Granted Patent B2

US 7,413,570 · App. 11/103,022 · Granted Aug 19, 2008

Abstract

Claims (79)

1. A primary intention healing medical closure method for closing a wound comprising a separation of first and second tissue portions, which method comprises the steps of:

said first and second tissue portions presenting respective first and second tissue edges, which extend into a depth of the wound including at least a subcutaneous layer;

providing multiple flexible screens with outwardly-projecting prongs;

configuring said prongs for retaining said tissue thereon;

configuring each said screen for placement in said tissue separation;

placing each said screen in said tissue separation and penetrating at least one of said tissue portions at the subcutaneous layer with said prongs;

closing said tissue separation;

providing each said screen with multiple, discrete clips having constructions chosen from among the list consisting of: stamped sheet metal; bioabsorbable; formed wire;

plastic; barbed-prong: and curved-prong;

providing each said clip with at least one of said prongs;

providing each said screen with a panel comprising a flexible matrix mounting said clips;

forming said matrix with multiple, flexible interwoven filaments;

providing each said screen with a pre-installation enclosure assembly with front and back backing sheets mounted on opposite sides of said panel pre-installation;

removing said backing sheets from each said screen exposing said prongs and engaging said tissue portions with said prongs;

installing multiple said panels in said tissue separation;

locating at least some of said panels adjacent to a skin surface with outer edges of said panels located exteriorly to the patient;

covering said tissue separation with a dressing applied to the skin surface;

providing a vacuum source;

providing a tube;

fluidically connecting at least some of said screens with said vacuum source via said tube;

applying a negative pressure to said screens and thereby extending a vacuum into the depth of the wound to said tissue separation;

draining said tissue separation with negative pressure; and

closing said tissue separation by holding said tissue edges together substantially throughout said wound with negative pressure in combination with said panels.

2. A primary intention method of closing an abdominal incision wound, which includes the steps of:

forming with said abdominal incision first and second tissue portions;

said first and second tissue portions presenting respective first and second tissue edges, which extend into a depth of the wound between first and second abdominal tissue layers;

providing a closure screen with a generally flat panel including opposite faces, multiple prongs projecting from said faces and a perimeter;

providing said panel with first and second portions and a medial line dividing said first and second portions;

orienting said prongs at said first and second portions oppositely towards said medial line;

placing said panel between first and second tissue edges exposed by said abdominal incision with said panel positioned in an orientation with said panel faces generally parallel to a skin surface and with said medial line thereof located below said abdominal incision:

penetrating said tissue edges layers with said prongs;

applying tension to said panel at said medial line with a pulling force:

further embedding said prongs with said pulling force on said panel;

primary intention closing said incision with said pulling force on said panel;

providing a vacuum source;

providing a tube;

fluidically connecting said screen with said vacuum source via said tube;

applying a negative pressure extending a vacuum into the depth of said incision wound via said panel;

draining said tissue separation with negative pressure; and

closing said tissue separation by holding said tissue edges together substantially throughout said wound with negative pressure in combination with said panel.

3. The method according to claim 2 , which includes the additional steps of:

providing said panel with a flexible, semi-rigid perimeter member at said perimeter;

locating said perimeter member at a perimeter of said abdominal tissue layer separation; and

maintaining the shape of said panel with said perimeter member.

4. The method according to claim 2 , which includes the additional steps of:

providing said panel with multiple semi-rigid, non-collapsible members oriented longitudinally, transversely or diagonally with respect to said panel; and

maintaining the shape of said panel with said members.

5. The method according to claim 2 , which includes the additional step of placing the panel in a pre-peritoneal position on the abdominal musculature.

6. The method according to claim 2 , which includes the additional step of placing the screen intra-abdominally below the abdominal musculature.

7. The method of claim 2 , which includes the additional steps of:

providing multiple clips and providing each said clip with a body and multiple said prongs extending therefrom;

providing a pre-installation enclosure assembly with front and back backing sheets mounted on opposite sides of said screen pre-installation; and

removing said backing sheets from said screen, exposing said prongs and engaging said tissue portions with said prongs.

8. A primary intention medical closure method for closing a wound comprising a separation of first and second tissue portions, which method comprises the steps of:

said first and second tissue portions presenting respective first and second tissue edges, which extend into a depth of the wound including at least a subcutaneous layer;

providing multiple flexible panels;

providing each said panel with an inner edge;

providing each said panel with first and second faces;

providing each said panel with multiple pronged clips;

providing each said pronged clip with at least one outwardly-projecting, distally-oriented prong;

providing each said panel with a flexible matrix mounting said pronged clips;

extending said prongs from the first and second faces of each said panel;

distally orienting said prongs away from respective panel inner edges;

forming each said matrix with multiple, flexible interwoven filaments;

providing at least one of said panels with a row of base clips along said inner edge;

providing each said base clip with first and second hooks with larger and thicker configurations than said prongs;

proximally orienting said hooks away from said at least one panel inner edge, oppositely to said prongs;

placing said at least one panel with base clips in said separation;

initially anchoring said panel and initially closing said tissue separation by penetrating an inner tissue layer at said first and second tissue edges with said hooks in a non-repositionable engagement;

placing other panels with pronged clips in said separation distally from said panel with base clips;

further closing said tissue separation distally from said inner tissue layer by penetrating an outer tissue layer at said tirst and second tissue edges with said prongs in a repositionable engagement;

locating at least one of said panels adjacent to the skin surface with an outer edge of said panel located exteriorly to the patient and forming a protruding portion; and

covering said tissue separation with a dressing applied to the skin surface;

providing a vacuum source;

providing a tube;

fluidically connecting at least some of said panels with said vacuum source via said tube;

applying a negative pressure to said panels and thereby extending a vacuum into the depth of the wound to said tissue separation;

draining said tissue separation with negative pressure; and

closing said tissue separation by holding said tissue edges together substantially throughout said wound with said negative pressure in combination with said panels.

Assignments (13)