Patent Publication Number: US-2021177661-A1

Title: Multi-module dressing and therapy methods

Description:
RELATED APPLICATIONS 
     The present invention claims the benefit, under 35 USC § 119(e), of the filing of U.S. Provisional Patent Application Ser. No. 62/584,045, entitled “Multi-Module Dressing and Therapy Methods,” filed Nov. 9, 2017. This provisional application is incorporated herein by reference for all purposes. 
    
    
     TECHNICAL FIELD 
     The invention set forth in the appended claims relates generally to tissue treatment systems and more particularly, but without limitation, to dressings for application to a tissue site, to systems including such dressings, and to methods related to the same. 
     BACKGROUND 
     Clinical studies and practice have shown that reducing pressure in proximity to a tissue site can augment and accelerate growth of new tissue at the tissue site. The applications of this phenomenon are numerous, but it has proven particularly advantageous for treating wounds. Regardless of the etiology of a wound, whether trauma, surgery, or another cause, proper care of the wound is important to the outcome. Treatment of wounds or other tissue with reduced pressure may be commonly referred to as “negative-pressure therapy,” but is also known by other names, including “negative-pressure wound therapy,” “reduced-pressure therapy,” “vacuum therapy,” “vacuum-assisted closure,” and “topical negative-pressure,” for example. Negative-pressure therapy may provide a number of benefits, including migration of epithelial and subcutaneous tissues, improved blood flow, and micro-deformation of tissue at a wound site. Together, these benefits can increase development of granulation tissue and reduce healing times. 
     While the clinical benefits of negative-pressure therapy are widely known, improvements to therapy systems, components, and processes may benefit healthcare providers and patients. 
     BRIEF SUMMARY 
     Systems, dressings, and methods for providing therapy to a tissue site, are set forth in the appended claims. Illustrative embodiments are also provided to enable a person skilled in the art to make and use the claimed subject matter. 
     For example, in some embodiments, a system may comprise a first manifold module. The first manifold module may comprise a first manifold layer and a first silicone adhesive layer. The first manifold module may further comprise a first perforated substrate and a first acrylic adhesive layer adhering the first manifold layer to a first surface of the first perforated substrate. The first silicone adhesive layer may be disposed on a second surface of the first perforated substrate. The system may also comprise a second manifold module configured to be releasably secured to the first manifold module by the first silicone adhesive layer. The second manifold module may comprise a second manifold layer and a second silicone adhesive layer. The second manifold module may further comprise a second perforated substrate and a second acrylic adhesive layer adhering the second manifold layer to a first surface of the second perforated substrate. The second silicone adhesive layer may be disposed on a second surface of the second perforated substrate. The first and second manifold modules may be adapted to distribute reduced pressure from a reduced-pressure source to a tissue site. 
     Also for example, a dressing may comprise a first manifold module. The first manifold module may comprise a first manifold layer and a first silicone adhesive layer. The first manifold module may further comprise a first perforated substrate and a first acrylic adhesive layer adhering the first manifold layer to a first surface of the first perforated substrate. The first manifold module may be configured to be releasably secured to a second manifold module. The second manifold module may comprise a second manifold layer and a second silicone adhesive layer. The second manifold module may further comprise a second perforated substrate and a second acrylic adhesive layer adhering the second manifold layer to a first surface of the second perforated substrate. The dressing may be adapted to be placed adjacent to the tissue site. 
     Also for example, a method for treating a tissue site with reduced pressure may comprise providing a plurality of manifold modules. The plurality of manifold modules may include a first manifold module. The first manifold module may comprise a first manifold layer and a first silicone adhesive layer. The plurality of manifold modules may also include a second manifold module releasably secured to the first manifold module by the first silicone adhesive layer. The second manifold module may comprise a second manifold layer and a second silicone adhesive layer. The plurality of manifold modules may further comprise a third manifold module releasably secured to the second manifold module by the second silicone adhesive layer. The third manifold module may comprise a third manifold layer and a third silicone adhesive layer. The method may further comprise preparing a dressing including at least two of the first manifold module, the second manifold module, and the third manifold module. The method may further comprise placing the dressing adjacent to the tissue site. 
     Also for example, a kit for a dressing adapted to be placed adjacent to the tissue site. The kit may comprise a plurality of manifold modules. Each of the plurality of manifold modules may comprise a manifold layer and a first silicone adhesive layer. The silicone adhesive layer of a manifold module may be configured to releasably secure that manifold module to another manifold module. 
     Also for example, a manifold module for assembling a dressing may comprise a perforated substrate having a first side and a second side. The manifold module may also comprise a first adhesive on the first side of the perforated substrate. The first adhesive may have a first bond strength. The manifold module may also comprise a second adhesive on the second side of the perforated substrate. The second adhesive may have a second bond strength. The manifold module may also comprise a manifold layer attached to the first adhesive coating. The first bond strength is greater than the second bond strength. 
     Objectives, advantages, and a preferred mode of making and using the claimed subject matter may be understood best by reference to the accompanying drawings in conjunction with the following detailed description of illustrative embodiments. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a functional block diagram of an example embodiment of a therapy system that can provide negative-pressure therapy in accordance with this specification; 
         FIG. 2  is a schematic diagram illustrating additional details that may be associated with an example manifold module used in some embodiments of the therapy system of  FIG. 1 ; and 
         FIG. 3  is schematic diagram illustrating additional details that may be associated with an example tissue interface used in some embodiments of the therapy system of  FIG. 1 . 
     
    
    
     DESCRIPTION OF EXAMPLE EMBODIMENTS 
     The following description of example embodiments provides information that enables a person skilled in the art to make and use the subject matter set forth in the appended claims, but may omit certain details already well-known in the art. The following detailed description is, therefore, to be taken as illustrative and not limiting. 
     The example embodiments may also be described herein with reference to spatial relationships between various elements or to the spatial orientation of various elements depicted in the attached drawings. In general, such relationships or orientation assume a frame of reference consistent with or relative to a patient in a position to receive treatment. However, as should be recognized by those skilled in the art, this frame of reference is merely a descriptive expedient rather than a strict prescription. 
       FIG. 1  is a simplified functional block diagram of an example embodiment of a therapy system  100  that can provide negative-pressure therapy in accordance with this specification. 
     The term “tissue site” in this context broadly refers to a wound, defect, or other treatment target located on or within tissue, including but not limited to, bone tissue, adipose tissue, muscle tissue, neural tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendons, or ligaments. A wound may include chronic, acute, traumatic, subacute, and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure, or venous insufficiency ulcers), flaps, and grafts, for example. The term “tissue site” may also refer to areas of any tissue that are not necessarily wounded or defective, but are instead areas in which it may be desirable to add or promote the growth of additional tissue. For example, negative pressure may be applied to a tissue site to grow additional tissue that may be harvested and transplanted. 
     The therapy system  100  may include a negative-pressure supply, and may include or be configured to be coupled to a distribution component, such as a dressing. In general, a distribution component may refer to any complementary or ancillary component configured to be fluidly coupled to a negative-pressure supply in a fluid path between a negative-pressure supply and a tissue site. A distribution component is preferably detachable, and may be disposable, reusable, or recyclable. For example, a dressing  102  may be fluidly coupled to a negative-pressure source  104 , as illustrated in  FIG. 1 . A dressing may include a cover, a tissue interface, or both in some embodiments. The dressing  102 , for example, may include a cover  106  and a tissue interface  108 . A regulator or a controller, such as a controller  110 , may also be coupled to the negative-pressure source  104 . 
     In some embodiments, a dressing interface may facilitate coupling the negative-pressure source  104  to the dressing  102 . For example, such a dressing interface may be the SENSAT.R.A.C.™ Dressing available from Acelity L.P. of San Antonio, Tex. The therapy system  100  may optionally include a fluid container, such as a container  112 , coupled to the dressing  102  and to the negative-pressure source  104 . 
     Additionally, the therapy system  100  may include sensors to measure operating parameters and provide feedback signals to the controller  110  indicative of the operating parameters. As illustrated in  FIG. 1 , for example, the therapy system  100  may include a pressure sensor, an electric sensor, or both, coupled to the controller  110 . The pressure sensor may also be coupled or configured to be coupled to a distribution component and to the negative-pressure source  104 . 
     Components may be fluidly coupled to each other to provide a path for transferring fluids (i.e., liquid and/or gas) between the components. For example, components may be fluidly coupled through a fluid conductor, such as a tube. A “tube,” as used herein, broadly includes a tube, pipe, hose, conduit, or other structure with one or more lumina adapted to convey a fluid between two ends. Typically, a tube is an elongated, cylindrical structure with some flexibility, but the geometry and rigidity may vary. In some embodiments, components may also be coupled by virtue of physical proximity, being integral to a single structure, or being formed from the same piece of material. Moreover, some fluid conductors may be molded into or otherwise integrally combined with other components. Coupling may also include mechanical, thermal, electrical, or chemical coupling (such as a chemical bond) in some contexts. For example, a tube may mechanically and fluidly couple the dressing  102  to the container  112  in some embodiments. 
     In general, components of the therapy system  100  may be coupled directly or indirectly. For example, the negative-pressure source  104  may be directly coupled to the controller  110 , and may be indirectly coupled to the dressing  102  through the container  112 . 
     The fluid mechanics of using a negative-pressure source to reduce pressure in another component or location, such as within a sealed therapeutic environment, can be mathematically complex. However, the basic principles of fluid mechanics applicable to negative-pressure therapy are generally well-known to those skilled in the art, and the process of reducing pressure may be described illustratively herein as “delivering,” “distributing,” or “generating” negative pressure, for example. 
     In general, exudates and other fluids flow toward lower pressure along a fluid path. Thus, the term “downstream” typically implies something in a fluid path relatively closer to a source of negative pressure or further away from a source of positive pressure. Conversely, the term “upstream” implies something relatively further away from a source of negative pressure or closer to a source of positive pressure. Similarly, it may be convenient to describe certain features in terms of a fluid “inlet” or “outlet” in such a frame of reference. This orientation is generally presumed for purposes of describing various features and components herein. However, the fluid path may also be reversed in some applications (such as by substituting a positive-pressure source for a negative-pressure source) and this descriptive convention should not be construed as a limiting convention. 
     “Negative pressure” generally refers to a pressure less than a local ambient pressure, such as the ambient pressure in a local environment external to a sealed therapeutic environment provided by the dressing  102 . In many cases, the local ambient pressure may also be the atmospheric pressure at which a tissue site is located. Alternatively, the pressure may be less than a hydrostatic pressure associated with tissue at the tissue site. Unless otherwise indicated, values of pressure stated herein are gauge pressures. Similarly, references to increases in negative pressure typically refer to a decrease in absolute pressure, while decreases in negative pressure typically refer to an increase in absolute pressure. While the amount and nature of negative pressure applied to a tissue site may vary according to therapeutic requirements, the pressure is generally a low vacuum, also commonly referred to as a rough vacuum, between −5 mm Hg (−667 Pa) and −500 mm Hg (−66.7 kPa). Common therapeutic ranges are between −50 mm Hg (−6.7 kPa) and −300 mm Hg (−39.9 kPa). 
     A negative-pressure supply, such as the negative-pressure source  104 , may be a reservoir of air at a negative pressure, or may be a manual or electrically-powered device that can reduce the pressure in a sealed volume, such as a vacuum pump, a suction pump, a wall suction port available at many healthcare facilities, or a micro-pump, for example. A negative-pressure supply may be housed within or used in conjunction with other components, such as sensors, processing units, alarm indicators, memory, databases, software, display devices, or user interfaces that further facilitate therapy. For example, in some embodiments, the negative-pressure source  104  may be combined with the controller  110  and other components into a therapy unit. A negative-pressure supply may also have one or more supply ports configured to facilitate coupling and de-coupling the negative-pressure supply to one or more distribution components. 
     The tissue interface  108  can be generally adapted to contact a tissue site. The tissue interface  108  may be partially or fully in contact with the tissue site. If the tissue site is a wound, for example, the tissue interface  108  may partially or completely fill the wound, or may be placed over the wound. The tissue interface  108  may take many forms, and may have many sizes, shapes, or thicknesses depending on a variety of factors, such as the type of treatment being implemented or the nature and size of a tissue site. For example, the size and shape of the tissue interface  108  may be adapted to the contours of deep and irregular shaped tissue sites. Moreover, any or all of the surfaces of the tissue interface  108  may have projections or an uneven, course, or jagged profile that can induce strains and stresses on a tissue site, which can promote granulation at the tissue site. 
     In some embodiments, the tissue interface  108  may comprise or consist of a manifold. A “manifold” in this context generally includes any substance or structure providing a plurality of pathways adapted to collect or distribute fluid across a tissue site under pressure. For example, a manifold may be adapted to receive negative pressure from a source and distribute negative pressure through multiple apertures across a tissue site, which may have the effect of collecting fluid from across a tissue site and drawing the fluid toward the source. In some embodiments, the fluid path may be reversed or a secondary fluid path may be provided to facilitate delivering fluid across a tissue site. In some illustrative embodiments, the pathways of a manifold may be interconnected to improve distribution or collection of fluids across a tissue site. 
     The tissue interface  108  may comprise two or more manifold modules  125 . For example, in various embodiments, the tissue interface  108  may include two, three, four five, six, seven, eight, nine, ten, or more manifold modules  125 , according to the needs of a prescribed therapy. The manifold modules  125  may be releasably secured to each other to form the tissue interface  108 . The term “releasably secured” in this context broadly refers to a configuration in which two or more manifold modules are physically engaged or coupled such that those two or more manifold modules may be physically disengaged, for example, uncoupled. In some embodiments, the two or more manifold modules  125  that have been disengaged may, after being disengaged, be physically re-engaged. In some embodiments, two or more manifold modules  125  may be releasably secured via a suitable interface, such as adhesive. 
     In some embodiments, the cover  106  may provide a bacterial barrier and protection from physical trauma. The cover  106  may also be constructed from a material that can reduce evaporative losses and provide a fluid seal between two components or two environments, such as between a therapeutic environment and a local external environment. The cover  106  may be, for example, an elastomeric film or membrane that can provide a seal adequate to maintain a negative pressure at a tissue site for a given negative-pressure source. The cover  106  may have a high moisture-vapor transmission rate (MVTR) in some applications. For example, the MVTR may be at least 300 g/m 2  per twenty-four hours in some embodiments. In some example embodiments, the cover  106  may be a polymer drape, such as a polyurethane film, that is permeable to water vapor but impermeable to liquid. The cover may have a thickness in the range of 25-50 microns. For permeable materials, the permeability generally may be low enough that a desired negative pressure may be maintained. 
     An attachment device may be used to attach the cover  106  to an attachment surface, such as undamaged epidermis, a gasket, or another cover. The attachment device may take many forms. For example, an attachment device may be a medically-acceptable, pressure-sensitive adhesive that extends about a periphery, a portion, or an entire sealing member. In some embodiments, for example, some or all of the cover  106  may be coated with an acrylic adhesive having a coating weight between 25-65 grams per square meter (g.s.m.). Thicker adhesives, or combinations of adhesives, may be applied in some embodiments to improve the seal and reduce leaks. Other example embodiments of an attachment device may include a double-sided tape, paste, hydrocolloid, hydrogel, silicone gel, or organogel. 
     A controller, such as the controller  110 , may be a microprocessor or computer programmed to operate one or more components of the therapy system  100 , such as the negative-pressure source  104 . In some embodiments, for example, the controller  110  may be a microcontroller, which generally comprises an integrated circuit containing a processor core and a memory programmed to directly or indirectly control one or more operating parameters of the therapy system  100 . Operating parameters may include the power applied to the negative-pressure source  104 , the pressure generated by the negative-pressure source  104 , or the pressure distributed to the tissue interface  108 , for example. The controller  110  is also preferably configured to receive one or more input signals, such as a feedback signal, and programmed to modify one or more operating parameters based on the input signals. 
     Sensors, such as the pressure sensor or the electric sensor, are generally known in the art as any apparatus operable to detect or measure a physical phenomenon or property, and generally provide a signal indicative of the phenomenon or property that is detected or measured. For example, the pressure sensor and the electric sensor may be configured to measure one or more operating parameters of the therapy system  100 . In some embodiments, the pressure sensor may be a transducer configured to measure pressure in a pneumatic pathway and convert the measurement to a signal indicative of the pressure measured. In some embodiments, for example, the pressure sensor may be a piezoresistive strain gauge. The electric sensor may optionally measure operating parameters of the negative-pressure source  104 , such as the voltage or current, in some embodiments. Preferably, the signals from the pressure sensor and the electric sensor are suitable as an input signal to the controller  110 , but some signal conditioning may be appropriate in some embodiments. For example, the signal may need to be filtered or amplified before it can be processed by the controller  110 . Typically, the signal is an electrical signal, but may be represented in other forms, such as an optical signal. 
     The container  112  is representative of a container, canister, pouch, or other storage component, which can be used to manage exudates and other fluids withdrawn from a tissue site. In many environments, a rigid container may be preferred or required for collecting, storing, and disposing of fluids. In other environments, fluids may be properly disposed of without rigid container storage, and a re-usable container could reduce waste and costs associated with negative-pressure therapy. 
     Manifold Modules-Manifold Layer 
       FIG. 2  is a perspective view of an example of one of the manifold modules  125 , illustrating additional details that may be associated with some embodiments. In some embodiments, the manifold modules  125  may each include a manifold layer  210 . In various embodiments, the manifold layer  210  may take any suitable form, and may have a suitable size, shape, or thickness depending on a variety of factors, such as the type of treatment being implemented or the nature and size of a tissue site. For example, the size and shape of the manifold layer  210  may be adapted to the contours of deep and irregular shaped tissue sites and/or may be configured so as to be adaptable to a given shape or contour. 
     In some embodiments, the manifold layer  210  may comprise or consist of a manifold having two substantially planar surfaces and a depth or thickness orthogonal to the planar surfaces. For example, the manifold layer  210  may comprise a first surface  212  and a second surface  214 . The first surface  212  and/or second surface  214  may have a surface area from about 1 cm 2  to about 400 cm 2 , or from about 2 cm 2  to about 200 cm 2 , or from about 4 cm 2  to about 100 cm 2 . In various embodiments, the first surface  212  and/or the second surface  214  may have any suitable shape, examples of which include but are not limited to, triangles, squares, rectangles, ellipses, circles, ovals, and various polygons having four, five, six, seven, eight, or more sides. The shape and area of the first surface  212  and the second surface  214  may be customized to the location and type of tissue site onto which the tissue interface  108  is to be applied. In some embodiments, the manifold layer  210  may have a thickness from about 10 mm to about 500 mm, for example, from about 10 mm to about 100, or from about 100 mm to about 200 mm, or from about 200 mm to about 300 mm, or from about 300 mm to about 400 mm, or from about 400 mm to about 500 mm. 
     In some embodiments, the manifold layer  210  may comprise a porous foam material having interconnected cells or pores. For example, the manifold layer  210  may comprise cellular foam, for example, open-cell foam such as reticulated foam. Liquids, gels, and other foams may also include or be cured to include apertures and fluid pathways. In some embodiments, the manifold layer  210  may comprise projections that form interconnected fluid pathways. For example, the manifold layer  210  may be molded to provide surface projections that define interconnected fluid pathways. 
     In some embodiments, the foam may have an average pore size that varies according to needs of a prescribed therapy. For example, in some embodiments, the manifold layer  210  may be foam having pore sizes in a range of 400-600 microns. In some embodiments, the manifold layer  210  may have a tensile strength that also varies according to needs of a prescribed therapy. 
     In some embodiments, the foam material of the manifold layer  210  may be characterized with respect to density. In some embodiments, the manifold layer  210  may be characterized as a relatively dense material. For example, in various embodiments, the manifold layer  210  may have a density of from about 24 kg/m 3  to about 125 kg/m 3  or from about 24 kg/m 3  to about 72 kg/m 3 . 
     In some embodiments, the manifold layer  210  may be hydrophobic. In some an embodiments, the hydrophobic characteristics may prevent the foam from directly absorbing fluid, such as wound exudate, but may allow the fluid to pass through a fluid pathway. For example, in some embodiments, the foam may be polyurethane foam, a silicone foam, a polyether block amide foam, such as PEBAX®, an acrylic foam, a polyvinyl chloride (PVC) foam, a polyolefin foam, a polyester foam, a polyamide foam, a thermoplastic elastomer (TPE) foam such as a thermoplastic vulcanizate (TPV) foam, or another crosslinking elastomeric foam such as foams formed from styrene-butadiene rubber (SBR) and ethylene propylene diene monomer (EPDM) rubber. For example, the manifold layer  210  may comprise a hydrophobic, open-cell foam. In one non-limiting example, the manifold layer  210  may comprise an open-cell, reticulated polyurethane foam such as the foam employed in the V.A.C.® GRANUFOAM™ Dressing or the foam employed in the V.A.C. VERAFLO™ Dressing, both available from available from Acelity L.P., Inc. of San Antonio, Tex. 
     In other embodiments, the manifold layer  210  may be hydrophilic. In some embodiments, the hydrophillic characteristics may be effective to wick fluid while also continuing to distribute negative pressure to the tissue site. In some embodiments, the wicking properties of the manifold layer  210  may draw fluid away from the tissue site by capillary flow or other wicking mechanisms. An example of a hydrophilic foam may include a polyvinyl alcohol or polyether, open-cell foam. Other foams that may exhibit hydrophilic characteristics include hydrophobic foams that have been treated or coated to provide hydrophilicity. For example, the manifold layer  210  may be a treated open-cell polyurethane foam. In one non-limiting example, the manifold layer  210  may comprise a polyvinyl alcohol, open-cell foam such as the foam employed in the V.A.C. WHITEFOAM™ Dressing available from Acelity L.P., Inc. of San Antonio, Tex. 
     Non-Adherent Layer 
     In some embodiments, the manifold modules  125  may include a non-adherent layer  220 . The term “non-adherent” is intended to refer broadly to a substrate that generally exhibits little tendency to adhere or stick to proximate tissue. 
     In various embodiments, the non-adherent layer  220  may comprise any suitable material and configuration. For example, in various embodiments, the non-adherent layer  220  may be a woven material or, alternatively, a nonwoven material such as a film. The non-adherent layer  220  may have a suitable thickness, for example, in the range of from about 10 μm to about 1000 μm. The non-adherent layer  220  may comprise a first surface  222  and a second surface  224 . 
     In some embodiments, the non-adherent layer  220  may be formed from a generally flexible material. Non-limiting examples of such materials include thermoplastic materials, such as acrylics, acrylates (for example, ethyl methacrylate (EMA)), and thermoplastic elastomers such as nylon, styrene ethylene butene styrene (SEBS) and other block copolymers; polyether block polyamide (PEBAX); silicone elastomers; poly caprolactam; poly lactic acid; and polyolefins, such as polyethylene and polypropylene. In one non-limiting example, the non-adherent layer  220  may comprise a nylon film. 
     In some embodiments, at least a portion of the non-adherent layer  220  may be configured so as to be permeable to fluids. For example, in some embodiments, the non-adherent layer  220  may be characterized as porous, as perforated, or both. For example, the non-adherent layer  220  may comprise apertures  225  extending there-through so as to allow communication through the non-adherent layer  220 . In such embodiments, the plurality of apertures  225  may have an average pore size in the range of from about 200 μm to about 3000 μm. In such embodiments, the plurality of apertures  225  may be present in the non-adherent layer  220  at a pore density in the range from about 2 pores/cm 2  to about 10 pores/cm 2 . 
     In some embodiments, the non-adherent layer  220  may be generally configured to cover a surface of the manifold layer  210 . For example, in the embodiment of  FIG. 2 , the second surface  224  of the non-adherent layer  220  may cover or be applied to or engaged with the first surface  212  of the manifold layer  210 . 
     Manifold Modules—Adhesives 
     In some embodiments, one or more of the manifold modules  125  may include one or more adhesive layers. For example, the manifold modules  125  may include a first adhesive layer  230  and a second adhesive layer  240 . 
     In some embodiments, the first adhesive layer  230  may couple the manifold layer  210  to the non-adherent layer  220 . In some embodiments, the first adhesive layer  230  may be coupled directly to the manifold layer  210 , the non-adherent layer  220 , or both. In some embodiments, the first adhesive layer  230  may be coextensive with the manifold layer  210 , the non-adherent layer  220 , or both. In some embodiments, the first adhesive layer  230  may have a thickness from about 10 microns (μm) to about 1000 microns (μm). Additionally or alternatively, in some embodiments, the first adhesive layer  230  may have a coating weight from about 15 gsm to about 70 gsm. 
     In some embodiments, the first adhesive layer  230  may be a medically-acceptable, pressure-sensitive adhesive. For example, the first adhesive layer  230  may comprise an acrylic-based adhesive, such as a high-bond strength acrylic adhesive. In some embodiments, the first adhesive layer  230  may be characterized as exhibiting a high bond strength and/or a high tackiness relative to the second adhesive layer  240 . For example, the first adhesive layer  230  may have a peel adhesion or resistance to being peeled from about 6 Newtons/25 millimeters (N/mm) to about 10N/25 mm from a stainless steel substrate at 23° C. at 50% relative humidity as defined by the American Society for Testing and Materials (“ASTM”) in standard ASTM D3330. 
     The first adhesive layer  230  may be continuous or uninterupted. Alternatively, the first adhesive layer  230  may be formed in a pattern and/or may include a plurality of apertures, for example, which may be aligned with the plurality of apertures  225  of the non-adherent layer  220 . In such embodiments, the plurality of apertures within the first adhesive layer  230  may be formed after application of the first adhesive layer  230  or may be formed by coating the first adhesive layer  230  in a pattern. Additionally or alternatively, in some embodiments, the plurality of apertures may be sized to control the resultant tackiness of the first adhesive layer  230 . 
     In some embodiments, the second adhesive layer  240  may be coupled to the non-adherent layer  220 , for example, to the first surface  222  of the non-adherent layer  220 . In some embodiments, the second adhesive layer  240  may have a thickness in the range from about 100 microns (μm) to about 1000 microns (μm). Additionally or alternatively, in some embodiments, the second adhesive layer  240  may have a coating weight of about 30 gsm to about 70 gsm. 
     In some embodiments, the second adhesive layer  240  may be a relatively soft material capable of adhering two manifold modules. For example, the second adhesive layer  240  may comprise a silicone adhesive, for example, including a silicone elastomer. Suitably, the silicone adhesive may be a soft skin adhesive. In some embodiments, silicone adhesives may be made by an addition reaction, for example, a hydrosilylation reaction, between (a) a vinyl functional polydimethyl siloxane, such as bis-dimethyl vinyl polydimethylsiloxane (PDMS), and (b) a hydrogen functional siloxane, such as dimethyl, methylhydrogen siloxane copolymers, or hydrogen dimethylsiloxy terminated PDMS. The reaction may be catalyzed by a hydrosilylation catalyst, for example, a noble metal catalyst such as a platinum catalyst. 
     In some embodiments, the second adhesive layer  240  may have a stiffness between about 5 Shore 00 and about 80 Shore 00. In some embodiments, the second adhesive layer  240  may be characterized as exhibiting a low to medium bond strength and/or a low to medium tackiness, relative to the first adhesive layer  230 . For example, the second adhesive layer  240  may have a peel adhesion or resistance to being peeled from about 0.5N/25 mm to about 1.5N/25 mm from a stainless steel substrate at 23° C. at 50% relative humidity as defined in standard ASTM D3330. The second adhesive layer  240  may achieve its bond strength after a contact time of less than 60 seconds. In some embodiments, the second adhesive layer  240  may exhibit a tackiness from about 30% to about 50% of the tackiness exhibited by the first adhesive layer  230 . 
     In some embodiments, the second adhesive layer  240  may be continuous or uninterupted. Alternatively, in some embodiments the second adhesive layer  240  may be formed in a pattern and/or may include a plurality of apertures, for example, which may be aligned with the plurality of apertures  225  of the non-adherent layer  220 . The apertures may be numerous shapes, for example, circles, squares, stars, ovals, polygons, slits, complex curves, rectilinear shapes, triangles, or other shapes. The apertures may have a uniform pattern or may be randomly distributed. The average effective diameter of each of the apertures may be in the range from about 6 mm to about 50 mm. 
     Manifold Modules—Arrangement 
     In some embodiments, at least two of manifold modules may be releasably secured to each other. For example, the second adhesive layer  240  may allow a first manifold module to be releasably secured with respect to a second manifold module. As illustrated in  FIG. 3 , a first manifold module  321  including a second adhesive layer  341  may be coupled to a second manifold module  322  via the second adhesive layer  341  of the first manifold module  321 . Additionally, the second adhesive layer  341  of the first manifold module  321  may also allow the second manifold module  322  to be released from the first manifold module  321  such that the second adhesive layer  341  of the first manifold module  321  may be later coupled to another manifold module. For example, after being disengaged, the second adhesive layer  341  of the first manifold module  321  may be coupled to the second manifold module  322  or a third manifold module. 
     In various embodiments, a tissue interface having one or more desired parameters may be achieved by arranging and coupling a suitable combination of manifold modules. For example, by coupling various, suitable manifold modules, a tissue interface having a desired thickness, a desired cross-sectional profile or shape, a desired surface area, or combinations thereof may be achieved. In some embodiments, any two manifold modules of a tissue interface may be similarly configured in at least one respect. For example, two or more manifold modules of a tissue interface may have the same or a similar physical dimension, the same or similar components, or the same or a similar arrangement of components. Additionally or alternatively, in some embodiments, two or more manifold modules of a tissue interface may have differing physical dimensions, the differing components, or a differing arrangement of components. For example, a first manifold module may include a manifold layer having a first thickness and a second manifold module may include a manifold layer having a second thickness. 
     Also, in some embodiments, a kit for forming a dressing interface may include two, three, four, five, six, seven, eight, nine, ten, or more manifold modules. In some embodiments, the manifold modules of the kit may be sterile and may be packaged in a microorganism-impermeable container. In some embodiments, one or more manifold modules may be individually packaged. Additionally or alternatively, in some embodiments one or more removable protective sheets may be applied to the second adhesive layer of a manifold module while packaged. The protective sheets may be removed by a physician or other caregiver when ready for use. 
     Methods 
     In operation, the tissue interface  108  may be prepared for use in a therapy by selecting two or more manifold modules that, when coupled, will impart the desired properties, for example, the desired physical dimensions. In some embodiments, the tissue interface  108  may be prepared from a kit including a plurality of manifold modules  125 . In some embodiments, preparing the tissue interface  108  may include repositioning a selected manifold module with respect to another selected manifold module. For example, a plurality of manifold modules may be provided together. In some embodiments, the manifold modules  125  may be provided in a kit or packaging where several manifold modules may be releasably coupled together. In such embodiments, preparing the tissue interface  108  may include uncoupling a manifold module from one or more other manifold modules, rearranging the selected manifold modules, such as by coupling two or more selected manifold modules that were not previously coupled to yield the tissue interface  108 . The selected manifold modules may be coupled to yield the tissue interface  108 . 
     When prepared, the tissue interface  108  may be placed within, over, on, or otherwise proximate to a tissue site. The cover  106  may be placed over the tissue interface  108  and sealed to an attachment surface near the tissue site. For example, the cover  106  may be sealed to undamaged epidermis peripheral to a tissue site. Thus, the dressing  102  can provide a sealed therapeutic environment proximate to a tissue site, substantially isolated from the external environment, and the negative-pressure source  104  can reduce the pressure in the sealed therapeutic environment. Negative pressure applied across the tissue site through the tissue interface  108  in the sealed therapeutic environment can induce macrostrain and microstrain in the tissue site, as well as remove exudates and other fluids from the tissue site, which can be collected in container  112 . 
     Advantages 
     In various embodiments, a therapy system like therapy system  100  or components thereof, such as the tissue interface  108 , may be advantageously employed in the provision of therapy, such as negative pressure therapy, to a patient. For example, a tissue interface having one or more desired and/or customized parameters, such as a desired thickness, a desired cross-sectional profile or shape, a desired surface area, or combinations thereof, may be achieved. As such, a tissue interface formed from a combination of manifold modules may yield a desired and/or customized parameters without the need to cut or manipulate the structure of a dressing. 
     Additionally, a second adhesive layer, such as a silicone adhesive, applied to a non-adherent layer, such as a nylon layer, may be effective both to couple two manifold modules together and to adhere the tissue interface to a tissue site, such as a wound bed. The silicone adhesive may allow for ease of application to the tissue site and ease of removal after use. For example, the silicone adhesive applied to a nylon layer may create a barrier to tissue in-growth and integration. 
     While shown in a few illustrative embodiments, a person having ordinary skill in the art will recognize that the systems, apparatuses, and methods described herein are susceptible to various changes and modifications. Moreover, descriptions of various alternatives using terms such as “or” do not require mutual exclusivity unless clearly required by the context, and the indefinite articles “a” or “an” do not limit the subject to a single instance unless clearly required by the context. Components may be also be combined or eliminated in various configurations for purposes of sale, manufacture, assembly, or use. For example, in some configurations the dressing  102 , the container  112 , or both may be eliminated or separated from other components for manufacture or sale. In other example configurations, the controller  110  may also be manufactured, configured, assembled, or sold independently of other components. 
     The appended claims set forth novel and inventive aspects of the subject matter described above, but the claims may also encompass additional subject matter not specifically recited in detail. For example, certain features, elements, or aspects may be omitted from the claims if not necessary to distinguish the novel and inventive features from what is already known to a person having ordinary skill in the art. Features, elements, and aspects described herein may also be combined or replaced by alternative features serving the same, equivalent, or similar purpose without departing from the scope of the invention defined by the appended claims.