TW200808393A - System for percutaneously administering reduced pressure treatment using balloon dissection - Google Patents

Abstract

A reduced pressure delivery system for applying a reduced pressure to a tissue site includes a manifold delivery tube having at least two lumens and a manifold having a plurality of flow channels. The manifold is disposed within a first of the lumens of the manifold delivery tube. A balloon having an inner space and being capable of assuming collapsed and expanded positions is provided. The inner space of the balloon is fluidly connected to a second of the lumens of the manifold delivery tube.

Description

200808393 IX. INSTRUCTIONS: [Technical field to which the invention pertains] The present invention relates to systems and methods for promoting tissue growth, and more particularly to the application of a tissue to a tissue site. Pressure tissue treatment system. ~ [Prior Art] People are gradually using decompression therapy to promote wound healing in soft tissue wounds that heal very slowly or not heal if they are not treated with decompression. Typically, ## is applied to the wound site by a reduced pressure of the open-cell foam, which acts as a manifold to distribute the reduced brilliance. The open-cell foam is sized to fit the existing wound, is in contact with the wound, and then begins to heal and become smaller as the wound begins; the t-stage is replaced with a smaller foam. In order to minimize the amount of tissue growing into the pores of the foam, it is necessary to frequently replace the open pore foam. During the removal of the foam, the large amount of tissue that is growing can cause pain to the patient. # Decompression therapy is usually applied to non-healing open injuries. In some cases, the tissue to be treated is subcutaneous tissue, and in other cases, the tissue is located in the skin tissue or in & A you from, above, traditionally, decompression therapy has been mainly applied to the right, and 4; salty pressure therapy has not been used to treat closed deep tissue injuries # 75〒 difficult to access these wounds. In addition, decompression therapy has not been used in conjunction with the treatment of sputum or skeletal growth, which is mainly due to the difficulty of accessing the collaterals. Applying decompression therapy by surgically exposing the bone network may cause more problems than the problem it solves. Finally, the application of decompression therapy for u ^ ° cattle and sputum, and the development of the filling almost did not exceed the opening of the open-cell foam 119637.doc 200808393 and then in the shape of the open-hole foam It is removed after the injury-decompression treatment cycle. SUMMARY OF THE INVENTION The system and method of the present invention solves the problems existing in existing wound healing systems and methods. According to the present invention, a "pressure reducing conveyor system" is provided for reducing the pressure on a tissue portion/virtual/vertical application. The reduced pressure delivery system includes a manifold delivery port, 1 mesh/, /, at least two lumens, and a station with a plurality of flow channels. d g

The ambiguity is disposed in the first of the lumens of the manifold delivery tube. A balloon is provided which has an internal space and is capable of taking a collapsed position and an expanded position. The inner garment of the balloon is fluidly coupled to a second one of the lumens of the manifold delivery tube. According to another embodiment of the present invention, a reduced pressure delivery system is provided which includes an impervious film having an internal space. The non-permeable film can be in a compressed state and a relaxed state. A manifold having a plurality of flow passages is disposed in the interior space of the impermeable membrane. The pressure within the impervious membrane is reduced by less than the pressure outside the impervious membrane to reduce the amount of space occupied by the manifold within the impervious membrane. In accordance with still another embodiment of the present invention, a reduced pressure delivery system is provided that includes a manifold delivery tube having at least one channel and a distal end, the distal end being positionable adjacent the tissue site. A manifold having a plurality of flow channels is configured to be delivered to the tissue site via a passageway of the manifold delivery tube. An impermeable membrane is provided which can be positioned at the distal end of the manifold delivery tube. The impermeable membrane includes an interior space and is capable of taking at least one of an expanded position and a collapsed position. 119637.doc 200808393 Other objects, features and advantages of the present invention will become apparent from the accompanying drawings. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S) The following is a detailed description of the preferred embodiments, which constitute a part of the present invention, and the drawings show the specific preferred embodiments of the present invention. The technicians can practice the implementation of this embodiment in sufficient oceans, fields, and fields, and it should be understood that other shellfish cases can be used and changes can be made in logical structures, machinery, helium, and chemistry. The teachings may omit certain information that is known to those skilled in the art in light of the spirit and scope of the invention. The following is not to be taken as limiting, and the scope of the invention is defined only by the scope of the accompanying claims. The term "elasticity" as used herein means having the properties of an elastomer. The term "elastomer" refers to a polymer material having the same properties as rubber: more specifically, λ most elastomers have an elongation of more than 100% and a significant degree of resilience. The resilience of the material refers to the material. It can recover from elastic deformation. Examples of elastomers may include, but are not limited to, natural, rubber, polyisobutylene, styrene butadiene rubber, chloroprene rubber, polybutadiene, nitrile rubber, isodecene. Rubber, ethylene propylene rubber, ethylene propylene dioxime monomer ^ gel, chlorosulfonated polyethylene, polysulfide rubber, polyurethane, and oxime. The term "flexible" used in this article refers to an object. Or the material can bend or bend. The elastic material is usually flexible, but the flexible material mentioned in this article: 119637.doc 200808393 = 疋 The selected material is limited to only the elastomer. The term π flexibility " The use of a large system in conjunction with the material of this month or a reduced-pressure delivery device means that the material can be applied or closely matched to the shape of a tissue site. For example, the use of a decompression device for the treatment of sacral dysfunction Sexual nature The device is capable of wrapping or wrapping a portion of the skeleton having a defect. The term "fluid" as used herein generally refers to a gas or liquid, but may also include any other flowable read material, including but not limited to gels, gels. Or foam. As used herein, the term "impervious" generally refers to the ability of a film, cover or other material to block or slow the penetration of a liquid or gas. Imperviousness can be used to refer to the covering of the crucible (four) body while allowing gas to pass through the cover, sheet or other film of the film. Although the impermeable film may be impermeable to liquids' however, the film may simply reduce the transmission of all or only certain liquids. The use of the term "impermeable" is not intended to imply that the impermeable film is above or below any particular 4 standard permeability measurement, such as a specific value for water vapor transmission rate (WVTR). As used herein, the term "manifold," large system refers to a substance or structure provided to facilitate the application of reduced pressure to a tissue site, the delivery or removal of fluid from the tissue site. The manifold typically includes a plurality of interconnected flow channels or passages to improve the distribution of fluids provided to or removed from the tissue region surrounding the manifold. Examples of the manifold may include a pen, a honeycomb foam (e.g., an open cell foam) having a structural member disposed to form a flow channel, a porous tissue collecting skirt, and a spoon containing or solidifying to contain a flow Channel liquid, gel and bubble. 119637.doc 200808393 The term "reduced stress" as used herein refers to a pressure at a tissue site that is receiving treatment that is less than the surrounding pressure. In most cases, the pressure of such reduction will be less than the environment in which the patient is located. Pressure. Alternatively, the reduced pressure may be less than the hydrostatic pressure of the tissue at the tissue site. Although the terms "vacuum" and "negative pressure" may be used to describe the pressure applied to the tissue site, the actual application to the tissue site The pressure can be significantly lower than the pressure normally associated with a pure vacuum. The reduced pressure can initially create fluid flow in the area of the tube and group 4 alpha clamp. As the hydrostatic pressure around the tissue site approaches the desired reduction The pressure, the flow may slow down, and then maintain the reduced pressure. Unless otherwise indicated, the pressure values described herein are gauge pressure. The term "scaffold" as used herein refers to the use of cells to enhance or promote cells. A substance or structure formed by growth and/or tissue. The scaffold is typically a three-dimensional porous structure that provides a template for cell growth. The rack may be infused with, coated with, or composed of cells, growth factors, or other nutrient agents for promoting cell growth. A scaffold may be used as a manifold according to embodiments described herein to decompress tissue at a tissue site Treatment. The term "tissue site" as used herein refers to a wound or defect located above or within any tissue, including but not limited to bone tissue, adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, Cartilage, tendon, or ligament. The term "tissue site" can further refer to the region of any tissue that is not necessarily injured or defective, but rather wants to enhance or promote the growth of additional tissue in such regions. For example, decompression tissue treatment can be used in some tissue regions to grow additional tissue and then harvested. 119637.doc -10- 200808393 This additional tissue is obtained and transplanted to another tissue site. Referring to Figures 1-5, a reduced pressure wheeling device or wing manifold 2 in accordance with the principles of the present invention includes a rib portion 215, a flexible barrier 213, and a pair of wing portions 219. Each wing portion 219 is positioned along the opposite side of the ridge portion. The ridge portion 215 defines an arcuate passage 223 that may or may not extend over the entire length of the wing manifold 211. The tube ridge portion 215 can be centrally positioned on the wing manifold 211 such that the width of each wing portion 219 is equal, however the ridge portion 215 can also be offset as shown in Figure #, thereby One wing portion 219 is wider than the other wing portion 219. If the wing manifold 211 is used in conjunction with bone regeneration or healing: the wide width of the wing-shaped manifold 211 will be wrapped around the fixed hardware attached to the bone, and the extra width of one of the wing portions 2丨9 may be particularly it works. The flexible barrier 213 is preferably sterilized by an elastic material such as a polyoxyl polymer. Suitable polyoxyl polymers - examples include by. ...Curry, med_6〇15 manufactured by Nusil Technologies of Qalifomia. However, it should be noted that the flexible barrier 213 can be made of any other biocompatible, flexible material: material. The flexible barrier 213 encloses a flexible backing 227 to enhance the strength and durability of the barrier 213. The flexible barrier 213 enclosing the flexible backing 227 may have a thickness in the arcuate channel 223 that is less than the thickness in the wing portion 219. If a polyphthalocyanine polymer is used to form the flexible barrier 213, a poly-xylene adhesive can also be used to help bond the flexible backing 227. An example of a polyoxynoxy binder may include med_MU sold also by Nusil Techn〇l〇gies&3. The flexible backing 227 is preferably made of a poly-knitted fabric, for example, manufactured by Bard 6〇13, 119637.doc 200808393, manufactured by C. R. Bard, Inc., Tempe, Arizona. However, the flexible backing 227 can be made of any biocompatible, flexible material that enhances the strength and durability of the flexible barrier 213. In some cases, the flexible backing 227 can be dispensed with if the flexible barrier 213 is made of a material of suitable strength. Preferably, the flexible barrier 213 or flexible backing 227 is impermeable to liquids, air and other gases, or alternatively, both the flexible backing 227 and the flexible barrier are impermeable to liquids, air and other gases. The Lu flexible barrier 213 and the flexible backing 227 can also be made of a bioresorbable material that does not have to be removed from the patient after use of the reduced pressure delivery device 211. Suitable bioresorbable materials can include, but are not limited to, polymeric blends of polylactic acid (PLA) and polyglycolic acid (PGA). The polymeric blends can also include, but are not limited to, polycarbonate, polyfumaric acid, and capralact〇ne. The flexible barrier 2 13 and the flexible backing 227 can be further used as a new cell growth support, or a stent material can be used in combination with the flexible barrier 213 and the flexible backing 227 to promote cell growth. Suitable scaffolding materials can include, but are not limited to, φ calcium phosphate, collagen, PLA/PGA, coral hydroxyapatite, carbonate, or meal-treated allograft materials. Preferably, the scaffold material will have a high void fraction (i.e., a high air content). In one embodiment, the flexible backing 227 can be secured to the surface of the flexure barrier 213 in an adhesive manner. If a polyether polymer is used to form the flexure barrier >1 213 ', the flexible backing 227 can also be secured to the flexible barrier 213 using a polyoxynitride adhesive. Although a method of securing the surface of the flexible backing 227 to the flexible barrier is preferred. 119637.doc 200808393 The flexible barrier 213 includes a plurality of protrusions 231 extending from the wing portion 219 on the surface of the flexible barrier 213. The protrusions 231 may be cylindrical, 'spherical, hemispherical, cubic, or any other shape, as long as at least some portion of each protrusion 231 is located in a different plane than the protrusion 23 1 is attached to the flexible backing. The plane associated with the side can be. In this regard, it is not even required that a particular protrusion 231 have the shape or size of the other protrusions 231; in fact, the protrusions 231 may comprise a random mixture of different shapes and sizes. Therefore, the distance from each of the protrusions 231 from the flexible barrier 213 may vary, but may also be uniform in the plurality of protrusions 23A. The arrangement of the projections 23 on the flexible barrier 213 forms a plurality of flow passages 233 between the projections. When the projections 231 have the same shape and size and are evenly spaced on the flexible barrier 213, the flow passages 233 formed between the projections 231 are equally uniform. The size and shape of the flow path 233 can also be varied by utilizing changes in the size, shape and spacing of the protrusions 231. As shown in Fig. 05, a reduced pressure delivery tube 241 is located in the arcuate passage 223 and is fixed to the flexible barrier 213. The reduced pressure delivery tube 241 may be fixed only to the flexible barrier 213 or the flexible backing 227, or the tube 241 may be simultaneously secured to both the flexible barrier 213 and the flexible backing 227. The reduced pressure delivery tube 241 includes a distal opening 243 at the distal end of the tube 241. The tube 241 can be positioned such that the distal aperture 243 is located at any point along the arcuate channel 223, but the tube 241 is preferably positioned such that the distal aperture 243 is located at approximately the midpoint along the longitudinal length of the arcuate channel 223. Preferably, the distal opening 243 is formed into an ellipse or egg by a planar cutting tube 241 oriented at an angle of 119637.doc -13 - 200808393 of less than ninety (9 ft) degrees relative to the longitudinal axis of the tube 241. Round open > shape. Although the aperture 243 may also be circular, the elliptical shape of the aperture 243 enhances fluid communication with the flow passage 233 formed between each projection 23. The reduced pressure delivery tube 241 is preferably made of poly-stone or urethane coated with paraiyne. However, any medical grade tubing material can be used to construct the reduced pressure delivery manifold 241. Other coatings that can be applied to the tube include heparin, anticoagulants, anti-fibrinogen, anti-adherents, anti-prothrombin, and hydrophilic coatings. In an embodiment, as an alternative to or in addition to the distal aperture 243, the reduced pressure delivery tube 241 may also include a discharge aperture or discharge aperture 251 positioned along the reduced pressure delivery tube 241, To further enhance the fluid communication between the reduced pressure delivery 241 and the flow channel 233. The reduced pressure delivery tube 241 can be positioned only along one of the longitudinal extents of the chevable channel 223 as shown in Figure 15 or alternatively can be positioned along the entire longitudinal extent of the arcuate channel 223. If positioned such that the reduced pressure delivery tube 241 occupies the entire length of the arcuate channel 223, the distal aperture 243 can be capped such that all fluid communication between the tube 241 and the flow channel 233 is via the discharge opening 2 5 1 proceed. The reduced pressure delivery tube 241 further includes a proximal aperture 255 at the proximal end of the tube 241. The proximal orifice 255 is configured to cooperate with a source of reduced pressure, which will be described in greater detail below with respect to Figure 9. The reduced pressure delivery tube 241 shown in Figures 1-3, 4 and 5 contains only a single lumen or passage 259. However, the reduced pressure delivery tube 241 can be provided with a plurality of lumens, such as the dual lumen tube 261 shown in Figure 4A. The double lumen tube 261 includes a first lumen 263 and a second lumen 119637.doc -14-200808393 265. The use of a dual lumen tube provides a separate fluid communication path between the proximal end of the reduced pressure delivery tube 241 and the flow channel 233. For example, a dual lumen tube 2 61 can be used to achieve communication between the reduced pressure source and the flow channel 2 3 3 along the first lumen 2 63 . The second lumen 265 can be used to introduce fluid into the flow channel 233. The fluid can be filtered air or other gas, antibacterial agent, antiviral agent, cell growth promoter, flushing fluid, chemically active fluid or any other fluid. If it is desired to pass multiple streams via separate fluid communication paths

The introduction of the body into the flow channel 233 allows the reduced pressure delivery tube to have more than two lumens. Still referring to Fig. 4B, a horizontal spacer 271 separates the first and first official chambers 263, 265 of the reduced pressure delivery tube 261 such that the first lumen 263 is positioned above the first official chamber 265. The relative positions of the first lumen and the second lumen 263, 265 may vary depending on how fluid communication is provided between the lumens 263, 265 and the flow channel 233. By way of example, when the first lumen 263 is not positioned as in _4B, a discharge opening similar to the discharge opening (5) can be provided to achieve communication with the flow passage 233. When the second f-cavity is positioned as shown in the figure, the second lumen 265 can be in communication with the flow channel 233 via an orifice similar to the distal orifice 243. Alternatively, the plurality of lumens in the squadron may be subdivided by a vertical spacer separated from each official chamber, or the lumens may be concentric or coaxial Positioning. Among them: the general technical staff should be familiar with the 'independent fluid communication path, can be hunted in a number of different ways to provide - multi-tube ... including as described above to another ^ ^   Fix a single lumen tube to another early lumen tube, or (10) Hunting right dry ▼ early or multiple lumens 119637.doc 15- 200808393 Unique, unfixed tube to provide independent fluid communication path · If a separate tube is used to provide a separate fluid communication path with the flow channel 233, the ridge portion 215 can include a plurality of arcuate channels 223, each of which has an arcuate channel 223. Alternatively, the expandable arch can be expanded. Shaped channel η) to accommodate a plurality of tubes. An example of a reduced pressure delivery tube reduced pressure delivery device having a separation from the fluid delivery tube will be described in more detail below with reference to Figure 9. Referring to Figures 6-8, a principle in accordance with the present invention The reduced pressure delivery device or wing manifold 311 includes a flexible barrier 313 having a ridge portion 315 and a pair of wing portions 319. Each wing portion 319 is positioned along the opposite side of the ridge portion 315. Part 315 forms an arch The passage 323, the arched passage Μ] may or may not extend over the entire length of the wing-shaped manifold 311. Although the ridge portion 315 may be centrally positioned on the wing-shaped manifold 311 to divide the width of each wing by 3 19 Equal, however, the ridge portion 315 can also be offset as shown in the figures such that one of the wing portions 319 is wider than the other wing portion φ 319. If the wing manifold 311 is used in conjunction with bone regeneration or healing and An additional width of one of the wing portions 319 may be particularly useful, as the wing-shaped manifold 3 11 will be wrapped around a fixed hardware attached to the bone. A honeycomb material 327 is secured to the flexible barrier 313, It may be provided as a single piece of material that covers the entire surface of the flexible barrier 313 across the ridge portion 315 and the two wing portions 319. The honeycomb material 327 includes a fixed surface disposed adjacent the flexible barrier 313 (in Figure 6 Not visible), a distribution surface 329 opposite the fixed surface, and a plurality of peripheral surfaces 330. In an embodiment, the flexible barrier 3丨3 can be similar to the flexible barrier 2丨3, and 119637.doc -16 - 200808393 contains a flexible back Although the adhesive is a preferred method for securing the honeycomb material 327 to the flexible barrier 313, the flexible barrier 313 and the honeycomb material 327 may be fixed by any other suitable fixing method, or The user is assembled at the treatment site. The flexible barrier 3 13 and/or the flexible lining serves as an impervious barrier to block the passage of fluids such as liquids, air or other gases. In one embodiment, The separation provides a dance barrier and a flexible backing to support the honeycomb material 327. Instead, the honeycomb material 327 can have an integral barrier layer that is an impermeable portion of the honeycomb material 327. The barrier layer may be formed of a closed cell material to prevent fluid from penetrating, thereby replacing the flexible barrier 313. If a monolithic barrier layer is used with the honeycomb material 327, the barrier layer may comprise a raised ridge portion and a wing portion as described above with reference to the flexible barrier 313. The flexible barrier 313 is preferably made of an elastic material such as a polyoxynitride polymer. An example of a suitable polyoxopolymer includes med_6〇i5 manufactured by Nusil Technologies, Inc. of Calif〇rnia. However, it should be noted that the flexible barrier 313 can be made of any other biocompatible, flexible material. If the flexible barrier encloses or otherwise comprises a flexible backing, the flexible backing is preferably made of a polyester knit fabric, such as Bard 6〇13 manufactured by CR Bard, Inc. of Tempe, Arizona. production. However, the flexible backing 227 can be made of any biocompatible, flexible material that enhances the strength and durability of the flexible barrier 313. In the examples, the honeycomb material 327 is an open-cell, reticulated polyurethane-based foamed m-gap size ranging from about 6 μm to 119637.doc -17 to 200808393. An example of such a foam may be included by being located in San Antonio,

GranuFoam, manufactured by Kinetic Concepts, Texas. Honeycomb material 327 can also be a gauze, felt pad, or any other biocompatible material that provides fluid communication in a plurality of dimensions in a plurality of channels. Honeycomb material 327 is primarily an "open-hole" material comprising a plurality of pores fluidly connected to the adjacent pores. By the honeycomb material 327, the open pores are between the π open pores A plurality of flow channels are formed. The flow channels month b are sufficient to achieve fluid communication in the entire portion of the honeycomb material 3 27 having open pores. The apertures and flow channels can have a uniform shape and size' or can include patterned or random shapes and dimensional changes. Variations in the size and shape of the apertures in the honeycomb material 327 can cause variations in the flow path' and such characteristics can be used to alter the dynamic properties of the fluid flowing through the honeycomb material 327. The bee-like material 3 2 7 may further include a portion containing a ''closed hole''. The closed cell portion of the honeycomb material 327 includes a plurality of holes, most of which are not fluidly connected to adjacent holes. An example of a closed hole portion is described above as a barrier layer that can replace the flexible barrier 3丨3. Similarly, a closed aperture portion can be selectively disposed in the honeycomb material 327 to prevent fluid from passing through the peripheral surface 330 of the honeycomb material 327. The flexible barrier 313 and the honeycomb material 327 can also be made of a bioresorbable material that does not have to be removed from the patient after use of the reduced pressure delivery device 31. Suitable bioresorbable materials can include, but are not limited to, polymeric blends of polylactic acid (PLA) and polyglycolic acid (PGA). The polymeric blends can also include, but are not limited to, polycarbonates, polyfumarates, and capralact〇ne. The flexible P early wall 3 13 and the honeycomb material 327 can be further used as a new cell growth branch 119637.doc 200808393 wood or a stent material and a flexible barrier 313, a wound backing 327 and/or a honeycomb material 327 can be used. Used in combination to promote cell growth. Suitable scaffold materials can include, but are not limited to, calcium phosphate, collagen, pLA/pGA, coral hydroxyapatite, sulphate, or treated allograft materials. Preferably, the distal scaffold material will have a high void fraction (i.e., a high air content). A reduced pressure delivery tube 341 is positioned within the arcuate passage 323 and secured to the flexible barrier 313. The decompression transfer tube 341 may also be fixed to the honeycomb material μ?, or in the case where only the honeycomb material 327 is present, the decompression delivery tube “^ may be fixed only to the honeycomb material 327. The decompression delivery tube 341 A distal aperture 343 is included at the distal end of the tube, which is similar to the distal aperture 243 of Figure 5. The reduced pressure delivery tube 341 can be positioned such that the distal aperture 343 is located at any point along the arcuate channel 323 , but preferably positioned along the longitudinal length of the arcuate channel 323 at approximately the midpoint. Preferably, the tube 341 is cut along a plane oriented at an angle of less than ninety (90) degrees with respect to the longitudinal axis of the tube 341. The distal aperture 343 is formed in an elliptical or oval shape. Although the aperture may be circular, the elliptical shape of the aperture enhances fluid communication with the flow channel in the honeycomb material 327. The reduced pressure delivery tube 341 can also include a discharge opening or discharge orifice (not shown) similar to the discharge opening 251 of Figure 5. As an alternative to or in addition to the distal opening 343 In addition, a discharge opening is arranged along the tube 341 to further enhance the reduced pressure delivery. 341 is in fluid communication with the flow passage. As previously described, the reduced pressure delivery tube 341 can be positioned only along one of the longitudinal lengths of the arcuate passage 323, or alternatively, can be positioned along the entire longitudinal length of the arcuate passage 323. If positioned such that the reduced pressure delivery tube 119637.doc -19-200808393 341 occupies the entire arcuate channel 323, the distal aperture 343 can be covered so that all fluid communication between the tube 341 and the flow channel is via The discharge opening is preferably performed. Preferably, the honeycomb material 327 covers and directly contacts the reduced pressure delivery tube 341. The honeycomb material 327 may be attached to the reduced pressure delivery tube 34ι, or the honeycomb material 327 may be fixed only to the flexible barrier 313 If the reduced pressure delivery tube 341 is positioned such that it extends only to a point in the arcuate passage 323, the honeycomb material 327 can also be connected to the flexible barrier in the region of the arched passage 323 that does not include the reduced pressure delivery tube 341. The ridge portion 315 of the 313. The reduced pressure delivery tube 341 further includes a proximal aperture 355 at the proximal end of the tube 341. The proximal aperture 355 is configured to cooperate with a reduced pressure source, as will be described below 9 in more detail The reduced pressure source. The reduced pressure delivery 341 shown in the figure 8 contains only a single lumen or passage 359. However, the reduced pressure delivery tube 341 can be provided with a plurality of lumens, such as described above with reference to Figure 4B. a lumen. As previously described, the use of a multi-lumen tube provides a separate fluid communication path between the proximal end of the reduced pressure delivery tube 341 and the flow channel. Alternatively, it can have a single or A separate tube of a plurality of lumens provides the separate fluid communication paths. Referring to Figures 8A and 8B, a reduced pressure delivery device in accordance with the principles of the present invention includes a reduced pressure delivery tube 373 that is remote from the reduced pressure delivery tube 373 There is an extension 375 at end 377. The extension portion 375 is preferably arched to match the curvature of the reduced pressure delivery tube 373. The extension portion 375 can be formed by removing a portion of the reduced pressure delivery tube 373 at the distal end 377, thereby forming a slit 381 having a shoulder 383. Multiple protrusions 385 set H9637.doc -20- 200808393

A plurality of flow passages 391 are formed between the projections 385 on an inner surface 387 of the reduced pressure delivery tube 373. The size, shape and spacing of the protrusions 385 can be similar to the protrusions described with reference to the figures. The reduced pressure delivery device is particularly suitable for applying reduced pressure to connective tissue that can be received in the incision 381 and regenerating tissue on the connective tissue. The ligaments, tendons, and cartilage are non-limiting examples of tissue that can be treated by the reduced pressure delivery device 371. Referring to Figure 9, decompression tissue treatment is applied to a tissue site 4!3 (e.g., human bone 415 of a patient) using a reduced pressure delivery device 411 - similar to other reduced pressure delivery devices described herein. When used to promote bone tissue growth, decompression tissue treatment increases the rate of healing associated with fractures, non-union, voids, or other bone defects. Further, it is believed that decompression tissue treatment can be used to improve the recovery of osteomyelitis. This treatment can be further used to increase the local bone density in patients with osteomyelitis. Finally, reduced pressure tissue treatment can be used to accelerate and improve oseointegration of orthopedic implants such as hip implants, knee implants, and fixation devices.

Still referring to Fig. 9, the reduced pressure delivery device 411 includes a reduced pressure delivery tube 419 having a proximal end 42i fluidly coupled to a reduced pressure source 427. The reduced pressure source 427 is a pump or any other device capable of applying a reduced pressure to the tissue site 413 via a plurality of flow channels associated with the reduced pressure delivery tube 4 19 and the reduced pressure delivery device 411. Applying a reduced pressure to the tissue site 413 is accomplished by arranging the wing portions of the reduced pressure delivery device 411 adjacent the tissue site 4 13 , which in the specific example of the g Hai involves wrapping the wings around the void defect 429 in the bone 415 Shaped part. The pressure-reducing delivery device 4ιι^ is inserted by surgery or through the skin. When inserted through the skin, the reduced pressure 119637.doc -21 - 200808393 delivery tube 419 is preferably inserted through a sterile insertion sheath that penetrates the patient's skin tissue. The application of reduced pressure tissue treatment typically produces granulation tissue in the area surrounding the tissue site 413. Granulation tissue is a common tissue formed by the moon il, which is often repaired in the human body. Under normal conditions, granulation tissue may form during the presence of foreign bodies or during wound healing. Granulation tissue is commonly used as a scaffold for healthy replacement tissue and further to form certain scar tissue. The granulation tissue is a tissue that is vascularized, and the increased growth rate of such highly vascularized tissue promotes the growth of new tissue at the tissue site 413 in the presence of reduced pressure. Still referring to Fig. 9, a fluid delivery tube 431 can be fluidly coupled to the flow channel of the reduced pressure transport device 411 at a distal end. Fluid delivery tube 431 includes a proximal end 432 that is fluidly coupled to a fluid delivery source 433. If the flow system air being delivered to the tissue site is preferably filtered, the air is filtered and sterilized by a filter 434 capable of filtering and as small as 0.22 μηη. Especially when the tissue site 413 is positioned beneath the surface of the skin, it may be important to introduce air into the tissue site 413, which facilitates good drainage of the tissue site 413 to mitigate or prevent occlusion of the reduced pressure delivery tube 419. Fluid transfer tube 431 and fluid delivery source 433 can also be used to introduce other fluids to tissue site 413 including, but not limited to, antibacterial agents, antiviral agents, cell growth promoters, irrigation fluids, or other chemically active agents. When inserted through the skin, the sputum "31 is preferably inserted through a sterile insertion sheath that penetrates the patient's skin tissue. A pressure sensor 43 5 can be operatively coupled to the fluid delivery tube. 119637.doc '22- 200808393 «I, to indicate whether the fluid delivery tube 431 is blocked by blood or other bodily fluids. The pressure sensing H 435 can be operatively connected to the fluid delivery source 433 to provide back H, thereby controlling the introduction to The amount of fluid in the tissue site 413. A check valve (not shown) may also be operatively coupled adjacent the withdrawal end of the fluid delivery tube 43i to prevent blood or other bodily fluids from entering the fluid delivery tube. The unique fluid communication path provided by the reduced pressure delivery tube 419 and the fluid delivery tube 431 can be achieved in a number of different ways, including as previously described with reference to the drawings.

4B depends on a single multi-tube (four). A person skilled in the art will know that a multi-lumen tube is used to the right, and the sensor valves and other components associated with the fluid delivery tube 431 can similarly be similar to one of the decompression tubes 4丨9. Associated with the official. Preferably, any lumen or body in fluid communication with the tissue site is coated with an anticoagulant to prevent body fluids or blood from clogging in the lumen or tube. Other coatings that can coat the lumen or tube include but not Limited to heparin anti-blood reducing agents, anti-fibrinogen, anti-adherent agents, anti-prothrombin, and hydrophilic coatings. Referring to Figures 10-19, trials have shown that when applied to decompressed tissue treatment of bone tissue, a positive effect is obtained. In a specific experiment, the skull of a rabbit was treated with decompressive tissue to confirm its effect on bone growth and regeneration. The specific objective of the test was to find the effect of decompression tissue treatment on rabbits that were not deficient or damaged on the skull, the effect of decompression tissue treatment on rabbits with critical size defects on the bone, and the decompression of a scaffold material. Tissue Therapy - The effect of using a critical size defect on the skull. The specific test protocol and number of rabbits are listed in table i below. H9637.doc -23 - 200808393 4 j There is no defect in the month of the month, and the honeycomb-shaped foam (GranuF〇amy^^^^ top of the periosteum is treated with decompression tissue (1〇>1) for 6 days. Afterwards, the organization was found to have no defects for 4 months, and the bee and nested foam were placed on the top of the intact periosteum without applying decompression tissue treatment (RPTT). The body was harvested immediately after the harvest (GranuFoam) reached 6 ----- - 4 has a critical size defect on which the stainless steel wire mesh is placed; a critical size defect in which the calcium phosphate stent is placed on one f; a 24-hour RPTT for the two; harvested tissue after 2 weeks of surgery Has a critical dimension defect on which the stainless steel mesh is placed; a critical dimension defect on which the calcium phosphate stent is placed; a 24-hour RPTT for the two Chuli dusts; a fine stretch 4 after 12 weeks of surgery has one The critical dimension defect of the stainless steel wire mesh placed thereon; a critical dimension defect on which the acid-filled drug stent is placed; the 6-day RPTT for the two; the harvested tissue after 2 weeks of surgery has a critical dimension of the stainless steel mesh placed thereon Defect The critical size defect was placed on the acid scaffold; the 6-day RPTT was applied to the two defects; the harvested group 4 after 12 weeks of surgery had a critical size defect on which the stainless steel mesh was placed; one placed on top of the calcium phosphate stent Critical size defect; _RPTT (control) is not applied; tissue is harvested after 2 weeks of surgery' 4 has a critical size defect with stainless steel mesh placed thereon; a critical size defect with calcium phosphate stent placed thereon; no RPTT applied (Control); harvested tissue after 12 weeks of surgery' 4 natural controls (no surgery; no RPTT) 4 sham surgery (no defect, no RPTT) · harvested tissue 6 days after surgery Table 1: Test protocol A critical dimension defect is a defect in a tissue (such as a skull) that is large enough to be healed by its own recovery. For rabbits, a full thickness hole of approximately 15 mm in diameter is drilled through the skull. The critical dimension defect of the skull is formed. See Figure 1 for more details, which illustrates a skeleton with original, undamaged 119637.doc -24- 200808393 The rabbit skull can also be cut κ _ ^ again, and weave the slice. The skeleton of the skull is soft around the magenta, and it is white, and the periosteum is highlighted by a yellow asterisk. In Figure 11, the illustration After applying the decompressed tissue treatment for 6 days and then immediately harvesting the tissue, it is early to humiliate π<, the stupid devil's head. The bone and periosteum can be seen and 幵 成 into I granulation tissue. In Figure 12, illustrated The rabbit skull after application of decompressed tissue treatment for 6 days followed by immediate harvesting of the tissue is illustrated. The tissue section of the figure is characterized by the formation of a new skeletal tissue beneath the granulation tissue. This skeletal tissue is highlighted by a yellow asterisk. In Figure (4), the rabbit skull is shown after application of reduced-pressure tissue treatment for 6 days followed by immediate harvesting of tissue. You can see new bones and periosteum. The tissue appearance of the osseous tissue formed by decompression tissue treatment is very similar to the appearance of the tissue formed by the (four) scalp road that is undergoing very rapid growth and deposition of new mites. More specifically, see Figures 14-19, and (S1^2 shows a number of photographs and tissue sections that show the procedure and results of decompressive tissue treatment of rabbit skulls with critical size defects. Figure 14 In the figure, a rabbit head f having two critical dimension defects formed thereon is illustrated. The full thickness critical dimension defect has a diameter of about 15 mm. In Fig. 15, a stainless steel wire mesh has been placed on one of the critical dimension defects. And placing a phosphate trap in the second critical dimension defect. In the ® 16 towel, use a pressure-reducing tissue treatment device similar to the one used here to apply the reduced pressure to the critical dimension defect. Pressure on each defect application The gauge is 25 gauge Hg. The reduced pressure is applied according to one of the test protocols listed in the table. In the figure, the illustration shows that after 6 days of decompression tissue treatment and after 12 weeks of surgery Harvest 119637.doc 200808393 Skull after tissue. The slice shown contains a calcium phosphate scaffold, which is indicated by a red arrow. Treatment with decompressed tissue will result in significant growth of new bone tissue, This is highlighted by the yellow asterisk in Figure 17. The amount of bone growth is significantly greater than the amount of skeletal growth in critical size defects that are treated with the same calcium phosphate scaffold but not treated with decompression tissue. There is a treatment threshold or duration required to induce a new bone formation reaction. The effect of decompression tissue treatment is most pronounced in the samples collected 12 weeks after surgery, indicating that decompression tissue treatment causes a cascade of biological events, thereby Enhances the formation of new bone structure. The critical size defect covered with stainless steel mesh (Fig. 15) but without the stent material in the defect is used as an intra-animal control, and the new bone growth is minimal. The data highlights the appropriate scaffold material. Advantages and positive effects of reduced-pressure tissue treatment on stent fusion and bioavailability. In Figures 18 and 19, radiographs of critical dimension defects filled with stents after six days of decompression tissue treatment are illustrated. Figure 18 illustrates Two weeks after the operation, the defect is revealed and • a certain new bone is deposited in the stent. The main structure of the stent It is still evident. Figure 19® illustrates the defect after 12 weeks of surgery and shows that the critical dimension defect is almost completely healed and the main stent architecture is nearly completely lost due to tissue fusion (ie, the formation of new bones within the stent matrix). 20. A reduced pressure delivery system 711 according to an embodiment of the present invention performs a reduced pressure tissue treatment on a tissue portion 713 of a patient. The reduced pressure delivery system 711 includes a manifold delivery tube 72. The manifold delivery tube 721 can be a fluid guide A tube or cannula and may include means for enabling the manifold delivery tube 721 to be guided to the tissue site 7, such as a guide unit 725 and a guide wire. 119637 丨doc -26- 200808393 Mirroring, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique to achieve placement and guidance of the guide wire 727 and manifold delivery tube 721. A manifold delivery tube 721 is provided for inserting a reduced pressure delivery device through the skin into the tissue site 713 of the patient. When inserted through the skin, the manifold delivery tube 721 is preferably inserted through a sterile insertion sheath that penetrates the patient's skin tissue. In Figure 20, the tissue site 713 contains bone tissue at a fracture site 731 adjacent the patient's bone 733. The manifold delivery tube 721 is inserted through the skin _ 735 of the patient and any soft tissue 739 surrounding the bone 733. As previously described, the tissue site 713 can also comprise any type of tissue including, but not limited to, adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage, tendon, or diligent band. Referring to Figures 21 and 22, the reduced pressure delivery system 7U is further illustrated. The esoteric delivery tube 721 can include a tapered distal end 743 for easy insertion through the patient's skin 735 and soft tissue 739. The tapered distal end 743 can be further configured to flex outwardly from φ 〜 radially outward to an open position such that the inner diameter of the distal end 743 will be substantially the same or greater than the inner diameter of the remainder of the tube 721. The open position of the distal end 743, shown in Figure 21, is schematically shown by dashed line 737. Manifold delivery tube 721 further includes a passageway 751 in which a reduced pressure delivery device 761 or any other reduced pressure delivery device is included. The reduced pressure delivery device 761 includes a flexible barrier 765 and/or a honeycomb material π?, which is similar to that described with reference to FIG. The flexible barrier 765 and/or the honeycomb material μ are preferably wound, folded or otherwise compressed around the reduced pressure delivery tube 769 to reduce the cross-sectional area of the reduced pressure delivery device 761 within the passage 751. 119637.doc -27 - 200808393 The reduced pressure delivery device 761 can be placed within the passageway 751 and directed to the tissue site 713 after the distal end 743 of the manifold delivery tube 721 is placed at the tissue site 713. Alternatively, the reduced pressure delivery device 761 can be pre-positioned within the passage 751 prior to insertion of the manifold delivery tube 721 into the patient. To push the reduced pressure delivery device 761 through passage 751, a biocompatible lubricant can be used to reduce friction between the reduced pressure delivery device 761 and the manifold delivery tube 721. When the distal end 743 has been positioned at the tissue site 713 and the reduced pressure delivery device 761 is delivered to the retraction end 743, then the reduced pressure delivery device 761 is urged toward the distal end 743 such that the distal end 743 is radially outwardly Expand to the open position. The decompression transfer device 761 is pushed out of the manifold delivery tube 721, preferably in the space or space of the moth adjacent tissue portion 713. The stenosis or space is usually formed by cutting the soft tissue, which can be done by the skin. In some cases the 'tissue site 713 can be located at the site, | due to wound dissection: naturally present - void. In other cases, the void can be separated by balloon, sharp separation, blunt separation, hydraulic separation, pneumatic Separation, ultrasonic separation, electrocautery separation, laser separation, or any other suitable separation technique is formed. When the reduced pressure delivery device 761 enters the gap adjacent the tissue site 713, the flexible barrier 765 of the reduced pressure delivery device 761 And/or honeycomb material work 解除 unwinding, unfolding or uncompressing (see Fig. 22) so that the delivery 718 can be placed in contact with the tissue site 713. Although not necessarily, "flexible The barrier 765 and/or the honeycomb material bearing the vacuum or reduced pressure provided by the reduced pressure delivery pipe 769, the amphoteric barrier 765 and/or the bee-like material may be added as follows; J flexible barrier (6) And/or the unfolding of the honeycomb material 767 = 119637.doc -28- 200808393 The reduced pressure delivered by the reduced pressure delivery pipe 769, or the positive pressure provided via the reduced pressure delivery pipe 769 to help complete the unwinding The process of wrapping. Ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique can be used to achieve final placement and manipulation of the reduced-pressure delivery device 761. After the device 761, the manifold delivery tube 721 is preferably removed from the patient, but the reduced pressure delivery tube associated with the reduced pressure delivery device 761 remains in place so as to be able to apply a reduced pressure to the tissue site π] through the skin. Referring to Figures 23-25, a reduced pressure delivery system η according to an embodiment of the present invention includes a manifold delivery tube 821 having a tapered distal end 843 that is configured to flex radially outwardly. Curved to an open position such that the inner diameter of the distal end 843 will be substantially the same or greater than the inner diameter of the tube 8. The opening position of the distal end (4) is indicated by a dashed line: 3: = ground. 0 manifold tube 821 further A passage is included in the passage including a reduced pressure delivery device 861 similar to the other reduced pressure delivery devices described herein. The reduced pressure transport device 861 includes a flexible barrier 865 and/or honeycomb material 867, flexible Barrier 865 and/or honeycomb The material 867 is preferably wound, folded or otherwise compressed around the reduced pressure delivery tube 869 to reduce the cross-sectional area of the reduced pressure delivery device 861 within the passageway. An impervious membrane 871 having an inner surface 873 is decompressed. The delivery device η is again disposed such that the reduced pressure delivery device 816 is contained within the inner surface 873 of the impermeable membrane 871. The impermeable membrane 871 can be a balloon, sheath or any other type that prevents fluid from penetrating. The film is such that the permeable film 871 of 119637.doc -29-200808393 can take at least one of a compressed position (see Figure 23), a relaxed position (see Figure 24), and an expanded position (see Figures 25 and 25A). The impervious film 871 is sealingly coupled to the manifold delivery tube 821 to communicate the interior space 873 of the impermeable membrane 871 with the passage body of the manifold delivery tube 821. Alternatively, the impermeable film π 1 may be fixed to the reduced pressure delivery tube 869 such that the internal space of the impermeable membrane 871 is in fluid communication with the passage of the reduced pressure delivery tube 869. The impermeable membrane 871 is in turn fixed to a separate control tube or control lumen in fluid communication with the interior space 873 (see, for example, Figure 25A). In one embodiment, an impermeable membrane 871 can be provided to further reduce the cross-sectional area of the reduced pressure delivery device 861 within the passageway. To this end, a pressure lower than the ambient pressure of the impermeable film 87 is applied to the inner space 873 of the impermeable film 871. Thereby a substantial portion of the air or other fluid within the interior space 873 is expelled to place the impermeable membrane 87i in the compressed position shown in Figure U. In this compressed position, the impermeable film 871 is attracted inwardly, thereby applying a pressure to the reduced pressure conveying device 861 to further reduce the cross-sectional area of the reduced pressure conveying device 861. As previously described with reference to Figures 21 and 22, the reduced pressure delivery device 861 can be delivered to the tissue site after the distal end 843 of the manifold delivery tube 821 is disposed at the tissue site. Endoscopic examination, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique can be used to achieve placement and manipulation of the impervious membrane and decompression delivery device 861. The impervious film 871 may contain a radiopaque marker 884, which improves the visibility of the impermeable film 8 7 在 under the fluorescent screen inspection prior to its removal. 119637.doc -30- 200808393 After pushing the reduced pressure delivery device 861 through the distal end 843, the reduced pressure applied to the interior space 873 can be released to place the impermeable membrane 871 in a relaxed position (see Figure 24). ), thereby facilitating easier removal of the reduced pressure delivery device 861 from the impermeable membrane 871. A removal device 8 85 (e.g., a sleeve, a needle or other sharp device) can be provided to break the impermeable film 871. Preferably, the removal tool 885 is inserted through the reduced pressure delivery tube 869 and is capable of being advanced to contact the impermeable membrane 871. After the impervious film 871 is broken, the removal device and the impermeable biofilm 8 71 can be withdrawn via the manifold delivery tube 821, thereby making the flexible barrier 8 $ and/or honeycomb of the reduced pressure delivery device $61 The material 867 can be unwound, unfolded, or decompressed, thereby allowing the reduced pressure delivery device 861 to be placed in contact with the tissue site. The unwinding of the flexible barrier 5 and/or the honeycomb material 836 can occur automatically after releasing the reduced pressure in the internal space 87 3 and removing the impermeable film 871. In some cases, positive pressure may be delivered via the reduced pressure delivery tube 869 to help unwind or uncompress the tread early wall 865 and/or the honeycomb material 867. After the final placement of the reduced pressure delivery device 861, the manifold delivery tube 821 is preferably removed from the patient, but the reduced pressure delivery tube 869 associated with the reduced pressure delivery device 861 remains in place so as to be able to pass through the skin to the tissue Apply a reduced pressure to the area. The impermeable film 871 can also be used to separate tissue adjacent to the tissue site prior to placement of the reduced pressure delivery device % to the tissue site. After the reduced pressure delivery device 861 and the intact impermeable membrane 871 are pushed through the distal end 843 of the manifold delivery tube 821, air or another fluid is injected or pumped into the interior space 873 of the impermeable membrane 871. Preferably, the liquid is used to swell the impervious 119637.doc -31 - 200808393 film 871 because the incompressibility of the liquid renders the impermeable film 871 more uniform and more consistently bloated. The impermeable film 871 may expand radially as shown in Figure 25, or may expand in an orientation depending on the method of manufacture and the manner in which it is secured on the manifold tube 821. When the impervious film 871 is expanded outward to the expanded position due to the pressure of air or fluid (see Fig. 25), a gap is separated from the adjacent tissue portion. When the void is large enough, air or other fluid in the interior space 873 can be released to enable the impermeable membrane 871 to assume a relaxed position. Then, the impervious film 871 can be broken as explained above and inserted into the reduced pressure delivery device 861 adjacent to the tissue site. Referring to Figure 25A, if the impermeable membrane 871 is primarily used to separate tissue adjacent to the tissue site, the impermeable membrane 871 can be sealingly secured to the manifold delivery tube 82, thereby associating the interior space 873 with one or The auxiliary lumen or tube 891 secured to the manifold delivery tube 821 is in fluid communication. The auxiliary lumen 891 u is used to deliver liquid, air or other fluid to the medial space 873 to place the impermeable membrane 871 in the expanded position. After separation, the impermeable film 871 can be relaxed and broken as previously described with reference to Figure 24. Referring to Figure 26, a reduced pressure delivery system 9 ι 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八 八The position of the opening is such that the inside of the distal end 943 will be substantially the same or larger than the inner diameter at other portions of the tube 921. The opening position of the distal end 943 is schematically shown in FIG. 26 by the dashed line 937. The 〇 吕 输送 921 921 further includes a passageway containing a U9637.ci0, -32 - 200808393 similar to the other _ transport described herein. The device's reduced pressure delivery device 9Q. The reduced pressure delivery device 961 comprises a wrap-around barrier milk and/or a honeycomb material 967, and the flexible _965 and/or the honeycomb material gamma 7 preferably wrap, fold or, and surround, and: Tube 969 is compressed to reduce the cross-sectional area of the reduced pressure delivery device 961 within the passage of the manifold delivery tube (2).

An impermeable film 971 having an inner surface 973 is disposed around the reduced pressure delivery device 961 w such that the reduced pressure delivery device 96 is contained within the inner surface 973 of the impermeable film 971. The impermeable film 971 is glued to the 977 on the impermeable film to provide a method of removing the reduced pressure delivery device 961 from the impermeable film 971. The impermeable membrane 971 is sealingly coupled to the manifold delivery tube 921 such that the interior space 973 of the impermeable membrane 971 is in fluid communication with the passage of the manifold delivery tube 921. Alternatively, the impermeable membrane 971 can be secured to a separate control tube (not shown) in fluid communication with the interior space 973. Similar to the impermeable film 871 of Fig. 23, the impermeable film 971 can prevent fluid from penetrating so that the impermeable film 971 can take at least one of a compressed position, a relaxed position, and an expanded position. Since the procedure for placing the impermeable film 971 in the compression position and the expansion position is similar to that of the impermeable film 871, only the process of removing the decompression conveying device 961 will be described. The reduced pressure delivery device 961 is delivered to the tissue site within the impermeable membrane 971 using endoscopy, ultrasound, fluoroscopy, auscultation, palpation, or any other suitable localization technique and then correctly Positioning. The impermeable film 971 may comprise a radiopaque marker 981 which will improve the visibility of the permeable film 971 under the screen inspection prior to its removal, without the H9637.doc-33-200808393. The reduced pressure delivery device 961 is then pushed through the distal end 943 of the manifold delivery tube 921. The reduced pressure applied to the interior space 973 can be released to place the film 971 in a relaxed position. Then, the reduced pressure conveying device 961 is pushed by the rubber seal 977 to push out the impervious film 971. Referring to Figure 26A', a reduced pressure delivery system 985 in accordance with an embodiment of the present invention may not include a manifold delivery tube similar to the manifold delivery tube 921 of Figure 26. Instead, the reduced pressure delivery system 985 can include a guide wire 987, a reduced pressure delivery & 989, and a reduced pressure delivery device 991. The reduced pressure delivery device comprises a plurality of fluidly connected flow channels to the reduced pressure delivery tube 989. Instead of using a separate manifold delivery tube to deliver the reduced pressure delivery device 991, the reduced pressure delivery device 991 and the reduced pressure delivery tube 989 are placed over the guide wire 987, which guides the guide wire 987 through the skin. To a tissue part 993. Preferably, the guide wire 987 and the reduced pressure delivery tube 989 penetrate the skin of the patient by a sterile sheath. By guiding the reduced pressure delivery tube 989 and the reduced pressure delivery device 991 along the guide wire 987, the fistula of the reduced pressure delivery device can be placed at the tissue site 993 to effect application of reduced pressure tissue through the skin. Since the reduced pressure delivery device 991 is not constrained in the manifold delivery tube during delivery to the tissue site 993, the reduced pressure delivery device 991 is maintained in the compressed position during delivery. If an elastic foam is used as the reduced pressure conveying means 991, the foam can be coated with a biocompatible soluble adhesive and the foam can be compressed. After reaching the tissue site, the body fluid or other fluid delivered via the reduced pressure delivery tube 989 dissolves the binder, thereby expanding the foam to contact the tissue site. Alternatively, a reduced pressure hydrogel can be made from a compressed dry hydrogel of 119637.doc -34 - 200808393. The hydrogel absorbs water after the group (four) position 993, thereby enabling decompression The delivery, the second expansion, and a reduced pressure delivery device "1 can be made of a self-heating active material (for example, polyethylene glycol), which is inflated by the body temperature of the patient. In still another embodiment, the compressed reduced pressure delivery device 991 can be delivered to the tissue site 993 in a dissolvable film.

<Fig. 27 According to an embodiment of the present invention, a reduced pressure delivery system 1011, a manifold delivery tube 1021 having a distal end 1043, and a distal end 1〇43 inserted through the tissue of the patient to contact the tissue site 1G25. The tissue site 1〇25 can comprise a void 1029 associated with a wound or other defect, or alternatively, can be formed by separation (including the separation technique described herein) to form a void 0 adjacent the tissue at the distal end 1043. After the site 1〇25 is placed in the gap 1〇29, an injectable, pourable or flowable reduced pressure transport device 1035 is rotated to the tissue site 1〇25 via the manifold delivery tube. The reduced pressure delivery device 1 035 preferably resides in a flowable state during transport to the tissue site, and then, upon arrival, forms a plurality of flow channels for distributing the reduced pressure or body. In some cases, the flowable material can be hardened to a solid state by a drying process, a curing process, or other chemical or physical reaction after reaching the tissue site. In other cases, the flowable material can form a foam in situ after delivery to the tissue site. Still other materials may exist in the gel state at the tissue site 1 〇 25, but still have a plurality of flow channels for delivering reduced pressure. The amount of reduced pressure delivery device 1035 delivered to the tissue site 丨〇 25 may be sufficient to partially or completely fill the void 119637.doc -35 - 200808393 1029. The reduced pressure delivery device 1035 can include both a manifold and a stent. As a manifold, the reduced pressure delivery device 1035 includes a plurality of holes or open holes that can be delivered to the gap! 〇29 is formed in the material. The specific holes or open holes communicate with each other, thereby forming a plurality of flow channels. These flow channels are used to apply and reduce the pressure on the tissue site 1〇25. As a stent, the reduced pressure delivery device 1035 is bioresorbable and serves as a substrate on which new tissue can be grown. In one embodiment, the reduced pressure delivery device 1035 can comprise p〇rageil, such as NaCl or other salts, distributed throughout the liquid or viscous gel. After the liquid or viscous gel is delivered to the tissue site 丨 025, the material is applied to the void 1029 and subsequently cured into a solid. The water-soluble NaC1 dissolves in the presence of body fluids, leaving a structure with interconnected pores or flow channels. The reduced flow and/or fluid is delivered to the flow channels. As the new organization is formed, the tissue will grow into the bore of the reduced pressure delivery device 1 〇 35 and then eventually replace the pressure reducing delivery device 1035 with the degradation of the reduced pressure delivery device 1 〇 35. In this particular example, the reduced pressure delivery device 1〇35 is used not only as a manifold' but also as a new tissue growth scaffold. In another embodiment, the reduced pressure delivery device 1035 is an alginate mixed with 4 (10) μηι mannose particles. The p〇Tagen or granules may be dissolved at the tissue site by local bodily fluids or by other fluids being flushed or delivered to the reduced pressure delivery device 丨〇35. After the poragen or granules are dissolved, the space previously occupied by the poragen or particles becomes a void which is interconnected with each other to form a flow passage in the reduced pressure conveying device 1035. The use of poragen in materials to form flow channels is effective, but 119637.doc -36_ 200808393 also forms pores and flow channels that are limited in size to the size of the selected poragen. A chemical reaction can be used in place of poragen to form larger pores by forming gaseous by-products. For example, in one embodiment, a flowable material comprising sodium bicarbonate and citric acid microparticles (which may be non-stoichiometric) may be delivered to tissue site 1025. When the flowable material forms a foam or solid in situ, the body fluid will cause an acid reaction between the sodium bicarbonate and the pump acid. The formed carbon dioxide gas particles form larger pores and ® flow channels throughout the reduced pressure delivery device 1035 as compared to the technique of relying on poragen dissolution. The conversion of the reduced pressure delivery device 1035 from a liquid or viscous gel to a solid or foam can be triggered by pH, temperature, light, or reaction with body fluids, chemicals, or other materials delivered to the tissue site. This transformation can also be carried out by mixing a plurality of reactive components. In one embodiment, the reduced pressure delivery device 1035 is prepared by selecting bioresorbable microspheres made from a bioresorbable polymer. The microspheres are dispersed in a solution containing a photoinitiator and a hydrogel forming material such as hyaluronic acid, collagen or polyethylene glycol having a photoreactive group. The microsphere-gel mixture is exposed to light for a brief period of time to partially crosslink the hydrogel and immobilize the hydrogel on the microspheres. Drain the excess solution and then dry the microspheres. The microspheres are delivered to the tissue site by injection or pouring, and after delivery, the mixture absorbs moisture and the hydrogel coating becomes a hydrated coating. Then, the mixture is again exposed to light, whereby the microspheres are crosslinked to form a plurality of flow channels. The crosslinked microspheres are then used as a manifold for delivering reduced pressure to the tissue site and a porous scaffold for promoting new tissue growth 119637.doc -37-200808393. ', 〒 前述 前述 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , 减压 减压 减压 减压 减压 减压 减压 减压 减压 减压 减压It can be delivered as a gas, liquid, gel, paste L' by ash, slurry, suspension or other flowable material to a group of four-dimensional sub-materials capable of forming a plurality of flow paths in fluid communication with the tissue site. The 13⁄4 flowable material may further comprise solid particles, for example, the solid particles of the outer right 4 are sufficiently small that they can flow through the manifold. The material delivered to the tissue site in a flowable state can be polymerized in situ or form a gel. As previously described, the reduced pressure delivery device 1035 can be directly injected or poured into the void 1029 adjacent the tissue site 1025. Referring to Figure 27A, the manifold delivery officer 1021 can include an impermeable or semi-permeable membrane 1051 at the distal end 1043 of the manifold delivery tube 1021. The membrane 1051 includes an internal space 1〇55 in fluid communication with an auxiliary lumen 1〇57 secured to the manifold delivery tube 1〇21. The manifold delivery tube 1021 is guided to a tissue portion 1025 on a guide wire 1〇61. The reduced pressure delivery device 1035 can be injected or poured through the auxiliary lumen 1057 to fill the interior space 1055 of the membrane 1051. When the fluid or gel fills the film, the film 1 〇5 1 expands to fill the void 1 〇 29, thereby causing the film to contact the tissue site 1025. When the film 1〇51 is inflated, the film 1051 can be used to separate additional tissue adjacent or adjacent to the tissue site 1025. If the film 1 〇 5 1 is an impermeable film, it can be physically broken and removed, thereby bringing the reduced pressure delivery device 1035 into contact with the tissue site 1025. Alternatively, the film 1〇51 119637.doc -38- 200808393 can be made from a soluble material that will dissolve in the presence of a body fluid or a biocompatible solvent delivered to the film 1G51. If the film is semi-permeable, the film can remain in place. The semi-permeable membrane 1() 51 is capable of delivering reduced pressure and possibly other fluids to the tissue site 1025. Referring to Fig. 28, a method 1111 for performing reduced pressure tissue treatment includes surgically inserting a manifold at an adjacent tissue site at a fistula 15 having a plurality of protrusions extending from the early wall of the flexible P. A plurality of flow channels are formed between the protrusions. The manifold is positioned at 1119 such that at least a portion of the projections contact the tissue site. At the 1123' level, a reduced pressure is applied to the tissue site by the manifold. Referring to Fig. 29, a method of applying reduced pressure tissue treatment to a tissue site 1211 includes inserting a manifold at 1215 through the skin adjacent the tissue site. The manifold can include a plurality of protrusions extending from a flexible barrier to form a plurality of flow channels between the protrusions. Alternatively, the manifold can comprise a honeycomb material' having a plurality of flow channels within the honeycomb material. Alternatively, the manifold can be formed from an injectable or pourable material. The injectable or pourable material is delivered to the tissue site and forms a plurality of flow channels upon reaching the tissue site. At 1219, the manifold is positioned such that at least a portion of the flow channels are in fluid communication with the tissue site. At 1223, a reduced pressure is applied to the tissue site via the manifold. Referring to Fig. 30, a method of applying reduced-pressure tissue treatment to a tissue site 1311 includes inserting a tube having a passage through the skin through one of the skins at 131 5 such that the distal end of the tube is placed adjacent to the tissue site. At 1319 119637.doc -39-200808393, the balloon associated with the tube can be inflated to separate tissue adjacent to the tissue site, thereby forming a void. At (10), the manifold is transported through the passage. The manifold can include a plurality of protrusions extending from the flexible barrier to form a plurality of flow channels between the protrusions. Alternatively, the manifold can comprise a honeycomb material having a plurality of flow channels therein. Alternatively, the manifold can be formed from an injectable or pourable material delivered to the tissue site as described above with reference to Figure (4). At 1327, the manifold is positioned such that at least a portion of the flow channels are in fluid communication with the tissue site. At 1331, the reduced pressure is applied to the tissue site via the manifold via a reduced pressure delivery tube or any other delivery route. Referring to Fig. 3, a method of applying reduced pressure tissue treatment to a tissue site 1411 includes inserting a tube having a passage through the skin through a skin at 1415 such that the distal end of the tube is placed adjacent to the tissue site. At 1423, a manifold is conveyed through the passage to the tissue portion in an impervious jacket which has been subjected to a first reduced pressure at 1419 that is less than the sheath ambient pressure. At 1427, the sheath is broken to contact the manifold with the tissue site. At 1431, a second reduced pressure is applied to the tissue portion via the manifold. Referring to Figures 32 and 33, a reduced pressure delivery device 1511 in accordance with an embodiment of the present invention includes a plastic surgical hip prosthesis 1515 for replacing an existing femoral head of a patient leg segment 1517. The hip prosthesis 1515 includes a post portion 1521 and a head portion 1525. The post portion 1521 is elongate for insertion into a passage 1529 that is hinged in the backbone of the leg section 1517. A porous coating 1535 is disposed around the perimeter of the column 119637.doc -40 - 200808393 and is preferably constructed of sintered or vitrified ceramic or metal. Alternatively, a honeycomb material having a porous property may be disposed around the column portion. A plurality of flow channels 1541 are disposed within the post portion 1521 of the hip prosthesis 1515 to fluidly communicate the flow channel 1541 with the porous coating 1535. A connection port 1545 is fluidly coupled to the flow channel 1541 which is configured to be releasably coupled to a reduced pressure delivery tube 1551 and a reduced pressure delivery source 1553. The flow channel 1541 is used to deliver a reduced pressure to the porous coating 1535 and/or bone surrounding the hip prosthesis 1515 after implantation of the hip prosthesis 1515. The flow passage 1541 can include a main feed line 1543' that is in fluid communication with a plurality of transverse branch lines i 547. The plurality of transverse branch lines 1547 are in communication with the porous coating 1535. The rib branch line 1545 can be oriented perpendicular to the main feed line 1543 as shown in Figure 32 or can be oriented at some angle to the main feed line 1543. An alternative method for distributing reduced pressure includes providing a hollow hip prosthesis and filling the honeycomb with a honeycomb-like (opening hole) material that is in fluid communication with the porous coating 1535. The internal space of the body. Referring more specifically to Figure 33, the hip prosthesis 1515 can further include a first plurality of flow channels 丨5 6丨 within the post portion 1521 to the porous coating 153 5 and/or bone surrounding the hip prosthesis 丨5丨5 Provide fluid. The fluid may include filtered air or other gas, an antibacterial agent, an antiviral agent, a cell growth promoter, a flushing fluid, a chemically active fluid, or any other fluid. Additional fluid communication paths may be provided if it is desired to introduce multiple fluids into the bone surrounding the hip prosthesis 151 5 . A port 1565 is fluidly coupled to the flow channel 1561 which is configured to be releasably coupled to a fluid delivery tube 1571 and a fluid delivery source 1573. The flow channel 1561 can include a main feed line 1583 in fluid communication with a plurality of lateral branch lines 119637.doc -41 - 200808393 1585 that are in communication with the porous coating 1535. The lateral branch line 1585 can be oriented perpendicular to the main feed line 1583 as shown in Figure 33, or can be oriented at some angle to the main feed line 1583. The transfer of the reduced pressure to the first plurality of flow passages 1541 and the delivery of the fluid to the second plurality of flow passages 1561 can be accomplished by separate tubes (e.g., the reduced pressure delivery conduit 1551 and the fluid delivery conduit 1571). Alternatively, a tube having a plurality of lumens as previously described herein can be used to separate the communication path for delivery of reduced pressure and fluid. It should be further noted that the superior tube preferably provides a separate fluid communication path within the hip prosthesis 1515, however, the first plurality of flow channels 1541 can also be used to transfer both the reduced pressure and fluid to the bone surrounding the hip prosthesis 1515. As mentioned earlier, applying reduced stress to bone tissue promotes and accelerates the growth of new bone tissue. By using the hip prosthesis 15 15 as a manifold to deliver the reduced pressure to the bone area surrounding the hip prosthesis, the recovery of the leg section 1517 is faster and the hip prosthesis 15 15 is more successfully integrated with the bone. . Providing a second plurality of flow channels 1561 to vent the bone surrounding the hip prosthesis 15 5 15 will improve the successful regeneration of the new bone surrounding the prosthesis. After applying the reduced pressure through the hip prosthesis 1515 for a selected amount of time, the reduced pressure delivery tube 1551 and the fluid delivery tube 1571 can be disconnected from the connection ports 1545, 1565 and removed from the patient's body - preferably not used Surgical invasive procedure. The connection between the ports 1545, 1565 and the tubes 1551, 1571 can be a connection that can be released by hand, which can be performed by applying an axial pulling force to the tubes 1551, 1571 outside the body of the patient. Alternatively, the connecting bee 119637.doc • 42- 200808393 1545, 1565 can be bioresorbable or soluble in the presence of the selected fluid or chemical so that the connection can be made 1545, 1565 Exposure to tubes 1551, 1571 is achieved by exposure to fluids or chemicals. The tubes 15 5 1 , 15 71 may also be made of a bioresorbable material that will dissolve over a period of time or an activating material that will dissolve in the presence of a particular chemical or other material. A reduced pressure delivery source 1553 can be provided outside the patient and attached to the reduced pressure delivery tube 1551' to deliver the reduced pressure to the hip prosthesis 1515. Alternatively, the reduced pressure delivery source 1553 can be implanted into the patient, on or near the hip prosthesis. Placing the reduced pressure delivery source 15 5 3 into the patient does not require the use of a fluid connection through the skin. The implanted reduced pressure delivery source 15 53 can be operatively coupled to the conventional pump of the k-channel 1 51. The pump can be powered by a battery implanted in the patient's body or by an external battery that is electrically connected to the pump via the skin. The pump can also be directly driven by a chemical reaction that delivers reduced pressure via flow channels 丨54i, 丨56j and circulates fluid through flow channels 1541, 1561. Although only the column portion 1521 and the head 4 knife 15 2 5 of the hip prosthesis 1515 are illustrated in FIGS. 32 and 33, it should be noted that the flow channels described herein and components for applying reduced pressure tissue treatment may also be applied. Any component of the prosthetic body 丨5丨5 that contacts the ossicular or other tissue, including, for example, a cup. Referring to Fig. 34, a method 1611 for repairing a joint of a patient includes implanting a prosthesis in the bone path adjacent to the joint at 16 15 . The prosthesis can be a hip prosthesis as described above or any other prosthesis that can help restore joint mobility in a patient. The prosthesis includes a plurality of channels configured to be in fluid communication with the bone 119637.doc -43 - 200808393 channels. At 1619, the reduced pressure is applied to the bone via the plurality of flow channels to improve the 〇Se〇integrati〇n of the prosthesis. Referring to Figures 35 and 36, a reduced pressure delivery device 1711, in accordance with an embodiment of the present invention, includes an orthopaedic fixation device 1715 for fastening a bone 1717 of a patient that includes a fracture site 1719 or other defect. The orthopaedic fixation device 1715 shown in Figures 35 and 36 has a plurality of passages 1721

The plate, the plurality of passages 1721 are used to align the orthopaedic fixation device i 7丨5 to the iliac crest 7 i 7 using screws 1725, pins, bolts or other fasteners. A porous coating 173 5 may be disposed on the surface of the contact bone 1717 of the orthopedic fixation device 1715. The porous coating is preferably constructed of sintered or vitrified ceramic or metal. Alternatively, a honeycomb material having porous characteristics can be disposed between the bone 1717 and the orthopaedic fixation device 1715. A plurality of flow channels 1741 are disposed within the orthopaedic fixation device 1715 to fluidly communicate the flow channel 1741 with the porous coating 1735. A port 1745 is fluidly coupled to the flow channel 1741 which is configured to be coupled to a reduced pressure delivery tube and a reduced pressure delivery source 1753. The flow channel 1741 is used to deliver a reduced pressure to the bone coating of the porous coating and/or the orthopaedic fixation device 1715 after the orthopedic fixation member 1715 is secured to the bone 1717. The flow channel 1741 can include - and several The lateral branch line (10) is in fluid communication with the main feed line m3 'the plurality of lateral branch lines (10) are in communication with the porous coating. The lateral branch line 1747 can be oriented perpendicular to the main feed line m3 as shown in Figure 35, or can be associated with the main The feed line 1743 is oriented at some angle. An alternative method for distributing the reduced pressure includes providing a hollow orthopedic device and capable of flowing with the porous coating (10) 119637.doc -44 - 200808393 Connected honeycomb-shaped (preferably open-hole) material to fill the internal space of the device. r-needle plastic orthopedic material 1715 can be as shown in Figure 35, another choice is, can be #一圊The pedicle is a member, such as a cannula, an orthosis column, or any other device for stabilizing a portion of the bone. The entire piece 1715 can be further used to secure a prosthesis or other plastic surgery. ::: Fasteners for implanted tissue (eg, bone path tissue or cartilage), which are limited to 2 "equal tights containing pressure for (4) adjacent or surrounding the fasteners, and the pressure of the reduction Examples of passages that include miscellaneous and ribbed fasteners may include (4) bolts, screws, or any other suitable fastener. Referring more specifically to Fig. 36, the orthopaedic fixation device i7i5 can include a -f in the #f π μ & 禝-禝 number of flow channels 1761 to the orthopedic orthopedic fixation device 1715. The fluid is supplied. The fluid may include a gas: 1:5 and/or bone _, an antiviral agent, a cell growth promoter, a rinsing fluid, a chemical agent, or any other fluid. An additional fluid communication path is provided if the 17] S 典 财 + + 禋 body is introduced into the surrounding hip prosthesis 5 months. - 1765 fluidly connected to the flow channel 丨 ^ 垾 1765 is configured to be connected to a fluid transfer tube (5) and - fluid delivery source m is connected to a, the melon moving channel 1761 can be s-connected to a plurality of lateral branch lines 1785 The main feed line 1 - 783 'the plurality of transverse branch lines 1785 and the porous coating (7) $ transverse branch line 1785 can be as shown in Figure 33, 1 1783^^, ^, straight to the main feed line - / line 1783 Some angles are oriented. Reduce the dust force to the brothers, a number of righteous grips, the transmission and fluid flow to the 174637.doc •45- 200808393 The second plurality (four) of the channel 1761 can be transported by a separate tube (❹ decompression duct 1751 And the fluid delivery tube 1771) is completed. Alternatively, a tube having a plurality of lumens as previously described herein can be used to separate the communication path for delivering reduced pressure to fluid. It should be noted that although a separate fluid communication path is preferably provided within the hip prosthesis 1715, the first plurality of flow channels 1741 can be used to deliver both the reduced pressure and fluid to the adjacent orthopedic fixation device 1715. The bones. The use of the orthopedic fixation device 1715 as a manifold to deliver reduced pressure to the bone region of the adjacent orthopaedic fixation device 1715 accelerates and improves the recovery of the defect 1719 of the bone 1717. Providing a second plurality of flow channels i76i to deliver fluid to the bone surrounding the orthopaedic fixation device 1715 improves the successful regeneration of new bone adjacent the orthopaedic fixation device. Referring to Fig. 37, a method 1811 for healing a bone defect in a bone includes using an orthopedic fixation device at 18 15 to secure the bone. The orthopedic fixation device includes a plurality of flow channels disposed within the orthopaedic fixation device. At 18 19, a reduced pressure is applied to the bone defect via the plurality of flow channels. Referring to Figure 38, a method 1911 for performing a decompression tissue therapy on a tissue site includes: at 1915, clamping a manifold having a plurality of flow channels to cause at least a portion of the flow channels to The tissue site is in fluid communication. At 1919, the reduced pressure is applied to the tissue site via the flow channels and at 1923, a fluid is delivered to the tissue site via the flow channels. Referring to Fig. 39, a U9637.doc-46-200808393 method for performing decompression tissue treatment on a tissue site includes: • positioning the distal end of a manifold tube adjacent to the tissue site at 2〇15 . At 2019, a fluid is delivered to the tissue site via the manifold delivery tube. The fluid is capable of filling a void adjacent the tissue site and becoming a solid manifold having a plurality of flow channels in fluid communication with the tissue site. At 2023, a reduced pressure is applied to the tissue portion via the flow path of the solid manifold. Referring to Figures 40-48, a reduced pressure delivery system 2111 includes a primary manifold 2115 having a flexible wall 2117 surrounding a primary flow path 2121. The flexible wall 2117 is coupled to a reduced pressure delivery tube 2125 at a proximal end 2123. Since the shape of the reduced pressure delivery tube 2125 will generally be a circular cross section, and since the cross-sectional shape of the primary manifold 2115 can be different from the circular shape (i.e., rectangular in Figures 4A-45, and triangular in Figures 46-48) Thus, a transition zone 2129 is provided between the reduced pressure delivery tube 2125 and the primary manifold 2115. The main manifold 2115 can be joined to the reduced pressure delivery tube 2125 by adhesive means, joined by other means such as fusion or back molding, or alternatively selected to be integrally joined by coextrusion. The reduced pressure delivery tube 2125 delivers the reduced pressure to the primary manifold 211 5 for distribution at or near the tissue site. An anti-blocking member 2135 is positioned within the main manifold to prevent the main manifold 2115 from collapsing and thereby blocking the main flow path 2121 during application of the reduced pressure. In one embodiment, the anti-blocking member 2135 can be provided with a plurality of protrusions 2137 (see FIG. 44) disposed on an inner surface 2141 of the flexible wall 2117 and extending into the main flow path 2121. In another embodiment, the anti-blocking member 2135 can be provided with a single or multiple ridges 2145 on the inner surface 2141 (see Figures 40 and 41). In yet another embodiment, the anti-blocking 119637.doc -47 - 200808393 component 2135 can include a honeycomb material 2149 disposed within the main flow path, such as shown in FIG. The anti-blocking member 2135 can be any material or structure that can be embedded within the flow passage or that can be integrally or otherwise secured to the flexible wall 2117. The anti-blocking member 2135 is capable of preventing the flexible wall 2117 from completely collapsing' while still allowing fluid to flow through the main flow path 2丨2丨. The flexible wall 2117 further includes a plurality of apertures 2155 that penetrate the flexible wall 2117, the apertures 2155 being in communication with the main flow path 2121. The aperture 2155 enables the reduced pressure delivered to the main flow path 2121 to be distributed to the tissue site. The aperture 2155 can be selectively positioned about the circumference of the manifold 2115 to preferentially direct the delivery of vacuum. For example, in Figure 5, the apertures can be placed facing the bone path, facing the tissue of the overlay, or both. The reduced pressure delivery tube 2125 preferably includes a first guide & 2161 having at least one outlet, at least one outlet fluidly connected to the main flow path ha, and the white main/'il moving path 2121 delivering a reduced pressure. A second conduit 2163 can also be provided to clean the main flow path 2121 and the first conduit 2161 with a fluid to prevent or dissolve the barriers formed by wound secretions and other fluids aspirated from the tissue site. The second conduit 2163 preferably includes at least one outlet positioned adjacent at least one of the main flow passage 2121. and the at least one outlet of the first conduit 2161. Referring specifically to Figures 4A and 41, in the reduced pressure delivery system 2111, the second guide & 2163 can include a plurality of conduits for flushing the main flow path 2121 and the first conduit 2161. Although the end of the flexible wall 2117 opposite to the end fixed to the decompression delivery tube can be open as shown in Figure (4), U9637.doc * 48 - 200808393 has been issued to cover the flexible wall 2117. The performance and reliability of the end m cleaning function. Preferably, a top gap 2171 is provided between the covered end of the flexible wall and the end of the second conduit 2163. The headspace 2171 is capable of achieving accumulation of cleaning fluid during the cleaning process, which helps drive the flushing fluid to flow into the first conduit 2161 through the primary flow path 2121. The spacer used as the anti-blocking member 2135 is also illustrated in FIG. The centrally located spacer causes the main flow path 2121 to enter the two chambers again.

The main manifold 2115 is allowed to continue to operate when one of the chambers is blocked and cannot be dissolved by the cleaning. Dreams of Figures 49 and 50, a reduced delivery system 22u includes a primary manifold 2215 that is decompressed to a pressure of 2217. (4) The delivery tube 2217 includes a middle; a lumen 2223 and a plurality of auxiliary lumens. Although the auxiliary lumen can be used to measure the pressure at or near the tissue site, the auxiliary lumen 2225 can be used to clean the central lumen 2223 in one step to prevent the ice from being smashed. The occlusion hole 2231 is connected to the central lumen 2223 and the reduced pressure is transmitted by the central lumen 222. As shown in Fig. 5, Sun Ruyi does not preferably make the hole 2231; The dental auxiliary and the auxiliary lumen 2225. In Fig. 50, the super-end hole end of the fresh-keeping vacuum tube is also illustrated, and a top gap 2241 is formed in the auxiliary lumen 2225. During the period, the tissue, ☆ π μ, , 〃 &; 文 文 文 文 文 文 文 或 或 或 或 或 或 或 或 或 或 或 或 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 224 2211 Reduced pressure mounting and removal During use, the decompression bearing system described in Figures 40-50 can be applied directly to the tissue site to force the tissue. The low profile of the main manifold is very beneficial. The technique described in the skin 119637.doc -49 - 200808393. Similarly, The main manifold is used in conjunction with an auxiliary manifold 2321. In Figure 51, the auxiliary manifold 2321 includes a two-layer felt pad. The auxiliary manifold 2321 The first layer contacts a bone tissue site containing the fracture site. The primary manifold 2115 is placed in contact with the first layer, and the first layer of the auxiliary manifold 2321 is placed on top of the primary manifold 2115 and the first layer. The tube 2321 can achieve fluid communication between the primary manifold 2115 and the tissue site and still prevent direct contact between the tissue site and the primary manifold 2115. Preferably, the secondary manifold 2321 is bioabsorbable, which aids The manifold 2321 can remain in place after the decompression treatment is completed. Once the decompression treatment is completed, the subject can be removed from the layers of the auxiliary manifold with little or no disturbance to the tissue site. Tube 2115. In one embodiment, the primary manifold may be coated with a lubricating material or a material that will form a hydrogel to facilitate removal of the primary manifold from between the layers. The secondary manifold is preferably used for new tissue growth Bracket The tube may be composed of at least one material selected from the group consisting of polylactic acid, polyglycolic acid, polycaprolactone, polyhydroxybutyrate, polyvaleric acid, polydioxane, p〇ly 〇rthoesthers, polyurethane, polyaminophthalate, collagen, hyaluronic acid, polyaminoglucose, hydroxyapatite, calcium silicate, calcium sulfate, calcium carbonate, bioglass, stainless steel, titanium, button, allogeneic Transplant and autologous tissue grafts. The cleaning functions of the reduced pressure delivery systems 2111, 2211 described above can be used with any of the manifolds described herein. The ability to deliver a reduced pressure manifold or 119637.doc -50- 200808393 catheters prevents the formation of obstructions that impede the pressure to reduce. Such obstructions are typically formed when the pressure near the tissue site reaches equilibrium and the flow of fluid around the tissue site slows. It has been found that the use of air to purge the manifold and decompression catheter at a selected interval for a desired amount of time can help prevent or dissolve the obstruction. More specifically, air is delivered via a second conduit that is separated from the first conduit that delivers the reduced pressure. One of the outlets of the second conduit is preferably sinned near the manifold or sinned to one of the outlets of the younger one. Although the air may be pressurized or π pushed to the outlet of the second conduit, it is preferred to draw in air through the second conduit by the reduced pressure at the tissue site. It has been found that in many cases, during the application of reduced pressure Two (2) seconds of air delivery at intervals of sixty (6 inches) seconds is sufficient to prevent the formation of obstructions. This cleaning program provides sufficient air to adequately move the manifold and fluid in the first conduit while preventing Introducing too much air. Introducing too much air, or introducing air at too high a frequency, will result in a decompression system that cannot return to the reduced target pressure between wash cycles. The amount of time and the interval between selected cleaning fluids will generally vary depending on the design and specifications of the system components (eg, pumps, tubes, etc.). However, the amount and frequency of delivery air should be high enough to adequately remove obstructions, At the same time, the full target pressure can still be restored between wash cycles. Referring to Figure 52, in an exemplary embodiment, a reduced pressure delivery system 2411 includes a manifold 241 5. The manifold 2415 is fluidly coupled to a first conduit 2419 and a second conduit mu. The first conduit 2419 is coupled to a reduced pressure source 2429 to provide reduced pressure to the manifold 2415. The second conduit 2423 includes 119637.doc -51 - 200808393 = outlet 2435, the outlet 2435 is positioned in fluid communication with the manifold 2415 and proximate to the outlet of the first guide 2419. The second conduit 2423 is fluidly coupled to a valve 2439 that is when the valve 2439 is placed in the open position The communication between the second guide 2423 and the ambient air can be achieved. The valve 2439 is operatively coupled to a controller 2453, and the controller 2453 can control the valve MM = on and off to adjust the ambient air to the second guide. F-implemented cleaning to prevent obstructions from being present in manifold 2415 and first conduit 2419. It is contemplated that any fluid (including liquids or gases) can be used to achieve the techniques described herein, despite the force used to clean the fluid. Preferably, the reduced pressure creates a suction at the tissue site, however, similar to that described with reference to Figure 9, the fluid delivery member can also deliver fluid in a similar manner. mm according to the description herein The method of decompressing tissue tissue at a tissue site can be achieved by applying a sufficiently low pressure to the tissue site and then maintaining the sufficiently low pressure for a selected period of time. Another option is The reduced pressure applied to the tissue site can be cyclical. More specifically, the magnitude of the applied reduced pressure can vary depending on the selected time cycle. Yet another method of applying the reduced pressure can randomly change the reduced pressure. Similarly, the rate or amount of fluid delivered to the tissue site can be constant, periodic, or random. If periodic, fluid delivery can occur during the application of reduced pressure, or can be absent This is done during the cycle of applying the reduced pressure. Although the magnitude of the reduced pressure applied to the tissue site will generally vary depending on the pathology of the tissue site and the environment in which the decompressed tissue treatment is performed, the reduced pressure is typically between about mm Hg and -500 mm Hg, but more Good is between about 119637.doc -52- 200808393

Between Hg and -300 mmHg. Although the systems and methods of the present invention are described above with reference to tissue growth and patient healing, it should be understood that such systems and methods for applying reduced pressure tissue treatment can be used in any living body in which tissue growth or healing is desired to be promoted. . Similarly, the systems and methods of the present invention are applicable to any tissue, including but not limited to bone tissue, adipose tissue, muscle tissue, nerve tissue, skin tissue, vascular tissue, connective tissue, cartilage tissue, tendon or ligament. Although tissue healing may be a focus of application of reduced-pressure tissue therapy as described herein, decompression tissue therapy (especially for tissues located beneath the patient's skin) may also be used in the absence of disease, defect or injury. Tissue growth is formed in the tissue. For example, it may be desirable to use a transdermal implant technique to apply reduced pressure tissue treatment to grow additional tissue at a tissue site and subsequently harvest the additional tissue. The harvested tissue can be transplanted to another tissue site to replace the diseased or damaged tissue, or alternatively, the harvested tissue can be transplanted to another patient. It should be noted that the reduced pressure delivery device described herein can be combined with the scaffold material to increase the growth and growth rate of the new tissue, which is also important. The stent material can be placed between the tissue site and the reduced pressure delivery device, or the reduced pressure delivery device itself can be made from a bioresorbable material that is used as a new tissue growth stent. * It should be apparent from the above description that this document provides an invention with significant advantages. While the present invention has been shown in its several forms, the present invention is not limited thereto, but various modifications and changes can be made without departing from the spirit of the invention. 119637.doc -53- 200808393 [Simple description of the schema] The 、, 彳 or declaration file contains at least one graphic with color. The patent or patent application publication with a color map is provided by the Patent Affairs Bureau after payment of the necessary fee. 1 is a perspective view of a reduced pressure conveying device having a plurality of protrusions extending from a flexible barrier to form a plurality of flow passages according to an embodiment of the present invention; 1 is a front view of the reduced pressure conveying device; FIG. 3 is a plan view showing the reduced pressure conveying device shown in Fig. 3; Fig. A is a side view showing the reduced pressure conveying device shown in Fig. Having a single lumen decompression delivery tube; Figure 4B is a green side view of the reduced pressure delivery device - a side view of the embodiment of the decompression delivery device having a dual lumen decompression delivery tube; Figure 5 illustrates Figure! An enlarged perspective view of one of the illustrated reduced pressure delivery devices; FIG. 6, and FIG. 3 are perspective views of a reduced pressure delivery device according to an embodiment of the present invention. The reduced pressure delivery device has an attachment to a flexible barrier. The honeycomb material 'money (four) wall has a ridge portion and a pair of wing portions, the honeycomb material has a plurality of flow channels; FIG. 7 illustrates a front view of one of the pressure reducing conveying devices shown in FIG. 6; FIG. 8A illustrates a cross-sectional front view of a decompression conveying farm according to the present invention. FIG. 8A is a cross-sectional side view of the decompressing conveying device according to the present invention. Side view of one of the reduced pressure transfer devices shown in FIG. 8A; 119637.doc -54- 200808393 FIG. 9 illustrates a front view of a reduced pressure delivery device for use in a patient's bones in accordance with an embodiment of the present invention. Figure 1 depicts a colored tissue section of a rabbit skull showing the original, undamaged bone; Figure 11 illustrates a color tissue section of a rabbit skull that is shown to be induced after deer treatment with decompression tissue Granulation tissue; Figure 12 A color tissue section of a rabbit skull showing the deposition of new bone after application of decompressed tissue treatment; Figure 13 illustrates a color tissue section of a rabbit skull showing deposition of new bone after application of reduced pressure tissue treatment Figure 14 depicts a color photograph of a rabbit skull in which two critical dimension defects are formed; Figure 15 illustrates a color photograph of the rabbit skull shown in Figure 14 showing phosphoric acid embedded in one of the critical size defects Calcium stent and a stainless steel mesh covering the second critical dimension defect; • > Figure 16 illustrates a color photograph of the rabbit skull of Figure 14 showing the application of reduced pressure tissue treatment to a critical size defect; Figure 17 illustrates the implementation After the decompression tissue treatment, the color of a rabbit skull, and the sputum section, the Hei tissue section shows the product of the new bone in the calcium phosphate scaffold; Figure 18 shows the figure after performing the decompression tissue treatment for six days and two weeks after the operation. Radiographs of critical size defects filled with jin, ding, and two stents; α Figure 19 shows the implementation of decompression tissue treatment for six days and implementation of hands Twelve weeks later, the radiograph of the critical dimension defect filled with the work branch; H9637.doc -55- 200808393 Fig.: The drawing of the decompression system according to the present invention is the same: The reduced pressure delivery system has a manifold delivery tube, for transcutaneously, inserting a reduced pressure delivery device into a tissue site;

Figure 21 illustrates an enlarged elevational view of the manifold delivery tube of Figure 20, the official delivery tube including a reduced pressure delivery device having an I* bio-barrier and/or a honeycomb material in a compressed position; 22 is an enlarged front view showing the manifold conveying pipe shown in FIG. 21, which is shown in the figure.

The flexible barrier of the reduced pressure delivery device after being pushed in from the manifold delivery tube: and/or the honeycomb material is in an expanded position; Figure 23 illustrates an embodiment of a reduced pressure delivery system in accordance with an embodiment of the present invention. The vacuum delivery system has a manifold delivery tube for inserting a decompression delivery device through the skin into a tissue site, the figure showing that the pressure delivery device is outside the manifold delivery tube, 15 is - The permeable membrane is constrained to a compression position; ', Figure 24 is a front elevational view of the reduced pressure delivery system of Figure 23, showing that the reduced pressure delivery device is outside the manifold delivery tube but is impervious Z film is constrained to a relaxed position; / Figure 25 illustrates a front view of the reduced pressure delivery system of Figure 23, showing the reduced pressure delivery device outside the manifold tube but with a non-permeable membrane Constrained to an expanded position; / Figure 25A illustrates a view of the reduced pressure delivery system of Figure 23, showing that the reduced pressure delivery device is outside the manifold delivery tube, and is in an expanded position </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> </ RTI> <RTIgt; a manifold duct of a tissue portion, the figure showing that the reduced pressure transport device is outside the manifold transport f, but is constrained by an impervious film having a glue seal; FIG. 26A illustrates an embodiment of the present invention Front view of a reduced pressure delivery system; Figure 27 illustrates a front view of a reduced pressure delivery system having a manifold delivery tube for a reduction through the skin, in accordance with an embodiment of the present invention. The pressure delivery device is injected into a tissue site; Figure 27A illustrates a front view of a reduced pressure delivery system having a manifold delivery tube for a reduction through the skin, in accordance with an embodiment of the present invention. The pressure delivery device is delivered to the impermeable film located at a tissue site; 0 2 8 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Figure 29 illustrates a flow chart of a method for performing decompression tissue treatment on a tissue site in accordance with an embodiment of the present invention; Figure 30 illustrates a decompression tissue treatment of a tissue site in accordance with an embodiment of the present invention. FIG. 31 illustrates a flow chart of a method for performing decompression tissue treatment on a tissue site according to an embodiment of the present invention; FIG. 32 illustrates a decompression roller device according to an embodiment of the present invention. A cross-sectional elevational view of the reduced pressure delivery device including a hip prosthesis having a plurality of flow channels for applying a pressure reduction of 119637.doc -57 - 200808393 to a bone region surrounding the hip prosthesis; FIG. 32 is a cross-sectional elevational view of the prosthetic body shown in FIG. 32, the prosthesis having a second plurality of flow channels for transferring fluid to the bone region surrounding the prosthesis; FIG. A flow chart of a method for repairing a joint of a patient using reduced pressure tissue according to the present invention.

Figure 35 illustrates a cross-sectional elevation view of a reduced pressure delivery device in accordance with an embodiment of the present invention, the reduced pressure delivery device including an orthopedic fixation device having a plurality of flow channels for use in a pair The reduced pressure is applied to the bone (four) domain of the orthopedic fixation device; and FIG. 36 is a cross-sectional front view of the orthopedic fixation device of FIG. 35, the bridge I surgical fixation device has a second plurality of flow channels for use Flowing fluid to a bone region adjacent to the orthopedic fixation device; FIG. 37 illustrates a flow chart of a method for treating bone defects in bone using reduced pressure tissue therapy in accordance with an embodiment of the present invention; A flowchart of a method for performing decompression tissue treatment on a tissue site in accordance with an embodiment of the present invention; and FIG. 39 illustrates a method for performing decompression tissue treatment on a tissue site in accordance with an embodiment of the present invention flow chart. 40-48 are various views of a reduced pressure delivery system in accordance with an embodiment of the present invention, the reduced pressure delivery system having a main manifold including a flexible wall surrounding a main flow channel and located therein A plurality of apertures in a flexible wall; Figures 49-50 illustrate a perspective view and a top cross-sectional view of a reduced pressure delivery system 119637.doc-58 - 200808393 in accordance with an embodiment of the present invention, the reduced pressure delivery system Connected to a main manifold of a reduced pressure delivery tube; Figure 513 of the woven portion shows a perspective view of a primary manifold shown in conjunction with an auxiliary manifold for a bone group 40-50; and Figure 52 A schematic diagram of a reduced pressure delivery system having a valve fluidly coupled to a second conduit in accordance with an embodiment of the present invention is illustrated. [Main component symbol description]

211 decompression delivery device or wing manifold 213 flex barrier 215 ridge portion 219 wing portion 223 arched channel 227 flexible backing 231 protrusion 233 flow channel 241 decompression delivery tube 243 distal aperture 255 proximal end Orifice 259 lumen or passage 261 double lumen tube 263 first lumen 265 second lumen 271 horizontal spacer 311 decompression delivery device or wing manifold 119637.doc -59- 200808393

313 Flex barrier 315 ridge portion 319 wing portion 323 arched channel 327 honeycomb material 329 distribution surface 330 peripheral surface 341 decompression delivery tube 343 distal orifice 355 proximal orifice 359 lumen or passage 371 reduced pressure delivery Device 373 decompression delivery tube 375 extension 377 distal end 381 incision 383 shoulder 385 protrusion 387 inner surface 391 flow channel 411 decompression delivery device 413 tissue site 415 human bone 419 decompression delivery tube 119637.doc 60- 200808393

421 proximal end 427 decompression source 429 void defect 431 fluid delivery tube 432 proximal end 433 fluid delivery source 434 filter 435 pressure sensor 711 decompression delivery system 713 tissue site 721 manifold delivery tube 725 guide unit 727 guide wire 731 fracture site 733 patient bone 735 skin 739 soft tissue 743 conical distal end 751 pathway 761 decompression delivery device 765 flexible barrier 767 honeycomb material 769 decompression delivery tube 811 decompression delivery system 119637.doc 61 200808393

821 manifold duct 837 dotted line 843 distal end 861 decompression conveyor 865 flexible barrier 867 honeycomb material 869 decompression duct 871 impervious membrane 873 inner surface 881 marking 885 removal device 891 auxiliary lumen or tube 911 minus Pressure delivery system 921 manifold delivery tube 937 dashed line 943 distal end 961 decompression delivery device 965 flexible barrier 967 honeycomb material 969 decompression delivery tube 971 impervious film 973 inner surface 977 plastic seal 981 mark 119637.doc 62 200808393

985 decompression conveying system 987 guiding wire 989 decompression conveying pipe 991 decompression conveying device 993 organization part 1011 decompression conveying system 1021 manifold conveying pipe 1025 organization part 1029 gap 1035 decompression conveying device 1043 remote end 1055 internal space 1057 Auxiliary lumen 1061 Guide wire 1511 Reduced pressure delivery device 1515 Orthopedic hip prosthesis 1517 Patient leg section 1521 Column section 1525 Head section 1529 Path 1535 Porous coating 1541 Flow channel 1543 Main feed line 1545 Lateral branch line 119637.doc - 63- 200808393

1547 Transverse branch line 1551 Decompression line 1553 Reduced pressure supply 1565 Connection 埠1571 Fluid delivery tube 1573 Fluid delivery source 1583 Main feed line 1585 Transverse branch line 1711 Reduced pressure delivery device 1715 Orthopedic fixation device 1717 Bone 1719 Fracture 1721 Pathway 1725 screw 1735 porous coating 1741 flow channel 1743 main feed line 1745 connection 埠 1747 lateral branch line 1751 decompression delivery line 1753 decompression delivery source 1761 flow channel 1765 connection 埠 1771 fluid delivery tube 119637.doc -64- 200808393

1773 Fluid delivery source 1783 Main feed line 1785 Transverse branch line 2111 Reduced pressure delivery system 2115 Main manifold 2117 Flexible wall 2121 Main flow path 2123 Proximal 2129 Transition zone 2135 Anti-blocking part 2137 Protrusion 2141 Inner surface 2145 Ridge 2149 Honeycomb Material 2155 2161 First conduit 2163 Second conduit 2171 Headspace 2211 Reduced pressure delivery system 2215 Main manifold 2217 Pressure relief tube 2223 Central lumen 2225 Secondary lumen 2231 119637.doc -65 200808393 2241 Top gap 2321 Auxiliary manifold 2411 Reduced pressure delivery system 2415 manifold 2419 first conduit 2423 second conduit 2429 decompression source 2435 outlet

2439 valve 2453 controller

119637.doc 66-

Claims (1)

200808393 X. Patent application scope: The utility model relates to a system for treating: a decompression conveying system for applying a decompressed tissue treatment to a woven part, a disambiguating conveying tube having at least two lumens, and a manifold having a plurality of flow passages The manifold is disposed in a first lumen of the lumens of the manifold delivery tube; and &quot; a balloon having an interior space and capable of undergoing a collapsed and expanded position 'the internal space is fluidly coupled to One of the two lumens of the manifold in the manifold. The reduced pressure delivery system of claim 1 further comprising a sharpened tip operatively associated with the manifold delivery tube for selectively puncturing the balloon. 3. The reduced pressure delivery system of claim 1, wherein the first and second lumens are substantially coaxial. 4. The reduced pressure delivery system of claim 1, further comprising a reduced pressure delivery tube fluidly coupled to at least one of the plurality of flow channels. 5. The reduced pressure delivery system of claim 4, wherein the reduced pressure delivery tube is disconnectable from the at least one flow channel. 6. The reduced pressure delivery system of claim 5, wherein the manifold is bioresorbable. 7. The reduced pressure delivery system of claim 4, which further comprises a reduced pressure source fluidly coupled to the reduced pressure delivery tube. 8. The reduced pressure delivery system of claim 4, wherein a reduced pressure is applied to the at least one flow channel by the reduced pressure delivery tube. 119637.doc 200808393 9. The reduced pressure delivery system of claim 8, wherein the reduced pressure is applied cyclically. 1 〇 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11. The reduced pressure delivery system of claim 1, wherein the manifold delivery tube is a set of tubes. 12. The reduced pressure delivery system of claim 1, further comprising a label operatively attached to at least one of the manifold delivery tube and the manifold to cause the manifold delivery tube Or the position of the manifold relative to one of the tissue sites is visualized. 13. The reduced pressure delivery system of claim 12, wherein the markers are radiopaque markers. 14. The reduced pressure delivery system of claim 1, wherein the manifold further comprises: a flexible wall that surrounds a main flow path and is adapted to be placed against the tissue site, the flexible wall comprising a plurality of a flexible wall and a bore communicating with the main flow passage; an anti-blocking member positioned within the main flow passage; a first conduit having at least one outlet fluidly connected to the main flow passage to reduce Pressure is delivered to the main flow passage; a second conduit having at least one outlet abutting the main flow passage or the at least one outlet of the first conduit to be in a gaseous state during application of the reduced pressure Fluid cleans at least one of the primary flow path and the outlet of the remote conduit. The decompression transfer system of claim 14, wherein the anti-blocking member is provided with 119637.doc 200808393 on an inner surface of one of the flexing walls and extending to a plurality of protrusions in the main flow path. 16. The reduced pressure delivery system of claim 14, wherein the anti-blocking component is a honeycomb material that must be located within the main flow path. 17. The reduced pressure delivery system of claim 1, wherein the manifold further comprises: a flexible barrier; a honeycomb material disposed adjacent to the flexible barrier, the honeycomb material comprising the plurality of flow channels; a reduced pressure delivery tube fluidly coupled to at least one of the plurality of flow channels. 18. The decompression delivery system of claim 1, wherein the balloon is inflated by injecting a fluid into the interior space. 19. The reduced pressure delivery system of claim 1, wherein the tissue site comprises a hard tissue. 20. The reduced pressure delivery system of claim 1, wherein the tissue site comprises a soft tissue. 21) A reduced-pressure delivery system for applying a reduced-pressure tissue treatment to a tissue site, comprising: an impermeable membrane having an internal space, the impermeable membrane being capable of undergoing compression and relaxation; a tube having a plurality of flow channels positioned in the interior space of the impermeable membrane; and wherein the reduced pressure in the interior space of the impermeable membrane is less than the pressure external to the impermeable membrane To reduce the amount of space occupied by the manifold within the permeable membrane 119637.doc 200808393. 22. The reduced pressure delivery system of claim 21, wherein the impermeable membrane is sealed to maintain the reduced pressure within the impermeable membrane. 2 3 · The reduced pressure delivery system of claim 21, further comprising a reduced pressure source fluidly coupled to the interior space of the impermeable membrane to maintain the reduction in the interior space pressure. ^24_ The reduced pressure delivery system of claim 21, wherein the impermeable membrane is soluble upon contact with body fluids or body tissue. The pressure-reducing delivery system of claim 21, wherein the impermeable membrane is capable of adopting an expanded position to separate tissue adjacent to the tissue site. 26. The reduced pressure delivery system of claim 25, wherein the impermeable membrane expands by injecting a fluid into the interior space. 27. The reduced pressure delivery system of claim 21, further comprising an instrument having a sharpened tip to selectively break the impermeable membrane. 28. The reduced pressure delivery system of claim 21, further comprising: • a seal disposed on the impermeable membrane; and an implement for propelling the manifold through the seal. 29. The reduced pressure delivery system of claim 21, further comprising indicia operatively attached to at least one of the impermeable membrane and the manifold to render the impermeable membrane or The manifold is visualized relative to only one of the locations of the tissue. 30. The reduced pressure delivery system of claim 29, wherein the markers are radiopaque markers. 3 1 - The reduced pressure delivery system of claim 21, further comprising a reduced pressure delivery 119637.doc 200808393 tube 'the reduced pressure delivery tube having at least one of the flow channels fluidly connected to the manifold end. 32. The reduced pressure delivery system of claim 3, further comprising a reduced pressure source fluidly coupled to a proximal end of the reduced pressure delivery tube to deliver a second reduced pressure to the at least A flow channel. 33. The reduced pressure delivery system of claim 32, wherein the second reduced pressure is applied cyclically. 34. The reduced pressure delivery system of claim 3, wherein the reduced pressure delivery tube is disconnectable from the at least one flow channel. 35. The reduced pressure delivery system of claim 34, wherein the manifold is bioresorbable. 3. The reduced pressure delivery system of claim 21, wherein the manifold further comprises a flexible wall surrounding a main flow path and adapted to be placed against the tissue site, the flexible wall comprising a plurality of wearing a hole passing through the flexible wall and communicating with the main flow path; an anti-blocking member positioned in the main flow path; a first conduit having at least one outlet fluidly connected to the main flow path to a reduced pressure is delivered to the main flow passage; a second guide having 'at least one outlet, the at least one outlet abutting the main flow passage or the at least one outlet of the first conduit to apply a reduced pressure during application At least one of the main flow passage and the outlet of the first conduit is purged with a fluid. 37. The reduced pressure delivery system of claim 36, wherein the anti-blocking component is disposed on an inner surface of the flexible wall and extends into the plurality of protrusions in the main flow path. 3. The reduced pressure delivery system of claim 36, wherein the anti-blocking component is a honeycomb material that must be located within the main flow path. 39. The reduced pressure delivery system of claim 36, wherein the flow system is a gas. 40. The reduced pressure delivery system of claim 36, wherein the flow system is a liquid. 41. The reduced pressure delivery system of claim 21, wherein the manifold further comprises: a flexible barrier; a honeycomb material attached to the flexible barrier, the honeycomb material comprising the plurality of flow channels; a reduced pressure delivery tube fluidly coupled to at least one of the plurality of flow channels. 42. The reduced pressure delivery system of claim 21, wherein the tissue site comprises a hard tissue. 43. The reduced pressure delivery system of claim 21, wherein the tissue site comprises a soft tissue. 44. A decompression delivery system for applying a decompressive tissue treatment to a tissue site, comprising: an escaping sergeant having at least one passageway and a distal end, the distal portion being adjacent to the tissue site Placement · Moss 8 /, there are a plurality of flow channels, the manifold is configured to be transported to the tissue site through the pathway of the border officer; and / / The distal end of the manifold delivery tube has an internal space and is capable of adopting at least one of an expanded position and a collapsed position. 119637.doc