Electrosurgical system and method for sterilizing chronic wound tissue

• US 9,168,087 B2
• Filed: 07/28/2010
• Issued: 10/27/2015
• Est. Priority Date: 01/06/2006
• Status: Active Grant

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Davison, Terry S., Warne, Brian, Kwende, Martin
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US12/845,283
• Publication Number:
  US 20100318083A1
• Time in Patent Office: 1,917 Days
• Field of Search: 606/32, 606/39, 606/40, 606/50, 606/41, 607/46, 607/50, 607 98-100, 607/115
• US Class Current: 1/1
• 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 sterilizing chronic wound tissue, comprising: positioning an active electrode in proximity to the chronic wound tissue; delivering an electrically conductive fluid proximate the active electrode; and applying a high frequency voltage between the active electrode and a return electrode in the presence of the electrically conductive liquid sufficient to generate an ionized vapor layer at the active electrode, wherein the ionized vapor layer sterilizes at least a portion of the chronic wound tissue.

Claims

1. An electrosurgical method of treating a chronic wound tissue comprising:

positioning an active electrode in proximity to the chronic wound tissue, wherein the chronic wound tissue comprises a wound bed;

delivering an electrically conductive fluid proximate the active electrode;

applying a high frequency voltage between the active electrode and a return electrode in the presence of the electrically conductive fluid sufficient to generate an ionized vapor layer at the active electrode;

removing at least a portion of the chronic wound tissue by application of the ionized vapor layer to the at least a portion of the chronic wound tissue, wherein removing the at least a portion of the chronic wound tissue further comprises;

molecularly dissociating the at least a portion of the chronic wound tissue and at least some surrounding avascular tissue on periphery her of the wound bed so as to bridge vascular gaps between surrounding vital tissue and the wound bed, and induce blood to flow directly to the wound bed, so as to prepare a smooth and uniform bleeding wound bed.

2. The method of claim 1, wherein the step of molecularly dissociating comprises debriding the at least a portion of the chronic wound tissue.

3. The method of claim 2, wherein debriding further comprises removing necrotic tissue to a controlled depth.

4. The method of claim 1, wherein at least a portion of energy induced from the application of the ionized vapor layer is in the form of photons having a wavelength in the ultraviolet spectrum.

5. The method of claim 1, wherein at least a portion of the energy induced is in the form of energetic electrons.

6. The method of claim 5, wherein the energy evolved by the energetic electrons is greater than 3 eV.

7. The method of claim 1, wherein the ionized vapor layer forms a plasma at the active electrode.

8. The method of claim 1 further comprising applying energy induced from the vapor layer to at least a portion of the bleeding wound bed and to a target tissue in the vicinity of the chronic wound tissue so as to sterilize at least a portion of the bleeding wound bed and target tissue.

9. The method of claim 8, wherein the step of applying energy so as to sterilize comprises removing pathogens in the wound bed and in the vicinity of the chronic wound tissue.

10. The method of claim 8 wherein the steps of applying the energy to sterilize the at least a portion of the bleeding wound bed and removing the at least a portion of chronic wound tissue clears epithelialization blocks from the wound bed and the target tissue in the vicinity of the chronic wound tissue and improves closure of the wound bed.

11. The method of claim 8, wherein the step of applying energy so as to sterilize comprises removing bacteria in the wound bed and in the target tissue in the vicinity of the chronic wound tissue.

12. The method of claim 11, wherein removing bacteria in the wound bed further comprises substantially reducing a concentration of bacteria in the wound bed.

13. The method of claim 11, further comprising inhibiting the growth of bacteria in the wound bed and in the target tissue in the vicinity of the wound tissue.

14. An electrosurgical method of treating a chronic wound tissue comprising:

positioning an active electrode in proximity to the chronic wound tissue, the chronic wound tissue comprising a wound bed having a surface layer and wherein avascular tissue surrounds at least portion of the wound bed;

positioning a return electrode in the presence of the chronic wound tissue, the return electrode proximally spaced away from the active electrode;

applying a high frequency voltage between the active electrode and the return electrode, wherein the high frequency voltage is sufficient to vaporize and ionize an electrically conductive fluid such that a vapor layer is formed and a discharge of plasma is induced from the vapor layer;

removing a portion of the chronic wound tissue, wherein removing the chronic wound tissue comprises;

applying the plasma to the chronic wound tissue; and

molecularly dissociating the chronic wound tissue as well as at least some of the avascular tissue sufficient to remove at least some gaps in vascularity surrounding the wound bed and prepare a smooth and uniform bleeding wound bed; and

substantially reducing a concentration of pathogens in the bleeding wound bed while applying the plasma.

15. The method of claim 14, wherein the plasma is comprised of photons having a wavelength in the ultraviolet spectrum.

16. The method of claim 14, wherein the plasma is comprised of energetic electrons.

17. The method of claim 16, wherein the energy evolved by the energetic electrons is greater than 3 eV.

18. The method of claim 14, wherein the pathogens comprise bacteria.

19. The method of claim 18, further comprising inhibiting the growth of bacteria in the wound bed and in the vicinity of the chronic wound tissue.

20. The method of claim 14, further comprising applying the plasma to sterilize at least a portion of the wound bed.

21. The method of claim 14 wherein the step of removing a portion of the chronic wound tissue restores blood flow to and in the presence of the wound bed and remaining chronic wound tissue and wherein the step of substantially reducing a concentration of pathogens in the wound bed in combination with the step of removing, clears epithelialization blocks from the surface layer to promote closure of the wound bed.

22. An electrosurgical method of treating a chronic wound tissue comprising:

positioning an active electrode in proximity to the chronic wound tissue, wherein the chronic wound tissue comprises a wound bed;

positioning a return electrode in the presence of the chronic wound tissue, the return electrode proximally spaced from the active electrode;

applying a high frequency voltage between the active electrode and the return electrode, the high frequency voltage sufficient to develop high electric field intensities associated with an ionized vapor layer proximate the active electrode;

removing at least a portion of the chronic wound tissue by application of the high electric field intensities to the chronic wound tissue, wherein removing the at least a portion of the chronic wound tissue further comprises;

engaging the chronic wound tissue with the ionized vapor layer sufficient to molecularly dissociate the at least a portion of the chronic wound tissue as well as some surrounding tissue sufficient to remove vascular gaps surrounding the wound bed and restore a blood flow to the wound bed and any remaining chronic wound tissue; and

sterilizing at least a portion of the wound bed with the application of the ionized vapor layer.

23. The method of claim 22, wherein molecularly dissociating the at least a portion of the chronic wound tissue further comprises debriding the tissue to a controlled depth to form a smooth and uniform bleeding wound bed.

24. The method of claim 22 wherein the molecular dissociation of the at least a portion of the chronic wound tissue expresses hydroxyl radicals in the vicinity of the wound bed.

25. The method of claim 24 further comprising sterilizing at least a portion of the wound bed with the application of the ionized vapor layer, wherein removing the at least a portion of the chronic wound tissue clears epithelialization blocks from the wound bed to promote closure of the wound bed.

26. The method of claim 24, wherein expressing hydroxyl radicals further comprises increasing a level of interleukin (IL)-8 expression.

27. The method of claim 26, wherein increasing the level of interleukin (IL)-8 expression results in a higher rate of neutrophil attraction to the chronic wound tissue, whereby the neutrophil attraction produces reactive oxygen species (ROS) for substantially reducing a concentration of bacteria in the wound bed.