DE202017002032U1 - fistula drainage - Google Patents

Abstract

Fistula drainage for the discharge of fistula fluid (6) from wounds (20) and fistulas (19), characterized in that a stable, transparent, round plate (2) with an insertion (13) or a connecting piece (14), cohesively with a film sleeve (8) connected, fistula fluid (6) through the drainage diameter (9) dissipates.

Description

The invention relates to a drainage device for supplying enteroatmosphärisch fistulas in the open abdomen. When a fistula develops in the treatment of an open abdomen, one can assume a difficult situation or complication. This results from the fact that in comparison with enterocutaneous fistulas inevitably difficulties in the supply and with simultaneous protection of the surrounding wound arise. An operative closure of the fistula or a resection of the fistula-bearing Daumsegmentes are often not feasible or advisable or not associated with a surgical or indication success.

There is a realistic possibility of supplying the fistula, separate from the other wound area, ie in the treatment, a separation of the fistula from a wound area, which is treated differently. The use of the separated fistula supply, combined with a vacuum therapy for the remaining wound area, produces useful results in practice. The present invention is intended to provide a safe placement of the drain as well as a secure separation of the fistula from the vacuum system. This should be done undisturbed granulation of the wound surface in a controlled supply or derivative of the fistula content.

It can, as a further background, a variety of fistulas occur in humans. These fistulas may occur for a variety of reasons, such as, but not limited to, congenital defect due to a result of inflammatory bowel disease such as Crohn's disease, radiation, trauma such as childbirth, or due to a side effect a surgical procedure. Also, there may be several different types of fistulas, for example, urethrovaginal fistulas, vesicovaginal fistulas, tracheoesophageal fistulas, gastro-cutaneous fistulas, and any number of anorectal fistulas, such as rectovaginal fistulas, rectovesical fistulas, rectourethral fistulas, or reoperative fistulas (see DE 11 2009 001 300 T5 ).

Anorectal fistulas may be due to an infection in the anal glands located around the distal anal canal, which forms the anatomical landmark called the dentate lineage. One finds about 20 to 40 such glands in humans. An infection in an anal gland can lead to an abscess. This abscess may pass through soft tissue (eg, through or around the sphincters) into the perianal skin, where it drains off either spontaneously or surgically. The resulting empty space through the soft tissue is called a fistula. The internal or internal opening of the fistula, which is usually at or near the dentate line, is referred to as the primary opening. Any external or external openings, usually located in the perianal skin, are referred to as secondary openings.

The path that these fistulas take and their complexity can vary. A fistula may take a "straight" path from the primary to the secondary opening, known as a simple fistula. Alternatively, the fistula may consist of several tracts branching from the primary opening and having a plurality of secondary openings. This is known as a complex fistula.

The anatomical path taken by such fistulas is classified according to their relationship to the anal sphincters. The anal sphincter consists of two concentric muscle bands, the internal or internal sphincter and the external or external sphincter. Fistulas that run between the two concentric anal sphincters are referred to as inter-fibril fistulas. Those that run between the internal and external sphincters are referred to as transsphincteric fistulas, and those that pass over both sphincters are referred to as suprasphincteric fistulas. Fistulas due to Crohn's disease usually "ignore" these anatomical levels and are referred to as "extra-anatomical" fistulas.

Treatment options for gastrointestinal fistula vary. Depending on the clinical situation, patients may need an intravenous diet and a period of time without food to give the fistula time to self-close. In fact, non-surgical therapy may allow spontaneous closure of the fistula, although it is estimated that this may be expected in less than 30% of cases. Different time periods are recommended to allow spontaneous closure of fistulas, ranging from 30 days to 6 to 8 weeks. During this preoperative preparation, external control of fistula drainage prevents rupture of the skin and provides lines for fluid and electrolyte exchange. In some cases, surgery is needed to remove the bowel section that is affected by a non-healing fistula.

Utility Model 20 2011 101 620.3 describes the gluing of a sealing insert in the case of pre-punched holes in wound foam.

The GB 20 2012 008 303.1 describes the use of a flexible sealing insert with a film wrapping, but when compressing the Wound foam closes the drain opening and is not vacuum tight.

In GB 20 2012 009 086.0, a hollow body inserted in a wound foam is compressed with a flow diameter by means of wound film over the fistula.

The GB 20 2014 009 520.5 includes a labyrinth drain through which the fistula fluid can drain.

In GB 20 2014 009 521.3, a sliding sleeve with a ball seal for the discharge hose is described.

There remains a need for improved and / or alternative devices and methods for treating fistulas, including rectovaginal fistulas. The present invention addresses such needs.

The invention enables the drainage of the fistula fluid while maintaining the vacuum wound treatment of a wound. In this case, the exact placement of the sequence is achieved with a film sleeve as a sealed foam, called drainage ring, with a flow diameter for the fistula.

The invention includes the focal points that the drainage ring consists of a soft foam, which is sealed by means of film against air ingress in the inner lumen and also takes on the compression height of the wound foam when compressing the wound foam by means of vacuum. A stable, above, transparent, materially connected to the drainage ring disc gives the necessary placement resistance for the wound film for wound covering.

The peculiarity of the invention is that a round, transparent plate with a plug-in opening or a connecting piece for the assembly of a drain hose over the above annular surface of the film sleeve is materially connected.

The invention is explained in more detail below with reference to schematic sketches.

Show it:

1 : the invention with mounted plate

2 : the plate of the invention

3 : the application of the invention.

LIST OF REFERENCE NUMBERS

1

drainage ring

2

plate

3

lens

4

drain hose

5

adhesive layer

6

Fistelflüssigkeit

7

attachment

8th

foil sleeve

9

Outflow diameter

10

Diameter drainage ring

11

Height drainage ring

12

adhesive film

13

insertion

14

connecting pieces

15

anfasser

16

recess

17

wound film

18

wound fill

19

fistula

20

wound

21

protector

22

clamping hook

The invention is in the 1 documented. The by means of film sleeve ( 8th ) jacketed drainage ring ( 1 ), consisting of flexible foam, is top through an adhesive layer ( 5 ) with the plate ( 2 ) connected. In the plate ( 2 ) was a connecting piece ( 14 ), which is connected to the drain hose ( 4 ) is mounted. Due to the transparency of the plate ( 2 ) and the lens ( 3 ) can be used when placing the drainage ring ( 1 ) over the fistula ( 19 ) the optical control can be improved. The drainage ring ( 1 ) is variable in drainage ring diameter ( 10 ) and drainage height ( 11 ) to manufacture. The fistula fluid ( 6 ) runs through the drainage diameter ( 9 ), wherein, inter alia, the film sleeve ( 8th ) by a fastening ( 7 ) on the foam of the drainage ring ( 1 ) the required drainage diameter ( 9 ) when compressed by vacuum.

The 2 shows the application of a plate ( 2 ) after placement of the drainage ring ( 1 ) in the recess ( 16 ) of the wound filling ( 18 ). After removal of the protective film ( 21 ) from the adhesive film ( 12 ) by means of handles ( 15 ) the plate ( 2 ) glued centrally on the above film sleeve surface. The right drain hose ( 4 ) is inserted into the insertion opening ( 13 ) of the plate ( 2 ). The clamping hooks attached there ( 22 ) lock the drain hose ( 4 ) and prevent accidental release of the drain hose ( 4 ) from the insertion opening ( 13 ).

The application of fistula drainage is in the 3 documented. The drainage ring ( 1 ) with mounted plate ( 2 ) is inserted into the recess ( 16 ) of the wound filling ( 18 ) centric over the fistula ( 19 ) in the wound ( 20 ). Into the wound film ( 17 ) to the Cover of the wound ( 20 ), after sticking a hole over the insertion ( 13 ) or the connecting piece ( 14 ). Then the drain hose ( 4 ) with the connecting piece ( 14 ) or with the insertion opening ( 13 ) connected. The fistula fluid ( 6 ) runs from the fistula ( 19 ) by the drainage diameter ( 9 ), the insertion opening ( 13 ) or the connecting piece ( 14 ), through the drain hose ( 4 ).

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• DE 112009001300 T5 [0003]

Claims (13)

Fistula drainage for the discharge of fistula fluid ( 6 ) from wounds ( 20 ) and fistulas ( 19 ), characterized in that a stable, transparent, round plate ( 2 ) with an insertion opening ( 13 ) or a connecting piece ( 14 ), cohesively with a film sleeve ( 8th ), fistula fluid ( 6 ) by the drainage diameter ( 9 ). Fistula drainage according to claim 1, characterized in that the insertion opening ( 13 ) with clamping hooks ( 22 ) is provided. Fistula drainage according to claim 1, characterized in that the plate ( 2 ) a lens ( 3 ) owns. Fistula drainage according to claim 1, characterized in that the drainage ring ( 1 ) in the discharge diameter ( 9 ) with a film sleeve ( 8th ) is sealed. Fistula drainage according to claim 1, characterized in that the drainage ring ( 1 ) and the film sleeve ( 8th ) by means of adhesive layer ( 5 ) with the plate ( 2 ) are connected. Fistula drainage according to claim 1, characterized in that the plate ( 2 ) is a round disc. Fistula drainage according to claim 1, characterized in that the plate ( 2 ) with a connecting piece ( 14 ) is trained. Fistula drainage according to claim 1, characterized in that the plate ( 2 ) with a through a protective film ( 21 ) protected adhesive film ( 12 ) is equipped. Fistula drainage according to claim 1, characterized in that the film sleeve ( 8th ) in the discharge diameter ( 9 ) by a fastening ( 7 ) is locked. Fistula drainage according to claim 1, characterized in that the film sleeve ( 8th ) consists of PVC or PU material. Fistula drainage according to claim 1, characterized in that a drain hose ( 4 ) with the connecting piece ( 14 ) is connected. Fistula drainage according to claim 1, characterized in that a drain hose ( 4 ) in the insertion opening ( 13 ) is placed. Fistula drainage according to claim 1, characterized in that the lens ( 3 ) an optical control of the fistula ( 19 ).

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