Mechanical Wound Therapy for Sub-Atmospheric Wound Care System

• US 20130165821A1
• Filed: 10/15/2012
• Published: 06/27/2013
• Est. Priority Date: 11/01/2011
• Status: Active Grant

• Current Assignee: J & M Shuler Medical, Inc.
• Original Assignee: J & M Shuler Medical, Inc.
• Inventors: Freedman, Brett, Shuler, Michael
• Granted Patent: US 9,393,354 B2
• Time in Patent Office: Days
• US Class Current: 601/2
• CPC Class Codes: A61B 46/00 Surgical drapes
• CPC Class Codes: A61F 13/00 Bandages or dressings radioactive dressings A61N5/1029; Absorbent pads
• CPC Class Codes: A61F 13/00063 comprising medicaments or additives, e.g. odor control, PH control, debriding, antimicrobic drug delivery dressings A61K9/70; chemical aspect of the additives A61L15/00
• CPC Class Codes: A61F 13/00085 having means for facilitating the application on the skin, e.g. single hand handling facilities A61F13/0259 takes precedence; bandage applicators separate from the bandage or the packaging A61F15/005
• CPC Class Codes: A61F 13/01021 characterised by the structure of the dressing
• CPC Class Codes: A61F 13/023 wound covering film layers without a fluid retention layer
• CPC Class Codes: A61F 13/0279 by attaching individual patches on moving webs
• CPC Class Codes: A61F 13/05 specially adapted for use with sub-pressure or over-pressure therapy, wound drainage or wound irrigation, e.g. for use with negative-pressure wound therapy [NPWT]
• CPC Class Codes: A61F 2013/00357 implanted wound fillings or covers membranes for covering bone defects A61F2/2846
• CPC Class Codes: A61F 2013/00536 for draining or irrigating wounds
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 1/85 with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants for negative pressure wound therapy A61M1/92, A61M1/94; combined with tracheal tubes A61M16/0463; dental instruments with combined rinsing and aspirating A61C17/0208
• CPC Class Codes: A61M 1/915 Constructional details of the pressure distribution manifold
• CPC Class Codes: A61M 1/916 specially adapted for deep wounds
• CPC Class Codes: A61M 1/918 for multiple suction locations
• CPC Class Codes: A61M 1/92 with liquid supply means
• CPC Class Codes: A61M 1/966 having a pressure sensor on or near the dressing
• CPC Class Codes: A61M 2205/15 Detection of leaks
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2205/3553 : remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3584 : using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 : using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 3/0279 : Cannula; Nozzles; Tips; their connection means
• CPC Class Codes: A61M 3/0283 : with at least two inner passageways, a first one for irrigating and a second for evacuating suction-irrigation systems A61M1/77; aspiration tips with fluid supply means A61M1/85; for negative pressure wound therapy A61M1/92
• CPC Class Codes: A61M 37/00 : Other apparatus for introducing media into the body for reproduction or fertilisation A61B17/425; apparatus for iontophoresis or cataphoresis A61N1/30; Percutany, i.e. introducing medicines into the body by diffusion through the skin salt baths A61H33/04
• CPC Class Codes: A61N 5/0624 : for eliminating microbes, germs, bacteria on or in the body
• CPC Class Codes: A61N 7/00 : Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: Y10T 29/49826 : Assembling or joining

Abstract

A mechanical wound therapy (MWT) system includes a connection for a vacuum source, which is routed through an airtight covering to a porous material positioned over the wound. The porous material may be a tubing network interspaced by a netting material constructed of biologically inert or bioabsorbable material. Alternatively, the porous material may be a layered unified dressing in which layers of mesh, netting or thin perforated film are separated and fixedly attached to functional elements of the dressing (e.g., irrigation tubing) or spacers. The vacuum and irrigation systems may be completely separated. An airtight sealing layer or foldable adhesive sealing layer may seal the dressing and facilitate sealing the dressing to the wound margins. Additional modular devices such as a wound approximating system, positive pressure bladders and adjuvant therapy modules as well as enhanced monitoring technology can be added to synergistically increase the capabilities of each dressing.

Claims

1. A unified dressing structure for a sub-atmospheric wound-care system, the unified dressing structure comprising:

an airtight cover component configured as a dorsal surface of the unified dressing structure;

a connector attached to the cover component and configured to connect to a line from a vacuum source; and

a porous dressing component disposed as a ventral surface of the unified dressing structure and fixedly attached to the cover component, wherein the porous dressing component is configured to cover an open wound.

2. The unified dressing structure of claim 1, further comprising:

an adhesive strip with a weak adhesive disposed on a perimeter edge of the cover component, said perimeter edge extending laterally beyond the porous dressing component.

3. The unified dressing structure of claim 2, wherein the adhesive strip is configured to removably affix to skin surrounding the open wound to make an airtight connection.

4. The unified dressing structure of claim 1, wherein the porous dressing component being affixed to the cover component allows the unified dressing structure to be placed over the wound as a single unit and maintains a spatial relationship of various dressing components of the unified dressing structure.

5. The unified dressing structure of claim 1, wherein the porous dressing component comprises a mesh.

6. The unified dressing structure of claim 1, wherein the connector fixedly attached to the cover component.

7. The unified dressing structure of claim 1, wherein the connector is attached to the cover component via a tube.

8. The unified dressing structure of claim 1, wherein the unified dressing structure has sufficient structural integrity so as to allow placement of the unified dressing structure as a single unit over the wound, and also allowing the unified dressing structure to serve as a fixation point between margins of the wound and between the unified dressing structure and other elements of the MWT system.

9. The unified dressing structure of claim 1, further comprising:

a vacuum port in the line from the vacuum source that allows for effluent to be sampled, said vacuum port further being configured to receive fluid to assist in clearing a blockage to said line from the vacuum source.

10. The unified dressing structure of claim 1, further comprising:

an irrigant port in a line from a source of irrigant, said irrigant port being configured to receive injections of therapeutic fluid.

11. The unified dressing structure of claim 1, wherein the porous dressing component is unidirectional and includes either gauze or sponge.

12. The unified dressing structure of claim 1, wherein the porous dressing component comprises a therapeutic adjuvant.

13. The unified dressing structure of claim 1, further comprising:

means for applying ultra-sound bone-healing modalities.

14. The unified dressing structure of claim 1, further comprising:

means for applying ultrasonic agitation for micro-debridement of the wound.

15. The unified dressing structure of claim 14, further comprising:

means for applying ionic irrigation solution simultaneously with the ultrasonic agitation for the micro-debridement of the wound.

16. The unified dressing structure of claim 1, further comprising:

an ultraviolet light adjuvant module configured to deliver microbicidal doses of ultraviolet light to the wound.

17. The unified dressing structure of claim 1, further comprising:

a sensor port configured to receive a probe, wherein the probe comprises one of a Near-Infrared Spectroscopy (NIRS) sensor, a pH sensor, or a temperature sensor;

wherein data or images from said probe is communicated via a wired connection or wirelessly to an electronic vacuum regulator (EVR).

18. The unified dressing structure of claim 1, further comprising:

one or more ultrasonic transducers embedded in the porous dressing component and positioned to sit in fluidic communication with a surface of the wound.

19. A method of providing sub-atmospheric wound-care using a unified dressing structure, the method comprising:

providing an airtight cover component as a dorsal surface of the unified dressing structure;

attaching a connector to the cover component, said connector being configured to connect to a line from a vacuum source; and

fixedly attaching a porous dressing component to the cover component, said porous dressing component being disposed as a ventral surface of the unified dressing structure;

wherein the porous dressing component is configured to cover an open wound.

20. A sub-atmospheric wound-care system, comprising:

a unified dressing structure including a porous dressing component positioned facing a wound surface;

an airtight cover component positioned dorsal to the unified dressing structure;

a connector attached to the cover component and configured to connect to a line from a vacuum source; and

an electronic vacuum regulator (EVR) in fluidic communication with the vacuum source.

21. The sub-atmospheric wound-care system of claim 20, wherein the EVR is a multi-channel vacuum regulator in fluidic communication with the vacuum source.

22. The sub-atmospheric wound-care system of claim 20, wherein the EVR is configured to control a rate of irrigation, an amount of vacuum, and an application of one or more adjuvants.

23. The sub-atmospheric wound-care system of claim 20, further comprising:

means for applying ultra-sound bone-healing modalities.

24. The sub-atmospheric wound-care system of claim 20, further comprising:

means for applying ultrasonic agitation for micro-debridement of the wound.

25. The sub-atmospheric wound-care system of claim 24, further comprising:

means for applying ionic irrigation solution simultaneously with the ultrasonic agitation for the micro-debridement of the wound.

26. The sub-atmospheric wound-care system of claim 20, further comprising:

an ultraviolet light adjuvant module configured to deliver microbicidal doses of ultraviolet light to the wound.

27. The sub-atmospheric wound-care system of claim 20, wherein the EVR is configured to be programmed to actuate a specialized algorithmic sequence of modular elements of the sub-atmospheric wound-care system.

28. The sub-atmospheric wound-care system of claim 20, wherein the EVR includes dataports suitable for exporting data to an electronic medical record system.

29. The sub-atmospheric wound-care system of claim 20, wherein the EVR is programmable to monitor and control a rate of irrigation cycles and a volume of irrigation per each of the irrigation cycles.

30. The sub-atmospheric wound-care system of claim 20, wherein the EVR is programmable to increase the threshold for flow alarms during periods of irrigation to prevent false alarms for elevated flow rates.

31. A negative pressure wound dressing assembly with an inner ventral surface and an outer dorsal surface, the wound dressing assembly comprising:

a first netting layer with a ventral side serving as the ventral surface of the wound dressing assembly configured for placement over a wound;

a covering layer with a dorsal side positioned away from the wound;

a second netting layer positioned between the first netting layer and the covering layer; and

a tubing layer positioned between the first netting layer and the second netting layer, the tubing layer being in fluidic communication with a vacuum source.

32. The negative pressure wound dressing assembly of claim 31, wherein the tubing layer is a first tubing layer, the assembly further comprising:

a second tubing layer positioned between the first netting layer and the second netting layer, the second tubing layer being in fluidic communication with a source of irrigant.

33. The negative pressure wound dressing assembly of claim 31, further comprising:

a first tubing connector in between the first tubing layer and the vacuum source; and

a second tubing connector in between the second tubing layer and the source of irrigant;

wherein the second tubing connector is configured to be disconnected from the source of irrigant and connected to the vacuum source in the event of a blockage in the first tubing layer.

34. The negative pressure wound dressing assembly of claim 31, further comprising:

a positive pressure pump in fluidic communication with the second tubing layer and configured to pump the irrigant.

35. The negative pressure wound dressing assembly of claim 32, wherein the first tubing layer is configured to be fluidically separate from the second tubing layer to produce a mixing point over the wound for the irrigant and negative pressure from the vacuum source.

36. The negative pressure wound dressing assembly of claim 32, further comprising:

a one-way irrigant valve in fluidic communication with the source of irrigant to prevent back-flow of the irrigant.

37. The negative pressure wound dressing assembly of claim 31, further comprising:

an interface chamber connecting the tubing layer and the vacuum source.

38. The negative pressure wound dressing assembly of claim 32, further comprising:

a one-way vacuum valve in fluidic communication with the vacuum source to prevent back-flow towards the vacuum source.

39. The negative pressure wound dressing assembly of claim 31, wherein a peripheral edge of the covering layer extends laterally beyond the first and second netting layers and the tubing layer.

40. The negative pressure wound dressing assembly of claim 31, further comprising:

an adhesive strip disposed near the peripheral edge on a ventral surface of the covering layer.

41. The negative pressure wound dressing assembly of claim 31, further comprising:

an adhesive disposed across an entirety of a ventral surface of the covering layer.

42. The negative pressure wound dressing assembly of claim 31, wherein the covering layer is fixedly attached to a dorsal surface of the second netting layer.

43. The negative pressure wound dressing assembly of claim 31, further comprising:

an semi-adhesive strip disposed upon a dorsal surface of the covering layer.

44. The negative pressure wound dressing assembly of claim 43, wherein the semi-adhesive strip is disposed only within 8 cm of a peripheral edge of the dorsal surface of the covering layer.

45. The negative pressure wound dressing assembly of claim 31, wherein the first netting layer has an abrasive ventral surface configured for debridement of the wound.

46. The negative pressure wound dressing assembly of claim 31, wherein the first netting layer has a non-stick ventral surface configured to reduce tissue injury upon removal of the first netting layer from the wound.

47. A method of assembling a wound with a negative pressure wound dressing assembly comprising an inner ventral surface and an outer dorsal surface, the method comprising:

providing a first netting layer with a ventral side serving as the ventral surface of the wound dressing assembly configured for placement over a wound;

providing a covering layer with a dorsal side positioned away from the wound;

providing a second netting layer positioned between the first netting layer and the covering layer;

providing a tubing layer positioned between the first netting layer and the second netting layer, the tubing layer being in fluidic communication with a vacuum source; and

assembling the first netting layer, the tubing layer, the second netting layer and the covering layer to fixedly connect the negative pressure wound dressing assembly.

48. A negative pressure wound care assembly, comprising:

a covering layer with a dorsal side positioned away from a wound;

an adhesive portion configured to stick to a patient'"'"'s skin around the wound forming an air tight seal;

an accessory tube connector in fluidic communication with the vacuum source; and

an accessory tube removably connected to said accessory tube connector, said accessory tube having vacuum perforations to pass negative pressure from the vacuum source.

49. The negative pressure wound dressing assembly of claim 48, wherein said perforations are on a dorsal side of the accessory tube facing away from a surface of the wound;

and

wherein there are no perforations on the ventral side of the accessory tube facing toward the surface of the wound.

50. The negative pressure wound dressing assembly of claim 48, further comprising:

a flow measurement device in configured to measure a drain output of the wound.

51. The negative pressure wound dressing assembly of claim 49, wherein the accessory tube is a first accessory tube and the accessory tube connector is a first accessory tube connector, the negative pressure wound dressing assembly further comprising:

a second accessory tube connector in fluidic communication with a source of irrigant; and

a second accessory tube connected to said second accessory tube connector, said second accessory tube having irrigant perforations configured for the irrigant to flow on to the wound.

52. The negative pressure wound dressing assembly of claim 51, wherein the irrigant perforations are located on the ventral side of the second accessory tube facing toward the surface of the wound.

53. The negative pressure wound dressing assembly of claim 51, wherein the first accessory tube and the second accessory tube are each configured in a figure eight shape;

and

wherein the first accessory tube is structurally connected to the second accessory tube to maintain a direction of the vacuum perforations relative to the irrigant perforations.

54. The negative pressure wound dressing assembly of claim 48, wherein the accessory tube is configured in a radial pattern with spokes extending outward from a central point.

55. The negative pressure wound dressing assembly of claim 54, further comprising:

an airtight cover component configured as a dorsal surface of the negative pressure wound dressing assembly;

a porous dressing component disposed ventral to the airtight cover component, wherein the porous dressing component is configured to cover an open wound;

wherein the accessory tube is configured to be positioned ventral to the porous dressing component in a deep portion of the wound.

56. The negative pressure wound dressing assembly of claim 55, the accessory tube is configured with a first section containing vacuum perforations and a second section containing irrigation perforations.

57. The negative pressure wound dressing assembly of claim 55, further comprising:

at least four pressure sensors positioned apart from each between the covering layer and the wound, said at least four pressure sensors being configured to detect directionality of a leak in the covering layer.

58. A negative pressure wound dressing assembly with an inner ventral surface and an outer dorsal surface, the wound dressing assembly comprising:

a covering layer with a dorsal side positioned away from the wound; and

a porous dressing component disposed as a ventral surface of the negative pressure wound dressing assembly, the porous dressing component being configured to cover an open wound.

59. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is netting of a biologically inert polymer material.

60. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is a perforated film of a biologically inert polymer material.

61. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is netting impregnated with one or more antimicrobial agents.

62. The negative pressure wound dressing assembly of claim 61, wherein the one or more antimicrobial agents comprise silver-ions.

63. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is netting of a bioabsorbable material.

64. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is impregnated with an antimicrobially active agents.

65. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is impregnated with one or more biologically active agents.

66. The negative pressure wound dressing assembly of claim 58, further comprising:

a tissue substrate affixed to the porous dressing component.

67. The negative pressure wound dressing assembly of claim 58, further comprising:

radio opaque markers integrated with one or more components of the negative pressure wound dressing assembly, the radio opaque markers being configured identify portions of said one or more components retained in the wound following removal of the negative pressure wound dressing assembly.

68. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component is netting covered with a pliable coating material in a manner configured to reduce fraying of the netting.

69. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component has an abrasive ventral surface configured for debridement of the wound.

70. The negative pressure wound dressing assembly of claim 58, wherein the porous dressing component has a non-stick ventral surface configured to reduce tissue injury upon removal of the porous dressing component from the wound.

71. The negative pressure wound dressing assembly of claim 58, further comprising:

one or more ultra-sonic transducers embedded in the porous dressing component and positioned to sit in fluidic communication with a surface of the open wound.

72. A negative pressure wound dressing assembly with an inner ventral surface and an outer dorsal surface, the wound dressing assembly comprising:

a covering layer with a dorsal side positioned away from the wound;

a tubing layer positioned on a ventral side of the covering layer and being in fluidic communication with a vacuum source; and

an interface component connecting the vacuum source with the tubing layer.

73. The negative pressure wound dressing assembly of claim 72, wherein the tubing layer is fixedly attached to the ventral side of the covering layer.

74. The negative pressure wound dressing assembly of claim 72, wherein the tubing layer is a first tubing layer, the assembly further comprising:

a second tubing layer positioned between the first netting layer and the second netting layer, the second tubing layer being in fluidic communication with a source of irrigant.

75. The negative pressure wound dressing assembly of claim 73, wherein the tubing layer is a first tubing layer, the assembly further comprising:

a second tubing layer positioned between the first netting layer and the second netting layer, the second tubing layer being in fluidic communication with a source of irrigant;

wherein the second tubing layer is fixedly attached to the covering layer.

76. The negative pressure wound dressing assembly of claim 74, wherein the first tubing layer and the second tubing layer are coplanar.

77. The negative pressure wound dressing assembly of claim 73, wherein the second tubing layer is the ventral surface of the negative pressure wound dressing assembly configured to face the wound.

78. The negative pressure wound dressing assembly of claim 72, wherein the tubing layer is removably attached to the interface component, and the interface component is removably attached to the covering layer.

79. The negative pressure wound dressing assembly of claim 72, wherein no wound filler is between the covering layer and the wound.

80. The negative pressure wound dressing assembly of claim 72, wherein tubing components of the irrigant tubing layer are positioned one or more predefined distances away from the vacuum interface chamber to promote a flow if irrigant from said tubing components across a surface of the wound to the vacuum interface chamber.

81. The negative pressure wound dressing assembly of claim 72, wherein tubing components of the irrigant tubing layer are positioned at the ventral surface of the dressing to direct irrigant towards a surface of the wound, the tubing components being separated by various distances from the vacuum interface chamber to direct the irrigant across the surface of the wound.

82. The negative pressure wound dressing assembly of claim 72, wherein tubing components of the irrigant tubing layer are positioned various distances away from the vacuum interface chamber, and wherein placement of the tubing components and vacuum interface chamber dictate a flow path for irrigant across a surface of the wound.

83. The negative pressure wound dressing assembly of claim 80, wherein no wound filler is between the covering layer and the wound.

84. A tubing network for a negative pressure wound care system, the tubing network comprising:

a plurality of spoke tubes each positioned to extend radially in a lateral direction from a central area of the tubing network;

a connector in fluidic communication with each of the plurality of spoke tubes and configured to be connected to a vacuum source;

wherein the plurality of spoke tubes each have one or more fluid passage holes configured to pass fluid through to the connector.

85. The tubing network of claim 84, further comprising:

a flange interface disposed between the connector and the plurality of spoke tubes.

86. The tubing network of claim 84, further comprising:

a brace portion connecting adjacent ones of the plurality of spoke tubes to each other.

87. The tubing network of claim 84, wherein the brace portion is configured to connect a radial end of each of the adjacent ones of the plurality of spoke tubes.

88. The tubing network of claim 85, wherein an outer end of each of the plurality of spoke tubes extends beyond the brace portion in the lateral direction away from the central area;

and

wherein the outer ends of the plurality of spoke tubes are configured to trimmed to length in order to alter coverage size of the tubing network.

89. The tubing network of claim 84, wherein the plurality of spoke tubes each have a plurality of said fluid passage holes including a fluid passage hole on a radial end.

90. The tubing network of claim 84, further comprising:

an accessory tube removably connected to said accessory tube connector, said accessory tube having vacuum perforations to pass negative pressure from the vacuum source.

91. The tubing network of claim 90, further comprising:

one or more support members configured to connect the accessory tube to at least one of the plurality of spoke tubes.

92. The tubing network of claim 91, further comprising:

a connector mounted on said at least one of the plurality of spoke tubes and configured to removably connect the accessory tube to be fluidic communication with said at least one of the plurality of spoke tubes.

93. A dressing layer for a negative pressure wound care system, the dressing layer network comprising:

a plurality of spoke tubes each positioned to extend radially in a lateral direction from a central area of the tubing network; and

netting configured to span between adjacent ones of the plurality of spoke tubes;

wherein the plurality of spoke tubes each have one or more fluid passage holes configured to pass fluid through to the connector.

94. The dressing layer for a negative pressure wound care system of claim 93, further comprising:

an interface chamber in fluidic communication with each of the plurality of spoke tubes and configured to provide a connection to a vacuum source.

95. The dressing layer for a negative pressure wound care system of claim 93, wherein the netting is a biologically inert polymer material.

96. The dressing layer for a negative pressure wound care system of claim 93, wherein the netting is a bioabsorbable material.

97. The dressing layer for a negative pressure wound care system of claim 93, wherein the netting is impregnated with one or more antimicrobial agents.

98. The dressing layer for a negative pressure wound care system of claim 97, wherein the one or more antimicrobial agents comprise silver-ions.

99. The dressing layer for a negative pressure wound care system of claim 93, wherein the netting is an interwoven mesh material.

100. The dressing layer for a negative pressure wound care system of claim 93, wherein the netting is configured to maintain a spatial relationship of various components of the dressing layer network.

101. The dressing layer for a negative pressure wound care system of claim 93, wherein the netting is a transparent material.

102. The dressing layer for a negative pressure wound care system of claim 93, further comprising:

a pliable coating material covering the netting in a manner configured to reduce fraying of the netting.

103. The dressing layer for a negative pressure wound care system of claim 93, wherein the plurality of spoke tubes and the netting are configured within one planar layer of said dressing layer.

104. The dressing layer for a negative pressure wound care system of claim 93, further comprising:

an abrasive ventral surface of the dressing layer configured to face a wound surface.

105. A negative pressure wound dressing assembly, comprising:

a covering layer with a peripheral edge, an inner ventral surface and an outer dorsal surface;

a porous layer configured for placement over a wound, the porous layer being disposed between the inner ventral surface of the covering layer and the wound; and

a flexible adhesive covering affixed to the outer dorsal surface of the covering layer;

wherein the flexible adhesive covering fits within the peripheral edge of the covering layer in a folded state, and wherein the flexible adhesive covering is of sufficient size to extend beyond the peripheral edge of the covering layer in an unfolded state.

106. The negative pressure wound dressing assembly of claim 105, further comprising:

paper strips affixed to an adhesive side of the flexible adhesive covering, said paper strips being configured to peel off of the flexible adhesive covering to reveal said adhesive side.

107. The negative pressure wound dressing assembly of claim 106, wherein the flexible adhesive covering, in said folded state, is configured to fit more than one inch within the peripheral edge of the covering layer.

108. The negative pressure wound dressing assembly of claim 106, wherein the flexible adhesive covering, in said folded state, is configured to fit more than two inches within the peripheral edge of the covering layer.

109. The negative pressure wound dressing assembly of claim 106, wherein the peripheral edge of the covering layer is configured to be trimmed to shape to fit the wound.

110. The negative pressure wound dressing assembly of claim 109, wherein the porous layer comprises a peripheral edge that is configured to be trimmed to said shape to fit the wound.

111. The negative pressure wound dressing assembly of claim 105, wherein said covering layer comprising an opening arranged to receive a source of vacuum.

112. The negative pressure wound dressing assembly of claim 111, wherein the flexible adhesive covering is configured to fit around said opening arranged to receive the source of vacuum.

113. The negative pressure wound dressing assembly of claim 106, wherein the covering layer of the wound dressing assembly is permanently affixed with a flexible adhesive covering configured to lie over a dorsal surface of the covering layer.

114. A method of packaging a flexible adhesive covering of a negative pressure wound dressing assembly, the method comprising:

providing a covering layer with a peripheral edge, an inner ventral surface and an outer dorsal surface;

providing a porous layer configured for placement over a wound, the porous layer being disposed between the inner ventral surface of the covering layer and the wound; and

affixing a flexible adhesive covering in a folded state to the outer dorsal surface of the covering layer, wherein the flexible adhesive covering fits within the peripheral edge of the covering layer in the folded state;

wherein the flexible adhesive covering is of sufficient size to extend beyond the peripheral edge of the covering layer in an unfolded state.

115. A unified dressing assembly for a negative pressure wound care system, the assembly comprising:

one or more layers for dispersing irrigant to a wound surface, the one or more layers being initially configured to cover a first surface area;

a sealing layer configured to serve as an outer dorsal surface of said unified dressing assembly, wherein the sealing layer, in an unfolded state, is configured to cover a second surface area which is larger than the first surface area;

connection means for connecting a vacuum line from a vacuum source and an irrigant line from an irrigant source; and

means for holding the unified dressing assembly together for placement on the wound surface as a single unit.

116. The unified dressing assembly of claim 115, wherein the sealing layer is configured to be folded within a packaging wrapper in a folded state;

and

wherein the sealing layer is configured to be unfolded to an unfolded state to create a seal between the dressing and the wound margins.

117. The unified dressing assembly of claim 115, further comprising:

vacuum interface chamber attached to the one or more layers and the sealing layer, the vacuum interface chamber serving as the means for holding the unified dressing assembly together.

118. The unified dressing assembly of claim 115, further comprising:

a vacuum accessory tube configured to be in fluidic communication with the vacuum source via the connection means.

119. The unified dressing assembly of claim 115, further comprising:

a disk-shaped central suction cavity configured with side wall pores and a floor with pores, the central suction cavity being one of said one or more layers, and configured to be in fluidic communication with the vacuum source via the connection means.

120. The unified dressing assembly of claim 115, further comprising:

a layer of vacuum lines among the one or more layers, the layer of vacuum lines being in fluidic communication with the vacuum source; and

a layer of irrigation lines among the one or more layers, the layer of irrigation lines being in fluidic communication with the irrigant source.

121. The unified dressing assembly of claim 115, further comprising:

a tubing connection point configured with a one-way valve to prevent back-flow of wound effluent, the tubing connection point serving as the connection means.

122. The unified dressing assembly of claim 115, wherein the sealing layer is initially package in a folded state which covers less surface area than the first surface area of said one or more layers.

123. The unified dressing assembly of claim 122, wherein the sealing layer, initially packaged in the folded state, is configured to be unfolded to the unfolded state to cover the second surface area which is larger than the first surface area.

124. The unified dressing assembly of claim 123, wherein the sealing layer in the unfolded state extends beyond said one or more layers in each lateral direction.

125. The unified dressing assembly of claim 124, wherein at least a portion of a ventral surface of the sealing layer is covered with an adhesive portion configured to stick to a patient'"'"'s skin around the wound surface, forming an air tight seal.

126. The unified dressing assembly of claim 125, further comprising:

one or more peel-away paper backing pieces configured to be removably affixed to the adhesive portion.

127. A negative pressure wound dressing assembly with an inner ventral surface configured to face a wound surface, the wound dressing assembly comprising:

a vacuum connector in fluidic communication with a vacuum source;

a covering layer with a dorsal side serving as a dorsal surface of the wound dressing assembly away from the wound surface;

an irrigant tubing layer positioned on a ventral side of the covering layer and being in fluidic communication with a source of irrigant; and

a control unit configured to control intermittent vacuum pulses provided to the wound surface.

128. The negative pressure wound dressing assembly of claim 127, wherein the intermittent vacuum pulses produce intermittent aliquots of the irrigant across the wound surface to cleanse the wound surface, the irrigant being removed from the negative pressure wound dressing assembly via the vacuum connector.

129. The negative pressure wound dressing assembly of claim 127, further comprising:

a vacuum interface chamber in fluidic communication with the vacuum source.

130. The negative pressure wound dressing assembly of claim 127, further comprising:

a vacuum tubing layer positioned on a ventral side of the covering layer and being in fluidic communication with the vacuum source.

131. The negative pressure wound dressing assembly of claim 127, further comprising:

a control valve in fluidic communication with the irrigant tubing layer configured to allow flow when negative pressure is applied.

132. The negative pressure wound dressing assembly of claim 127, wherein the irrigant tubing layer is configured to deliver the irrigant to a periphery of the wound surface so that a flow path of irrigant is across the wound surface.

133. The negative pressure wound dressing assembly of claim 127, wherein the irrigant tubing layer is positioned adjacent the wound surface to serve as the inner ventral surface facing the wound surface, creating a flow path for the irrigant across the wound surface and through the vacuum connector.

134. A negative pressure wound care system for treating a wound, the negative pressure wound care system comprising:

a vacuum connector in fluidic communication with a vacuum source;

a covering layer with a dorsal side positioned away from the wound surface;

an adhesive portion configured to removably attach to skin around the wound, forming an air-tight seal;

an irrigant tubing layer positioned on a ventral side of the covering layer and being in fluidic communication with a source of irrigant; and

an inflatable bladder configured to be inflated to an inflated state and apply positive pressure to the wound.

135. The negative pressure wound care system of claim 134, further comprising:

a hand pump connected to the inflatable bladder and configured to inflate the inflatable bladder.

136. The negative pressure wound care system of claim 134, further comprising:

a control unit configured to control inflation and deflation of the inflatable bladder.

137. The negative pressure wound care system of claim 136, wherein the control unit is configured to control inflation and deflation to stimulate micro-abrasion to produce a micro-debridement effect.

138. The negative pressure wound care system of claim 134, wherein fluid used to inflate the inflatable bladder a liquid, the negative pressure wound care system further comprising:

a temperature control unit configured to control pre-heating or pre-cooling of the liquid.

139. The negative pressure wound care system of claim 134, wherein the inflatable bladder is controlled to stretch tissues before applying an approximation device.

140. The negative pressure wound care system of claim 134, wherein the inflatable bladder can be maintained in an inflated state to apply pressure to tissue beneath the inflatable bladder.

141. The negative pressure wound care system of claim 134, further comprising:

a pressure bladder sleeve positioned on a dorsal side of the inflatable bladder and configured to direct pressure towards the wound surface.

142. The negative pressure wound care system of claim 134, wherein the inflatable bladder comprises a ventral side and a dorsal side, the ventral side being more pliable and easier to inflate than the dorsal side.

143. A negative pressure wound care system for treating a wound, comprising:

a netting layer with a ventral side serving as a ventral surface of the negative pressure wound care system;

a covering layer with a dorsal side positioned from the wound;

a tubing layer positioned dorsal to said netting layer, the tubing layer being in fluidic communication with a vacuum source, and

an approximating device configured to be positioned dorsal to said covering layer and removably affixed to skin surrounding the wound.

144. The negative pressure wound care system of claim 143, further comprising:

an inflatable bladder positioned ventral to the approximating device.

145. The negative pressure wound care system of claim 144, further comprising:

one or more support ribbons positioned on a dorsal surface of said approximating device and configured to hold the approximating device in place upon inflation of said inflatable bladder to an inflated state.

146. The negative pressure wound care system of claim 143, wherein said approximating device is modular and may be attached dorsal to said covering layer and other components of the negative pressure wound care system or may be attached to the skin surrounding the wound without said covering layer and other components of the negative pressure wound care system.

147. The negative pressure wound care system of claim 143, further comprising:

one or more ribbons positioned on a dorsal surface of said approximating device and configured to hold the approximating device in place; and

a central crankshaft disposed to receive said one or more ribbons for tightening the approximating device.

148. The negative pressure wound care system of claim 147, further comprising:

one or more pull tabs attached to said one or more ribbons, the one or more pull tabs being configured to be points of fixation to the skin surrounding the wound.

149. The negative pressure wound care system of claim 147, wherein the central crankshaft can be adjusted to produce different torsion.

150. The negative pressure wound care system of claim 147, further comprising:

at least one torque limiter that limits the magnitude of tension or duration of tension applied by at least a portion of said one or more ribbons.

151. The negative pressure wound care system of claim 147, wherein the at least one torque limiter comprises a series of torque limiters configured to be sequentially activated.

152. The negative pressure wound care system of claim 143, wherein the approximating device is configured to apply force using an adjustable spring mechanism.

153. The negative pressure wound care system of claim 143, further comprising:

a connector attached to the covering layer and configured to connect to a line from the vacuum source;

a structural support ring configured to be positioned over the connector and provide support to the approximating device.

154. The negative pressure wound care system of claim 143, wherein the approximating device is a first approximating device, the negative pressure wound care system further comprising:

a second approximating device configured to be affixed to fascia proximate the wound.

155. A canister system for a sub-atmospheric wound-care system comprising a porous dressing component positioned facing a wound and disposed to collect effluent discharge from the wound including effluent liquid and effluent gas, the canister system comprising:

a collapsible collection bag in fluidic communication with the porous dressing component and configured to expand with a volume of the effluent discharge collected;

hydrophilic particles that absorb the effluent liquid components of the effluent discharge suctioned from the wound; and

a suction line configured to suction effluent gas into a vacuum source.

156. The canister system of claim 155, further comprising:

a filter configured to separate the effluent liquid from the effluent gas;

wherein the filter is positioned on an egress side of the collapsible collection bag.

157. The canister system of claim 156, wherein the filter is a one-way microbial filter.

158. The canister system of claim 155, further comprising:

a humidity sensor configured to indicate the collapsible collection bag reaching full capacity.