combination of an annular rotary knife blade, head arrangement for an energy-operated dermatome and

专利摘要:
COMBINATION OF AN ANNULAR ROTARY KNIFE BLADE, HEAD ARRANGEMENT FOR AN ENERGY OPERATED DERMATOMO, ENERGY-ROTATED KNIFE BLADE COMBINATION AND DERMATOMOUS OPERATED DERMATOMA (2290) of a rotating blade (2290) and a 23 rotary knife blade blade housing (2400) for an energy operated dermatome (2000). The rotary knife blade includes an inner wall (2310) defining an inner region (2301) and including a lower tissue targeting surface (2370) adjacent to a cutting edge (2360) and an upper radially recessed portion (2380) . The blade housing arrangement includes a blade housing (2410) having a first end (2412) and an axially spaced second end (2414) and an inner wall (2416) and a radially spaced outer wall (2418) . The blade housing includes a blade housing cover (2450) extending from the inner wall to the inner blade region. The blade housing cover includes a protector (2470) extending along the upper recessed portion of the rotating knife blade inner wall and having an adjacent inner surface (2472) and continuing the lower tissue targeting surface of the wall internal rotating knife blade.
公开号:BR112015005027B1
申请号:R112015005027-1
申请日:2013-09-05
公开日:2020-11-17
发明作者:Jeffrey A. Whited；Bernard J. Esarey
申请人:Exsurco Medical, Inc.；
IPC主号:

专利说明:

Technical field
[0001] The present disclosure relates to an energy-operated dermatome including a rotary knife blade and a blade housing arrangement supporting the rotary knife blade for rotation about an axis of rotation, the rotary knife blade including a wall internal region defining an interior region of the rotary knife blade and having a cutting edge at one end of the rotary knife blade defining a cutting plane orthogonal to the axis of rotation of the rotary knife blade, the blade housing arrangement including a blade housing blade having a fabric guiding blade housing protector overlapping an upper portion of the inner wall of the rotating knife blade. Historic
[0002] Dermatomes are portable surgical instruments used by a doctor or medical professional (hereinafter operator) to cut thin layers or sections of skin tissue. Dermatomes are used in hospitals and other medical facilities for the removal or removal of skin tissue from patients with respect to a variety of medical procedures including split-thickness and full-thickness skin grafting, skin debridement (eg, removal of burnt tissue) skin removal), tumor / lesion removal and breast reduction, among other procedures. Dermatomes are also used to remove skin tissue from human donors or deceased animals for skin grafting purposes.
[0003] Previous dermatomes included both energy-operated and manual-operated dermatomes. Manual dermatomes typically included a fixed blade and a handle protruding from the blade. Manual dermatomes have often been found to be boring to use and prone to operator fatigue, especially when large sections of skin tissue need to be removed, requiring multiple sections of skin tissue to be removed. For example, a deceased human donor can provide 6-9 square feet of recoverable skin tissue.
[0004] It is generally desired that an excised skin section be of uniform or consistent thickness along the longitudinal extension of the skin section and across the width of the skin section. The thickness of a section of excised skin is dependent on the depth of cut of the dermatome's cutting blade. The use of manual dermatomes often resulted in excised sections of skin of varying thickness and irregular edges. The uniformity of the depth of the cut was largely dependent on the skill of the operator. While limited numbers of manual dermatomes continue to be used, energy-operated dermatomes are favored in procedures where large sections of skin tissue need to be removed efficiently and / or operator fatigue is an issue.
[0005] Previous energy-operated dermatomes typically included a reciprocating cutting blade arranged on a leading or leading edge of the dermatome with a depth gauge or guard to allow the operator to define a cut depth of the dermatome to remove a desired thickness of tissue of skin. The blade was typically orthogonal to a handle extending to the rear or handpiece of the dermatome. Because the blade cutting direction of previous energy-operated dermatomes is facing forward, such dermatome configurations required the operator to move the dermatome in a direction generally away from the operator's body to excise or cut a section of skin tissue. This direction of movement of the operator's hand and dermatome away from the operator's body is less natural and less accurate than a direction of movement of the operator's hand and dermatome towards the operator. Furthermore, when moving the dermatome away from the operator's body, the position of the dermatome tends to block the area of the skin tissue being excised from the operator's view. This is especially problematic where the tissue to be removed is adjacent to, for example, a raised or bony prominence of the body that must be carefully navigated around with the cutting edge of the dermatome's cutting blade.
[0006] Additionally, with previous energy operated dermatomes, in order to cut a section of skin tissue with a consistent and desired depth of cut, the cutting angle, the speed of the dermatome across the skin and the pressure applied at the dermatome they had to be carefully controlled by the operator. The cut angle of the dermatome refers to an acute angle between the cut blade of the dermatome and the skin tissue being removed or excised. If the cut angle of the dermatome is too shallow, the desired depth of cut will not be reached. If the cut angle of the dermatome is too pronounced, gouging or excavation of the excised skin tissue will occur. In addition, if the cutting angle is changed as the energy-operated dermatome is moved along the skin tissue, the depth of cut will vary over a longitudinal extension of the excised section of the skin tissue.
[0007] The speed or forward movement rate of previous energy-operated dermatomes also had to be carefully controlled by the operator. If the speed of the dermatome is too fast or too slow, the cutting depth of the excised skin section can be greater or less than the desired cutting depth as defined by the operator using the dermatome depth gauge.
[0008] The operator using a typical anterior energy operated dermatome was also required to apply considerable pressure to the dermatome to ensure that the entire length or length of the cutting edge of the reciprocating blade remained in contact with the skin tissue. The pressure applied by the operator to the dermatome needed to remain constant. If the pressure applied by the operator to the dermatome is too high or too low during a cutting operation, the cutting depth could change and the section of skin excised would have portions that were more or less deep than the desired depth of cut as defined with the depth gauge of the dermatome. If the pressure applied by the operator to the dermatome is too low, the excised skin tissue can be very thin resulting in holes in the excised skin tissue and / or vibrating edges.
[0009] Uniformity in the depth of cut of the excised skin sections is especially important in divided skin grafts where it is desired to remove only the outer epidermis and a portion of the dermis. The desired thickness of skin tissue in a thin type split-thickness skin graft is in the range of 0.127 to 0.304 mm. Thus, there is little margin for error where the desired thickness and depth of skin cut is very thin.
[0010] With previous dermatomes using a reciprocating blade, it was sometimes necessary for the operator to have an assistant to provide opposite traction to flatten the skin surface in front of or behind the path of the dermatome to allow the dermatome blade to perform a initial cut. Adding an additional person to the procedure not only increases the cost of the procedure, but also increases the risk of infection and contamination due to the presence of another person in the operating or procedure room.
[0011] What is needed is an energy-operated dermatome in which obtaining a desired and consistent thickness of a section of excised skin tissue is less dependent on the operator's ability to maintain a desired constant angle of cut, speed and pressure on the dermatome . What is needed is an energy-operated dermatome that reduces operator fatigue by removing large sections of skin tissue. What is needed is an energy-operated dermatome that facilitates the removal of skin tissue in narrow spaces and around bony prominences. What is needed is an energy-operated dermatome that facilitates improved control of the dermatome by the operator by moving the cutting edge of the blade along a path towards the operator, rather than moving the blade away from the operator. What is needed is an energy-operated dermatome that allows for improved visibility of the skin site being excised by the operator. What is needed is an energy-operated dermatome that facilitates the removal of very thin layers of skin tissue and tangential excision of burnt tissue. What is needed is an energy-operated dermatome that does not require an additional person involved in the procedure to provide opposite traction at the skin removal site to allow an initial cut to be made by the dermatome. summary
[0012] In one aspect, the present disclosure relates to a head arrangement for an energy operated dermatome, the head arrangement comprising: a frame body supporting a gear train, a blade housing arrangement, a blade annular rotary knife supported for rotation on an axis of rotation by the blade housing arrangement, the rotary knife blade including an inner wall defining an inner region of the rotary knife blade and having a cutting edge at one end of the knife blade swivel defining a cutting plane orthogonal to the axis of rotation of the rotary knife blade and a depth gauge arrangement including a depth gauge holder and a depth gauge including a depth gauge plate supported by the depth gauge for axial movement along the axis of rotation of the rotary knife blade, the depth gauge plate extending into the inner region of the blade swiveling and depth gauge support attached and extending from the frame body.
[0013] In another aspect, the present disclosure relates to an energy-operated dermatome comprising: an elongated handle arrangement and a removable head arrangement coupled to the handle arrangement, the head arrangement including a supporting frame body a gear train, a blade housing arrangement, an annular rotary knife blade supported for rotation on an axis of rotation by the blade housing arrangement, the rotary knife blade including an inner wall defining an inner region of the knife blade rotary and having a cutting edge at one end of the rotary knife blade defining a cutting plane orthogonal to the axis of rotation of the rotary knife blade and a depth gauge arrangement including a depth gauge holder and a depth gauge including a depth gauge plate supported by the depth gauge for axial movement along the axis of rotation of the rotary knife blade, the depth gauge plate extending in the inner region of the rotary knife blade and the attached depth gauge support and extending from the frame housing.
[0014] In another aspect, the present disclosure relates to a combination of an annular rotary knife blade and a blade housing arrangement for an energy operated dermatome, the combination comprising: the rotary knife blade supported for rotation over an axis of rotation through the blade housing arrangement, the rotary knife blade including a first end and a second end axially spaced and an inner wall and an outer wall radially spaced, the second end defining a cutting edge, the inner wall defining an interior region of the rotating knife blade and including a lower material guiding surface adjacent to the cutting edge and an upper portion radially lowered; and the blade housing arrangement including a blade housing having an axially spaced first end and a second end and a radially spaced inner wall and outer wall, the blade housing including a blade housing cover extending if from the inner wall to the inner region of the rotary knife blade, the blade housing cover including a protector extending along the lowered top portion of the inner wall of the rotary knife blade and having an adjacent inner surface and continuing to lower material guide surface of the inner wall of the rotating knife blade.
[0015] In another aspect, the present disclosure relates to a combination of a rotating knife blade and a blade housing arrangement for an energy-operated dermatome, the rotating knife blade supported for rotation on an axis of rotation by blade housing arrangement and the combination defining a fabric guiding surface for cutting fabric by the rotary knife blade, the combination comprising: the rotary knife blade including a first end and an axially spaced second end and an inner wall and a radially spaced outer wall, the second end having a cutting edge defining a cutting plane substantially orthogonal to the axis of rotation, the inner wall defining an inner region of the rotating knife blade and including an adjacent tissue guiding surface the cutting edge and an upper portion radially lowered; and the blade housing arrangement including a blade housing having an axially spaced first end and a second end and a radially spaced inner wall and outer wall, the blade housing including a blade housing cover extending if from the inner wall to the inner region of the rotary knife blade, the blade housing cover including a protector extending along the recessed upper portion of the inner wall of the rotary knife blade and having an internal tissue guiding surface adjacent and continuing on the lower tissue targeting surface of the rotary knife blade inner wall, the tissue targeting surface of the rotary knife blade and the inner surface of the tissue targeting surface of the blade housing protector comprising the surface of targeting tissue from the combination.
[0016] In another aspect, the present disclosure relates to a head arrangement for an energy-operated dermatome, the head arrangement comprising: a frame body supporting a gear train, a blade housing arrangement, a blade annular rotary knife supported for rotation about an axis of rotation by the blade housing arrangement, the rotary knife blade including the rotary knife blade including a first end and an axially spaced second end and an inner wall and an outer wall radially spaced, the second end defining a cutting edge, the inner wall defining an interior region of the rotating knife blade and including a lower material guiding surface adjacent to the cutting edge and an upper portion radially recessed; and the blade housing arrangement including a blade housing having an axially spaced first end and a second end and a radially spaced inner wall and outer wall, the blade housing including a blade housing cover extending if from the inner wall to the inner region of the rotary knife blade, the blade housing cover including a protector extending along the lowered top portion of the inner wall of the rotary knife blade and having an adjacent inner surface and continuing to lower material guide surface of the inner wall of the rotating knife blade. Brief description of the drawings
[0017] The previous and other features and advantages of the present disclosure will become apparent to one skilled in the art to which the present disclosure relates by considering the following description of the invention with reference to the accompanying drawings, in which similar numerals of reference, unless otherwise described, refer to similar parts by all drawings and in which:
[0018] Figure 1 is a schematic perspective view of a first exemplary embodiment of a portable energy operated dermatome of the present disclosure including a handle arrangement and a head arrangement including a rotating knife blade and a depth gauge arrangement. extending into a central interior region defined by the rotating knife blade;
[0019] Figure 2 is a schematic exploded perspective view of the energy operated dermatome of Figure 1;
[0020] Figure 3 is a schematic side elevation view of the energy operated dermatome of Figure 1;
[0021] Figure 4 is a schematic top plan view of the energy operated dermatome of Figure 1;
[0022] Figure 5 is a schematic bottom plan view of the energy operated dermatome of Figure 1;
[0023] Figure 6 is a schematic frontal elevation view of the energy operated dermatome of Figure 1;
[0024] Figure 7 is a schematic longitudinal section view of the energy-operated dermatome of Figure 1, as seen along a longitudinal axis LA of the dermatome handle arrangement;
[0025] Figure 8 is a schematic top plan view of the energy-operated dermatome head arrangement of Figure 1, with a gear train from the head arrangement removed for clarity;
[0026] Figure 9 is a schematic rear elevation view of the head arrangement of Figure 8;
[0027] Figure 10 is a schematic exploded top view of the head arrangement of Figure 8;
[0028] Figure 11 is a schematic exploded bottom perspective view of the head arrangement of Figure 8;
[0029] Figure 12 is a schematic sectional view of the head arrangement of Figure 8 as seen from a plane indicated by line 12-12 in Figure 9;
[0030] Figure 13 is a schematic enlarged sectional view of a portion of the head arrangement of Figure 8 that is within a dotted circle labeled Fig. 13 in Figure 12;
[0031] Figure 14 is a schematic front elevation view of an exemplary embodiment of the rotating knife blade of the energy operated dermatome of Figure 1;
[0032] Figure 15 is a schematic sectional view of the rotating knife in Figure 14, as seen from a plane indicated by line 15-15 in Figure 14;
[0033] Figure 16 is a schematic enlarged sectional view of a cutting edge portion of the rotating knife blade shown in Figure 15 which is within a dotted circle labeled Fig. 16 in Figure 15;
[0034] Figure 17 is a schematic sectional view of the energy operated dermatome of Figure 1, as manipulated to make an initial incision or cut in the skin tissue for a thin-skinned split-thickness graft in which a depth of a layer of skin tissue being excised from a patient or donor graft site is in the range of 0.127 mm (0.005 in) to 0.305 mm (0.012 in);
[0035] Figure 18 is a schematic view, partly in perspective and partly in section, of the energy-operated dermatome of Figure 1, as manipulated to cut or excise a thin-thickness divided skin graft in which a depth of one layer of skin tissue being excised from a patient or donor graft site is in the range of 0.127 mm (0.005 in) to 0.305 mm (0.012 in);
[0036] Figure 19 is a schematic view, partly in perspective and partly in section, of the energy-operated dermatome of Figure 1, as manipulated to end an incision in a thin-thickness divided skin graft in which a depth of a layer of skin tissue being excised from a patient or donor graft site is in the range of 0.127 mm (0.005 in) to 0.305 mm (0.012 in); .
[0037] Figure 20 is a schematic view, partly in perspective and partly in section, of the energy operated dermatome of Figure 1, as used in a full thickness skin graft where a depth of one layer of skin tissue is excised from a donor graft site is in the range of 0.762 mm (0.030 in) to 1.092 mm (0.043 in);
[0038] Figure 21 is a schematic sectional view of a portion of the dermatome of Figure 1 showing the depth gauge arrangement in a fully closed position providing a minimum cut depth of the dermatome; and
[0039] Figure 22 is a schematic perspective view of a second exemplary embodiment of a portable energy operated dermatome of the present disclosure including a handle arrangement and a head arrangement including a rotating knife blade and depth gauge arrangement. extending into a central interior region defined by the rotating knife blade;
[0040] Figure 23 is a schematic front elevation view of the energy operated dermatome of Figure 22;
[0041] Figure 24 is a schematic longitudinal section view of the energy operated dermatome of Figure 22, as seen along a longitudinal axis LA 'of the dermatome handle arrangement and as seen from a plane indicated by line 24 -24 in Figure 23;
[0042] Figure 25 is a schematic front elevation view of a head arrangement of a third exemplary embodiment of a portable energy-operated dermatome of the present disclosure, the head arrangement comprising a rotating knife blade and a housing arrangement of blade including a blade housing having a fixed tissue targeting protector overlapping an upper portion of an inner wall of the rotating knife blade;
[0043] Figure 26 is a schematic longitudinal section view of the head arrangement of Figure 25, as seen from a plane indicated by line 26-26 in Figure 25;
[0044] Figure 27 is a schematic enlarged sectional view of a portion of the head arrangement of Figure 25 that is within a dotted circle labeled Fig. 27 in Figure 26;
[0045] Figure 28 is a schematic front perspective view of the head arrangement of Figure 25;
[0046] Figure 29 is a schematic front perspective view of the head arrangement of Figure 25 with a rotating knife blade and a blade lock ring of a removed blade housing arrangement;
[0047] Figure 30 is a schematic top plan view of the head arrangement of Figure 25 with a rotating knife blade and a blade locking ring of a removed blade housing arrangement; and
[0048] Figure 31 is a schematic bottom plan view of the head arrangement of Figure 25 with a rotating knife blade and a blade locking ring of a removed blade housing arrangement. Detailed Description
[0049] The present disclosure relates to a portable energy-operated dermatome 100 for medical use to remove a layer of SK skin tissue (Figures 17-21) from a patient or donor with respect to various medical procedures including skin grafting split and full thickness, skin debridement, e.g., removal of burnt skin tissue, tumor / lesion removal, breast reduction, among other procedures, including removing a layer of skin tissue from a human donor or deceased animal for skin grafting / transplantation purposes. Advantageously, dermatome 100 of the present disclosure includes an annular rotary knife blade 300 which is driven on a central axis of rotation R at a high speed of rotation (in the order of 500 - 1,500 RPM) by a drive arrangement 500 of dermatome 100 and also includes a 600 gauge arrangement to allow precise configuration and adjustment of a DOC cut depth of dermatome 100.
[0050] A 360 cutting edge of the rotary knife blade 300 cuts or excises an upper layer of SK skin tissue from a GR graft region, resulting in an excised section or layer of EST skin tissue, as shown in Figures 18 -20. In dermatome 100 of the present disclosure, a cutting angle CA (Figures 7, 12, 13 and 16) of blade section 304 adjacent to cutting edge 360 with respect to a cutting plane CP of the rotary knife blade 300 is relatively shallow . In an exemplary embodiment, the cutting angle CA is approximately 30 ° with respect to the cutting plane CP. The dermatome 100 depth gauge arrangement 600 includes an axially adjustable depth gauge 620. The axially adjustable depth gauge 620 includes a 622 depth gauge plate and a 640 depth gauge rod affixed to the plate. depth gauge 622. Depth gauge 620 extends into a central opening 301 defined by the rotating knife blade 300.
[0051] An axial position of the depth gauge plate 622 with respect to the cutting edge 360 of the rotary knife blade 300 is determined by a position of rotation of a depth adjustment knob 650 of the depth gauge arrangement 600. A Axial position of the 622 gauge plate of the 620 gauge with respect to the cutting edge 360 of the rotary knife blade 300 defines the DOC cutting depth of the dermatome 100. The DOC cutting depth of the dermatome 100 determines the depth or thickness of a section of SK skin tissue excised by dermatome 100. The depth or thickness of a section of excised skin tissue or layer is labeled DEST in Figures 18-20. That is, the depth or thickness of a section of DEST excised skin tissue from a patient or donor is determined by the DOC cutting depth of dermatome 100, as precisely defined by the operator of dermatome 100 using the 650 depth adjustment knob.
[0052] As compared to energy-operated or previous manual dermatomes, the high rotational speed of the rotary knife blade 300 of dermatome 100 of the present disclosure, in combination with a superficial CA cutting angle of knife blade 300 and arrangement configuration depth gauge 600, and specifically the depth gauge plate 622, facilitates an operator's ability to cut or harvest an excised layer of EST skin tissue having a desired depth of cut from the excised DEST tissue that is more uniform and consistent over a longitudinal LE extension (Figures 18 and 19) of the EST excised skin tissue than would be expected using an anterior manual dermatome or an anterior energy operated dermatome. The dermatome 100 of the present disclosure advantageously provides improved control and manipulation of the dermatome 100 by an operator, using one hand, as the dermatome 100 is moved along a PT travel path to cut the SK skin tissue to produce the skin. extirpated skin section EST. Furthermore, the high speed of rotation of the rotating knife blade 300 of dermatome 100 reduces operator fatigue by removing large sections of ST skin tissue in a GR graft region. The high speed of rotation of the rotary knife blade 300 also facilitates making an initial incision (Figure 17) in a layer of SK skin tissue at the cutting edge 360 of the rotary knife blade 300 without the need to apply pull opposite the ST skin tissue in the GR graft region.
[0053] Advantageously, the rotation of the depth adjustment knob 650 of the depth gauge arrangement 600 quickly and precisely changes the axial position of the depth gauge plate 622 with respect to the cutting edge of the rotary knife blade 300, thus allowing the operator to change the DOC cutting depth of dermatome 100, as desired. The DOC cut depth of dermatome 100 directly determines the resulting cut depth of the DEST excised skin tissue. By way of example and without limitation, dermatome 100 of the present invention can be used advantageously for split-thickness skin grafting (schematically illustrated in Figures 17-19) and full-thickness skin grafts (schematically illustrated in Figure 20 ). The approximate variations in depth or thickness for split-thickness skin grafting can be categorized into three types of split-thickness skin graft: a) thin type - variation in skin tissue depth 0.127 mm (0. 005 in) - 0.305 mm (0.012 in); b) intermediate type - depth variation 0.305 mm (0.012 inch) - 0.457 mm (0.018 inch); and c) thick type - depth variation 0.457 mm (0.018 in) - 0.762 mm (0.030 in) The approximate variation in depth or thickness for full thickness skin graft is 0.762 mm (0.030 in) - 1.092 mm (0.043 in)
[0054] Dermatome 100 of the present disclosure provides quick and accurate adjustment of the depth of cut of the DOC dermatome and improved control and handling of the dermatome 100. These features enhance an operator's ability to produce a section of EST excised skin tissue having a desired depth of the DEST excised skin tissue and having a consistent or uniform depth along the longitudinal LE extension of the EST excised skin tissue section, even when performing thin-thickness split skin grafts in which the depth or thickness of the EST extirpated skin tissue is in a range of approximately 0.127 mm (0.005 in) to 0.305 mm (0.012 in) in depth (Figures 17-19). Advantageously, the operator only needs to keep the cutting edge 360 of dermatome 100 level or flat against the ST skin tissue as the dermatome 100 is moved along its PT travel path to excise a section of the EST skin tissue. This makes the cutting procedure less dependent on the skill level of, as opposed to, a cutting procedure where the operator was required to maintain a particular angle of the dermatome with respect to the skin tissue as the dermatome is moved along its path. course or where the operator was required to change the angle of the dermatome with respect to the skin tissue as the dermatome is moved along its path. The characteristics of dermatome 100 of the present disclosure allow an operator to cut sections of extirpated skin tissue EST of desired depth and substantially uniform depth from a patient / GR donor graft region with less dependence on operator skill and more dependence on attributes and characteristics of dermatome 100.
[0055] Furthermore, as can be seen in Figure 5, due to the cutting edge 360 of the rotating knife blade 300 of the dermatome 100 extending around the entire 360 ° circumference of the rotating knife blade 300, a the cutting region of dermatome 100 likewise extends 360 ° around the cutting edge 360. In this way, unlike energy-operated or anterior manual dermatomes having a straight cutting blade and are therefore generally limited to a single cutting direction, dermatome 100 of the present disclosure can be used advantageously in any desired cutting direction - towards the operator, away from the operator, parallel to the operator and any direction between them. In this way, dermatome 100 of the present disclosure can be moved in several directions, as desired by the operator, to cut SK skin tissue from a GR graft region, including a natural sweeping movement of the operator's hand and arm in one path. generally arched inward towards the operator's body, thus cutting the ST skin tissue section according to dermatome 100 along a generally arched path towards the operator's body. Advantageously, such a cutting direction "towards the operator" of dermatome 100 facilitates a clear view of the GR graft region by the operator. In addition, advantageously, the variation in the cutting directions provided by dermatome 100 of the present disclosure facilitates the maneuver of dermatome 100 around narrow spaces and / or bony prominences in the GR graft region. First exemplary realization - dermatome operated by energy 100
[0056] The first exemplary embodiment of a portable energy operated dermatome of the present disclosure is schematically shown at 100 in Figures 1-7. The energy-operated dermatome 100 includes an elongated handle arrangement 110 and a head arrangement 200 extending from an advanced or distal end 160 of the handle arrangement 110. An attachment arrangement 120 releasably fixes the head arrangement 200 to the handle arrangement 110. As is best seen in Figures 8-13, the head arrangement 200 includes a frame body or frame housing 202, the rotary knife blade 300, an annular blade housing arrangement 400 that pivotally supports the rotary knife blade 300 for rotation on the central axis of rotation R and depth gauge arrangement 600. The blade housing arrangement 400 includes an annular blade housing 410 and a blade lock ring 450 that is releasably attached to the blade housing 410 for capture and fixes the rotary knife blade 300 for rotation with respect to the blade housing arrangement 400. As best seen in Figures 14-16, the rotary knife blade Story 300 includes a body section 302, a blade section 304 and a continuous rolling bearing structure 370 defining a portion of an outer peripheral surface 369 (Figure 13) of the rotating knife blade 300. As can be seen in better in Figure 17, the continuous roller bearing structure 370 is permanently attached to a concave bearing surface 319 of the rotary knife blade body section 302 and, in turn, defines a convex bearing surface 380 of the rotary knife blade 300.
[0057] As can be seen schematically in Figure 7, the rotary knife blade 300 is rotated with respect to the blade housing arrangement 400 on the central axis of rotation R by a drive arrangement 500 that includes a drive motor arrangement 501 and a gear train 520. In an exemplary embodiment, the drive motor arrangement 501 is supported by the handle arrangement 110, while the gear train 520 is supported by a gearbox housing 203 of the frame body 202 of the head arrangement 200. The depth gauge arrangement 600 is also supported by the frame body 202 and includes a depth gauge holder 602. The depth gauge support 602, which extends from the frame body 202, by in turn, supports the 620 depth gauge including the 622 depth gauge plate and the 640 depth gauge rod. The 620 depth gauge extends into the central interior region 301 of the blade. swiveling 300. Handle arrangement 110 & attachment arrangement 120
[0058] As can best be seen in Figures 1-5 and 7, the handle arrangement 110 extends between the forward or distal end 160 and an end at the rear or proximal 162 and includes an elongated handle 112 and a cover of proximal or rear handle 170. The handle arrangement 110 establishes and extends along a longitudinal axis LA. The longitudinal axis LA of the handle arrangement 110 establishes a longitudinal axis of the dermatome 100. In an exemplary embodiment, the longitudinal axis of the handle arrangement LA is substantially orthogonal and crosses the central axis of rotation R of the rotating knife blade 300. A surface outer 113 of handle 112 is contoured for easy grip by the operator. The handle 112 includes a generally long cylindrical longitudinal hole 114 that supports the drive motor arrangement 501 of the drive arrangement 500. An forward or front end 116 of the handle 112 includes a radially inward portion 118 that serves as a point attachments for attachment arrangement 120.
[0059] In an exemplary embodiment, the drive motor arrangement 501 is driven by a combination of an actuator lever 150 that is pivotally mounted with respect to handle 112, a lever read switch 151 and an actuator switch 152. When the actuator lever 150 is rotated to an "on" position, generally parallel to the outer surface 113 of handle 112, a lever read switch 151 disposed within the complete handle hole is activated. An actuation switch 152 is located on cover 170 at the proximal end 162 of the handle arrangement 110. When the actuator lever 150 is turned to the "on" position and the actuation switch 152 is pressed within five seconds of switch activation. lever readout 151, drive arrangement 500 is actuated to rotate the rotary knife blade 300. If actuation switch 152 is not pressed within five seconds of activating lever readout switch 151, actuator lever 150 it must be released and turned back to the "on" position. Alternatively, the drive motor arrangement 501 can be actuated by a foot pedal valve positioned at the operator's feet affixed to the handle arrangement 110 or a rocker switch or toggle switch mounted on the handle arrangement 110.
[0060] The handle arrangement 110 extends orthogonally in a direction at the rear RW (Figure 7) away from the head arrangement 200 along the longitudinal axis of the handle axis LA. The longitudinal axis LA is substantially orthogonal to the central axis of the rotating blade R and parallel to the cutting plane CP of the rotary knife blade 300. This configuration allows the operator of dermatome 100 to use and manipulate dermatome 100 effectively using one hand. The rear handle cover 170 of the handle arrangement 110 overlaps a proximal end of the handle 112 and is coupled to an air line or air hose 180 that provides a source of high pressure air to supply motive energy for the engine arrangement of drive 501.
[0061] Attachment arrangement 120 includes a coupling collar 122, a retainer 128 and an inner sleeve 130 that attaches to the stepped-in portion 118 at the front end 116 of handle 112. Coupling collar 122 includes an inner surface 124 having a threaded portion 126. As best seen in Figure 7, coupling collar 122 is swiveled to handle 112 by retainer 128 and inner sleeve 130. In turn, coupling collar 122 is threaded in a threaded outer surface 230 of the frame body 202 to releasably secure the head arrangement 200 to the forward end 160 of the handle arrangement 110. Advantageously, the attachment arrangement 120 allows for easy coupling and uncoupling of the head arrangement 200 of the handle arrangement 110 to facilitate the breakdown and sterilization of the components of the head arrangement 200 upon completion of a skin graft or other medical procedure performed with dermatome 100.
[0062] As used herein, axial, top and bottom will mean movement or a dimension in a direction generally along or parallel to an extension of the central axis of rotation R. Forward or distal will mean in a direction generally along a labeled direction FW in Figure 7, the forward direction FW is generally parallel to or along the longitudinal axis LA. At the rear or proximal it will mean a direction generally along a direction labeled RW (opposite to the forward direction FW) in Figure 7. Drive arrangement 500
[0063] As best seen in Figure 7, the drive arrangement 500 includes the drive motor arrangement 501 and the gear train 520. The present disclosure contemplates at least three different drive motor assemblies, a realization motor air (schematically shown in Figure 7) and, alternatively, an electric motor arranged in the handle arrangement (not shown), and a flexible driving rod realization (not shown) to provide driving power to rotate the rotating knife blade 300 in. of the blade housing arrangement 400. In an exemplary embodiment, the drive motor arrangement 501 includes a vane or pneumatic air motor 502 and a planetary gear reduction unit 504 arranged within the full longitudinal hole 114 of the handle 112. The high pressure air is communicated via air hose 180 attached to the cover 170 at the proximal end 162 of the handle arrangement 110 and directed to the engine 502. The air is encamped through the motor body and directed against a plurality of vanes to rotate a motor rotor 502. The rotor includes an output rod 503 coupled to the planetary gear reduction unit 504. The planetary gear reduction unit 504 serves to convert the high rotational speed of the rotor rod for a 506 drive coupling that rotates at a lower speed, but a higher torque output than the rotor rod 503.
[0064] In an exemplary embodiment, the gear train 520 comprises a pinion gear 522 (Figure 2). An input rod 524 at a proximal end of the pinion gear 522 receives the drive coupling 506 from the drive motor arrangement 501. The pinion gear 522 includes a gear head 526 at its distal end. In an exemplary embodiment, the gear head 526 defines a chamfer gear 528 including a set of chamfer gear teeth 530. The pinion gear 522 is supported for rotation in the gearbox housing 203 of the frame body 202 over a rotating pinion gear shaft PGR (Figure 7) and is positioned so that the chamfer gear teeth set 5 of the pinion gear 522 joins with a matched set of chamfer gear teeth 330 of a driven gear 328 of the rotary knife blade 300. The gear head 526 of the pinion gear 522 engages and drives the driven gear of the rotary knife blade 300 to rotate the blade 300 about its axis of rotation R.
[0065] As can be seen in Figure 7, the rotating pinion gear axis PGR is substantially congruent with the longitudinal axis of handle arrangement LA. According to the drive coupling 506 of the drive motor arrangement 501 rotates the pinion gear 522 inside the gearbox housing 203. The rotation of the pinion gear 522, in turn, rotates the rotary knife blade 300 on its axis rotation speed R. A suitable pneumatic motor / planetary gear reduction unit configuration is disclosed in U.S. Patent Application Serial No. 13 / 073,207 to Whited et al., filed March 28, 2011, and called Knife Energy Operated Swivel With Disposable Blade Support Arrangement ("order '207"). The '207 order is assigned to the assignee of the present order and is incorporated herein in its entirety by reference.
[0066] Alternatively, the 501 drive motor arrangement may comprise an external drive motor, for example, an external brushless DC servo motor, and a flexible rod drive transmission (not shown). The drive motor arrangement rotates a drive rod from a flexible rod drive transmission. A portion of the flexible rod drive transmission extends through the full longitudinal hole 114 of the elongated handle 112 of the handle arrangement 110. A suitable DC motor / flexible drive rod transmission configuration is disclosed in the U.S. Patent Application Serial No. 13 / 344,760 for Rapp et al., Deposited on January 6, 2012, and called Flex Rod - Drive Motor Connection for Energy Operated Rotating Knife (the "order '760"). Order '760 is assigned to the assignee of the present order and is incorporated herein in its entirety by reference.
[0067] Alternatively, the 501 drive motor arrangement may comprise an electric drive motor arranged within the complete longitudinal orifice 114 of handle 112. In an exemplary embodiment, the electric drive motor is a DC motor. A suitable DC electric motor, for example, the Maxon Model No. EC22 386680 and an associated gear reduction unit, for example, Maxon Model No. GPM 22M 305130, can be obtained from Maxon Motor AG, Sachsein, Switzerland (www. maxonmotor.com). Head arrangement
[0068] With reference to Figures 8-13, the head arrangement 200 of the energy operated dermatome 100 of the present disclosure includes the frame body 202, the rotary knife blade 300, the annular blade housing arrangement 400 and the arrangement depth gauge 600. In dermatome 100, both the depth gauge arrangement 600 and the blade housing arrangement 400 are supported and extend from the frame body 202. The depth gauge plate 622 of the depth gauge 600 extends into the inner region 301 of the rotary knife blade 300. A lower edge region 634 of the depth gauge plate 622, in combination with the cutting edge 360 of the rotary knife blade 300, determines the depth section of the dermatome 100. Frame body 202
[0069] As best seen in Figures 8-13, the frame body 202 includes a rear handle attachment portion 204 and an forward interface portion 206. The rear handle attachment portion 204 comprises a body generally cylindrical 205 defining the threaded outer surface 230 of the frame body 202. The threaded outer surface 230 of the cylindrical body of the frame body 205 is engaged by the attachment arrangement 120 to releasably fix the head arrangement 200 to the handle arrangement 110.
[0070] The frame body 202 includes a gearbox housing 203 which pivotally supports the gear train 520 of the drive arrangement 500, specifically the pinion gear 522. The gearbox housing 203 includes a surface internal 208 of the frame body 202. The internal surface 208 defines a complete orifice extending longitudinally 209. As seen in Figure 7, the pinion gear 522 is seated in the complete orifice 209. A front opening 232 (Figures 11 and 12) of the full orifice 209 is configured to allow the gear head 526 of the pinion gear 522 to engage the driven gear 328 of the rotary knife blade 300. A rear opening 234 (Figures 9 and 12) of the full orifice 209 allows entry of the coupling of drive 506 of the drive motor arrangement 501 to the pinion gear input rod 524 when the head arrangement 200 is releasably attached to the handle arrangement 110.
[0071] The forward interface portion 206 of the frame body 202 includes an upper interface region 220 that extends or changes between the cylindrical body 205 of the rear handle attachment portion 204 and the central cylindrical support 602 of the gauge arrangement. depth 600. In an exemplary embodiment, the upper interface region 220, when viewed from above in plan view, comprises a rib generally shaped in V 222 in which the rib shaped in V 222 is wider adjacent to the cylindrical body 205 and tapers or converges in one direction proceeding towards the central cylindrical support 602, that is, the central cylindrical support 602 can be seen as serving as a termination or apex of the rib 222. In this way, the central cylindrical support 602 of the arrangement depth gauge 600 is attached and extends from the frame body 202 and, more specifically, the depth gauge arrangement 600 is attached and extends from the region of insertion upper face 220 of frame body 202.
[0072] Positioned axially below the upper interface region 220 there is a lower interface region 210 that extends or changes between the cylindrical body 205 of the rear handle attachment portion 204 and the annular blade housing 410 of the mounting arrangement blade housing 400. In an exemplary embodiment, the lower interface region 210, when viewed from the bottom in plan view, comprised a Y-shaped support 212 that includes arms extending circumferentially over the annular blade housing 410. In this way, the annular blade housing 410 of the blade housing arrangement 400 is attached and extends from the frame body 202 and, more specifically, the lower interface region interface region 220 of the frame body 202. 300 rotary knife blade
[0073] As can best be seen in Figures 14-17, in an exemplary embodiment, the annular rotary knife blade 300 includes an inner wall 365 and an outer wall 366 and a first upper end 367 and a second lower end 368. The inner wall 365 defines the open inner region 301 of the rotary knife blade 300. The rotary knife blade 300 includes the upper body section 302, the lower blade section 304 and the continuous rolling bearing structure 370. The bearing structure continuous roller 370 forms a portion of a peripheral outer surface 303 of the body section 302 and defines the convex bearing surface 380 of the rotary knife blade 300. The upper body section 302 extends between a first upper end 306 and a second lower end 308. The upper end 306 corresponds to and is congruent with the first upper end 367 of the rotary knife blade 300. One shoulder extending radially 308a between the body section 302 and blade section 304 defines second lower end 308 of body 302. Body section 302 includes an inner wall 310 and a radially spaced outer wall 312. The first upper end 306 of body section 302 defines the driven gear 328 of the rotary knife blade 300. The driven gear 328 comprises the set of chamfer gear teeth 330 which operatively fit and join with the chamfer gear 528 of the pinion gear 522, as previously discussed, so that the rotation of the chamfer gear 528 results in the rotation of the rotary knife blade 300 on its axis of rotation R.
[0074] The body section 302 of the rotary knife blade 300 includes a bearing surface 319 formed on the outer wall 312 of the body 302. In an exemplary embodiment, the bearing surface 319 comprises a bearing ring 320 which extends radially to inside the outer wall 312. The bearing ring 320 includes a generally convex arched bearing face 322. The bearing face 322 provides a seating surface for the continuous rolling bearing structure 370 of the rotary knife blade 300. The bearing structure rolling roller 370 defines the convex bearing surface 380 of the rotating knife blade 300 which projects radially outwardly from the outer wall 312 of the body section 302 of the blade 300 and thus forms a portion of a peripheral outer surface 303 of the cutting section. body 302 and forms a portion of a peripheral outer surface 369 of the rotary knife blade 300. The rotary bearing frame 370 rotatably supports the blade rotating blade 300 with respect to blade housing arrangement 400.
[0075] The continuous roller bearing structure 370 comprises an annular roller bearing strip 372 that extends continuously 360 ° around the periphery of the outer wall 312 of the body section 302 and is arranged in the bearing ring 320. The bearing strip roller 372 includes a plurality of rotating spaced ball bearings 376 supported in radially spaced pockets of a separator cage 378. In an exemplary embodiment, the separator cage is flexible and a diameter of each of the ball bearings 376 is approximately 2 mm., Although it should be understood that the diameter could be larger or smaller. The portions of the plurality of ball bearings 376 extend radially outwardly from the outer wall 310 of the body blade section 302 and thereby form a part of the outer periphery 303 of the body section 302. Specific details concerning the structure and configuration of the plurality of spaced ball bearings and flexible separator cage are disclosed in U.S. Patent Application Serial No. 13 / 189,951, filed on July 25, 2011 to Whited et al., and called the Rotary Knife Energy Operated (the "order '951"). The '951 application is assigned to the assignee of this application and is incorporated herein in its entirety by reference. [007 6] The roller bearing strip 372 is arranged in an annular gap G defined between the opposite faces of the rotary knife blade 300, the blade housing 410 and a blade lock ring 450 of the blade housing arrangement 400, in the region of the bearing washer of the rotating knife blade 320. Specifically, the plurality of ball bearings 376 of the roller bearing strip 372 is arranged within an annular passage 374, which is circular in cross section and defined by the arched bearing surfaces. opposite 319, 426, 458 of the rotary knife blade 300, blade housing 410 and blade lock ring 450, respectively.
[0076] The roller bearing strip 372 is arranged in an annular gap G defined between the opposite faces of the rotary knife blade 300, the blade housing 410 and a blade lock ring 450 of the blade housing arrangement 400, in the region of the bearing ring of the rotary knife blade 320. Specifically, the plurality of ball bearings 376 of the roller bearing strip 372 is arranged within an annular passage 374, which is circular in cross section and defined by the opposite arched bearing surfaces. 319, 426, 458 of the rotary knife blade 300, blade housing 410 and blade lock ring 450, respectively.
[0077] Due to the annular roller bearing strip 372 being continuous and disposed within the bearing ring 320, the strip 372 is permanently attached and, therefore, is part of the blade 300. However, according to the plurality of ball bearings 376 of the roller bearing strip 372 comes into contact with the bearing ring of the blade 320, the roller bearing can rotate with respect to the blade body 302 and blade section 304 of the blade 300. When the rotary knife blade 300 is rotated by the arrangement drive 500 and, specifically, pinion gear 522, at a specific desired RPM, the separator cage 378 also moves or becomes a circle along the annular gap G, although the rotation speed of the separator cage 378 inside the G-gap is lower than the RPM of the rotary knife blade 300. Thus, when the dermatome is in operation, the annular roller bearing strip continues 372 through the annular passage 374 forming a circle over the e ix of rotation of the knife blade R. Similarly, when the dermatome 100 is in operation, the separator cage 37 8, due to its movement or conversion along the annular gap G on the axis of rotation of the knife blade R , can be considered to form a complete cylinder within the G-gap. Additionally, when the rotary knife blade 300 is rotated, the plurality of ball bearings 376 both rotate relative to the separator cage 378 and also move or convert. if along the annular passage 374 on the axis of rotation of the knife blade R as the separator cage 378 moves or converts along the annular gap G. A plane passing through the respective centers of the plurality of ball bearings 376 defines a rotation plane RP (Figures 13 and 15) of the rotary knife blade 300. The rotation plane RP of the rotary knife blade 300 is substantially parallel to the cutting plane CP of the blade 300 and substantially orthogonal to the axis rotation speed R of blade 300.
[0078] The rotary knife blade 300 also includes blade section 304 extending between a first upper end 350 (adjacent to shoulder 308a of body section 302) and a second lower end 352. The second lower end 352 corresponds to and it is congruent with the lower end 368 of the rotary knife blade 300. The blade section includes an inner wall 354 and an outer wall radially spaced 356. The inner and outer walls 354, 356 are generally parallel and frustro-conical, converging in one direction proceeding downward or towards the 360 cutting edge of the blade. The cutting edge 360 of the rotary knife blade 300 is generally circular. The inner wall 310 of the body section 302 and the inner wall 354 of the blade section 304 combine to form the inner wall 365 of the rotary knife blade 300 and define the inner region 301 of the blade 300. The inner region 301 of the blade rotating knife is usually frustro-conical, converging in one direction to the 360 cutting edge of the blade 300. A plane aligned with the generally circular cutting edge 360 of the rotating knife blade 300 defines the CP cutting plane (Figure 15) 300.
[0079] In an exemplary embodiment, blade section 304 includes an upper region 358 and a lower region 359 separated by a knee or discontinuity between the two regions. Clearly, it must be recognized that the blade section 304 can comprise a single region without any discontinuity. The lower region 359 defines the cutting angle AC of the blade and is defined by an angle between the inner wall 354 in the lower region 359 of the blade section 304 and the cutting plane CP. In an exemplary embodiment, the AC cut angle is approximately 30 °, although it should be understood that the AC cut angle could be greater or less. As can best be seen in Figure 16, the lower end 352 of the blade section 304 that defines the cutting edge 360, includes a short wall section 362 connecting the inner and outer walls 354, 356. The cutting edge 360 is formed at the intersection of the short section of the wall 362 and the inner wall 354. The short section of the wall 362 is slightly angled with respect to the cutting plane CP, by about 5 ° in an exemplary embodiment, to provide relief for the cutting edge 360.
[0080] In an exemplary embodiment, the inner diameter (defined by the cutting edge 360) of the rotary knife blade 300 is approximately 101,600 mm (4,000 in), while the outer diameter (defined by the outer periphery of the plurality of ball bearings) 376 the roller bearing strip 372 is approximately 131,800 mm (5,189 inches), although it should be understood that the diameters could be larger or smaller. Blade housing arrangement 400
[0081] As can best be seen in Figures 10-13 and 16-17, the blade housing arrangement 400 includes the annular blade housing 410 and the blade lock ring 450. The annular blade housing 410 extends from and is supported by the Y-shaped support 212 of the lower interface region 210 of the forward interface portion 206 of the frame body 202. The blade housing 410 includes a first upper end 412 and a second lower end spaced from axial mode 414. The blade housing 410 further includes an inner wall 416 and a radially spaced outer wall 418. The blade housing 410 includes three peripherally spaced threaded openings 430 of the blade housing 410. The three threaded openings 430 extend from the lower lower end 414 through the first upper end 412. The inner wall 416 of the blade housing 410 includes a bearing surface 420. In an exemplary embodiment, the bearing surface 420 comprises a bearing ring 422 which extends radially inward to the inner wall 416 of the blade housing 410. Bearing ring 422 includes the arched concave face or face 426.
[0082] As can best be seen in Figures 13, 17 and 18, in axial extension, the arcuate bearing face 426 is a curved bearing surface that extends from an upper region 376a of ball bearing 376 and generally conforms to the curvature of ball bearing 376 over a midpoint 376b of ball bearing 376. The arcuate bearing face 426 does not, however, extend the entire length to a lower region 376c of ball bearing 376. When instead, an arched bearing surface or face 458 formed on an inner surface 456 of the blade locking ring 450 constitutes a portion of a total bearing ring 470 (Figures 17 and 18) provided by the blade housing arrangement 400. A total bearing washer 470 defined by the blade housing arrangement 400 results from a combination of the housing surfaces of the blade housing 410 and the blade locking ring 450, specifically, the arched bearing face 426 of the blade housing at 410 and arcuate bearing face 458 of the blade lock ring 450. The total bearing washer 470 serves as an arcuate bearing surface for the annular roller bearing strip 372 of the rotary knife blade 300 when the blade lock ring 450 is attached to the blade housing 410 and the rotary knife blade 300 is captured or sandwiched between them.
[0083] The blade locking ring 450 includes an upper surface 451 and a lower surface 452 and comprises an upper seating region 453 and a lower bearing region radially inward 454. The upper seating region 453 rests flush against the blade housing 410 and includes three peripherally spaced slits 462 on an outer periphery 460 of the blade lock ring 450. The blade lock ring 450 adapted to be attached to a stepped shoulder 415 (Figure 18) near the lower end 414 of the blade housing 410. The blade lock ring 450 is attached to the stepped shoulder 415 of the blade housing 410 via three threaded fasteners 464, each of which passes through a corresponding peripherally spaced slot 462 at an outer periphery 460 of the ring blade lock 450.
[0084] To install or attach the rotary knife blade 300 to the blade housing arrangement 400, with the blade lock ring removed, the head arrangement 200 is turned upside down and the rotary knife blade 300 is placed in the upside down blade housing 410. The plurality of ball bearings 37 6 of the rotary knife blade 300 rests on the bearing ring 422 of the blade housing 410, thus the rotary knife blade 300 is supported by the blade housing 410 The three slots 462 of the blade lock ring 450 are aligned with the threaded openings 430 of the blade housing 410. The three threaded fasteners 464 pass through the slits 462 and are threaded into the threaded openings 430 of the blade housing 410 to complete the installation. Due to the configuration of the three slots 462, it is only necessary to loosen the three threaded fasteners 464 in an amount sufficient to rotate the blade lock ring 450 with respect to the blade housing 410. This allows the blade lock ring 450 to be removed at from the blade housing 410 without removing the three threaded fasteners 464 from the threaded openings 430 of the blade housing 410. When the blade lock ring 450 is removed from the blade housing 410 turn the head arrangement 200 upside down causes the rotary knife blade 300 to fall from the blade housing 410 thus removing the blade 300 from the blade housing arrangement 400. Depth Gauge 600 Arrangement
[0085] As can best be seen in Figures 10-13 and 17-21, the depth gauge arrangement 600 includes the depth gauge support 602 and depth gauge 620. The depth gauge 620 includes the gauge rod depth gauge 64 0 and the depth gauge plate 622. The depth gauge arrangement 600 also includes the depth adjustment knob 650, a stop ring 670, a skew spring 680 and a pin 690 (Figures 10 and 11). Advantageously, the 600 depth gauge arrangement allows an operator to quickly and accurately change the DOC cut depth of the dermatome from essentially 0.000 mm (0.000 in) (without cut depth of ST skin tissue - shown schematically in Figure 21 ) up to 1,143 mm (0.045 in) (total cut depth of ST skin tissue - shown schematically in Figures 12 and 20). Obviously, the variation in depth of cut DOC can be changed based on the configuration of the depth gauge arrangement 600 and the present invention is not limited to the exemplary variation in depth of cut established here. As the change in the DOC cutting depth of dermatome 100 is carried out by rotating the depth adjustment knob 650, the DOC cutting depth is infinitely variable between the end points of 0.000 mm (0.000 in) and 1.143 mm (0.045 in) ) That is, the operator can precisely enter an exact desired DOC cutting depth for dermatome 100. 602 depth gauge cylindrical support
[0086] As best seen in Figures 8 and 10-12, the cylindrical support of depth gauge 602 extends from and is supported by the V-shaped rib 222 of the upper interface region 220 of the forward interface portion 206 of the frame body 202. The depth gauge support 602, in an exemplary embodiment, is generally cylindrical and includes an upper end 604 and an axially spaced lower end 606. The cylindrical support of depth gauge 602 defines an opening axially extending 608 (Figure 12) passing through support 602. A radially extending flange 610 is arranged at the upper end 604 of the cylindrical support of depth gauge 602. As can be seen in Figure 10, the flange 610 includes a first smaller opening 612 that is axially aligned with the central opening 608 and a second larger opening 614 that is connected but compensated from the first ab minor coverage 612. A radially extending slot 616 (Figure 12) is disposed between the flange 610 and the central opening 608 of the cylindrical support of the depth gauge 602.
[0087] An upper surface 618 of flange 610 includes indicia or markings 619 (Figure 10) representing gradations for the DOC cutting depth of dermatome 100 as the depth adjustment knob 650 is turned. Specifically, each of the smaller gradations represents a change in the defined depth of cut DOC of 0.025 mm (0.001 in), while the larger gradations represent a change in the defined depth of cut of 0.127 mm (0.005 in). The 619 indications facilitate the precise configuration cutting depth of the DOC dermatome by the operator.
[0088] The depth gauge rod 640 is received at the central opening extending axially 608 of the cylindrical support 602. The depth gauge rod 640 is supported by the cylindrical support 602 for axial movement with respect to the cylindrical support 602. Specifically, the cylindrical support 640 comes into contact and supports the 640 gauge rod with an axial length labeled AL in Figure 12. In an exemplary embodiment, the axial length AL of the cylindrical support 602 is approximately 26.67 mm (1 , 05 in.), While the overall axial length of cylindrical support 602 extending between the upper end 604 of cylindrical support 602 and the lower end 606 of cylindrical support 602 is approximately 31.75 mm (1.25 in). Depth gauge 620
[0089] The depth gauge 620 is supported by the depth gauge support 602 and includes the depth gauge plate 622 and the stem gauge 640. As can be seen in Figure 12, the stem gauge 640 and the depth gauge plate 622 are substantially concentric with the axis of rotation of the knife blade R. The depth gauge 20 is adjustable to move axially along the axis of rotation R, that is, the gauge depth gauge moves axially with respect to the 602 depth gauge holder and with respect to the CP cutting plane of the rotary knife blade 300. The movement of the 622 depth gauge plate in relation to the CP cutting plane of the blade rotary knife 300 changes the cutting depth of the DOC dermatome. The depth gauge plate 622 and a portion of the depth gauge stem 640 extend into the inner region 301 of the rotary knife blade 300. The depth gauge 620 also includes the stop ring 67 0 which is attached to one end the depth gauge 640 and moves with the stem 640 axially to limit the downward movement of the depth gauge 620. That is, the stop ring 670 ensures that the minimum DOC cutting depth is 0.000 mm (0.000 in), as opposed to the 622 depth gauge plate moving in a downward DW direction to a DOC cutting depth negative position. 622 depth gauge plate
[0090] The depth gauge plate 622 is generally disk-shaped and includes an upper surface 623 and a planar bottom surface generally spaced axially 624. The depth gauge plate 622 includes a central body 626 and an annular margin radially spaced out 628. The central body 626 and the annular margin 628 are connected by three ribs extending radially 630. The central body 626 of the depth gauge plate 622 includes a central opening 627 which receives a lower connecting end 642 of the 640 gauge rod to secure the 622 gauge plate to the 640 gauge rod.
[0091] The depth gauge plate 622 includes an outer radially peripheral surface 632. A bottom edge region 634 of the depth gauge plate 622 is a region of intersection between the lower planar surface 624 of the depth gauge plate 622 and the outer peripheral surface 632 of the depth gauge plate. At any axial position of the depth gauge plate 622, the lower edge region 634 of the depth gauge plate 622 is the closest portion of the depth gauge 622 to the cutting edge 360 of the rotary knife blade 300. The region of bottom edge 634 is almost (but not exactly) axially aligned with the 360 cutting edge rotary knife blade. As such, an axial distance between the bottom edge region 634 of the 622 depth gauge plate and cutting edge 3 60 of the rotary knife blade 300 determines the depth of cut DOC of the dermatome 100. Remember that the cutting edge 360 defines the cutting plane CP of the rotary knife blade 300, therefore, otherwise stated, an axial distance AD (Figure 18) between the lower edge region 634 of the depth gauge plate 622 and the cutting plane CP of the rotary knife blade 300 determines the DOC cutting depth of dermatome 100. 640 depth gauge rod
[0092] As best seen in Figure 12, the depth gauge rod 640 is generally cylindrical and includes the lower connecting end 642 which is received at the central opening 627 of the center body 626 of the depth gauge plate 622 to attach the 640 gauge stem and 622 gauge plate. The 640 gauge stem includes a top threaded portion of reduced diameter 643. When the 640 gauge stem is inserted into the central opening extending so axis 608 of the depth gauge holder 602, first, the second threaded portion 648 of the depth gauge stem 640 is threaded into the central threaded opening 656 of the depth adjustment knob 650, then the stop ring 670 is threaded into the portion upper threaded thread 643 of the depth gauge 64 0 to secure the depth gauge stem 640 (and attached depth gauge plate 622) to the cali support depth 602. When it is desired to remove the depth gauge 640 from the depth gauge holder 602, the stop ring 67 0 is unscrewed and removed from the depth gauge 640 and the depth gauge 640 is unscrewed from the central threaded opening 656 of the depth adjustment button 650, allowing the depth gauge rod 640 to fall from the depth gauge holder 602 for cleaning / sterilization purposes.
[0093] The depth gauge rod 640 includes an outer surface 647 defining a slot extending axially 646. The slot extending axially 646 receives pin 690 (Figures 10 and 11) that passes through a radial opening 617 in the cylindrical support of the depth gauge 602 to prevent relative rotation between the rod of the depth gauge 640 as supported within the cylindrical support 602. The rod of the depth gauge 640 also includes a second threaded portion 648 which is disposed below the upper threaded portion 643. The second threaded portion 648 of the depth gauge rod 640 is threadedly received into a central threaded opening 656 of the depth adjustment knob 650. 650 depth adjustment knob
[0094] The depth adjustment button 650 includes an upper end 652 and a lower end 654. The depth adjustment button 650 includes a central threaded opening 656 which is threaded on the second threaded portion 648 of the depth gauge rod 640. The pin pin 690 and the slot axially extending 64 6 of the depth gauge rod 656 allows the depth gauge rod 656 to move axially within the central opening extending axially 608 of the support depth gauge 602. The depth adjustment knob 650, when turned, activates the depth gauge rod 65 6 up or down with respect to the cylindrical support of depth gauge 602.
[0095] The depth adjustment button 650 includes a central trunk 660, an enlarged upper head 658 above the trunk 660 and an enlarged lower head 664 below the trunk 660. The enlarged lower head 664 is adjusted to pass through the compensation opening 614 of the flange 610 of the cylindrical support of the depth gauge 602 and is received in the slot 616 of the cylindrical support 602 to restrict the axial movement between the depth adjustment knob 650 and the cylindrical support 602. The enlarged upper head 658 of depth adjustment 650 includes a recessed contact surface 666 which is configured to be contacted by a lower surface 674 of the stop ring 670. An upper surface of the enlarged upper head 658 will include an arrow or some other marking that can be aligned with the indicia 619 marked on the upper surface 618 of the cylindrical support flange 610 to assist the operator in adjusting and configuring the depth of co rte DOC of the dermatome 100.
[0096] As the depth adjustment knob 650 is rotated by the operator, the pin pin 690 extending in the slot extending axially 646 prohibits the 640 gauge rod and the 622 depth gauge plate. rotate with the 650 depth adjustment knob. The pin / slot pin configuration extending axially 690/646 does not allow the 640 depth gauge rod to move up and down axially within the cylindrical support depth gauge 602 to change the DOC cutting depth of dermatome 100. Meanwhile, the stem gauge 640 is restricted to rotate with the depth adjustment knob 650 due to the pin 690 adjusting in the slot extending axially 646. The 640 gauge rod is restricted to rotate with the depth adjustment button 650 and the button 650 is restricted from axial movement due to the enlarged lower head 664 of the button 664 being in the slot extending radially 616 out of the cylindrical support of the depth gauge 602. Thus, the rotation of the depth adjustment knob 650 drives the depth gauge rod 640 in an axial direction in the UP direction or direction to low DW with respect to the cylindrical support of the depth gauge, depending on the direction of rotation of the depth adjustment knob 650.
[0097] When the depth adjustment knob 650 is rotated to move the depth gauge 620 in the downward direction DW, the pin 690 prevents rotation of the depth gauge 620 with the depth adjustment knob 650. Thus , depending on the direction of rotation of the depth adjustment knob 650, the depth gauge 620 will be moved in the upward direction UP or downward direction DW with respect to cylindrical support 602 and rotary knife blade 300. The movement of the depth gauge 620 in the upward direction is limited by contact between the upper surface 645 of the central portion 644 of the depth rod 64 0 and a lower end 654 of the depth adjustment knob 650 so that a maximum DOC depth of cut is 1.143 mm ( 0.045 in) This maximum DOC depth of cut setting is shown in Figures 12 and 13 and is referred to as the fully open position of dermatome 100.
[0098] The movement of the depth gauge in the downward direction DW is limited by contact between the lower surface 674 of the stop ring 670 and the recessed contact surface 666 of the enlarged upper head 658 of the depth adjustment knob 650. This configuration minimum depth of cut DOC is shown in Figure 21 and is termed as the fully closed position of dermatome 100. Skew spring 680 is clamped between the center body 626 of the depth gauge plate 622 and the lower end 606 of the cylindrical support of the depth gauge 602 to induce depth gauge 620 to the fully closed position.
[0099] In an exemplary embodiment, the handle arrangement 110 can be made of plastic or other material or materials known to have comparable properties and can be formed by molding and / or machining. The attachment arrangement 120, the frame body 202 and the depth gauge arrangement 600 can be made of aluminum or stainless steel or other material or materials known to have comparable properties and can be formed / shaped by casting and / or machining. The rotary knife blade 300 and blade housing arrangement 400 can be manufactured from a hardenable grade of alloy steel or a hardenable grade of stainless steel, or other material or materials known to have comparable properties and can be formed / shaped by machining , forming, casting, forging, extrusion, metal injection molding and / or electrical discharge machining or other suitable process or combination of processes. Dermatome 100 operation
[0100] Figures 17-19 schematically illustrate the use of dermatome 100 of the present disclosure to excise an ST layer skin tissue in a GR donor graft region and, particularly, to obtain a thin type split skin graft where a depth of a layer of skin tissue being excised from the GR graft region is in the range of 0.127 mm (0.005 in) to 0.305 mm (0.012 in) Figure 17 schematically shows the initial incision in an upper layer or SST surface of the ST skin tissue with the dermatome 100. Remember that in the illustrated and exemplary embodiment, the AC cutting angle of the rotary knife blade 300 is approximately 30 °. When making an incision on the SST skin tissue surface, the angle of dermatome 100 is manipulated so that a cut angle of STCA skin tissue is more superficial than the AC cut angle of knife blade 300. In one embodiment exemplary, the cutting angle of the inner wall 310 in the lower region 359 of the blade section 304 adjacent to the cutting edge 360 with respect to the SST surface of the ST skin tissue being excised is approximately 15 °. Thus, the cutting angle of STCA skin tissue (approximately 15 °) is less than the cutting angle of the AC blade. (approximately 30 °). In this way, the outer wall 418 of the blade housing 410 is not vertical, but instead is angled slightly downward towards the ST skin tissue.
[0101] Figure 18 schematically shows the cut or excision of the ST skin tissue. As the actuated dermatome 100 moves along a path path PT, the dermatome 100 produces an excised section of the EST skin tissue that flows along the inner wall 365 and through the central inner region 301 of the rotating knife blade 300 and the tilted or frustro-conical top portion of the inner wall of the blade housing 416. The inclined top portion of the inner wall of the blade housing 416 generally continues the frustro-conical inner wall 365 of the rotary knife blade 300. The extirpated section of the EST skin tissue is a generally flexible rectangular piece or section of the ST skin tissue that comes out of dermatome 100 when moving or "shaking" (since the skin tissue is flexible or flabby) over the top end or wall 412 of the housing blade 410. As schematically illustrated in Figure 18, a longitudinal LE extension of the EST excised section, a depth or thickness of the DEST excised skin tissue must be uniform and must conform thick sea with the depth of cut DOC defined by the operator of dermatome 100. When moving along the path of travel PT, the angle of dermatome 100 is kept relatively flat, that is, the cut angle of STCA skin tissue is approximately equal to the cutting angle of the AC rotary knife blade. The cutting angle of STCA skin tissue and the cutting angle of the CA rotary knife blade both being approximately 30 °. Advantageously, the operator only needs to keep the CP cutting plane of dermatome 100 level or flat against the SST surface of the ST skin tissue as the dermatome 100 is moved along its PT path to remove a section of the skin tissue. skin EST. Thus, with dermatome 100 of the present disclosure, performing a successful excision procedure that results in a section of EST excised skin tissue having a consistent and desired depth or thickness is more objective and less dependent on the skill level of the operator.
[0102] Figure 19 schematically shows the end of the extirpation procedure, that is, the end of cutting the ST skin tissue in the GR graft region with dermatome 100. As with the incision, dermatome 100 is manipulated by the operator to have a more superficial cut angle of STCA skin tissue of approximately 15 °. This cutting angle of STCA superficial skin tissue causes the blade 300 to tend to move upward through the SK skin tissue. If necessary, the operator can slightly swing dermatome 100 in a lateral to lateral motion to facilitate the rotating knife blade when cutting upward and across the surface of the ST skin tissue. When blade 300 passes or emerges from the SST surface of the ST skin tissue, this terminates the cut or excision and determines or fixes the total longitudinal extension LE of the EST excised skin tissue section.
[0103] Figure 20 schematically illustrates the removal of a thicker layer of ST skin tissue with dermatome 100. Here, dermatome 100 is used to obtain a full thickness skin graft from a GR donor graft region in that a depth of a DEST layer of EST skin tissue being excised from a GR donor graft region is in the range of 0.762 mm (0.030 in) to 1.092 mm (0.043 in)
[0104] It should be understood by one of ordinary skill in the art that a mechanism described as dermatome 100 could be adapted and used for a wide variety of other medical applications, including, but not limited to, harvesting and / or removing soft tissue, bone collection and / or removal, dermatological treatment needs and other medical procedures. Second exemplary realization - dermatome operated by energy 1000
[0105] A second exemplary embodiment of a portable energy operated dermatome of the present disclosure is schematically shown at 1000 in Figures 22-24. The energy-operated dermatome 1000 is similar in configuration and operation to the energy-operated dermatome 100, as described above, and the description of dermatome 100, as established above, is referenced and incorporated into the present with respect to dermatome 1000.
[0106] The energy-operated dermatome includes an elongated handle arrangement 1110, similar to the handle arrangement 110, and a head arrangement 1200, similar to the head arrangement 200, extending from an early or distal end 1160 of the handle arrangement 1110. Handle arrangement 1110 includes a handle 1112 and an actuator lever 1150 and extends between the distal end 1160 adjacent the head arrangement 1200 and a proximal end 1162. A cover 1170 on the proximal end 1162 of the arrangement handle 1110 is coupled to an air hose 1180 that supplies the driving energy to the driving arrangement 1500, similar to the driving arrangement 500, of the dermatome 1000. An attachment arrangement 1120, similar to the attachment arrangement 120, reliably displays head arrangement 1200 to handle arrangement 1110.
[0107] Dermatome 1000 includes the drive arrangement 1500, similar to the drive arrangement 500, including a drive motor arrangement 1501, similar to the drive motor arrangement 501 and a gear train 1520, similar to the gear train 520 The gear train 1520, in an exemplary embodiment, comprises a pinion gear 1522, similar to pinion gear 522.
[0108] Head arrangement 1200 includes a frame body or frame housing 1202, similar to frame body 202, a rotary knife blade 1300, similar to rotary knife blade 300, a blade housing arrangement 1400, including a blade housing 1410 and a blade lock ring 1450, similar to the blade housing arrangement 400, and a depth gauge arrangement 1600, similar to the depth gauge arrangement 600. The frame body 1202 includes an attachment portion rear handle 1204 comprising a cylindrical body 1205 and an advanced interface portion 1206. The frame body 1202 includes a gearbox housing 1203 defined by a complete orifice 1209 through the frame body 1202. The gear train 1520 is supported within the gearbox housing 1203. The front interface portion 1206 of the frame body 1202 includes a lower interface region 1210 that extends or changes between the portion rear attachment handle 1204 and the annular blade housing 1410 of the blade housing arrangement 1400. The lower interface region 1210 includes a generally Y-shaped support 1212. The forward interface portion 1206 of the frame body 1202 also includes an upper interface region 1220 that extends or changes between the rear handle attachment portion 1204 and a central cylindrical support 1602 of the depth gauge arrangement 1600. The upper interface region 122 0 includes a generally shaped rib of V 1222 that converges proceeding towards and has a vertex generally in the central cylindrical support 1602.
[0109] The depth gauge arrangement 1600 includes the central cylindrical support of the depth gauge 1602, similar to the central cylindrical support 602, which extends from the V-shaped rib 1222 of the upper interface region 1220 of the interface portion front 1206 of frame body 1202. The depth gauge arrangement 1600 also includes a depth gauge 1620, similar to the depth gauge 620. The depth gauge 1620 includes the stem gauge 1640 depth and a plate gauge depth 1622. The depth gauge arrangement 1600 still includes a depth adjustment knob 1650 and a stop ring 1670, similar to the depth adjustment knob 650 and stop ring 670.
[0110] The rotary knife blade 1300 is supported for rotation on a rotation axis R ', similar to the rotation axis R, by the blade housing arrangement 1400. The rotary knife blade 1300 includes a cutting edge 1360 that defines a CP 'cutting plane, similar to the CP cutting plane, and also includes a continuous rolling bearing structure 1370, similar to the continuous rolling bearing structure 370, which defines a rotation plane RP' of the blade 1300, similar to the cutting plane blade RP rotation 300. The blade housing arrangement 1400 includes an annular blade housing 1410, similar to blade housing 400, and a blade lock ring 450, similar to blade lock ring 1450, which is securely attached releasable to blade housing 1410 to secure and secure the rotary knife blade 1300 for rotation with respect to blade housing arrangement 1400.
[0111] As can be better seen in Figure 24, the handle arrangement 1110 extends along a longitudinal axis LA 'which is oblique or angled upwards at a handle angle HA' with respect to the cutting plane CP 'and the plane of rotation RP' of the rotary knife blade 1300 and with respect to the lower planar surface 1624 of the depth gauge plate 1622. That is, a proximal end 1162 of the handle arrangement 1110 is spaced top in an upward direction UP 'above the cutting plane CP' of the rotary knife blade 1300 or planar bottom surface 1624 of the depth gauge plate 1622 which is the distal end 1160 of the handle arrangement 1110. In dermatome 100, the handle angle was substantially 0o . In an exemplary embodiment of the dermatome 1000, the handle angle HA 'with respect to the cutting plane CP' or rotation plane RP 'of the rotary knife blade is in a range of 10 ° - 20 ° and, more particularly, in a exemplary embodiment, the handle angle HA 'can be approximately 15 °. The HA 'handle angle advantageously provides ease of operation and release for the operator's fingers. Remember that with dermatomes 100, 1000 of the present disclosure, in the removal of a layer of ST skin tissue, the operator generally holds the CP 'cut plane of the dermatome 1000 level or flat against the ST skin surface of ST skin as the dermatome 1000 is moved along its PT travel path. The HA 'upward angle of the handle arrangement 1110 of the dermatome 1000 makes it easy to keep the cutting plane CP' of the head arrangement of the dermatome 1200 flush or flat against the SST surface of the ST skin tissue during an extirpation procedure.
[0112] The rear handle attachment portion 1204 of the frame body 1202 of the dermatome 1000 is slightly different than the corresponding rear handle attachment portion 204 of the frame body 202 of the dermatome 100. To match the oblique angle or tilted upwards of handle HA 'of handle arrangement 1100, the handle attachment portion at the rear 1204 is also angled upward to match the handle angle of handle arrangement 1100. This is best seen in Figure 24. similarly, the gear train 1520 of the head arrangement 1200 is modified correspondingly to account for the different contact angle between the pinion gear 1522 and the gear teeth set of the rotary knife blade 1300.
[0113] Another difference between dermatomes 100, 1000 involves an axial length of the respective central cylindrical supports of depth gauge 602, 1602. To provide additionally lateral stability and accuracy to the depth gauge plate 1622, in dermatome 1000, a length axial AL 'was slightly increased. Remember that the axial length AL of cylindrical support 602 of dermatome 100, in an exemplary embodiment, was approximately 26.67 mm (1.05 inch), while the overall axial length of cylindrical support 602 extending between the upper end 604 of cylindrical support 602 and lower end 606 of cylindrical support 602 was approximately 31.75 mm (1.25 in). In an exemplary embodiment of dermatome 100, the axial length AL 'of the cylindrical support is approximately 33.02 mm (1.30 in), while the general axial length of the cylindrical support 1602 between the upper and lower ends is approximately 38, 10 mm (1.50 in). Third exemplary realization - dermatome operated by energy 2000
[0114] A third exemplary embodiment of a portable energy-operated dermatome of the present disclosure is schematically shown in 2000 in Figures 25-27. Only one head arrangement 2200 of the 2000 energy-operated dermatome is schematically illustrated in Figures 25-27, the remainder of the 2000 energy-operated dermatome, including the handle and drive arrangement, being similar in configuration and operation to the dermatomes operated by energy 100 and 1000, as described above. The descriptions of dermatomes 100 and 1000, as established above, are referenced and incorporated in the present with respect to dermatome 2000.
[0115] The 2200 head arrangement includes a 2600 depth gauge arrangement, including a cylindrical support of the 2602 depth gauge. In the 2200 head arrangement, as shown in Figures 25-27, parts of the 2600 depth gauge arrangement, including a depth gauge plate and a depth gauge rod, have been removed for clarity. The 2600 depth gauge arrangement of the 2200 head arrangement is similar in configuration and operation to the 1000 energy operated dermatome 1600 depth gauge arrangement. The 2200 head arrangement also includes a frame or body housing 2202, similar to the body frame 1202 of the energy-operated dermatome 1000. Like the frame body 1202 of the energy-operated dermatome 1000, a rear handle attachment portion 2204 of frame body 2202 of the dermatome 2000 is angled upward to match an angle of handle of the handle arrangement (not shown). In addition, a continuous rolling bearing structure of the 2200 head arrangement, similar to the continuous rolling bearing structures 370, 1370 of energy operated dermatomes 100, 1000 has been removed from Figures 25-27 for clarity.
[0116] The head arrangement 2200 of the present disclosure includes a 2300 annular rotary knife blade, similar to the rotary knife blades 300, 1300 of energy operated dermatomes 100, 1000, supported for rotation by a 2400 blade housing arrangement on a central axis of rotation R ". The rotary knife blade 2300 defines a cutting plane CP" substantially orthogonal to the axis of rotation of the rotary knife blade R ". The 2200 head arrangement also includes the 2400 blade housing arrangement including a blade housing 2410 and a blade lock ring 2450, similar to blade housing assemblies 400, 1400 of energy-operated dermatomes 100, 1000. Combination of rotary knife blade and 2290 blade housing
[0117] During certain tissue cutting operations with an energy-operated dermatome, skin tissue excised in contact with an inner wall of the rotary knife blade may tend to rotate with the rotary knife blade, albeit at a speed of rotation much slower. That is, during certain tissue cutting operations, the excised skin tissue may tend to slide along the inner wall of the knife blade in the direction of blade rotation. Rotation of the excised skin tissue, even at a low rotation speed, is undesirable, as the excised tissue could potentially wrap around the depth gauge plate and / or migrate to the pinion gear / blade interface region. Knife. To mitigate this potential problem, the section of the excised skin tissue can be lifted with a collection tool (i.e., tweezers) up and away from the cutting edge of the blade and inner blade wall. However, if such additional operation is required, the operator must perform an additional task (use of the collection tool) in addition to manipulating the energy-operated dermatome or an assistant would be required to manipulate the collection tool while the operator used the dermatome operated by energy. Both alternatives are generally not desirable.
[0118] Advantageously, the head arrangement 2200 of the energy operated dermatome 200 of the present disclosure addresses the potential problem of unwanted rotation of the excised tissue. The 2200 head arrangement includes a 2290 combination of a 2300 annular rotary knife blade and a 2400 blade housing arrangement. The 2400 blade housing arrangement comprises a 2410 blade housing including a 2470 protector extending from a central body 2411 of the blade housing 2410 and overlaps a portion of an inner wall 2310 of the rotary knife blade 2300. Protector 2470, which is part of a blade housing cover 2450, is fixed and does not rotate with the knife blade swivel 2300. Protector 2470 defines a main part of an excised material guiding surface or TDS tissue guiding surface (Figure 27) of combination 2290 that extends from a cutting edge 2360 of the rotating knife blade 2300 to a first upper end 2412 of the blade housing 2410.
[0119] The material targeting surface or TDS tissue targeting surface receives the cut or excised skin tissue after being cut by the cutting edge 2360 of the rotary knife blade 2300 and directs the excised tissue up and away from the edge cutting tool 2360 so as not to interfere with continuous cutting. The inner wall 2310 of the rotary knife blade 2300 includes a raised tissue guiding surface 2370 adjacent the cutting edge 2360. Advantageously, an inner surface 2472 of protector 2470 is adjacent and continues a tissue guiding surface 2370 of the wall internal 2310 of the 2300 rotary knife blade. The fixed guard 2470 of the present disclosure advantageously mitigates the problem of rotation of the excised skin tissue by providing a fixed tissue guiding surface 2472 to receive the excised skin tissue over a long distance short after the fabric is cut by the cutting edge 2360 of the 2300 rotary knife blade.
[0120] As can be better seen in Figure 27, an extension of the TDS total tissue targeting surface includes two components defined by two surfaces: a) an LPTDS lower portion of the TDS tissue targeting surface is defined by the targeting surface 2370 bottom fabric of the 2310 rotary knife blade inner wall; and b) an upper UPTDS portion of the TDS tissue targeting surface is defined by the inner tissue targeting surface 2474 of the protector 2470. The lower portion LPTDS tissue targeting surface is defined by the rotary knife blade 2300, thus the bottom of the LPTDS tissue-guiding surface rotates with the 2300 knife blade at a high speed of rotation. In contrast, the UPTDS upper tissue guiding surface is defined by protector 2470 and is fixed, that is, protector 2470, being attached to the blade housing 2410, does not rotate with the rotary knife blade 2300.
[0121] As can best be seen in Figure 27, the LPTDS lower tissue swiveling surface defines a relatively small part of an overall extent of the TDS tissue targeting surface. In an exemplary embodiment, an extension of the LPTDS lower tissue targeting surface is in the order of 2.54 mm - 3.175 mm (0.100 - 0.125 inch). In comparison, the fixed UPTDS upper tissue targeting surface defines a relatively large extent of the overall extent of the TDS tissue targeting surface. In an exemplary embodiment, an extension of the UPTDS upper tissue targeting surface is in the order of 19.05 mm - 25.4 mm (0.75 - 1.00 inch). Correspondingly, during a tissue cutting operation with the 2000 energy operated dermatome of the present disclosure, after cutting by the cutting edge of the rotary knife blade 2360, the excised tissue moves up and away from the cutting edge. cut 2360 along a path of ESTPT excised skin tissue (Figure 27). Up means axially upwards, that is, in the direction labeled UP in Figure 25, away means radially away from the rotation axis R "of the rotary knife blade 2300. The path of the ESTPT excised skin tissue can be described as angled upwards with respect to the cutting plane CP "and rotation axis R" of the rotary knife blade 2300 since the ESTPT path is a combination of an upward axial mode (the UP direction) with relation to blade 2300 and radially away from the R "axis of rotation of blade 2300. (Although shown in two dimensions as an arrow in the section of Figure 27, it should be understood that the extinct skin patent of ESTPT path when viewed in three dimensions would have a width due to the sections of the excised skin tissue having a width and the travel path would generally be according to a section of a frustrated or frustro-conic surface.) As the dermatome 2000 is manipulated during a cutting operation of tissue, the excised skin tissue moves quickly through the short-rotating tissue targeting surface 2370 of the inner wall 2310 of the rotary knife blade 2300. The excised skin tissue is rapidly deposited on the inner surface 2472 of the protector 2470 where excised skin tissue tends to gather or clump together.
[0122] At any given time, a length of the excised skin tissue exposed to the rotational forces applied by the inner wall of the 2310 blade is limited to the length of the LDTDS lower tissue targeting surface. In this way, in the combination 2290 of the present disclosure, the contact between the excised skin tissue and the 2300 rotary knife blade is advantageously minimized and the rotational forces applied by the 2300 rotary knife blade to the skin tissue section extirpated are also minimized due to the fixed protector 2470. Stated otherwise, moving the extirpated skin tissue as short a distance as possible through the LPTDS rotating lower tissue direction surface is desirable, as this limits forces rotations applied to the skin tissue excised by the 2300 rotary rotary knife blade. Correspondingly, in the 2290 combination, the excised skin tissue is deposited on the fixed protector 2470 of the 2400 blade housing arrangement without any required or necessary external manipulation for an assistant. 2300 rotary knife blade
[0123] The rotary knife blade 2300 extends axially between a first upper end 2367 and a second lower end 2368 and includes an upper body section 2302 adjacent to the upper end 2367 and a blade section 2304 adjacent to the lower end 2368 of the blade 2300. The blade includes the inner wall 2310 and an outer wall radially spaced 2312. The inner wall 2310 defines an inner region 2301 that is generally frustro-conical, converging in one direction proceeding towards the lower end 2368 of the blade 2300. The cutting edge 2360 of blade 2300 is defined at an intersection of the lower end 2368 and inner wall 2310. The body section 2302 of the blade extends axially between an upper end 2306 and a lower end 2308 and includes the driven gear 2328 (like the driven gear 328 of the rotary knife blade 300) defining the upper end 2367 of the blade and the super end 2306 of body section 2302. Body section 2302 defines a bearing surface 2319 (like the bearing surface 319 of the rotary knife blade 300) extending inwardly on the outer wall 2312. Body section 2302 of the blade 2300 rotary knife also includes a triangular cutout (when viewed in a cross section) or notch region 2390 formed on the inner wall 2310.
[0124] The blade section 2304 includes the cutting edge 2360 and the tissue guiding surface 2370 defined by the inner wall 2310 of the blade 2300 which is adjacent to the cutting edge 2360. The tissue guiding surface 2370, which defines the LPTDS lower portion tissue guiding surface, includes an arcuate cut or concave portion 2372 adjacent to cutting edge 2360 and a ramp portion 2374 that provides a transition or ramp from the inner wall 2310 of blade 2300 to the guiding surface of inner fabric 2472 of the protector 2470 of the blade housing 2410, which defines the UPTDS upper tissue direction surface. As can be seen in Figure 28, for machining release purposes, there will be a slight gap G on the TDS tissue guiding surface along the ESTPT excised skin tissue path between an upper end 237 6 of the 2374 ramp portion and a lower end 2374 of the inner surface of protector 2472.
[0125] The inner wall 2310 of the rotary knife blade 2300 further includes the upper recessed portion 2380 extending between the upper end 2370c of the ramp portion 2370b and the upper end 2367 of the blade 2300. With respect to the inner wall 2310, the portion upper recessed 2380 is radially recessed or radially offset inwardly to the inner wall 2310 with respect to the portion of the inner wall 2310 defined by the raised fabric guiding surface 2370. That is, the upper recessed portion 2380 is generally axially located above the surface directing fabric 2370 and the upper recessed portion 2380 is radially compensated inwardly on the inner wall 2310 from the fabric directing surface 2370, as seen along a direction labeled RIW "(radially on the inner wall 2350 of the rotating knife 2300) in Figure 27. The direction labeled RIW "in Figure 27 is generally orthogonal to a defined surface defined by the inner wall 2310 of the rotary knife blade 2300. Stated otherwise, if it is considered a frustro-conical surface defined by the lower recessed portion 2380 in three dimensions, such a frustro-conical surface would be radially spaced from a frustrated surface conical defined by the tissue directing surface 2370 in the direction RIW ", that is, going radially to the inner wall 2310, as shown in Figure 27. The direction RIW" is transversal to the axis of rotation R "and crosses the plane of rotation of the blade RP ".
[0126] The upper recessed portion 2380 includes a lower recessed region 2382, the groove region 2390 and an upper recessed region 2384. The lower recessed region 2382 is generally frustro-conical and is recessed radially inwardly to the inner wall 2310 with respect to the the upper end 2376 of the ramp portion 2374 of the tissue guiding surface 2370. The lower recessed region 2382 extends from the upper end 2376 of the ramp portion 2374 to the groove region 2390. The lower recessed region 2384 is also generally frustrated - conical and continues the frustro-conic surface defined by the lower recessed region 2382. That is, the upper and lower recessed regions 2384, 2382 define a single frustro-conic surface, which is interrupted by the notch region 2390.
[0127] The upper recessed portion 2380 of the inner wall 2310 includes and connects both the body section 2302 and the blade section 2304 of the rotary knife blade 2300 and defines a channel, usually rectangular in cross section, that advantageously receives the protector 2470 so that the inner surface 2472 of protector 2470 is adjacent to the upper end 237 6 of the ramp portion 2374 of the tissue guiding surface 2374 of the inner wall 2310 of the rotary knife blade 2300 and so that the inner surface of the protector 2472 is axially and radially aligned with the fabric steering surface 2372 of the rotary knife blade 2300. That is, the lower recessed portion 2390 of the inner wall 2310 is configured to provide a non-contact seat or opening to receive the 2470 guard and allow the alignment of the fabric steering surface 2372 of the rotary knife blade 2300 and the inner surface 2472 of the protector 2470 of the blade housing 2410 along the truck path of the ESTPT excised skin tissue. This alignment forms a substantially continuous TDS tissue guiding surface from the cutting edge 2360 of the rotary knife blade 2300 to the upper end 2412 of the blade housing 2410. The TDS tissue guiding surface is continuous from the cutting edge 2360 of the rotary knife blade 2300 to the upper end 2412 of the blade housing 2410, except for the small discontinuity of the G gap along the TDS tissue targeting surface between an upper end 237 6 of the ramp portion 2374 and a lower end 2374 of inner surface of protector 2472 due to the release required for manufacturing tolerance purposes. 2400 blade housing arrangement
[0128] The blade housing arrangement 2400 includes the annular blade housing 2410, similar to the blade housing 410, 1410 of energy operated dermatomes 100, 1000, and a blade lock ring 2490, similar to the blade 450, 1450 of energy-operated dermatomes 100, 1000. Blade housing 2410 and lock ring 2490 are attached together to secure the rotary knife blade 2300 for rotation, supported by a continuous rolling bearing structure, similar to the structure of 370 continuous rolling bearing of the dermatome. The functionality of the blade housing 2410 and locking ring 2490, together with the roller bearing structure (not shown in Figures 25-27, are similar to the corresponding structures described with respect to dermatomes 100, 1000 and, for brevity, will not be repeated ).
[0129] The blade housing 2410 includes the central body 2411 which is generally axially positioned upwardly and radially outward of the rotary knife blade 2300 and includes the first upper end 2412 and a second lower end axially spaced 2414. The blade housing 2410 further includes an inner wall 2416 and a radially spaced outer wall 2418. The inner wall 2416 includes an upper portion 2416a adjacent to the upper end 2412 and a stepped lower portion 2416b adjacent to the lower end 2414. The lower portion 2416b includes a bearing surface 2420 adjacent to the lower end 2414, similar to the bearing surface 420 of the energy operated dermatome 100.
[0130] As can best be seen in Figure 27, the upper portion 2416a of the inner wall 2416 of the blade housing 2410 is axially positioned above the upper end 2367 of the rotary knife blade 2300. The blade housing cover 2450 , which is part of the blade housing 2410, extends radially inward (that is, in a direction to the rotation axis R "of the rotary knife blade 2300, shown as RI" in Figure 27) from the top portion 2416a of the inner wall. The blade housing cover 2450 can be manufactured as integral with the blade housing 2410 or as a separate component that is permanently attached to the blade housing 2410, for example, by welding. The blade housing cover 2450 includes a base 2452 which is generally triangular in cross section. The base 2452 is axially positioned above and the upper end 2367 of the rotary knife blade 2300. Base 2452 defines an upper end 2454 and an axially spaced lower end 2456. The upper end 2454 of the blade housing cover 2450 is aligned with and defines a portion of the upper surface 2412 of the blade housing 2410. The base 2452 includes an inner surface 2458 that defines a portion of and is part of the inner fabric guiding surface 2472 of the protector 2470. That is, the surface inner tissue targeting method 2472 of protector 2470 extends from the lower end 2474 of the inner surface 2472 to an upper transition region 2476 adjacent to the upper end 2454 of the base 2452 and thus includes the base inner surface 2458.
[0131] Extending at an angle radially inward RI "and downward (direction DW" in Figure 27) there is protector 2470. Protector 2470 is generally rectangular in cross section and, in three dimensions, protector 2470 is generally frustro-conical in shape, following the general contours of the upper and lower regions frustro-conical 2384, 2382 of the lower recessed portion 2380 of the inner wall 2310 of the blade 2300. The protector 2370 includes the inner fabric guiding surface 2472 and an outer surface radially spaced 2480. Protector 2470 is received at and extends along the upper recessed portion 2380 of the inner wall 2310 of the rotary knife blade 2300. Protector 2470 is adjusted to fit the upper recessed portion 2380 so that the inner surface 2472 of protector 2470 is in proximity to and adjacent to, aligned with and continues the tissue targeting surface 2370 of the rotary knife blade inner wall 2310. The surface and inner protector 2472 defines a portion of the ESTPT excised skin tissue path path and defines the UPTDS upper portion of the substantially continuous TDS tissue directing surface of the 2290 blade-blade housing combination.
[0132] The lower end 2474 of the inner surface 2472 of the protector is slightly spaced out radially RO "(Figure 27) from the upper end 2376 of the ramp portion 2374 of the fabric guiding surface 2370 of the inner wall 2310 of the rotary knife blade 2300 to mitigate the possibility of the excised tissue entering the small gap G between the rotating knife blade 2300 and the protector 2470 as the excised tissue flows along the path of
[0133] As can best be seen in Figures 29-31, which schematically illustrate the frame body of the head arrangement 2202 and the blade housing 2410, with the rotary knife blade 2300 and the blade lock ring 2490 of the blade housing arrangement 2400 removed for clarity, the blade housing cover 2450, including protector 2470, extends over an entire 360 ° circumference of the blade housing 2410. That is, no matter which angular section of the blade rotary knife 2300 is used in a cutting or trimming operation, protector 2470 is positioned with respect to the fabric guiding surface 2370 of the rotary knife blade 2300 so that the inner surface 2472 of protector 2470m defining the fabric guiding surface UPTDS upper portion, it is adjacent and aligned with the raised tissue guidance surface 2370 of the rotary knife 2300, defining the LPTDS lower tissue guidance surface , in order to form a substantially continuous TDS total tissue targeting surface extending from the cutting edge 2360 of the blade 2300 to the upper end 2412 of the blade housing 2410.
[0134] It should be understood that the energy-operated dermatomes of the present disclosure, including the energy-operated dermatome 2000, can be used to trim and cut various materials, in addition to cutting or excising skin tissue. Correspondingly, references in this application, including the claims, to tissue, skin tissue, excised skin tissue, pathway of excised skin tissue, tissue targeting surface, etc. should be understood to apply equally to any material, be it fabric, skin tissue or otherwise, cut or trimmed by the dermatome 2000. In this way, references to the tissue, skin tissue, pathway of excised skin tissue, surface for directing tissue, etc. are to be understood broadly as including or referring to any material suitable for cutting or trimming by the energy operated dermatomes of the present disclosure, including the energy operated dermatome 2000.
[0135] As used herein, the terms of orientation and / or direction, such as, front, rear, forward, rear, distal, proximal, distally, proximally, superior, inferior, inward, outward, horizontally, horizontally, vertically, vertically, axially, radially, longitudinally, axially, radially, longitudinally, etc., are provided for convenience and generally refer to the orientation shown in the Figures and / or discussed in the Detailed Description. Such guidance / direction terms are not intended to limit the scope of the present disclosure, this application and / or the invention or inventions described therein, and / or any of the claims attached hereto. In addition, as used herein, the terms understand, understand and understanding are obtained to specify the presence of the declared resources, elements, integers, steps or components, but do not prevent the presence or addition of one or more other resources, elements, numbers integers, steps or components.
[0136] What has been described above are the examples of the present invention. It is clearly not possible to describe each conceivable combination of components or methodologies for the purposes of describing the present invention, but one of ordinary skill in the art will recognize that many additional combinations and permutations of the present invention are possible. Correspondingly, the present invention is intended to cover all such changes, modifications and variations that are within the spirit and scope of the appended claims.

权利要求:
Claims (6)
[0001]
1. Combination of an annular rotary knife blade, and a blade housing arrangement (2400) for an energy-operated dermatome (2000), the combination (2290), characterized by the fact that it comprises: - the rotary knife blade ( 2300) supported for rotation on a geometric axis of rotation (R ") by the blade housing arrangement (2400), the rotating knife blade (2300) includes: - a first end (2367) and a second spaced end of axial mode (2368) and an inner wall (2310) and a radially spaced outer wall (2312), the second end (2368) defining a cutting edge (2360), - the inner wall (2310) defining an inner region (2301) of the rotary knife blade (2300) and including a lower material guiding surface (2370) adjacent to the cutting edge (2360) and a radially lowered top portion (2380); and the blade housing arrangement (2400 ) includes: - a blade housing (2410) having a first ex (2412) and a second end (2414) axially spaced and an inner wall (2416) and a radially spaced outer wall (2418), the blade housing (2410) including a blade housing cover (2450) extending from the inner wall (2416) of the blade housing (2400) within the inner region (2301) of the rotary knife blade (2300), and the blade housing cover (2450) includes a protector (2470 ) extending along the lowered top portion (2380) of the rotating knife blade inner wall (2310) and having an adjacent inner surface (2472) and continuing the lower material targeting surface (2370) of the inner blade wall rotary knife (2310).
[0002]
2. Combination according to claim 1, characterized in that the protector (2470) of the blade housing cover (2450) extends in the lower recessed top (2380) of the rotating knife blade inner wall (2310) .
[0003]
3. Combination according to claim 1 or 2, characterized in that the blade housing arrangement (2400) includes a blade lock ring (2490) removably attached to the blade housing (2410) to secure the rotary knife blade (2300) to the blade housing arrangement (2400).
[0004]
4. Combination according to claim 1, 2 or 3, characterized in that the cutting edge (2360) of the rotary knife blade (2300) defines a cutting plane (CP ") orthogonal to the geometric axis of rotation ( R "), and the material guiding surface (2370) of the rotary knife blade (2300) and the inner surface (2472) of the blade housing protector (2470) comprises a fabric guiding surface of the combination (2290) .
[0005]
5. Head arrangement for an energy-operated dermatome, the head arrangement (2200), characterized by the fact that it comprises: - a combination (2290) of an annular rotary knife blade (2300) and a blade housing arrangement ( 2400), as defined in any of claims 1 to 4, and a frame body (2202) supporting a gear train (1520) and coupled to the combination (2290).
[0006]
6. Energy operated dermatome, characterized by the fact that it comprises: - a head arrangement (2200), as defined in claim 5, and - a handle arrangement (1110) coupled to a handle attachment portion (2204) of the body frame (2202) of the head arrangement (2200).

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CA2884690A1|2014-03-13|

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EP2892698B1|2020-04-08|

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AU2013312731C1|2018-04-05|

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US20180344341A1|2018-12-06|

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AU2013312731A1|2015-03-19|

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法律状态:
2018-11-21| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-12-03| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2020-07-07| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2020-11-17| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 05/09/2013, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US13/606,836|US9592076B2|2012-09-07|2012-09-07|Power operated dermatome with rotary knife blade|

---

US13/606,836|2012-09-07|

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US13/842,224|US10039567B2|2012-09-07|2013-03-15|Power operated dermatome with shielded rotary knife blade|

---

US13/842,224|2013-03-15|

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PCT/US2013/058142|WO2014039609A1|2012-09-07|2013-09-05|Power operated dermatome with shielded rotary knife blade|

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