Abdominal dressing with mechanism and means for fascial closure

Abstract

A system for treating a deep abdominal wound. The system includes a wound dressing. The wound dressing includes a visceral-protective layer, a compressive layer, and a sealing layer. The visceral-protective layer is configured to be positioned in an open abdomen. The compressive layer is configured to be disposed proximate to the visceral-protective layer. The compressive layer includes a pattern of voids configured for anisotropic collapse of the compressive layer when under negative pressure. The sealing layer is configured to form a sealed space in the open abdomen. A negative pressure source configured to provide negative pressure to the compressive layer.

What is claimed is: 
     
         1 . A compressive layer for use with a deep abdominal wound dressing, the compressive layer comprising:
 a body formed of a material having a plurality of voids configured to provide a first modulus of elasticity in a first direction and a second modulus of elasticity in a second direction substantially perpendicular to the first direction, the first modulus of elasticity being smaller than the second modulus of elasticity so that the body is configured to compress in the first direction and to resist compression in the second direction, the body including the plurality of voids shaped and/or positioned for lateral compression in the first direction and radial compression in the second direction.   
     
     
         2 . The compressive layer of  claim 1 , wherein the first direction is a substantially lateral direction and the second direction is a substantially vertical direction. 
     
     
         3 . The compressive layer of  claim 1 , wherein the plurality of voids forms the first modulus of elasticity and the second modulus of elasticity. 
     
     
         4 . The compressive layer of  claim 1 , wherein the plurality of voids is formed by at least one of felting and cutting. 
     
     
         5 . The compressive layer of  claim 1 , wherein at least one of a shape or a pattern of the plurality of voids is selected based on material properties of the body. 
     
     
         6 . The compressive layer of  claim 1 , wherein the body and the voids form a manifold configured to distribute negative pressure and/or add or remove fluids. 
     
     
         7 . The compressive layer of  claim 1 , wherein the body includes a first body portion, and wherein at least a first portion of the plurality of voids is formed on the first body portion, the first portion of the plurality of voids is shaped and/or positioned to promote substantially lateral compression and positioned to resist substantially vertical compression. 
     
     
         8 . The compressive layer of  claim 1 , wherein the body includes a second body portion surrounding at least a portion of a first body portion, and wherein at least a second portion of the plurality of voids is formed on the second body portion, the second portion of the plurality of voids is shaped and/or positioned for radially inward compression in the first direction. 
     
     
         9 . The compressive layer of  claim 1 , wherein the voids of the plurality of voids are shaped are curved and form concentric rings that generally follow a contour of the body. 
     
     
         10 . A method for forming a compressive layer for a deep abdominal wound dressing, the method including:
 heating a foam layer, the foam layer having substantially isotropic material properties;   applying a compressive force to the foam layer to increase a density of the foam layer in a direction of the compressive force to cause anisotropy in the foam layer by generating a first modulus of elasticity in a first direction corresponding to a direction of the applied force and a second modulus of elasticity in a second direction substantially perpendicular to the first direction;   cutting the foam layer in a direction substantially perpendicular to the direction of the compressive force;   rotating the pieces of the foam layer;   securing adjacent pieces of the foam layer; and   forming a compressive layer from the foam layer.   
     
     
         11 . The method of  claim 10 , wherein the first modulus of elasticity is larger than the second modulus of elasticity. 
     
     
         12 . The method of  claim 10 , wherein the second modulus facilitates lateral compression of the compressive layer. 
     
     
         13 . The method of  claim 10 , further comprising the step of forming a pattern of voids in the compressive layer, the voids of the pattern of voids shaped to facilitate lateral compression of the compressive layer. 
     
     
         14 . The method of  claim 13 , wherein the position and shape of the voids of the pattern of voids is selected to establish the first modulus of elasticity and the second modulus of elasticity. 
     
     
         15 . The method of  claim 10 , wherein the foam layer is a reticulated polyurethane foam. 
     
     
         16 . The method of  claim 10 , wherein the compressive layer has a felting ratio of 3-7.