# US 10,945,720 B2 · Systems and methods for closing incisions formed in fragile tissue > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,945,720 B2 - Document ID: US10945720B2 - Status: Granted - Kind: B2 - Application number: 15/703,344 - Filed: 2017-09-13 - Published: 2019-03-14 - Granted: 2021-03-16 - Earliest claimed: 2017-09-13 - Assignees: Ethicon, Inc. - Applicants: Ethicon, Inc. - Inventors: Julian Quintero; Leo B. Kriksunov; Shane A. Lacy; Ibraheem T. Badejo - Web page: https://patentgrep.com/patent/US10945720B2 ## CPC - A61B 17/0466: {Suture bridges} - A61B 17/04: for suturing wounds; Holders or packages for needles or suture materials - A61B 17/085: {with adhesive layer} - A61B 17/06166: {Sutures (suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M)} - A61B 2017/0495: {Reinforcements for suture lines} - A61B 2017/081: {Tissue approximator (A61B2017/1103, A61B17/8866 take precedence)} - A61B 2046/205: {Adhesive drapes} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract A method of reinforcing subcutaneous fragile tissue includes obtaining an absorbable surgical mesh having top and bottom major surfaces, the absorbable surgical mesh including a stitching zone and first and second reinforcing zones that bound opposite sides of the stitching zone. The method includes making an incision in a patient's skin for exposing subcutaneous fragile tissue, using one or more absorbable adhesives for adhering the bottom major surface of the absorbable surgical mesh to the subcutaneous fragile tissue, creating an incision through the stitching zone of the absorbable surgical mesh and into the subcutaneous fragile tissue, performing a surgical procedure through the incision, and passing an absorbable suture through the stitching zone of the absorbable surgical mesh and the fragile tissue for closing the incision. ## Claims ### Claim 1 A method of reinforcing subcutaneous fragile tissue comprising: obtaining a reinforcing incision drape having top and bottom major faces; using an adhesive for directly adhering said bottom major face of said reinforcing incision drape to subcutaneous fragile tissue; creating an incision through said reinforcing incision drape and into said subcutaneous fragile tissue; performing a surgical procedure through said incision; passing a surgical closing component through said reinforcing incision drape and said subcutaneous fragile tissue for closing said incision. ### Claim 2 (depends on 1) The method as claimed in claim 1, wherein said reinforcing incision drape, said adhesive and said surgical closing component are absorbable. ### Claim 3 (depends on 1) The method as claimed in claim 1, wherein said reinforcing incision drape comprises an absorbable surgical mesh, said adhesive comprises absorbable adhesive, and said surgical closing component comprises an absorbable suture. ### Claim 4 (depends on 1) The method as claimed in claim 1, wherein said reinforcing incision drape comprises: a centrally located stitching zone; first and second reinforcing zones that extend along opposite sides of said centrally located stitching zone, wherein said centrally located stitching zone has different structural properties than said first and second reinforcing zones. ### Claim 5 (depends on 4) The method as claimed in claim 4, wherein said first and second reinforcing zones are more porous than said centrally located stitching zone. ### Claim 6 (depends on 5) The method as claimed in claim 5, wherein the using an adhesive step comprises: using a weaker adhesive for securing said centrally located stitching zone to said subcutaneous fragile tissue; and using a stronger adhesive for securing said first and second reinforcing zones to said subcutaneous fragile tissue. ### Claim 7 (depends on 6) The method as claimed in claim 6, wherein said stronger adhesive comprises an absorbable adhesive containing a cross-linking initiator. ### Claim 8 (depends on 7) The method as claimed in claim 7, wherein said stronger adhesive comprises cyanoacrylate. ### Claim 9 (depends on 6) The method as claimed in claim 6, further comprising after the using a weaker adhesive step, applying said stronger adhesive over said top surface of said reinforcing incision drape and within said first and second reinforcing zones of said reinforcing incision drape. ### Claim 10 (depends on 9) The method as claimed in claim 9, further comprising: obtaining a releasable liner over said top surface of said reinforcing incision drape within said stitching zone of said reinforcing incision drape, wherein said releasable liner covers said stitching zone during the applying said stronger adhesive step; after the applying said stronger adhesive step, removing said releasable liner from said top surface of said reinforcing incision drape for exposing said stitching zone at said top surface of said reinforcing incision drape. ### Claim 11 (depends on 4) The method as claimed in claim 4, wherein said creating an incision step comprises forming an incision in said stitching zone of said reinforcing incision drape and said subcutaneous fragile tissue underlying said stitching zone, and wherein said passing a surgical closure step comprises passing a surgical suture through said stitching zone of said reinforcing incision drape and said subcutaneous fragile tissue underlying said reinforcing incision drape. ### Claim 12 (depends on 1) The method as claimed in claim 1, wherein said surgical closing component is selected from the group consisting of sutures, barbed sutures, surgical staples and surgical adhesives. ### Claim 13 (depends on 1) The method as claimed in claim 1, wherein after the using an adhesive for directly adhering said bottom major face of said reinforcing incision drape to subcutaneous fragile tissue, said bottom major face of said reinforcing incision drape is in contact with said subcutaneous fragile tissue. ### Claim 14 A method of reinforcing subcutaneous fragile tissue comprising: obtaining an absorbable surgical mesh having top and bottom major surfaces, said absorbable surgical mesh including a stitching zone and first and second reinforcing zones that bound opposite sides of said stitching zone; making an incision in a patient's skin for exposing subcutaneous fragile tissue; using one or more absorbable adhesives for directly adhering said bottom major surface of said absorbable surgical mesh to said subcutaneous fragile tissue; creating an incision through said stitching zone of said absorbable surgical mesh that is directly adhered to said subcutaneous fragile tissue and into said subcutaneous fragile tissue; performing a surgical procedure through said incision; passing an absorbable suture through said stitching zone of said absorbable surgical mesh that is directly adhered to said subcutaneous fragile tissue and said subcutaneous fragile tissue for closing said incision. ### Claim 15 (depends on 14) The method as claimed in claim 14, wherein the using one or more absorbable adhesives step comprises: using a weaker absorbable adhesive for adhering said stitching zone of said absorbable surgical mesh to said subcutaneous fragile tissue; using a stronger absorbable adhesive for adhering said first and second reinforcing zones of said absorbable surgical mesh to said subcutaneous fragile tissue. ### Claim 16 (depends on 15) The method as claimed in claim 15, wherein the using a stronger absorbable adhesive step comprises: after placing a bottom surface of said absorbable surgical mesh in contact with said subcutaneous fragile tissue, applying said stronger absorbable adhesive over said top major surface of said absorbable surgical mesh and within said first and second reinforcing zones of said absorbable surgical mesh. ### Claim 17 (depends on 16) The method as claimed in claim 16, further comprising: obtaining a releasable liner that covers said top major surface of said absorbable surgical mesh within said stitching zone; after the applying said stronger absorbable adhesive over said top major surface of said absorbable surgical mesh step, removing said releasable liner for uncovering said stitching zone at said top major surface of said absorbable surgical mesh. ### Claim 18 (depends on 14) The method as claimed in claim 14, wherein said stitching zone of said absorbable surgical mesh is less porous than said first and second reinforcing zones of said absorbable surgical mesh. ### Claim 19 (depends on 14) The method as claimed in claim 14, wherein after the using one or more absorbable adhesives for directly adhering said bottom major surface of said absorbable surgical mesh to said subcutaneous fragile tissue, said bottom major surface of said absorbable surgical mesh is in contact with said subcutaneous fragile tissue. ### Claim 20 A method of reinforcing subcutaneous fragile tissue comprising: obtaining an absorbable surgical mesh having top and bottom major surfaces, said absorbable surgical mesh including a stitching zone and first and second reinforcing zones that bound opposite sides of said stitching zone, wherein said stitching zone of said absorbable surgical mesh is less porous than said first and second reinforcing zones of said absorbable surgical mesh; making an incision in a patient's skin for exposing subcutaneous fragile tissue; using one or more absorbable adhesives for adhering said bottom major surface of said absorbable surgical mesh to said subcutaneous fragile tissue; creating an incision through said stitching zone of said absorbable surgical mesh and into said subcutaneous fragile tissue; performing a surgical procedure through said incision; passing an absorbable suture through said stitching zone of said absorbable surgical mesh and said fragile tissue for closing said incision.