Wound closure systems for reducing surgical site infections comprising incision drapes filled with releasable antimicrobial agents

Abstract

A surgical incision drape, comprises a flexible substantially flat areal substrate having an upper side and an opposing tissue-facing side, having a longitudinal axis and a pressure sensitive adhesive disposed on the tissue-facing side; at least one hollow microtubular compartment containing a flowable medical agent, said hollow microtubular compartment positioned to intersect the longitudinal axis and embedded into the substrate or positioned on the substrate.

Claims

1. A surgical incision drape, comprising: a flat, flexible areal substrate having an upper side and an opposing tissue-facing side, a longitudinal axis and a pressure sensitive adhesive disposed on the tissue-facing side; and at least one hollow microtubular compartment containing a flowable medical agent, wherein said at least one hollow microtubular compartment is positioned to intersect the longitudinal axis and is embedded into or positioned on the substrate, wherein said at least one hollow microtubular compartment is configured to be opened, and wherein said at least one hollow microtubular compartment is a plurality of first hollow microtubular compartments arranged side by side and positioned across the longitudinal axis so that each of said plurality of first hollow microtubular compartments crosses the longitudinal axis.

2. The surgical incision drape of claim 1, wherein said plurality of first hollow microtubular compartments are all connected together to a peripheral channel which is distal from the longitudinal axis and parallel to the longitudinal axis.

3. The surgical incision drape of claim 2, wherein said peripheral channel terminates in a bulb positioned on a periphery of said surgical incision drape and containing said agent.

4. The surgical incision drape of claim 1, wherein each of said plurality of first hollow microtubular compartments comprise a first type microtubular compartments containing a first agent; and a second type microtubular compartments containing a second agent; wherein said first and second type microtubular compartments are interspersed or disposed interdigitally with each other.

5. The surgical incision drape of claim 4, wherein said first type microtubular compartments containing the first agent are configured for fast release of the first agent; and the second type microtubular compartments containing the second agent are configured for slow release of the second agent; wherein said first and second type microtubular compartments are interspersed or disposed interdigitally with each other.

6. A method of using the surgical incision drape of claim 1, comprising the steps of: positioning the surgical incision drape on a tissue with the tissue-facing side facing towards the tissue and in contact with the tissue; orienting the longitudinal axis along an expected incision line; adhering the surgical incision drape to the tissue via the pressure sensitive adhesive; performing a surgical incision of the tissue through the surgical incision drape, in the process cutting or severing at least one of the at least one hollow microtubular compartment thus opening the at least one hollow microtubular compartments; and allowing the agent to leach or ooze from the at least one hollow microtubular compartment onto edges of a tissue wound formed by said incision.

7. The method of claim 6, wherein leaching or oozing of up to 80% of the agent from at the least one hollow microtubular compartment is configured for release within 3 to about 600 seconds.

8. The surgical incision drape of claim 1, wherein said at least one hollow microtubular compartment is frangible, severable, easily cuttable, or combinations thereof.

9. The surgical incision drape of claim 1, wherein said plurality of first hollow microtubular compartments comprises at least eight hollow microtubular compartments.

10. The surgical incision drape of claim 1, wherein each of said plurality of first hollow microtubular compartments is linear, angular, U-shaped, or V-shaped.

11. The surgical incision drape of claim 1, wherein each of said plurality of first hollow microtubular compartments comprise: a capillary central portion having a smaller diameter, said capillary central portion proximal and at least partially over the longitudinal axis, and a larger diameter peripheral portion which is distal from the longitudinal axis.

12. The surgical incision drape of claim 1, wherein said surgical incision drape further comprises a plurality of second hollow microtubular compartments that do not intersect the longitudinal axis and are interconnected with said plurality of first hollow microtubular compartments forming a grid.

13. The surgical incision drape of claim 1, wherein each of said plurality of first hollow microtubular compartments comprise: a smaller diameter microtubular compartments configured for slow release of the agent; and a larger diameter microtubular compartments configured for faster release of the agent, wherein said smaller diameter microtubular compartments are interspersed or disposed interdigitally with said larger diameter microtubular compartments.

14. The surgical incision drape of claim 1, wherein each of said plurality of first hollow microtubular compartments comprise: a first type microtubular compartments containing a high viscosity formulation of said agent and configured for slow release of the agent; and a second type microtubular compartments containing a low viscosity formulation of said agent and configured for fast release of the agent; wherein said first and second type microtubular compartments are interspersed or disposed interdigitally with each other.

15. The surgical incision drape of claim 1, wherein said medical agent comprises antimicrobial agent, antibacterial agent, antibiotic, antiviral, triclosan, chlorohexidine gluconate, polyhexamethylene biguanide, or combinations thereof.

16. The surgical incision drape of claim 1, wherein each of said plurality of hollow microtubular compartments comprise individual sealed microfluidic channels formed directly in said substrate.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) FIG. 1A shows an embodiment of an incision drape in a schematic top view.

(2) FIG. 1B shows an embodiment of an incision drape in a schematic side cross-sectional view.

(3) FIG. 1C shows an embodiment of an incision drape in a schematic side cross-sectional view with microtubular compartments comprising individual sealed microfluidic channels formed directly in substrate.

(4) FIG. 2 shows an embodiment of an incision drape in a schematic perspective view prior to cutting through drape with a scalpel blade.

(5) FIG. 3 shows an embodiment of an incision drape in a schematic side cross-sectional view.

(6) FIG. 4 shows an embodiment of an incision drape in a schematic top view.

(7) FIG. 5 shows an embodiment of an incision drape in a schematic top view.

(8) FIG. 6 shows an embodiment of an incision drape in a schematic top view.

(9) FIG. 7 shows an embodiment of an incision drape in a schematic top view.

(10) FIG. 8 shows an embodiment of an incision drape in a schematic top view.

(11) FIG. 9 shows an embodiment of an incision drape in a schematic top view.

(12) FIG. 10 shows an embodiment of an incision drape in a schematic top view.

(13) FIG. 11A shows an embodiment of an incision drape in a schematic top view and connected via cannula to a source of pressurized agent.

(14) FIG. 11B shows an embodiment of an incision drape in a schematic top view and having no medicinal agent prior to connection via cannula to a source of pressurized agent.

(15) FIG. 12 shows an embodiment of an incision drape in a schematic top view.

(16) FIG. 13 shows an embodiment of an incision drape in a schematic top view.

(17) FIG. 14 shows an embodiment of an incision drape in a schematic top view.

(18) FIG. 15 shows an embodiment of an incision drape in a schematic top view.

(19) FIG. 16A shows an embodiment of an incision drape in a schematic top view in use positioned on a tissue.

(20) FIG. 16B shows an embodiment of an incision drape in a schematic side cross-sectional view in use positioned on a tissue.

DETAILED DESCRIPTION

(21) Filled incision drapes that can deliver therapeutic agents at and to the surgical site are described herein. Exemplary embodiments of filled incision drapes of the present disclosure are generally comprised of liquid impervious microtubular compartments that encapsulate a flowable or fluid therapeutic agent, such compartments embedded into an adhesive patch or sheet used as a drape. Once applied to the surgical site and appropriately prepared, an incision can be made through the filled incision drape. Upon incising or otherwise puncturing through the filled incision drape, the therapeutic agent will be expressed from the drape and delivered into the incision. Embodiments of this invention enable the delivery of highly effective compositions of therapeutic agents typically not used after the initial incision in traditional surgery, because it would require an additional step, and bacteria from the incision is not typically recognized as a contributor to surgical infections. Filled incision drapes of this disclosure provide a single step for delivering a therapeutic agent directly to the surgical incision and to the surgical instrument as the incision is made.

(22) Briefly, a surgical wound incision drape comprises an isolating patch or dressing or pad made of a flexible sheet of fabric, mesh, or non-woven material, that is adhesively and removably attached to the tissue in the area where tissue is about to be incised during surgical procedure. The drape is then cut through during surgery as the underlying tissue is being cut. Cutting through the drape opens up microcompartments filled with flowable anti-microbial agent containing fluid that is released in the area of the cut onto the surgical instrument (such as a surgical incision tool, saw, knife, scalpel, etc.) and onto the edge of the incision.

(23) In a surgical wound incision drape of the present invention, an isolating patch/dressing/pad is adhesively attached to the tissue and then cut through during surgery, the drape material contains embedded elongated sealed compartments such as tubes which are filled with a liquid, flowable anti-microbial agent. The tubes are oriented generally across the cut axis of the drape so that they are cut through and opened during incision thus releasing the fluid agent along the cut, over the wound internal wall and over the scalpel, providing anti-bacterial action at the beginning and throughout surgery.

(24) Advantageously, the release of the anti-infective medicant is proportional to the size of the incision, preventing excessive amounts of antimicrobial agent flooding the wound area. Advantageously, in some embodiments, the medicinal agent is released slowly and over time, thus providing necessary coverage during the procedure. Advantageously, all agent is available for release compared with systems with embedded microcapsules whereby only a small portion of the agent is released upon incising.

(25) Referring now to FIG. 1A, an embodiment of a drape 10 is shown in top view, with drape 10 comprising flat areal substrate 20 visible from the upper side 22 in FIG. 1A, with straight or linear closed microtubular compartments 30 containing liquid agent 100 embedded within substrate 20 and shown in dashed lines. Microtubular compartments 30 are positioned and oriented generally across longitudinal axis 21 of substrate 20, in other words across the expected surgical incision line, which generally can align with axis 21, with incision generally performed within the perimeter of substrate 20 and in the central area of substrate 20. At least a portion of microtubular compartments 30 is proximal and at least partially over longitudinal axis 21. Referring now to FIG. 1B, drape 10 is shown in side cross-sectional view, with upper side 22 facing upwards and tissue-facing side 24 facing downwards, with microtubular compartments 30 embedded within the substrate 20. On tissue-facing side 24 of substrate 20 is disposed adhesive 40, such as pressure-sensitive adhesive, which is configured for attachment to tissue prior to the surgical incision and removal after the surgical procedure. Adhesive 40 can be present as a continuous coating as shown, or applied in stripes, spots, dots, or any other shapes with some areas of tissue-facing side 24 free of adhesive 40.

(26) Referring now to FIG. 1C, drape 10 is shown in side cross-sectional view, with upper side 22 facing upwards and tissue-facing side 24 facing downwards, with microtubular compartments 30 comprising individual sealed microfluidic channels formed directly in substrate 20.

(27) Referring to FIG. 2, showing a schematic perspective view, a scalpel blade 26 is shown in position prior to cutting through drape 10 along longitudinal axis 21 of substrate 20. In use, cutting though drape 10 and underlying tissue (not shown) will also cut through microtubular compartments 30 embedded within substrate 20 resulting in the instant or delayed release of liquid agent 100. Microtubular compartments 30 are configured to be frangible, severable, easily cuttable, or combinations thereof.

(28) Advantageously, in this embodiment, only microtubular compartments 30 which are intersecting the cut performed by blade 26 will release agent 100. This results in release of the amount of agent proportional to the length of the cut. If all agent 100 from all microtubular compartments 30 was released into a relatively small cut that intersects only one microtubular compartment 30, resulting potentially in excessive amounts of agent 100 released, that could be detrimental due to flooding a relatively small wound area and resulting in an excess dose of anti-microbial agent. Thus in the shown embodiment the amount of agent released is proportional to the length of the cut.

(29) Advantageously, in some embodiments, microtubular compartments 30 are configured to slowly release agent 100 from each cut microtubular compartment 30, with some fluid released instantly and some fluid released slowly over time supplying agent 100 to the wound edge. This is advantageously compared to embedding microcapsules in drape 10 that only able to release a very small amount of agent 100 from a small number of cut capsules in the line of incision, but not from other capsules, with no time delay effect as in the case of microtubular compartment 30. This is also advantageously compared to one large compartment in drape 10, which will release all agent 100 in response to even a short cut.

(30) Referring now to FIG. 3, an embodiment of drape 10 is shown in side cross-sectional view similar to FIG. 1B, with the embodiment shown different from FIG. 1B in that microtubular compartments 30 are located not in the bulk or in the middle of drape 10, but on the upper side 22.

(31) Referring now to FIG. 4, an embodiment of drape 10 is shown in top view, with microtubular compartments 30a oriented generally not perpendicular and across longitudinal axis 21 of substrate 20, as in FIG. 1A, but under angle with respect to longitudinal axis 21 and still intersecting longitudinal axis 21 or the expected incision line. The angle between microtubular compartments 30a and longitudinal axis 21 is from about 20° to 70°, more preferably from about 30° to about 60°, most preferably about 45° as shown.

(32) Referring now to FIG. 5, an embodiment of drape 10 is shown in top view, with microtubular compartments 30b not linear as shown in embodiments of FIG. 1A, 4, but “V” or “U” shaped and oriented generally across longitudinal axis 21 of substrate 20, with a mid-point “M” of the “V” or “U” shape being positioned approximately on longitudinal axis 21. This arrangement provides more agent 100 available for discharging, leaching, or oozing from each cut microtubular compartment 30b vs. microtubular compartments 30, 30a of other embodiments.

(33) Referring now to FIG. 6, an embodiment of drape 10 is shown in top view, with microtubular compartments 30c comprising one long generally spirally shaped microcompartment arranged over and across longitudinal axis 21 of substrate 20. This arrangement provides all agent 100 available for discharging, leaching, or oozing from the spiral-shaped microtubular compartment 30c when it is cut anywhere. Advantageously, the release is slow due to the distance agent 100 needs to travel through the microtubular compartment 30c to the area where the spiral-shaped microtubular compartment 30c was cut or severed. Spiral-shaped microtubular compartment 30c intersects longitudinal axis 21 at least 4 times, and up to 100 times, such as 9 times as shown in FIG. 6.

(34) Referring now to FIG. 7, an embodiment of drape 10 is shown in top view, with generally linear microtubular compartments 30d positioned across/perpendicular longitudinal axis 21 of substrate 20 similar to embodiment of FIG. 1A. Microtubular compartments 30d have capillary central portion 32 of smaller diameter which is proximal and at least partially over longitudinal axis 21. Microtubular compartments 30d have larger volume (such as larger diameter) peripheral portion 31 which is distal from longitudinal axis 21. In the embodiment shown, there are two peripheral portions 31 arranged on either side of capillary central portion 32. This arrangement provides more agent 100 available for discharging from each cut microtubular compartment 30d, but with a slow leaching or oozing of agent 100 due to smaller diameter capillary central portion 32. Peripheral portion 31 can be of linear and rectangular shape, cylindrical shape, spherical balloon-like shape or generally of any suitable geometry to provide repository for additional agent 100 for leaching through a cut capillary central portion 32.

(35) In an alternative embodiment (not shown), there is only one peripheral portion 31 arranged on one side of capillary central portion 32.

(36) Referring now to FIG. 8, an embodiment of drape 10 is shown in top view, with microtubular compartments 30e linear-shaped and positioned across/perpendicular longitudinal axis 21 of substrate 20 similar to embodiment of FIG. 1A. Microtubular compartments 30e are all connected to a larger diameter peripheral channel 33 which is distal from and generally parallel to longitudinal axis 21.

(37) In the embodiment shown, there is one peripheral channel 33 arranged on one side of substrate 20. This arrangement provides more agent 100 available for discharging from each cut microtubular compartment 30e, but with a slow leaching or oozing of agent 100 due to smaller diameter capillary central portion 32. Peripheral channel 33 can be of linear and rectangular shape, cylindrical shape, spherical balloon-like shape or generally of any suitable geometry to provide repository for additional agent 100 for leaching through severed or cut microtubular compartments 30e. In an alternative embodiment (not shown), there are two peripheral channels 33 on each side of substrate 20 which are located on periphery of substrate 20, distal from and generally parallel to longitudinal axis 21.

(38) Referring now to FIG. 9, an embodiment of drape 10 is shown in top view, with microtubular compartments 30f randomly distributed throughout substrate 20, with at least some intersecting longitudinal axis 21. Advantageously, in this embodiment, cutting through drape 10 in any direction will result in release of agent 100.

(39) Referring now to FIG. 10, an embodiment of drape 10 is shown in top view, with microtubular compartments 30g arranged perpendicular to microtubular compartments 30h, which are parallel to longitudinal axis 21, forming substantially square grid. In one embodiment, microtubular compartments 30g, 30f are connected to each other at each intersection point 34. In another embodiment, microtubular compartments 30g, 30f are not connected to each other at each intersection point, such as by being positioned in different planes within substrate 20. Advantageously, cutting of drape 10 in any direction will intersect certain microtubular compartments 30g, 30f resulting in release of agent 100 along the cut and in the cut.

(40) Referring now to FIG. 11A, an embodiment of drape 10 is shown in top view, with microtubular compartments 30i linearly shaped and positioned across or perpendicular longitudinal axis 21 of substrate 20 similar to embodiment of FIG. 1A. Microtubular compartments 30i are connected to a peripheral channel 35 which is distal from and generally parallel to longitudinal axis 21 and located on periphery of substrate 20, and terminates in a port 36 positioned on a periphery of drape 10. Peripheral channel 35 can be of linear or rectangular shape, cylindrical shape, or generally of any suitable geometry to provide for delivery of agent 100 to microtubular compartments 30i.

(41) Port 36 is shown connected via cannula 37 to source of pressurized agent 100, such as a pump, which in one embodiment can be, as shown, a syringe 38. Alternatively, any pump 38 can be used, including a pump comprising a hydrostatic pressure source, i.e. elevated source (not shown) of agent 100, which is positioned higher that drape 10, to enable gravity-driven flow. Other pumps can include low volumetric flow peristaltic pumps, piston pumps, elastic bulbs and similar. In one embodiment (not shown) pump 38 comprises a pressurized container.

(42) Pressurizing agent 100 in pump 38 as indicated by arrow in FIG. 11A, delivers agent 100, as needed, to the edges of the wound after drape 10 and corresponding microtubular compartments 30i are cut.

(43) In some embodiments, as shown in FIG. 11B, drape 10 is supplied with no agent 10 inside. After applying drape 10 to the tissue, pressurized agent 100 is supplied to drape 10 via cannula 37 by connecting to port 36 preferably before cutting of drape 10. In this embodiment, a selection of agent 100 can be made based on a specific need and area of tissue, patient needs, risks, etc. Advantageously, there can be a change in the supplied agent 100 from one agent another agent (such as different types of agents or different concentration of agents), intraoperatively, as needed.

(44) Referring now to FIG. 12, an embodiment of drape 10 is shown in top view, with microtubular compartments 30j linearly shaped and positioned across/perpendicular longitudinal axis 21 of substrate 20 similar to embodiment of FIG. 1A. Microtubular compartments 30i are connected to peripheral channel 35 which is distal from and generally parallel to longitudinal axis 21 and located on periphery of substrate 20 and terminates in a hollow bulb 39 positioned on a periphery of drape 10 and containing agent 100. In one embodiment, bulb 39 is elastic and contains agent 100 under pressure. Pressurized agent 100 in bulb 39 is delivered to the edges of the wound after drape 10 and corresponding microtubular compartments 30j are cut or severed. In another embodiment, manual compression of bulb 39 is facilitating additional flow of agent 100 through microtubular compartments 30j that are cut or severed.

(45) In some embodiments, and referring to FIG. 13, showing a schematic top view of an embodiment of drape 10, microtubular compartments present are of two or more types, with microtubular compartments 301 with smaller diameter having slower or delayed release of agent 100, and microtubular compartments 302 with larger diameter having faster release of agent 100 upon severing or cutting microtubular compartments 301, 302. As shown, majority of microtubular compartments of different types are preferably interspersed or disposed interdigitated so that microtubular compartments 301 of the first type are surrounded by microtubular compartments 302 of the second type and mutatis mutandis microtubular compartments 302 of the second type are surrounded by microtubular compartments 301 of the first type. Such arrangement results in immediate release of agent 100 from microtubular compartments 302, and sustained release of agent 100 during surgical procedure thereafter from microtubular compartments 301.

(46) In some embodiments, and referring to FIG. 14, microtubular compartments present are of two or more types, with microtubular compartments 303 having higher viscosity agent 100 formulation (indicated by letters “HV” in FIG. 14) and thus having slower or delayed release of agent 100, and microtubular compartments 304 (shown slightly shorter in FIG. 14 for easier identification) having lower viscosity agent 100 formulation (indicated by letters “LV” in FIG. 14) and thus having faster or instant release of agent 100 upon severing or cutting microtubular compartments. As shown, microtubular compartments of different types are preferably interspersed or disposed interdigitally so that most microtubular compartments 303 are surrounded by microtubular compartments 304 of the second type and mutatis mutandis most microtubular compartments 304 of the second type are surrounded by microtubular compartments 303 of the first type. Such arrangement results in immediate release of agent 100 from microtubular compartments 304, and sustained release of agent 100 during surgical procedure thereafter from microtubular compartments 303.

(47) In some embodiments, and referring to FIG. 15, microtubular compartments present are of two or more types, and having the same diameters (as shown) or different diameters (not shown, but similar to embodiments of FIG. 13), with microtubular compartments 305 (shown slightly longer in FIG. 15 for easier identification) containing a first agent 100a, and microtubular compartments 306 containing a second agent 100b. Having two or more agents 100a, 100b in separate compartments simplifies storage for incompatible agents which can be active against different microorganisms, such as gram-negative and gram-positive bacteria.

(48) While release of agent 100a, 100b can be simultaneous, in some embodiments, the release is performed with a different profile, such as when agent 100a is released instantly or within first 3-30 seconds, and agent 100b is released slower via delayed release. Delayed release can be achieved by diameters of microtubular compartments as was illustrated above, and/or by formulating viscosity of agent 100a, 100b with excipients and diluents, with higher viscosity resulting in delayed or slower release as was illustrated above.

(49) As shown, microtubular compartments of different types are preferably interspersed or disposed interdigitated so that most microtubular compartments 305 of the first type are surrounded by microtubular compartments 306 of the second type and mutatis mutandis most microtubular compartments 306 of the second type are surrounded by microtubular compartments 305 of the first type. Such arrangement results in release of both agent 100a, 100b upon severing or cutting microtubular compartments.

(50) In use, and referring to FIGS. 16A, 16B, drape 10 is positioned on tissue 50 and adhered to tissue 50, with upper side 22 facing upwards and tissue-facing side 24 facing downwards towards tissue 50 and in contact with tissue 50. Longitudinal axis 21 of substrate 20 is oriented generally along the expected incision line. Tissue-facing side 24 of substrate 20 is adhered to tissue 50 via adhesive 40.

(51) Surgical incision 55 of tissue 50 is then performed through drape 10, in the process cutting or severing at least one of microtubular compartments 30. Opening of microtubular compartments 30 along the cut line or edge 55 of the wound 56 enables agent 100 to leach or ooze from microtubular compartments 30 onto the sides of the surgical instrument (not shown) and onto edges 55 of wound 56 and partially into the wound 56 as schematically shown by arrows in FIG. 16B.

(52) In some embodiments, microtubular compartments 30 are collapsible. In some embodiments, microtubular compartments 30 are elastic and pressurized. In some embodiments, microtubular compartments 30 are configured for collapsing when manually pressed through substrate 20.

(53) In some embodiments, the release or leaching/oozing of all or up to about 80% of agent 100 from microtubular compartments 30 is configured for release within about 3 to 10 seconds after cutting or severing microtubular compartments 30, such as within 5 to 10 seconds. In alternative embodiments, the release of all or up to 80% of agent 100 is occurring over extended period such as from 10 to 600 seconds and up to 10 hours.

(54) In some embodiments, the release of about 40-60% of agent 100 occurs very quickly, i.e. within 10 seconds, and the rest is slowly released over about 30 to 600 seconds (10 min), or up to about 6000 seconds (100 min) or up to 10 hours.

(55) Dimensions

(56) Microtubular compartments can have inner diameters ranging from about 0.15 mm to about 2 mm, more preferably 0.2 mm to 1 mm, such as 0.3, 0.5, 1 mm. Microtubular compartments can also have rectangular, oval, etc. cross-section, with a similar cross-sectional area. The length of microtubular compartments is from about 10 mm to about 500 mm, such as 15, 20, 30, 50, 75, 100 mm. The wall thickness of microtubular compartments is from about 0.05 mm to about 1 mm, such as 0.1, 0.3, 0.5 mm.

(57) The number of microtubular compartments can vary from 1 for spiral embodiment to about from 10-500, such as 8, 12, 20, 30, 40, 50, 80, 100.

(58) Substrate 20 can have any geometric shape, including rectangular, oval, square, or similar.

(59) The length of substrate 20 is from about 5 cm to about 300 cm, such as 10, 15, 20, 25 cm. The width of substrate 20 is from about 2 cm to about 300 cm, such as 3, 5, 10, 15, 20, 25 cm. The thickness of substrate 20 is from about 0.5 mm to about 5 mm, such as 1, 2, 3 mm.

(60) Materials

(61) Substrate 20 materials may be any polymetric materials, which are inert and/or biocompatible, such as polyethylene, polypropylene, polyesters, oxidized regenerated cellulose (ORC), chitosan, collagen, gelatin, and similar, and combinations thereof. Substrate 20 can be molded or extruded sheet, woven fabric, non-woven felt, or combinations thereof. In one embodiment, substrate 20 comprises a wicking material that is able to distribute agent 100 from discrete microtubular compartments for release over the whole area of drape that is cut.

(62) Microtubular compartments 30 materials are any polymetric materials, which are biocompatible and stable in contact with agent 100, such as polyethylene, polypropylene, polyesters, and similar.

(63) Flowable medicant or medicinal agent 100 comprises liquid or semi-liquid formulations containing a diluent and at least one anti-microbial and/or anti-infective and/or, antiseptic agent. The diluent can be any fluid, such as water, saline, ethanol, etc., and combinations thereof. The agent can be a natural or synthetic agent suitable for topical application on wounds, skin, mucosa, or cavities, a Topical Anti-Infective Agent, having therapeutic or prophylactic antibiotic properties against infectious viral, bacterial, or protozoal agents by inhibiting growth and survival of such organisms.

(64) The agent can be ethanol, triclosan, chlorhexidine gluconate (CHG), polyhexamethylene biguanide, antibiotic, such as gentamicin, and or fluoroquinolone antibiotics, including ciprofloxacin, ofloxacin, and norfloxacin, etc. A number of agents suitable for use with the present invention are known to a skilled artisan, including 3,6-Diamino-10-methylacridinium Chloride; 8-Hydroxyquinoline product; 8-Hydroxyquinoline Sulfate Ointment; Acriflavine product; Acrisorcin; Actinoquinol; Alexidine; Aluminum acetate; Ambazone; Aminacrine hydrochloride; Aminacrine product; Aminacrine Pyruvate; Aminacrine Undecylate; Amphomycin Calcium; Amylmetacresol; Auriclosene; Azelaic acid; Bensalan; Benzalkonium product; Benzethonium chloride; Benzethonium product; Benzododecinium; Benzododecinium bromide; Benzoin; Benzoxiquine; Benzoxonium Chloride; Benzoyl peroxide; Benzyl alcohol; Benzylsulfamide; Bibrocathol; Biclotymol; Bismuth subgallate; Bismuth Tribromophenate; Boric acid; Calcium hydroxide; Camphor product; Carbamide peroxide; Cetalkonium; Cetalkonium chloride; Cetrimonium; Cetrimonium Chloride; Cetylpyridinium Acetate; Cetylpyridinium Bromide; Cetylpyridinium chloride; Cetylpyridinium Chloride Anhydrous; Cetylpyridinium product; Chaulmosulfone; Chloramine-T; Chlorhexidine gluconate; Chlorhexidine hydrochloride; Chlorhexidine product; Chlorindanol; Chloroazodin; Chlorocresol; Chlorothymol; Chloroxylenol; Chlorphenesin product; Chlorphenoctium Amsonate; Cicliomenol; Cinoquidox; Cloflucarban; Cloguanamil; Cloponone; Cocamidopropylbetaine (in water); Crotamiton; Crotoniazide; Cuprimyxin; Cyclomenol; Dakins Solution; Debropol; Decominol; Deditonium; Deditonium Bromide; Dibromopropamidine product; Dichlorobenzyl alcohol; Dichloroxylenol; Dicresulene; Dipyrithione; Disiquonium; Disiquonium Chloride; Dodeclonium bromide; Dofamium; Dofamium Chloride; Famiraprinium Chloride; Fenticlor product; Fepradinol; Fludazonium; Fludazonium Chloride; Fluorosalan; Furmethoxadone; Gloxazone; Guaiacol product; Halazone; Halopenium Chloride; Haloprogin; Hexachlorophene product; Hexedine; Hexetidine product; Hexylresorcinol product; Hydrogen peroxide; Iodoform; Laurcetium; Laurcetium Bromide; Laurixamine; Lauroguadine; Laurolinium Acetate; Lopobutan; Mafenide acetate; Mecetronium; Mecetronium ethylsulfate; Mequidox; Meralein; Merbromin product; Mercurous iodide; Mercury ammonium chloride product; Metabromsalan; Methaniazide; Methylisothiazolinone; Monalazone; Monalazone Disodium; Morniflumate; Myristalkonium Chloride; Nibroxane; Nifuradene; Nifuraldezone; Nifuralide; Nifurethazone; Nifurfoline; Nifurimide; Nifurizone; Nifuroquine; Nifuroxazide; Nifuroxime; Nifurpirinol; Nifurprazine; Nifurvidine; Nifurzide; Nitromersol; Noxythiolin product; Octafonium Chloride; Octenidine Saccharin; Olanexidine; Opratonium Iodide; Oxyquinoline sulfate; Parachlorophenol; Penoctonium; Penoctonium Bromide; Phanquone; Phenolate Sodium; Phenoxyethanol product; Phenyl ethyl alcohol; Phthalylsulfacetamide; Picloxydine; Picric acid; Pirralkonium; Pirralkonium Bromide; Pirtenidine; Pirtenidine Hydrochloride; Prednicarbate; Proflavine Dihydrochloride; Proflavine Hemisulfate; Proflavine product; Proflavine Sulfate; Resorcinol; Resorcinol Monoacetate; Romifenone; Salicylanilide; Sanguinarium Chloride; Selenium sulfide; Sepazonium; Sepazonium Chloride; Silver nitrate; Silver Oxide; Silver Picrate; Silver sulfadiazine; Sodium meralein; Sulfacecole; Sulfarsphenamine; Symclosene; Talmetoprim; Tavaborole; Temodox; Tetradonium; Tetradonium Bromide; Thimerosal product; Thymol iodide; Thymol product; Tibezonium; Tibezonium Iodide; Toliodium; Toliodium Chloride; Tribromsalan; Trichlorocarbanilide product; Undecoylium Chloride; Zinc Carbonate; Zinc phenolsulfonate;

(65) Pressure sensitive adhesive (PSA) materials are known to these skilled in the art, and can include, for instance, one of the following: hydrocolloids; homo-polymer emulsion (PVA); water-based acrylic adhesives; polyurethane dispersions (PUDs); polyethylene glycol; dextrin/starch-based adhesives; N-vinyl caprolactam homopolymers; N-vinyl pyrrolidone copolymers; polyvinyl alcohol; cellulose ethers; methylcellulose; carboxymethylcellulose; polyvinylpyrrolidone; polyvinyl acetates, non-water based acrylic adhesives; cyanoacrylate adhesives; epoxy; silicone based adhesives; urethane, and similar, and combinations thereof.

(66) It should be understood that the foregoing disclosure and description of the embodiments of the present invention are illustrative and explanatory thereof and various changes in the size, shape and materials as well as in the description of the preferred embodiment may be made without departing from the spirit of the invention.