembly may be used to monitor the progress of wound healing.
In some embodiments, the nanosensor may communicate with one or more other sensors or other communication devices (e.g., a remote controller) (e.g., using an incorporated antenna). The nanosensor data can be wirelessly transmitted and analyzed.
Sensor placement
Accurate placement of the sensor or sensor array may be important for effective treatment of the wound or for effective data collection. For example, various locations in or around a wound may have significantly different characteristics. Without knowing where the sensors (e.g., relative to the wound, other sensors, the patient, etc.) are located, the measured or calculated data may lead to misleading or inaccurate, thereby making it difficult to provide effective treatment to the patient. In some embodiments, one or more techniques are utilized to assist in improving the accuracy of the sensor data. For example, one or more techniques are provided to reduce the chance of imperfect or incorrect placement. Additionally, one or more techniques are provided to improve the accuracy of the sensor data despite imperfections or incorrect placement. Similarly, one or more techniques are provided that do not require special, precise placement of sensors to gather accurate information.
The position or orientation of one or more sensor strings, sensor bars, sensor arrays or sensor matrices (commonly referred to as sensor packages), wounds, wound dressings, wound fillers, wound dressing assemblies, etc. may be tracked or determined and may be used to limit orientation errors. For example, alignment or orientation may be considered for how the sensor package is placed in or on the wound (or wound periphery) to ensure that its orientation in each case is known when the sensor package is installed or replaced. This may require common reference and cross-reference data. Additionally, the position or orientation data may be used to assist in the placement (e.g., initial placement or subsequent adjustment) of the wound dressing or sensor package to reduce the likelihood of imperfect placement. The sensor data or sensor functionality may be modified based on the position or orientation data, for example, to improve the accuracy of the sensor data despite placement imperfections.
The sensor package may be used to limit orientation errors. For example, it may prove difficult to place a single sensor in a desired location because, for example, the sensor may be small or difficult to orient correctly. On the other hand, the sensor package may be more easily oriented because, for example, the size or potential of the orientation marker is increased, as described herein.
The sensor or sensor package may be incorporated into or encapsulated within a wound dressing or wound packing material. For example, the sensor may be stitched to or otherwise permanently or semi-permanently attached to a gauze or stiff fabric or one or more layers of a wound dressing. As another example, the sensor may be mounted to a foam protrusion that fits into the wound. Still, in another example, the sensors or sensor packages may be deployed as an expandable matrix, foam, or other wound-filling material. In some embodiments, one or more sensors may be used to monitor the progress of wound healing.
In some embodiments, one or more sensors may be positioned on or supported by the substrate. The substrate may be flexible or substantially flexible. The substrate may be part of the wound contact layer. Additional details of sensors positioned on a substrate are disclosed in international patent application No. PCT/EP2018/059333 filed on 11/4/2018, which is incorporated herein by reference in its entirety.
Alignment features
Fig. 4A-C illustrate diagrams of a monitoring or therapy system 400 (e.g., a Negative Pressure Wound Therapy (NPWT) system) having a plurality of alignment features 406, 410, 412 for assisting in the proper placement of a wound dressing 402 in or on a wound 404, according to some embodiments.
Fig. 4A shows a wound dressing 402 prior to placement in, on or around a wound 404. Fig. 4B-4C illustrate a wound dressing 402 suitably positioned in, on, or around a wound 404 using one or more alignment features 406, 410, 412. As shown, the alignment features include alignment ring 406 and orientation features 410, 412. It should be noted, however, that one or more other alignment features may additionally or alternatively be used. For example, other alignment features may include all or part of an image or map of the patient. For example, when the orientation of the patient in the figures matches the orientation of the patient, the wound dressing may be correctly oriented. Additionally, the alignment feature may include a corner indicator that indicates a location area for placement of a corner of the wound dressing. The alignment feature may also include an anatomical feature indicator. For example, an arrow or other directional element is on the wound dressing and will point to a particular location (e.g., the left foot of the patient) when properly positioned. In some embodiments, the alignment feature may also include a pattern or other indicia that may indicate the correct orientation of the wound dressing. For example, the alignment feature may comprise a plurality of blocks placed in corners of the wound dressing. When the block is in the upper left corner, the wound dressing is oriented correctly.
The alignment feature may include an orientation indicator, such as an accelerometer, an orientation sensor, a gravity sensor, or a level. For example, the alignment feature may include a sealed chamber or a bubble of fluid having a different density (e.g., a bubble in saline). The orientation or position of the fluid may be indicative of the orientation of the wound dressing. The one or more alignment features may help guide the patient or caregiver in the placement or replacement of the wound dressing, wound filler material, sensor, or sensor package. As described herein, one or more sensors may be integrated into a sensor pack, wound dressing, wound filler material, or the like. Similarly, the sensor pack may be integrated into a wound dressing or wound filler material.
Alignment ring 406 may be configured such that when wound dressing 402 is aligned (e.g., fitted inside, mated, or otherwise corresponding) with alignment ring 406, the wound dressing or any sensors integrated in the wound dressing are properly positioned. Alignment ring 404 may be semi-permanently attached or printed in or around wound 402 to allow precise placement or replacement of wound dressing 401 at a desired location. The alignment ring may be any semi-permanent or permanent visual or other indicator that may aid in the placement of wound dressing 402. For example, the alignment feature may be a temporary tattoo, ink (e.g., invisible ink), tape, adhesive, anatomical feature, or the like.
In some cases,
The image may still be an image, a video frame, a video, a combination, and so on. Wearable systems may include wearable devices that may individually or in combination present virtual reality (e.g., present digital or virtual image information, impervious to other real-world visual inputs), augmented reality (e.g., present digital or virtual image information as an intuitive augmentation to the real world around a user), or mixed reality (e.g., presentations related to merging real and virtual worlds to produce a new environment in which physical and virtual objects coexist and interact in real-time) environments for user interaction. The wearable device may be a Head Mounted Device (HMD) or other device.
Although alignment ring 406 is shown as having a rectangular shape, it should be understood that alignment ring 406 may take on any shape, including other shapes such as rectangular, circular, oval, and the like. In some embodiments, the shape of the alignment ring advantageously matches the shape of wound dressing 402 to allow for easy and accurate placement. However, in some cases, the shape of alignment ring 406 is different than the shape of wound dressing 402.
In some embodiments, other alignment features are used in addition to or in place of alignment ring 406. For example, indicators or sensors indicating the desired position of edges, corners, etc. may be used. As a non-limiting example, the alignment feature may include two or more corner indicators such that when a corner of the wound dressing 402 is positioned at the corner indicator, the wound dressing is accurately placed. As another example, alignment features may be included on wound dressing 402 and may correspond to anatomical features of a patient. For example, wound dressing 402 may include an arrow designed to point toward an anatomical feature (e.g., a patient's head) when properly aligned.
In some embodiments, the patient, caregiver, computer guide device, or the like may pull, place, stick, or otherwise position one or more alignment features on the wound dressing, sensor package, or patient body to assist in the positioning of the wound dressing or sensor. In other cases, the alignment features may be projected (e.g., with a light source) or viewed using a form of virtual or augmented reality.
In some cases, the alignment features are determined prior to placement of the wound dressing 402. For example, a computing system or physician may determine where the alignment ring should be placed on the patient based at least in part on the known sensor positioning within the wound dressing. As another example, the location or orientation of the alignment feature may be determined based at least in part on the size, location, shape, depth, etc. of the wound. Alternatively or additionally, the location or orientation of the alignment feature may be determined based at least in part on the type of sensor used in the wound dressing.
The alignment feature may be determined after the wound dressing or sensor has been attached or placed on the patient for the first time. For example, in some cases, wound dressings may need to be replaced periodically. In such examples, for example, the wound dressing may be initially placed in or on the wound without utilizing any alignment features. For example, as described herein, a wound dressing or sensor may not need to be placed specifically in or on a wound. Rather, each sensor component may have means to register its position relative to each other in order to understand its position within the wound. However, when replacing a wound dressing with a new wound dressing, it may be desirable to place the new wound dressing in the same or substantially the same location as the old wound dressing (e.g., for data accuracy or consistency). Thus, in some embodiments, the alignment features may be determined after initial placement and sensor position registration. For example, contours or other indications of the wound dressing may be marked on the patient's body. Subsequently, when the wound dressing is replaced, the alignment features can be used to accurately place a new wound dressing.
In some embodiments, to further reduce the likelihood of imperfect or incorrect placement, the wound dressing or sensor pack may be at least partially rotationally symmetric such that the accuracy of the sensor is not affected by rotational misalignment. In some embodiments, rotational symmetry means that the sensors are rotationally symmetrically positioned in the wound dressing or sensor pack such that when rotated to some extent, the same type of sensor remains positioned in the same location. For example, wound dressing 402 shown in fig. 4A-4C includes orientation marker (A, B, B, A)410, which corresponds to orientation marker (A, B, B, A)412 at wound 404. As shown in fig. 4B and 4C, because wound dressing 402 is rotationally symmetric, the wound dressing can be accurately positioned regardless of whether the wound dressing is oriented as shown in fig. 4B or as shown in fig. 4C. Note that the orientation marks 410 and 412 match in both orientations (e.g., A corresponds to A, B corresponds to B, etc.).
Position or orientation of sensors
A system (e.g., system 400) may utilize a positioning sensing device to determine or track the position or orientation of a sensor or other object of interest, estimate the motion, position, or location of the sensor, wound, patient, etc. For example, the system may include sensors that may continuously or repeatedly report or receive, for example, position or orientation data of one or more other sensors. Additionally or alternatively, the system may utilize a sensor package in which the position or orientation of each sensor on the sensor package is known or can be determined, and the position of the sensor package may be registered using a single or several sensors.
As described herein, the location or orientation (also referred to as placement) may be considered in relation to the manner in which the one or more sensors (or wound dressings) are placed in or on the wound to ensure that their orientation in each case is known when the one or more sensors are installed or replaced. The term in-position as used herein may refer to, but is not limited to, a position or orientation or any other suitable position information. These placement considerations may be required, for example, to co-reference and cross-reference the data so that the location of each sensor relative to the wound or reference point can be determined. For example, the individual sensor components may have means to register their positions relative to each other in order to know or record the position on, near or within the wound.
Various techniques may be used to track or determine the position or orientation of the sensor, sensor pack, or wound dressing. For example, one or more in-situ sensors may be used or integrated into a sensor pack, wound dressing, or the like, and a position sensing device (sometimes referred to as a position or position sensing unit) may track or otherwise determine the position or orientation of the one or more in-situ sensors within the tracking area. The position sensing device may provide position data to a processor (e.g., a processor of the NPWT system or a remote processor) that may collectively reference or cross-reference data from other sensors. Alternatively, the processor may co-reference or cross-reference the received in-place data with known in-place data (e.g., the position or orientation of the sensors in the sensor package) to determine additional in-place information. In some cases, one or more in-situ sensors may include one or more capabilities. For example, the one or more in-position sensors may include an orientation sensor, such as an accelerometer, gyroscope, or magnetometer, such that it may output an inertial measurement combination (IMU).
As a non-limiting example, one or more in-situ sensors may be communicatively coupled to a position sensing device, such as a position sensing unit. The positioning sensing device may be part of the wound dressing or it may be a separate component. The position sensing device may be used to determine the position of a sensor or a set of sensors (e.g., an array of sensors). For example, the position sensing device may determine the pose of one or more in-position sensors with respect to the room coordinate system. The pose and the room coordinate system may then be used to determine the pose of the other sensors. The positioning sensing device may determine the seating information of one or more sensors, wound dressings, reference points, and the like using various techniques. For example, the positioning sensing device may utilize echolocation, ultrasound, sonar, to locate sensors, wounds, wound dressings, regions of interest, reference points, and the like. Additionally or alternatively, the location sensing device may utilize Global Positioning System (GPS), Radio Frequency Identification (RFID) technology, imaging (e.g., external cameras), radio frequency sensing, location tracking, etc. to locate the sensor, wound dressing, region of interest, reference point, etc.
In some embodiments, the position sensing device may include one or more sensing devices, such as a HiBall tracking system, a GPS device, an RFID device, an RF sensor, an antenna, an ultrasonic wave, a sonar device, an echo location device, or a signal emitting device, which will allow for tracking the position of one or more position sensors. In some embodiments, a positioning sensing device may be attached to the wound dressing. The wound dressing assembly may be tracked by a positioning sensing device. The room coordinate system reference may also be tracked by the position sensing unit in order to determine the position of the sensor or wound dressing relative to the room coordinate system. Additionally or alternatively, the position of one or more sensors or wound dressings may be determined relative to a reference point, such as a fiducial, a wound, a body part of a patient, or the like. In some embodiments, the wound dressing may also include or have coupled thereto one or more accelerometers that may also be used to estimate the motion, position, and location of the wound, patient, etc.
As another example, the position sensing device may include a signal emitting device. The signal emitting device may comprise a Radio Frequency Identifier (RFID). In such embodiments, the signal emitting device may use GPS coordinates of one or more tracking units, or may, for example, triangulate radio frequency signals emitted by RFID associated with one or more tracking units to determine the position of the wound dressing, sensors, etc. Alternatively or additionally, the sensor package may register itself using electromagnetic tags (e.g., RFID tags) placed on or near the patient that allow the sensor package to define its position and orientation with respect to the tags.
As another example, the positioning sensing device may include an imaging device, such as an optical sensor, a camera, or a scanner. In such examples, for example, the imaging device may read, scan, image, record, or collect information from an alignment feature associated with the wound or wound dressing. For example, one or more alignment features may be printed onto the surface of the wound dressing. The imaging device may be configured to determine a position or orientation of the wound dressing (or wound, body part, etc.) based at least in part on the alignment feature. For example, the imaging device may image the alignment feature and may determine the angle of the alignment feature or dressing relative to the positioning sensing device. Additionally or alternatively, the imaging device may determine the relative sizes of elements in an image or video of the imaging device. Additionally or alternatively, the imaging device may determine the location or position of the alignment feature on or near the wound dressing. Based on the one or more features of the alignment feature, such as code, distance, tilt, parallax, etc., the system may determine the position of one or more sensors, points of interest, wound dressings, wounds, etc. The determined seating may be absolute seating or seating relative to a reference point (such as a region of interest, a wound dressing, a sensor, a body part of a patient, etc.).
As another example, the system may determine a position or orientation of the wound or wound dressing based at least in part on a position or orientation of the reference point. The determined position or orientation may be an absolute position or a relative position (e.g., relative to the wound, wound dressing, object, or a particular body part of the patient). For example, the sensors may be fixed shapes or fixed strings. By locating a reference point, which may include one or more sensors, the position of one or more other sensors may be determined. In other words, known seating relationships between sensors, wound dressings, reference points, and the like may be utilized to determine seating information for one or more sensors, wound dressings, and the like.
The wound dressing may be associated with a reference point. For example, the reference point may be attached to or embedded in the wound dressing. Further, the reference point may have a known seating relationship between the wound dressing or one or more of the various sensors of the wound dressing. For example, the distance of the reference point from one or more sensors (e.g., sensors within the wound dressing) may be known. The reference point may be a sensor, such as a position sensor. Alternatively, the reference point may be a point, a line, a surface, a hole, a set of holes, an object, or other non-sensor. The positioning sensing device may track or determine the position of the reference point, and based at least in part on the position of the reference point, the position of one or more wound dressings, one or more sensors, a region of interest, and/or the like may be determined. In some cases, the system may include more than one reference point, and the position sensing device may track or determine the position of each of the reference points.
Additionally or alternatively, the reference point may be remote from the wound dressing. For example, the reference point may be at a known location on the body, a known distance from a portion of the body, or a known distance from the wound. In some cases, the reference point may be a location sensing device. The reference point determines the location of the wound dressing, the region of interest, or the position or orientation of the one or more sensors relative to the reference point. For example, the reference point or one or more of the individual sensor components may be configured to register its position with the reference point to learn or record the position of the sensor or wound dressing on, near or within the wound.
In some embodiments, the seating of one or several sensors is tracked or determined, and other seating data (e.g., seating data for other sensors, wound dressings, wounds, patients, etc.) is determined using known relationships. As described herein, one or more sensors may be incorporated into a sensor package, e.g., a sensor string, a sensor strip, a sensor array, a sensor matrix, or a flexible circuit board. Alternatively or additionally, one or more sensors may be incorporated into the wound dressing or wound filler. The location of the sensor in the sensor pack, wound dressing or wound filler may be known, and the relationship between other sensors, wound location, etc. may be determined.
A system, such as a Negative Pressure Wound Therapy (NPWT) system, may determine the seating of a first sensor, and then may determine the seating of other sensors based at least in part on the determined seating of the first sensor and known relationships between the first sensor and the other sensors. Additionally or alternatively, the system may determine the position of the entire sensor package and determine the position of one or more sensors on the sensor package using the position data of the sensor package and the known relationships.
In some embodiments, the system may include a reference point for use as a reference for determining the position or orientation of one or more sensors, sensor packages, wounds, and the like. For example, the system may determine the position of a reference point or the position of one or more sensors relative to a reference point. Based at least in part on the location of the reference point, the system may determine the location of the one or more sensors, e.g., relative to the reference point or relative to the wound. The reference point may be a sensor, a point, a line, a surface, a hole, a set of holes, etc.
In some embodiments, the position of several or all sensors may be tracked or determined. In some cases, the system may use more than one technique described herein (e.g., tracking the sensors, determining based on known relationships, etc.) to determine the position of each sensor in place. The system may appropriately arbitrate between seating determined using a variety of techniques, and may determine whether seating is deemed inaccurate or unreliable.
Fig. 5 illustrates a cross-section of a wound 522 dressed with a plurality of wound filler materials 520 (or wound fillers) incorporating sensors 530 or sensor packs according to some embodiments. The wound filling material may be any material as described herein, including an expandable foam or matrix that may be configured to fill a wound. The sensors 530 in the wound filler material 520 may be used in conjunction with sensors incorporated into wound dressings (such as those described with respect to fig. 4A-4C) to provide data relating to the wound or other physiological or health data relating to the patient. Alternatively, the sensor 530 may be dedicated to providing wound data. Also, in other examples, sensor 530 may be in communication with one or more sensors or components external to the wound.
In some embodiments, no special placement of the sensor 530 is required. For example, one or more sensors 530 may be incorporated into the wound filler material 520, and the wound filler material 520 may be inserted into the wound. The position or orientation of one or more sensors 530 may be determined using one of the methods described herein. In some embodiments, the sensor 530 is positioned in the wound filler material 520 such that the position or orientation is known. For example, the sensors 530 may be positioned in a pattern, and the wound filler 520 may have a concentration or density such that the sensors 530 will not move when the wound filler is inserted into the wound cavity 522.
Fig. 6A illustrates a system having a sensor string or
The system can include a
A camera or other recording device may be used to determine the position or orientation of the sensor, sensor pack, wound dressing, etc. For example, one or more pictures or videos of the wound may be taken before filling the wound filler or dressing, after filling the wound dressing, after placing the sensor, or after placing the wound dressing. These images may allow for the calculation of the orientation of the sensor, wound dressing, etc. after placement. In some embodiments, an image of a wound or dressing may be used to determine or assign data integrity to data output from sensors of the wound dressing.
Fig. 6B illustrates a system having a sensor string or
The
In certain instances, the system may determine a position or orientation of the wound or wound dressing based at least in part on a position or orientation of the reference point. The determined position or orientation may be an absolute position or a relative position (e.g., relative to the wound, wound dressing, object, or a particular body part of the patient). For example, the sensors may be fixed shapes or fixed strings. By locating a reference point, which may include one or more sensors, the position of one or more other sensors may be determined. In other words, known seating relationships between sensors, wound dressings, reference points, and the like may be utilized to determine seating information for one or more sensors, wound dressings, and the like.
In some embodiments, the system may monitor a region of
However, in some cases, it is expected that there will be a variety of dressing or sensor system changes over the duration of wound healing. For example, a wound dressing may be replaced every few days, and wound healing may take approximately 4 weeks. Thus, it may be advantageous to determine the manner in which the wound dressing is positioned relative to the region of
The system may determine the position or orientation of the wound dressing, for example, relative to the
Alignment features
Fig. 7 illustrates a monitoring or therapy system 700 for determining the position or orientation of the wound dressing 100. The system may include a wound dressing 100 and a position sensing device 760. In some cases, system 700 may be an NPWT system. As shown, alignment features 764 may be associated with wound dressing 100. The location device 760 may be configured to determine a location or orientation of the wound dressing (or wound, body part, etc.) based at least in part on the alignment feature 764.
Alignment features 764 may include any of the alignment features described herein, including, but not limited to, alphanumeric or other codes, standard or irregular shapes, or other discrete markings (e.g., referred to as a baseline shape). For example, a starburst (starburst) (e.g., the signature of Smith & Nephew) may be used with the included numbers. In addition, any standard shape with a known aspect ratio may be used for the baseline shape. One or more alignment features 764 may be printed onto the surface of wound dressing 100. However, it will be understood that the alignment features 764 may be associated with the wound dressing 100 in various ways.
The position sensing device 760 (or an associated processor) may determine the position or orientation of the wound dressing 100, wound, etc. For example, the positioning sensing device 760 may include an optical sensor (e.g., a red green blue transparent (RGBC) sensor or a Red Green Blue White (RGBW) sensor), a camera, or a scanner, and the positioning sensing device 760 may read or determine the features of the alignment features 764.
The position sensing device 760 may read, scan, or gather information from the alignment features 764. For example, the position sensing device 760 may determine the angle of the alignment feature 764 or the dressing 100 relative to the position sensing device 760 or the light beam 762 (such as a scanning beam). Additionally or alternatively, the position sensing device 760 may determine the relative sizes of elements in an image or video of the position sensing device 760. Additionally or alternatively, the positioning sensing device 760 may determine the location of the alignment feature 764 on the wound dressing 100.
In some embodiments, one or more features of the alignment features 764 may be used to determine one or more other features. For example, the angle of the alignment feature 764 relative to the position sensing device 760 may be identified based at least in part on the relative sizes of elements within the image or video of the position sensing device 760. For example, the tilt or parallax of the element may be used to determine the angle.
Various inks may be used to form or place the alignment features 764. For example, the alignment features 764 may include pH-sensitive inks such as, but not limited to, pH-sensitive dyes, pH-sensitive pigments, and the like. For example, a pH sensitive ink may be configured to change color based on a solution that comes into contact with the ink. Thus, in some cases, the wound fluid may cause the ink to change to a particular color. Other substances, such as non-pH sensitive inks, may be used in addition to or in place of pH sensitive inks. In some embodiments, multiple markers may be used.
In some embodiments, the alignment features 764 are used to determine a model, such as a 3D map, of the wound dressing 100. For example, the 3D orientation of the alignment feature 764 may be identified by a foreshortening of a known shape. For example, if a square is tilted away from the camera, it will appear trapezoidal. Thus, in some embodiments, when the position, shape, orientation, or size of the alignment feature 764 is known, the position, three-dimensional angle, or distance of the alignment feature 764 from the position sensing device, the patient, or another object may be calculated. Thus, a 3D map of the dressing shape may be generated by interpolating between known points (e.g., the angle and position of the alignment feature 764). Such 3D modeling may also be used with alignment features 764 incorporated with pH inks. For example, the 3D map may be determined based on the position or color of the pH element.
Additionally or alternatively, the alignment features 764 may be used to determine the compression of the wound dressing 100. For example, the 3D orientation, angle, size, shape, etc. of the alignment features 764 may be identified and from this information, the compression of the wound dressing 100 may be determined. For example, a smaller shape, a particular angle, a broken shape, etc., indicates that the wound dressing 100 is compressed.
In some embodiments, for example, a pH sensor may be used to measure, assess, or treat a wound. For example, in some embodiments, a pH sensitive ink may be used to convert an optical sensor into a pH sensor. For example, the pH sensitive ink may be incorporated into a binder substance, such as an adhesive foam or gel, to form a pH sensitive binder substance that may be placed or printed onto an optical component (e.g., an optical sensor) of the sensing platform. The remainder of the sensing platform may be coated with a transparent or translucent adhesive.
By combining the pH sensitive ink with the binder material and generating a pH sensitive binder material, the pH sensitive binder material effectively increases the thickness of the pH sensitive ink (compared to the layer thickness of the pH sensitive ink itself). Thus, the pH sensitive adhesive material provides greater color gain for greater signal to noise ratio. Thus, almost any optical sensor can be converted to a pH sensor simply by printing a pH doped adhesive on the optical sensor and using a color response table.
The pH sensitive ink may be incorporated into the adhesive foam using a variety of techniques. For example, the pH sensitive ink may be added to the original foam material prior to mixing. Alternatively, the adhesive foam may be soaked in a pH sensitive ink. Similarly, pH sensitive inks can be incorporated into the binder gel using various techniques. For example, the pH sensitive ink may simply be mixed with the binder gel.
In some embodiments, the pH change pad may function as a pH sensor configured to change color in response to a pH change in the wound environment. The color change can then be measured and evaluated optically. For example, a spectrometer and a broadband white light source may be used to measure the spectral response of a pH dye. Illumination and imaging may be provided on the surface of the wound dressing in contact with the wound and on the same side as the fluid application (bottom surface). Alternatively, in some embodiments, the illumination and imaging sources may be disposed on the top surface of the dressing opposite the bottom surface and away from the surface to which the fluid is applied.
In some embodiments, the pH sensor includes a foam or other expanding material that can change spectral absorption depending on the pH of the environment. Advantageously, the foam may be integrated into a wound dressing or wound packing material.
In some embodiments, the pH sensor may also have a built-in exudate channel system configured to enable the pH sensor to more effectively direct the exudate stream through the pH sensitive region.
Term(s) for
In some cases, one or more sensors may be positioned at specific locations on a substrate or layer. Markers, such as color markers, may be included to guide the way the user should position one or more sensors in the wound.
Depending on the embodiment, certain operations, acts, events or functions of any process described herein may be performed in a different order, may be added, merged, or omitted entirely (e.g., not all of which may be necessary to practice the process). Further, in some embodiments, operations, actions, functions, or events may be performed concurrently, e.g., through multi-threaded processing, interrupt processing, or multiple processors or processor cores, or on other parallel architectures, rather than sequentially.
The processing of the various components of the illustrated system may be distributed across multiple machines, networks, and other computing resources. Further, two or more components of the system may be combined into fewer components. The various components of the illustrated system may be implemented in one or more virtual machines, rather than in dedicated computer hardware systems and/or computing devices. Likewise, the illustrated data stores may represent physical and/or logical data stores, including for example, storage area networks or other distributed storage systems. Furthermore, in some embodiments, the connections between the illustrated components represent possible paths of data flow, rather than actual connections between hardware. Although a few examples of possible connections are shown, any subset of the components shown may communicate with any other subset of the components in various embodiments.
Any patents and applications and other references mentioned above, including any references that may be listed in the accompanying filing papers, are incorporated herein by reference. Aspects of the disclosure can be modified, if necessary, to employ the systems, functions, and concepts of the various references described herein to provide yet further embodiments.
Features, materials, characteristics, or groups described in connection with a particular aspect, embodiment, or example are understood to apply to any other aspect, embodiment, or example described herein unless incompatible therewith. All of the features disclosed in this specification (including any accompanying claims, abstract and drawings), or all of the steps of any method or process so disclosed, may be combined in any combination, except combinations where at least some of such features or steps are mutually exclusive. The protection is not restricted to the details of any of the foregoing embodiments. Any novel feature or any novel combination of features disclosed in this specification (including any accompanying claims, abstract and drawings), or any novel feature or any novel combination of steps of any method or process so disclosed, is claimed.
While certain embodiments have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of protection. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. Furthermore, various omissions, substitutions and changes in the form of the methods and systems described herein may be made. Those of skill in the art will understand that in some embodiments, the actual steps taken in the processes shown or disclosed may differ from those shown in the figures. According to embodiments, some of the steps described above may be eliminated, and other steps may be added. For example, the actual steps or sequence of steps taken in the disclosed processes may differ from those shown in the figures. According to embodiments, some of the steps described above may be eliminated, and other steps may be added. For example, the various components shown in the figures may be implemented as software or firmware on a processor, controller, ASIC, FPGA, or dedicated hardware. Hardware components such as processors, ASICs, FPGAs, etc. may comprise logic circuitry. Furthermore, the features and attributes of the specific embodiments disclosed above may be combined in different ways to form additional embodiments, all of which fall within the scope of the present disclosure.
While the present disclosure includes certain embodiments, examples, and applications, it will be understood by those skilled in the art that the present disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments or uses and obvious modifications and equivalents thereof, including embodiments that do not provide all of the features and advantages described herein. Accordingly, the scope of the present disclosure is not intended to be limited by the described embodiments, and may be defined by the claims presented herein or by claims presented in the future.
Conditional language, such as "can," "might," or "may" is generally intended to convey that certain embodiments include, but not others include, certain functions, elements or steps, unless expressly stated otherwise or otherwise understood in the context of usage. Thus, such conditional language is not generally intended to imply that features, elements, or steps are in any way required for one or more embodiments or that one or more embodiments necessarily include logic for deciding, with or without user input or prompting, whether these features, elements, or steps are included or are to be performed in any particular embodiment. The terms "comprising," "including," "having," and the like are synonymous and are used inclusively, in an open-ended fashion, and do not exclude additional elements, features, acts, operations, and the like. Furthermore, the term "or" is used in its inclusive sense (and not in its exclusive sense) so that, when used, e.g., to connect a list of elements, the term "or" means one, some, or all of the elements in the list. Likewise, the term "and/or" when referring to a list of two or more items, encompasses all of the following interpretations of the word: any one item in the list, all items in the list, and any combination of items in the list. Further, the term "each" as used herein may mean any subset of a set of elements to which the term "each" applies, except having its ordinary meaning. Additionally, the words "herein," "above," "below," and words of similar import, when used in this application, refer to this application as a whole and not to any particular portions of this application.
Joint language such as the phrase "X, Y and at least one of Z" is understood in this context to generally mean that an item, term, etc. can be X, Y or Z unless explicitly stated otherwise. Thus, such conjunctive language is not meant to imply that certain embodiments require the presence of at least one of X, at least one of Y, and at least one of Z in general.
The terms "about," "approximately," "substantially," and "approximately" as used herein mean a value, amount, or characteristic that is close to a stated value, amount, or characteristic, that still performs the desired function or achieves the desired result. For example, the terms "about," "substantially," and "substantially" may refer to an amount within less than 10%, within less than 5%, within less than 1%, within less than 0.1%, and within less than 0.01% of the specified amount. As another example, in certain embodiments, the terms "substantially parallel" and "substantially parallel" refer to values, amounts, or features that deviate from exact parallelism by less than or equal to 15 degrees, 10 degrees, 5 degrees, 3 degrees, 1 degree, or 0.1 degrees.
Any of the embodiments described herein may be used with or without a canister. Any of the dressing embodiments described herein can absorb and store wound exudate.
The scope of the present disclosure is not intended to be limited by the description of certain embodiments and may be defined by the claims. The language of the claims is to be construed broadly based on the language employed in the claims and not limited to examples described in the specification or during the prosecution of the application, which examples are to be construed as non-exclusive.
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