WOUND TREATMENT SYSTEM AND METHOD

Abstract

A system for treating open wounds includes a foam material configured for pouring, spraying, injecting or spreading on a wound bed. The foam material can comprise a base component and a curing component, which can be pre-mixed before application, or mixed in situ as the components are being applied to the wound site. A third component can comprise a sacrificial porogen. Foam can be placed in the wound bed as a wound liner on the wound surfaces. An additional foam insulation can provide a foam filler partially contained by the wound liner and generally flush with a patient's epidermis. A method of treating open wounds includes the steps of applying the wound liner and filler components. An optional step comprises covering the wound liner with a semi-permeable (breathable) membrane and mounting inlet and outlet ports thereon for introducing healing compositions as input, and extracting wound exudates as output.

Claims

1. A wound treatment system comprising: a foam dressing configured for application to and for lining or filling a wound cavity; said foam dressing being comprised of a foam mixture of a first component and a second component; said foam mixture is configured for curing within said wound cavity; and wherein said foam dressing is configured for compacting and for accommodating transfer of fluid from said wound out of said wound under negative or other pressure gradient system.

2. The wound treatment system according to claim one wherein said foam mixture is configured for curing in response to application of a curing agent.

3. The wound treatment system according to claim 1, wherein: said foam dressing further comprises a third component; and said third component comprises a sacrificial porogen.

4. The wound treatment system according to claim 1, wherein: said foam dressing comprises an open-cell foam.

5. The wound treatment system according to claim 1, which includes: a foam wound liner lining said wound bed; and a foam wound filler poured, sprayed, injected or spread in said liner.

6. The wound treatment system according to claim 1, which includes one of a hydrogel and a fibrin-based glue in said foam.

7. The wound treatment system according to claim 1, which includes: a semi-permeable membrane covering said foam mixture; and at least one of: an inlet port connected to said membrane and a fluid source; and an outlet port connected to said membrane and a suction device, said outlet port configured for discharging exudate from said wound via said outlet port.

8. The wound treatment system according to claim 6, wherein said foam wound liner and said, foam wound filler comprise foam materials with different cellular and pore configurations.

9. The wound treatment system according to claim 1, which includes: a bioactive synthetic or natural compound applied to said foam material and configured for promoting tissue growth, cell migration, proliferation, improving dimensional stability or augmenting porous fractions.

10. The wound treatment system according to claim 1, further comprising: an amorphous wound liner configured for application to and for conforming to said wound cavity; said wound liner being comprised of a mixture of a first liner component and a second liner component; wherein said wound liner is configured for curing within said wound cavity in response to application of a liner curing agent; and wherein said wound liner is configured for application to said wound in a deeper position in relation to said foam dressing.

11. The wound treatment system according to claim 1, which includes: a foam insert embedded in said foam filler; pore size and bulk porosity variables of said foam effect compactability or compressibility of said foam insert; and said compactability or compressibility of said foam insert effect degrees of physiochemical and mechanotransduction response of damaged tissue in said wound site.

12. The wound treatment system according to claim 3 wherein: said third liner component comprises a liner bioactive agent.

13. The wound treatment system according to claim 12, wherein: said liner bioactive agent is configured for release from said wound liner into said wound cavity.

14. The wound treatment system according to claim 3, wherein: said wound liner further comprises a fourth liner component; said third liner component comprises a liner sacrificial porogen; and said fourth liner component comprises a liner bioactive agent.

15. The wound treatment system according to claim 4, wherein: said wound liner comprises a closed-cell foam.

16. A method of treating a wound comprising the steps of: mixing a first component and a second component forming an amorphous foam dressing; applying said foam dressing into a wound cavity; said foam dressing forming to and filling said wound cavity; applying a curing agent to said wound; and said foam dressing curing within said wound cavity.

17. The method according to claim 11, further comprising the steps of: applying negative or other pressure gradient to said wound; said foam dressing compacting under said negative or other pressure gradient; and fluid from said wound transferring from said wound through said foam dressing and out of said wound under a pressure gradient.

18. The method according to claim 11, further comprising the steps of: mixing a first liner component and a second liner component forming an amorphous wound liner; applying said wound liner into said wound cavity; and wherein said applying said foam dressing into said wound cavity comprises applying said foam dressing into said wound cavity closer to the surface than said wound liner.

19. The method according to claim 11, wherein: said mixing said first component and said second component forming said foam dressing further comprises mixing a third component with said first and second components; and said third component comprises a sacrificial porogen.

20. The method according to claim 14, further comprising the step of: removing said sacrificial porogen from said foam dressing.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0029] The drawings constitute a part of this specification and include exemplary embodiments of the present invention illustrating various objects and features thereof.

[0030] FIG. 1 is a cross-sectional view of an open wound, which can be treated with the present invention.

[0031] FIG. 2 shows a liner applied to the wound.

[0032] FIG. 3 shows foam applied as filler for the wound.

[0033] FIG. 4 shows an optional insert installed in the foam.

[0034] FIG. 5 shows a re-epithelialized, healing, outcome.

[0035] FIG. 6 shows a modified or alternative embodiment of the present invention configured for negative pressure wound therapy (NPWT), with a semi-permeable membrane cover and inlet and outlet ports.

[0036] FIG. 7 shows another modified or alternative embodiment of the present invention with foam applied directly to the exposed tissue in the wound bed.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

I. Introduction and Environment

[0037] As required, detailed aspects of the present invention are disclosed herein, however, it is to be understood that the disclosed aspects are merely exemplary of the invention, which may be embodied in various forms. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art how to variously employ the present invention in virtually any appropriately detailed structure.

[0038] Certain terminology will be used in the following description for convenience in reference only and will not be limiting. For example, up, down, front, back, right, and left refer to the invention as orientated in the view being referred to. The words “inwardly” and “outwardly” refer to directions toward and away from, respectively, the geometric center of the aspect being described and designated parts thereof. Forwardly and rearwardly are generally in reference to the direction of travel, if appropriate. Additionally, anatomical terms are given their usual meanings. For example, proximal means closer to the trunk of the body, and distal means further from the trunk of the body. Said terminology will include the words specifically mentioned, derivatives thereof and words of similar meaning.

[0039] As described herein, the term foam shall be defined as any liquid or solid material having pockets of gas within the liquid or solid material, including both open-cell and closed-cell pockets. The term foam shall be interpreted broadly enough to include materials of any thickness, including thin materials such as meshes. Furthermore, the terms cure and curing shall be defined as the process of hardening a material, including but not limited to cross-linking of biological and/or synthetic components. A curing agent shall mean a substance or factor applied to a material to initiate curing of that material.

II. Preferred Embodiments

[0040] The present invention discloses an improved system and method for wound treatment. In an exemplary embodiment, a curable, amorphous wound dressing is applied to a wound in a liquid or semi-liquid state, which dressing forms to the shape of the wound cavity and cures within the wound. Preferably, the wound dressing forms into a foam material. Embodiments include both open-cell and closed-cell dressings, and the wound dressing material components can be configured for being poured, sprayed, injected, or spread into a wound. The wound dressing can include pores which are sized for physiologic effect, i.e., large, granulation-enmeshing or small, non-enmeshing pores. Additionally, the dressing may be hydrophobic or hydrophilic.

[0041] FIG. 1 shows an open wound 2 penetrating the epidermis 4 and extending into the dermis 6. Such wounds can be caused by a variety of conditions, including disease and trauma. Diabetes, impaired circulation, prolonged patient immobility and other medical conditions can exacerbate such wounds. If left untreated, the negative consequences can include infection, functional disability, limb loss and even death. FIGS. 2 and 3, respectively, show the application of a foam wound liner 8 and a foam filler 10 generally flush with the patient's epidermis 4.

[0042] Without limitation on the generality of useful materials for forming a wound dressing 12 according to the present invention, the foam liner 8 and the filler 10 can be gel and/or foam, which can comprise premade, tailored solutions. Such solutions can include first and second compounds, which are the components of the gel and/or foam liner. A third, additional compound can comprise, for example, a sacrificial porogen (e.g., bioactive factors, curing agent or adhesion protein). The third compound can be added to either the first or second compound, or it can be added separately and allowed to mix within the wound 2 bed upon application with the first and second compounds.

[0043] The third compound can consist of a mixture of multiple solutions or be separated into multiple distinct solutions. Utilizing an application system such as a dual syringe (or other modality), the first and second compounds can be kept separate until application to the wound 2. Alternatively, they can be mixed together in a single chamber and then applied, depending on the compounds used and the method of curation.

[0044] Upon application of the multi-compound to the wound 2, the solution mixture will disperse throughout the wound 2 and cure to form a wound liner layer 8. The wound liner 8 can be used as its own modality or with other wound dressings and therapies, such as the foam filler 10. FIG. 4 shows a porous foam insert 14 embedded in the foam filler 10. The insert 14 can be used to alter the performance characteristics of the dressing 12, such as directing fluid flow, facilitating pressure gradient formation, facilitating exudate drainage and the dispersion of growth factors and other medications. In some embodiments, the foam wound dressing material is configured to be expandable within a wound to form to the shape of the wound cavity, while in other embodiments, the foam wound dressing does not expand.

[0045] FIG. 5 shows a healing outcome with re-epitheliazation consisting of an intact epidermis over a dermis-like, healed granulation layer. The wound dressing 12 of the present invention can be modified, removed and reapplied as necessary to achieve such a healing outcome.

[0046] FIG. 6 shows a modified or alternative embodiment of the present invention comprising wound dressing 22 with a porous, semi-permeable membrane 24 covering the wound 2. Inlet/outlet port patches 26 can be placed where necessary and configured for extracting exudate or introducing solutions to the wound site. Such solutions can include growth factors, antibiotics and other medications. Pressure gradients can be formed by connecting the inlet/outlet port patches 26 to suction sources for outlet operating modes in NPWT applications, and to fluid delivery devices for inlet operating modes.

[0047] FIG. 7 shows yet another modified or alternative embodiment of the present invention comprising foam filler 34 poured, sprayed, injected or spread directly into the wound 2 without a liner. The volume of foam filler 34 applied to the wound 2 is variable. Pouring, spraying, injecting or spreading foam filler 34 in a liquid or semi-viscous state into the bed of the wound 2 enables controlling variables such as thickness, volume, evaporation and fluid transfer functions.

[0048] The foam wound dressing material can be configured to cure via a chemical curing agent, a photo-initiator curing agent, water moisture, or change in temperature. Different embodiments of the wound dressing material may be made up of a polyurethane ester, a polyurethane ether, a polyethylene glycol, a polyvinyl alcohol, a polylactic acid, a polyester, a polycaprolactone (PCL), a silicone-based derivative or a polysaccharide. Furthermore, the foam wound dressing may be formed by covalent bonds, ionic bonds, or hydrogen bonds.

[0049] The wound dressing of the present invention may be used with additional wound dressing and/or wound therapies, as desired. The dressing may further be covered with an adhesive dressing covering. Additionally, negative pressure or positive pressure may be applied to the wound and dressing. In some embodiments, the wound dressing is configured for compacting or compressing under negative pressure, while in other embodiments, the wound dressing is configured to hold its structure under negative pressure. As the wound heals, the wound dressing of the present invention can be configured for removal from the wound or the dressing material may be configured for being resorbed in the wound.

[0050] In embodiments incorporating a sacrificial component, a sacrificial solution may be dissolved into the wound dressing compound. Alternatively, a sacrificial solution can be dissolved into a solution and then added to the wound dressing compound system. Moreover, in other embodiments, the sacrificial solution is dissolved into a solution and added into the wound simultaneously with the residual foam component system. The sacrificial component may also be removed by the application of negative pressure or vacuum after its dissolution, or the sacrificial component may be dissolved into the wound site and taken up by the surrounding tissue.

[0051] In some embodiments of the present invention, the porous fraction of the foam insert can be modified by modulating molecular characteristics of the sacrificial porogen, including but not limited to modification of the molecular weight or size of the porogen. The porous fraction of the foam insert can alternatively be modified by modulating molecular characteristics of the residual foam component, including but not limited to modification of the molecular weight or size of the residual compound or modification of the relative concentration of the residual foam compound. In additional embodiments, the porous fraction of the foam is created by using gas as a porogen. The gas porogen may be dissolved, mixed or incorporated into the multi-solution system before application and allowed to dissolve, permeate or evaporate out of the foam upon application to the wound or the gas may be applied to the wound site promoting the formation of bubbles within the residual polymer foam as it cures. In some embodiments, the sacrificial porogen may be resorbed or dissolved within the wound environment or degraded and removed by enzymatic activity. In other embodiments, the sacrificial porogen is dissolved within the wound environment after a change in temperature or after application of a solvent over the foam material. The solvent may be aqueous-based, an acid, or a base and may or may not contain an enzyme.

[0052] In a preferred embodiment, the sacrificial porogen is a natural occurring biological compound, including but not limited a protein, polysaccharide, nucleic acid, or salt. Protein sacrificial porogens include but are not limited to collagen, gelatin, silk fibroin, and fibrin. Polysaccharide sacrificial porogens include but are not limited to dextran, xanthan gum, pectin, hyaluronic acid, carrageenan, guar gum, and cellulose. Polymer sacrificial porogens may also be used, including but not limited to polyethylene oxide, polyethylene glycol, polyvinyl alcohol, polyvinyl pyrrolidone, polyacrylic acid, polyacrylamides, polyphosphate, and hydroxypropyl methacrylamide.

[0053] A smaller, preformed foam material may further be used as a core element in conjunction with the multi-solution system of the present invention. This core foam insert may become a vacuum core under negative pressure.

[0054] In an exemplary embodiment, a synthetic polymer foam is utilized, preferably a polyurethane fabricated by mixing isocyanate and polyols, but alternative polymer foam materials may be used. A sacrificial porogen including natural and/or synthetic compounds that dissolve in water, such as polyethylene glycol or gelatin, or a gas contained within a solution is mixed with the foam material. In some embodiments, the sacrificial compound can also dissolve into the wound site naturally. Biological sacrificial components may include fibrin, collagen, and/or hyaluronic acid. Soluble bioactive factors utilized may include growth factors and/or exosomes. In an exemplary embodiment, a crosslinking or curing agent is applied to the foam material to cure the foam within the wound. The crosslinking or curing agent may be a natural enzyme or factor such as factor XIII or calcium, water, natural enzyme, biological agent, chemical agent, temperature change or a particular spectrum of light such as UV light.

[0055] In some embodiments, an amorphous gel liner is utilized either in conjunction with the foam dressing or standalone. The liner may be poured, sprayed, injected, or spread into the wound. In a preferred embodiment, the liner is a closed-cell material used in conjunction with an open-cell foam material superficial to or positioned closer to the surface than the liner. A liner may also be used alone with negative pressure therapy. In preferred embodiments, a closed-cell liner is made up of bioactive compounds or extracellular matrix (ECM), such as but not limited to fibrin, collagen, or hyaluronic acid. The liner may or may not need to be removed from the wound site during the wound healing process. Similarly, the foam dressing material also may or may not need to be removed from the wound site.

[0056] In an exemplary embodiment of a pourable foam dressing material, isocyanate is mixed with polyol and a sacrificial porogen of polyethylene glycol or gelatin to form the foam material. In an exemplary embodiment of a pourable gel liner material, a fibrinogen-based first solution containing factor XIII and bioactive growth compounds is mixed with a thrombin-based second solution containing calcium chloride and ECM compounds to form the liner material. The liner material may optionally further include a sacrificial porogen (if desired) and/or synthetic or natural polymer (to enhance structural stability of the final gel material).

III. Examples of Exemplary Embodiments

[0057] The following is a non-limiting listing of additional exemplary embodiments of the present invention: [0058] 1. Fabrication of an open-cell foam from a pourable, sprayable, injectable, or spreadable multi-solution system that expands within a wound as it cures. This is achieved by utilizing a multi-component system of materials within the multi-solution system that will ultimately be used to compose foam solutions. One component is a residual foam insert created inside the wound cavity. Another component is a sacrificial component. The residual compound material can be fabricated from two or more separate solutions and may include a biological compound or a synthetic biomaterial. In an exemplary embodiment, the residual compound material is configured to remain within the wound bed. The sacrificial compound material can be a sacrificial porogen material. Preferably, the sacrificial compound material will be removed from the final foam by dissolution or absorption. [0059] 2. The foam wound insert in example 1, wherein the multi-solution system of the residual foam component creates an expanding foam upon mixture of solutions [0060] 3. The foam wound insert in example 1, wherein the multi-solution system of the residual foam component fills an entire wound without first needing to expand. [0061] 4. The foam wound insert in example 1, wherein the multi-solution system is premixed into a single chamber before pouring into a wound. [0062] 5. The foam wound insert in example 1, wherein the multi-solution system is mixed at the time of pouring multiple solutions into a wound. [0063] 6. The foam wound insert in example 1, wherein the multi-solution system is applied via a multi-syringe chamber system that mixes solution through a cannula tip immediately before application into a wound. [0064] 7. The foam wound insert in example 1, wherein the multi-solution system is poured into a wound and allowed to expand and cure. [0065] 8. The foam wound insert in example 1, wherein the multi-solution system is sprayed into a wound and allowed to expand and cure. [0066] 9. The foam wound insert in example 1, wherein the multi-solution system is injected into a wound and allowed to expand and cure. [0067] 10. The foam wound insert in example 1, wherein the multi-solution system is spread into a wound and allowed to expand and cure. [0068] 11. The foam wound insert in example 1, wherein the residual compound cures via a chemical curing agent. [0069] 12. The foam wound insert in example 1, wherein the residual compound cures via a photo-initiator curing agent. [0070] 13. The foam wound insert in example 1, wherein the residual compound cures via water moisture. [0071] 14. The foam wound insert in example 1, wherein the residual compound cures via temperature. [0072] 15. The foam wound insert in example 1, wherein the residual compound formed is a polyurethane ester. [0073] 16. The foam wound insert in example 1, wherein the residual compound formed is a polyurethane ether. [0074] 17. The foam wound insert in example 1, wherein the residual compound formed is a polyethylene glycol. [0075] 18. The foam wound insert in example 1, wherein the residual compound formed is a polyvinyl alcohol. [0076] 19. The foam wound insert in example 1, wherein the residual compound formed is a polylactic acid. [0077] 20. The foam wound insert in example 1, wherein the residual compound formed is a polyester, a polycaprolactone (PCL) or a silicon-based derivative [0078] 21. The foam wound insert in example 1, wherein the residual compound formed is a polysaccharide. [0079] 22. The foam wound insert in example 1, wherein the residual compound formed is a formed with peptide bonds. [0080] 23. The foam wound insert in example 1, wherein the residual compound formed is a formed with covalent bonds. [0081] 24. The foam wound insert in example 1, wherein the residual compound formed is a formed with ionic bonds. [0082] 25. The foam wound insert in example 1, wherein the residual compound formed is a formed with hydrogen bonds. [0083] 26. The foam wound insert in example 1, wherein the residual compound formed can be applied with additional wounds dressings. [0084] 27. The foam wound insert in example 1, wherein the residual compound formed is covered with an adhesive dressing. [0085] 28. The foam wound insert in example 1, wherein the residual compound formed is attached to a negative pressure system. [0086] 29. The foam wound insert in example 1, wherein the residual compound formed is attached to a positive pressure system, such as topical oxygen delivery and therapy. [0087] 30. The foam wound insert in example 1, wherein the residual compound formed will become compacted upon application of negative pressure. [0088] 31. The foam wound insert in example 1, wherein the residual compound can be removed from the wound as needed. [0089] 32. The foam wound insert in example 1, wherein the residual compound can be resorbed in the wound as needed [0090] 33. The foam wound insert in example 1, wherein the residual compound contains pores greater than 100 micrometers in size. [0091] 34. The foam wound insert in example 1, wherein the residual compound contains pores that are continuous. [0092] 35. The foam wound insert in example 1, wherein the residual compound is hydrophobic. [0093] 36. The foam wound insert in example 1, wherein the residual compound is hydrophilic. [0094] 37. The foam wound insert in example 1, wherein the relative concentration of sacrificial porogen to residual compound is changed to modify porosity. [0095] 38. The foam wound insert in example 1, wherein the sacrificial porogen is resorbed within the wound environment. [0096] 39. The foam wound insert in example 1, wherein the sacrificial porogen is dissolved within the wound environment. [0097] 40. The foam wound insert in example 1, wherein the sacrificial porogen is degraded/removed by enzymatic activity. [0098] 41. The foam wound insert in example 1, wherein the sacrificial porogen is dissolved within the wound environment by a change in temperature. [0099] 42. The foam wound insert in example 1, wherein the sacrificial porogen is dissolved by application of a solvent over the foam inert. [0100] 43. The solvent used to dissolve porogen in example 42, wherein the solvent is aqueous-based. [0101] 44. The solvent used to dissolve porogen in example 42, wherein the solvent is an acid. [0102] 45. The solvent used to dissolve porogen in example 42, wherein the solvent is a base. [0103] 46. The solvent used to dissolve porogen in example 42, wherein the solvent contains an enzyme. [0104] 47. The foam wound insert in example 1, wherein the sacrificial porogen used is a natural biological compound. [0105] 48. The natural biological compound in example 47, wherein the biological porogen is a protein. [0106] 49. The protein porogen in example 48, wherein the protein is collagen. [0107] 50. The protein porogen in example 48 wherein the protein is gelatin. [0108] 51. The protein porogen in example 48, wherein the protein is silk fibroin. [0109] 52. The protein porogen in example 48, wherein the protein is fibrin. [0110] 53. The natural biological compound in example 47, wherein the biological porogen is a polysaccharide. [0111] 54. The polysaccharide porogen in example 53, wherein the polysaccharide is dextran. [0112] 55. The polysaccharide porogen in example 53, wherein the polysaccharide is xanthan gum. [0113] 56. The polysaccharide porogen in example 53, wherein the polysaccharide is a pectin. [0114] 57. The polysaccharide porogen in example 53, wherein the polysaccharide is hyaluronic acid. [0115] 58. The polysaccharide porogen in example 53, wherein the polysaccharide is carrageenan. [0116] 59. The polysaccharide porogen in example 53, wherein the polysaccharide is guar gum. [0117] 60. The polysaccharide porogen in example 53, wherein the polysaccharide is cellulose. [0118] 61. The natural biological compound in example 47, wherein the biological porogen is a nucleic acid. [0119] 62. The foam wound insert in example 1, wherein the sacrificial porogen used is a salt. [0120] 63. The foam wound insert in example 1, wherein the sacrificial porogen used is a polymer. [0121] 64. The sacrificial porogen polymer in example 63, wherein the polymer is polyethylene oxide. [0122] 65. The sacrificial porogen polymer in example 63, wherein the polymer is polyethylene glycol. [0123] 66. The sacrificial porogen polymer in example 63, wherein the polymer is polyvinyl alcohol. [0124] 67. The sacrificial porogen polymer in example 63, wherein the polymer is polyvinyl pyrrolidone. [0125] 68. The sacrificial porogen polymer in example 63, wherein the polymer is polyacrylic acid. [0126] 69. The sacrificial porogen polymer in example 63, wherein the polymer is polyacrylamides. [0127] 70. The sacrificial porogen polymer in example 63, wherein the polymer is a polyphosphate. [0128] 71. The sacrificial porogen polymer in example 63, wherein the polymer is hydroxypropyl methacrylamide. [0129] 72. The foam wound insert system in example 1, wherein the sacrificial solution is dissolved into the residual foam compound system. [0130] 73. The foam wound insert system in example 1, wherein the sacrificial solution is dissolved into solution and then added the residual foam compound system. [0131] 74. The foam wound insert system in example 1, wherein the sacrificial solution is dissolved into solution and added simultaneously with the residual foam component system into the wound. [0132] 75. The foam wound insert system in example 1, wherein the sacrificial component is removed by negative pressure application under vacuum after its dissolution. [0133] 76. The foam wound insert system in example 1, wherein the sacrificial component is dissolved into the wound site and taken up by the tissue. [0134] 77. The foam wound insert system in example 1, wherein the porous fraction of the foam insert can be modified by modulating molecular characteristics of the sacrificial porogen. [0135] 78. The molecular characteristics in example 77, wherein the molecular weight or size of the porogen is modified. [0136] 79. The foam wound insert system in example 1, wherein the porous fraction of the foam insert can be modified by modulating molecular characteristics of the residual foam component. [0137] 80. The molecular characteristics in example 79, wherein the molecular weight or size of the residual compound is modified. [0138] 81. The molecular characteristics in example 79, wherein the relative concentration of the residual compound is modified. [0139] 82. The foam wound insert system in example 1, wherein the porous fraction of the foam is created by using gas as a porogen. [0140] 83. The gas porogen in example 82, wherein the gas is dissolved into the multi-solution system before application and allowed to dissolve out of the foam upon application to wound. [0141] 84. The gas porogen in example 82, wherein the gas is applied to the wound site promoting the formation of bubbles within the residual polymer foam as it cures. [0142] 85. The foam wound insert system in example 1, wherein a smaller preformed foam material is used as a core element in conjunction with the multi-solution system surrounding it. [0143] 86. The preformed foam material in example 85, wherein the core foam insert becomes the vacuum core under negative pressure. [0144] 87. Fabrication of an open-cell or closed-cell gel or foam that lines a wound from an initial pourable, sprayable, injectable, or spreadable multi-solution system that cures within the wound as it contours to the shape of the wound. The discontinuity, minimal pore size and low bulk porosity found with a closed-cell liner will decrease the rate at which tissue enmeshing occurs normally found with only using open-cell foam insert. However, the closed-cell liner is also porous enough to allow for fluid and exudate to be removed. The liner can be achieved in a similar fashion as describe in example 1, wherein a multi-solution system is used to apply to a wound which then covers the wound with or without the use of an expanding foam wound insert. When used with a foam wound insert, the gel and/or foam liner can be separate or detached from the foam insert or bound to the foam insert via the manipulation of the curation process or other methods, such as chemical or protein interactions between the liner and the insert. The liner can be fabricated with biological compounds or synthetic biomaterials. The liner can augment wound healing with the addition of bioactive factors or using a bioactive compound to construct the liner. [0145] 88. The gel and/or foam liner in example 87, wherein the liner is open-celled with continuous pore with diameters greater than 100 micrometers. [0146] 89. The gel and/or foam liner in example 87, wherein the liner is closed-celled with discontinuous pore with diameters less than 100 micrometers. [0147] 90. The gel and/or foam liner in example 87, wherein the liner is poured into a wound and allowed to cure. [0148] 91. The gel and/or foam liner in example 87, wherein the liner is cured via a photo-initiator. [0149] 92. The gel and/or foam liner in example 87, wherein the liner is cured via natural crosslinking compounds, which include minerals and/or ions. [0150] 93. The gel and/or foam liner in example 87, wherein the liner is cured with a chemical additive, which includes an acid, base, organic compound, or inorganic compound. [0151] 94. The gel and/or foam liner in example 87, wherein the liner is cured with water moisture. [0152] 95. The gel and/or foam liner in example 87, wherein the liner is cured with a change in temperature. [0153] 96. The gel and/or foam liner in example 87, wherein the liner is used to coat a preformed foam insert before application into a wound site. [0154] 97. The gel and/or foam liner in example 87, wherein the liner is used independently without other wound therapies. [0155] 98. The gel and/or foam liner in example 87, wherein the liner is used independently without other pharmacologic therapies. [0156] 99. The gel and/or foam liner in example 87, wherein the liner is used with a foam insert on top of the liner. [0157] 100. The foam insert in example 87, wherein the foam insert is open-celled. [0158] 101. The foam insert in example 87, wherein the foam insert is expandable and poured on top of the liner. [0159] 102. The gel and/or foam liner in example 87, wherein the liner is used with other pharmacologic therapies. [0160] 103. The gel and/or foam liner in example 87, wherein the liner is used with other wound dressings. [0161] 104. The gel and/or foam liner in example 87, wherein multiple liner layers are used. [0162] 105. The multilayered liner system in example 104, wherein one of the layers contains bioactive compounds. [0163] 106. The multilayered liner system in example 104, wherein at least one of the layers is a closed-cell liner. [0164] 107. The gel and/or foam liner in example 87, wherein the liner is used with negative pressure therapy. [0165] 108. The gel and/or foam liner in example 87, wherein the liner is poured into a wound site before application of an open-celled foam insert. [0166] 109. The gel and/or foam liner in example 87, wherein a liner solution system is poured into a wound and before complete curation a second solution system for an expanding foam insert is applied in order to bind the two systems. [0167] 110. The gel and/or foam liner in example 87, wherein the liner compound is hydrophobic. [0168] 111. The gel and/or foam liner in example 87, wherein the liner compound is hydrophilic. [0169] 112. The gel and/or foam liner in example 87, wherein the liner compound is biodegradable. [0170] 113. The gel and/or foam liner in example 87, wherein the liner compound is resorbable. [0171] 114. The gel and/or foam liner in example 87, wherein the liner is a polymer. [0172] 115. The polymer liner in example 114, wherein the polymer is a polyurethane ester. [0173] 116. The polymer liner in example 114, wherein the polymer is a polyurethane ether. [0174] 117. The polymer liner in example 114, wherein the polymer is a polyvinyl alcohol. [0175] 118. The polymer liner in example 114, wherein the polymer is a polylactic acid. [0176] 119. The polymer liner in example 114, wherein the polymer is a polyglycolic acid. [0177] 120. The polymer liner in example 114, wherein the polymer is a polycaprolactone. [0178] 121. The polymer liner in example 114, wherein the polymer is a polyester. [0179] 122. The gel and/or foam liner in example 87, wherein the liner compound is a natural biological compound. [0180] 123. The natural biological compound in example 122, wherein the biological compound is a protein. [0181] 124. The protein liner in example 123, wherein the protein contains collagen. [0182] 125. The protein liner in example 123, wherein the protein contains fibrin. [0183] 126. The protein liner in example 123, wherein the protein contains vitronectin. [0184] 127. The protein liner in example 123, wherein the protein contains elastin. [0185] 128. The protein liner in example 123, wherein the protein contains laminin. [0186] 129. The protein liner in example 123, wherein the protein contains thrombin. [0187] 130. The protein liner in example 123, wherein the protein contains silk fibroin. [0188] 131. The protein liner in example 123, wherein the protein contains gelatin. [0189] 132. The natural biological compound in example 122, wherein the biological compound is polysaccharide. [0190] 133. The polysaccharide liner in example 132, wherein the polysaccharide contains pectin. [0191] 134. The polysaccharide liner in example 132, wherein the polysaccharide contains hyaluronic acid. [0192] 135. The polysaccharide liner in example 132, wherein the polysaccharide contains cellulose. [0193] 136. The polysaccharide liner in example 132, wherein the polysaccharide contains chitosan. [0194] 137. The polysaccharide liner in example 132, wherein the polysaccharide contains keratan sulfate. [0195] 138. The polysaccharide liner in example 132, wherein the polysaccharide contains chondroitin sulfate. [0196] 139. The polysaccharide liner in example 132, wherein the polysaccharide contains dermatan sulfate. [0197] 140. The polysaccharide liner in example 132, wherein the polysaccharide contains heparin. [0198] 141. The gel and/or foam liner in example 87, wherein the liner solution system has soluble bioactive factors incorporated into the solutions. [0199] 142. The soluble bioactive factors in example 141, wherein the bioactive factors are growth factors. [0200] 143. The soluble bioactive factors in example 141, wherein the bioactive factors are enzymes. [0201] 144. The soluble bioactive factors in example 141, wherein the bioactive factors are cytokines 145. The soluble bioactive factors in example 141, wherein the bioactive factors are chemokines. [0202] 146. The soluble bioactive factors in example 141, wherein the bioactive factors are exosomes. [0203] 147. The soluble bioactive factors in example 141, wherein the bioactive factors are antimicrobial agents. [0204] 148. The soluble bioactive factors in example 141, wherein the bioactive factors are pharmacological agents. [0205] 149. The soluble bioactive factors in example 141, wherein the bioactive factors are MicroRNAs. [0206] 150. The soluble bioactive factors in example 141, wherein the bioactive factors are oligonucleotides. [0207] 151. The soluble bioactive factors in example 141, wherein the bioactive factors are covalently bound to the liner compound. [0208] 152. The soluble bioactive factors in example 141, wherein the bioactive factors are released about dissolution in the wound environment. [0209] 153. The soluble bioactive factors in example 141, wherein the bioactive factors are released upon degradation of the liner. [0210] 154. The soluble bioactive factors in example 141, wherein the bioactive factors are released by enzymatic activity. [0211] 155. The gel and/or foam liner in example 87, wherein the liner solution system has stem cells incorporated into the solutions. [0212] 156. The gel and/or foam liner in example 87, wherein the liner solution system has keratinocytes incorporated into the solutions. [0213] 157. The gel and/or foam liner in example 87, wherein the liner solution system has fibroblasts incorporated into the solutions. [0214] 158. The gel and/or foam liner in example 87, wherein the liner solution system has endothelial cells incorporated into the solutions. [0215] 159. The gel and/or foam liner in example 87, wherein the liner solution system has pericytes incorporated into the solutions. [0216] 160. The gel and/or foam liner in example 87, wherein the liner solution system has a combination of stem cells, keratinocytes, fibroblasts, endothelial cells, and/or pericytes incorporated into the solutions. [0217] 161. The gel and/or foam liner in example 87, wherein the liner is removed to apply a new liner as needed. [0218] 162. The gel and/or foam liner in example 87, wherein the liner is left inside the wound. [0219] 163. The gel and/or foam liner in example 87, wherein the liner degrades within the wound with use. [0220] 164. The gel and/or foam liner in example 87, wherein the liner resorbs within the wound with use. [0221] 165. The gel and/or foam liner in example 87, wherein the liner is biodegradable and used with a non-degradable liner superficial to it. [0222] 166. The gel and/or foam liner in example 87, wherein the liner is biodegradable and is used with a foam open-cell wound insert. [0223] 167. The foam insert in example 166, wherein the foam insert used poured into the wound on top of the liner and replaced as needed. [0224] 168. The gel and/or foam liner in example 87, wherein the liner is able to contract the wound under negative pressure therapy. [0225] 169. The gel and/or foam liner in example 87, wherein the liner is used preoperatively to prep a surgical site. [0226] 170. The gel and/or foam liner in example 87, wherein the liner is used to intraoperatively to improve surgical outcomes. [0227] 171. The gel and/or foam liner in example 87, wherein the liner is used postoperatively to improve surgical outcomes. [0228] 172. The gel and/or foam liner in example 87, wherein the liner is used to attach or bind other dressings to a wound. [0229] 173. The foam wound insert in example 1, wherein the wound insert is used preoperatively to prep a surgical site. [0230] 174. The foam wound insert in example 1, wherein the wound insert is used to intraoperatively to improve surgical outcomes. [0231] 175. The foam wound insert in example 1, wherein the wound insert is used postoperatively to improve surgical outcomes. [0232] 176. The gel and/or foam liner in any of the above properties, wherein the liner solutions are sprayed into a wound instead of poured. [0233] 177. The gel and/or foam liner in any of the above properties, wherein the liner solutions are injected into a wound instead of poured. [0234] 178. The gel and/or foam liner in any of the above properties, wherein the liner solutions are spread into a wound instead of poured. [0235] 179. The foam wound insert in example 1, may be structurally manipulated via use of an electromagnetic field prior to curing. [0236] 180. The foam wound insert in example 1, may be structurally manipulated via use of an electromagnetic field post curing. [0237] 181. The foam wound insert in example 1, may be used to deliver an electrical current to stimulate cell proliferation and migration within the wound site. [0238] 182. The foam wound insert in example 1, may be structurally manipulated via use of an osmotic gradient prior to curing. [0239] 183. The foam wound insert in example 1, may be structurally manipulated via use of an osmotic gradient post curing. [0240] 184. The foam wound insert in example 1, may be used to change/control temperature within the wound site. [0241] 185. The gel and/or foam liner in example 87, may be structurally manipulated via use of an electromagnetic field prior to curing. [0242] 186. The gel and/or foam liner in example 87, may be structurally manipulated via use of an electromagnetic field post curing. [0243] 187. The gel and/or foam liner in example 87, may be structurally manipulated via use of an osmotic gradient prior to curing. [0244] 188. The gel and/or foam liner in example 87, may be structurally manipulated via use of an osmotic gradient post curing. [0245] 189. The gel and/or foam liner in example 87, may be used to change/control temperature within the wound site. [0246] 190. The gel and/or foam liner in example 87 or foam wound insert in example 1, wherein the multi-solution device system of an injectable material can be utilized in situations where separated bone, ligaments, tendons, and/or tissues are repaired via application of an injection of a glue-type fixating device, a spacer joining the two segments, or even simulating a plate by applying linearly across the tissue in case of a fracture, rupture, or tear. Utilization of an injectable material that can structurally stabilize in situ and support and stabilize a closed wound fracture, rupture, or tear of tissue that provides weight bearing support for the body without requiring open surgical correction. [0247] 191. The injectable device in example 190, wherein the solutions are applied via syringe injection. [0248] 192. The injectable device in example 190, wherein the solutions are applied via a percutaneous catheter or tubing. [0249] 193. The injectable device in example 190, wherein the solutions are applied via syringe injection. [0250] 194. The injectable device in example 190, wherein the device is able to fix tissue in place. [0251] 195. The injectable device in example 190, wherein the device is used in conjunction with an external fixation device such as a cast or a splint. [0252] 196. The injectable device in example 190, wherein the device is applied to tissue and provides structural support. [0253] 197. The injectable device in example 190, wherein the device is used to bind prosthetic devices in the body. [0254] 198. The injectable device in example 190, wherein the device is used to coat a joint articulation. [0255] 199. The injectable device in example 190, wherein the device is used as a spacer to join two or more segments of tissue. [0256] 200. The injectable device in example 190, wherein the device is applied after negative pressure application through a tubing or catheter to drain the interior of a closed wound. [0257] 201. The injectable device in example 190, wherein the device is used with negative pressure after device insertion to promote healing [0258] 202. The injectable device in example 190, wherein the device is biodegradable and resorbed by the body over time [0259] 203. The injectable device in example 190, wherein the device does not degrade and may need to be removed at a later point in time. [0260] 204. The removal of the injectable device in example 203, wherein the device is removed via an open surgery through an incision. [0261] 205. The removal of the injectable device in example 203, wherein the device is removed via a percutaneous port. [0262] 206. The removal of the injectable device in example 203, wherein the device is removed by dissolution into a solution and evacuated from the wound site of implantation via negative or vacuum pressure.

[0263] It is to be understood that the invention can be embodied in various forms and is not to be limited to the examples specifically discussed above. The range of components and configurations which can be utilized in the practice of the present invention is virtually unlimited.