Electrosurgical method and system for treating foot ulcer

• US 8,663,154 B2
• Filed: 05/05/2009
• Issued: 03/04/2014
• Est. Priority Date: 01/06/2006
• Status: Expired due to Fees

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Warne, Brian, Davison, Terry S.
• Primary Examiner(s): Sirmons, Kevin C.
• Assistant Examiner(s): Hall, Deanna K
• Application Number:
  US12/435,728
• Publication Number:
  US 20090222004A1
• Time in Patent Office: 1,764 Days
• Field of Search: 606/41, 606/45, 606 49- 50, 604/22
• US Class Current: 604/22
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 2018/00452 Skin
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

An electrosurgical method for treating foot ulcer, including diabetic foot ulcer, comprising: positioning an active electrode in close proximity to the ulcer, the active electrode being disposed on a distal end of an electrosurgical shaft; applying a high-frequency voltage potential difference across the active electrode and a return electrode in the presence of an electrically conductive fluid, the voltage potential being sufficient to generate plasma at the active electrode; and stimulating the ulcer with the active electrode to increase blood flow, remove unhealthy tissue and induce the body'"'"'s natural healing response.

Claims

1. An electrosurgical method of treating ulcer tissue, comprising:

positioning an active electrode proximate to the ulcer tissue, the active electrode disposed on a distal end of a shaft; and

applying a high-frequency voltage potential difference across the active electrode and a return electrode sufficient to form a plasma at the active electrode;

modifying the ulcer tissue, wherein modifying the ulcer tissue comprises;

applying the plasma at the active electrode to the ulcer tissue to remove a portion of the ulcer tissue;

inducing blood flow from an underlying tissue, wherein inducing blood flow restores blood flow to and in the presence of the ulcer tissue; and

passing a minimal current flow through the ulcer tissue;

wherein modifying the ulcer tissue in the presence of the plasma, restored blood flow, and minimal current flow alters the expression of inflammatory response in the ulcer tissue to stimulate healthy tissue growth in place of the removed ulcer tissue and promotes the healing of the ulcer tissue.

2. The method of claim 1, wherein an electrically conductive liquid is provided on the active electrode.

3. The method of claim 2, wherein applying the high-frequency voltage further comprises vaporizing the electrically conductive liquid.

4. The method of claim 1, wherein applying the high-frequency voltage and forming the plasma further comprises applying a sufficiently high voltage to vaporize an electrically conductive liquid in a region proximate the active electrode.

5. The method of claim 1, wherein the ulcer tissue comprises skin ulcer tissue.

6. The method of claim 1, wherein the ulcer tissue comprises mucus membrane ulcer tissue.

7. The method of claim 1, wherein the ulcer tissue comprises foot ulcer tissue.

8. The method of claim 1, wherein the ulcer tissue comprises diabetic foot ulcer tissue.

9. The method of claim 1, wherein the ulcer tissue comprises cellulitic tissue.

10. The method of claim 1, wherein applying the plasma at the active electrode to the ulcer tissue comprises directing the plasma to contact at least a portion of the ulcer tissue.

11. The method of claim 10, wherein modifying the ulcer tissue further comprises perforating the ulcer tissue.

12. The method of claim 10, wherein modifying the ulcer tissue further comprises debriding the ulcer tissue.

13. The method of claim 11, wherein modifying the ulcer tissue further comprises perforating at least a portion of a tissue in the vicinity of the ulcer tissue.

14. The method of claim 13, wherein perforating the at least a portion of the tissue in the vicinity of the ulcer tissue further comprises inducing blood-flow to the at least a portion of the tissue in the vicinity of the ulcer tissue.

15. The method of claim 1, wherein the active and the return electrode are disposed on the shaft.

16. The method of claim 2, wherein the plasma is formed by applying the high-frequency voltage across the electrically conductive liquid.

17. The method of claim 2, wherein the electrically conductive liquid comprises a conductive bridge between the active electrode and return electrode.

18. The method of claim 2, wherein the electrically conductive liquid is selected from the group consisting of body fluid, conductive gel, isotonic saline, and Ringer'"'"'s lactate solution.

19. The method of claim 1, wherein positioning the active electrode further comprises contacting at least a portion of the ulcer tissue with the active electrode.

20. The method of claim 1, further comprising submerging the ulcer tissue with conductive liquid.

21. The method of claim 1, further comprising limiting the application of the high-frequency voltage for a selected time period.

22. The method of claim 11, wherein perforating the tissue comprises forming a plurality of perforations in the ulcer tissue and in the vicinity of the ulcer tissue, the plurality of perforations spaced less than 5 mm apart.

23. The method of claim 11, wherein perforating the ulcer tissue comprises forming a plurality of perforations with diameters of up to about 3 mm in the ulcer tissue and in the vicinity of the ulcer tissue.

24. The method of claim 11, wherein perforating the ulcer tissue comprises forming a plurality of perforations up to about 3 mm in depth in the ulcer tissue and in the vicinity of the ulcer tissue.

25. The method of claim 11, wherein perforating the ulcer tissue comprises forming a plurality of perforations up to about 5 mm in depth in the ulcer tissue and in the vicinity of the ulcer tissue.

26. The method of claim 1, further comprising adjusting the voltage to cause coagulation of at least portions of ulcer tissue and at least portions of tissue in the vicinity of the ulcer tissue.

27. The method of claim 1, wherein the active electrode is connected with a high-frequency voltage supply and a conductive liquid supply.

28. The method of claim 1, wherein the active electrode comprises an electrode having a pointed tip.

29. The method of claim 1, wherein the shaft comprises a suction lumen.

30. The method of claim 2, wherein the shaft comprises a liquid delivery lumen.

31. The method of claim 1, wherein altering the expression of inflammatory response comprises decreasing the level of interlukin-1 (IL-1).

32. The method of claim 1, wherein altering the expression of inflammatory response comprises increasing the level of interlukin-8 (IL-8).

33. The method of claim 1, further comprising coordinating the inflammatory response and a tissue repair response within the ulcer tissue.

34. The method of claim 1, whereby the plasma stimulates a tissue healing response within the ulcer tissue.

35. The method of claim 34, wherein the tissue healing response is mediated by increased levels of interlukin-8 (IL-8).