Patent Publication Number: US-2021186552-A1

Title: Wound-care apparatus and method for cleansing, desloughing, and debriding wounds

Description:
RELATED APPLICATIONS 
     This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/953,441 filed Dec. 24, 2019, which is hereby incorporated by reference. 
    
    
     BACKGROUND 
     1. Field of the Invention 
     This invention relates to wound care and, more particularly, to novel systems and methods for cleansing, desloughing, and debriding wounds. 
     2. Background Art 
     Different types of devitalized tissue commonly appear in wound beds. Such tissue may interrupt granulation and delay healing. For example, devitalized tissue may stimulate the overproduction of matrix metalloproteases (MMPs) and thereby slow the healing process. Additionally, devitalized tissue may provide an environment favorable to bacteria. Bacterial biofilms grow on 60-90% of chronic wounds and about 6% of acute wounds. Bacterial biofilms are low grade infections, cause chronic inflammation, impair wound healing, and increase risk of cellulitis. Various technologies and/or methods have been developed to improve wound care. However, those technologies and/or method have certain drawbacks. For example, ultrasonic debridement (e.g., debridement involving oscillations at about 20 kHz or above) is too expensive to be widely adopted. Conversely, pulse lavage is often too untidy for use in clinic or emergency room settings. Accordingly, what is needed are improved systems and methods for cleansing, desloughing, and debriding wounds and removing bacterial biofilms. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present invention will become fully apparent from the following description and appended claims, taken in conjunction with the accompanying drawings. Understanding that these drawings depict only typical embodiments of the invention and are, therefore, not to be considered limiting of its scope, the invention will be described with additional specificity and detail through use of the accompanying drawings in which: 
         FIG. 1  is a perspective view of one embodiment of a wound-care device in accordance with the present invention; 
         FIG. 2  is another perspective view of the wound-care device of  FIG. 1 ; 
         FIG. 3  is a side cross-sectional view of the wound-care device of  FIG. 1 ; 
         FIG. 4  is a schematic block diagram of one embodiment of a wound-care device in accordance with the present invention; 
         FIG. 5  is a block diagram of one embodiment of a method for using a wound-care device in accordance with the present invention; 
         FIG. 6  is a perspective view of a removable head of the wound-care device of  FIG. 1 ; 
         FIG. 7  is a side cross-sectional view of the removable head of  FIG. 6 ; 
         FIG. 8  is a perspective view of an alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 9  is a side cross-sectional view of the removable head of  FIG. 8 ; 
         FIG. 10  is a perspective view of an alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 11  is another perspective view of the wound-care device of  FIG. 10 ; 
         FIG. 12  is an exploded perspective view of the wound-care device of  FIG. 10 ; 
         FIG. 13  is a side cross-sectional view of the wound-care device of  FIG. 10 ; 
         FIG. 14  is a side cross-sectional view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 15  is a block diagram of an alternative embodiment of a method for using a wound-care device in accordance with the present invention; 
         FIG. 16  is a block diagram of another alternative embodiment of a method for using a wound-care device in accordance with the present invention; 
         FIG. 17  is a perspective view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 18  is a top view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 19  is a bottom view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 20  is a front view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 21  is a rear view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 22  is a first side view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 23  is a second, opposite side view of the main body and head portions of the wound-care device of  FIG. 10 ; 
         FIG. 24  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 25  is a bottom view of the wound-care device of  FIG. 24 ; 
         FIG. 26  is a side view of the wound-care device of  FIG. 24 ; 
         FIG. 27  is a front view of the wound-care device of  FIG. 24 ; 
         FIG. 28  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 29  is a bottom view of the wound-care device of  FIG. 28 ; 
         FIG. 30  is a side view of the wound-care device of  FIG. 28 ; 
         FIG. 31  is a front view of the wound-care device of  FIG. 28 ; 
         FIG. 32  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 33  is a top view of the wound-care device of  FIG. 32 ; 
         FIG. 34  is a bottom view of the wound-care device of  FIG. 32 ; 
         FIG. 35  is a front view of the wound-care device of  FIG. 32 ; 
         FIG. 36  is a rear view of the wound-care device of  FIG. 32 ; 
         FIG. 37  is a first side view of the wound-care device of  FIG. 32 ; 
         FIG. 38  is a second, opposite side view of the wound-care device of  FIG. 32 ; 
         FIG. 39  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 40  is a top view of the wound-care device of  FIG. 39 ; 
         FIG. 41  is a bottom view of the wound-care device of  FIG. 39 ; 
         FIG. 42  is a front view of the wound-care device of  FIG. 39 ; 
         FIG. 43  is a rear view of the wound-care device of  FIG. 39 ; 
         FIG. 44  is a first side view of the wound-care device of  FIG. 39 ; 
         FIG. 45  is a second, opposite side view of the wound-care device of  FIG. 39 ; 
         FIG. 46  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 47  is a top view of the wound-care device of  FIG. 46 ; 
         FIG. 48  is a bottom view of the wound-care device of  FIG. 46 ; 
         FIG. 49  is a front view of the wound-care device of  FIG. 46 ; 
         FIG. 50  is a rear view of the wound-care device of  FIG. 46 ; 
         FIG. 51  is a first side view of the wound-care device of  FIG. 46 ; 
         FIG. 52  is a second, opposite side view of the wound-care device of  FIG. 46 ; 
         FIG. 53  is a perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 54  is another perspective view of the removable head of  FIG. 53 ; 
         FIG. 55  is a top view of the removable head of  FIG. 53 ; 
         FIG. 56  is a bottom view of the removable head of  FIG. 53 ; 
         FIG. 57  is a front view of the removable head of  FIG. 53 ; 
         FIG. 58  is a rear view of the removable head device of  FIG. 53 ; 
         FIG. 59  is a first side view of the removable head device of  FIG. 53 ; 
         FIG. 60  is a second, opposite side view of the removable head of  FIG. 53 ; 
         FIG. 61  is a side cross-sectional view of the removable head of  FIG. 53 ; 
         FIG. 62  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 63  is another perspective view the wound-care device of  FIG. 62 ; 
         FIG. 64  is a perspective view the wound-care device of  FIG. 62  with a tube applied thereto that may extend to a remote fluid reservoir; 
         FIG. 65  is a perspective view the wound-care device of  FIG. 62  with a fluid reservoir applied thereto; 
         FIG. 66  is another perspective view the wound-care device of  FIG. 62  with a fluid reservoir applied thereto; 
         FIG. 67  is a top view of the wound-care device of  FIG. 62 ; 
         FIG. 68  is a bottom view of the wound-care device of  FIG. 62 ; 
         FIG. 69  is a front view of the wound-care device of  FIG. 62 ; 
         FIG. 70  is a rear view of the wound-care device of  FIG. 62 ; 
         FIG. 71  is a first side view of the wound-care device of  FIG. 62 ; 
         FIG. 72  is a second, opposite side view of the wound-care device of  FIG. 62 ; 
         FIG. 73  is a perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 74  is another perspective view of the removable head of  FIG. 73 ; 
         FIG. 75  is a top view of the removable head of  FIG. 73 ; 
         FIG. 76  is a bottom view of the removable head of  FIG. 73 ; 
         FIG. 77  is a front view of the removable head of  FIG. 73 ; 
         FIG. 78  is a rear view of the removable head device of  FIG. 73 ; 
         FIG. 79  is a first side view of the removable head device of  FIG. 73 ; 
         FIG. 80  is a second, opposite side view of the removable head of  FIG. 73 ; 
         FIG. 81  is a perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 82  is another perspective view of the removable head of  FIG. 81 ; 
         FIG. 83  is a top view of the wound-care device of  FIG. 81 ; 
         FIG. 84  is a bottom view of the wound-care device of  FIG. 81 ; 
         FIG. 85  is a front view of the wound-care device of  FIG. 81 ; 
         FIG. 86  is a rear view of the wound-care device of  FIG. 81 ; 
         FIG. 87  is a first side view of the wound-care device of  FIG. 81 ; 
         FIG. 88  is a second, opposite side view of the wound-care device of  FIG. 81 ; 
         FIG. 89  is a block diagram of an alternative embodiment of a method for using a wound-care device in accordance with the present invention; 
         FIG. 90  is a block diagram of another alternative embodiment of a method for using a wound-care device in accordance with the present invention; 
         FIG. 91  is a perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 92  is a perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 93  is an exploded perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 94  is a perspective view of the removable head of  FIG. 93  in an assembled configuration; 
         FIG. 95  is another perspective view of the removable head of  FIG. 93  in an assembled configuration; 
         FIG. 96  is an exploded perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 97  is a perspective view of the removable head of  FIG. 96  in an assembled configuration with the protective cover removed; 
         FIG. 98  is an exploded perspective view of another alternative embodiment of a removable head for a wound-care device in accordance with the present invention; 
         FIG. 99  is a perspective view of the removable head of  FIG. 98  in an assembled configuration; 
         FIG. 100  is an exploded perspective view of another alternative embodiment of a wound-care device in accordance with the present invention; 
         FIG. 101  is a perspective view of the wound-care device of  FIG. 100  in an assembled configuration with the protective cover removed and a fluid reservoir installed; 
         FIG. 102  is a perspective view of the wound-care device of  FIG. 100  in an assembled configuration with a fluid reservoir installed; 
         FIG. 103  is a perspective view of the wound-care device of  FIG. 100  in an assembled configuration with a Luer-type connector installed; and 
         FIG. 104  is an exploded perspective view of the wound-care device of  FIG. 103 . 
     
    
    
     DETAILED DESCRIPTION OF SELECTED EMBODIMENTS 
     It will be readily understood that the components of the present invention, as generally described and illustrated in the drawings herein, could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description of the embodiments of the system and method of the present invention, as represented in the drawings, is not intended to limit the scope of the invention, as claimed, but is merely representative of various embodiments of the invention. The illustrated embodiments of the invention will be best understood by reference to the drawings, wherein like parts are designated by like numerals throughout. 
     Referring to  FIGS. 1-4 , devitalized tissue appearing in a wound bed may include fibroslough (primarily fibrinous tissue), leukoslough (primarily WBC accumulation), necroslough (primarily necrotic tissue), and bioslough (primarily biofilm). Slough may be defined as devitalized tissue comprising primarily fibrin, but it may also include white blood cells, debris, and the like. The presence of slough may interrupt granulation and delay healing. It may also provide a favorable environment in which bacteria may grow and spread. There is also an infection continuum in wounds, proceeding from contaminated wound bed (bacteria on surface of wound but not replicating), colonized (bacteria are living on wound bed and replicating), early biofilm formation, mature biofilm formation, and local to systemic infection with biofilm seeding. Accordingly, to promote healing, a wound-care device  10  in accordance with the present invention may facilitate the removal of devitalized tissue from a wound. This removal may be described as wound cleansing, desloughing, and/or debridement. 
     Depending on various factors, devitalized tissue in a wound bed may have different consistencies. For example, the consistency of devitalized tissue may be described as (1) mucinous (i.e., slimy and soft), (2) gelatinous. (3) stringy and/or clumpy, (4) fibrinous, and/or (5) leathery. Depending on the consistency of the devitalized tissue, different debridement tools and/or methods may be needed. For example, debridement suitable for devitalized tissue that is “leathery” may be too aggressive for devitalized tissue that is “mucinous.” Accordingly, a wound-care device  10  may be adjustable or adaptable to provide proper cleansing and/or debridement across the range of consistency of devitalized tissue. 
     Bacterial biofilms can be found in 60-90% of chronic wounds and in approximately 6% of acute wounds. Biofilms usually contain multiple bacterial species. Biofilms can be found in multiple places, including within a wound bed (i.e., to a depth of about 60-70 microns below the surface of a wound), on a wound surface, in slough, in fluids on and around a wound bed, etc. and can migrate onto the wound dressings as well. Accordingly, a wound-care device  10  may be used to disrupt bacteria growth, prevent the formation of bacterial biofilms, and/or treat bacterial biofilms. 
     Wound care is complicated by the fact that a wide variety of people with a wide variety of medical experience and/or training are tasked with providing such care. For example, at home, patients with little to no medical experience or training are often tasked with providing their own wound care (e.g., tasked with fitting and/or changing their own would dressings). For patients with more serious wounds, wound care may be provided at their respective homes by ancillary healthcare staff having various levels of wound-care training. Some ancillary healthcare staff may have associate nursing degrees. Others have bachelor degrees in nursing. Still others may be specialized wound, ostomy, and continence nurses (WOCN). However, regardless of such educational background, ancillary healthcare staff will have different comfort levels and skill sets with respect to cleansing wounds and conducting even basic wound cleansing and/or debridement. 
     In institutional, long-term care settings such as nursing homes and long-term acute care (LTAC) hospitals, there may be wound-care teams with more advanced training and an enhanced skill set due to their repeated and regular treating of complicated wounds. In the offices of physicians and surgeons, wounds often need cleansing or mild surgical debridement. Such treatment is often performed in an operating room. However, such use of an operating room is often unnecessary and increases the cost of treatment and may increase morbidity depending on choice of anesthesia. 
     Accordingly, to address the wide variety of people tasked with providing wound care, a wound-care device  10  in accordance with the present invention may be easy to use. Moreover, it may be configured so as to limit the potential for misuse or harmful use. Accordingly, both an inexperienced patient and a highly trained medical professional may both use a wound-care device  10  to beneficial effect. 
     In selected embodiments, a wound-care device  10  may comprise a main body  12  or handle portion  12  and a head  14 . In other embodiments, a wound-care device  10  may comprise a main body  12 , a head  14 , and a fluid system  16 . A head  14  may removably connect to a main body  12 . In operation, a head  14  may apply motion (e.g., vibration, oscillation, reciprocation, or the like) generated by a main body  12  to a wound surface. Accordingly, a main body  12  may be responsible for generating a desired motion and a head  14  may be responsible to conduct that motion from the main body  12  to a wound surface. 
     In certain embodiments, a main body  12  may include a motion generator  18 , one or more batteries  20 , a controller  22 , a housing  24 , one or more other components  26  or structures  26 , or the like or a combination or sub-combination thereof. A motion generator  18  may generate vibration, oscillation, reciprocation, or the like at a desired frequency. One or more other structures  26  (e.g., a physical linkage, shaft, or the like), a housing  24 , or the like may conduct the vibration, oscillation, or reciprocation to a head  14 . 
     In selected embodiments, a motion generator  18  may vibrate, oscillate, reciprocate, or the like at a relatively low sonic frequency in a range from about 100 Hz to about 1000 Hz. Alternatively, or in addition thereto, a motion generator  18  may vibrate, oscillate, reciprocate, or the like at a relatively high amplitude (e.g., an amplitude in the range from about 1 mm to about 10 mm and, more preferably, about 3 mm to about 8 mm). That is, once a head  14  is applied to a main body  12 , the vibration, oscillation, reciprocation, or the like of a motion generator  18  may produce a side-to-side sweeping motion at a distal end of the head  14  that is about 1 mm to about 10 mm (and, more preferably, about 3 mm to about 8 mm) from one extreme to the other. In other embodiments, the amplitude and/or motion may be different, but may still be in a relatively low sonic frequency range. Thus, a device  10  in accordance with the present invention operate at a frequency that is much lower than any ultrasonic debridement device and benefit from the higher amplitude that may be obtained at that lower frequency. 
     In selected embodiments, a motion generator  18  may comprise an electromagnet with a polarity that is alternated at a desired frequency in order to create a desired vibration, oscillation, or reciprocation (e.g., a desired vibration, oscillation, or reciprocation in a linkage that extends to engage a head  14 ). In other embodiments, a motion generator  18  may comprise an electric motor turning a shaft having an eccentric weight secured thereto to generate a vibration, oscillation, or reciprocation effect. 
     For example, a motion generator  18  may comprise an electric motor having a rated speed of about 9,000 to about 36,000 revolutions per minute (and preferably about 18,000 to about 22,000 revolutions per minute) when a rated load (e.g., an eccentric mass of about 0.5 to about 1.0 grams and preferably about 0.75 grams) is applied to the shaft thereof. That speed may translate to a vibration, oscillation, reciprocation, or the like in the sonic range of about 150 Hz to about 600 Hz, where each cycle may comprise two strokes (e.g., one stroke or deflection to the left and a return stroke or deflection to the right) across a wound bed. Thus, a motion generator  18  operating at about 150 Hz may produce about 300 vibration strokes per second, while a motion generator  18  operating at about 600 Hz may produce about 1,200 vibration strokes per second. 
     A motion generator  18  may generate vibration, oscillation, and/or reciprocation in a linkage  28  or other structure  28  that extends to engage a head  14 . For example, in selected embodiments, one end of a main portion  12  may comprise or form a horn  28  within which a motion generator  18  may be positioned. When turned “on,” a motion generator  18  may cause a horn  28  to vibrate, oscillate, and/or reciprocate at a desired frequency. Accordingly, when a horn is inserted within or otherwise connected to a correspondingly shaped head  14 , the horn  28  may communicate that vibration, oscillation, and/or reciprocation to the head  14 . 
     In selected embodiments, the structure configuration of a horn  28 , a head  14 , or a horn  28  and head  14  combination may define the type or shape of motion generated by a motion generator  18 . For example, by selecting where the greatest mass is located, which axis of bending or deflection is preferred (i.e., is less resistant to bending or deflection), or the like or a combination thereof, the motion of a head  14  may be defined as being more circular, rocking back and forth, translating side to side, or the like in order to provide a desired effect, action, or operation on a wound bed. 
     A battery  20  may provide the electrical power required by a motion generator  18 . In selected embodiments, a battery  20  may be rechargeable. For example, a battery  20  (e.g., a lithium ion battery) may include or be connected to a receiving or secondary coil to enable or support wireless charging when a corresponding device  10  is placed on or in a charging station. Alternatively, or in addition thereto, a device may be at least partially powered and/or charged by one or more supercapacitors. 
     A controller  22  may control operation of a main body  10 . In selected embodiments, a controller  22  may comprise a switch  30  for turning a motion generator  18  on and off. Alternatively, or in addition thereto, a controller  22  may comprise a printed circuit board (PCB)  32 , one or more integrated circuits, one or more processors (e.g., an application-specific integrated circuit (ASIC), a programmable logic controller (PLC), or the like), memory, or the like or a combination or sub-combination thereof in order to control a motion generator  18 . Accordingly, a controller  22  may automatically control certain functions of a wound-care device  10 . 
     For example, a controller  22  may turn off a motion generator  18  if a battery is low on charge, if a particular time interval (e.g., 2 to 3 minutes) has passed since the device  10  was turned on, or the like. A controller  22  may control the speed and/or power of a device  10  through one or more switches  30 , buttons  30 , or the like that may be operated by a user. In selected embodiments, a controller  22  may regulate or condition a voltage (e.g. increase a voltage from 3.0 V to 3.7 V or some other desired voltage) of electrical current passing from a battery  20  or other power source to a motion generator  18  as desired or necessary. 
     In selected embodiments, a controller  22 , may pulse, momentarily pause vibration, beep, flash a light, or the like at predetermined, regular intervals (e.g., every 30 seconds) so that the user may more easily monitor and control the time spent cleansing or debriding a wound. Accordingly, a physician may instruct a patient or home-healthcare nurse to use a device  10  for 30 seconds to cleanse a small wound, 90 seconds for a large wound, or the like. The patient or nurse may then watch for the appropriate number of pulses or beeps in order to meet the prescribed treatment time. 
     A housing  24  may contain various other components of a main body  12 . For example, a housing  24  may contain and provide structure for mounting or anchoring a motion generator  18 , battery  20 , controller  22 , and the like. In selected embodiments, a housing  24  may form a handle. Accordingly, when a user uses a wound-care device  10 , the user may grasp and hold the housing  24 . 
     In certain embodiments, a head  14  may include a frame  34 , a contact surface  36 , one or more other components  38  or structures  38 , or the like or a combination or sub-combination thereof. A frame  34  may extend from a main body  12  to support a contact surface  36 . For example, a frame  34  may engage a physical linkage  28 , horn  28 , or the like that is selectively vibrated, oscillated, and/or reciprocated by a motion generator  18 . Accordingly, a frame  34  may conduct vibrations, oscillations, and/or reciprocations that originate with a motion generator  18  to a contact surface  36 . 
     A contact surface  36  may be configured to contact a wound surface. In selected embodiments, a head  14  may be considered as having a front side  40  and a back side  42 . In such embodiments, a contact surface  36  may be or correspond to a front side  40  of a head  14 . Accordingly, a contact surface  36  may be configured to provide a desired cleansing, desloughing, debridement, or the like. 
     In certain embodiments, a contact surface  36  may be selectively separable from a corresponding frame  34 . Accordingly, a user may obtain or control a cleansing, desloughing, or debriding effect by selecting and installing a contact surface  36  designed to provide the cleansing, desloughing, or debriding effect. Alternatively, a contact surface  36  may be integrally or substantially permanently connected to a frame  34 . Accordingly, in certain embodiments, a user may obtain or control a cleansing, desloughing, or debriding effect by selecting and installing a head  14  having a contact surface  36  designed to provide the cleansing, desloughing, or debriding effect. 
     In selected embodiments, a contact surface  36  may be configured for single use. For example, a contact surface  36  (or a head  14  comprising a frame  34  and a contact surface  36 ) may be provided to a user in a sterile condition and within sterile packaging. After being used on a wound, a contact surface  36  will no longer be sterile and may have significant bacterial contamination. Accordingly, the contact surface  36  (or the head  14  comprising the frame  34  and the contact surface  36 ) may be discarded and a new contact surface  36  (or a new head  14 ) may be used for the next cleansing, desloughing, or debridement. 
     A fluid system  16  may facilitate wound cleansing, desloughing, and/or debridement. Fluid provided or delivered by a fluid system  16  may tend to flush loose material and particles out of a wound bed. For example, fluid delivered to a central location on a contact surface  36  may irrigate outward (e.g., radially outward) and across the contact surface  36  (e.g., within various channels formed in the contact surface  36 ) to aid in removing, dislodging, and flushing bacteria, toxins, and cellular debris and preventing clogging of the contact surface  36 . Alternatively, or in addition thereto, fluid may tend to soften materials that are being removed so as to aid in (e.g., speed) their removal. 
     In selected embodiments, a fluid system  16  may include a fluid reservoir  44 , a compression element  46 , one or more other components  48  or structures  48 , or the like or a combination or sub-combination thereof. A fluid reservoir  44  may contain a fluid (e.g., saline, an antibiotic or antiseptic in liquid form, a gel, a paste, or the like). A fluid reservoir  44  may be deformable. Deformation of a fluid reservoir  44  may tend to expel fluid therefrom. Accordingly, manual deformation (e.g., squeezing, flattening, etc.) of a fluid reservoir  44  may provide the motive force for and/or control a rate of expelling fluid from a fluid reservoir  44 . 
     In certain embodiments, a fluid reservoir  44  may be directly manually compressed by the hand or fingers of a user. In other embodiments, a compression element  46  may be included to assist in compressing a fluid reservoir  44 . A compression element  46  may be a structure or combination of structures that facilitates deformation (e.g., compression) of a fluid reservoir  44 . For example, a compression element  46  may be a structure that holds a fluid reservoir  44  in place along a housing  24  (e.g., along an underside of a housing  24 ) so that a user can hold the device  10  and squeeze the fluid reservoir  44  at the same time (e.g., with the same hand). Alternatively, or in addition thereto, a compression element  46  may comprise a lever that operates in conjunction with a housing  24  so that a fluid reservoir  44  may be squeezed therebetween. Accordingly, by pulling the lever, the same hand with which a user holds a main body  12  may be used to expel fluid from the fluid reservoir  44 . 
     In selected embodiments, a wound-care device  10  may include a conduit  50 . A conduit  50  may extend to place a fluid reservoir  44  in fluid communication with a head  14 . Accordingly, manual deformation of a fluid reservoir  44  may urge fluid out of the fluid reservoir  44  and into a conduit  50 . The fluid may then travel through the conduit  50  until it reaches the head  14  where it may be expelled proximate a contact surface  36 . In other embodiments, a fluid conduit  50  (or selected portions of a fluid conduit  50 ) may be integral to a head  14 . 
     A conduit  50  may include a check valve  52 , a disconnect  54 , one or more other components  56  or structures  56 , or the like or a combination or sub-combination thereof. A check valve  52  may permit fluid to move from a fluid reservoir  44  toward a head  14  and prevent fluid from moving from the head  14  back toward a fluid reservoir  44 . This may prevent contaminated fluid from being sucked into a wound-care device  10 . In certain embodiments, a check valve  52  may be part of a fluid reservoir  44  rather than part of a conduit  50 . In other embodiments, a check valve  52  may be part of a head  14  rather than part of a conduit  50 . However, wherever a check valve  52  may be located, it may enforce the same one way flow of fluid. 
     One or more disconnects  54  may enable a conduit  50  to be selectively connected and/or disconnected to a fluid reservoir  44 , a head  14 , or the like. Alternatively, a conduit  50  may simply have one or more ends that may be inserted within or over a properly sized aperture or port of a head  14  or fluid reservoir  44  in order to enable fluid to flow across the resulting interface. In either case, a conduit  50  may selectively connect to and disconnect from a head  14 , a fluid reservoir  44 , or both a head  14  and fluid reservoir  44 . Accordingly, heads  14 , fluid reservoirs  44 , and conduits  50  may be installed, removed, and/or discarded as needed. 
     In selected embodiments, a fluid system  16  and conduit  50  may be omitted from a wound-care device  10 . In such embodiments, cleansing, desloughing, and/or debridement of a wound bed may be conducted in a “dry” manner without the addition of any fluid. Alternatively, fluid may be applied in a separate process. For example, a liquid, gel, paste, or the like may be applied to a wound bed in a first process that precedes and is separate from using a wound-care device  10  in accordance with the present invention to clean, deslough, or debride the wound bed. 
     In selected embodiments, a device  10  may be provided or used in combination with one or more disposable (e.g., single use) sleeves so that the device  10  or portions of the device  10  (e.g., a main body  12  or handle portion  12 ) may be reusable between patients safely without contamination of the device  10 . In such embodiments, to configure a device  10  for use, a new and/or clean (e.g., sterile) head  14  and sleeve may be applied to a main body  12  so that all surfaces coming in contact with a patient and a care-giver are clean. In certain embodiments, a sleeve may cover a horn  28  and a housing  24  and a head  14  may slide over the sleeve when it is installed on the horn  28 . 
     Referring to  FIG. 5 , in selected embodiments, a method  58  for cleansing, desloughing, and/or debriding a wound bed may begin when a device  10  is configured  60  for use. Configuring  60  a device  10  for use may include selecting and installing an appropriate contact surface  36  or head  14 , selecting and installing a fluid reservoir  44  and/or conduit  50 , or the like or a combination thereof. Thereafter, a device  10  may be turned  62  “on” (e.g., to start oscillation or other motion of a head  14 ) and then a contact surface  36  may be positioned  64  proximate a wound bed. 
     To initiate cleansing, desloughing, and/or debriding, a user may manually squeeze  66  a fluid reservoir  44  to create a flow of fluid to the contact surface  36  and/or place  68  a contact surface  36  in contact with the wound bed. Thereafter, the user may move  70  the contact surface  36  over the wound bed. Oscillation or other motion of the contact surface  36  alone or in combination with a rinsing effect produced by the fluid may tend to clean, deslough, and/or debride the wound bed. Accordingly, a user may continued to dispense  66  fluid, apply  68  the contact surface  36  to the wound bed, and move  70  the contact surface  36  over the wound bed until it is determined  72  that the cleansing, desloughing, and/or debriding is complete. Once it is complete, the device  10  may be turned  74  “off.” 
     Referring to  FIGS. 6 and 7 , in selected embodiments, a frame  34  of a head  14  may have an aperture  76  to support securement to a main body  12 . In certain embodiments, such an aperture  76  may be shaped and sized to selectively receive (e.g., frictionally engage via mating tapers) a physical linkage  28 , horn  28 , or the like that conducts vibration, oscillation, and/or reciprocation from a main body  12  to a head  14 . 
     In certain embodiments, an aperture  78  may be formed in a head  14  to enable fluid to pass therethrough. For example, a head  14  may include an aperture  78  extending from a back side  42  to a front side  40  of the head  14 . A front portion  78   a  of an aperture  78  may be positioned centrally with respect to a contact surface  36 . Accordingly, when fluid is expelled through that front portion  78   a  of the aperture  78 , the fluid may flow, migrate, or otherwise move radially outward with respect to the contact surface  36 . This radial flow or movement may tend to clean or flush the contact surface  36 . A back portion  78   b  of an aperture  78  may be sized and shaped to receive and secure (e.g., frictionally secure) one end of a conduit  50  therewithin, thereby placing the aperture  78  in fluid communication with a fluid reservoir  44 . In embodiments where a device  10  does not include a fluid system  16  and conduit  50 , an aperture  78  in a head  14  may be omitted. 
     Contact surfaces  36  in accordance with the present invention may have any suitable configuration. Suitable configurations may vary in shape (e.g., rectangular, circular, diamond, oval, or the like), size (e.g., have a length and width in a range from about 5 mm to about 30 mm and preferably a length of about 28 mm and a width of about 14 mm), surface area (e.g., have a footprint of about 200 square millimeters to about 400 square millimeters and preferably a footprint of about 300 square millimeters), surface contour (e.g., flat, convex, or the like), surface texture or profile (e.g., sharp, rounded, course, fine, or the like), channeling (e.g., no channels, radial channels, orthogonally intersecting channels, circumferential channels, or the like or combinations or sub-combinations thereof, composition (e.g., solid polymer, solid elastic polymer, silicone, open cell foam, closed cell foam, or the like), hardness, or the like or in various combinations or sub-combinations thereof. Accordingly, the configuration may be selected to provide a desired performance. 
     In selected embodiments, contact surfaces  36  may be formed of silicone elastomer or some other polymer in various hardnesses (e.g., having a Shore A hardness in the range from about 15 to about 100, Shore D hardness in the range from about 40 to about 90, or Rockwell R hardness in the range from about 50 to about 100). In certain embodiments, a contact surface  36  may comprise a base  80  and one or more extensions  82  extending from the base  80 . The base  80  and the one or more extensions  82  may be formed of different materials to support different functions. For example, a base  80  may be formed of a material that is easily formable and relatively rigid (e.g., polymer), while one or more extensions  82  may be formed of a material that is compatible with the function of cleansing, desloughing, and/or debriding a wound (e.g., an elastomer having a desired Shore A hardness). In selected embodiments, one or more extensions  82  may be insert molded or otherwise embedded within a base  80  to enable the extensions  82  to securely extend away from the base  80  and define a texture or profile for the contact surface  36 . 
     In selected embodiments, varying the number and sharpness of the edges of one or more extensions  82 , the pointedness of one or more extensions  82 , the height of one or more extensions  82 , the lateral offset of one extension  82  with respect to one or more adjacent extensions  82 , the hardness of the material (e.g., polymer, elastomer, or the like) forming the one or more extensions  82 , and/or the pressure applied by the user (e.g., the force with which the user urges the contact surface  36  against a wound bed) may be used to control the aggressiveness of the cleansing, desloughing, and/or debrided. Accordingly, extensions  82  providing a high concentration of sharp edges formed of a relatively hard material may produce a very aggressive contact surface  36 , while extensions  82  having an absence (or lesser quantity) of sharp edges (e.g., rounded edges) and/or being formed of a relatively soft material may provide a very gentle contact surface  36 . Fluid dispensed from the one or more openings  78   a  may flow over and in between extensions  82  and flush the contact surface  36  of debris during use of a device  10 . This flushing action may better cleanse a wound bed and facilitate dislodgement and removal of bacteria, biofilm, and devitalized tissues during cleansing, desloughing, and/or debridement. 
     In certain embodiments, different extensions  82  of a particular contact surface  36  may have different edges and/or hardnesses associated therewith. For example, the extensions  82  associated with the ends (e.g., distal and proximal ends) of a contact surface  36  may be formed of a harder material than the more centrally located extensions  82 . Alternatively, or in addition thereto, the extensions  82  associated with the ends (e.g., distal and proximal ends) of the contact surface  36  may have sharper edges than the more centrally located extensions  82 . Accordingly, a user may apply different portions of a contact surface  36  to a wound bed to provide a different effect. 
     Referring to  FIGS. 8 and 9 , in selected embodiments, a contact surface  36  may be formed as a boot  84  (e.g., a boot formed of an elastomer) that slips over a supporting structure  86  formed as part of a frame  34 . In such embodiments, a boot  84  may form (e.g., monolithically form) both one or more extensions  82  and a base  80  from which the one or more extension  82  project. Such an embodiment may allows selected portions of a head  14  to be reusable, and the boot  84  to include the contact surface  36  and be a single use item formed of a very inexpensive elastomeric material, to reduce cost of use of the device. This may also simplify manufacturing, facilitate interchangeability, or the like. Alternatively, a boot  84  may be applied to a frame  34  in a two-step, over-molding process. In such embodiments, the resulting head  14  may be a single use item in its entirety. 
     In certain embodiments, a removable contact surface  36  (e.g., a base  80  portion of a contact surface  36 ) may include a length of tubing  87  extending away from a back thereof. A conduit  50  of a fluid system  16  may connect to such tubing to deliver fluid to the contact surface  36 . Accordingly, in such embodiments, fluid may never contact a frame  34 . The length of the tubing  87  may be selected to reduce the likelihood of biological contamination of the conduit  50 . In selected embodiments, the length of the tubing  87  may be about 1 cm to about 13 cm. As a result, a contact surface  36  and associated tubing  87  may be discarded after use, while a conduit  50  may be used multiple times. 
     Referring to  FIGS. 10-13 , in selected embodiments, a wound-care device  10  may be configured for maximum utility and minimum cost. Accordingly, in certain embodiments, a wound-care device  10  in accordance with the present invention may be non-electric (e.g., a motion generator and  18  and corresponding or related structures  20 ,  22 ,  24 ,  28  may be omitted from a device  10 ). Alternatively, or in addition thereto, a wound-care device  10  may be single use. For example, in selected embodiments, a wound-care device  10  may comprise a main body  12  or handle portion  12  that is monolithically formed together with a head  14  (e.g., the main body  12  and head  14  may be injection molded as a single unit). The material forming the main body  12  and head  14 , including the contact surface  36  of the head  14 , may be homogeneous throughout. This may reduce the cost of manufacturing a device  10  in accordance with the present invention, make a device  10  viable as a single use device  10 , and avoid all sanitation and sterilization issues associated with reuse of any part of a device  10 . 
     In certain embodiments, the material used to form the main body  12  and head  14  of a device  10  may be or reflect a compromise between the structural requirements for the main body  12  and head  14  and the structural requirements for a contact surface  36  of the head  14 . In selected embodiments, the material may be or comprise a polymer having a Rockwell R hardness of about 100 or lower. For example, the material may be or comprise polypropylene (e.g., polypropylene random copolymer with a Rockwell R hardness of about 90 and a flexural modulus of about 966 MPa). Accordingly, in certain embodiments, a wound-care device  10  may comprise a main body  12 , head  14 , and contact surface  36  that are monolithically formed (e.g., injection molded as a single unit) in a polymeric material such as polypropylene. 
     A fluid system  16  paired with a simplified main body  12  and head  14  combination may be similarly simplified. For example, a conduit  50  may be omitted and a fluid system  16  may comprise a fluid reservoir  44  (e.g., a fluid reservoir  44  in the form of a squeeze bottle, single use container, saline bullet, or the like) having an outlet  88  that directly engages (e.g., is inserted into a mating back portion  78   b  of) an aperture  78  of a head  14 . In certain embodiments, a fluid reservoir  44  may be a sterile, single-use, 15 ml saline bullet. 
     In selected embodiments, a main body  12  or handle portion  12  of a device  10  may have a concavity  90  formed therein. A concavity  90  may be sized and shaped to support a fluid reservoir  44  at least partially therewithin. For example, a fluid reservoir  44  (e.g., a squeeze bottle, saline bullet, or the like) may have a cylindrical side wall. Accordingly, a concavity  90  of a main body  12  may have an interior surface  92  that follows, tracks, or otherwise cradles at least a portion of a cylindrical side wall of a fluid reservoir  44 . Such cradling, alone or in combination with insertion of an outlet  88  of a fluid reservoir  44  into an aperture  78  of a head  14 , may secure a fluid reservoir  44  in place or make it easier for a user to hold a fluid reservoir  44  in place during use (e.g., during movement of a device  10  with respect to a wound bed and/or squeezing of a fluid reservoir  44  to expel fluid). 
     In certain embodiments, an exterior surface  94  of a main body  12  may track or follow an interior surface  92 . Alternatively, or in addition thereto, the spacing between the interior and exterior surface  92 ,  94  may be relatively small. Accordingly, a thickness of a material forming a main body  12  (e.g., a thickness of a material located between the interior and exterior surfaces  92 ,  94 ) may be relatively thin and/or substantially uniform. This may reduce the amount of material needed to produce of device  10 . Additionally, in selected embodiments, a curvature of a main body  12  that produces a concavity  90  may effectively define or form at least one corrugation running lengthwise from one end of a main body  12  to the other. Such a corrugation may stiffen a main body  12  against bending without requiring large or larger amounts of material. 
     In selected embodiments, a main body  12  may extend in a first direction  96  (e.g., may have a line or axis of symmetry that extends in a first direction  96 ). A head  14  may extend away from a main body  12  in a second direction  98  that is different from the first direction  96  (e.g., may have a line or axis of symmetry that extends in a second direction  98  that is different from the first direction  96 ). For example, in certain embodiments, a head  14  may extend away from a main body  12  in a second direction  98  that departs from the first direction  96  at an angle  100  in a range from about 25 to about 55 degrees and preferably at an angle  100  in a range from about 40 to about 50 degrees. In selected embodiments, a head  14  may extend away from a main body  12  in a second direction  98  that departs from the first direction  96  at an angle  100  of about 45 degrees. 
     In selected embodiments and/or uses, a fluid reservoir  44  may be omitted from a device  10  comprising a simplified main body  12  and head  14  combination. In such embodiments, cleansing, desloughing, and/or debridement of a wound bed may be conducted in a “dry” manner without the addition of any fluid. Alternatively, fluid may be applied in a separate process. For example, a liquid, gel, paste, or the like may be applied to a wound bed in a first process that precedes and is separate from using a wound-care device  10  in accordance with the present invention to clean, deslough, or debride the wound bed. 
     When a fluid reservoir  44  is omitted, a concavity  90  formed in a main body  12  may provide a location for a finger (e.g., an index finger) of a user to extend and rest during use of the corresponding device  10 . That is, rather than cradling a fluid reservoir  44  (e.g., a saline bullet  44  having a diameter that is about equal to or slightly larger than a typical finger diameter), a concavity  90  may cradle a finger (e.g., an index finger) of a user. When using a device  10  in such a manner, a user may place the tip of whichever finger is cradled within a concavity  90  against a proximal end  102  of a structure  104  or conduit  104  forming a back portion  78   b  of an aperture  78  extending through the head  14 . This engagement or abutment with the tip of the finger may enable a user to apply a desired or sufficient amount of pressure to a head  14  as it contacts a wound bed and/or better sense or control how much pressure is applied through a head  14  to a wound bed. 
     In certain embodiments, a finger positioned within a device  10  may enable a user to selectively apply specific regions of a head  14  or contact surface  36  (e.g., a distal end of a head  14 , either side of a head  14 , a proximal end of a head  14 ) to a wound bed with greater user control of the force applied and the angle of the contact surface  36  relative to a wound bed. This may give a user superior control over a pressure and location of engagement between a head  14  and a wound bed and better results or performance for the medical procedure. 
     In selected embodiments, a simplified main body  12  and head  14  combination may be distributed in an individually wrapped, sterile condition. In certain embodiments, multiple individually wrapped devices  10  may be combined into packs of a selected quantity (e.g., a pack of about five or some other quantity corresponding to about a two week supply). Accordingly, when tending to a patient, a medical professional may select a pack of devices  10 , open and use one device  10  to clean, deslough, or debride a wound bed of a patient and/or teach the patient how to do it, and then send the remaining unopened devices  10  in the pack home with the patient for the patient use in the interim before the next visit with a medical professional. In certain embodiments, such a pack may include or be provided to a patient with a selected number of fluid reservoirs  44  containing fluid (e.g., a selected number of saline bullets of a size that fits the simplified main body  12  and head  14  combination). 
     Referring to  FIG. 14 , in selected embodiments, a proximal end  102  of a structure  104  or conduit  104  forming a back portion  78   b  of an aperture  78  extending through the head  14  may be shaped so as to comfortably engage a finger tip of a user. For example, a proximal end  102  may have a curvature  106  formed therein that follows or replicates a portion of the curvature of a finger tip. Accordingly, a structure  104  or conduit  104  may be configured to alternatively and with equal effectiveness engage an outlet  88  of a fluid reservoir  44  and a tip of a finger of a user. 
     In certain embodiments, a structure  104  or conduit  104  may be sized and shaped to engage a conduit  50  with a Luer-taper type connection. For example, an interior surface of an aperture  78  may be sized and shaped to receive and frictionally engage a Luer-type, male, slip-fit connector. Alternatively, or in addition thereto, an exterior surface of a structure  104  or conduit  104  may be sized and shaped to receive and frictionally engage a Luer-type, female, slip-fit connector. Such an arrangement may enable standard conduits  50  (e.g., standard or commonly available intravenous tubing, intravenous connectors, saline bags, or the like) to be used as part of a fluid system  16  in accordance with the present invention. 
     Referring to  FIG. 15 , in selected embodiments, an alternative method  108  for cleansing, desloughing, and/or debriding a wound bed may begin when a device  10  is configured  60  for use. Configuring  60  a device  10  for use may include selecting a device  10  with an appropriate contact surface  36 , opening packaging containing the device  10 , and installing a fluid reservoir  44  (e.g., selecting a saline bullet, removing a cap of the saline bullet, inserting an outlet  88  of the saline bullet into a back portion  78   b  of an aperture  78  of a head  14 ). Thereafter, a device  10  may be moved to position  64  a contact surface  36  proximate a wound bed. 
     To initiate cleansing, desloughing, and/or debriding, a user may manually squeeze  66  a fluid reservoir  44  to create a flow of fluid to the contact surface  36  and/or place  68  a contact surface  36  in contact with the wound bed. Thereafter, the user may move  70  the contact surface  36  over the wound bed. Moving  70  the contact surface  36  with respect to the wound bed in combination with a rinsing effect produced by the fluid may tend to clean, deslough, and/or debride the wound bed. The moving  70  of the contact surface may be side to side, front to back, at some angle, in small circles, or the like or a combination or sub-combination thereof. Accordingly, a user may continue to dispense  66  fluid, apply  68  the contact surface  36  to the wound bed, and move  70  the contact surface  36  over the wound bed until it is determined  72  that the cleansing, desloughing, and/or debriding is complete. Once it is complete, the device  10  may be discarded  110 . 
     Referring to  FIG. 16 , in selected embodiments, another alternative method  112  for cleansing, desloughing, and/or debriding a wound bed may begin when a device  10  is configured  60  for use. Configuring  60  a device  10  for use may include removing the device from sterile packaging. To initiate cleansing, desloughing, and/or debriding, a user may manually place  68  a contact surface  36  in contact with the wound bed. Thereafter, the user may move  70  the contact surface  36  over the wound bed. Moving  70  the contact surface  36  with respect to the wound bed may tend to clean, deslough, and/or debride the wound bed. If using a finger (e.g., an index finger) to guide a device  10  or a head  14  of a device  10 , a user may selectively change a pressure and/or orientation of a head  14  with respect to a wound bed to more precisely control an outcome of the procedure. Accordingly, a user may continue to apply  68  the contact surface  36  to the wound bed and move  70  the contact surface  36  over the wound bed until it is determined  72  that the cleansing, desloughing, and/or debriding is complete. Once it is complete, the device  10  may be discarded  110 . 
     In certain embodiments, a method  112  may be preceded by the application of a fluid or the like to a wound bed. Accordingly, a method  112  may benefit from the fluid without the fluid being applied while a contact surface  36  is in contact  68  with a wound bed or as a contact surface  36  is moved  70  over a wound bed. 
     In other embodiments, a wound may be treated in one session using a combination of two methods  108 ,  112 . For example, for a first period of time, a user may employ various steps  64 ,  66 ,  68 ,  70  corresponding to a “wet” method  108 , then remove a fluid reservoir  44  (e.g., remove a saline bullet positioned within a concavity  90 ) and transition to employing various steps  68 ,  70  corresponding to a “dry” method  112  wherein a finger placed within a concavity  90  to provide greater control over the force, orientation, etc. of a device  10 . Such a hybrid method may end by using fluid remaining in the fluid reservoir  44  to flush or rinse of the wound bed. 
     Referring to  FIGS. 17-31 , different wounds may fall on different locations within a wound infection continuum. Accordingly, the treatment needed for different wounds may also vary. For example, in certain situations, a wound infection continuum may be divided into multiple zones (e.g., three zones). A first zone may correspond to a lower level of infection, while one or more other zones may correspond to one or more higher levels of infection. Accordingly, one or more methods  58 ,  108 ,  112  in accordance with the present invention may enable wounds corresponding to the first zone to be treated differently from wounds corresponding to one or more other zones. 
     For example, if an examination of a wound bed reveals that a wound corresponds to the second zone or other higher zone of a wound infection continuum, a user (e.g., a medical professional) may select, install, and/or use a contact surface  36  that is relatively aggressive. Conversely, if an examination of a wound bed reveals that a wound corresponds to the first zone of a wound infection continuum, a user may select, install, and/or use a contact surface  36  that is less aggressive. 
     Alternatively, in one or more methods  58 ,  108 ,  112  in accordance with the present invention, a wound may be evaluated based on the presence and/or nature of devitalized tissue. For example, in certain situations, a wound may be classified into one of three situations. A first situation may correspond to devitalized tissue that is firmly adherent. A second situation may correspond to devitalized tissue that is loosely adherent. A third situation may correspond to a wound that could simply benefit from cleansing. Accordingly, one or more methods  58 ,  108 ,  112  in accordance with the present invention may enable wounds corresponding to the first, second, and third situations to be treated differently. 
     For example, if an examination of a wound bed reveals that a wound corresponds to devitalized tissue that is firmly adherent, a user may select, install, and/or use a contact surface  36  that is relatively aggressive. Such as a contact surface  36  may be referred to as a debridement surface  36   a . If an examination of a wound bed reveals that a wound corresponds to devitalized tissue that is loosely adherent, a user may select, install, and/or use a contact surface  36  that is intermediately aggressive. Such a contact surface  36  may be referred to as a desloughing surface  36   b . If an examination of a wound bed reveals that a wound could simply benefit from cleansing, a user may select, install, and/or use a contact surface  36  that is not aggressive. Such a contact surface  36  may be referred to as a cleansing surface  36   c.    
     A contact surface  36  in accordance with the present invention may have any suitable configuration. In general, increasing the sharpness and/or number of the edges of the various extensions  82  of a contact surface  36  may result in a more aggressive effect when applied to a wound bed. Accordingly, a cleaning surface  36   c  may have few if any sharp edges, a desloughing surface  36   b  may have an intermediate number of edges and/or edges of intermediate sharpness, and a debridement surface  36   a  may have a significant number of edges and/or edges of increased sharpness. 
       FIGS. 17-23  show one embodiment of a simplified main body  12  and head  14  combination where the head  14  includes (e.g., is monolithically formed or molded to have) a cleansing surface  36   c.    
       FIGS. 24-27  show one embodiment of a simplified main body  12  and head  14  combination where the head  14  includes (e.g., is monolithically formed or molded to have) a desloughing surface  36   b.    
       FIGS. 28-31  show one embodiment of a simplified main body  12  and head  14  combination where the head  14  includes (e.g., is monolithically formed or molded to have) a debridement surface  36   a . In selected embodiments, the extensions  82  of a contact surface  36  (e.g., a debridement surface  36   a ) may alternate in height or be laterally offset side to side. For example, as shown in  FIG. 28 , the two distal most and two proximal most extensions  82  may be oriented so that the highest portion thereof is positioned to the outside for better cutting at the apices of the head  14 , but the extensions  82  may otherwise alternate to make a broader cutting path. 
     Referring to  FIGS. 32-38 , in selected embodiments, a simplified main body  12  and head  14  combination may be formed without an aperture  78  for fluid to pass through the head  14 . Rather, the combination may include one or more ribs  114  that extend to connect and/or reinforce a base  80  of a head  14  with respect to a main body  12  or handle portion  12 . In certain embodiments, such ribs  114  may include proximal ends  102  having a curvature  106  formed therein that follows or replicates a portion of the curvature of a finger tip. Accordingly, one or more ribs  114  may be configured to engage a tip of a finger of a user. 
     In selected embodiments, a head  14  may include a base  80  without any extensions  82  projecting therefrom. For example, as shown in  FIG. 32-38 , a front side  40  of a base  80  may be substantially flat. Such a flat surface may provide a location for adhering a contact surface  36  comprising a scrubbing pad (e.g., open cell foam, closed cell foam, soft silicone, or other semi-abrasive surface). Alternatively, a base  80  may provide a location or structure to which an appropriate contact surface  36  may be fastened, snapped, slid over both ends of the base  80 , or otherwise secured to a head  14 . A main body  12  may, therefore, be provided in a non-sterile condition and still be safely used when a sterile contact surface  36  is secured in place. Accordingly, in such embodiments, a contact surface  36  may comprise or be formed by a scrubbing pad or the like of a material that is dissimilar to a material forming a head  14  or a head  14  and main body  12 . 
     Referring to  FIGS. 39-45 , in selected embodiments, a simplified main body  12  and head  14  combination may be formed with a base  80  that includes a wedge  116 , ramp  116 , crescent  116 , or the like that provides an abutment for a finger tip of a user. Accordingly, there are various ways in which a base  80  may be configured to engage a tip of a finger of a user. 
     Referring to  FIGS. 46-52 , an alternative embodiment of a simplified main body  12  and head  14  combination is illustrated. As shown, a head  14  may include (e.g., may be monolithically formed or molded to have) a debridement surface  36   a . In selected embodiments, the extensions  82  of a contact surface  36  (e.g., a debridement surface  36   a ) may face outside (i.e., have a highest portion along an outside edge) so that the outer edge of the head  14  may better engage and cut into tissue in need of debridement. Additionally, a head  14  may be manipulated as it engages a wound bed to pull the head  14  along an outer edge thereof, thereby making a more sharply debrided wound edge as may be desired by a medical professional using the device  10  or supervising use thereof. For example, a head  14  may be manipulated in a carving motion along the edges thereof, thereby giving the medical professional maximal control over the aggressiveness of the debridement obtained during the procedure. 
     In selected embodiments, a device  10  (e.g., a main body  12  and/or a head  14 ) in accordance with the present may have a number  118 , letter  118 , marking  118 , symbol  118 , color code  118 , or the like applied thereto that is indicative of where a corresponding contact surface  36  falls on an aggressiveness scale. For example, on a number scale from one to four, a number one marking  118  may indicate a cleansing surface  36   c  or some other least aggressive surface  36 , while a number four marking  118  may indicate a sharp debridement surface  36   a  or some other most aggressive surface  36 . Accordingly, a medical professional or other user may refer to a number  118  or the like when selecting a device  10  for use. 
     Referring to  FIGS. 53-61 , in selected embodiments, an aperture  78  may be omitted from a removable head  14  of a device  10  in accordance with the present invention. In such embodiments, a frame  34  of the head  14  may still include an aperture  76  to support securement to a main body  12 . Such an aperture  76  may be shaped and sized to selectively receive a physical linkage  28 , horn  28 , or the like that conducts vibration, oscillation, and/or reciprocation from a main body  12  to a head  14 . 
     Referring to  FIGS. 62-72 , in selected embodiments, a fluid system  16  may be separated from (e.g., located somewhat remotely with respect to) a main body  12  and/or head  14 . For example, a fluid system  16  may comprise a pump (e.g., a peristaltic pump) that draws fluid from a fluid reservoir  44  (e.g., a saline bag) and urges the fluid through a relatively long conduit  50   a  to an aperture  78  in a head  14 . In this manner, the flow of liquid to head  14  may be controlled (e.g., finely controlled) and may be set to a relatively low flow rate so as to avoid creating a puddling, liquid control, or liquid absorption problem for a user and/or patient. In such embodiments, a main body  12  may provide a channel  120  for receiving and engaging the conduit  50   a . The channel  120  may grip the conduit  50   a  and ensure that the conduit  50   a  moves with the main body  12  and is not inadvertently pulled away or disengaged from a head  14 . 
     In certain embodiments, a main body  12  and/or head  14  configured for use with a remote fluid reservoir  44  may also be configured for use with an on-board or attached reservoir  44 . For example, a main body  12  may be shaped to house, extend over, or cradle at least a portion of a fluid reservoir  44  (e.g., at least a portion of a saline bullet). In such arrangements, a channel  120  may receive and secure a relatively short conduit  50   b . Insertion of an outlet  88  of a fluid reservoir  44  into one end of the relatively short conduit  50   b  may secure or connect the fluid reservoir  44  to the rest of the device  10 . 
     Referring to  FIGS. 73-88 , in selected embodiments, a head  14  may be configured for use on an open, deep wound or in undermined areas or tunneling wound-care situations. Accordingly, a contact surface  36  and frame  34  for such embodiments may be sized, shaped, and of sufficient length to support or facilitate that function. In certain embodiments, such a “deep pocket” head  14  may have an aperture  76  to support securement to a main body  12 . Such an aperture  76  may be shaped and sized to selectively receive a physical linkage  28 , horn  28 , or the like that conducts vibration, oscillation, and/or reciprocation from a main body  12  to a head  14 . In other embodiments, a deep pocket head  14  may be monolithically connected to (e.g., molded as a single unit with) a main body  12  or handle portion  12  that is shaped to cradle a finger of a user or fluid reservoir  44  as described hereinabove. 
     Referring to  FIGS. 89 and 90 , in selected embodiments, a wound-care device  10  in accordance with the present invention may be used in certain alternative methods  122 . Such alternative methods  122  may be performed as standalone methods of wound care or may be incorporated into one or more other methods set forth hereinabove (e.g., between steps  72  and  74  in the method  58  of  FIG. 5 , between steps  72  and  110  in the method  108  of  FIG. 15 , between steps  72  and  110  in the method  112  of  FIG. 16 , or the like). In certain embodiments, one or more alternative methods  122  may involve applying an antiseptic and/or antibiofilm gel, paste, powder, or the like to a wound bed. This may assist in physically breaking up any biofilm (e.g., disrupt the Extra Polymeric Substance (EPS) of the biofilm) while, at the same time, actively working to (1) expose, lift up, flush away, and/or kill bacteria, and/or (2) otherwise chemically disrupt the biofilm. 
     For example, in one alternative method  122   a , an antiseptic and/or antibiofilm material (e.g., gel, paste, powder, or the like) may be applied  124  to a wound bed. Thereafter, a wound-care device  10  in accordance with the present invention may be used to scrub  126  the material into the wound bed. The material may be left  128  in place for a limited period of time (e.g., a time period in a range from about 1 minute to about 15 minutes) and then rinsed  130  off. Thereafter, a dressing may be applied  132  if desired or necessary. 
     If an antiseptic and/or antibiofilm material is of a nature that prolonged application or exposure to a wound bed is beneficial and not potentially harmful, a different method  122   b  may be used. Specifically, after the material is applied  124  and scrubbed  126 , it may be left  134  in place for an extended period of time. For example, a material may be left  134  in place for hours to days (e.g., up to seven days) in the case of an acutely infected wound. Accordingly, an antiseptic and/or antibiofilm material may affirmatively act to prevent bacterial growth, biofilm regrowth, and to provide an appropriate moist wound healing environment for an extended period of time. 
     In selected embodiments, an example of an antiseptic and/or antibiofilm material that may be rinsed  130  off after a few minutes may be hypochlorous acid, iodine, polyhexamethylene biguanide (PHMB), or the like. In certain embodiments, a preferred material may combine one or more antiseptics and/or antibiotics with one or more surfactants. Surfactants may break down the protective outer layer(s) of bacteria and/or viruses, kill bacteria or viruses, bind to dead or living bacteria and lift them off a wound bed, or the like. Therefore, one or more surfactants may be a valuable contributor to a gel, paste, power, or the like applied to a wound bed in one or more methods  58 ,  108 ,  112 ,  122  in accordance with the present invention. 
     EDTA is a metal chelator that may help break up biofilm and work well when combined with one or more surfactants. Adding EDTA to a combination of antiseptics such as iodine and PHMB may produce or enable a liquid material (e.g., an emulsified gel) suitable for application to a wound bed in one or more methods  58 ,  108 ,  112 ,  122  in accordance with the present invention (i.e., when combined with a manual and/or low sonic frequency electromechanical manipulation of a wound bed using a wound-care device  10 ). 
     An example of an antiseptic and/or antibiofilm material that may be left  134  in place for an extended period of time may be a slow-release iodine dressing, a PHMB dressing, or a combination or sub-combination of iodine, PHMB, EDTA, one or more surfactants, and the like. If such a combination is made in the context of a viscous gel or paste, it may be applied to a contact surface  36  of a head  14  and then scrubbed into a wound bed to break up biofilm bacteria and EPS and kill the bacteria. 
     Referring to  FIGS. 91 and 92 , in selected embodiments, certain heads  14  in accordance with the present invention may include a cutting element  136  (e.g., a curette  136   a , scalpel  136   b , or the like) rather than a contact surface  36 . For example, a head  14  may configured as a removable head  14  having an aperture  76  for receiving a horn  28  or the like therewithin. Accordingly, when such a head  14  is applied to a horn  28  and the corresponding device  10  is turned “on,” a motion generator  18  may cause a cutting element  136  to vibrate, oscillate, and/or reciprocate at a desired frequency. This motion may enable a user to remove dead tissue, callous material, or the like more easily or in a more controlled manner. 
     In view of the foregoing, a wound-care device  10  in accordance with the present invention may be supplied with or simply fit a variety of different heads  14  (e.g., one or more cleanings heads  14 , one or more desloughing heads, one or more debriding heads  14 , one or more cutting heads  14 , or the like or a combination or sub-combination thereof). Accordingly, a user may select and install a particular head  14  to perform a particular task. When that task is complete, the user may remove that head  14  and install a different head  14  to perform a different task. 
     Referring to  FIGS. 93-95 , in selected embodiments, certain heads  14  in accordance with the present invention may include a cutting element  136  (e.g., a curette  136   a , scalpel  136   b , or the like) in addition to a contact surface  36 . For example, a head  14  may configured to receive and retain a removable cutting element  136 . Accordingly, when such a head  14  is applied to a horn  28  and the corresponding device  10  is turned “on,” a motion generator  18  may cause a removable cutting device  136  to vibrate, oscillate, and/or reciprocate at a desired frequency. 
     In selected embodiments, an engagement mechanism  138  may selectively and/or removably secure a cutting element  136  to the rest of a head  14 . For example, a main portion of a head  14  may include one or more recesses  140  and an engagement mechanism  138  may include one or more extensions  142  shaped to engage the one or more recesses  140 . Clamping “jaws”  144  or the like may be manually flexed to open an engagement mechanism  138  sufficiently that it may engage the rest of a head  14  (e.g., sufficiently that one or more extensions  142  may be positioned so as to align with one or more recesses  140 ). When manual flexing of the engagement mechanism  138  ends, the engagement mechanism  138  may return to a closed position wherein the clamping jaws  144  thereof are in a neutral and/or undeflected position. The tendency of an engagement mechanism  138  to remain in the closed position may hold the one or more extensions  142  within the one or more recesses  140  and, thereby, selectively and/or removably secure the cutting element  136  to the rest of the head  14 . 
     Referring to  FIGS. 96-99 , in selected embodiments, an engagement mechanism  138  may selectively and/or removably secure within an aperture  146  formed in a main portion of a head  14 . For example, a main portion of a head  14  may include a tapered aperture  146  and an engagement mechanism  138  may include a tapered shaft  148  shaped to engage the tapered aperture  146 . A frictional engagement between a tapered aperture  146  and a tapered shaft  148  of an engagement mechanism  138  may be sufficient to secure a cutting element  136  to the rest of a head  14 . 
     In certain embodiments, an axis of symmetry  150  may exist between a tapered shaft  148  and a tapered aperture  146 . Accordingly, before inserting an engagement mechanism  138  into a tapered aperture  146  of a head  14 , a user may select a desired orientation for the corresponding cutting element  136 . Once the orientation is selected and the tapered shaft  148  is seated within the tapered aperture  146 , a friction engagement between the two components  146 ,  148  may resist relative rotation of one with respect to the other about the axis of symmetry  150 . 
     In selected embodiments, a kit or system in accordance with the present invention may include a removable cover  152  for a cutting element  136 . A removable cover  152  may protect a user and/or patient from inadvertent or unwanted contact with the cutting element  136  before the user is ready to use the cutting element  136 . Alternatively, or in addition thereto, a cover  152  may preserve sterility of a cutting element  136  prior to use. 
     Referring to  FIGS. 100-102 , in selected embodiments, a simplified main body  12  and head  14  combination may include a cutting element  136  (e.g., a curette  136   a , scalpel  136   b , or the like) in addition to a contact surface  36 . In such embodiments, an engagement mechanism  138  may selectively and/or removably secure a cutting element  136  to the rest of a head  14 . For example, a main portion of a head  14  may include a rail  154  and an engagement mechanism  138  may include an aperture  156  shape to engage the rail  154 . When the aperture  156  is slid onto the rail  154 , the engagement mechanism  138  may frictionally and/or mechanically engage the rail  154  and, thereby, selectively and/or removably secure the cutting element  136  to the rest of the head  14 . 
     Referring to  FIGS. 103 and 104 , a wound-care device  10  may enable standard conduits  50  (e.g., standard or commonly available intravenous tubing, intravenous connectors, saline bags, or the like) to be used as part of a fluid system  16  in accordance with the present invention. For example, in certain embodiments, a kit corresponding to a wound-care device  10  may include an adaptor  158 . The adaptor  158  may interface between an aperture  78  (e.g., an aperture  78  suitable for receiving an outlet  88  of a saline bullet) and a standard connector  160  (e.g., a Luer-type connector). That is, an adaptor  158  may have one end sized and shaped to be inserted within and frictionally engage an aperture  78  in a head and have a second, opposite end sized and shaped to receive and frictionally or mechanically engage a standard connector. 
     The flowcharts of  FIGS. 5, 15, 16, 89, and 90  illustrate the functionality and/or use of devices and systems in accordance with the present invention. It should be noted that, in some alternative implementations, the functions noted in the blocks may occur out of the order noted in the Figures. In certain embodiments, two blocks shown in succession may, in fact, be executed substantially concurrently, or the blocks may sometimes be executed in the reverse order, depending upon the functionality involved. Alternatively or in addition thereto, certain steps or functions may be omitted if not needed. 
     References in the specification to “one embodiment,” “an embodiment,” “an example embodiment,” “selected embodiments,” “certain embodiments,” or the like, indicate that the embodiment or embodiments described may include a particular feature, structure, or characteristic, but every embodiment may not necessarily include the particular feature, structure, or characteristic. Such phrases are not necessarily referring to the same embodiment. Moreover, when physically possible or desired, it is understood that features, structures, or characteristic described in the context of one embodiment may be applied to or incorporated within one or more other embodiments. For example, any contact surface  36  shown or described in connection with one embodiment of a device  10  or head  14  may be used on any other embodiment of a device  10  or head  14 . 
     The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative, and not restrictive. The scope of the invention is, therefore, indicated by the appended claims, rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.