Patent Publication Number: US-2022226162-A1

Title: Negative pressure wound treatment system and method

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. application Ser. No. 15/761,659 filed Mar. 20, 2018, which represents the national stage entry of PCT International Application PCT/US2016/052817 filed Sep. 21, 2016, which claims benefit of U.S. Provisional Application 62/221,342 filed Sep. 21, 2015, all of which are incorporated herein in its entirety by reference 
    
    
     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH 
     Not applicable 
     SEQUENCE LISTING 
     Not applicable 
     BACKGROUND OF THE INVENTION 
     Field of the Invention 
     The present disclosure generally relates to a wound treatment system and method, and more specifically, to a negative pressure wound treatment system and method for treating wounds with negative pressure generated by a user walking while wearing a device. 
     Description of the Background of the Invention 
     Negative pressure wound therapy (NPWT) is a treatment that aids in the healing of wound injuries by increasing blood flow to the target area and promoting the formation of granulation tissue. It also functions in removing and draining fluid and leakage, diminishing both the amount and rate of infection and bacterial growth, assisting in closure, and providing protection from the surrounding environment. Such a device typically is comprised of: 1) a gauze or wound dressing to fill the cavity, 2) a drainage tube held near the area of injury, sometimes inside of the dressing, 3) an adhesive sealant placed atop the dressing to create an air tight seal, 4) a container or outlet for the fluid drained from the injured area, and 5) a low-pressure vacuum to create negative pressure. The dressing of the wound requires frequent replacement. According to the Food and Drug Administration, NPWT is proven to provide aid to chronic wounds, burns, diabetic and pressure ulcers, acute wounds, traumatic wounds and dehisced wounds. In addition negative pressure can locally induce or mimic the therapeutic effects of massage. 
     A special case of wounds are diabetic foot ulcers (DFUs). DFUs are a leading cause of lower limb amputations. Diabetes affects hundreds of millions of people worldwide, including tens of millions of patients in US, and are projected to double by 2030. DFUs are a primary cause of hospital admissions in the developed world and one of the most impaired conditions associated with diabetes, often leading to pain, suffering, and a poor quality of life for patients. DFUs precede a significant majority of all diabetes-related lower-leg amputations and are characterized by impaired healing. 
     Portable NPWT devices have been proposed in the art, however many require an external power supply for creating negative or positive air pressure. Another disadvantage of the devices described in the art is that patients cannot wear them for natural walking. Some of the prior art devices that can be worn while walking require the entire foot and lower leg to be sealed and covered, resulting in comfort issues. Further still, other devices in the prior art require a hand powered device that is to be used at developing areas, but the operation requires active patient activity and attention. 
     Therefore, there is a need for a NPWT system that overcomes one or more of the aforementioned drawbacks of NPWT devices known in the art. In particular, there is a need for a NPWT system and method that generates low pressure by introducing means under a foot of the user configured to be actuated by walking and the area treated is specific to an area slightly larger than one or more DFU&#39;s positioned on a lower extremity of the user. 
     SUMMARY OF THE INVENTION 
     A negative pressure wound treatment system includes a bandage portion and a negative pressure portion. The bandage portion includes a dressing portion in contact with a wound and a sealing layer positioned in contact with the dressing portion. The sealing layer creates a seal around the wound. The negative pressure portion is in fluid communication with the bandage portion and includes a first valve and a second valve. The first valve is in fluid communication with the bandage portion and the negative pressure portion. The second valve is in fluid communication with the negative pressure portion and the surrounding environment. The negative pressure wound treatment system is configured to provide negative pressure to an area sealed by the bandage portion upon the actuation of the negative pressure portion. The negative pressure portion is configured to be actuated by compressing the negative pressure portion while walking. The sealing layer may include an adhesive creating the seal around the wound. 
     According to another aspect of the negative pressure wound treatment system, the bandage portion and the negative pressure portion are configured as an innersole device that is positioned within a shoe of the user. 
     According to another aspect of the negative pressure wound treatment system, the bandage portion is sized to seal an area that is substantially the entire bottom of a user&#39;s foot. 
     According to another aspect of the negative pressure wound treatment system, the negative pressure portion comprises a collapsible hollow bulb. 
     According to another aspect of the negative pressure wound treatment system, the dressing portion comprises at least one of gauze, porous foam, and a therapeutic scaffold. 
     According to another aspect of the negative pressure wound treatment system, the bandage portion is sized to seal a portion of the bottom of a user&#39;s foot surrounding the wound and the negative pressure portion is positioned under an adjacent portion of the user&#39;s foot. 
     According to another aspect of the negative pressure wound treatment system, the bandage portion is positionable to seal an area located on a lower extremity of a user and the negative pressure portion is positionable below the user&#39;s foot. 
     According to another aspect of the negative pressure wound treatment system, the system includes at least one sensor. 
     According to another aspect of the negative pressure wound treatment system, the sensor is at least one of a pedometer and a pressure sensor. 
     According to another aspect of the negative pressure wound treatment system, the information collected by the sensor is at least one of recorded and broadcasted to an external device. 
     According to another aspect of the negative pressure wound treatment system, the valve includes a release mechanism, trigger or switch. 
     A wound healing device includes a first chamber and a second chamber. The first chamber includes a dressing and is configured to form a seal around a wound of a user. The dressing is in contact with the wound. The seal is around the perimeter of the first chamber. The second chamber includes at least one valve. The second chamber is in fluid communication with the first chamber through the at least one valve. Actuation of the second chamber creates a negative pressure environment in the first chamber. The second chamber is configured and positioned to be actuated by a user while walking. The seal may be formed by an adhesive around the perimeter of the first chamber. 
     According to another aspect of the wound healing device, the first chamber collects liquid from the wound. 
     According to another aspect of the wound healing device, the second chamber includes a reservoir configured to collect liquid from the wound. 
     According to another aspect of the wound healing device, the reservoir comprises an absorbent material. 
     According to another aspect of the wound healing device, the first chamber includes a reservoir configured to collect fluid from the wound. 
     According to another aspect of the wound healing device, the first chamber includes a reservoir configured to collect fluid from the wound and the reservoir comprises an absorbent material. 
     According to another aspect of the wound healing device, the second chamber is in fluid communication with the first chamber through the at least one valve, and the second chamber is in fluid communication with the surrounding environment through a second valve. 
     According to another aspect of the wound healing device, the at least one valve and the second valve are one-way valves. 
     According to another aspect of the wound healing device, the first chamber and the second chamber are configured as part of a shoe insole and the second chamber is configured to form a seal around a portion of a bottom of the user&#39;s foot and the portion includes the wound. 
     According to another aspect of the wound healing device, the first chamber is configured to form a seal around a wound on a portion of a user&#39;s lower extremity away from a bottom of the user&#39;s foot and the second chamber is configured to be position under a user&#39;s foot within a shoe. 
     According to another aspect of the wound healing device, the first chamber and the second chamber are connected via a flexible tube. 
     According to another aspect of the wound healing device, the second chamber is part of a shoe insole. 
     According to another aspect of the wound healing device, wherein any of the valves include a release mechanism, trigger or switch. 
     A method of treating a wound on a lower body extremity with negative pressure wound therapy includes the following steps. A first chamber is positioned over a wound on the lower body extremity and the first chamber includes a dressing configured to contact the wound. A seal is formed around the perimeter of the first chamber. A second chamber is positioned below the lower body extremity and the second chamber is configured to be actuated by the lower body extremity during walking. The first chamber is fluidly coupled to the second chamber through a first valve. The second chamber is fluidly coupled to the surrounding environment through a second valve. Actuation of the second chamber causes a negative pressure environment to be formed within the first chamber over the wound. The seal may be formed around the perimeter of the first chamber with an adhesive. However, a seal can be made without adhesives, for example, using a rubber or plastic piece as sealing and holding and pressing the perimeter with a bandage. 
     According to another aspect of the therapy, the method includes the second chamber positioned within a shoe and the first and second chambers are configured as an insole device sized to fit with the shoe. 
     According to another aspect of the therapy, the method includes the second chamber positioned within the shoe of the user and the first chamber positioned away from the shoe of the user. The first chamber is connected to the second chamber through a flexible tube. 
     According to another aspect of the therapy, the method includes collecting fluid from the wound in the first chamber, wherein the first chamber includes an absorbent reservoir. 
     According to another aspect of the therapy, the method includes collecting fluid from the wound in the second chamber, wherein the second chamber includes an absorbent reservoir. 
     According to another aspect of the therapy, the method includes positioning the first chamber adjacent the second chamber and the first chamber is configured to seal around the wound located on the bottom of a foot of a user. The first chamber and the second chamber are configured as components of a self-adhesive bandage. 
     According to another aspect of the therapy, the method includes the negative pressure environment formed within the first chamber is in the range from about 40 millimeters of mercury to about 200 mm of mercury. 
     According to another aspect of the therapy, the method includes that any of the valves include a release mechanism, trigger or switch. 
     According to another aspect of the wound healing device, a wound healing device comprises a first chamber, a second chamber and at least one valve wherein the first chamber is in contact with a wound and the second chamber exchanges fluids in care of the pressure applied by the lower extremity of a subject and the valve regulates the pressure between any of the first chamber, the second chamber, and external surroundings of the wound healing device. 
     According to another aspect of the wound healing device, the first chamber collects fluids from the wound. 
     According to a further aspect, the wound healing device includes a reservoir that collects and stores fluids from the wound. 
     According to another aspect of the wound healing device, the reservoir is positioned within the second chamber. 
     According to another aspect of the wound healing device, the reservoir includes an absorbent material. 
     According to another aspect of the wound healing device, the reservoir is positioned within one of the first chamber, or a duct or passage between the first chamber and the second chamber. 
     According to another aspect of the wound healing device, the device lacks the reservoir that collects or store fluids from the wound 
     According to another aspect of the wound healing device, the first chamber and the second chamber are combined into one chamber for providing NPWT. 
     According to another aspect of the wound healing device, the first chamber and the second chamber are in fluid communication through at least one of a valve, a duct, and a flexible tube. 
     According to another aspect of the wound healing device, the second chamber further includes a valve in fluid communication with the surrounding environment. 
     According to another aspect of the wound healing device, the whole device is sized to fit within footwear of the user. 
     According to another aspect of the wound healing device, the first chamber is affixed to a lower extremity of a user with a mesh outside of the user&#39;s footwear. 
     According to another aspect any of the above devices can be applied over non wounded skin to induce therapeutic effects different from the wound healing 
     These and other features, aspects, and advantages of the present invention will become better understood upon consideration of the following detailed description, drawings and appended claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a schematic representation of a NPWT system; 
         FIG. 2  is a depiction of a first embodiment of a NPWT system according to the invention; 
         FIG. 3  is a depiction of a second embodiment of a NPWT system according to the invention; 
         FIG. 4  is a depiction of a fourth embodiment of a NPWT system according to the invention; 
         FIG. 5  is a depiction of a fifth embodiment of a NPWT system according to the invention; 
         FIG. 6  is a flow chart depicting a treatment process utilizing a NPWT system according to the invention; and 
         FIG. 7  is a flow chart depicting a treatment process utilizing a NPWT system including a sensor according to the invention. 
     
    
    
     Like reference numerals will be used to refer to like parts from Figure to Figure in the following description of the drawings. 
     DETAILED DESCRIPTION 
     Patients affected by chronic wounds are often bed-ridden due to the presence of bulky dressings and equipment which impair their ability to move and walk. This condition worsens the quality of life of the patients as well as their ability to heal since walking has a beneficial effect on lower limb microcirculation. A portable and wearable NPWT device may provide enhanced quality of life and healing benefits to patients suffering from DFU and other wounds located on the lower extremities and other parts of the body. In the embodiments disclosed hereinafter, patients may produce the low pressure or vacuum needed for NPWT just by walking with at least a portion of the wearable NPWT device under a foot. This would give patients the improved ability to maintain a healthy and improved quality of life over traditional systems. Further, no external power supply is needed and the patient&#39;s ability or capacity to move and walk during treatment would not be limited as compared to traditional methods. It has been show that negative pressure can induce therapeutic effects when applied to healthy skin. It can create a suction effect that increases blood and lymphatic circulation systemically and to the local area, relaxes muscle tissue and support, draws stagnation, pathogenic factors and toxins out of the body and releases a myriad of pain causing factors. A common application of these effects are known from several years in techniques as cupping that can even being combined with massage along with the movements performed and areas treated by a therapist will produce stimulating (toning) or sedating (draining) effects. Conditions as chronic venous insufficiency (CVI) or plantar fasciitis, the present invention can be employed in addition to other physiotherapy surgery, drug treatment and sclerotherapy, with both prophylactic and curative intent. Apart from improving the hemodynamic situation, localized negative pressure therapy aims in particular to preserve or reactivate the active and passive pump mechanisms of the lower limbs, for example, the calf muscle pump and the ankle pump. In addition, localized negative pressure can help desensitize those areas affected by neurogenic pain as foot neuropathy as a complement or in replacement of traditional massage. In lymphedema, tissue fluid steadily accumulates in the subcutaneous space containing loose connective tissue. Since there is no force that could mobilize and propel stagnant fluid to the regions where lymphatics absorb and contract, this task should be taken over by external massage or forces. In one embodiment, negative pressure can be applied one the skin surface of the affected region redirecting fluids and restoring lymphatic function. In a similar manner some of the devices described can be used to treat edema. 
     In one embodiment at least one of the valves can be activated or deactivated by a release mechanism, trigger or switch, thus creating different cycles of presence or absence of negative pressure over the interest area. The release mechanism, trigger or switch can be electric or mechanic and even can be activated remotely or triggered by an external device or timer. In a more specific embodiment, the release mechanism, trigger or switch includes a pressure sensor that enables the application of negative pressure can be regulated or determined by a threshold. 
     Referring to  FIG. 1 , a schematic embodiment of a negative pressure wound treatment system  100  according to the invention for providing negative pressure wound therapy is depicted. The treatment system  100  is shown covering a wound  102  located on a body portion  104  of a patient. The wound  102  may be a chronic wound, a DFU, a burn or any type of wound that one having ordinary skill in the art would understand as appropriate for NPWT. The body portion  104  may be located on the sole of a patient&#39;s foot or any other portion of a patient&#39;s body including but not limited to the lower extremities. As will be disclosed later, different embodiments will demonstrate treatment of wounds positioned away from a patient&#39;s foot while walking generates the necessary conditions for successful NPWT. 
     Still referring to  FIG. 1 , the treatment system  100  includes a first chamber or bandage portion  106  and a second chamber or negative pressure portion  108 . The first chamber  106  includes a sealing layer  110  that forms an air-tight seal over the wound  102  and a small area around the wound. The sealing layer  110  may form the seal over the wound  102  by application of an adhesive  112  around the perimeter of the sealing layer  110 . It is contemplated that the sealing layer  110  may be a flexible layer of any shape that facilitates the coverage of the wound  102 . For example, the shape and type of materials used for the sealing layer  110  may be optimized depending on the location placed on the body of the patient. In some embodiments, the sealing layer  110  may be formed from a rigid or semi-rigid material that is secured by adhesive  112  around the perimeter of the sealing layer  110 . Alternatively, a sealing layer  110  may be attached and form a seal on the body portion  104  by other methods involving adhesive  112 . For example, a tape layer (not shown) may be placed over the sealing layer  110  that extends around the sealing layer  110  to form an air-tight seal over the wound  102 . Further, the sealing layer may be formed by spreading an adhesive that forms the sealing layer  110  and thus creates the first chamber  106 . One non limiting example of adhesive can be cyanoacrylate or its derivatives. One having ordinary skill in the art would understand the various ways adhesive  112  could be applied to flexible and rigid or semi-rigid materials to form an air-tight seal over a wound  102 . 
     Continuing to refer to  FIG. 1 , the first chamber  106  may include a dressing portion  114 . The dressing portion is positioned to be in contact with the wound  102  and the sealing layer  110 . It is contemplated that the dressing portion may comprise any number of materials or combination of materials. Some not limiting examples would be traditional gauze and bandage materials, porous foam, and therapeutic or regenerative scaffolds. The dressing portion  114  may be any combination of these or other materials. In some embodiments, the first chamber may include a reservoir  116  for the collection of fluids from the wound  102 . The reservoir  116  may include an absorbent material in contact with the dressing portion  114 . Non limiting examples of absorbent materials can include gauze and bandage, nafion or a combination thereof. Alternative embodiments can avoid this chamber for fluid collection, for example when applied to wounds that have no significant liquid excretions. 
     The second chamber  108  is in fluid communication with the first chamber  106  through a first valve  118 . The first valve  118  may be positioned within the first chamber  106 , within the second chamber  108 , or in a tube  120  that connects the first chamber  106  to the second chamber  108 . In some embodiments, the tube  120  may be just a duct and the first chamber  106  and the second chamber  108  may be in very close proximity and or contact with each other. In other embodiments, the tube  120  may be longer allowing the first chamber  106  to be spaced a distance away from the second chamber  108 . It is contemplated that the distance between the first chamber  106  and the second chamber  108  can vary based on the application and the location of the wound  102  to be treated. As will be shown in later embodiments, the first chamber  106  may be placed adjacent to the second chamber  108  or the first chamber  106  may be placed away from the second chamber  108 . 
     Still referring to  FIG. 1 , the second chamber  108  may also include a reservoir  122  for the collection of fluids from the wound  102 . The reservoir  122  may be positioned within the second chamber  108  in any orientation or location favorable for the collection of fluid. The reservoir  122  may be formed from absorbent material placed within the second chamber  108 . Alternatively, it is contemplated that in some embodiments a separate reservoir may be formed from a third chamber (not shown) that is positioned between the first chamber  106  and the second chamber  108  for the purpose of collecting fluids from the wound  102 . It is also contemplated that the first chamber  106 , the second chamber  108 , and the third chamber (not shown) are in fluid communication with each other. Further, in some embodiments the third chamber (not shown) may include absorbent materials (not shown) disposed within the third chamber (not shown). The tube  120  may be divided into two sections (not shown)) connecting the third chamber (not shown) to the first chamber  106  and the second chamber  108 . 
     The second chamber  108  also includes a second valve  128  that may be placed in a duct  130  that provides fluid communication between the second chamber  108  and the surrounding environment. It is also contemplated that the second chamber  108  is constructed of a resilient but compressible material. As will be detailed later, the actuation (i.e., the application and removal of a compressive force) of the second chamber creates the low pressure environment in the first chamber  106  for the NPWT. It is contemplated that the actuation of the second chamber  108  will result in a low pressure environment in the first chamber  106  that is in the range from about 40 millimeters of mercury (mm of Hg) to about 200 mm of Hg, or in the range from about 80 millimeters of mercury (mm of Hg) to about 140 mm of Hg. It is contemplated that the low pressure created within the first chamber  106  may be tuned or adjusted by the use of different second chambers  108 , first valves  118 , or second valves  128 . The treatment system  100  may include an outer cover  132 . It is contemplated that the outer cover  132  may take different forms in the different embodiments disclosed below. The outer cover  132  may assist in retaining the treatment system  100  or portions of the treatment system  100  in place on the patient. The outer cover  132  may include adhesive for securing portions of the treatment system  100  in place or may comprise a wrap that would wrap around a foot or lower extremity portion of a patient. 
     Still referencing  FIG. 1 , the general operation of the treatment system  100  is disclosed. The first chamber  106  is positioned over a wound  102  and the dressing portion  114  is positioned in contact with the wound  102 . A seal is formed around the perimeter of the first chamber with adhesive  112 . The second chamber  108  is positioned below a foot of the patient. The first chamber  106  is fluidly coupled to the second chamber  108  through the first valve  118 . The second chamber  108  is fluidly coupled to the surrounding environment through the second valve  128 . The patient begins walking. As the patient steps onto the foot with the second chamber  108  positioned below it, a compressive force is applied to the second chamber  108 . As the second chamber  108  is compressed, air within is pushed out through the second valve  128 . Upon the release of the compressive force, the resilient nature of the second chamber  108  causes the second chamber  108  to revert to the original uncompressed shape and a low pressure environment is created. The low pressure in the second chamber  108  will then draw air and possibly fluid from the first chamber  106  through the first valve  118  creating a lower pressure environment in the first chamber  106 . It is contemplated that the compression of the second chamber  108  is only partial and that several cycles of compression may be required for the first chamber to reach the desired low pressure range for NPWT as described above. Eventually, the pressure in the first chamber  106  will be low enough to provide the therapeutic benefits of NPWT to the wound  102 . The pressure in the first chamber may eventually reach equilibrium with the resilient nature of the second chamber  108  such that the second chamber remains partially compressed even after the compressive force is removed. As the pressure increases in the first chamber  106  however, the second chamber  108  may partially uncompress and draw air and fluid from the first chamber  106  thus maintaining a low pressure environment in the first chamber  106 . The positioning of the second chamber  108  under the sole can vary according to the embodiment and use. 
     It is also contemplated that the first valve  118  and the second valve  128  may include a release mechanism that is accessible by the user. In this way the user can create different cycles of the presence or absence of negative pressure over the area of interest. It is further contemplated that the release mechanism may be a trigger or a switch. 
     It is contemplated that the duration of time that the treatment system  100  may be used to treat a wound  102  depends on numerous variables. In some embodiments, all of the components may be sized such that any absorbent materials within the first chamber  106  and the second chamber  108  may become saturated from fluids from the wound  102  in a few hours. In some embodiments the time period may be between about 3 hours to about 6 hours, or about 3 hours to about 12 hours, or about 3 hours to about 24 hours. Alternatively, the time period may be extended to multiple days depending on the size of the components and the nature and condition of the wound. 
     Still referring to  FIG. 1 , it is contemplated that the treatment system  100  may include at least one sensor  150  in communication with at least one external device  155 . The communication (represented by a line  160 ) between the at least one sensor  150  and the external device  155  may be by a wired or wireless process. One having ordinary skill in the art would recognize the multitude of ways the at least one sensor  150  could send or transmit information to the at least one external device  155 . It is contemplated that the at least one sensor could be a wide variety of sensor types that may provide a wide variety of useful data to the patient and/or a healthcare provider monitoring the patient. In one exemplary embodiment, the sensor  150  may be a pressure sensor the determines the pressure level achieved in the first chamber  106  while the patient is walking and/or not walking. In another exemplary embodiment, the sensor  150  may include the ability to determine the number of times the second chamber  108  has been actuated to generate negative pressure in the first chamber  106 . Further embodiments may include external devices  155  that is at least one of a pedometer, a smart phone, a smart wearable device (e.g., a watch) that is capable of receiving communications from the at least one sensor  150 . It is further contemplated that the external device may be capable of at least recoding and or displaying the data. Some embodiments may include the external device  155  communicating the data received from the sensor  150  to other external devices via a variety of means (e.g., a cellular data connection, a Wi-Fi connection, a wired internet connection, a Bluetooth connection). It is also contemplated that the health care provider may monitor the data transmissions from the patient in person or remotely via electronic transmissions. One having skill in the art would understand the multitude of ways via different communication protocols that the sensor  150  may communicate information to the external device  155  and in turn that information is recorded for or transmitted to the health care provider for aid in determining the effectiveness of the treatment. 
     Turning to  FIG. 2 , a schematic embodiment of a negative pressure wound treatment system  200  is depicted in the form of an innersole device configured to fit inside footwear of patient. The treatment system  200  includes a first chamber  206  and a second chamber  208 . The first chamber  206  includes a sealing layer  210  that is in the form of an innersole of footwear that a patient may wear. The perimeter of the first chamber  206  forms a seal with an adhesive strip  212 . In the present embodiment, the first chamber includes a dressing portion  214  that may contact any wounds (not shown) on the lower surface of the patient&#39;s foot. The second chamber  208  is in fluid communication with the first chamber  206  through a first valve  218 . The second chamber  208  is also in fluid communication with the surrounding environment through a second valve  228 . It is contemplated that the embodiment depicted in  FIG. 2  may include all or some of the characteristics and features of the treatment system  100  depicted in  FIG. 1 . 
     Still referring to  FIG. 2 , the treatment system  200  may be configured to cover and create a low pressure environment that is substantially the entire bottom of the foot of a patient. In some embodiments, the treatment system  200  may be sized to only provide NPWT to a portion of the patient&#39;s foot. Specifically, the area sealed may only be a heel portion of the foot or some portion of the bottom of the foot larger than just the heal portion but smaller that the entire bottom of the foot. 
     The operation of the treatment system  200  is similar to that of treatment system  100  as described above. After a seal is created, the patient would insert the foot into footwear that is configured to receive the treatment system  200 . Upon the commencement of walking, the second chamber  208  would be repeatedly compressed by the foot pressing down and create a low pressure environment within the first chamber  206 . One of the advantages of the treatment system  200  would be the ability to treat multiple DFUs on the bottom of a patient&#39;s foot while providing a high level of comfort along with ease of use to the patient. Treatment system  200  may be configured to work with any footwear that includes removable innersoles, thus allowing a patient to treat wounds on the bottom of the foot while still using footwear of their own choosing. 
     Now referring to  FIG. 3 , another schematic embodiment of a negative pressure wound treatment system  300  is depicted as configured to treat a wound away from the foot of a patient. The treatment system  300  may include all or some of the characteristics and features of the treatment systems  100 ,  200  depicted in  FIGS. 1 and 2 . Treatment system  300  includes a bandage portion  306  and a negative pressure portion  308 . The negative pressure portion  308  is in fluid communication with the bandage portion  306  through a first valve (not shown) and a flexible tube  320 . The negative pressure portion  308  is also in fluid communication with the surrounding environment through a second valve (not shown). It is contemplated that the operation of treatment system  300  is similar to the operations already described. The patient would place the bandage portion  306  over a wound located somewhere on the body, in  FIG. 3  it is depicted on a leg just below the knee. Then the negative pressure portion  308  would be placed under the foot. As the patient walks, the negative pressure portion  308  would be cyclically compressed, thus forming a low pressure environment under the bandage portion  306  and over the wound. It is contemplated that the flexible tube enables the bandage portion  306  to be placed anywhere on the body that a wound is located. 
     It is also contemplated that the negative pressure portion  308  may be configured in multiple ways. In some embodiments, the negative pressure portion may be configured to sit under a patient&#39;s foot within footwear of the patient&#39;s choosing. In other embodiments, the negative pressure portion  308  may be included in an innersole device or built into a footwear item. Further still, in other embodiments, the negative pressure portion  308  may be configured to be in fluid communication with multiple bandage portions  306 , wherein each bandage portion  306  is located over a different wound on a different location of the body. It is contemplated that the negative pressure portion  308  may be adhesively attached to the bottom of the patient&#39;s foot or a wrap may hold it in place such that the patient is not required to wear footwear during use. 
     Turning now to  FIG. 4 , another schematic embodiment of a negative pressure wound treatment system  400  is depicted in a configuration to fit under the bottom of the foot of a patient. The treatment system  400  includes a first chamber  406  and a second chamber  408 . The first chamber  406  includes a dressing portion  414  and a reservoir  416 . The first chamber  406  is in fluid communication with the second chamber  408  through a first valve  418  and a tube  420 . The second chamber  408  is in fluid communication with the surrounding environment through a second valve  428 . The treatment system  400  may include all or some of the characteristics and features of the treatment systems  100 ,  200 ,  300  depicted in  FIGS. 1-3 . The operation of the treatment system  400  is similar to the systems  100 ,  200 ,  300  described above. The first chamber  406  may be secured by adhesive to cover a wound on a portion of the patient&#39;s foot. The second chamber  408  may be placed under another portion of the patient&#39;s foot. Upon walking, the patient will cyclically actuate the second chamber  408  as described in the embodiments above to create a low pressure environment in the first chamber  406 . 
     With continued reference to  FIG. 4 , the treatment system  400  has the advantage of being a compact device that will easily fit in the footwear of the patient while providing NPWT to a wound on the bottom of a patient&#39;s foot. The first chamber  406  may be sized small enough to only cover an area slightly larger than a single wound. In some embodiments, the first chamber  406  may be sized to cover a larger area to provide treatment to several wounds at the same time. Further, the second chamber  408  may be placed under the portion of the foot to provide maximum comfort based on the individual preferences of the patient. 
     Turning now to  FIG. 5 , a schematic embodiment of a negative pressure wound treatment system  500  is depicted as a single device configured as a single bandage. The treatment system  500  includes a first chamber  506  and a second chamber  508 . The first chamber  506  includes a dressing portion  514  that is in contact with a wound and a reservoir  516 . The first chamber  506  is in fluid communication with the second chamber  508  through a first valve  518 . The second chamber  508  is in fluid communication with the surrounding environment through a second valve  528 . An outer cover  532  contains all of the components and aids the patient or healthcare provider in applying the treatment system  500  and helps retain the treatment system  500  to the patient&#39;s foot. The treatment system  500  may include all or some of the characteristics and features of the treatment systems  100 ,  200 ,  300 ,  400  depicted in  FIGS. 1-4 . The operation of the treatment system  500  is similar to the systems  100 ,  200 ,  300 ,  400  as described above. The patient attaches the treatment system  500  such that the first chamber  506  is over a wound and the dressing portion  514  is in contact with the wound. The first chamber  506  may be secured with adhesive and forms a seal around the wound. The outer cover  532  may also be secured with adhesive to retain the treatment system  500  in place similar to a self-adhesive bandage. As the patient walks, the second chamber  508  is cyclically compressed. It is contemplated that the treatment system  500  may be placed to treat a wound located anywhere on the foot such that the second chamber  508  is actuated appropriately during walking. While the treatment system  500  is depicted placed under the front part of the foot, other portions (e.g., the arch, the heal, a toe) would also be acceptable as long as the first chamber  506  can create a seal around the wound and the second chamber  508  is actuated by the walking motion of the patient. It is also contemplated that the treatment system  500  may be sized to treat different sized wounds on different parts of the foot depending on the size and severity of the wound. 
     Turning now to  FIG. 6 , a flow chart depicting a NPWT process  600  for utilizing any of the treatment systems  100 ,  200 ,  300 ,  400 ,  500  to treat a patient with a DFU. The process starts out with a DFU patient  610  that needs treatment. The healthcare provider must determine if the DFU patient  610  is eligible for treatment with the one of the treatment systems  100 ,  200 ,  300 ,  400 ,  500  by deciding in block  620  if the patient can walk and if the patient meets any and all other criteria. If the patient is not eligible the healthcare provider may suggest alternative treatment in block  630 . Should the healthcare provider determine the patient is eligible; the next step is to prescribe the treatment and device for X days in block  640 . At this time the healthcare provider may apply the treatment system selected to the wound or give the treatment system selected to the DFU patient  610  for application later. It is contemplated that X days could be any of the values or ranges previously mentioned including from a few hours to a few weeks. Next, the DFU patient  610  is examined by the healthcare provider in block  650 . The healthcare provide then must determine in block  660  if there are any unexpected complications. If there are complications, the healthcare provider may reevaluate the DFU patient in block  620  for eligibility to be treated with any of the treatment systems  100 ,  200 ,  300 ,  400 ,  500  and continue the process accordingly. If the healthcare provide does not identify any complications, a decision to continue treatment is made in block  670 . If the patient does not require further treatment, the treatment is ended in block  690 . However, if further treatment is required, the healthcare provider may replace the entire treatment system  100 ,  200 ,  300 ,  400 ,  500  or only a relevant portion in block  680 . The process then moves back to assigning the X length of time from treatment in block  640  and repeats as described above. 
       FIG. 7  depicts a flowchart of a NPWT process  700  similar to the process  600  except the treatment system  100 ,  200 ,  300 ,  400 ,  500  includes at least one sensor  150  and/or an external device  155 . The process  700  starts out with a DFU patient  710  that needs treatment. The healthcare provider must determine if the DFU patient  710  is eligible for treatment with the one of the treatment systems  100 ,  200 ,  300 ,  400 ,  500  by deciding in block  720  if the patient can walk and if the patient meets any and/or all other criteria. If the patient is not eligible, the healthcare provide may suggest alternative treatment in block  730 . Should the healthcare provider determine the patient is eligible; the next step is to apply appropriate treatment system and determine if the sensor  150  is showing that the DFU patient  710  is walking in block  732 . The process continues on to block  736  where the healthcare provider verifies that the sensor is measuring a low pressure from the walking action of the DFU patient. If during the process of blocks  732  and  736  the healthcare provide determines that the treatment system is not performing, the healthcare provider may change out the treatment system or reposition the treatment system. The process proceeds once it is determined that the treatment system is operating correctly to block  740  where the healthcare provider prescribes the treatment for X days. The next block  750  is the examination of the DFU patient  710  by the healthcare provider after the treatment time period X has elapsed. The healthcare provider then must determine in block  760  if there are any unexpected complications. If there are complications, the healthcare provider may move back in the process to block  720  to reevaluate the DFU for eligibility to be treated with any of the treatment systems  100 ,  200 ,  300 ,  400 ,  500  and continue the process accordingly. If the healthcare provide does not identify any complications, a decision to continue treatment is made in block  770 . If the patient does not require further treatment, the treatment is ended in block  790 . However, if further treatment is required, the healthcare provider may replace the entire treatment system or only a relevant portion in block  780 . The process then moves back to assigning the X length of time from treatment in block  740  and repeats as described above. 
     It is contemplated that one or more aspects of the treatment system  500  provide unique advantages to a patient. Walking while wearing the treatment system  500  is easy and comfortable because of the small size. Further, the ability to only treat a single wound as opposed to the entire foot or lower leg is a significant improvement over the prior art. Treatment system  500  requires no special footwear and is easily applied by the user over a wound. The comfort and quality of life improvements provided by a patient being able to easily treat a wound located on the bottom surface of a foot is a significant advantage that should lead to better and faster healing. 
     In a different embodiment, any of the systems described herein may be applied wherein no wound is present to locally induce or mimic the therapeutic effects of massage. 
     Any of the embodiments described herein may be modified to include any of the structures or methodologies disclosed in connection with different embodiments. Further, the present disclosure is not limited to negative pressure wound treatment systems of the type specifically shown. 
     A negative pressure wound treatment system is presented that provides negative pressure wound therapy to a wound. Thus, a user may experience the benefit provided of improved quality of life as the wound heals while the treatment system helps prevent infection and increases blood flow to the area of the wound. 
     In a different embodiment, a negative pressure treatment system is presented wherein a wound or ulcer is present or not, to treat conditions as seroma plantar fasciitis, foot pain including form circulatory problems, lymphedema and neurogenic origins as foot neuropathy. 
     Numerous modifications to the present invention will be apparent to those skilled in the art in view of the foregoing description. Accordingly, this description is to be construed as illustrative only and is presented for the purpose of enabling those skilled in the art to make and use the invention and to teach the best mode of carrying out same. The exclusive rights to all modifications which come within the scope of the appended claims are reserved.