Tissue approximation device

Abstract

A tissue approximation device comprising two elongate arms, an attachment means to secure the elongate arms to each other, adhesive pads on at least a portion of the elongate arms to anchor the tissue approximation device to the skin, and a locking means to lock the elongate arms in place relative to each other.

We claim: 
     
         1 . A tissue approximation device comprising two elongate arms, an attachment means to secure the elongate arms to each other at one or more locations, adhesive pads movably connected on the ends of the elongate arms to anchor the tissue approximation device to the skin, and a locking means to lock the elongate arms in place relative to each other, wherein (i) the adhesive pads are spaced apart from the one or more locations of the attachment means in the direction of the elongate arms, and (ii) the tissue approximation device has an open and a closed position, and when in the closed position, the adhesive pads are parallel and non-contiguous to each other, where the adhesive pad has a first adhering surface and a second surface rotatably coupled to the distal end of each of the elongate arms by a ball and socket connector, wherein the second surface has one of a socket and a ball that communicates with the other one of a ball and a socket on the distal end of each of the elongate arms, and the adhesive pad is rotatable around the ball about at least two axes, wherein the elongate arms form parallel forceps, the attachment means is a pair of slidable bosses, and the locking means is a ratchet mechanism on the forceps. 
     
     
         2 . The tissue approximation device of  claim 1 , where the distance between the elongate arms is adjustable by means of a ratchet mechanism. 
     
     
         3 . A tissue approximation device comprising two elongate arms, an attachment means to secure the elongate arms to each other at one or more locations, adhesive pads movably connected on the ends of the elongate arms to anchor the tissue approximation device to the skin, and a locking means to lock the elongate arms in place relative to each other, wherein (i) the adhesive pads are spaced apart from the one or more locations of the attachment means in the direction of the elongate arms, and (ii) the tissue approximation device has an open and a closed position, and when in the closed position, the adhesive pads are parallel and non-contiguous to each other, where the adhesive pad has a first adhering surface having a center line and a connector formed of one of a male protruding mechanism and a female receiving mechanism, wherein the connector is formed on an edge of the adhesive pad offset from the center line and slidingly engages the other of a male protruding mechanism and a female receiving mechanism disposed on the distal end of each of the elongate arms, wherein each adhesive pad is rotatable about the distal end of the elongate arm to which it is connected. 
     
     
         4 . The tissue approximation device of  claim 3 , where the elongate arms form a pair of forceps, the attachment means is a yoke on the forceps, and the locking means is a ratchet mechanism on the forceps. 
     
     
         5 . The tissue approximation device of  claim 4 , where the distance between the elongate arms is adjustable by means of the ratchet mechanism. 
     
     
         6 . The tissue approximation device of  claim 3 , wherein the connector of the adhesive pad is a male protruding mechanism formed as a rod and the distal end of the elongate arm is a female receiving mechanism formed as a sleeve. 
     
     
         7 . The tissue approximation device of  claim 3 , wherein the connector of the adhesive pad is a female receiving mechanism formed as a sleeve and the distal end of the elongate arm is a male protruding mechanism formed as a rod. 
     
     
         8 . A tissue approximation device for application to a skin surface adjacent to a wound, comprising:
 a pair of arms, each arm having a longitudinal axis and opposed ends, wherein one end includes a handle and the other end includes a tong with a connector;   an attachment mechanism coupled to each arm that movably couples the arms to each other so that a distance between each tong is selectively variable;   an adhesive pad removably coupled to the connector of each tong, wherein each adhesive pad has an adhesive surface that extends in a plane generally parallel to the longitudinal axis of the respective tong, the adhesive surface having a high shear resistance for holding the skin surface and a low peel resistance for removal from the skin surface, and wherein the connectors support the adhesive pads to be positionable in a common plane on opposed sides of the wound and conform to the skin surface adjacent to the wound; and   a locking mechanism coupled to each arm to selectively lock the pair of arms in a fixed position relative to each other, wherein the connector is a pivotal connector that connects one edge of the adhesive pad to the tong to pivot about the longitudinal axis of the respective arm wherein the pivotal connector is one of a rod and a sleeve and the adhesive pad includes the other of the rod and the sleeve, wherein the rod and the sleeve are slidably coupled together in a press fit manner.   
     
     
         9 . The tissue approximation device of  claim 8 , wherein the arms are connected in a scissors configuration. 
     
     
         10 . The tissue approximation device of  claim 8 , wherein the adhesive pad includes serrations that provide flexibility to the adhesive surface. 
     
     
         11 . The tissue approximation device of  claim 8 , wherein the locking mechanism includes a ratchet. 
     
     
         12 . The tissue approximation device of  claim 8 , wherein the arms are made of a resilient material. 
     
     
         13 . A tissue approximation device for application to a skin surface adjacent to a wound, comprising:
 a pair of arms, each arm having a longitudinal axis and opposed ends, wherein one end includes a handle and the other end includes a tong with a connector;   an attachment mechanism coupled to each arm that movably couples the arms to each other so that a distance between each tong is selectively variable;   an adhesive pad removably coupled to the connector of each tong, wherein each adhesive pad has an adhesive surface that extends in a plane generally parallel to the longitudinal axis of the respective tong, the adhesive surface having a high shear resistance for holding the skin surface and a low peel resistance for removal from the skin surface, and wherein the connectors support the adhesive pads to be positionable in a common plane on opposed sides of the wound and conform to the skin surface adjacent to the wound; and   a locking mechanism coupled to each arm to selectively lock the pair of arms in a fixed position relative to each other, wherein the connector is a rotatable connector that connects the adhesive pad to the tong to pivot at least about the longitudinal axis and an axis substantially perpendicular to the longitudinal axis and the rotatable connector is one of a ball and a socket and the adhesive pad includes the other of the ball and the socket, wherein the ball and socket are snap fit together in an interference fit.   
     
     
         14 . The tissue approximation device of  claim 13 , wherein the arms are connected in a parallel configuration. 
     
     
         15 . The tissue approximation device of  claim 13 , wherein the attachment mechanism includes at least one pair of slidable bosses coupled between the arms. 
     
     
         16 . The tissue approximation device of  claim 13 , further comprising a spring disposed between the arms to bias the arms with respect to each other. 
     
     
         17 . A method for closing a wound in the surface of a patient's skin, comprising the steps of
 (1) providing a tissue approximation device comprising two elongate arms, an attachment means to secure the elongate arms to each other at one or more locations, and a locking means to lock the elongate arms in place relative to each other, wherein providing the tissue approximation device includes connecting an adhesive pad to an end of each elongate arm and adjusting a position of each pad relative to the skin surface, wherein (i) the adhesive pads are spaced apart from the one or more locations of the attachment means in the direction of the elongate arms, and (ii) the tissue approximation device has an open and a closed position, and when in the closed position, the adhesive pads are parallel and non-contiguous to each other;   (2) positioning the adhesive pads to skin on opposed sides of a wound;   (3) approximating the wound by actuating the tissue approximation device in a direction to move the adhesive pads towards each other in a common plane that is generally parallel to the skin tissue;   (4) engaging the locking means to assure that the edges of the wound do not move;   (5) applying a topical skin closure adhesive to the wound; and   (6) removing the adhesive pads from the skin surface.   
     
     
         18 . The method of  claim 17 , wherein the elongate arms of the tissue approximation device form parallel forceps, the attachment means including a pair of slidable bosses, and the locking means including a ratchet mechanism on the forceps. 
     
     
         19 . The method of  claim 18 , wherein the distance between the elongate arms of the tissue approximation device is adjustable by means of a ratchet mechanism. 
     
     
         20 . The method of  claim 17 , wherein the elongate arms of the tissue approximation device form a pair of forceps, the attachment means is a yoke on the forceps, and the locking means is a ratchet mechanism on the forceps. 
     
     
         21 . The method of  claim 20 , wherein the distance between the elongate arms of the tissue approximation device is adjustable by means of a ratchet mechanism. 
     
     
         22 . The method of  claim 18 , wherein the adhesive pad has a first adhering surface and a second surface having a socket mechanism that communicates with a ball on the distal end of each of the elongate arms, and the adhesive pad is optionally rotatable around the ball. 
     
     
         23 . The method of  claim 20 , wherein the adhesive pad has a first adhering surface and a second surface having a socket mechanism that communicates with a ball on the distal end of each of the elongate arms, and the adhesive pad is optionally rotatable around the ball. 
     
     
         24 . The method of  claim 18 , wherein the adhesive pad has a first adhering surface and a second surface having a ball that communicates with a socket mechanism on the distal end of each of the elongate arms. 
     
     
         25 . The method of  claim 20 , wherein the adhesive pad has a first adhering surface and a second surface having a ball that communicates with a socket mechanism on the distal end of each of the elongate arms. 
     
     
         26 . The method of  claim 18 , wherein the adhesive pad has a first adhering surface and a second surface having female receiving mechanism that communicates with a male protrusion on the distal end of each of the elongate arms. 
     
     
         27 . The method of  claim 20 , wherein the adhesive pad has a first adhering surface and a second surface having female receiving mechanism that communicates with a male protrusion on the distal end of each of the elongate arms. 
     
     
         28 . The method of  claim 18 , wherein the adhesive pad has a first adhering surface and a second surface having a male protruding mechanism that communicates with a female receiving mechanism on the distal end of each of the elongate arms. 
     
     
         29 . The method of  claim 20 , wherein the adhesive pad has a first adhering surface and a second surface having a male protruding mechanism that communicates with a female receiving mechanism on the distal end of each of the elongate arms. 
     
     
         30 . The method of  claim 18 , wherein the distal end of each of the elongate arms has a passageway therein such that the adhesive pad communicates with said passageway. 
     
     
         31 . The method of  claim 20 , where the distal end of each of the elongate arms has a passageway therein such that the adhesive pad communicates with said passageway. 
     
     
         32 . The method of  claim 18 , where the adhesive pad has a passageway therein such that the distal end of each of the elongate arms is within said passageway. 
     
     
         33 . The method of  claim 20 , where the adhesive pad has a passageway therein such that the distal end of each of the elongate arms is within said passageway. 
     
     
         34 . The method of  claim 17 , where the attachment means and the locking means are the same. 
     
     
         35 . The method of  claim 34 , where the adhesive pads are located on at least a portion of each of the elongate arms.