Methods for obtaining hemostasis of percutaneous wounds

• US 20060030886A1
• Filed: 10/06/2005
• Published: 02/09/2006
• Est. Priority Date: 07/20/2001
• Status: Abandoned Application

• Current Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Original Assignee: Trustees Of The University Of Pennsylvania (University of Pennsylvania)
• Inventors: Clark, Timothy W.
• Application Number:
  US11/244,168
• Publication Number:
  US 20060030886A1
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/34 Trocars; Puncturing needles pointed biopsy instruments A61B10/0233; devices for piercing the ear-lobes A44C7/001; seals or hemostasis valves A61M39/06
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2017/00663 the implement being a suture
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/1142 Purse-string sutures

Abstract

This invention relates to novel methods, kits, and devices for stopping hemorrhaging of percutaneous wounds. The inventive subject matter involves insertion of a purse-string suture around the wound, insertion of the free two ends of the suture through a tension collar, manual tightening of the tension collar until hemostasis is achieved, and application of a suture lock to the free ends of the suture to secure the tension collar and maintain hemostasis. After a sufficient period of time to allow complete hemostasis, the suture lock and the tension collar are loosened; if hemostasis has been achieved, the suture lock, the tension collar, and the suture material are removed. If bleeding continues from the wound, the tension collar is tightened and the suture lock reapplied. This process may be repeated until complete hemostasis is achieved, without the need for additional suturing or manual compression.

Claims

1-13. -13. (canceled)

14. A method for producing hemostasis of a percutaneous wound, comprising

inserting a purse-string suture around a percutaneous wound using multiple passes of a suture needle and a physiologically suitable suture material in a manner such that a final pass of the suture needle is oriented so as to bring the final exit site of the suture material substantially adjacent to an initial entry site of the suture material through the skin;

bringing the initial entry and final exit limbs of the suture material through a tension collar;

tightening the tension collar to achieve hemostasis of the percutaneous wound; and

applying a suitable suture lock to the free ends of the suture material to secure the tension collar.

15. The method of claim 14, wherein the percutaneous wound is associated with the insertion of a vascular sheath, cannula or catheter through the skin.

16. The method of claim 15, wherein the purse-string suture is inserted through the skin contemporaneously with the vascular sheath, cannula, or catheter.

17. The method of claim 15, wherein the vascular sheath, cannula or catheter is removed prior to tightening the tension collar.

18. The method of claim 14, wherein the suture material comprises monofilament 2.0 polypropylene or nylon.

19. The method of claim 14, wherein the purse-string suture is inserted within about 3 mm of the percutaneous wound.

20. The method of claim 14, comprising

releasing the suture lock and loosening the tension collar after a sufficient period of time is allowed for hemostasis to occur;

re-tightening the tension collar and re-applying the suture lock as needed to prevent bleeding or oozing of blood; and

removing the suture material when satisfactory hemostasis has been achieved.

21. A percutaneous wound homeostasis kit, comprising

suture(s) of size and material characteristics suitable for the type and location of the percutaneous wound to be treated;

suture needle(s);

tension collar(s);

suture-lock(s); and

Instructions for use of the kit.

22. The kit of claim 21, wherein the suture material(s) comprise(s) a non-absorbable monofilament.

23. The kit of claim 21, wherein the suture material(s) comprise(s) 2.0 monofilament polypropylene or nylon.