• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    Skin expansion system (1) for reducing a tissue-lined wound, the skin expansion system (1) comprising: - an elastically deformable link (5) for extending between the tissues lining the wound in such a manner a tension in the link (5) produces a traction along the tissues bordering the wound to bring said tissues close to each other, the link (5) having opposite first (5a) and second ends, - a tensioner (10) ) adapted to maintain a tension in the link (5), wherein the link (5) is adapted to suture the wound directly through the tissue bordering the wound into at least two stitches, the link being made of biocompatible material and comprising a suture needle (6) secured to the first end (5a).
    公开号:FR3032344A1
    申请号:FR1550937
    申请日:2015-02-06
    公开日:2016-08-12
    发明作者:Olivier Beatrix
    申请人:Medical Innovation Developpement SAS；
    IPC主号:
    专利说明:

    [0001] The invention relates to a skin expansion system. In particular, the invention relates to a vascular loop closure-type skin expansion system utilizing an elastic linkage external tissue extension to reduce a wound by exerting traction along the tissues lining the wound. . The external tissue extension by elastic link is known and described for several decades and in particular in the following publications: - Harris I, "Gradual closure of fasciotomy wounds using a vessel loop shoelace", Injury 1993; 24 (8): 565-6, AsgariMM, Spinelli HM, "The vessel loop shoelace technique for cloaking of fasciotomy wounds", Ann Plast Surg 1999; 43: 225-9, Bashir AH, "Wound closure by skin traction: an application of tissue expansion", Br J Plast Surg 1987; 40 (6): 582-7, - Bulstrode CJ, "A simple method for closing fascitomies", Ann R ColSurg Engl 1985; 67 (2): 119-20, - Almekinders LC, "Gradual closure of fasciotomy", Orthop Rev 1991; 20 (1): 82-4, - Monnier J, Uni-axial tissue extension in coverage of limb loss ", Annal chir plast 52 (2007): 577-581. This technique uses the elastic properties of the skin in particular and consists in making a gradual traction on two skin edges bordering the wound when the direct suture is impossible due to a loss of substance, excessive tension between the two banks or when discharge fascia performed in cases of compartment syndrome. The latter is defined as neuromuscular pain that can go as far as necrosis, linked to an increase in intratissue pressure in an inextensible muscular lodge. It is secondary to trauma or ischemia. The only way to lower the pressure in the box is to open it wide. This gesture is performed in vascular surgery or orthopedic surgery, it saves the muscle concerned and its function, but it causes a wide cutaneous bite equivalent to a loss of substance. The invention therefore applies to the treatment of a large wound having, for example, a surface area of between 100 cm 2 and 500 cm 2 and resulting, for example, from a fasciotomy or ablation procedure. a cutaneous tumor. The invention is also applicable to the treatment of a wound of smaller size having, for example, a surface area of less than 100 cm 2, resulting, for example, from postoperative disunity. The principle of the external tissue extension is to achieve a progressive traction on the two skin banks in order to bring them closer and ideally to put them in contact with a wound then completely closed. The skin expansion system is put in place at the end of the procedure. Progressive traction is generally performed in the immediate aftermath of the procedure (second day postoperative) and continued for a fortnight. Traction is increased every forty-eight hours in the patient's bed. The skin expansion system is removed without anesthesia.
    [0002] At present, this technique is carried out thanks to non-specific material, diverted from its initial use and in particular by: a silicone lake as an elastically deformable link intended to extend between the tissues bordering the wound in such a way that tension in the link produces traction along the tissues bordering the wound to bring said tissues closer together; the silicone lake is then diverted from its field of use which is the intraoperative identification of vascular or noble structures (ureter, common bile duct), - staples usually used for closing the skin at the end of the procedure, - a tensioner adapted to maintain a tension in the link. In this known skin expansion system, the link is successively passed through the staples anchored through the tissue lining the wound. The link is then held in tension by the tensioner, for example in the form of a cleat on one or more of the staples. However, although widespread and ethical because used in a rescue situation where there is no other alternative, skin extension technique, the result of diversion of medical equipment, often shows disappointing results. In particular, the known cutaneous expansion system is long and complex to implement because of the need to pre-anchor the staples along the tissues bordering the wound. In addition, in this skin expansion system, the traction on the tissues bordering the wound is exerted via the staples and depends on the anchoring of each of the staples. Despite the care taken in anchoring the staples, they do not make it possible to exercise controlled traction, in particular in a proper orientation. The known cutaneous expansion system does not therefore ensure uniformity of traction along the tissues bordering the wound. There is then, at least locally and especially at locations where the traction is the strongest, a risk of deterioration or tissue necrosis. In addition, staples diverted from their usual use have no particular mechanical quality and may tear. The invention aims to overcome the problems mentioned above.
    [0003] To this end, the invention proposes a cutaneous expansion system for reducing a wound bordered by tissues, the cutaneous expansion system comprising: an elastically deformable link intended to extend between the tissues bordering the wound of such whereby a tension in the link produces traction along the tissues bordering the wound to bring said tissues closer to one another, the link presenting opposing first and second ends, - a tensioner adapted to maintain a tension in the link, wherein the link is adapted to suture the wound directly through the tissue bordering the wound in at least two stitches, the link being made of biocompatible material and comprising a suture needle secured to the first end.
    [0004] Thus, the link directly suturing the wound can be set up quickly and easily by means of an intuitive gesture for a surgeon. On the other hand, the traction exerted by the elastically deformable linkage directly on the skin can be better distributed between the sutures and more uniformly along the tissues bordering the wound so that the risks of deterioration and necrosis are reduced.
    [0005] The skin expansion system according to the invention also has the following advantages: - a solid cutaneous docking to complete the procedure, - a cutaneous protection to exert traction without damage to the skin, the development of a reversible locking system that can easily be used on the elastic lake; good ergonomics combining ease of installation, manipulation and ablation; reliable system for maximum patient safety. It offers an improvement in the actual benefit of the external cutaneous extension technique in its current classical indications, and in particular: - in vascular surgery to close discharge fascia after post-ischemia syndrome, - in orthopedic surgery to close aponeurotomy discharge after post traumatic and / or ischemic lodge syndrome. 3032344 4 - in oncological surgery (oncology) to close large losses of cutaneous and subcutaneous substance. The skin expansion system according to the invention also has an adaptability which also makes it possible to extend the indications of the external cutaneous extension technique to new indications, such as: the reduction of the surface to be grafted after resection of small tumor or enlarged recovery in the management of melanomas, - postoperative cicatricial disunions. The link may be made of polymer, and in particular silicone.
    [0006] The tensioner may comprise: a body secured to the second end of the link, and a locking member displaceable relative to the body between an inactive state in which said locking member releases a passage for the connection between a locking portion of said locking member and the body, and an active state in which said locking member 15 maintains a portion of the link at a distance from the second end between the locking portion of said locking member and the body. In a complementary or alternative manner to the aforementioned provisions, the skin expansion system may further comprise at least one wedge intended to be interposed between the link and the tissues bordering the wound, the wedge having a bearing surface adapted to rest on the tissue bordering the wound, and a guide surface opposite to the bearing surface and adapted to receive a portion of the link. Thus, the use of one or more wedges makes it possible to protect the tissues bordering the wound by improving the return of the traction exerted on the tissues bordering the wound by an extended superficial zone of the tissues corresponding to the bearing surface. The shims can also make it possible to improve the guiding of the link and to facilitate its installation. Such a wedge could be used independently of the skin expansion system as defined above for any other application using a suture, with any type of appropriate link possibly different from the link defined above.
    [0007] The bearing surface may be devoid of an anchoring element adapted to pierce the tissue lining the wound and penetrate into said tissue. The wedges do not then constitute an anchor point, the anchor being constituted by the suture point of the link through the tissues.
    [0008] The guide surface may extend along a guide axis and have a concavity around the guide axis. The shim may comprise at least one guide aperture having a lateral surface about a central axis and adapted to allow passage of the link, the lateral surface forming at least a portion of the guiding surface. The shim may comprise at least two guiding apertures separated from one another by a breakable portion. The shim can be made of polymer, and in particular silicone. These provisions make it possible to promote the anatomical adaptation of the hold to the tissues on which it rests. According to another aspect, the invention relates to a method of reducing a wound surrounded by tissues using a skin expansion system as defined above, the wound reduction method comprising the steps of: suturing the wound directly through the tissue bordering the wound in at least two stitches with the link in such a way that the link extends between the tissues bordering the wound, - exerting a tension in the link so as to produce a traction along the tissues bordering the wound to bring said tissues closer to each other, - maintain the tension in the link with the tensioner.
    [0009] The wound reduction method may further provide for adjusting, and in particular increasing, the tension in the link. The method of reducing a wound may provide, during the step of suturing the wound, interposing at least one wedge between the link and the tissues bordering the wound, the wedge having a bearing surface resting on the tissue bordering the wound, and a guide surface 25 opposite the bearing surface and receiving a portion of the link. Other objects and advantages of the invention will appear on reading the following description of a particular embodiment of the invention given by way of non-limiting example, the description being made with reference to the appended drawings in which FIG. 1 is a perspective representation of a cutaneous expansion system according to one embodiment of the invention, the cutaneous expansion system comprising a link adapted to suture the wound, a suture needle secured to a first end of the link and a tensioner secured to a second end of the link, - Figure 2 is a sectional representation in the orientation referenced II-II in Figure 1 of the linkage of the cutaneous expansion system of FIG. 1, - Figure 3 is a sectional representation in the orientation referenced III-III in Figure 1 of the tensioner of the cutaneous expansion system of Figure 1, 5 - Figures 4 and 5 are rep respectively in perspective and in elevation of a variant of the tensioner of the cutaneous expansion system of FIG. 1; FIG. 6 is a perspective representation of a wedge according to a first embodiment that can be implemented in the FIG. 1 is a perspective view of a variant of the wedge of FIG. 6; FIG. 7 is a perspective representation of a variant of the wedge of FIG. FIGS. 8 and 9 are diagrammatic representations illustrating the placement of the wedge of FIG. 7 on tissue bordering a wound, FIG. 10 is a diagrammatic representation of a reduction of a wound 15 implementing the system. FIG. 1 is a diagrammatic representation of a reduction of a wound using the expansion system of the invention. FIG. FIG. 1 is a perspective representation of a shim according to a second embodiment that can be implemented in the expansion system. FIG. Figure 13 is a cross-sectional representation of the shim of Figure 12. In the figures, the same references denote like or similar elements. FIGS. 1 to 3 show a cutaneous expansion system 1 for reducing a wound 2 bordered by tissues 3. The cutaneous expansion system 1 is of the vascular loop closure type in which the wound 2 is reduced by pulling along the tissues 3 bordering the wound 2.
    [0010] The skin expansion system 1 comprises a link 5 adapted to suture the wound 2 by passing directly through the tissues 3 bordering the wound at several sutures 4. In particular, the link 5 is made of a biocompatible and elastically deformable material, such as silicone. The link 5 has, at rest, i.e. in the absence of external stress, a length between first and second opposing ends 5a and 5b and can be stretched so as to spread the first 5a and second 5b. ends of each other. In particular, the length of the link 5 may be between 20 cm and 80 cm, preferably between 40 cm and 60 cm. The link 5 may have a graduation along its entire length.
    [0011] In Figure 2, the link 5 is shown with a circular cross-section of diameter between 1 and 3 mm. Alternatively, the link 5 could have any other non-circular cross-section and having, for example, first and second dimensions respectively according to first D1 and second D2 directions perpendicular to each other such that the first dimension is greater than the second dimension. In particular, the link could have an oval cross-section having a major axis a in the first direction D1 and a small axis b in the second direction D2. The link 5 also comprises a suture needle 6 secured to its first end 5a. The suture needle 6 is, for example, curved and can be crimped onto the first end 5a of the link 5. A ring 7, integral with an end opposite a tip 8 of the suture needle 6 and adapted for receive the first end 5a of the link 5, is then deformed to retain the link 5 inside the ring 7. To be able to separate the suture needle 6 of the link 5 once the suture performed, one of the selected elements between the link 5 and the suture needle 6 may comprise a breakable portion. In particular, because of the nature of the link material 5, it can be cut close to the suture needle 6. Alternatively, the suture needle 6 can be secured to the first end 5a of the link 5 by any appropriate means and in particular by press fitting, overmoulding or by means of any suitable fastening device, possibly removable. The second end 5b of the link 5 is secured to a tensioner 10 adapted to maintain a tension in the link 5. In the embodiment shown in Figures 1 and 3, the tensioner 10 comprises a body 11 which extends in a longitudinal direction L between a distal portion 12 to which the link 5 is secured, and a proximal portion 13. The distal portion 12, for example of parallelepiped shape, has a transverse end surface 14 with respect to the longitudinal direction L and provided with an orifice 15 which extends along an axis and which is adapted to house the second end 5b of the link 5. To maintain the second end 5b of the link 5 in the orifice 15, a clamping member 16 is mounted in a hole 18 on an upper surface of the distal portion 12 of the body 11 movably displaceable perpendicularly to the axis of the orifice 15. The clamping member 16 can then be moved between: - a position of clamping wherein a portion of the clamping member 16 extends into the port 15 to wedge the link 5 between one end of the clamp member 16 and a side surface of the port 15, and a retracted position in which the clamping member 16 does not extend into the orifice 15 so as not to interfere with the link 5. Alternatively, the second end 5b of the link 5 could be held in the orifice 15 by any other appropriate means.
    [0012] The proximal portion 13 extends in the longitudinal direction L from a surface opposite to the end surface 14 of the distal portion 12. It is added in a transverse direction T, perpendicular to the longitudinal direction L. It comprises, in in particular, a base wall 17 whose bottom surface 17a extends in the extension of a lower surface 12a of the distal portion 12. The base wall 17 has, on an upper surface 17b opposite the lower surface 17a, a projection 20 which extends over its entire width measured in the transverse direction T. The proximal portion 13 also comprises a transverse wall 21 which extends perpendicular to the longitudinal direction L, in a vertical direction V, from one end of the base wall 17 opposite the distal portion 12.
    [0013] The tensioner 10 also comprises a locking member in the form of a locking lever 22 and adapted to reversibly block a portion of the link 5 away from the second end 5b. In the embodiment shown, the locking lever 22 is integral with the body 11 made of plastics material. The locking lever 22 is, moreover, 25 shaped so that at rest, in the absence of external stress, a free end 22a of the locking lever 22 is disposed near a free end 21a of the transverse wall 21 of the proximal portion 13 of the body 11. In particular, the locking lever 22 comprises a locking wall 23 arranged substantially facing the base wall 17 of the proximal portion 13, and comprising the free end 22a of the lever Blocking 22. The locking wall 23 is connected to the distal portion 12 by a connecting wall 24 substantially perpendicular to the longitudinal direction L. At rest, the locking lever 22 is in an open position corresponding to an inactive state in which its free end 22a is located in the vicinity 3032344 9 of the free end 21a of the transverse wall 21 of the proximal portion 13 of the body 11 by providing a passage for the link 5. The locking lever 22 can be d formed elastically to be moved to a closed position corresponding to an active state in which it maintains a portion of the link 5 away from the second end 5b between its free end 22a forming a locking portion and the free end 21a of the wall transverse 21 of the proximal portion 13 of the body 11. The free end 21a of the transverse wall 21 of the proximal portion 13 of the body 11 is then provided with a lug 25 to be able to maintain the locking lever 22 in the active state , in closed position.
    [0014] The locking lever 22 has a locking tab 26 which extends perpendicularly from a lower surface 23a of the locking wall 23 opposite the upper surface 17b of the base wall 17 of the proximal portion 13 of the body 11. The locking tab 26 is arranged so that: in the open position of the locking lever 22 in the inactive state, a free end 26a of the locking tab 26 is at a distance from the projection 20 of the base wall 17 and of the upper surface 17b of the base wall 17 so as to allow the link 5 to pass, - in the closed position of the locking lever 22 in the active state, the free end 26a of the locking tab 26 is close the projection 20 of the base wall 17 and the upper surface 17b of the base wall 17 so as to block a portion of the link 5, the free end 26a of the locking lug 26 forming another blocking portion of the locking lever 22. In an alternative embodiment 4 and 5, the tensioner 10 'also comprises a body 11' similar to the body 11 of the tensioner 10 previously described. The body 11 'of the tensioner 10' according to this variant has an orifice 15 'formed in a transverse end surface 14' of a distal portion 12 '. The second end 5b of the link 5 is housed in the orifice 15 'and held by a clamping member mounted in a hole 18' on a lateral surface of the distal portion 12 'of the body 11' in a displaceable manner perpendicular to the axis of the orifice 15 'between the clamping position and the retracted position described above.
    [0015] The proximal portion 13 'extends in the longitudinal direction L from a surface opposite to the end surface 14' of the distal portion 12 '. It comprises, on the upper surface 17b 'of the base wall 17', a groove 19a 'adapted to receive a portion of the link 5 and which opens into a notch 19b' formed over the entire height of the transverse wall 21 ' . The locking lever 22 ', also integrally formed with the body 11' made of plastic material, comprises one or more, for example two, locking tabs 26 'which extend perpendicularly from the bottom surface 23a' of the wall blocking 23 'facing the upper surface 17b' of the base wall 17 'of the proximal portion 13' of the body 11 '. The locking tabs 26 are arranged so that: in the open position of the locking lever 22 'and in the inactive state, the free ends 26a' of the locking tabs 26 'are spaced from the groove 19a' of the wall base 17 '10 so as to allow a portion of the link 5 to be placed in the groove 19a', - in the closed position of the locking lever 22 in the active state, the free ends 26a 'of the locking tab 26 'extend in the groove 19a' of the base wall 17 'so as to block the portion of the link 5 placed in the groove 19a', the free ends 26a 'of the locking tab 26' forming blocking portions of the locking lever 22 '.
    [0016] In the embodiment shown, the skin expansion system 1 further comprises one or more shims 30 intended to be interposed between the link 5 and the tissues 3 bordering the wound 2. The shim 30 is made of any material suitable for allow a recovery of the traction exerted by the link 5 on the tissue 3 bordering the wound 2 and, where appropriate, to improve the guide of the link 5 and facilitate its implementation.
    [0017] In particular, to promote its anatomical adaptation to the tissues on which it rests, the wedge 30 can be made of polymer and in particular silicone. In a first embodiment shown in FIG. 6, the shim 30 is in the form of a wafer extending in an extension direction E. The shim 30 has a bearing surface 31 adapted to rest on the tissue 3 bordering the wound 2, and a guide surface 32 opposite to the bearing surface 31 and adapted to receive a portion of the link 5. The bearing surface 31 is flat and devoid of anchoring element adapted to pierce the tissue 3 bordering the wound 2 and penetrate into these tissues 3. In particular, the bearing surface 31 may be smooth. Alternatively, while preferably free of anchoring element, the bearing surface 31 could be curved and / or textured, i.e. provided with a network of non-perforating projections, for improve adhesion to a tissue surface 3 bordering the wound 2.
    [0018] The guide surface 32 extends along a guide axis A, an essential part of which is parallel to the direction of extension E, and has a concavity around the guide axis A. In particular, two longitudinal flanges 33, parallel to the extension direction E, are disposed on either side of a central portion 34 in recess with respect to the longitudinal flanges 33. The spacer 30 comprises two guide openings 35 arranged substantially at two opposite ends. of the shim 30 and adapted to allow passage of the link 5. The guide openings 35 are connected to each other by the guide surface 32 and each have a lateral surface 35a, for example cylindrical, around a central axis 10. Part of the lateral surface 35a of each of the guide openings 35 forms an end of the guide surface 32 of the wedge 30. Between the guide openings 35, for example in a substantially median zone, the wedge 30 has a breakable portion , materialized by a groove 36, for separating the shim 30 in two half-shims 30a each having one of the guide openings 35 and a portion of the bearing surfaces 31 and guide 32. In a variant shown in FIGS. FIGS. 7 to 9, the shim 30 'is shaped such that at rest, in the absence of external stresses, the bearing surface 31' has a convexity R1 facing away from the guiding surface 32 ' . In addition, the central portion 34 'of the guide surface 32' has a convexity R2 directed away from the bearing surface 31 'between the guide openings and the bearing surface 31'. In this way, when the spacer 30 'is positioned on the tissue 3 bordering the wound 2 and the link 5 passes between the guide openings 35' on the guide surface 32 ', the wedge 30' can be deformed to fit the anatomical surface of the tissues 3 bordering the wound 2 by exerting on the link 5 a resultant force F opposite the traction T, which results in a reduction of the stresses on the tissues 3. FIG. 10 represents an implementation of the system of FIG. cutaneous expansion 1 which has just been described in a bridge assembly. The wound 2 is sutured by passing the suture needle 6 through the tissues 3 bordering the wound 2, from below, to a first suture point 4 and then through one of the guide openings 35. a first shim 30 whose bearing surface 31 rests on tissue 3 bordering the wound 2. The suture needle 6 then passes into the other opening 35 of the first shim 30 and then through the tissues 3 bordering the wound 2, in a second stitch 4, the link 5 thus passing through the guide apertures 35 and extending into the central portion 34 of the guide surface 32. This same operation is repeated for a given number of wedges 30 so that the link 5 extends around the wound 2, passing under the tissues 3 bordering the wound 2 between two consecutive wedges 30, and on the guide surface 32 between the two guide openings 35 of each of the wedges 30. Once the link 5 suture 2, the suture needle 6 can be separated from the link 5 and the link 5 can be inserted into the passage between the locking lever 22 in the open position and the body 11 of the tensioner 10 to adjust the tension in the 10 link 5. The orifice 15 holding the second end 5b of the link 5 and the passage holding another portion of the link 5 being arranged on either side of the tensioner 10 in the longitudinal direction L, the tensioner 10 can be arranged in the alignment of the link 5 between two consecutive stitches 4. When a satisfactory voltage is obtained, the lock lever 22 is moved to the closed position to lock a portion of the link 5 away from the second end 5b of the link 5. Subsequently, the link voltage 5 can again be adjusted. , and in particular increased, by passing the locking lever 22 in the open position and pulling the link 5 before returning the locking lever 22 in the closed position.
    [0019] As tension in link 5 increases, traction on tissue 3 lining wound 2 increases resulting in wound reduction 2. The skin expansion system thus constitutes a dynamic system for reducing a wound. 2. Alternatively, the skin expansion system 1 could be similarly operated in the absence of wedges 30, the link 5 directly suturing the wound alternately passing above and below the tissues 3 bordering the wound 2 between two consecutive stitches 4. In addition, the arrangement of the sutures 4 and, if appropriate, the wedges 30 could be different from that described above. For example, Figure 11 illustrates an implementation of the cutaneous expansion system 1 previously described in a yaw assembly. In such an assembly, the sutures 4 are not joined successively around the wound 2 as previously described but successively on both sides of the wound 2, so that link portions 5 extend over the wound. 2. In addition, in FIG. 6, the wedges 30 have been separated into half-wedges 30a, the bearing surface 31 of one of the half-wedges 30a resting on the tissues 3 bordering the wound 2 in each suture 4, the link 5 passing through the guide opening 35 and extending on the portion of the guide surface 32 of the half-wedge 30a. The tension in the link 5 can be maintained and adjusted as previously described with the aid of the tensioner 10. In a second embodiment shown in FIGS. 12 and 13, the wedge 30 "is in the form of a stud. also having a bearing surface 31 "adapted to rest on the tissues 3 bordering the wound 2, and a guide surface 32" opposite to the bearing surface 31 "and adapted to receive a portion of the link 5.
    [0020] The bearing surface 31 "is similar to that of the shim 30 according to the first embodiment, whereas, unlike the shim 30 according to the first embodiment, the shim 30" according to the second embodiment has a single guide opening 35 "having a lateral surface 35a" about a central axis curved about an axis 15 of the bearing surface 31 "parallel to the extension direction E". The lateral surface 35a "is thus substantially toroidal and comprises the guiding surface 32" having a form of hyperbolic paraboloid with a concavity around the central axis forming the guide axis A ", and a convexity around the axis of the bearing surface 31 ". The wound 2 is sutured by passing the suture needle 6 through the tissue 3 bordering the wound 2, from below, to a first suture point 4 and then through the guide opening 35 "of a first wedge 30 "whose bearing surface 31" rests on tissue 3 bordering the wound 2. The suture needle 6 then passes through the tissues 3 bordering the wound 2, from above, to a second point of suture 4. The same operation is repeated for a given number of shims 30 "so that the link 25 extends around the wound 2 or on the wound 2, passing under the tissues 3 bordering the wound 2 between two 30 "consecutive spacers, and on the guide surface 32" of each of the spacers 30 ".The tension in the link 5 can be maintained and adjusted as previously described with the aid of the tensioner 10.
    权利要求:
    Claims (10)
    [0001]
    REVENDICATIONS1. Skin expansion system (1) for reducing a wound (2) bordered by tissues (3), the skin expansion system (1) comprising: - an elastically deformable link (5) intended to extend between the tissues (3) bordering the wound (2) such that a tension in the link (5) provides traction along the tissues (3) bordering the wound (2) to bring said tissues (3) closer to each other, the link (5) having first (5a) and second (5b) opposite ends, - a tensioner (10) adapted to maintain a tension in the link (5), the skin expansion system (1) being characterized in that the link (5) is adapted to suture the wound (2) directly through the tissue (3) bordering the wound (2) in at least two stitches (4), the link being made of a biocompatible material and comprising a suture needle (6) secured to the first end (5a).
    [0002]
    2. skin expansion system (1) according to claim 1, wherein the link (5) is made of polymer, and in particular silicone.
    [0003]
    3. cutaneous expansion system (1) according to claim 1 or 2, wherein the tensioner (10) comprises: - a body (11) secured to the second end (5b) of the link (5), and - an organ for locking (22) movable relative to the body (11) between an inactive state in which said locking member (22) releases a passage for the link (5) between a locking portion (22a, 26a) of said locking member ( 22) and the body (11), and an active state in which said locking member (22) holds a portion of the link (5) away from the second end (5b) between the locking portion (22a, 26a) of said locking member (22) and the body (11).
    [0004]
    4. skin expansion system (1) according to any one of claims 1 to 3, further comprising at least one shim (30; 30 '; 30 ") intended to be interposed between the link (5) and tissues (3) bordering the wound (2), the shim (30; 30 '; 30 ") having a bearing surface (31; 31'; 31") adapted to rest on the tissue (3) bordering the wound (2 ), and a guide surface (32; 32 '; 32 ") opposite the bearing surface (31; 31'; 31") and adapted to receive a portion of the link (5).
    [0005]
    The skin expansion system (1) according to claim 4, wherein the bearing surface (31; 31 '; 31 ") is devoid of an anchoring element adapted to pierce the tissue (3) bordering the wound. (2) and penetrating into said tissues (3).
    [0006]
    6. skin expansion system (1) according to claim 4 or 5, wherein the shim (30 ') is shaped such that at rest the bearing surface (31') has a convexity (R1) directed opposite the guiding surface (32 ').
    [0007]
    The skin expansion system (1) according to any of claims 4 to 6, wherein the guide surface (32; 32 '; 32 ") extends along a guide axis (A; A'). A ") and has a concavity around the guide axis (A; A '; A").
    [0008]
    The skin expansion system (1) according to any of claims 4 to 7, wherein the shim (30; 30 '; 30 ") has at least one guide opening (35; 35'; 35") having a lateral surface (35a; 35a '; 35a ") about a central axis and adapted to allow passage of the link (5), the lateral surface (35; 35a'; 35a") forming at least a portion of the guide surface (32; 32 '; 32 ").
    [0009]
    9. cutaneous expansion system (1) according to claim 8, wherein the shim (30) comprises at least two guide openings (35) separated from each other by a breakable portion (36). 15
    [0010]
    10. skin expansion system (1) according to any one of claims 4 to 9, wherein the wedge (30; 30 '; 30 ") is made of polymer, and in particular silicone.
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    EP2334255B1|2012-03-28|Prosthetic implant for suburethral support with gussets
    EP3763297A1|2021-01-13|Bone anchoring device
    EP1980147A1|2008-10-15|Plant staking collar
    FR3012317A1|2015-05-01|SURGICAL INSTRUMENT FOR THE INSTALLATION OF A UROGENITAL IMPLANT
    FR2902314A1|2007-12-21|Tendon fixation device for knee ligament surgery, has anchoring unit arranged to be integrated to interference screw through bore so as to anchor tendon by insertion of unit in bore across tendon and wall of bone tunnel
    FR3096883A1|2020-12-11|Fastening system between a medical device and at least part of a bone
    同族专利:
    公开号 | 公开日
    JP2018508271A|2018-03-29|
    BR112017016939A2|2018-04-03|
    US10751042B2|2020-08-25|
    US20180021037A1|2018-01-25|
    CN107427297B|2020-10-20|
    MX2017009881A|2017-11-15|
    EP3253299B1|2020-07-08|
    IL253721D0|2017-09-28|
    RU2017131110A|2019-03-06|
    CN107427297A|2017-12-01|
    AU2016214148A1|2017-08-24|
    RU2718320C2|2020-04-01|
    FR3032344B1|2020-11-13|
    ES2822432T3|2021-05-04|
    WO2016124872A1|2016-08-11|
    RU2017131110A3|2019-06-18|
    AU2016214148B2|2021-02-18|
    EP3253299A1|2017-12-13|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    EP0592960A2|1992-10-09|1994-04-20|United States Surgical Corporation|Sternum closure buckle|
    WO1999035974A1|1998-01-19|1999-07-22|Wisebands Ltd.|A suture tightening device for closing wounds and a method for its use|
    US20030092969A1|2001-05-09|2003-05-15|O'malley Michael T.|Clinical and surgical system and method for moving and stretching plastic tissue|
    US20040260344A1|2003-05-07|2004-12-23|Anpa Medical, Inc.|Suture lock|
    EP1852071A2|2006-05-02|2007-11-07|Ethicon Endo-Surgery, Inc.|Suture tensioning device and method|
    US20110040325A1|2009-07-28|2011-02-17|Matthias Moehrle|Device For Stretching Regions Of Tissue|
    US20120016384A1|2010-07-19|2012-01-19|Wilke Robert C|Wound closure system|
    JP2013094409A|2011-10-31|2013-05-20|Olympus Corp|Tissue ligating device|
    WO2013134767A1|2012-03-09|2013-09-12|Knoell Keith A|Lattice stitch surgical tension limiting device|
    JP2014217633A|2013-05-09|2014-11-20|泉工医科工業株式会社|Suture knot-tying member and suture set|
    US3695271A|1970-06-03|1972-10-03|Technalytics Inc|Retention suture bridge|
    US4210148A|1978-11-03|1980-07-01|Stivala Oscar G|Retention suture system|
    US7153312B1|1999-12-02|2006-12-26|Smith & Nephew Inc.|Closure device and method for tissue repair|
    US20060064125A1|2001-05-09|2006-03-23|James Henderson|Button anchor system for moving tissue|
    US6972027B2|2002-06-26|2005-12-06|Stryker Endoscopy|Soft tissue repair system|
    AR041144A1|2003-09-04|2005-05-04|Alberto Luis Garay|A SUTURE DEVICE FOR SOFT FABRICS AND / OR FIXING OF SOFT FABRICS TO BONES|
    ES2639027T3|2004-05-14|2017-10-25|Ethicon Llc|Suture devices|
    CN201831917U|2010-09-27|2011-05-18|浙江省中医院|Matching inserted pin type auxiliary device for abdomen incision expansion-resisting suture|
    CN103519856B|2013-10-16|2016-09-28|中国人民解放军第二军医大学|The auxiliary used in a kind of operation stitching subtracts prop tool|FR3095586A1|2019-05-05|2020-11-06|Marie-Christine Missana|BREAST IMPLANT EQUIPPED WITH A FIXATION TIE|
    CN112168257A|2020-10-30|2021-01-05|杭州中奥工业设计有限公司|Flexible skin stretching system|
    CN112168258A|2020-10-30|2021-01-05|杭州中奥工业设计有限公司|Large-wound flexible skin traction system|
    法律状态:
    2016-02-25| PLFP| Fee payment|Year of fee payment: 2 |
    2016-08-12| PLSC| Publication of the preliminary search report|Effective date: 20160812 |
    2017-02-24| PLFP| Fee payment|Year of fee payment: 3 |
    2018-02-26| PLFP| Fee payment|Year of fee payment: 4 |
    2019-02-20| PLFP| Fee payment|Year of fee payment: 5 |
    2020-02-25| PLFP| Fee payment|Year of fee payment: 6 |
    2021-02-25| PLFP| Fee payment|Year of fee payment: 7 |
    2022-02-01| PLFP| Fee payment|Year of fee payment: 8 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1550937A|FR3032344B1|2015-02-06|2015-02-06|SKIN EXPANSION SYSTEM|FR1550937A| FR3032344B1|2015-02-06|2015-02-06|SKIN EXPANSION SYSTEM|
    JP2017541382A| JP2018508271A|2015-02-06|2016-02-05|Skin stretching system|
    EP16704690.3A| EP3253299B1|2015-02-06|2016-02-05|Skin expansion system|
    ES16704690T| ES2822432T3|2015-02-06|2016-02-05|Skin expansion system|
    RU2017131110A| RU2718320C2|2015-02-06|2016-02-05|Skin stretching device|
    PCT/FR2016/050257| WO2016124872A1|2015-02-06|2016-02-05|Skin expansion system|
    MX2017009881A| MX2017009881A|2015-02-06|2016-02-05|Skin expansion system.|
    AU2016214148A| AU2016214148B2|2015-02-06|2016-02-05|Skin expansion system|
    US15/548,459| US10751042B2|2015-02-06|2016-02-05|Skin expansion system|
    BR112017016939-8A| BR112017016939A2|2015-02-06|2016-02-05|skin expansion system to reduce a tissue-surrounded wound|
    CN201680009119.2A| CN107427297B|2015-02-06|2016-02-05|Skin dilation system|
    IL253721A| IL253721D0|2015-02-06|2017-07-30|Skin expansion system|
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