Failsafe percutaneous wound barrier
Provided are approaches to establish a failsafe barrier to internal bleeding from percutaneous wounds to protect a patient from failed wound closure devices or related complications due to a variety of contributing factors such as state of systemic anticoagulation, errors in surgical procedure, variability in patient anatomy, and the like. Systems include a clotting agent to encase, and thus isolate, substantially the entire wound access area from the rest of the patient and an instrument, such as an intravascular introducer sheath, inserted through a wound at an access site on a vessel, for delivering the clotting agent to the entire enveloping tissue region around the accessed area as a mold cavity to be filled with the clotting agent. With benefits of patient safety, user simplicity, and low healthcare cost driving the effort, autologous whole blood is the preferred injected agent.
1. A kit for use in forming a failsafe percutaneous wound barrier, the kit comprising:
a clotting agent transfer apparatus; and
instructions for forming the failsafe percutaneous wound barrier, the instructions comprising instructions directing a practitioner to
deliver, by the clotting agent transfer apparatus, a tissue forming fluid to a subcutaneous region at least partially surrounding a vessel wound in a body of a patient,
fill the subcutaneous region with the tissue forming fluid, and
maintain a position of at least a portion of the apparatus within an access path through skin of the patient for a period of time to allow the tissue forming fluid to at least partially solidify into a tissue mass;
wherein the tissue mass is capable of being reabsorbed by the body of the patient; and
wherein, upon removing the apparatus from the access path, a core pin channel impression in the form of the portion of the apparatus is exposed via an opening in the skin of the patient, wherein the core pin channel impression provides a channel for directing any bleeding out to the skin of the patient, thereby providing a failsafe mechanism to avoid internal bleeding.
2. The kit of claim 1 , wherein the instructions comprise instructions for forming the access path.
3. The kit of claim 1 , wherein the apparatus comprises a cannula for providing fluid communication between a source of the tissue forming fluid and the subcutaneous region via the access path.
4. The kit of claim 3 , wherein the apparatus comprises the source of the tissue forming fluid.
5. The kit of claim 4 , wherein the source is a syringe.
6. The kit of claim 1 , wherein the apparatus comprises a sheath.
7. The kit of claim 1 , wherein the apparatus comprises a needle.
8. The kit of claim 1 , wherein the apparatus comprises a dilator for minimizing disruption of wounded tissue along the access path.
9. The kit of claim 1 , wherein the apparatus comprises an indicator for identifying fullness of the subcutaneous region.
10. The kit of claim 1 , wherein the instructions further direct the practitioner to, while filling the subcutaneous region, monitor the fullness of the subcutaneous region.
11. The kit of claim 1 , wherein the instructions further direct the practitioner to, after removing the apparatus, apply compression, thereby collapsing the core pin channel impression.
12. The kit of claim 1 , wherein the instructions further inform the practitioner that, after removing the apparatus, the core impression channel is configured to accept introduction of another instrument for performing an additional medical procedure.
13. The kit of claim 1 , wherein the tissue forming fluid comprises a clotting agent.
14. The kit of claim 13 , comprising the clotting agent.
15. A kit for use in closing a percutaneous wound in a failsafe manner, the kit comprising:
an apparatus for placing a clotting agent in internal bleeding pathways in a body of a patient while in a flowable form; and
instructions for use, the instructions comprising instructions for performing a method comprising
positioning, via an access path, a portion of the apparatus through skin of a patient,
placing, using the apparatus, the clotting agent in the internal bleeding pathways at least partially surrounding a percutaneous vessel of the patient while in the flowable form,
maintaining a position of the portion of the apparatus for a period of time to allow the clotting agent to at least partially solidify into a tissue cast formed within the internal bleeding pathways at least partially surrounding the percutaneous vessel;
wherein the tissue cast, after solidification, is capable of being reabsorbed by the body of the patient over time, and comprises a core pin casting cavity in the form of the portion of the apparatus; and
wherein, upon removal of the apparatus from the access path, the core pin casting cavity provides a channel for directing any bleeding out to the skin of the patient, thereby closing the percutaneous wound in the failsafe manner.
16. The kit of claim 15 , wherein:
the clotting agent comprises autologous whole blood; and
the tissue cast is formed in part of the autologous whole blood.
17. The kit of claim 15 , wherein the tissue cast is formed within a percutaneous region defined by one or more of interstitial loose connective tissue, blood vessels, cutaneous tissue, and muscle tissue.
18. The kit of claim 15 , wherein the apparatus comprises a cannula.
19. The kit of claim 18 , wherein the apparatus comprises a syringe attachable to the cannula.
20. The kit of claim 15 , wherein the apparatus comprises a pressure gauge for gauging pressure of the clotting placement in the internal bleeding pathways during placement.