US20230026081A1 - Wound dressing - Google Patents

Abstract

A method and apparatus are disclosed for dressing a wound. The apparatus comprises an absorbent layer for absorbing wound exudate, a liquid impermeable, gas permeable filter layer over the absorbent layer, a cover layer comprising at least one orifice and a first liquid and gas permeable transmission layer underlying the absorbent layer. The transmission layer is in fluid communication with the filter layer.

Description

• This application is a continuation of U.S. application Ser. No. 15/940,788, filed Mar. 29, 2018, which is a continuation of U.S. application Ser. No. 14/259,026, filed Apr. 22, 2014, now U.S. Pat. No. 9,956,121, which is a continuation of U.S. application Ser. No. 12/744,277, filed Sep. 20, 2010, now U.S. Pat. No. 8,764,732, which is the U.S. National Phase of PCT International Application No. PCT/GB2008/051090 filed on Nov. 20, 2008, designating the United States and published on May 28, 2009 as WO 2009/066106, which claims priority to Great Britain Patent Application No. 0722820.8, filed Nov. 21, 2007, and Great Britain Patent Application No. 0817020.1, filed Sep. 17, 2008. The disclosure of these prior applications are incorporated by reference in their entireties and should be considered a part of this specification.
• The present invention relates to a method and apparatus for dressing a wound and a method for manufacturing a wound dressing. In particular, but not exclusively, the present invention relates to a wound dressing useable during topical negative pressure (TNP) therapy in which the wound dressing itself acts as a waste canister to collect and store wound exudate removed from a wound site.
• There is much prior art available relating to the provision of apparatus arid methods of use thereof for the application of topical negative pressure (TNP) therapy to wounds together with other therapeutic processes intended to enhance the effects of the TNP therapy. Examples of such prior art include those listed and briefly described below.
• TNP therapy assists in the closure and healing of wounds by reducing tissue oedema; encouraging blood flow and granulation of tissue; removing excess exudates and may reduce bacterial load and thus, infection to the wound. Furthermore, TNP therapy permits less outside disturbance of the wound and promotes more rapid healing.
• In International patent application, WO 2004/037334, apparatus, a wound dressing and a method for aspirating, irrigating and cleansing wounds are described. In very general terms, the application describes the treatment of a wound by the application of TNP therapy for aspirating the wound together with the further provision of additional fluid for irrigating and/or cleansing the wound, which fluid, comprising both wound exudates and irrigation fluid, is then drawn off by the aspiration means and circulated through means for separating the beneficial materials therein from deleterious materials. The materials which are beneficial to wound healing are recirculated through the wound dressing and those materials deleterious to wound healing are discarded to a waste collection bag or vessel.
• In International patent application, WO 2005/04670, apparatus, a wound dressing and a method for cleansing a wound using aspiration, irrigation and cleansing wounds are described. Again, in very general terms, the invention described in this document utilizes similar apparatus to that in WO 2004/037334 with regard to the aspiration, irrigation and cleansing of the wound, however, it further includes the important additional step of providing heating means to control the temperature of that beneficial material being returned to the wound site/dressing so that it is at an optimum temperature, for example, to have the most efficacious therapeutic effect on the wound.
• In International patent application, WO 2005/105180, apparatus and a method for the aspiration, irrigation and/or cleansing of wounds are described. Again, in very general terms, this document describes similar apparatus to the two previously mentioned documents hereinabove but with the additional step of providing means for the supply and application of physiologically active agents to the wound site/dressing to promote wound healing.
• The content of the above-noted references is included herein by reference.
• However, the above described apparatus and methods are generally only applicable to a patient when hospitalised as the apparatus used is complex, needing people having specialist knowledge in how to operate and maintain the apparatus, and also relatively heavy and bulky, not being adapted for easy mobility outside of a hospital environment by a patient, for example.
• Some patients having relatively less severe wounds which do not require continuous hospitalisation, for example, but whom nevertheless would benefit from the prolonged application of TNP therapy, could be treated at home or at work subject to the availability of an easily portable and maintainable TNP therapy apparatus. To this end GB-A-2 307 180 describes a portable TNP therapy unit which may be carried by a patient and clipped to belt or harness. A negative pressure can thus be applied at a wound site.
• During TNP therapy a portable or non-portable therapy unit generates a negative pressure at a wound site. As fluid, including air as well as wound exudate material is removed from the wound site this must be collected in some manner remote from the wound site. With prior known therapy units ‘the collection and storage of wound exudate material is typically carried out by a waste canister connected to a pump unit of the therapy unit. The use of a canister, however, can result in the therapy unit apparatus itself being quite bulky and expensive to manufacture. Also replacing a canister or a bag in a canister in which wound exudate is collected can be a time consuming and relatively unhygienic process.
• Prior known therapy units also tend to include a pump which is used to generate the negative pressure. Such pumps can be costly to manufacture and are relatively heavy.
• WO 2007/030601, which is incorporated herein by reference discloses a self-contained wound dressing with a micro pump. The pump for drawing wound fluid into a vacuum zone is included in a wound dressing itself. Nevertheless wound exudate from the dressing can only be removed via a complex series of steps. The exudate removal process is also prone to contamination since once an absorbent layer is fully saturated with wound exudate an access door must be opened in the wound dressing so that the absorbent layer and micro pump can be removed. It will be appreciated that such exudate removal and pump removal can be time consuming and can lead to cross contamination between users. A further problem is that the wound dressing is prone to over expansion and rupture.
• It is an aim of the present invention to at least partly mitigate the above-mentioned problems.
• It is an aim of certain embodiments of the present invention to provide a method for providing negative pressure at a wound site to aid in wound closure and healing in which wound exudate drawn from a wound site during the therapy is collected and stored in a wound dressing.
• It is an aim of certain embodiments of the present invention to provide a wound dressing which is able to be placed over a wound site and which includes an integrated pump to generate negative pressure at that wound site. Also for certain embodiments the wound dressing can collect any wound exudate.
• According to a first aspect of the present invention there is provided apparatus for dressing a wound, comprising:
• • an absorbent layer for absorbing wound exudate;
  • a liquid impermeable, gas permeable filter layer over the absorbent layer; and a cover layer comprising at least one orifice;
  • wherein the absorbent layer is in fluid communication with the filter layer.
• According to a second aspect of the present invention there is provided a method of applying topical negative pressure (TNP) at a wound site, comprising the steps of:
• • pumping wound exudate and air from a wound site, a peripheral region around the wound site being sealed with a wound dressing;
  • collecting wound exudate, pumped from the wound site in an absorbent layer of the wound dressing; and
  • exhausting gas through at least one orifice in a cover layer of the wound dressing
  • and a filter layer in fluid communication with the absorbent layer.
• Certain embodiments of the present invention provide the advantage that a disposable wound dressing can be fixed over a wound site and can simultaneously be used to provide negative pressure at the wound site and collect and store wound exudate.
• Certain embodiments of the present invention provide the advantage that a separate therapy unit is not required to generate negative pressure at a wound site and collect and store any wound exudate. Rather a wound dressing can carry out both a pumping and wound exudate collecting process. The wound dressing may then be a one use item which can be disposed of subsequent to use. This reduces a risk of contamination.
• Certain embodiments of the present invention provide the advantage that a wound dressing can be used to collect wound exudate generated during a negative pressure therapy process. A pump remote from the wound dressing can be connected to the wound dressing and reused whilst the wound dressing itself is used to collect wound exudate and may then be disposed of after use.
• Embodiments of the present invention will now be described hereinafter, by way of example only, with reference to the accompanying drawings in which:
• FIG.1 illustrates a wound dressing;
• FIG.2 illustrates a top view of a wound dressing;
• FIG.3 illustrates a portion of the wound dressing;
• FIG.4 illustrates an exploded view of a wound dressing with a mounted pump; and
• FIG.5 illustrates a view of a horizontal section through a wound dressing.
• In the drawings like reference numerals refer to like parts.
• FIG.1 illustrates a cross section through a wound dressing100 according to an embodiment of the present invention. A plan view from above of the wound dressing100 is illustrated inFIG.2 with the line A-A indicating the location of the cross section shown inFIG.1. It will be understood thatFIG.1 illustrates a generalised schematic view of anapparatus100. It will be understood that embodiments of the present invention are generally applicable to use in topical negative pressure (TNP) systems. Briefly, negative pressure wound therapy assists in the closure and healing of many forms of “hard to heal” wounds by reducing tissue oedema; encouraging blood flow and granular tissue formation; removing excess exudate and reducing bacterial load (and thus infection risk). In addition, the therapy allows for less disturbance of a wound leading to more rapid healing.
• The wound dressing100 can be located over a wound site to be treated. The dressing100 forms a sealed cavity over the wound site. Optionally wound packer can be used within a wound cavity below the dressing. Aptly the packer material can be a gauze or reticulated PU foam material.
• It is envisaged that the negative pressure range for the apparatus embodying the present invention may be between about −50 mmHg and −200 mmHg (note that these pressures are relative to normal ambient atmospheric pressure thus, −200 mmHg would be about 560 mmHg in practical terms). Aptly the pressure range may be between about −75 mmHg and −150 mmHg. Alternatively a pressure range of up to −75 mmHg, up to −80 mmHg or over −80 mmHg can be used. Also aptly a pressure range of below −75 mmHg could be used. Alternatively a pressure range of over −100 mmHg could be used or over −150 mmHg.
• As illustrated inFIG.1 alower surface101 of the wound dressing100 is provided by an optionalwound contact layer102. Thewound contact layer102 can be a polyurethane layer or polyethylene layer or other flexible layer which is perforated, for example via a hot pin process or in some other way, or otherwise made permeable to liquid and gas. The wound contact layer has alower surface101 and anupper surface103. Theperforations104 are through holes in the wound contact layer which enables fluid to flow through the layer. The wound contact layer helps prevent tissue ingrowth into the other material of the wound dressing. The perforations are small enough to meet this requirement but still allow fluid through. The wound contact layer also helps hold the whole wound dressing together and acts as a carrier for an optional lower and upper adhesive layer (not shown). For example, a lower pressure sensitive adhesive may be provided on theunderside surface101 of the wound dressing whilst an upper pressure sensitive adhesive layer may be provided on theupper surface103 of the wound contact layer. The pressure sensitive adhesive which may be a silicone or acrylic based adhesive or other such adhesives may be formed on both sides or optionally on a selected one or none of the sides of the wound contact layer. When a lower pressure sensitive adhesive layer is utilised this helps adhere the wound dressing to the skin around a wound site.
• Anoptional layer105 of porous material such as a foam layer or the like is located above the wound contact layer. This porous layer allows transmission of fluid including liquid and gas away from a wound site into upper layers of the wound dressing, Thelayer105 also helps distribute pressure generated by a pump, mentioned in more detail below, so that a whole wound site sees an equalised negative pressure. Reticulated foam or a non-woven material which might be natural or synthetic can be used as the porous material of theporous layer105.
• Alayer110 of absorbent material is provided above thetransmission layer105 or where no lower transmission layer is used on the wound contact layer or where notransmission layer105 or woundcontact layer102 are used the absorbent layer lower surface forms the wound contact layer. The absorbent material which may be a foam or non-woven natural or synthetic material and which may optionally include or be super-absorbent material forms a reservoir for fluid, particularly liquid, removed from the wound site. The material of the absorbent layer also prevents liquid collected in the wound dressing from flowing in a sloshing manner. Theabsorbent layer130 also helps distribute fluid throughout the layer via a wicking action so that fluid is drawn from the wound site and stored throughout the absorbent layer. This prevents agglomeration in areas of the absorbent layer. Since in use the absorbent layer experiences negative pressures the material of the absorbent layer is chosen to absorb liquid under such circumstances. Superabsorber material is an example of such a material. Non superabsorber material can be utilised however even where significant negative pressures are envisaged. The material of the absorbent layer does not need to be hydrophilic. Aptly a material with connective open voids can be used. Aptly a material is used that can resist the compressive force of the negative pressure e.g. precompressed FT11M foam manufactured by Foam Techniques. Aptly the absorbent material is selected so that fluid is prevented from draining back out when the dressing is removed. It is to be noted that if a superabsorber is used such a material is able to expand against the compressive force of the negative pressure.
• A furtheroptional layer112 of porous material such as a foam layer or the like is located above theabsorbent layer110. This porous layer allows transmission of fluid including liquid and gas away from a wound site into upper layers of the wound dressing. Thelayer112 also helps distribute pressure generated by a pump, mentioned in more detail below, so that a whole wound site sees an equalised negative pressure. Reticulated foam or a non-woven material which might be natural or synthetic can be used as a porous material of theporous layer112. The material may the same or different from the previously mentionedlayer105 of porous material.
• Afilter layer130 is provided over theabsorbent layer110. The filter layer permits moisture vapour and gas but no liquid through. A suitable material for the filter material of thefilter layer130 is 0.2 micron Gore™ expanded PTFE from the MMT range. Larger pore sizes can also be used but these may require a secondary filter layer to ensure full bioburden containment. As wound fluid contains lipids it is preferable, though not essential, to use an oleophobic filter membrane for example 1.0 micron MMT-332 prior to 0.2 micron MMT-323. This prevents the lipids from blocking the hydrophobic filter.
• It will be understood that other types of material could be used for the filter layer. More generally a microporous membrane can be used which is a thin, flat sheet of polymeric material, this contains billions of microscopic pores. Depending upon the membrane chosen these pores can range in size from 0.01 to more than 10 micrometers. Microporous membranes are available in both hydrophilic (water filtering) and hydrophobic (water repellent) forms. Aptly the wound dressing100 according to certain embodiments of the present invention uses microporous hydrophobic membranes (MHMs). Numerous polymers may be employed to form MHMs. For example, PTFE, polypropylene, PVDF and acrylic copolymer. All of these optional polymers can be treated in order to obtain specific surface characteristics that can be both hydrophobic and oleo phobic. As such these will repel liquids with low surface tensions such as multi-vitamin infusions, lipids, surfactants, oils and organic solvents.
• MHMs block liquids whilst allowing air to flow through the membranes.
• They are also highly efficient air filters eliminating potentially infectious aerosols and particles. A single piece of MHM is well known as an option to replace mechanical valves or vents. Incorporation of MHMs can thus reduce product assembly costs improving profits and costs/benefit ratio to a patient.
• Thefilter layer130 thus enables gas to be exhausted upwards through the wound dressing. Liquid, particulates and pathogens however are contained in the dressing.
• A gasimpermeable sealing layer140 extends across the width of the wound dressing. The sealing layer which may, for example, be a polyurethane film having a pressure sensitive adhesive on both sides is impermeable to gas and this layer thus operates to seal a wound cavity over which the wound dressing is placed. In this way an effective chamber is made beneath the sealing layer and between the sealing layer and a wound site where a negative pressure can be established. Thesealing layer140 is sealed to thefilter layer130. For example via adhesive or welding techniques. Gas leaving the dressing thus passes through the filter layer and sealing layer.
• Aptly the material of the sealing layer can have a high moisture vapour permeability for example Elastollan (Trade name) SP9109 manufactured by BASF. A dotted pattern spread acrylic adhesive can optionally be used to help improve moisture vapour permeability. An advantage of using a high moisture vapour permeability material as thesealing layer160 is that the fluid handling capacity of the dressing may be increased significantly by the action of moisture transpiring through the film and dispersing into the atmosphere. Advantageously, transpiration rates can be easily achieved of the order of 3000 grams/centimetre square/24 hours as a result of the high humidity achieved in the dressing and intimate contact of material achieved during use of the apparatus at a negative pressure of up to 250 mmHg below atmospheric pressure.
• As illustrated inFIG.1 a grid array of throughholes141 are provided in the sealing layer. These enable fluid including gas and liquid to pass through thesealing layer140. Alternatively where a separate cover layer and sealing layer are used the sealing layer may extend around only a circumferential area of the underlying layers where it seals between an outer layer (mentioned below in more detail) and the filter layer. As a result any gas leaving the wound site must leave via the filter layer. Liquid is retained in layers below the filter layer.
• Alayer150 of porous material such as a foam layer or the like is located above thesealing layer140. This porous layer allows transmission of fluid including liquid and gas away from a wound site. Thelayer150 also helps distribute pressure generated by a pump, mentioned in more detail below, so that a whole wound site sees an equalised negative pressure. Reticulated foam or a non-woven material which might be natural or synthetic can be used as the porous material of thelayer150. The material may be the same or different from the material of theunderlying layers105,112.
• Acover layer160 covers the absorbent layer of the wound dressing100. The cover layer which, for example, may be a polyurethane film acts as a bacterial barrier and helps hold in liquid to stop fouling. The cover layer also provides integrity for the dressing and is impermeable to moisture vapour and gas. The cover layer helps hold the wound dressing together thus providing structural integrity. Anupper surface171 also presents a bacteria free non soiling surface. As an alternative the material of the cover layer can have a high moisture vapour permeability, for example Elastollan (Trade name) SP9109 manufactured by BASF. A dotted pattern spread acrylic adhesive can optionally be used to help improve moisture vapour permeability. An advantage of using a high moisture vapour permeability material as thecover layer160 is that the fluid handling capacity of the dressing may be increased significantly by the action of moisture transpiring through the film and dispersing into the atmosphere. Advantageously, transpiration rates can be easily achieved of the order of 3000 grams/centimetre square/24 hours as a result of the high humidity achieved in the dressing and intimate contact of material achieved during use of the apparatus at a negative pressure of up to 250 mmHg below atmospheric pressure.
• Asingle aperture165 farmed as a single hole or close arrangement of holes is formed in a central region of the upper cover layer. Theaperture165 is in fluid communication with an inlet to apump170 which is mounted on theupper surface171 of the cover layer. In operation thepump170 pumps fluid through the wound dressing from a wound site below thewound contact layer102 upwards through thefirst transmission layer105,absorbent layer110,further transmission layer112,filter layer130, sealinglayer140, andfurther transmission layer150.
• Turning toFIG.2 which illustrates a wound dressing100 in accordance with an embodiment of the present invention one can see theupper surface171 of thecover layer170 which extends radially outwardly away from a centre of the dressing into aborder region200 surrounding a central raisedregion201 overlying the foam layers andlayer110 of absorber.FIG.2 also helps illustrate the location of thepump170 on the cover layer. As indicated inFIG.2 the general shape of the wound dressing is a square having equal side lengths with roundedcorner regions202. It will be appreciated that wound dressings according to other embodiments of the present invention can be shaped differently such as rectangular, circular or elliptical dressings.
• FIG.3 illustrates an expanded view of theborder region200 of the wound dressing100 illustrated inFIGS.1,2 and3. As seen, thecover layer160 extends over thefoam transmission layer150 into an edge region. Here the cover layer is secured to thesealing layer140 and thewound contact layer102.FIG.3 also helps illustrate how theperforations104 in thewound contact layer102 extend around thefoam layer105 andabsorbent layer110. It will be noted that aspace301 is indicated inFIG.3 underneath thesealing layer140 and above thewound contact layer102 and ends of the transmission layers105,112 andabsorbent layer110. Thespace301 is shown for illustrative reasons only and in practice the transmission layers and absorbent layers will be bevelled somewhat so as to reduce the space. Afurther space302 is likewise illustrated inFIG.3 above the sealing layer and below the inner surface of the cover layer. Again this is included for illustration only and in practice these spaces will be avoided due to a nipping process in the method of manufacture. It will also be appreciated by those skilled in the art that when put in use the wound dressing will be subject to a negative pressure within a region defined by the inner surface of the cover layer. Such a negative pressure will tend to collapse any remaining spaces.
• It will be understood that according to embodiments of the present invention the wound contact layer is optional. This layer is, if used, porous to water and faces an underlying wound site. A lowerporous layer105 such as a reticulated PU foam layer is used to distribute gas and fluid removal such that all areas of a wound are subjected to equal pressure. The sealing layer together with the filter layer forms a substantially liquid tight seal over the wound. Thus as thepump170 pumps a negative pressure is generated below the sealing layer. This negative pressure is thus experienced at the target wound site. Fluid including air and wound exudate is drawn through the wound contact layer andreticulated foam layer105. The wound exudate drawn through the lower layers of the wound dressing is dissipated and absorbed into the absorbent layer where it is collected and stored. Air and moisture vapour is drawn upwards through the wound dressing through theintermediate transmission layer112 and through the filter layer and sealing layer. The filter layer and sealing layer are secured together so as to prevent upward movement through the wound dressing of anything other than moisture vapour and air. This air and moisture vapour is drawn upwards by thepump170 into thefluid inlet300. The pump exhausts the fluid as air and moisture vapour through a fluid exit (not shown).
• It is to be noted that theupper transmission layer150 andcover layer160 are optional. Their use is helpful during multi orientation use when portions of the filter layer might otherwise become occluded. When aseparate cover layer160 is not utilised the sealing layer also performs the extra function of covering the dressing and will thus additionally act as a cover layer.
• It will be appreciated by those skilled in the art that rather than have a cover layer overlying the filter layer the cover layer may itself be overlain by a filter layer. The cover layer may thus be the outermost layer of the wound dressing or the filter layer may be the outermost layer of the wound dressing. Further outer layers (not shown) may optionally be used so long as they are gas and water vapour permeable.
• As still further options the dressing can contain anti-microbial e.g. nanocrystalline silver agents on the wound contact layer and/or silver sulphur diazine in the absorbent layer. These may be used separately or together. These respectively kill micro-organisms in the wound and micro-organisms in the absorption matrix. As a still further option other active components, for example, pain suppressants, such as ibuprofen, may be included. Also agents which enhance cell activity, such as growth factors or that inhibit enzymes, such as matrix metalloproteinase inhibitors, such as tissue inhibitors of metalloproteinase (TIMPS) or zinc chelators could be utilised. As a still further option odour trapping elements such as activated carbon, cyclodextrine, zealite or the like may be included in the absorbent layer or as a still further layer above the filter layer.
• FIG.4 illustrates an exploded view of the wound dressing illustrated inFIGS.1,2 and3. As illustrated inFIG.4 the lower-most layer of the wound dressing is a perforatedwound contact layer102. It will be appreciated that prior to use a still lower protective layer may be secured to thelower surface101 of the wound contact layer. The protective paper (not shown) is removed immediately prior to application of the wound dressing over a wound site. During manufacture acentral region400 of thewound contact layer102 is made slightly concave so as to provide a dishedupper surface103 for the wound contact layer.
• Atransmission layer105 is duly located in the dishedcentral region400 of the wound contact layer. The foam layer includes a substantiallyrectangular base region401 together with an array ofupstanding columns402. As illustrated inFIG.4 an array of 8×8columns402 may be used. It will be appreciated that other numbers of columns may be utilised. Thecolumns402 have a substantially circular cross section although it will be appreciated that column elements having different cross section shapes could be used. Thecolumn elements402 andbase section402 are aptly integrally formed although these could be separately formed with the column elements being secured to the base section in some appropriate way such as via adhesive techniques.
• Theabsorbent layer110 is located above thetransmission layer105. Theabsorbent layer110 is a layer of absorbent material and includes throughholes403 formed in a substantiallyrectangular block404 of absorbent material. The through holes are set out in an 8×8 array to coincide with theupstanding columns402 in the underlying transmission layer. It will be appreciated that the number and pattern of throughbores403 is selected to tally with the shape and number and arrangement of the columns.
• Theintermediate transmission layer112 is a substantiallyrectangular base section405 of porous material such as reticulated foam with an array ofcolumns406 extending downwardly from a lower surface of thebase405. Thecolumns406 coincide with locations of the throughbores403 in the absorbent layer. It will be appreciated that thecolumns406 of theintermediate transmission layer112 may be integrally formed with thebase portion405 of the transmission layer or may be secured in some fashion thereto. The height of thecolumns402,406 of the lower and intermediate transmission layers respectively is such that an upper contact surface of thecolumns402 of the lower transmission layer and a lower contact surface of thecolumns406 of the intermediate transmission layer contact when the wound dressing is put together. These thus provide fluid transmission paths through the absorber layer so that fluid, including air and wound exudate and liquid, is drawn from the lower region upwardly through the absorbent layer when thepump170 is operating.
• A rectangular layer offilter material130 is located above the upper surface of thebase section405 of the intermediate transmission layer. The filter layer blocks movement therethrough of liquid. The filter layer is aptly a 0.2 micron Gore™ expanded PTFE sheet.
• Asealing layer140 is located over thefilter layer130. The sealing layer has a border region and a generally concave central region407. The underside of thesealing layer140 is thus recessed. An array of apertures set out in a 5×5 grid array is made through thesealing layer140. The sealing layer away from the apertures is gas and fluid tight. If a material having a high moisture vapour permeability is optionally used then the sealing layer will of course be permeable to moisture vapour. Fluid, including liquid and gas, can of course penetrate through the perforations. Thefilter layer130 which is secured on the underside of the sealing layer, however, prevents liquid penetration through the apertures and to an extent prevents penetration of air through the apertures. Moisture vapour can penetrate through the apertures.
• An upper transmission layer formed as a sheet of reticulated foam is located over the central region of the upper surface of thesealing layer140. The upper transmission layer acts as a manifold and diffuser to help spread the negative pressure generated by thepump170.
• Acover layer160 is located over the sealing layer andupper transmission layer150. The cover layer has aborder region200 and a central raisedregion201. The underside of the cover layer thus presents a central dished region to receive the upper transmission layer, raised central region of the sealing layer and the filter layer, intermediate transmission layer, absorbent layer and lower transmission layer. Acentral aperture165 is made in the centre of the upper surface of the cover layer. Thecentral aperture165 is located to coincide with afluid inlet300 of thepump170. Thus in use when apump170 is in use a negative pressure is generated under thecover160. This negative pressure is distributed throughout the wound dressing and at a target wound site located under the wound contact layer. As the negative pressure is established and maintained wound exudate and air is drawn upwards away from the wound site through the wound dressing. Liquid and air is drawn upwards through the wound contact layer into the base of thelower transmission layer105 and upwards through the connecting columns in the lower transmission layer and intermediate transmission layer. It will be appreciated of course that columns having a height sufficient to bridge the whole of the absorbent layer could be provided on either the upper surface of thelower transmission layer105 or the lower surface of theintermediate transmission layer112. Alternatively theapertures403 in the absorbent layer may be filled with transmissive material such as foam cylinders when the wound dressing is manufactured. Any wound exudate being drawn upward through the wound dressing is dissipated outwardly from the absorbent material in the aperture regions of the absorbent layer. The liquid is thus collected and stored in the absorbent layer. Air and moisture vapour carries on upwards through thefilter layer130 and sealinglayer140 and is evacuated by thepump170.
• FIG.5 illustrates a horizontal cross section through the wound dressing illustrating anupper surface404 of the absorbentlayer including apertures403. Each of theapertures403 is filled with absorbent material such ascolumns402 from the lower intermediate layer.
• It will be appreciated that according to certain embodiments of the present invention fluid communication paths through which fluid can be transmitted from the lower transmission layer to the intermediate transmission layer can be made by pinching together peripheral regions of the lower and intermediate regions. Fluid transmission would thus proceed around the peripheral edges of the wound dressing. Such fluid paths may replace the fluid paths formed by the columns passing through apertures in the absorbent layer or may alternatively take the place of such passageways. This would maximise the quantity of absorber material in thelayer110 in the resultant wound dressing.
• It is to be noted that according to certain other embodiments of the present invention a remote pump may be mounted to a border region of the wound dressing rather than onto the top surface. In such case tubes may be connected directly to the pump. Subsequent to a single use the wound dressing and pump may thus be discarded. As an option the tubes may be provided with a click fit connector or other easy fit connector which can be connected to corresponding mating connectors joined via corresponding tubes to a remote pump. In this way a remote pump may be reused whilst the wound dressing itself including connecting tubes and connectors is disposable after a single use.
• It will be appreciated that alternatively the tubes could be provided by a single dual lumen tube. As a still further alternative the tubes may be provided by a single continuous looped tube, the tube then passing through pinch rollers for a peristaltic pump.
• It will be understood that for embodiments of the present invention which include a pump mounted on the cover layer or on a peripheral border area of the dressing an integral power source and control circuitry can be included. Alternatively the power source can be external to the pump and remotely mounted. A remote power source and/or control circuitry improves the disposability of the dressing and permits battery recharge if spare batteries are used.
• It is to be noted that in use the dressing may be used “up-side down”, at an angle or vertical. References to upper and lower are thus used for explanation purposes only.
• Where a separate cover layer and sealing layer are utilised such layers may be manufactured from the same or different materials.
• Throughout the description and claims of this specification, the words “comprise” and “contain” and variations of the words, for example “comprising” and “comprises”, means “including but not limited to”, and is not intended to (and does not) exclude other moieties, additives, components, integers or steps.
• Throughout the description and claims of this specification, the singular encompasses the plural unless the context otherwise requires. In particular, where the indefinite article is used, the specification is to be understood as contemplating plurality as well as singularity, unless the context requires otherwise.
• Features, integers, characteristics, compounds, chemical moieties or groups described in conjunction with a particular aspect, embodiment or example of the invention are to be understood to be applicable to any other aspect, embodiment or example described herein unless incompatible therewith.

Claims (21)

1.-37. (canceled)

38. A method of treating a wound, the method comprising:

applying a dressing to a wound, the dressing comprising a cover layer, a manifold, a wound contact layer comprising a perforated polymer layer, the wound contact layer comprising a first wound facing surface and an opposite second surface, wherein the wound contact layer comprises a silicone material on the first surface of the wound contact layer;

sealing the perforated wound contact layer to the wound with the silicone material and covering at least a portion of skin around the wound;

fluidly coupling the dressing to a negative-pressure source; and

applying negative pressure from the negative pressure source to the dressing.

39. The method ofclaim 38, further comprising a wound packer positioned in a wound cavity below the dressing.

40. The method ofclaim 39, wherein the wound packer comprises a gauze or reticulated foam material.

41. The method ofclaim 38, wherein the wound contact layer comprises a polyurethane layer or polyethylene layer.

42. An apparatus for treatment of a wound by applying negative pressure to the wound, the apparatus comprising:

a cover layer comprising a first wound facing surface and a second surface opposite the first surface, the first surface comprising an adhesive;

a perforated wound contact layer configured to be positioned over the wound, the perforated wound contact layer comprising a first wound facing surface and a second surface opposite the first surface, the first surface of the perforated wound contact layer comprises a silicone material; and

wherein a portion of the first surface of the cover layer is adhered to the second surface of the wound contact layer; and

wherein the adhesive of the cover layer and the silicone on the perforated wound contact layer are configured to contact skin surrounding the wound.

43. The apparatus ofclaim 42, wherein the adhesive comprises an acrylic adhesive.

44. The apparatus ofclaim 42, further comprising a transmission layer configured to allow transmission of fluid away from a wound site and distribute negative pressure over the wound site being treated, wherein the transmission layer is positioned between the cover layer and the perforated wound contact layer.

45. The apparatus ofclaim 44, further comprising a porous layer positioned beneath the cover layer and above the transmission layer.

46. The apparatus ofclaim 42, further comprising an absorbent layer configured to absorb fluid removed from a wound site, wherein the absorbent layer is positioned between the cover layer and the perforated wound contact layer.

47. The apparatus ofclaim 46, further comprising a transmission layer configured to allow transmission of fluid away from the wound site and distribute negative pressure over the wound site being treated, wherein the transmission layer is positioned beneath the absorbent layer and above the perforated wound contact layer.

48. The apparatus ofclaim 42, wherein the cover layer is configured to create a seal between the cover layer and the wound.

49. The apparatus ofclaim 42, further comprising a negative pressure source configured to apply negative pressure to the wound.

50. A method of treating a wound, the method comprising:

applying a wound dressing to the wound and skin surrounding the wound, the wound dressing comprising:

a cover layer comprising a first wound facing surface and a second surface opposite the first surface, the first surface comprising an adhesive;

a perforated wound contact layer comprising a first wound facing surface and a second surface opposite the first surface, the first surface of the perforated wound contact layer comprises a silicone material; and

wherein a portion of the first surface of the cover layer is adhered to the second surface of the wound contact layer; and

wherein the adhesive of the cover layer and the silicone on the perforated wound contact layer contact the skin surrounding the wound;

coupling the wound dressing to a negative pressure source; and

delivery negative pressure to the wound dressing from the negative pressure source.

51. The method ofclaim 50, wherein the adhesive comprises an acrylic adhesive.

52. The method ofclaim 50, further comprising a transmission layer configured to allow transmission of fluid away from a wound site and distribute negative pressure over the wound site being treated, wherein the transmission layer is positioned between the cover layer and the perforated wound contact layer.

53. The method ofclaim 52, further comprising a porous layer positioned beneath the cover layer and above the transmission layer.

54. The method ofclaim 50, further comprising an absorbent layer configured to absorb fluid removed from a wound site, wherein the absorbent layer is positioned between the cover layer and the perforated wound contact layer.

55. The method ofclaim 54, further comprising a transmission layer configured to allow transmission of fluid away from the wound site and distribute negative pressure over the wound site being treated, wherein the transmission layer is positioned beneath the absorbent layer and above the perforated wound contact layer.

56. The method ofclaim 50, wherein the cover layer is configured to create a seal between the cover layer and the wound.

57. The method ofclaim 50, further comprising a negative pressure source configured to apply negative pressure to the wound.

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