Surgical incision and closure apparatus
An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.
1. An incision closure apparatus comprising:
a first base panel for being adhered to a first side of an incision or wound, the first base panel comprising an upper surface and a tissue adherent lower surface;
a second base panel for being adhered to a second side of the incision or wound opposite the first side, the second base panel comprising an upper surface and a tissue adherent lower surface;
a first plurality of longitudinally spaced-apart supports coupled to the upper surface of the first base panel;
a second plurality of longitudinally spaced-apart supports coupled to the upper surface of the second base panel; and
a plurality of lateral ties coupling the first and second base panels to one another,
wherein the lateral ties each have a first end permanently fixed relative to a support of the first base panel and a second end reversibly and adjustably attached to a laterally opposed support of the second base panel, thereby allowing the lateral ties to draw the first and second base panels laterally together to compress the wound or incision covered by the incision closure apparatus,
wherein the first end of each lateral tie is integral with its respective support on the first base panel, and
wherein the lateral ties are each reversibly and adjustably attached to the second base panel such that a lateral spacing between the first and second base panels is adjustable.
2. The incision closure apparatus of claim 1 , wherein the second end of each lateral tie is disengagable and re-engagable from its respective support on the second base panel.
3. The incision closure apparatus of claim 1 , wherein the lateral ties are independently adjustable such that the lateral spacing between the first and second base panels is variable along the length of the first and second base panels.
4. The incision closure appliance of claim 1 , wherein the second end of each lateral tie is releaseably attached to a lock, and wherein the lateral tie and lock together form a ratchet tightening mechanism.
5. The incision closure appliance of claim 1 , wherein one or more of the first or second plurality of longitudinally spaced-apart supports comprise force distribution structures.
6. The incision closure apparatus of claim 1 , wherein one or more supports of the first or second plurality of longitudinally spaced-apart supports is disposed laterally between inner and outer edges of the first or second base panel, respectively.
7. The incision closure apparatus of claim 1 , wherein one or more of the first or second plurality of longitudinally spaced-apart supports comprise flexible, non-distensible materials.
8. The incision closure apparatus of claim 1 , wherein one or more of the first or second plurality of longitudinally spaced-apart supports is embedded in or laminated to the upper surface of each base panel.
9. The incision closure apparatus of claim 1 , wherein one or more of the first or second plurality of longitudinally spaced-apart supports is C-shaped.
10. The incision closure apparatus of claim 1 , wherein one or more of the first or second base panels comprise an elastic matrix.
11. The incision closure apparatus of claim 10 , wherein the elastic matrix comprises an elastomeric membrane, a woven fabric, a spun fabric, rubber, latex, urethane, polyurethane, silicone, or a thermo plastic elastomer (TPE).
12. The incision closure apparatus of claim 11 , wherein the elastic matrix comprises a fabric woven from elastic elements and having inelastic elements along lateral edges of the one or more of the first or second base panels and extending laterally thereacross.
13. The incision closure apparatus of claim 1 , wherein one or more of the first or second base panels comprise one or more preferentially separating regions to facilitate one or more of longitudinal separation or lateral stretching of the one or more of the first or second base panels.
14. The incision closure apparatus of claim 13 , wherein the one or more preferentially separating regions comprise one or more perforations.
15. The incision closure apparatus of claim 14 , wherein the one or more perforations are disposed longitudinally between axially adjacent supports on the one or more of the first or second base panels.
16. The incision closure apparatus of claim 14 , wherein the one or more perforations comprise a plurality of perforations disposed along a lateral line of the one or more of the first or second base panels.
17. The incision closure apparatus of claim 14 , wherein the one or more perforations are disposed along a lateral edge of the one or more of the first or second base panels.
18. The incision closure apparatus of claim 1 , wherein the tissue adherent lower surface of one or more of the first or second base panels comprises a hydrophilic adhesive material.
19. The incision closure apparatus of claim 18 , wherein the hydrophilic adhesive material comprises one or more of a hydrocolloid, a hydrogel, an acrylic polymer, or poly(ethylene glycol).
20. The incision closure apparatus of claim 1 , further comprising a securing layer adapted to be placed over an assembly of the first and second base panels and the lateral ties after the assembly has been secured over the incision or wound.
21. The incision closure apparatus of claim 20 , wherein the securing layer has an inner self-adhesive surface.
22. The incision closure apparatus of claim 20 , wherein the securing layer is configured to laterally extend beyond an outer lateral edge of the first or second base panel.
23. The incision closure apparatus of claim 20 , wherein the securing layer has one or more preferentially separating regions to allow the securing layer to at least partially stretch longitudinally in response to longitudinal stretching of the incision or wound and surrounding tissue the incision closure apparatus is placed over.
24. The incision closure apparatus of claim 23 , wherein the one or more preferentially separating regions comprises one or more perforations.
25. The incision closure apparatus of claim 1 , wherein each lateral tie is longitudinally pivotable relative to one or more of the first or second ends thereof.
26. The incision closure apparatus of claim 25 , wherein each lateral tie is configured to longitudinally pivot relative to the one or more of the first or second ends thereof when one or more of the first or second base panels are longitudinally stretched.
27. The incision closure apparatus of claim 25 , wherein the lateral ties bring the first and second base panels closer together laterally when the lateral ties are pivoted longitudinally.