External vacuum expander with non-adhesive rim

Abstract

A tissue expander having a shell, an opening in the shell in communication with an external vacuum source to apply a vacuum within the shell and impart a distracting force to expand tissue, and a rim connected to the shell and adapted to be in contact with a skin of a patient. The rim is non-fixedly attached to the skin of the patient and moves laterally outwardly with respect to the shell under application of the vacuum.

1 - 20 . (canceled) 
     
     
         21 . A wearable tissue expander comprising a shell, an opening in the shell in communication with an external vacuum source to apply a vacuum within the shell and impart a distracting force to expand tissue into the wearable tissue expander, and a skirt extending downwardly from the shell and composed of a softer material than the shell and conforming to a contour of the body of a patient, the skirt connected to the shell and adapted to be in contact with a skin of a patient, wherein the skirt is non-fixedly attached to the skin of the patient and moves laterally outwardly with respect to the shell under application of the vacuum as the skirt increasingly spreads under increasing pressure to reduce shear stresses at a junction with the skin, the skirt maintaining an air-tight seal to prevent air leaks. 
     
     
         22 . The tissue expander of  claim 21 , wherein the skirt is composed of synthetic rubber and has a lubricating layer on a bottom surface to glide over the skin, thereby reducing shear stress between the skirt and contact surface of the skin. 
     
     
         23 . The tissue expander of  claim 21 , wherein the skirt feathers down to a tapered edge. 
     
     
         24 . The tissue expander of  claim 21 , wherein the skirt has a malleable edge thinner than an inner portion of the rim, the edge being more deflectable than the inner portion. 
     
     
         25 . The tissue expander of  claim 21 , wherein the skirt includes a lubricant to reduce friction and reduce shear force. 
     
     
         26 . The tissue expander of  claim 21 , wherein the skirt has a tapered surface progressively decreasing in thickness toward an outer periphery. 
     
     
         27 . The tissue expander of  claim 21 , wherein the shell is removably connectable to the skirt such that another shell of a different size can be connected to the rim. 
     
     
         28 . The tissue expander of  claim 27 , wherein shells of progressively increasing size are connectable to the skirt to accommodate increased tissue expansion over time. 
     
     
         29 . A wearable tissue expander comprising a shell and a skirt extending downwardly from the shell, the shell having an opening in communication with an external vacuum source to apply a vacuum within the shell and impart a distracting force to expand tissue into the shell while worn by a patient, the skirt connected to the shell and adapted to be in contact with a skin of a patient, wherein the skirt has a concave lower surface in a first initial pre-vacuum condition, and at least a segment of the concave lower surface deforms upon the application of vacuum to a second vacuum induced condition to invert to a convex surface upon application of vacuum. 
     
     
         30 . The tissue expander of  claim 29 , wherein the skirt changes angle from a more vertical to a more horizontal with application of pressure as downward pressure is applied. 
     
     
         31 . The tissue expander of  claim 29 , wherein the skirt tapers down to a feathered edge. 
     
     
         32 . The tissue expander of  claim 29 , wherein the skirt is asymmetric with differing lengths of a lateral side and a medial side. 
     
     
         33 . The tissue expander of  claim 29 , wherein the skirt is composed of a softer material than the shell. 
     
     
         34 . A wearable issue expander comprising a shell wherein a distracting force expands tissue into the shell of the wearable tissue expander, a skirt extending radially from the shell, the skirt adapted to be in contact with a skin of a patient and non-fixedly attached to the skin to provide slidable movement with respect to the skin, the shell removably connectable to the skirt such that shells of varying size can be selectively connectable to the skirt. 
     
     
         35 . The tissue expander of  claim 34 , wherein the shells are of progressively increasing size. 
     
     
         36 . The tissue expander of  claim 34 , wherein the distracting force is applied by elastic recoil of the shell. 
     
     
         37 . The tissue expander of  claim 34 , wherein the distracting force is applied by an external vacuum in communication with the shell. 
     
     
         38 . The tissue expander of  claim 34 , further comprising a circumferentially extending connector mechanism for securing the shell to the skirt. 
     
     
         39 . The tissue expander of  claim 34 , wherein the skirt is asymmetric with differing lengths of a lateral side and a medial side. 
     
     
         40 . The tissue expander of  claim 34 , wherein the skirt is composed of a softer material than the shell.