APPARATUS AND METHODS FOR PRESSURE MANAGEMENT WITHIN A WOUND CHAMBER
20210001022 ยท 2021-01-07
Inventors
Cpc classification
A61M2205/6036
HUMAN NECESSITIES
International classification
Abstract
A wound therapy apparatus disclosed herein includes a wound interface sealingly securable to a skin surface around a wound bed to form an enclosed space over the wound bed. An inflow fluid pathway and an outflow fluid pathway communicate fluidly with the enclosed space through an inflow port and an outflow port, respectively. The inflow port and the outflow port may be in spaced relation to define a flow path within the enclosed space equivalent in length to a characteristic length of the enclosed space. Pressure sensors may be in communication with the inflow fluid pathway and the outflow fluid pathway to detect inflow pressure p.sub.in, and outflow pressure p.sub.out.
Claims
1. A wound therapy apparatus, comprising: a wound interface sealingly securable to a skin surface around a wound bed to form an enclosed space over the wound bed; an inflow port disposed about the wound interface to form a portion of an inflow fluid pathway that communicates an inflow fluid into the enclosed space; an outflow port disposed about the wound interface to form a portion of an outflow fluid pathway that communicates an outflow fluid out of the enclosed space, the outflow port in spaced relation with the inflow port to define a flow path within the enclosed space equivalent to a characteristic length of the enclosed space; an inflow pressure sensor in communication with the inflow fluid pathway to detect an inflow pressure p.sub.in of the inflow fluid; an outflow pressure sensor in communication with the outflow fluid pathway to detect an outflow pressure p.sub.out of the outflow fluid; and wherein the inflow pressure p.sub.in and the outflow pressure p.sub.out in combination are indicative of a pressure p.sub.a within the enclosed space.
2. The apparatus of claim 1, wherein the enclosed space has a circular shape and the characteristic length is defined as a radius of the circular shape.
3. The apparatus of claim 1, wherein the enclosed space has a rectangular shape and the characteristic length is defined as a diagonal of the rectangular shape.
4. The apparatus of claim 1, wherein the wound interface has a square shape and the characteristic length is defined as a diagonal of the square shape.
5. The apparatus of claim 1, wherein the wound interface has an irregular polygonal shape and the characteristic length is defined as a longest diagonal of the irregular polygonal shape.
6. The apparatus of claim 1, wherein the wound interface has a U shape and the characteristic length is defined from end to end of the U shape.
7. The apparatus of claim 1, further comprising: a controller in operative communication with the inflow pressure sensor and with the outflow pressure sensor to receive data from the inflow pressure sensor and from the outflow pressure sensor, the data indicative of the inflow pressure p.sub.in of the inflow fluid, a time rate of change of the inflow pressure
8. The apparatus of claim 7, wherein the operational condition is indicated by |p.sub.inp.sub.out|< where represents a sensitivity and
9. The apparatus of claim 7, wherein the operational condition is indicated by |p.sub.inp.sub.out|> where represents a sensitivity and
10. The apparatus of claim 9, wherein a pulse of the input fluid is input into the enclosed space to clear an occlusion from the outflow fluid pathway upon indication of the operational condition.
11. The apparatus of claim 7, wherein the operational condition is indicated by |p.sub.inp.sub.out|< and by
12. The apparatus of claim 11, wherein the pressure p.sub.a within the enclosed space is decreased below ambient pressure p.sub.amb upon indication of the operational condition.
13. The apparatus of claim 7, wherein the operational condition is indicated by
14. A wound therapy apparatus, comprising: a wound interface sealingly securable to a skin surface around a wound bed to form an enclosed space over the wound bed; an inflow fluid pathway that communicates the inflow fluid into the enclosed space; an outflow fluid pathway that communicates an outflow fluid out of the enclosed space; data indicative of the inflow pressure p.sub.in of the inflow fluid, a time rate of change of the inflow pressure
15. The apparatus of claim 14, wherein the operational condition is indicated by |p.sub.inp.sub.out|< where represents a sensitivity and
16. The apparatus of claim 14, wherein the operational condition is indicated by |p.sub.inp.sub.out|> where represents a sensitivity and
17. The apparatus of claim 16, wherein a pulse of the input fluid is input into the enclosed space to clear an occlusion from the outflow fluid pathway upon indication of the operational condition.
18. The apparatus of claim 14, wherein the operational condition is indicated by |p.sub.inp.sub.out|< and by
19. The apparatus of claim 18, wherein the pressure p.sub.a within the enclosed space is decreased below ambient pressure p.sub.amb upon indication of the operational condition.
20. The apparatus of claim 14, wherein the operational condition is indicated by |p.sub.inp.sub.out|< and by
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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[0028] The Figures are exemplary only, and the implementations illustrated therein are selected to facilitate explanation. The number, position, relationship and dimensions of the elements shown in the Figures to form the various implementations described herein, as well as dimensions and dimensional proportions to conform to specific force, weight, strength, flow and other physical requirements are explained herein or are understandable to those of ordinary skill in the art upon study of this disclosure. Where used in the various Figures, the same numerals designate the same or similar elements. Furthermore, when the terms top, bottom, right, left, forward, rear, first, second, inside, outside, and similar terms are used, the terms should be understood in reference to the orientation of the implementations illustrated in the Figures and are utilized only to facilitate description thereof. Use herein of relative terms such as generally, about, approximately, essentially, may be indicative of engineering, manufacturing, or scientific tolerances such as 0.1%, 1%, 2.5%, 5%, or other such tolerances, as would be recognized by those of ordinary skill in the art upon study of this disclosure.
DETAILED DESCRIPTION OF THE INVENTION
[0029] A wound therapy apparatus disclosed herein includes a wound interface sealingly securable to a skin surface around a wound bed to form an enclosed space over the wound bed, an inflow port disposed about the wound interface to form a portion of an inflow fluid pathway that communicates an inflow fluid into the enclosed space, and an outflow port disposed about the wound interface to form a portion of an outflow fluid pathway that communicates an outflow fluid out of the enclosed space, in various aspects. The outflow port is in spaced relation with the inflow port to define a flow path within the enclosed space having a length equivalent to a characteristic length of the enclosed space, in various aspects, so that a combination of an inflow pressure p.sub.in of the inflow fluid in the inflow fluid pathway and an outflow pressure p.sub.out are measured to measure a pressure p.sub.a within the enclosed space at the length equivalent to the characteristic length of the enclosed space. In various aspects, the inflow pressure p.sub.in of the inflow fluid, a time rate of change of the inflow pressure
of the inflow fluid, the outflow pressure p.sub.out of the outflow fluid, and a time rate of change of the outflow pressure
of the outflow fluid are measured to determine an operational condition of the wound therapy apparatus. Time rates of change of time rates of change
(e.g., 2.sup.nd derivatives) may be measured, in various aspects.
[0030] The pressure p.sub.a is the actual pressure within the enclosed space. The characteristic length defines a length scale of the enclosed space, and the characteristic length may be, for example, a diameter, a radius, a diagonal length, a side length, a hydraulic diameter, or a hydraulic radius. In various aspects, because the inflow port and the outflow port are spaced to define the flow path having length within the enclosed space commensurate with the characteristic length, the inflow pressure p.sub.in of the inflow fluid and outflow pressure pour of the outflow fluid are indicative of pressure p.sub.a within the enclosed space as measured at a length scale commensurate with the characteristic length of the enclosed space. That is, the length at which measurements of the pressure p.sub.a within the enclosed space is commensurate with the length scale of the enclosed space, in various aspects. For example, in aspects having a tube that communicates with the enclosed space, the characteristic length of the enclosed space and length of the flow path are both multiples of a diameter of the tube. Such aspects stand in contrast to pressure measurements of pressure p.sub.a within the enclosed space at a single location or at multiple locations separated by less than a diameter of the tube.
[0031] Fluid, as used herein, includes liquid(s), gas(ses), and combinations thereof. Liquid may include, for example, water, saline solution, proteolytic enzyme solutions, antimicrobial lavages, amniotic fluid, and exudate, and combinations thereof. Gas may include, for example, air, oxygen, nitric oxide, nitrogen, therapeutic or inert gasses, and combinations thereof. Exudate, as used herein, includes, for example, proteinaceous liquids exuded from the wound bed, along with various plasma and blood components. Exudate may also include other liquids used in treating the wound bed or produced by the wound bed or by surrounding tissues.
[0032] In various aspects, the term fluid-tight or related terms, as used herein, means sufficiently leak-resistant to allow insufflation or vacuum suction to create a pressure p.sub.a within the enclosed space that may be above or below ambient pressure p.sub.amb. The term fluid-tight means sufficiently leak-resistant to substantially retain fluids including both gasses and liquids within the enclosed space other than by controlled fluid communication through one or more lumen that fluidly communicate through the wound interface with the enclosed space, in certain aspects. In certain aspects, fluid tight means sufficiently leak-resistant to maintain pressure p.sub.a within the enclosed space that may be above or below ambient pressure p.sub.amb.
[0033] Ambient pressure p.sub.amb, as used herein, refers to the pressure in a region surrounding the wound therapy apparatus. Ambient pressure p.sub.amb, for example, may refer to atmospheric pressure, hull pressure within an aircraft or submarine where the wound therapy apparatus is being utilized, or pressure maintained generally within a building or other structure where the wound therapy apparatus is being utilized. Ambient pressure p.sub.amb may vary, for example, with elevation or weather conditions. Pressure p.sub.a within the enclosed space refers to the pressure actually occurring within the enclosed space. Minimum pressure p.sub.min refers to the minimum pressure achieved within the enclosed space of the wound therapy apparatus, and periodically varying of pressure p.sub.a, pressure variation, varying pressure, and similar term refer to changes of pressure p.sub.a within the enclosed space over time. Maximum pressure p.sub.max refers to the maximum pressure achieved within the enclosed space of the wound therapy apparatus. Pressures such as suction pressure p.sub.s, pressure p.sub.a, minimum pressure p.sub.min, and maximum pressure p.sub.max and their associated pressure values are as gauge pressure in this disclosure.
[0034] As used herein the terms distal and proximal are defined from the point of view of a physician, including various other healthcare providers, treating a patient with the wound therapy apparatus. When so treating the patient, a distal portion of the wound therapy apparatus is oriented toward the patient and a proximal portion of the wound therapy apparatus is oriented toward the physician. A distal portion of a structure is the portion closest to the patient while a
[0035] Although time rates of change such as
are expressed mathematically as differentials in this disclosure, it should be recognized that such time rates of change may be indicative of various approximations such as finite differences including other discretizations and approximations, and these approximations may be represented digitally in conformance to engineering, manufacturing, or scientific tolerances, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure. For example, the finite difference representation of time rates of change such as
in various implementations may be limited by byte size and may include various errors such as roundoff error and truncation error. In various implementations, quantities such as suction pressure p.sub.s, pressure p.sub.a, inflow pressure p.sub.in, outflow pressure p.sub.out, minimum pressure p.sub.min, and maximum pressure p.sub.max and time rates of change of pressure as used in the various mathematical relationships and formulations disclosed herein as well as the various mathematical relationships and formulations disclosed herein may include various errors such as roundoff error and truncation error and may conform to engineering, manufacturing, or scientific tolerances, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure. Quantities such as suction pressure p.sub.s, inflow pressure p.sub.in, and outflow pressure p.sub.out as measured may be in the form of averages, median values, or other statistical representations of a plurality of measurements made using a sensor, in various implementations, and may include errors inherent in measurement by the sensor as well as errors in digital representations.
[0036]
[0037] Pump 88 under control of controller 87 withdraws outflow fluid 18 from enclosed space 17 via fluid pathway 28, and outflow fluid pathway 28 includes outflow port 44. Outflow fluid 18 may include, for example, inflow fluid 16 and exudate 19, as illustrated. Liquid, such as liquid 24 and exudate 19, in outflow fluid 18 is captured in reservoir 57 of canister 50 as outflow fluid 18 is communicated through canister 50 by pump 89, and only gaseous portions of outflow fluid 18 are communicated from canister 50 to pump 89, in this implementation. Gaseous portions of outflow fluid 18 are discharged into the ambient environment by pump 89, as illustrated. Canister 50 including reservoir 57 may be omitted, for example, when the quantity of exudate 19 is minimal or there is no liquid, such as liquid 24 from liquid source 84, in outflow fluid 18. Canister 50 may be replaceable and disposable, in certain implementations.
[0038] Inflow pressure sensor 91 is in operable communication with inflow fluid pathway 26 to detect inflow pressure p.sub.in of inflow fluid 16 and the time rate of change of inflow pressure
Outflow pressure sensor 93 is in operable communication with outflow fluid pathway 28 to detect outflow pressure p.sub.out of outflow fluid 18 the time rate of change of outflow pressure
Inflow pressure sensor 91 may communicate with inflow fluid pathway 26 at one or more locations along inflow fluid pathway 26, for example, at or about oxygen source 82, air source 83, liquid source 84, valve 88, and/or within or about inflow port 42. Outflow pressure sensor 93 may communicate with outflow fluid pathway 28 at one or more locations along outflow fluid pathway, for example, within or about outflow port 44, reservoir 57 of canister 50, and/or suction side of pump 89.
[0039] Inflow port 42 and outflow port 44 are spaced length L.sub.1 apart, and enclosed space 17 has characteristic length D.sub.1, as illustrated. Characteristic length D.sub.1 is a characteristic length of enclosed space 17 such as, for example, diameter, radius, diagonal length, side length, hydraulic diameter, hydraulic radius, and so forth, that defines a scale of enclosed space 17. Because inflow port 42 is located length L.sub.1 from outflow port 44, inflow pressure p.sub.in detected by inflow pressure sensor 91 and outflow pressure p.sub.out detected by outflow pressure sensor 93 are indicative of pressure p.sub.a at locations length L.sub.1 apart in enclosed space 17 proximate inflow port 42 and proximate outflow port 44, respectively. In various implementations, length L.sub.1 may be commensurate with characteristic length D.sub.1 of enclosed space 17, so that the inflow pressure p.sub.in detected by inflow pressure sensor 91 and outflow pressure p.sub.out detected by outflow pressure sensor 93 are commensurate with the scale of enclosed space 17. That is, in contrast to a single pressure measurement or multiple pressure measurements proximate one another, in exemplary wound therapy apparatus 10 pressure p.sub.a within enclosed space 17 is measured by measuring inflow pressure p.sub.in and outflow pressure p.sub.out at locations length L.sub.1 apart where length L.sub.1 is commensurate with characteristic length D.sub.1 of enclosed space 17. In various implementations, length L.sub.1 may be, for example, greater than 50% of characteristic length D.sub.1. In various implementations, length L.sub.1 may be, for example, greater than 80% of characteristic length D.sub.1. In various implementations, length L.sub.1 may be, for example, greater than 90% of characteristic length D.sub.1.
[0040] Note that inflow pressure sensor 91 and outflow pressure sensor 93 are illustrated as separate pressure sensors for purposes of explanation. In various implementations, inflow pressure sensor 91 and outflow pressure sensor 93 may be formed as a single pressure sensor configured to detect inflow pressure p.sub.in and outflow pressure p.sub.out, or inflow pressure sensor 91 or outflow pressure sensor 93 may be formed as multiple pressure sensors.
[0041] Controller 87 communicates operably with valve 88, pump 89, inflow pressure sensor 91, outflow pressure sensor 93, via communication pathway 61, 62, 63, 65, respectively, to control operations of valve 88, pump 89, inflow pressure sensor 91, and outflow pressure sensor 93 in order to deliver a therapy regimen within enclosed space 17. Controller 87 communicates operably with user I/O 86 to allow a user to control the operations of wound therapy apparatus 10, for example, to select the therapy regimen delivered within enclosed space 17. Controller 87 may control the operation of wound therapy apparatus 10, at least in part, based upon data 74 communicated to controller 87 from user I/O 86 via communication pathway 64, and controller 87 may control the operation of wound therapy apparatus 10, at least in part, based upon data 71, 72, 73, 75 communicated between controller 87 and valve 88, pump 89, inflow pressure sensor 91, and outflow pressure sensor 93 via communication pathways 61, 62, 63, 65, respectively.
[0042] Data 74 input from the user via user I/O 86 is communicated to controller 87, for example, in order to allow the user to direct the operation of wound therapy apparatus 10. At least in part in response to data 74, controller 87 may direct delivery of various therapy regimens within enclosed space 17 of wound interface 15. For example, controller 87 may variously select inflow fluid 16 as oxygen 22 from oxygen source 82, air 23 from air source 83, liquid 24 from liquid source 84, or combinations thereof, and controller 87 may control the actual pressure p.sub.a within enclosed space 17 by controlling the inflow of inflow fluid 16 into enclosed space 17 and the withdrawal of outflow fluid 18 from enclosed space 17 through operations of valve 88 and pump 89. Controller 87 may alter the selection of inflow fluid 16 as oxygen 22 from oxygen source 82, air 23 from air source 83, liquid 24 from liquid source 84, combinations thereof, and/or the controller 87 may alter the pressure p.sub.a within enclosed space 17 over time according to the therapy regimen(s) being delivered. As examples, at certain times during the therapy regimen, (i) outflow fluid 18 is being withdrawn from enclosed space 17 while no inflow fluid 16 is being flowed into enclosed space 17 in order to reduce pressure p.sub.a to minimum pressure p.sub.min; (ii) inflow fluid 16 is being flowed into enclosed space 17 while no outflow fluid 18 is being withdrawn from the enclosed space 17 in order to increase pressure p.sub.a to maximum pressure p.sub.max; or, (iii) no inflow fluid 16 is being flowed into the enclosed space 17 and no outflow fluid 18 is being withdrawn from the enclosed space 17 as pressure p.sub.a is held at minimum pressure p.sub.min or at maximum pressure p.sub.max.
[0043] Data 71 may be indicative of the operation of valve 88, for example, the position of valve 88fully closed, fully open, intermediate of fully closed and fully open, allowing flow of oxygen 22 from oxygen source 82, allowing flow of air 23 from air source 83, allowing flow of liquid 23 from liquid source 84. Controller 87 may communicate data 71 with valve 88 to alter the operation of valve 88, for example, to select inflow fluid 16 as oxygen 22 from oxygen source 82, air 23 from air source 83, liquid 23 from liquid source 84, and combinations thereof. Controller 87 may communicate data 71 with valve 88 to alter the operation of valve 88, for example, to regulate, at least in part, the rate at which oxygen 22, air 23, liquid 24, or combinations thereof are flowed into enclosed space 17 as inflow fluid 16. It should be recognized that valve 88 is illustrated as a single valve 88 for purposes of explanation, and that, in various implementations, valve 88 may be formed as one or more valves of various types in various arrangements, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure. For example, valve 88 may include one or more valves disposed about wound therapy apparatus to select inflow fluid 16 as gas 22, liquid 24, combinations of gas 22 and liquid 24, to regulate, at least in part, the inflow of inflow fluid 16 into enclosed space 17 of wound interface 15, and to regulate, at least in part, the withdrawal of outflow fluid 18 from enclosed space 17 of wound interface 15.
[0044] Data 72 communicated from pump 89 to controller 87 may be indicative of the operation of pump 89, for example, rate of operation, and quantity of electrical power being supplied. Pump 89 may be, for example, a centrifugal pump, positive displacement pump, or peristaltic pump, or multiple pumps of various types, in various implementations, and rate of operation refers to rate of rotation, rate of displacement, rate of contraction, etc. as appropriate. Data 72 communicated from controller 87 to pump 89 may alter the operation of pump 89, for example, setting pump 89 in an ON state, setting pump 89 in an OFF state, or controlling the rate of operation of pump 89 in order to control, at least in part, the withdrawal of outflow fluid 18 from enclosed space 17 including the rate at which outflow fluid 18 is withdrawn.
[0045] Data 73 indicative of the inflow pressure pm and/or the time rate of change of inflow pressure
detected by inflow pressure sensor 91 is communicated with controller 87 via communication pathway 63, and data 75 indicative of the outflow pressure p.sub.out and/or the time rate of change of outflow pressure
detected by outflow pressure sensor 93 is communicated with controller 87 via communication pathway 65, as illustrated. Controller 87 may communicate data 73 with inflow pressure sensor 91 to control the operation of inflow pressure sensor 91 such as, for example, the frequency at which inflow pressure p.sub.in is detected and locations along inflow fluid pathway 26 at which inflow pressure p.sub.in is detected. Controller 87 may communicate data 75 with outflow pressure sensor 93 to control the operation of outflow pressure sensor 93 such as, for example, the frequency at which outflow pressure pour is detected and locations along outflow fluid pathway 28 at which outflow pressure pour is detected. Controller 87 may control the operation of valve 88 in combination with the operation of pump 89 in order to achieve a specified pressure p.sub.a within enclosed space 17 as may be indicated by the inflow pressure p.sub.in detected by inflow pressure sensor 91 and outflow pressure pour detected by outflow pressure sensor 93.
[0046] Controller 87 may include, for example, a processor, memory, software operably communicating with the processor, A/D converter, D/A converter, clock, I/O connectors, and so forth, and controller 87 may be configured for example, as a single chip or as an array of chips disposed about a circuit board, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure. In some implementations, controller 87 may be configured, at least in part, as software operatively received by a computer, and the computer may, for example, communicate by network with valve 88, pump 89, inflow pressure sensor 91, and outflow pressure sensor 93.
[0047] User I/O 86 may include various switches, push buttons, dials, sliders, graphs, and so forth, whether virtual or physical, for obtaining data 74 from the user. In certain implementations, user I/O 86 may be formed, at least in part, as software operably received by a computer. Controller 87 may communicate data 74 to user I/O 86 that may be indicative of the operation of wound therapy apparatus 10, and user I/O 86 may display data 74 to the user using physical display(s), virtual display(s), and combinations thereof.
[0048] Oxygen source 82 may be, for example, a cylinder of oxygen, an oxygen bag, an oxygen generator, or mains oxygen. Air source 83, may be, for example, ambient air at ambient pressure or compressed air such as a cylinder of air or mains air. Liquid source 84 may be, for example, a container of liquid or mains supply of liquid. Oxygen source 82, air source 83, and liquid source 84 may include various traps, filters, fittings, and so forth, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure.
[0049] Inflow fluid 16 may be communicated under pressure of oxygen source 82 (e.g., a tank of compressed gas), pressure of air source 83, pressure of liquid source 84 (e.g., piezometric head at liquid source), with respect to pressure p.sub.a within enclosed space 17, suction of pump 89, and combinations thereof.
[0050] Wound therapy apparatus 10 may include various fluid conveyances, for example hoses, pipes, valves, tubing, connectors, pressure regulators, plenums, and various other fittings, that form inflow fluid pathway 26 for the communication of oxygen 22, air 23, and liquid 24 from gas source 82, air source 83, and liquid source 84, respectively, to enclosed space 17 of wound interface 15 as inflow fluid 16 and form outflow fluid pathway 28 for the communication of outflow fluid 18 withdrawn from enclosed space 17 of wound interface 15. Note that in various other implementations, at least one of inflow port 42 and outflow port 44 may be used for monitoring directly or indirectly parameters within the enclosed space such as pressure p.sub.a, temperature, humidity, pH, tissue oxygenation level, blood flow, etc. to affect the therapy regimen delivered to the wound bed.
[0051] Communication pathways 61, 62, 63, 64, 65 may be, for example, wired, wireless, optical (e.g., fiberoptic, infrared), networked (e.g., Internet), or various combinations thereof, in various implementations. Valve 88, pump 89, inflow pressure sensor 91, and outflow pressure sensor 93 may include, for example, A/D converters, D/A converters, actuators, solenoids, stepper motors, microprocessors, to control the operations of valve 88, pump 89, inflow pressures sensor 91, and outflow pressure sensor 93 using data 71, 72, 73, 75 respectively, or to communicated data 71, 72, 73, 75 to controller 87 indicative of the operation of valve 88, pump 89, inflow pressure sensor 91, and outflow pressure sensor 93, as would be readily recognized by those of ordinary skill in the art upon study of the present disclosure. Data 71, 72, 73, 74, 75 may be digital, analog, or combinations thereof, in various implementations.
[0052] Power source 97 includes one or more source(s) of electrical power disposed about wound therapy apparatus 10 in electrical communication with wound therapy apparatus 10 including user I/O 86, controller 87, valve 88, pump 89, inflow pressure sensor 91, and outflow pressure sensor 93 to flow electrical power thereupon. Power source 97 may be, for example, mains electric, battery, or combinations of mains electric and battery, and power source 97 may include, for example, a transformer, an inverter, a rectifier, filter(s), surge protector(s), and so forth, as would be readily recognized by those of ordinary skill in the art upon study of the present disclosure. Wound therapy apparatus 10 may include various other fluid communication, data communication, electrical communication, and other pathways, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure.
[0053]
[0054] In various implementations, base 120 may be formed, for example, of one or more medical polymers including, for example, ABS, polystyrene or polypropylene, and base 120 may be structurally rigid. Cover 140 may be transparent, at least in part, to allow visual inspection of enclosed space 117 including a wound bed, such as wound bed 213 (see
[0055] As illustrated in
[0056] Cover 140 is hingedly attached to base 120 by hinge 147 that allows cover 140 to be positionable between open position 103, illustrated in
[0057] As illustrated in
[0058] Base 120, as illustrated, has an annular shape, as illustrated in
[0059] Inflow port 142 and outflow port 144 are disposed about cover 140, as illustrated, to fluidly communicate with enclosed space 117 when cover 140 is in closed position 101. As illustrated in
[0060] Fluid communication with inflow port 142 and with outflow port 144 may be at least in part via tubing (not shown) including hoses, pipes, valves, and various other fluid conveyances and fittings that may cooperate with inflow port 142 and outflow port 144, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure.
[0061] Dressing 150, which is cylindrical in shape, extends forth from cover 140 to contact the wound bed when cover is in closed position 101, in this implementation. Dressing 150 may be variously sized to occupy various portions of enclosed space 117, and dressing 150 may be a therapeutic or protective material configured to intermittently contact the wound bed. Dressing 150 may be formed, for example, of cotton, absorbent foam, or fabric, and dressing 150 absorbs exudate 119 while allowing the transmission of fluids therethrough, in this implementation.
[0062] Inflow port 142 is located proximate periphery 163 to introduce inflow fluid 116 into enclosed space 117 via lumen 143 of inflow port 142. Outflow port 144 is positioned at center 161 so that lumen 145 of outflow port 144 fluidly communicates with dressing 150 for withdrawal of outflow fluid 118 from enclosed space 117. Outflow fluid 118 may include exudate, such as exudate 19, withdrawn from dressing 150, as well as inflow fluid 116 and other liquids and gasses that may be present within enclosed space 117. Thus, inflow fluid 116 inflows into enclosed space 117 via lumen 143 of inflow port 142 at periphery 163 of enclosed space 117, and outflow fluid 118 withdrawn from enclosed space 117 via lumen 145 of outflow port 144 at center 161 of enclosed space 117, so that fluid flow is generally from periphery 163 to center 161 of enclosed space 117 along flow path 171 with length L.sub.2D.sub.2, in this implementation. Length L.sub.2 of flow path 171 may be multiple times the diameter d.sub.1 of lumen 143 of inflow part 142 and length L.sub.2 of flow path 171 may be multiple times the diameter d.sub.2 of lumen 145 of outflow port 144. For example, length L.sub.2 of flow path 171 may be at least 10 times the diameter d.sub.1 of lumen 143 of inflow part 142. Length L.sub.2 of flow path 171 may be at least 100 times the diameter d.sub.1 of lumen 143 of inflow part 142, in certain implementations. In various implementations, length L.sub.2 of flow path 171 may be greater than 50% of characteristic length D.sub.2. In various implementations, length L.sub.2 of flow path 171 may be greater than 80% of characteristic length D.sub.2. In various implementations, length L.sub.2 of flow path 171 may be greater than 90% of characteristic length D.sub.2.
[0063] An exemplary implementation of a wound therapy apparatus 200 that includes wound interface 215 is illustrated in
[0064] As illustrated in
[0065] Inflow of inflow fluid 216 into enclosed space 217 via lumen 243 of inflow port 242 and withdrawal of outflow fluid 218 from enclosed space 217 via lumen 245 of outflow port 244 may be sequential with one another, meaning inflow fluid 216 is not being inflowed into enclosed space 217 simultaneously with outflow fluid 218 being withdrawn from enclosed space 217. Inflow fluid 216 may be being inflowed into enclosed space 217 while no outflow fluid 218 is being withdrawn from enclosed space 217, outflow fluid 218 may be being withdrawn from enclosed space 217 while no inflow fluid 216 is being inflowed into enclosed space 217, or no inflow fluid 216 is being inflow into enclosed space 217 and no outflow fluid 218 is being withdrawn from enclosed space 217, in various implementations.
[0066] Inflow port 242 and outflow port 244 are spaced length L.sub.3 apart to form flow path 271, and enclosed space 217 has characteristic length D.sub.3, as illustrated. Inflow port 242 and outflow port 244 are located proximate opposing ends of enclosed space 217, in this implementation, to form flow path 271 of length L.sub.3 where length L.sub.3 is commensurate with characteristic length D.sub.3 (e.g., D.sub.3L.sub.3). implementation. Length L.sub.3 of flow path 271 may be multiple times the diameter d.sub.3 of lumen 243 of inflow part 242 and length L.sub.3 of flow path 271 may be multiple times the diameter d.sub.4 of lumen 245 of outflow port 244. For example, length L.sub.3 of flow path 271 may be at least 10 times the diameter d.sub.3 of lumen 243 of inflow part 142. In various implementations, length L.sub.3 of flow path 271 may be greater than 95% of characteristic length D.sub.3 of enclosed space 217.
[0067] As illustrated in
[0068]
[0069] As illustrated in
[0070] As illustrated in
[0071] As illustrated in
[0072] In operation of a wound therapy apparatus, such as wound therapy apparatus 10, 100, 200, 300, 400, 500, 600, a wound interface, such as wound interface 15, 115, 215, 315, 415, 515, 615 is attached to a skin surface, such as skin surface 11, 111, 211, to enclose a wound bed, such as wound bed 213 (also see
[0073] As part of the therapy regimen, the inflow fluid may include oxygen from an oxygen source, such as oxygen 22 from oxygen source 82, air from an air source, such as air 23 from air source 83, liquid from a liquid source, such as liquid 24 from liquid source 84, or various combinations of oxygen, air, or liquid. The controller may select oxygen, air, liquid, or various combinations thereof as inflow fluid by positioning a valve, such as valve 88. The controller may regulate the inflow of inflow fluid into the enclosed space and withdrawal of outflow fluid from the enclosed space by regulating the valve and by regulating a pump, such as pump 87, in order to deliver the therapy regimen.
[0074] An inflow pressure sensor, such as inflow pressure sensor 91, is in operable communication with the inflow fluid pathway to detect inflow pressure p.sub.m of the inflow fluid and the time rate of change of inflow pressure
of the inflow fluid in the inflow fluid pathway. An outflow pressure sensor, such as outflow pressure sensor 93, is in operable communication with the outflow fluid pathway to detect outflow pressure p.sub.out of the outflow fluid and the time rate of change of outflow pressure
of the outflow fluid in the outflow fluid pathway. The controller may operate the valve and the pump and otherwise regulate the operation of the wound therapy apparatus using data, such as data 73, from the inflow pressure sensor and using data, such as data 75, from the outflow pressure sensor, where the data are indicative of inflow pressure p.sub.m of the inflow fluid, the time rate of change of inflow pressure
of the inflow fluid, outflow pressure p.sub.out of the outflow fluid, and the time rate of change of outflow pressure
of the outflow fluid.
[0075] Various operational conditions of wound therapy apparatus may be detected using the inflow pressure p.sub.in of the inflow fluid, the time rate of change of inflow pressure
of the inflow fluid, outflow pressure p.sub.out of the outflow fluid, and the time rate of change of outflow pressure
of the outflow fluid. Hysteresis of changes in the inflow pressure p.sub.in, changes in the outflow pressure p.sub.out, the time rate of change of inflow pressure
the time rate of change of outflow pressure
alone or in combination may be indicative of various operational conditions of the wound therapy apparatus including the wound bed.
[0076] In the following examples of exemplary operational conditions, it is considered that net fluid is being withdrawn from the enclosed spacethe withdrawal of outflow fluid is greater than the inflow of inflow fluid so that pressure p.sub.a within the enclosed space is being decreased toward minimum pressure p.sub.min. Examples of operational conditions, without limitation, include:
[0077] i) Normal operation. Inflow pressure p.sub.in of the inflow fluid in the inflow fluid pathway is generally equal to the outflow pressure p.sub.out of the outflow fluid and therefor indicative of pressure p.sub.a within the enclosed space. Mathematically, this may be stated as:
p.sub.inp.sub.ap.sub.out(1)
or
|p.sub.inp.sub.out<(2)
where represents a sensitivity. The time rate of change of the inflow pressure p.sub.in generally tracks the time rate of change in outflow pressure p.sub.out. That is:
where represents another sensitivity. Note that the brackets in the form of vertical lines (e.g., | |) denote absolute values of the quantities enclosed therein. Under normal operational conditions, the inflow pressure p.sub.in detected by the inflow pressure sensor and the outflow pressure p.sub.out detected by the outflow pressure sensor are indicative of pressure p.sub.a in the enclosed space proximate the inflow port and proximate the outflow port, respectively. The inflow port and the outflow port are separated by a length, such as length L.sub.1, L.sub.2, L.sub.3, L.sub.4, L.sub.5, L.sub.6, L.sub.7, away from the outflow port, and the length may be commensurate with a characteristic length, such as characteristic length D.sub.1, D.sub.2, D.sub.3, D.sub.4, D.sub.5, D.sub.6, of the enclosed space, in various implementations. Inflow pressure p.sub.in and outflow pressure p.sub.out may, for example, be averaged to determine pressure p.sub.a in the enclosed space. Thus, pressure p.sub.a in the enclosed space is determined from inflow pressure p.sub.in and outflow pressure p.sub.out detected at the length apart with respect to the enclosed space.
[0078] ii) Occlusion of the outflow fluid pathway. The outflow pressure p.sub.out of the outflow fluid deviates from the inflow pressure p.sub.in of the inflow fluid by occlusion of the outflow fluid pathway between the enclosed space and the outflow pressure sensor. Because of the occlusion, the outflow pressure p.sub.out detected by the outflow pressure sensor is not indicative of pressure p.sub.a within the enclosed space and does not generally equal the inflow pressure p.sub.in. Occlusion of the outflow fluid pathway may be caused, for example, by exudate, such as exudate 19, that accumulates and hardens within the outflow fluid pathway or liquid that collects at low points in the outflow fluid pathway. That is:
Note that:
p.sub.inp.sub.a but p.sub.outp.sub.a(7)
[0079] iii) Reservoir filled. The reservoir of the canister may become filled with liquid, in which case the time rate of change of outflow pressure p.sub.out of the outflow fluid increases due to resulting decreased volume within the outflow fluid pathway. Inflow pressure p.sub.in is generally equal to the outflow pressure p.sub.out. That is:
where is a sensitivity representing, at least in part, a maximum time rate of change outflow pressure
at which the reservoir has capacity (i.e., is not filled).
[0080] iv) Leak in sealing engagement between wound interface and skin surface. Two bounding exemplary operational conditions are as follows. Note that operational conditions intermediate of these two bounding operational conditions may be possible. These bounding exemplary operational conditions are:
[0081] (1) If the leak is large including detachment of the wound interface from the skin surface, then the inflow pressure p.sub.in is generally equal to the outflow pressure p.sub.out and both are generally equal to ambient pressure p.sub.amb. Because the inflow pressure p.sub.in and outflow pressure p.sub.out are generally unchanged, both
where .sub.1 and .sub.2 are sensitivities. Accordingly, p.sub.inp.sub.ap.sub.outp.sub.amb so that |p.sub.inp.sub.out|<.
[0082] (2) If the leak is small, then the time rate of change of inflow pressure
lags the time rate of change of outflow pressure
as net fluid is withdrawn from the enclosed space but inflow pressure p.sub.m and outflow pressure equilibrate p.sub.out after withdrawal of fluid is competed, which distinguishes this operational condition from occlusion of the outflow fluid pathway. That is:
[0083] As used herein, sensitivity, such as sensitivity , .sub.1, .sub.2, , accounts for roundoff error, truncation error, measurement error, provides damping or hysteresis, and so forth, as would be readily recognized by those of ordinary skill in the art upon study of this disclosure. In various implementations, the sensitivity may be a positive finite value that may approach zero as limited by the physical and digital numeric limitations of the wound therapy apparatus. In various implementations, the sensitivity may be experimentally derived, while, in theory, the sensitivity may approach zero.
[0084] The foregoing discussion along with the Figures discloses and describes various exemplary implementations. These implementations are not meant to limit the scope of coverage, but, instead, to assist in understanding the context of the language used in this specification and in the claims. The Abstract is presented to meet requirements of 37 C.F.R. 1.72(b) only. The Abstract is not intended to identify key elements of the apparatus and methods disclosed herein or to delineate the scope thereof. Upon study of this disclosure and the exemplary implementations herein, one of ordinary skill in the art may readily recognize that various changes, modifications and variations can be made thereto without departing from the spirit and scope of the inventions as defined in the following claims.