Miller Digivac Toe (MDT) and
Miller Digivac Finger (MDF) Chambers
At present, no NPWT dressing is truly designated or designed to address injuries to the fingers and toes. Current therapies consist of either a mass of open cell foam encasing the digit and then enveloped in the sealing film with a drain tube protruding or modifying a silicone drain and gauze complex to “envelope” the finger. Recognizing the extreme sensitivity of terminal digits such as fingers and toes, these methods are potentially exquisitely painful, and cumbersome to apply and remove. Additionally, the sheer bulk of the dressing complex virtually precludes any useful function of the affected hand. Current treatments include using a “splint” to stabilize the injured digit itself or to an adjacent digit. The associated dressings are bulky, difficult to apply and remove with the process of both actions usually quite painful. Recognizing that the benefits of NPWT translate well to tissue injuries in all locations, the application of NPWT to tissue injuries of the toes and fingers is a natural progression. Typical injuries for use would include tissue avulsions, postoperative treatment, burns, lacerations, etc.
The requirements for an NPWT device that is amenable to these problems would require the following characteristics:
There are differences between the MDT and MDF. The MDT is shorter and wider than the MDF. However, recognizing that the toes are thin and their position between the other toes precludes the use of a wide device, the smaller MDF device would be more suitable. As such, there will be at least 2 modifications for the fingers (wider for the thumb and a narrower form for the other fingers and toes excluding the great toe).
The MDT is wider and shorter to better fit the great toes and the thumbs.
The walls of the MDT and MDF are of a rigid material which will allow for slightly greater pressures to be used during NPT. The entry of the digit into the chamber is accomplished by inserting the digit through an elastic cover with a small, elastic distensible membrane with a centrally placed hole. This assures a complete seal of the chamber without compromise of the digital circulation. The Gasket can be easily modified by enlarging the hole by simply and sharply removing a small piece of the membrane to assure a good seal without discomfort.
Instructions for applying the Miller Digivac-T Drain
Instructions are available as PDF files. You will need Adobe Reader or another PDF viewer to view them.
Instructions for applying the Miller Digivac-F Drain
Instructions are available as PDF files. You will need Adobe Reader or another PDF viewer to view them.