Opinion ID: 806478
Heading Depth: 4
Heading Rank: 7

Heading: “Caulk” the tube exit site with a small amount

Text: of Stomahesive Paste where the film dressing is 2 A “fistula” is generally considered to be a hole in an organ. Kinetic Concepts, Inc. v. Blue Sky Med. Grp., Inc., 554 F.3d 1010, 1016 (Fed. Cir. 2009). KINETIC CONCEPTS v. SMITH & NEPHEW 12 crimped around the tube. This ensures air-tight closure. 8. Reinforce this site with waterproof “pink tape” as illustrated. 9. Turn your attention now to the connection of the Jackson-Pratt to continuous suction. (Do not attempt to use the bulb of the Jackson-Pratt sys- tem.) With some brands of canister and tubing, all that is necessary is to cut the funnel end off the tubing and the small J-P tubing will fit snugly into the larger lumen tube. The junction should be taped securely with pink tape. Otherwise you may use small “Christmas tree” connector or can- nibalize IV tubing to get a small plastic adapter to connect the tubing. 10. Turn on continuous suction to the upper range of the low setting (approximately 60 to 80 mmHg) and observe the wound site. The dressing should contract noticeably. If it does not, the system is not closed and wound drainage will not be effi- ciently removed. When this occurs, fistula drainage will accumulate, causing skin damage and leakage outside of the dressing. Another indica- tion that you have not obtained a closed suction system is a whistling sound indicating that the dressing is not air-tight. J.A. 10052 (footnote added). Chariker-Jeter II explains that “[o]ur clinical observations suggest that fistula effluent does inhibit wound healing. . . . By minimizing the inflammatory response [associated with the presence of effluent], fibroplasia is reduced. This, we believe, encourages rapid wound contraction and re- epithelialization.” J.A. 10055. Finally, with respect to the Chariker-Jeter public use, Dr. Chariker testified that he treated Mr. Aderholt in 13 KINETIC CONCEPTS v. SMITH & NEPHEW 1989 with his closed suction wound drainage system. “[Mr. Aderholt] was injured with a log chain that flew off another truck into his truck, entered his chest, his abdomen, ruptured his lung, his [diaphragm], his pancreas, his spleen, his stomach.” J.A. 22032:8–11. With the aid of pictures of Mr. Aderholt’s treatment, Dr. Chariker stated that his treatment was an example of the drainage system facilitating the healing of a wound on a patient without a fistula. J.A. 22035:6–38:11.