Methods for the prevention of surgical site infections

• US 9,788,823 B2
• Filed: 06/15/2015
• Issued: 10/17/2017
• Est. Priority Date: 01/10/2012
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford University)
• Inventors: Suh, Insoo, Coe, Jonathan, Gnanashanmugam, Swaminadhan, Koehler, Jeremy, Welton, Mark
• Primary Examiner(s): JOHANAS, JACQUELINE T
• Application Number:
  US14/739,484
• Publication Number:
  US 20150272565A1
• Time in Patent Office: 855 Days
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0293 with ring member to support retractor elements
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/3437 with means for removing or absorbing fluid, e.g. wicks or absorbent pads
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 2217/007 with irrigation system

Abstract

Several methods to reduce surgical site infections include inserting a surgical access device into an incision, retracting tissue, and introducing fluid into the surgical access device such that the fluid exits the surgical access device and irrigates a surgical site. Other methods do not include introducing fluid into a surgical access device but include suctioning a fluid into the surgical access device and removing the fluid from the body.

Claims

1. A method for irrigating a surgical site in patient'"'"'s body, said method comprising:

providing a surgical access device, wherein the surgical access device comprises a first retention member, a second retention member, and a pliable membrane coupled to the first and second retention members, wherein the pliable membrane comprises an inner layer and an outer layer joined together at a plurality of locations, wherein the plurality of joined locations form a quilted pattern, and wherein the outer layer comprises a plurality of perforations;

advancing the first retention member into the body through an incision;

disposing the second retention member outside the body;

irrigating the surgical site with fluid delivered from the plurality of perforations.

2. The method of claim 1, further comprising expanding the second retention member whereby expanding the second retention member causes the pliable membrane to retract tissue around the incision.

3. The method of claim 1, wherein a first group of one or more perforations are fluidly isolated from a second group of one or more perforations.

4. The method of claim 1, wherein the plurality of joined locations form a plurality of chambers, the method further comprising passing the fluid through some of the chambers without passing the fluid through other chambers.

5. The method of claim 1, further comprising supplying the fluid to the pliable membrane by passing the fluid through an inlet conduit fluidly coupled to the pliable membrane.

6. The method of claim 1, further comprising maintaining patency between the inner and the outer layers by providing a porous or non-porous material disposed therebetween, wherein the porous or non-porous material maintains patency when a compressive force is applied to the inner and the outer layers.

7. The method of claim 6, further comprising retaining the fluid in the porous or non-porous material.

8. The method of claim 6, wherein the porous material or the non-porous material facilitates fluid flow between the inner and the outer layers.

9. The method of claim 1, further comprising maintaining patency between the inner and the outer layers by providing a compressible or an incompressible material disposed therebetween, wherein the compressible or incompressible material maintains patency when a compressive force is applied to the inner and the outer layers.

10. The method of claim 1, wherein irrigating comprises selectively delivering the fluid to one or more perforations.

11. The method of claim 1, further comprising controlling fluid flow from the perforations with one or more valves fluidly coupled thereto.

12. The method of claim 1, further comprising applying suction to the surgical site to remove fluid therefrom through the plurality of perforations.

13. A method for irrigating a surgical site in patient'"'"'s body, said method comprising:

providing a surgical access device, wherein the surgical access device comprises a first retention member, a second retention member, and a pliable membrane coupled to the first and second retention members, wherein the pliable membrane comprises an inner layer and an outer layer joined together at a plurality of locations, wherein the outer layer comprises a plurality of perforations, and wherein a first group of one or more perforations are fluidly isolated from a second group of one or more perforations;

advancing the first retention member into the body through an incision;

disposing the second retention member outside the body;

irrigating the surgical site with fluid delivered from the plurality of perforations.

14. The method of claim 13, further comprising expanding the second retention member whereby expanding the second retention member causes the pliable membrane to retract tissue around the incision.

15. The method of claim 13, wherein the plurality of joined locations form a quilted pattern.

16. The method of claim 13, wherein the plurality of joined locations form a plurality of chambers, the method further comprising passing the fluid through some of the chambers without passing the fluid through other chambers.

17. The method of claim 13, further comprising supplying the fluid to the pliable membrane by passing the fluid through an inlet conduit fluidly coupled to the pliable membrane.

18. The method of claim 13, further comprising maintaining patency between the inner and the outer layers by providing a porous or non-porous material disposed therebetween, wherein the porous or non-porous material maintains patency when a compressive force is applied to the inner and the outer layers.

19. The method of claim 18, further comprising retaining the fluid in the porous or non-porous material.

20. The method of claim 18, wherein the porous material or the non-porous material facilitates fluid flow between the inner and the outer layers.

21. The method of claim 13, further comprising maintaining patency between the inner and the outer layers by providing a compressible or an incompressible material disposed therebetween, wherein the compressible or incompressible material maintains patency when a compressive force is applied to the inner and the outer layers.

22. The method of claim 13, wherein irrigating comprises selectively delivering the fluid to one or more perforations.

23. The method of claim 13, further comprising controlling fluid flow from the perforations with one or more valves fluidly coupled thereto.

24. The method of claim 13, further comprising applying suction to the surgical site to remove fluid therefrom through the plurality of perforations.

25. A method for irrigating a surgical site in patient'"'"'s body, said method comprising:

providing a surgical access device, wherein the surgical access device comprises a first retention member, a second retention member, and a pliable membrane coupled to the first and second retention members, wherein the pliable membrane comprises an inner layer and an outer layer joined together at a plurality of locations, and wherein the outer layer comprises a plurality of perforations;

maintaining patency between the inner and the outer layers by providing a porous or non-porous material disposed therebetween, wherein the porous or non-porous material maintains patency when a compressive force is applied to the inner and the outer layers;

advancing the first retention member into the body through an incision;

disposing the second retention member outside the body;

irrigating the surgical site with fluid delivered from the plurality of perforations.

26. The method of claim 25, further comprising expanding the second retention member whereby expanding the second retention member causes the pliable membrane to retract tissue around the incision.

27. The method of claim 25, wherein the plurality of joined locations form a quilted pattern.

28. The method of claim 25, wherein a first group of one or more perforations are fluidly isolated from a second group of one or more perforations.

29. The method of claim 25, wherein the plurality of joined locations form a plurality of chambers, the method further comprising passing the fluid through some of the chambers without passing the fluid through other chambers.

30. The method of claim 25, further comprising supplying the fluid to the pliable membrane by passing the fluid through an inlet conduit fluidly coupled to the pliable membrane.

31. The method of claim 25, further comprising retaining the fluid in the porous or non-porous material.

32. The method of claim 25, wherein the porous material or the non-porous material facilitates fluid flow between the inner and the outer layers.

33. The method of claim 25, wherein the porous or non-porous material comprises a compressible or an incompressible material disposed therebetween, wherein the compressible or incompressible material maintains patency when a compressive force is applied to the inner and the outer layers.

34. The method of claim 25, wherein irrigating comprises selectively delivering the fluid to one or more perforations.

35. The method of claim 25, further comprising controlling fluid flow from the perforations with one or more valves fluidly coupled thereto.

36. The method of claim 25, further comprising applying suction to the surgical site to remove fluid therefrom through the plurality of perforations.

37. A method for irrigating a surgical site in patient'"'"'s body, said method comprising:

providing a surgical access device, wherein the surgical access device comprises a first retention member, a second retention member, and a pliable membrane coupled to the first and second retention members, wherein the pliable membrane comprises an inner layer and an outer layer joined together at a plurality of locations, and wherein the outer layer comprises a plurality of perforations;

maintaining patency between the inner and the outer layers by providing a compressible or an incompressible material disposed therebetween, wherein the compressible or incompressible material maintains patency when a compressive force is applied to the inner and the outer layers;

advancing the first retention member into the body through an incision;

disposing the second retention member outside the body;

irrigating the surgical site with fluid delivered from the plurality of perforations.

38. The method of claim 37, further comprising expanding the second retention member whereby expanding the second retention member causes the pliable membrane to retract tissue around the incision.

39. The method of claim 37, wherein the plurality of joined locations form a quilted pattern.

40. The method of claim 37, wherein a first group of one or more perforations are fluidly isolated from a second group of one or more perforations.

41. The method of claim 37, wherein the plurality of joined locations form a plurality of chambers, the method further comprising passing the fluid through some of the chambers without passing the fluid through other chambers.

42. The method of claim 37, further comprising supplying the fluid to the pliable membrane by passing the fluid through an inlet conduit fluidly coupled to the pliable membrane.

43. The method of claim 37, wherein the compressible or incompressible material comprises a porous or non-porous material, wherein the porous or non-porous material maintains patency when a compressive force is applied to the inner and the outer layers.

44. The method of claim 43, further comprising retaining the fluid in the porous or non-porous material.

45. The method of claim 43, wherein the porous material or the non-porous material facilitates fluid flow between the inner and the outer layers.

46. The method of claim 37, wherein irrigating comprises selectively delivering the fluid to one or more perforations.

47. The method of claim 37, further comprising controlling fluid flow from the perforations with one or more valves fluidly coupled thereto.

48. The method of claim 37, further comprising applying suction to the surgical site to remove fluid therefrom through the plurality of perforations.