Electrosurgical system and method for sterilizing chronic wound tissue

• US 9,254,167 B2
• Filed: 12/09/2009
• Issued: 02/09/2016
• 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:
  US12/633,966
• Publication Number:
  US 20100087812A1
• Time in Patent Office: 2,253 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, at least a portion of which comprises necrotic 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 fluid sufficient to generate an ionized vapor layer at the active electrode;

removing at least a portion of the necrotic tissue in a substantially non-thermal manner by application of the ionized vapor layer to the chronic wound tissue, wherein the step of removing further comprises;

sterilizing at least a portion of the wound bed while applying the ionized vapor layer; and

preparing a uniform tissue surface more conducive to wound healing.

2. The method of claim 1, further comprising removing debris around a substantial portion of a border of the chronic wound tissue and in the vicinity of the chronic wound tissue.

3. The method of claim 1, wherein removing the at least a portion of the necrotic tissue and sterilizing at least a portion of the wound bed comprises removing pathogens in the chronic wound tissue, wound bed and in the vicinity of the chronic wound tissue.

4. The method of claim 1, wherein sterilizing at least a portion of the wound bed comprises removing biofilm in the vicinity of the chronic wound tissue.

5. The method of claim 1, wherein sterilizing at least a portion of the wound bed comprises removing bacteria in the wound bed and the vicinity of the chronic wound tissue.

6. The method of claim 5, wherein removing bacteria in the wound bed and in the vicinity of the chronic wound tissue further comprises substantially reducing a concentration of bacteria in any remaining chronic wound tissue.

7. The method of claim 5, further comprising inhibiting the growth of bacteria in the wound bed and in the vicinity of the wound tissue.

8. The method of claim 1, wherein removing the at least a portion of the necrotic tissue further comprises debriding at least some of the chronic wound tissue and a chronic wound tissue border.

9. The method of claim 1, further comprising removing tissue adjacent and within the wound bed to the extent that a bleeding wound bed is prepared.

10. The method of claim 1, wherein removing the at least a portion of the necrotic tissue further comprises removing tissue to a controlled depth and forming a modified chronic wound tissue surface having a substantially non-necrotic tissue surface.

11. The method of claim 1, wherein removing the at least a portion of the necrotic tissue further comprises removing a border of the necrotic tissue to remove any gaps in vascular structure between the wound bed and surrounding healthy tissue.

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

13. The method of claim 12, further comprising directing the plasma to intermittently contact the chronic wound tissue for about 0.5 seconds on each instance.

14. The method of claim 13, wherein directing the plasma further comprises a total exposure time of at least 3 seconds.

15. The method of claim 1 wherein the steps of removing and sterilizing clear epithelialization blocks from the wound bed and a target tissue in the vicinity of the chronic wound tissue to promote closure of the wound bed.

21. The method of claim 1 or 16 wherein the chronic wound tissue is formed as a result of a patient burn.

22. The method of claim 1 or 16 wherein the chronic wound tissue is disposed on the skin.

16. 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 necrotic tissue and a 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, thereby forming a plasma at the active electrode; and

applying the plasma to the chronic wound tissue;

removing at least a portion of the chronic wound tissue by application of the plasma wherein removing the at least a portion of the chronic wound tissue further comprises the steps of;

molecularly dissociating the at least a portion of the chronic wound tissue including at least a portion of the necrotic tissue so as to leave a uniform, smooth, and contoured surface layer, conducive to proper healing.

17. The method of claim 16 further comprising directing the plasma to intermittently contact the chronic wound tissue for about 0.5 seconds on each instance.

18. The method of claim 17, wherein directing the plasma further comprises a total exposure time of at least 3 seconds.

19. The method of claim 16, further comprising substantially reducing biofilm in the wound bed.

20. The method of claim 16, further comprising sterilizing the wound bed.

23. The method of claim 16 further comprising molecularly dissociating the at least a portion of the chronic wound tissue and tissue on the periphery of the wound bed to the extent that a bleeding wound bed is prepared so as to stimulate an acute healing response.

24. The method of claim 16 further comprising substantially reducing a concentration of pathogens in the wound bed while applying the plasma.

25. The method of claim 24, wherein the pathogens comprise bacteria.

26. The method of claim 25, further comprising inhibiting the growth of bacteria in the chronic wound tissue and in the vicinity of the wound tissue.

27. The method of claim 24 wherein the steps of substantially reducing the concentration of pathogens and removing the at least a portion of the chronic wound tissue clear epithelialization blocks from the surface layer and a target tissue in the vicinity of the chronic wound tissue to promote closure of the wound bed.