Area management of tissue sites on articulating joints

Abstract

A dressing for managing an incision and surrounding tissue where edema and swelling may be present post-operation. The dressing may maximize coverage of area in articulating joints, such as a knee or elbow, while allowing for substantial range of motion. In some embodiments, the dressing may comprise an adhesive border configured to be adhered to skin around an articulating joint, a skin-interfacing fabric for minimizing skin irritation, a foam body for manifolding negative pressure and absorbing exudate and other body fluids, and a thin polymer film cap for sealing the assembly so negative pressure can be maintained throughout the dressing.

1 . A dressing for treating an area around an articulating joint with negative pressure, the dressing comprising:
 an attachment device having a treatment aperture;   a manifold comprising a stem, a first arm joined to the stem, and a second arm joined to the stem, the manifold at least partially exposed through the treatment aperture;   a cover disposed over the manifold and coupled to the attachment device around the manifold; and   an adhesive on the attachment device configured to bond to the area around the articulating joint.   
     
     
         2 . The dressing of  claim 1 , wherein the first arm has a greater span than the second arm. 
     
     
         3 . The dressing of  claim 1 , wherein:
 the first arm has a first span;   the second arm has a second span; and   a ratio of the first span to the second span is in a range of 1.2 to 3.4.   
     
     
         4 . The dressing of  claim 1 , wherein:
 the first arm has a first span;   the second arm has a second span; and   a ratio of the first span to the second span is in a range of 1.2 to 1.6.   
     
     
         5 . The dressing of  claim 1 , wherein the first arm and the second arm flare away from the stem. 
     
     
         6 . The dressing of  claim 1 , wherein the first arm and the second arm comprise converging edges. 
     
     
         7 . The dressing of  claim 1 , wherein the stem, the first arm, and the second arm define biconcave edges. 
     
     
         8 . The dressing of  claim 1 , wherein the manifold comprises a face that is biconcave. 
     
     
         9 . The dressing of  claim 1 , wherein the manifold has a line of symmetry through the stem. 
     
     
         10 . The dressing of  claim 1 , wherein:
 the manifold has a line of symmetry through the stem; and   the first arm and the second arm define a void adjacent to each side of the stem.   
     
     
         11 . The dressing of  claim 1 , wherein:
 the manifold has an edge bounding the first arm and the second arm; and   a portion of the edge bounding the first arm and the second arm converges toward the stem to define a concave void adjacent to each side of the stem.   
     
     
         12 . The dressing of  claim 1 , wherein the stem comprises flexibility notches. 
     
     
         13 . The dressing of  claim 1 , wherein the first arm and the second arm comprise flexibility notches. 
     
     
         14 . The dressing of  claim 1 , further comprising a dressing interface fluidly coupled to the first arm through the cover. 
     
     
         15 . The dressing of  claim 1 , wherein the manifold comprises foam. 
     
     
         16 . The dressing of  claim 1 , further comprising a comfort layer coupled to the manifold, the comfort layer at least partially exposed through the treatment aperture. 
     
     
         17 . The dressing of  claim 1 , wherein:
 the first arm and the second arm comprise a first foam;   the stem comprises a second foam; and   the first foam has a different density than the second foam.   
     
     
         18 . The dressing of  claim 1 , wherein the stem is fluidly isolated from at least one of the first arm and the second arm. 
     
     
         19 . The dressing of  claim 1 , wherein the adhesive is disposed in a border of the attachment device. 
     
     
         20 . The dressing of  claim 1 , wherein the adhesive covers at least a portion of the attachment device opposite the first arm and the second arm. 
     
     
         21 . The dressing of  claim 1 , wherein the adhesive covers about 50% of the attachment device opposite the first arm and the second arm. 
     
     
         22 . A method of treating edema around an articulating joint of a limb, the method comprising:
 applying the dressing of  claim 1  so that the stem is disposed over the articulating joint;   wrapping the first arm around a proximal portion of the limb;   wrapping the second arm around a distal portion of the limb;   fluidly coupling a negative-pressure source to the manifold; and   applying negative-pressure from the negative-pressure source.   
     
     
         23 . A dressing for treating an area of tissue with negative pressure, the dressing comprising:
 a sealing ring having a treatment aperture;   a cover having a perimeter coupled to the sealing ring; and   a manifold disposed between the sealing ring and the cover and at least partially exposed through the treatment aperture;   wherein the manifold comprises:
 a first portion configured to be disposed over an articulating surface of a limb; 
 a second portion configured to be at least partially wrapped around a proximal portion of the limb; and 
 a third portion configured to be at least partially wrapped around a distal portion of the limb. 
   
     
     
         24 . The dressing of  claim 23 , wherein the second portion and the third portion flare away from the first portion. 
     
     
         25 . The dressing of  claim 23 , wherein the second portion and the third portion comprise converging edges. 
     
     
         26 . The dressing of  claim 23 , wherein the first portion, the second portion, and the third portion define biconcave edges. 
     
     
         27 . A method of treating edema around an articulating joint of a limb, the method comprising:
 applying the dressing of  claim 23  so that the first portion of the manifold is disposed over the articulating joint;   wrapping the second portion around a proximal portion of the limb;   wrapping the third portion around a distal portion of the limb;   fluidly coupling a negative-pressure source to the manifold; and   applying negative-pressure from the negative-pressure source;   wherein the dressing allows the articulating joint to articulate.   
     
     
         28 . The method of  claim 27 , wherein the articulating joint is a knee. 
     
     
         29 . The method of  claim 27 , wherein the articulating joint is an elbow. 
     
     
         30 . A dressing for treating an area with an incision on an articulating joint, the dressing comprising:
 an attachment device having a treatment aperture;   a manifold having a first portion configured to cover the incision and a second portion configured to cover the area around the articulating joint; and   a cover disposed over the manifold and coupled to the attachment device around the manifold;   wherein the manifold is at least partially exposed through the treatment aperture.   
     
     
         31 . The dressing of  claim 30 , wherein the manifold is a generalized cylinder having a biconcave face. 
     
     
         32 . The dressing of  claim 31 , wherein the biconcave face has contoured extremities. 
     
     
         33 . (canceled)