Systems and methods for using negative pressure wound therapy to manage open abdominal wounds

1. A system for the treatment of a wound site using negative pressure, the system comprising:

a wound contact layer, wherein the wound contact layer is provided with one or more openings for channeling wound exudate and distributing negative pressure;

a porous pad comprising:

a generally planar shape with a thickness less than a width and a length;

a major axis;

a minor axis;

four quadrants defined by the major and minor axes;

a plurality of arcuate outer cuts or perforations extending through at least a portion of the thickness of the pad and having an elliptical shape, the plurality of arcuate outer cuts or perforations comprising four outer cuts each separated from adjacent outer cuts by uncut, unperforated bridge portions wherein an outer cut is located in each of the four quadrants and the bridge portions separating the outer cuts are positioned at opposite ends along the major and minor axes;

a plurality of arcuate inner cuts or perforations extending through at least a portion of the thickness of the pad and having an elliptical shape similarly shaped to the plurality of arcuate outer cuts or perforations, the plurality of arcuate outer cuts or perforations surrounding the plurality of arcuate inner cuts or perforations, the plurality of arcuate inner cuts or perforations comprising four inner cuts each separated from adjacent inner cuts by uncut, unperforated bridge portions, wherein an inner cut is located in each of the four quadrants and the bridge portions separating the inner cuts are positioned at opposite ends along the major and minor axes;

an upper arcuate cut or perforation and a lower arcuate cut or perforation symmetrically arranged about the minor axis located at opposite ends of the pad, wherein the upper arcuate cut or perforation and the lower arcuate cut or perforation are positioned between the outer cuts or perforations and the inner cuts or perforations, wherein the upper arcuate cut or perforation extends across two quadrants symmetricall about the major axis on a first side of the minor axis, and the lower arcuate cut or perforation extends across two quadrants symmetrically about the major axis on a second side of the minor axis opposite the first side, and wherein the upper arcuate cut or perforation and the lower arcuate cut or perforation have a larger radius of curvature than that of at least a portion of the outer cuts or perforations near the major axis; and

wherein the cuts or perforations define at least one pad section configured to be detachable from the pad;

a flexible drape configured to be placed over the porous pad;

a source of negative pressure; and

a conduit configured to transmit negative pressure from the source to the flexible drape.

2. The system of claim 1 , wherein the wound contact layer is constructed from a material that is minimally adherent to the wound site.

3. The system of claim 1 , wherein the wound contact layer comprises polyurethane.

4. The system of claim 1 , wherein the porous pad comprises a porous polyurethane foam.

5. The system of claim 1 , further comprising a port attachable to an aperture formed in the drape and the conduit.

6. A method of treating a wound site using negative pressure, wherein the treatment comprises:

placing a wound contact layer onto the wound site;

sizing a porous pad to fit within the wound site, wherein the porous pad comprises:

a generally planar shape with a thickness less than a width and a length;

a major axis;

a minor axis;

four quadrants defined by the major and minor axes;

a plurality of arcuate outer cuts or perforations extending through at least a portion of the thickness of the pad and having an elliptical shape, the plurality of arcuate outer cuts or perforations comprising four outer cuts each separated from adjacent outer cuts by uncut, unperforated bridge portions, wherein an outer cut is located in each of the four quadrants and the bridge portions separating the outer cuts are positioned at opposite ends along the major and minor axes;

a plurality of arcuate inner cuts extending through at least a portion of the thickness of the pad and having an elliptical shape similarly shaped to the plurality of arcuate outer cuts or perforations, the plurality of arcuate outer cuts or perforations surrounding the plurality of arcuate inner cuts or perforations, the plurality of arcuate inner cuts or perforations comprising four inner cuts each separated from adjacent inner cuts by uncut, unperforated bridge portions, wherein an inner cut is located in each of the four quadrants and the bridge portions separating the inner cuts are positioned at opposite ends along the major and minor axes;

an upper arcuate cut or perforation and a lower arcuate cut or perforation symmetrically arranged about the minor axis located at opposite ends of the pad, wherein the upper arcuate cut or perforation and the lower arcuate cut or perforation are positioned between the outer cuts or perforations and the inner cuts or perforations, wherein the upper arcuate cut or perforation extends across two quadrants s mmetricall about the major axis on a first side of the minor axis, and the lower arcuate cut or perforation extends across two quadrants symmetrically about the major axis on a second side of the minor axis opposite the first side, and wherein the upper arcuate cut or perforation and the lower arcuate cut or perforation have a larger radius of curvature than that of at least a portion of the outer cuts or perforations near the major axis; and

wherein the cuts or perforations define at least one pad section config red to be detachable from the pad;

wherein sizing the porous pad comprises removing portions of the porous pad along at least one of said cuts or perforations;

placing the porous pad over the wound contact layer;

sealing the wound site with a flexible drape configured to be positioned over the wound and sealed to the skin surrounding the wound;

connecting a source of negative pressure to the wound site, wherein the source of negative pressure is connected through a conduit fluidically connected between the drape and the source of negative pressure; and

maintaining the application of negative pressure to the wound site until the wound site has reached a desired level of healing.

7. The method of claim 6 , further comprising storing wound exudate and other fluids removed from the wound in a container.

8. The method of claim 6 , further comprising connecting the conduit to the drape through a port applied to an aperture in the drape.

9. The method of claim 6 , comprising placing the wound contact layer onto an abdominal wound site.

10. The method of claim 6 , wherein removing portions of the porous pad along at least one of said cuts or perforations to size the porous pad is accomplished by hand.

11. The method of claim 6 , wherein sizing the porous pad comprises removing portions of the porous pad such that the pad is asymmetrically resized.

12. A porous pad for the treatment of wounds using negative pressure, wherein the pad comprises:

a porous material suitable for channeling wound exudate from a wound site and negative pressure to the wound site;

a generally planar shape with a thickness less than a width and a length;

a major axis;

a minor axis;

four quadrants defined by the major and minor axes;

a plurality of arcuate outer cuts or perforations extending through at least a portion of the thickness of the pad and having an elliptical shape, the plurality of arcuate outer cuts or perforations comprising four outer cuts each separated from adjacent outer cuts by uncut, unperforated bridge portions, wherein an outer cut is located in each of the four quadrants and the bridge portions separating the outer cuts are positioned at opposite ends along the major and minor axes;

a plurality of arcuate inner cuts or perforations extending through at least a portion of the thickness of the pad and having an elliptical shape similarly shaped to the plurality of arcuate outer cuts or perforations, the plurality of arcuate outer cuts or perforations surrounding the plurality of arcuate inner cuts or perforations, the plurality of arcuate inner cuts or perforations comprising four inner cuts each separated from adjacent inner cuts by uncut, unperforated bridge portions, wherein an inner cut is located in each of the four quadrants and the bridge portions separating the inner cuts are positioned at opposite ends along the major and minor axes;

an upper arcuate cut or perforation and a lower arcuate cut or perforation symmetrically arranged about the minor axis located at opposite ends of the pad, wherein the upper arcuate cut or perforation and the lower arcuate cut or perforation are positioned between the outer cuts or perforations and the inner cuts or perforations, wherein the upper arcuate cut or perforation extends across two quadrants symmetrically about the major axis on a first side of the minor axis, and the lower arcuate cut or perforation extends across two quadrants symmetrically about the major axis on a second side of the minor axis opposite the first side, and wherein the upper arcuate cut or perforation and the lower arcuate cut or perforation have a larger radius of curvature than that of at least a portion of the outer cuts or perforations near the major axis; and

wherein the cuts or perforations define at least one pad section configured to be detachable from the pad.

13. The pad of claim 12 , wherein the pad comprises an open-celled, reticulated foam.

14. The pad of claim 12 , wherein the pad comprises a polyurethane foam.

15. The pad of claim 12 , further comprising a plurality of intermediate cuts or perforations between the outer cuts and the inner cuts or perforations, at least some of the intermediate cuts or perforations extending generally lengthwise across the pad and at least some of the intermediate cuts or perforations extending generally widthwise across the pad.

16. The pad of claim 12 , wherein the cuts or perforations allow the at least one pad section to be detached by hand.

17. The pad of claim 12 , wherein removal of the at least one pad section results in an irregularly or asymmetrically shaped pad.

18. The pad of claim 12 , wherein the pad may be resized asymmetrically by removal of the at least one pad section.