(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT)

(19) World Intellectual Property

Organization
International Bureau
(10) International Publication Number
(43) International Publication Date WO 2014/174291 Al
3 0 October 2014 (30.10.2014) PO PCT

(51) International Patent Classification:
A61F 13/00 (2006.01)
(21) International Application Number:
PCT/GB20 14/05 1270
(22) International Filing Date:
24 April 2014 (24.04.2014)
(25) Filing Language: English
(26) Publication Language: English
(30) Priority Data:
1307544.5 26 April 2013 (26.04.2013) GB
(71) Applicant: BRIGHTWAKE LIMITED [GB/GB]; Sid
ings Road, Lowmoor Ind Est, Kirkby in Ashfield, Notting
ham, Nottinghamshire NG17 7JZ (GB).
(72) Inventor: COTTON, Stephen; 204 Moor Road, Pap-
plewick, Nottingham, Nottinghamshire NG15 8EQ (GB).
(74) Agents: JONES, Stephen et al; Adamson Jones, BioCity
Nottingham, Pennyfoot Street, Nottingham, Nottingham
shire NG1 IGF (GB).
(81) Designated States (unless otherwise indicated, for every
kind of national protection available): AE, AG, AL, AM,
AO, AT, AU, AZ, BA, BB, BG, BH, BN, BR, BW, BY,
BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM,
DO, DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT,
HN, HR, HU, ID, IL, IN, IR, IS, JP, KE, KG, KN, KP, KR,
KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME,
MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ,
OM, PA, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SA,
SC, SD, SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM,
TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM,
ZW.
(84) Designated States (unless otherwise indicated, for every
kind of regional protection available): ARIPO (BW, GH,
GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ,
UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, RU, TJ,
TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, DK,
EE, ES, FI, FR, GB, GR, HR, HU, IE, IS, IT, LT, LU, LV,
MC, MK, MT, NL, NO, PL, PT, RO, RS, SE, SI, SK, SM,
TR), OAPI (BF, BJ, CF, CG, CI, CM, GA, GN, GQ, GW,
KM, ML, MR, NE, SN, TD, TG).
Declarations under Rule 4.17 :
— as to applicant's entitlement to apply for and be granted a
patent (Rule 4.1 7(H))
— of inventorship (Rule 4. 1 7(iv))
Published:
— with international search report (Art. 21(3))

(54) Title: WOUND DRESSINGS

FIG. 1

(57) Abstract: A wound dressing (1) comprises an absorbent body of foam material with first and second major surfaces. The first
major surface is, in use, the wound-facing surface of the absorbent body (1). A thermochromic indicator (13) is incorporated into, or
is in intimate contact with, the second major surface of the absorbent body (1). The thermochromic indicator (13) is sensitive to a
change in temperature of the skin below the dressing (1) and so is indicative of an infection.
Title Wound dressings

The present invention relates to wound dressings. More particularly, the present
invention relates to foam wound dressings.

Different types of wound dressing are required to meet different clinical needs.
However, a common requirement for wound dressings is that they are able to
absorb exudate from a wound, while retaining sufficient structure that they can be
easily removed from the wound after use without tearing or disintegrating. In
addition, infrequent dressing changes are preferable as changing a dressing can
aggravate a wound, as well as causing pain and/or discomfort for the patient.

Infection of wounds during the healing process is a major concern in healthcare

and, as well as being a source of pain and distress to the patient, can be very
expensive. Infection of a wound can greatly increase the length of a patient's stay
in hospital. However, pre-emptive prescribing of antibiotics is not currently

recommended due to the rising number of resistant strains of bacteria. It is

therefore important to monitor wounds for early signs of infection so that
appropriate steps can be taken to treat the infection.

It is known that infection causes the temperature of the skin surrounding a wound

to rise. The monitoring of skin temperature under wound dressings to detect

infection is known. Methods such as liquid crystal displays and other temperature
sensing devices such as thermocouples have been described for use as part of
bandages and wound dressings. These allow the wound to be monitored without
necessarily having to remove the dressing. As a result of this, the discomfort
caused to the patient is reduced.

The general concept of monitoring a wound for signs of infection by incorporating

an indicator that is capable of producing a visual indication of temperature at a
wound surface in a bandage or wound dressing is known.
For example, in WO2007/1 44795, a temperature sensing element that is applied
to the skin with the aid of a bandage is described. Thermocouples and LED or
LCD displays are described as preferred indicators.

Foam dressings are a common form of wound dressing and are known to be of
particular use in dressing chronic wounds that have high levels of exudate. Foam
dressings are commonly made of polyurethane and comprise open cells that are
capable of absorbing large volumes of exudate. It is essential for efficient wound
healing that the area of the wound be kept moist but the surrounding skin be kept
dry to avoid maceration.

Foams are by nature, however, thermal insulators. It is, therefore, problematic to

measure temperature changes of the skin surface that occur under a foam
dressing at the non-wound-facing surface of the foam dressing.

Although methods of monitoring the skin surface temperature which measure the
temperature at the surface and relay the information to an external indicator such
as a thermocouple linked to an appropriate display unit are known and can be
used to directly monitor the temperature of the skin below dressings, these types
of system are expensive and require the user to be trained in their implementation.

Surprisingly, given the foam's insulating properties, a foam dressing with a simple
temperature indicator on the external surface of the dressing has now been
devised that enables the temperature of the skin surface covered by the foam
dressing to be monitored directly.

According to the first aspect of the invention there is provided a wound dressing
comprising an absorbent body of foam material, the absorbent body having first
and second major surfaces, the first major surface being, in use, the wound-facing
surface of the absorbent body, wherein a thermochromic indicator is incorporated
into, or is in intimate contact with, the second major surface of the absorbent body.
The dressing according to the invention is advantageous primarily in that, despite
the thermal insulating properties of the foam, the thermochromic indicator on the
second (non-wound-facing) surface of the foam absorbent body is sufficiently
sensitive to the temperature of the skin below the dressing to allow that
temperature to be monitored directly. The thermochromic indicator is capable of
indicating a change in temperature of the skin below the foam dressing.
Preferably the thermochromic indicator indicates a change in temperature from a
temperature that is characteristic of normal, healthy skin to a temperature
indicative of infection. This allows the wound to be monitored for signs of infection
without removing the dressing, thus providing an early indication of infection, and
alleviating a cause of discomfort for patients.

By a "thermochromic indicator" is meant a visual indicator that undergoes a

change in response to a change in temperature. For instance, the change may be
a change in colour, eg a change from one colour to another, or a change from a
colour to colourless, or vice versa.

For a human being, the external skin temperature (ie the temperature measured
on the surface of the skin) is normally approximately 32°C. In case of an infection
this can rise by several degrees, eg to approximately 37°C.

The thermochromic indicator may be any suitable thermochromic indicator known

in the art. Preferably the indicator changes colour at a temperature of between 33

and 39°C. More preferably the indicator changes colour at a temperature of

between 35 and 37°C

In certain embodiments, the thermochromic indicator is a liquid crystal indicator,

such as those used in liquid crystal thermometers. The liquid crystal is

thermotropic, ie it changes alignment with changing temperature and the
wavelength of light reflected by the crystal changes as a result. Typically the liquid
crystal will have a cholesteric or twisted nematic structure with a pitch that
changes with temperature. A continuous sheet of liquid crystals may be applied to
the foam sheet of the dressing of the invention. A continuous sheet of the liquid
crystal indicator allows areas of increased temperature to be easily observed by
the user. The liquid crystals may be any suitable liquid crystal or combination of
liquid crystals known in the art. The liquid crystal may be a mixture of cholesterol
derivatives such as cholesteryl nonanoate, cholesteryl oleyl carbonate, cholesteryl
pelargonate and cholesteryl benzoate.

In other, currently preferred embodiments, the thermochromic indicator is a

thermochromic ink. The thermochromic ink may be any suitable thermochromic

ink known in the art. Such inks commonly comprise leuco dyes, the molecules of
which are able to exist in two forms, one of which is strongly coloured and the
other of which may be colourless. Suitable leuco dyes are those that are
transformed from one form to the other by the action of heat. The ink used in the
present invention may exhibit an irreversible colour change, but more commonly
an ink that exhibits a reversible colour change is appropriate. Suitable inks will be
familiar to those skilled in the art and are available commercially, eg from LCR
Hallcrest, Riverside Building, Connah's Quay, Flintshire CHS 4DS, United
Kingdom or from CTI, 1096 Elkton Drive, Suite 600, Colorado Springs, CO 80907,
USA.

In currently preferred embodiments, the thermochromic ink becomes colourless at

elevated temperature, the loss of colour occurring at a temperature indicative of

infection in an underlying wound. In one embodiment the ink changes colour from
bright pink to colourless.

In simple embodiments of the invention, a dressing consists of the absorbent

body, which in use is applied to a wound and held in place by means of a separate
secondary dressing, or simply by means of adhesive tape or the like. In other
embodiments, the absorbent body forms part of a composite dressing.

The thermochromic ink may be applied directly to the second major surface of the
absorbent body. Preferably, however, the ink is applied to a plastics film that is
bonded to the second major surface of the absorbent body. This prevents any
possibility of the ink contaminating the wound site, as well as permitting more
precise application of the ink. The presence of such a film will also inhibit ingress
of bacteria into the wound. The ink may be applied to either surface of the plastics
film or, in certain embodiments, the ink may be applied to the interior of the
plastics film, for example by double casting the film, ie a layer of the film is cast,
the ink is applied to the film and then a second layer of the film is cast on top of the
ink. Double casting is also advantageous in that it reduces the risk of there being
pinholes present in the plastics film as, although pinholes may be present in each
individual casting, the likelihood of any such pinholes being present in both layers
of the film and aligned with one another is very low.

The ink may be applied across the full extent of the second major surface. More
commonly, however, the ink is applied in a pattern, eg a regular, repeating pattern.
The regular pattern makes a temperature change in a small area easier for the
user to identify. The pattern may comprise continuous elements, such as lines, or
graphic elements arranged in a regular array. For instance, the pattern may
comprise an array of dots or other graphic elements. In order to make visible an
increase in temperature that occurs in a relatively small region, the spacing
between elements in the pattern is preferably less than 10mm, more preferably
less than 5mm or less than 3mm.

Printing the ink across the entire absorbent body in a closely repeating pattern is
advantageous as it allows the user or medical practitioner to monitor the
temperature of the skin at the wound and identify a possible infection. The
presence of the pattern across the full extent of the absorbent body prevents false
indications of local infection when the temperature of the skin is above a normal
temperature over the entire body of the patient, eg as a result of a systemic
infection. n the case of a raised temperature across the whole body, the entire
pattern will show a change in colour. The continuous pattern also enables the
absorbent body to be cut to any suitable size whilst maintaining the ability to
monitor the skin temperature.
The thermochromic ink is most preferably applied by a printing process. Suitable
printing methods will be familiar to those skilled in the art.

Preferably, the surface of the dressing is, in addition to the thermochromic

indicator, printed with another ink that does not change colour with temperature or
any other environmental factor. This can be used to print a distinctive pattern
across the surface of the dressing which enables the user to identify the dressing
as the dressing of the invention if the temperature change has already occurred
across the entire surface of the dressing. Thus, in preferred embodiments of the
invention, the second major surface of the absorbent body carries not only the
thermochromic indicator (for instance a regular pattern of graphical elements
printed in thermochromic ink), but also a non-thermochromic visual element (for
instance a graphical pattern or image printed in an ink with an appearance that
does not change with temperature). The combination of a printed indicator that
does change in appearance at elevated temperature and a printed indicator that
does not is beneficial in that it differentiates, in use, a dressing according to the
invention in which the thermochromic indicator has, for instance, become
colourless from a conventional dressing of similar physical form that carries no
such indicator.

indeed, patterns printed on the dressing of the invention in thermochromic and

non-thermochromic inks may complement each other, for instance such that a
warning symbol or the like printed in non-thermochromic ink may become visible
when a surrounding pattern printed in thermochromic ink loses its colour.

The foam material may be any suitable foam known in the art. Usually, the foam
is an open-celled foam. Preferably the foam is a hydrophilic foam. More
preferably the hydrophilic foam is a polyurethane foam. Most preferably the foam
is an open-celled polyurethane foam. The foam typically has a thickness of
0.5mm to 10mm, preferably from 1 m to 7mm, or from 2mm to 7mm, and the
foam most preferably has a thickness of 2mm, 3mm, 4mm or 5mm.
As described above, the foam may be bonded at its second major surface to a
plastics film. Preferably the film s a polyurethane film. When the film is present,
the thermochromic indicator is applied to the outward-facing surface of the film.

The film will generally be impermeable to wound exudate and other liquids, but is
preferably permeable to air and moisture vapour. In particular, the film preferably
exhibits a relatively high moisture vapour transmission rate (MVTR). The MVTR of
the film may be at least 300g/m 2/24h, more suitably at least 500g/m 2/24h and
preferably at least 7Q0g/m 2/24h at 37°C and 00% to 10% relative humidity
difference. The MVTR of film may be up to 20Q0g/m /24h under such conditions.

It is particularly surprising that the thermochromic indicator is able to provide a

reliable indication of increased temperature at the wound site when the foam
material has a thickness of 2mm or more.

Thus, according to a particularly preferred aspect of the invention, there is

provided a wound dressing comprising an absorbent body of open-celled foam
having first and second major surfaces and a thickness of at least 2mm, the first
major surface being, in use, the wound-facing surface, and the second major
surface being bonded to a plastics film that is permeable to air and moisture
vapour and which is printed in thermochromic ink with a regular pattern of
graphical elements, wherein the thermochromic ink is coloured at ambient
temperature, but becomes colourless at an elevated temperature indicative of
infection at a wound site to which the dressing is, in use, applied.

As noted above, in addition to the pattern printed in thermochromic ink, the

dressing may be printed with a non-thermochromic pattern that remains visible
when the thermochromic ink becomes colourless.

Where the absorbent body forms part of a composite dressing, it will generally be
overlaid with a backing layer, which forms a barrier between the wound and the
surrounding atmosphere and may also extend beyond the absorbent body to
provide a means of attachment of the dressing to the skin around the wound site.

The backing layer is most preferably a plastics film, eg a polyurethane film, having
the desired characteristics, which may be similar to those described above in
relation to the plastics film that may be bonded to the foam material.

The backing layer may be transparent, in which case the thermochromic indicator
may be applied to the second major surface of the absorbent body (eg directly to
the foam material or to a plastics film bonded to the foam material as described
above) such that it can be seen through the backing layer.

Alternatively, the thermochromic indicator may be applied to the backing layer

itself, which is bonded to the absorbent body. In such a case, the backing layer
does not need to be transparent.

The backing layer may be larger in size than the absorbent body, such that it
extends beyond the edge of the absorbent body on one or more sides. Preferably,
the backing layer extends beyond the edge of the absorbent body on all sides,
forming a border around the absorbent body.

Where the backing layer forms a border around the absorbent body, the border
may carry an adhesive to adhere the wound dressing to the patient's skin around
the wound. Suitable skin contact adhessves for wound dressings are known, and
any suitable adhesive known in the art may be used in the present invention.

Where the wound dressing includes a skin contact adhesive, the dressing will
generally be supplied with a releasabie liner on its underside. The releasabie liner
may cover the adhesive and wound contact portions of the wound dressing prior to
use, and be removed from the dressing immediately before application of the
dressing to the wound. This reduces the risk of contamination of the wound
dressing and facilitates handling of the dressing.
The invention will now be described in greater detail, by way of example only, with
reference to the accompanying drawings, in which

Figure 1 shows a perspective view of a first embodiment of a wound dressing

according to the invention;

Figure 2 is a view similar to Figure , but showing the appearance of the dressing
in the event of a rise in temperature below it, for instance where the wound to

which it is applied becomes infected; and

Figure 3 shows a cross-sectional view of a second embodiment of a wound

dressing according to the invention

In Figure 1 there is shown a first embodiment of a wound dressing according to

the invention, generally designated 1. The dressing 1 is generally square in form

and comprises an absorbent body of open-celled polyurethane foam 11, to the
upper (as viewed in Figure 1) surface of which is bonded a breathable
polyurethane film 12. The foam sheet is approximately 5mm thick.

A regular pattern of dots 13 is printed on the film 12 using a thermochromic ink. In

addition, the film 12 is printed with a pattern of diagonal lines 14 in non-
thermochromic ink.

In use, the dressing 1 is applied to an exuding wound, eg an ulcerous wound such

as a leg ulcer. The dressing 1 is secured in place by means of a secondary

dressing, eg an occlusive film dressing, or simply by means of adhesive tapes.
Exudate is absorbed by the foam 11, liquid material being retained within the foam
11 by the polyurethane film 12, though air and water vapour can pass through the
film 12 by virtue of its breathability.
The thermochromic ink used for the printing of the pattern of dots 13 changes from
a strong visible colour at ambient temperature to colourless at more elevated
temperature, and specifically at a temperature reached in the event that the wound
site beneath the dressing becomes infected. This leads to a change in the
appearance of the dressing as shown in Figure 2 , where it can be seen that the
dots near the centre of the dressing 1 have lost their colour. This indicates to the
patient, or to a responsible healthcare professional, that there has been a local
rise in temperature beneath the dressing, which may be due to infection of the
wound. The diagonal lines 14 are not affected by the increase in temperature and
so remain visible across the full extent of the dressing 1.

Of course, in the event of a more general infection resulting in a fever or elevated

systemic temperature, the whole pattern of dots 13 may disappear, which at least
where the dressing 1 is substantially greater in extent than the underlying wound
site) allows for differentiation between a local infection and a more general,
systemic infection. Again, in such a case, the diagonal lines 14 are unaffected and
remain visible.

A second embodiment of a wound dressing, generally designated 2 , is shown in

Figure 3 . This dressing 2 incorporates an absorbent body that is broadly similar to
the dressing 1 of Figure 1, and which comprises open-celled polyurethane foam
2 1 to which is bonded a polyurethane film 22. The film 22 is printed in

thermochromic ink with a pattern of dots (not visible in Figure 3) similar to that
present on the dressing 1, and with non-thermochromic diagonal lines, as for the
first embodiment.

In the dressing of Figure 3 , however, the upper (as viewed in Figure 3) surface of

the absorbent body is overlaid by, and adhered to, a backing layer 24 comprising a
sheet of transparent microporous polyurethane. The backing layer 24 extends
beyond the foam 2 1 in all directions such that it forms a border around the foam
2 1 . The underside of that border carries a layer of skin contact adhesive 25, by

which the dressing may be affixed to the healthy skin surrounding a wound site.
Because the backing layer is transparent, the pattern of dots applied to the film 22
is visible through it, as are the diagonal lines printed in non-thermochromic ink. In
a similar manner to the dressing 1 of Figure 1, therefore, the disappearance of the
dots provides an indication of a local infection or (in the case of complete
disappearance of the pattern of dots across the whole extent of the absorbent
body) of a systemic infection.

n other embodiments, the patterns of dots and lines or other pattern may be

applied to the upper surface of the backing layer 24, in which case the backing
layer 24 does not need to be transparent and the polyurethane film 22 may be
omitted, the foam 2 1 being affixed directly to the backing layer 24.
Claims

1. A wound dressing comprising an absorbent body of foam material, the

absorbent body having first and second major surfaces, the first major surface
being, in use, the wound-facing surface of the absorbent body, wherein a
thermochromic indicator is incorporated into, or is in intimate contact with, the
second major surface of the absorbent body.

2. A dressing according to Claim 1, wherein the thermochromic indicator

indicates a change in temperature from a temperature that is characteristic of a
normal, healthy skin to a temperature indicative of infection.

3. A dressing according to any preceding claim, wherein the change in

temperature indicated by the indicator is from a temperature that is characteristic
of a normal, healthy skin to between 33° and 39°C.

4. A dressing according to Claim 3 , wherein the change in temperature

indicated by the indicator is from a temperature that is characteristic of a normal,
healthy skin to between 35° and 37°C.

5. A dressing according to any preceding claim, wherein the indicator is a

thermochromic ink.

6. A dressing according to Claim 5 , wherein the ink is applied in a regular

pattern.

7. A dressing according to Claim 6 , wherein the spacing between elements in

the pattern is less than 10mm.

8. A dressing according to Claim 7 , wherein the spacing between the

elements is less than 5mm.
9. A dressing according to Claim 8 , wherein the spacing between the
elements is less than 3mm.

0. A dressing according to any one of Claims 5 to 9 , wherein the ink is applied

by a printing process

11. A dressing according to any one of Claims 5 to 10 , wherein the ink is

coloured at ambient temperature and colourless at an elevated temperature.

12 . A dressing according to any preceding claim, wherein, in addition to the

thermochromic indicator, a non-thermochromic visual element is incorporated into,
or is in intimate contact with, the second major surface of the absorbent body.

13 . A dressing according to any preceding claim, wherein the foam is an open-

celled foam.

14. A dressing according to any preceding claim, wherein the foam is a

hydrophilic foam.

15 . A dressing according to any preceding claim, wherein the foam is a

polyurethane foam.

16 . A dressing according to Claim 5 , wherein the foam is an open-celled

polyurethane foam.

1 . A dressing according to any preceding claim, wherein the foam has a

thickness of 0.5mm to 10mm.

18 . A dressing according to Claim 17 , wherein the foam has a thickness of from

1mm to 7mm.
19 . A dressing according to Claim 18 , wherein the foam has a thickness of from
2mm to 7mm.

20. A dressing according to any preceding claim, wherein a film is bonded to

the second major surface of the absorbent body.

2 1. A dressing according to Claim 20, wherein the film is a plastics film.

22. A dressing according to Claim 2 1 , wherein the film is a polyurethane film.

23. A dressing according to any one of Claims 20 to 22, wherein the film is
permeable to air and moisture vapour.

24. A dressing according to Claim 23, wherein the moisture vapour

transmission rate of the film is at least 300g/m /24h.

25. A dressing according to any one of Claims 20 to 24, wherein the

thermochromic indicator is applied to the film.

26. A dressing according to Claim 25, wherein the thermochromic indicator is a

thermochromic ink applied to the film in a regular pattern of graphical elements.

27. A dressing according to Claim 1, wherein the dressing comprises an

absorbent body of open-celled foam having first and second major surfaces and a
thickness of at least 2mm, the first major surface being, in use, the wound-facing
surface, and the second major surface being bonded to a plastics film that is
permeable to air and moisture vapour and which is printed in thermochromic ink
with a regular pattern of graphical elements, wherein the thermochromic ink is
coloured at ambient temperature, but becomes colourless at an elevated
temperature indicative of infection at a wound site to which the dressing is, in use,
applied.
28. A dressing according to Claim 27, wherein the plastics film is further printed
with a non-thermochromic pattern that remains visible when the thermochromic ink
becomes colourless.
A . CLASSIFICATION O F SUBJECT MATTER
INV. A61F13/00
ADD.

According to International Patent Classification (IPC) o r t o both national classification and IPC

B . FIELDS SEARCHED
Minimum documentation searched (classification system followed by classification symbols)
A61F G01K

Documentation searched other than minimum documentation to the extent that such documents are included in the fields searched

Electronic data base consulted during the international search (name of data base and, where practicable, search terms used)

EPO-Internal , WPI Data

C . DOCUMENTS CONSIDERED TO B E RELEVANT

Category* Citation of document, with indication, where appropriate, of the relevant passages Relevant to claim No.

US 2010/268112 Al (SHORT DAN C [US] ET AL) 1-28

2 1 October 2010 (2010-10-21)
paragraphs [0002] , [0003] , [0006] ,
[0007] , [0015] , [0019] ; f i gure 1

US 2013/030341 Al ( FREER CARL J [US] ET 1-28

AL) 3 1 January 2013 (2013-01-31)
paragraphs [0059] , [0142] ; f i gures
13A. 13B, 25-27

US 3 633 425 A (SANF0RD ROBERT A) 1-28

1 1 January 1972 (1972-01-11)
col umn 5 , l i ne 3 1 - l i ne 69 ; c l aims 1-22 ;
f i gures 1-4

US 2011/201715 Al (SCH0ENBERGER JAN [DE] 1-28

ET AL) 18 August 2011 (2011-08-18)
c l aims 1-15

-I
X| Further documents are listed in the continuation of Box C . XI See patent family annex.

* Special categories of cited documents :

"T" later document published after the international filing date o r priority
date and not in conflict with the application but cited to understand
"A" document defining the general state of the art which is not considered
the principle o r theory underlying the invention
to be of particular relevance
"E" earlier application o r patent but published o n o r after the international
"X" document of particular relevance; the claimed invention cannot be
filing date considered novel o r cannot b e considered to involve a n inventive
"L" documentwhich may throw doubts o n priority claim(s) orwhich is step when the document is taken alone
cited to establish the publication date of another citation o r other
"Y" document of particular relevance; the claimed invention cannot be
special reason (as specified)
considered to involve a n inventive step when the document is
"O" document referring to a n oral disclosure, use, exhibition o r other combined with one o r more other such documents, such combination
means being obvious to a person skilled in the art
"P" document published prior to the international filing date but later than
the priority date claimed "&" document member of the same patent family

Date of the actual completion of the international search Date of mailing of the international search report

1 1 June 2014 18/06/2014

Name and mailing address of the ISA/ Authorized officer
European Patent Office, P.B. 5818 Patentlaan 2
NL - 2280 HV Rijswijk
Tel. (+31-70) 340-2040,
Fax: (+31-70) 340-3016 Gennari , Si l v i a
C(Continuation). DOCUMENTS CONSIDERED TO BE RELEVANT

Category* Citation of document, with indication, where appropriate, of the relevant passages Relevant to claim No.

GB 2 428 581 A (ETHICON INC [US] ETHICON 1-28

INC [US] ; SYSTAGENIX WOUND MAN I P CO BV
[NL] ; ) 7 February 2007 (2007-02-07)
c l aims 1-18
 Patent document Publication Patent family Publication
cited in search report date member(s) date

US 2010268112 Al 21-10-2010 US 2010268112 Al 21-10-2010

O 2010123986 Al 28-10-2010

US 2013030341 Al 31-01-2013 US 2013030341 Al 31-01-2013

US 2014046237 Al 13-02-2014

US 3633425 A 11-01-1972 NONE

US 2011201715 Al 18-08-2011 AU 2009287069 Al 04 -03 -2010

CA 2735199 Al 04 -03 -2010
CN 102197074 A 2 1 -09 -2011
EP 2159255 Al 03 -03 -2010
EP 2328959 Al 08 -06 -2011
P 2012500869 A 12 -01 -2012
KR 20110073430 A 29 -06 -2011
RU 2011111291 A 1 -10 -2012
T 201026762 A 16 -07 -2010
US 2011201715 Al 18 -08 -2011
O 2010022893 Al 04 -03 -2010

GB 2428581 A 07-02-2007 NONE