DE4012232A1 - Dressing for deep wounds - has main sheet applied to skin with centre hole over wound, fed and drainage tubes with perforated ends at wound, and overall cover film - Google Patents

Abstract

A "Radom" or instillation dressing is partic. for treatment of deep or fibrinous suppurating wounds; it has a smooth and inert skin-protecting sheet for application or sticking to the wound. This sheet has a centre hole shaped to fit the wound, it has at least one drain and can also have supply feed; these have perforations at their ends, and the dressing has a transparent covering for the wound. The skin-protecting sheet is anti-hygroscopic and has a feed tube running parallel to and between the two opposite edges; this tube extends across the complete width of the sheet and its inlet and outlet drains can be closed off; its feed and/or outlet drain can be inserted into the feed and/or outlet hole in the feed tube so that the perforated ends of the drains do not project over the remote feed/outlet holes in the tube; the exterior surface of the drains is sealed by the interior of the feed tube. The skin-protecting sheet is pref. made of polyisobutylene foam. ADVANTAGE - The prod. is versatile and simple to use. It reduces the number of changes of dressing needed and consequently shortens treatment time and material usage.

Description

The invention relates to a redon or Instillation association, especially for treatment deeper and fibrinous purulent wounds, showing a smooth, inert skin protection plate to put on or sticking around the wound to be treated, whereby in the skin protection plate has a central opening can be introduced, the contour of the to be treated Wound corresponds to at least one drain and where appropriate, an inflow drain on their proximal end areas with a perforation are provided, and a covering the wound transparent bandage film.

There are a number of deeper and larger areas Wounds caused by bedsores, pressure burns or Pressure ulcers in sick people due to long lying can arise. Such cuts from Tissue structures of the human body in wide But space can also be created mechanically Wounds, such as cuts, punctures, bruises, lacerations, Lacerations, etc., or by thermal or chemical means created wounds on the skin, muscles and Vessels, but also by surgical means, especially in the abdomen. Such tissue losses may have to be replaced or the large or deep wound be closed again.

However, especially with fibrinous purulent wounds closing the wounds a lengthy process, who is constantly accompanied by contamination risks  is. This process is not just that Restore tissue continuity, d. H. the To close the wound again, but also in the wound area the surrounding tissue in as much as possible adapt to a high degree.

In the past, wound treatment and Wound care by the fact that plaster or Bandages were placed on the wound, whereby this due to the liquid formation in the area of Wound had to be changed frequently, which was constant led to contamination problems and treatment and adversely affected wound healing.

In addition, the introduction of one anticoagulant varidas solution into the wound Problematic dissolution of exudates in the wound, because this solution is immediately absorbed by the gauze bandage and had no time to adjust the viscosity of to reduce viscous, purulent exudates. The Removal of degradation products, such as the viscous, purulent exudate, the blood coagula, as well as cell debris from the wound indispensable requirement for a sufficient Wound treatment and wound care to the To make the healing process safer and too accelerate.

An association was therefore developed for the Treating such large, deep and fibrinous purulent wounds is quite suitable.

With this method, an adhesive booster is placed around the Wound around applied to the patient's skin. This is usually done with a Adhesive soaked cloth. Then one  certain required amount of sealing paste in a Disposable syringe filled and with this syringe only stripes interrupted by the wound placed on the surface with adhesive reinforcement. At Use of the association as an instillation association with the possibility of injecting medication and other liquids, was in these strips an inflow drain on the one hand and a Drain drain inserted on the other hand, so that the most proximal end portion of the drains attached Perforation lies on or in the wound is introduced. When using the association as Redon dressing, in which only wound fluid can run without medication or the like injected, only the drain was inserted in the strip or the inserted Inflow drain closed. The drains are in embedded the sealing paste strip. A Skin protection plate that has an opening in its center whose contour corresponds to that of the wound, is now going around the wound over the drains on the surface provided with adhesive reinforcement hung up. The edges of the skin protection plate will be with the one in the disposable syringe Sealing paste sealed. Then one Bandage film over the entire area of Skin protection plate placed to cover the wound. The distal end of the inflow drain is connected to a Bottle in connection with the Varidas solution brought so that this solution fed to the wound can be. The distal end of the drain drain again was connected to a Redon bottle, which through the vacuum it contains aspirates liquid from the wound. This suction can be interrupted that a flow inhibitor at the drain is provided.  

Through this well-known wound dressing, the Treatment time significantly reduced and the Contamination risks are significantly reduced, however, this solution has several disadvantages afflicted.

When introducing the drainage before applying the Skin protection plate on the wound flowed blood and other liquids on the future adhesive surface of the Skin protection plate, these liquids before the Sticking the skin protection plate away again had to be.

The available skin protection plates show usually different hygroscopic Properties on. Through the wound fluids the edges of the skin protection plate swell relatively short time so that the skin protection plate again must be removed. This requires a frequent one Dressing change, which in turn is a significant one Material consumption and a significant Involves labor.

Another disadvantage is that the drainage in their position must be held until the used sealing paste is dried and the Drainage gives an independent hold. Of further there was frequent closure of the Drain perforations due to the use of the Sealing paste. These disadvantages have a particular effect poor handling of the association.

The object of the present invention is therefore a Redon or instillation association, in particular for the treatment of deep and fibrinous purulent wounds  to create the versatile and easy in the manageability is, the number of Dressing changes reduced and thus the Treatment time is shortened and material consumption can be reduced.

According to the invention the object is achieved in that the skin protection plate is antihygroscopic is and a parallel between a couple yourself opposite edges of the skin protection plate arranged guide tube, which is in the essentially across the entire width of the Skin protection plate extends and one if necessary closable inlet opening and an outlet opening has, the inflow drain and / or the Drain drain into the inflow or Drain opening of the guide tube in such a way are insertable that the perforated end regions the drains don't have the distant ones Protruding openings of the guide tube and themselves the outer surface of the drains in a sealing relationship with the inner surfaces of the guide tube.

In a preferred embodiment, when using the Association as instillation association of the inflow drain and the drain drain into the inflow or Drainage opening of the guide tube insertable. At Use of the association as a Redon association is at least the drain into the drain opening of the Guide tube insertable, the inflow is designed to be closable.

In a preferred embodiment, the perforated end portions of the inflow drain and Drain drains right into the wound.  

The distant openings of the Guide tubes can each with a elastic plug part be provided, the one slightly smaller inner diameter than that smallest outside diameter of the drain to be inserted having.

In a preferred embodiment, there is Skin protection plate made of an elastic skin-friendly plastic material, preferably made of foamed polyisobutylene.

The bandage film can preferably be a semipermeable film.

In further training is at the distal end of the Inflow drains arranged a cannula connector, which as self-closing safety valve can be trained.

On the other hand, at the distal end of the drain drain Redon bottle can be connected, where on Drain drain itself a flow inhibitor can be provided.

This solution according to the invention is particularly based on the areas of secondary healing, at low secreting fistulas, wounds with necrosis, Decubitus ulcers, and ulcer for promotion of the granulation process with superficial applicable to clean wounds.

In addition to its versatile applicability to the different areas of indication, the simple Manageability, the need for the rarer  Association change and the associated Time saving and shortening the treatment time and the material saving brings this invention Solution with a number of special advantages.

The elastic formation of the skin protection plate ensures good contact even in rough conditions Wound areas, which is particularly true when moving Body parts is desirable. Through the antihygroscopic property of the skin protection plate the skin protection plate is prevented from swelling. In addition, a quick introduction of the Inflow and outflow drain into the guide tube the skin protection plate possible without this longer Time must be fixed in position. By previous Part of the perforated can be tried out End of the drains are cut away if this over the distant openings of the Protrude.

By aspirating the wound fluid as a result of Soges caused by the Redon bottle is the fluid released from the wound measurable and assessable, especially if the dispensed liquid in the Redon bottle sedimented.

By using a bandage film, a airtight closure of the wound reached, whereby the risk of contamination is reduced. The continuous use of such a semipermeable Bandage film causes cell formation in the wound, d. H. it promotes the formation of the granulation tissue and thus wound healing. Through the thin transparent bandage film is a permanent one Inspection of the wound by the attending doctor,  the clinic staff and by the patient himself possible. The bandage film lays down as a result of Soges created by the Redon bottle the wound, causing the released wound fluid can be derived well and completely. On the Inflow drain becomes the possibility of Drug application and installation created by providing a Flow inhibitor device on the drain drain Residence time of the applied drug on the Wound can be regulated.

Using an exemplary embodiment, the present invention will be explained in more detail. The associated drawing shows a complete Instillationsverband, which in the field of Guide tube is shown cut. On the representation of a Redon association was waived, since this essentially from Instillation association is included. At the Redonverband is either not the inflow drain is present or is the inflow drain or Inflow opening closed. The following is therefore the association according to the invention as Instillationsverband called.

The instillation bandage 1 has, among other things, a skin protection plate 3 which contains a central opening 5 in its central region. This opening 5 can already be provided by the manufacturer and can have different sizes in different skin protection plates. On the other hand, the central opening 5 can also be made by the treating personnel immediately before the skin protection plate 3 is placed on the wound 7 . The central opening 5 advantageously has a contour that corresponds to the contour of the wound 7 .

The skin protection plate 3 , which is designed to be antihygroscopic, has a guide tube 9 , which is arranged parallel between a pair of opposing edges of the skin protection plate 3 and extends essentially over the entire width of the skin protection plate 3 . If the central opening 5 is made in the skin protection plate 3 , the middle part of the guide tube 9 is necessarily cut away and this guide tube 9 is divided into two parts.

The skin protection plate 3 , which incidentally, like all other parts of the instillation dressing 1 , is contained in a sterile packaging before use, is advantageously provided on its underside with an adhesive layer which is protected from the use of the skin protection plate 3 by a peelable paper film. After the patient's wound has been treated aseptically, the skin protection plate 3 is glued to the patient's skin with its central opening 5 , so that the central opening 5 and the wound area 7 are in mutual overlap.

An inflow drain 11 and an outflow drain 13 belong to the instillation association 1 . At their proximal end regions, these are each provided with a perforation 15 , which is advantageously distributed over the entire circumference of the proximal end region of the drains 11 and 13 . The inflow and outflow drains 11 and 13 are inserted with their proximal perforated ends into the associated guide tube 9 in such a way that the perforated end regions 15 of the drains 11 and 13 do not protrude beyond the distant inflow or outflow openings 17 and 19 of the guide tube 9 . However, the perforated end regions 15 of the drains 11 and 13 should protrude into the wound region 7 or into the wound. If the perforations 15 of the drains 11 and 13 extend in the direction of their distal ends beyond the inflow opening 17 or the outflow opening 19 of the guide tube 9 , a part of the perforation 15 must be cut away in the wound area 7 . The inner diameter of the guide tube 9 corresponds approximately to the outer diameter of the inflow or outflow drains 11 and 13 , so that they lie non-slip and tightly in the guide tube 9 . In a further embodiment, the distal ends of the guide tube 9 can each have a stopper part 21 which has a slightly smaller inside diameter than the smallest outside diameter of the drain 11 or 13 to be inserted. Since this plug part 21 consists of a highly elastic material, the inner diameter adapts to the drain diameter to be inserted in each case, so that drains of different thicknesses can be inserted. The drains 11 and 13 are thus sealed off from the surrounding atmosphere.

The thus installed inflow drain 11 and the outflow drain 13 are thus fixed in position relative to the skin protection plate 3 . A transparent, thin and semipermeable bandage film 23 is now covered over the skin protection plate 3 and the drains 11 and 13 installed thereon and thus over the wound area 7 . In a preferred embodiment, the entire surface of the skin protection film 23 is provided with a self-adhesive layer which is applied to the skin protection plate. As a result, the bandage film 23 also seals the wound area 7 .

At the distal end of the inflow drain 11 , a cannula connection 25 is provided, which can be designed as an automatically closing safety valve. A syringe (not shown) can be connected to this cannula connection 25 and can apply medication to the wound area 7 via the inflow drain 11 . If the syringe is removed from the inflow drain 11 , the cannula connection closes automatically. If necessary, namely when medication or other liquids are to be injected, the cannula connection opens when the syringe is pierced.

At the distal end of the drain drain 13 , a Redon bottle 27 can be connected, in which there is a vacuum. Wound fluid is aspirated through this vacuum via the perforation 15 of the drain drain 13 . If the suction is to be interrupted because the injected medication is to remain in the wound area 7 , a flow inhibitor device 29 located on the drain drain 13 is actuated and the drain drain 13 is closed. After the flow inhibitor device 29 has been opened , the wound fluid is sucked off again.

With this solution according to the invention, a easy to use and versatile Applicability of the Redon or instillation association reached. Bandage changes are less necessary, thereby saving time, shortening the time Treatment time and material savings achieved becomes.

Claims (9)

1. Redon or instillation dressing, in particular for the treatment of deeper and fibrinous purulent wounds, comprising a smooth, inert skin protection plate for laying on or sticking around the wound to be treated, wherein a central opening can be made in the skin protection plate, which corresponds to the contour of the wound to be treated corresponds to at least one outflow drain and possibly an inflow drain, which are provided with perforations at their proximal end region, and a transparent dressing film covering the wound, characterized in that the skin protection plate ( 3 ) is designed antihygroscopically and a parallel one between a pair of opposing ones Edges of the skin protection plate ( 3 ) arranged guide tube ( 9 ) which extends substantially over the entire width of the skin protection plate ( 3 ) and an optionally closable inflow opening ( 17 ) and a drain opening ( 19 ), the inflow drain ( 11 ) and /or the Outflow drain ( 13 ) in each case in the inflow or outflow opening ( 17 ; Of the guide tube (9) are such insertable 19) that the perforated end portions (15) of the drains (11; 13) does not have the distance lying inflow and outflow openings (17; jut 19) of the guide tube (9) and the outer surfaces the drains ( 11 ; 13 ) are in sealing relationship with the inner surfaces of the guide tube ( 9 ). 2. A dressing according to claim 1, characterized in that when used as an instillation dressing the inflow drain ( 11 ) and the outflow drain ( 13 ) can each be inserted into the inflow or outflow opening ( 17 ; 19 ) of the guide tube ( 9 ). 3. Dressing according to claim 1, characterized in that when using the dressing as a Redon dressing at least the drain ( 13 ) in the drain opening ( 19 ) of the guide tube ( 9 ) can be inserted, wherein the inflow ( 17 ) is closable. 4. Dressing according to claim 1, characterized in that the perforated end regions ( 15 ) of the inflow drain ( 11 ) and the outflow drain ( 13 ) protrude into the wound ( 7 ). 5. Association according to at least one of claims 1 to 4, characterized in that the distant inflow or outflow openings ( 17 ; 19 ) of the guide tube ( 9 ) are each provided with an elastic stopper part ( 21 ) which has a slightly smaller inner diameter than the smallest outside diameter of the drain ( 11 ; 13 ) to be inserted. 6. A dressing according to claim 1, characterized in that the skin protection plate ( 3 ) consists of an elastic skin-compatible plastic material, preferably of foamed polyisobutylene. 7. Dressing according to claim 1, characterized in that the dressing film ( 23 ) is a semi-permeable film. 8. Dressing according to at least one of the preceding claims 1 to 7, characterized in that a cannula connection ( 25 ) is arranged at the distal end of the inflow drain ( 11 ), which can be designed as an automatically closing safety valve. 9. A dressing according to at least one of the preceding claims 1 to 8, characterized in that a Redon bottle ( 27 ) can be connected to the distal end of the drainage drain ( 13 ), it being possible for a flow-inhibiting device ( 29 ) to be provided on the drainage drain ( 13 ) .