Tissue healing

1 . An apparatus for promoting scar-free healing at a tissue site, the apparatus comprising:

a tissue contact layer comprising silicone and a plurality of perforations the combined open area of the perforations comprising around 20% or less of the total area of a single side of the tissue contact layer, the silicone in the tissue contact layer comprising a moisture vapor transmission rate of between about 350 to 410 gm −2 /24 hrs when unperforated;

a source of negative pressure connectable to the tissue site and configured to apply negative pressure through the tissue contact layer to a wounded area beneath the tissue contact layer;

wherein the tissue contact layer is configured to reduce transepidermal water loss after negative pressure is applied through the tissue contact layer for a period of time, compared to if the negative pressure is applied at the tissue site without using the tissue contact layer; and

wherein the tissue contact layer is configured to reduce scar tissue formation by at least one point on the Vancouver or Manchester Scar Scale after negative pressure is applied through the tissue contact layer for a period of time sufficient to close the wound, compared to if negative pressure is applied at the tissue site without using said tissue contact layer.

2 . The apparatus of claim 1 , further comprising a transmission layer positioned over the tissue contact layer.

3 . The apparatus of claim 2 , further comprising an absorbent layer configured to absorb wound exudate, the absorbent layer positioned over the transmission layer.

4 . The apparatus of claim 1 , wherein the tissue contact layer comprises a basis weight of about 130 gsm when unperforated.

5 . The apparatus of claim 1 , wherein the tissue contact layer comprises a moisture vapor transmission rate of about 380 gm −2 /24 hrs when unperforated.

6 . The apparatus of claim 1 , further comprising a cover layer comprising a fluid passage.

7 . The apparatus of claim 1 , wherein the silicone comprises polysiloxane, polyorganosiloxane, or polydimethylsiloxane.

8 . The apparatus of claim 1 , wherein the combined area of the apertures comprises about 17.5% or less of the total area of a single side of the tissue contact layer.

9 . An apparatus for promoting scar-free healing at a tissue site, the apparatus comprising:

a tissue contact layer comprising silicone and a plurality of perforations, individual perforations comprising an average diameter of 0.025 mm to 1.5 mm, the combined open area of the perforations comprising around 20% or less of the total area of a single side of the tissue contact layer;

a source of negative pressure connectable to the tissue site and configured to apply negative pressure through the tissue contact layer to a wounded area beneath the tissue contact layer;

wherein the silicone comprises polysiloxane, polyorganosiloxane, or polydimethylsiloxane; and

wherein the tissue contact layer is configured to reduce scar tissue formation by at least one point on the Vancouver or Manchester Scar Scale after negative pressure is applied through the tissue contact layer for a period of time sufficient to close the wound, compared to if negative pressure is applied at the tissue site without using said tissue contact layer.

10 . The apparatus of claim 9 , further comprising a transmission layer positioned over the tissue contact layer.

11 . The apparatus of claim 10 , further comprising an absorbent layer configured to absorb wound exudate, the absorbent layer positioned over the transmission layer.

12 . The apparatus of claim 9 , further comprising a cover layer comprising a fluid passage.

13 . The apparatus of claim 9 , wherein the combined area of the apertures comprises about 17.5% or less of the total area of a single side of the tissue contact layer.

14 . An apparatus for promoting scar-free healing at a tissue site where negative pressure is applied, the apparatus comprising:

a tissue contact layer comprising silicone and a plurality of perforations, the combined open area of the perforations comprising about 20% or less of the total area of a single side of the tissue contact layer;

a source of negative pressure connectable to the tissue site and configured to apply negative pressure through the tissue contact layer to a wounded area beneath the tissue contact layer;

a transmission layer positioned over the tissue contact layer, the transmission layer configured to distribute negative pressure; and

a cover layer positioned over the transmission layer, the cover layer comprising an opening, the opening configured to connect to the source of negative pressure; and

wherein the tissue contact layer is configured to reduce scar tissue formation by at least one point on the Vancouver or Manchester Scar Scale after negative pressure is applied through the tissue contact layer for a period of time sufficient to close the wound, compared to if negative pressure is applied at the tissue site without using said tissue contact layer.

15 . The apparatus of claim 14 , wherein individual perforations comprise an average diameter of 0.025 mm to 1.5 mm.

16 . The apparatus of claim 14 , wherein the silicone comprises polysiloxane, polyorganosiloxane, or polydimethylsiloxane.

17 . The apparatus of claim 14 , wherein the combined open area of the apertures comprises about 17.5% or less of the total area of a single side of the tissue contact layer.