Abstract: A scar reducing device for stretching skin having a closed wound therein is provided. The device is for reducing scar formation. The device comprises first and second fasteners removably attachable to skin regions located proximate to the wound. The device also comprises an extension mechanism cooperating with said first and second fasteners. The extension mechanism is movable between contracted and extended configurations. When the fasteners are affixed to the skin, the mechanism forces the first and second fasteners away from one another with a predetermined tensile force, stretching the skin proximate to the wound. Use of the device is also provided, along with a method for reducing scarring of a closed wound.

Abstract: The multipurpose medical wrap serves as a dressing, covering, splint holder, and/or various other emergency medical uses. The wrap includes a central pad having two layers of material defining a plurality of internal pockets therebetween for the insertion of various treatment packs and/or splints therein. The pad includes a relatively soft sheet to protect the area to which it is applied, and a relatively thin, non-insulating sheet that allows the pad to be reversed for use in applying hot and cold packs and the like. An end flap extends from each end of the central pad for additional protection and/or treatment. A plurality of laterally overlapping straps extends from each side of the central pad. Corresponding opposite straps are interwoven to secure the wrap to the body, some straps being used to form a sling and/or torso securing swath when the wrap is used as an arm treatment.

Abstract: A hemostatic device for promoting the clotting of blood includes a gauze substrate, a clay material disposed on the gauze substrate, and also a polyol such as glycerol or the like disposed on the gauze substrate to bind the clay material. When the device is used to treat a bleeding wound, at least a portion of the clay material comes into contact with blood emanating from the wound to cause the clotting. A bandage that can be applied to a bleeding wound to promote the clotting of blood includes a flexible substrate and a gauze substrate mounted thereon. The gauze substrate includes a clay material and a polyol. A hemostatic sponge also includes a gauze substrate and a dispersion of hemostatic material and a polyol on a first surface of the substrate.

Abstract: Devices, kits and methods described herein are provided for treatment to skin, including but not limited to wound healing, the treatment, amelioration, and/or prevention of scars or keloids. A book-like packaging, applicator and/or tensioning device can be used to apply a dressing to a subject.

Abstract: Devices, kits and methods described herein are provided for treatment to skin, including but not limited to wound healing, the treatment, amelioration, and/or prevention of scars or keloids. A book-like packaging, applicator and/or tensioning device can be used to apply a dressing to a subject.

Abstract: A composite wound dressing apparatus promotes healing of a wound via the use of a micropump system housed within a wound dressing member. The micropump system includes a miniature pump that applies a subatmospheric pressure to the wound to effectively draw wound fluid or exudate away from the wound bed without the need for an external vacuum source. Hence, the wound dressing and micropump system is portable which allows the patient mobility that is unavailable when an external vacuum source is used. The patient does not need to be constrained for any period of time while exudate is being removed from the wound.

Abstract: Devices, kits and methods described herein may be for treatment to skin, including but not limited to wound healing, the treatment, amelioration, and/or prevention of scars or keloids. An applicator and/or tensioning device may be used to apply a dressing to a subject. The applicator and/or tensioning device applies and/or maintains a strain in an elastic dressing, wherein at least some of the strain is out-of-plane or at a non-orthogonal, non-parallel and non-aligned orientation to other strains in the dressing.

Abstract: Disclosed herein are compression bandages that include one or more fluid bladders (such as an air bladder) disposed in or on a bandage, such as an elastic bandage. In various embodiments, the one or more bladders may be adapted to apply focused pressure to a wound site, for example where direct pressure is required in order to stop or slow bleeding. In various embodiments, such a fluid bladder may permit sufficient pressure to be applied where needed, while also preventing the over-application of pressure to other tissues in proximity to the wound.

Abstract: A reduced-pressure treatment system for treating a wound on a patient includes a composite manifold that may help prevent or minimize injury to a wound edge of the wound being treated with reduced pressure. The composite manifold includes a perimeter manifold member and an inboard manifold member. The perimeter manifold member is designed to not collapse substantially under reduced pressure in a therapy range. The perimeter manifold member may be more rigid with respect to compressibility than the inboard manifold member. A sealing member is used to form a fluid seal over the wound, and a reduced-pressure subsystem provides reduced pressure to the composite manifold. Other systems, methods, and dressings are presented.

Abstract: A wound treatment appliance is provided for treating all or a portion of a wound. In some embodiments, the appliance comprises an impermeable flexible overlay that covers all or a portion of the wound for purposes of applying a reduced pressure to the covered portion of the wound. In other embodiments, the wound treatment appliance also includes a vacuum system to supply reduced pressure to the wound in the area under the flexible overlay. In yet other embodiments, the wound treatment appliance also includes wound packing means to prevent overgrowth of the wound or to encourage growth of the wound tissue into an absorbable matrix comprising the wound packing means. In still other embodiments, the appliance may include a suction drain. In other embodiments, the appliance may include a collection chamber to collect and store exudate from the wound. In yet other embodiments, a suction bulb may be used to provide a source of reduced pressure to an impermeable overlay that covers all or a portion of the wound.

Abstract: A device for promoting the clotting of blood comprises a clay material in particle form and a receptacle for containing the clay material. At least a portion of the receptacle is defined by a mesh. Another device comprises a gauze substrate and a clay material disposed on the gauze substrate. Another device is a bandage comprising a substrate, a mesh mounted on the substrate, and particles of a clay material retained in the mesh. A hemostatic sponge comprises a substrate, a hemostatic material disposed on a first surface of the substrate, and a release agent disposed on a second surface of the substrate. The release agent is disposed on the wound-contacting surface of the substrate. When treating a bleeding wound, application of the hemostatic sponge causes at least a portion of the hemostatic material to come into contact with blood through the release agent and through the substrate.

Abstract: A device configured to apply a compressive force to a patient's skin at the site of a wound to assist in hemostasis. The device includes a footplate configured to adhere to the patient's skin, a receiving device positioned on the footplate, a plunger positioned within the receiving device and configured to move through both the receiving device and the footplate such that a downward force applied on the plunger toward the patient's skin results in the plunger moving through the receiving device and the footplate until the plunger contacts the patient's skin, and the plurality of motion restricting components interposed between the receiving device and the plunger, the plurality of motion restricting components configured such that as the plunger moves toward the skin movement of the plunger away from the skin is restricted until the restricting components are released.

Abstract: Auxetic fabric structures, of the sort which can be useful in conjunction with composite materials, and related methods of fabrication.

Abstract: A hemostatic device includes a flexible band adapted to be wrapped around a patient's limb at a site on the limb where bleeding is to be stopped, a portion for securing the band in a wrapped state to the limb, a curved plate which is made of a material more rigid than the band and at least a portion of which is curved toward the inner peripheral side thereof, a main balloon which is provided on the inner peripheral side of the curved plate and which inflates when a fluid is introduced therein, and a pressing member which is provided between the curved plate and the main balloon so that at least a portion thereof overlaps with the balloon and which is adapted for pressing against the balloon. The device provides an excellent hemostatic effect and prevents numbness and poor circulation in areas peripheral to the site of attachment.

Abstract: Devices and methods are disclosed for achieving hemostasis in traumatized patients. Such haemostatic packing devices and methods are especially useful in the emergency, trauma surgery or military setting. The patient may have received trauma to abdominal viscera, the thoracic cavity or the periphery. The devices utilize fluid impermeable outer surfaces and distributed pressure to achieve tamponade and hemostasis, primarily by exertion of pressure. The devices come in a variety of configurations including sheet, rolled sheet, folded sheet and polygonal solids including extruded shapes. The devices are capable of serving as carriers for thrombogenic or anti-pathogenic agents. The devices are flexible, bendable, and conformable in their wet or dry state so that they exert distributed pressure on the wound. The hemostatic packing devices may be placed and removed by open surgery or laparoscopic access without generating excessive re-bleeding, and may further comprise antimicrobial or thrombogenic regions.

Abstract: A wound closure system having first, second and third adhesive pads with a pair of strap members fixedly secured to the first and third adhesive pads. The pair of strap members are slidably received within the second adhesive pad. When the third adhesive pad is displaced, the first and second adhesive pads are displaced toward each other to close the wound.

Abstract: The invention provides an adhesive support article for supporting a body part of a user. A single-sided stretchable adhesive tape blank is precut into a sheet having a central anchoring portion and a plurality of outwardly extending fingers. The sheet is marked with visual indicators to guide the user of the support article for applying the central anchoring portion onto a first exterior surface of the body part and for stretching the fingers before adhering them at a predetermined distance away from the central anchoring portion. The adhesive support article can also be provided in a support system with at least one corresponding body landmark article, providing further guidance for applying the support article to the desired body part.

Abstract: Devices, kits and methods described herein may be for wound healing, including the treatment, amelioration, or prevention of scars and/or keloids by applying and/or maintaining a predetermined strain in an elastic skin treatment device that is then affixed to the skin surface using skin adhesives to transfer a generally planar force from the bandage to the skin surface. Applicators are used to apply and/or maintain the strains, and some of the applicators are further configured to provide at least some mechanical advantage to the user when exerting loads onto the skin treatment device.

Abstract: Devices, kits and methods described herein may be for wound healing, including the treatment, amelioration, or prevention of scars and/or keloids by applying and/or maintaining a pre-determined strain in an elastic skin treatment device that is then affixed to the skin surface using skin adhesives to transfer a generally planar force from the bandage to the skin surface. Applicators are used to apply and/or maintain the strains, and some of the applicators are further configured to provide at least some mechanical advantage to the user when exerting loads onto the skin treatment device.

Abstract: A dressing for covering a wound. The dressing including: a first component having a first shape with a first dimension; a second component releasably attached to a first surface of the first component to maintain the first component in a second shape different from the first shape, the second shape having a second dimension longer than the first dimension; and an adhesive disposed on a surface of the first component different from the first surface for attaching the first component to the wound such that the second component can be released from the first component to allow the first component to take the first shape to apply a pressure to portions of the skin surrounding the wound to close the wound. Wherein the first and second dimensions are a length in more than one direction.

Abstract: A limb wound treatment device is described having a first end, a second end and an interior therebetween for accommodating a treatment gas. The device can include a flexible housing that can be inflated or a rigid housing. The first end can include an inflatable cuff seal for hermetically sealing against the limb being treated. The second end can include a closed end or an access port that is releasably sealed with a clamping mechanism. Further, the device can include a controller that can inflate that housing, inflate the cuff seal and provide treatment gas to the interior, in response to pressures within the cuff seal and the housing. Further, the device can accommodate different types of wound treatments, such as hyperbaric therapy, compression therapy or negative pressure therapy.

Abstract: A first aid bandage includes bandaging material, a dressing pad and a bandaging element. The dressing pad is attached underneath the bandaging element. The bandaging material is attached to the bandaging element. The bandaging element has been rolled up so that there is a rolled-up portion and a straight portion in the bandaging element. The rolling has been done so that the rolled-up portion can be rolled up over the straight portion, whereby the bandaging element is put in a state of tension. There is an opening arrangement in the rolled-up portion of the bandaging element, in which opening arrangement there are guiding structures. The bandaging material is arranged to fit into the opening arrangement so that a part of the bandaging material is under the guiding structures.

Abstract: A pad of elastomeric material having a softness of no more than about durometer 30 Shore 00. The pad may carry adhesive for adhering the pad to a surface, either directly or indirectly through an envelope which surrounds the pad and carries the adhesive. Such a pad exhibits hemostatic and leak prevention properties against needle puncture holes in the skin or the wall of a hollow medical device. Particularly, hemostasis may be prevented with low pressure application of the pad to the skin. The pad may be previously applied to the skin of the patient or a wall of a medical device such as tubing or a solution bag, and the needle may then penetrate both the pad and the skin or medical device wall, to make a resealable puncture with leakage reduction and hemostasis when the needle is withdrawn.

Abstract: Devices, kits and methods described herein may be for wound healing, including the treatment, amelioration, or prevention of scars and/or keloids by applying and/or maintaining a pre-determined strain in an elastic skin treatment device that is then affixed to the skin surface using skin adhesives to transfer a generally planar force from the bandage to the skin surface. Applicators are used to apply and/or maintain the strains, and some of the applicators are further configured to provide at least some mechanical advantage to the user when exerting loads onto the skin treatment device.

Abstract: The invention provides wound dressings comprising an absorbent (porous) hydrogel composition comprising a foam portion which comprises a flexible plasticized hydrophilic polymer matrix having an internal cellular structure, and a continuous portion which comprises a flexible plasticized hydrophilic polymer matrix having relatively continuous internal structure. The continuous portion of the hydrogel composition includes apertures providing fluid flow communication through the continuous portion between an external surface of the continuous portion and the foam portion whereby the foam portion can take up external water or other fluid into the cellular structure through the apertures of the continuous portion. The continuous portion of the hydrogel composition may be tacky to the skin, allowing its use as a bioadhesive.

Abstract: A pad of elastomeric material having a softness of no more than about durometer 50 Shore 00. The pad may carry adhesive and/or a housing for adhering the pad to a surface, either directly or indirectly through an envelope which surrounds the pad and carries the adhesive. Such a pad exhibits hemostatic and leak prevention properties against needle puncture holes in the skin or the wall of a hollow medical device. Particularly, hemostasis may be prevented with low pressure application of the pad to the skin. The pad may be previously applied to the skin of the patient or a wall of a medical device such as tubing or a solution bag, and the needle may then penetrate both the pad and the skin or medical device wall, to make a resealable puncture with leakage reduction and hemostasis when the needle is withdrawn.

Abstract: A medical device for covered wound relief, comprising: an annular pressure member for separating a skin fold covering or overlapping a wound, and wherein the pressure member has at least one aperture extending therethrough for aeration of the wound.

Abstract: An apparatus for treatment of external hemorrhaging has a panel for applying pressure to an absorbent pad and a wound on a body part. The panel has a central portion located between first and second arms which extend outwardly and in transversely opposed directions from the central portion. The apparatus includes a strap which is attached to the first arm at or near a first strap end, and is releasably attachable to the second arm at an attachment region of the strap spaced apart from the first strap end. When the panel is strapped to the body part, the tension in the strap pulls on and elastically deforms the first and second arms of the panel inwardly toward the body part, and applies localized pressure to the pad and wound.

Abstract: A dressing for covering a wound in which the dressing includes: a first component having a first shape with a first dimension; a second component releasably attached to a first surface of the first component to maintain the first component in a second shape different from the first shape, the second shape having a second dimension longer than the first dimension; and an adhesive disposed on a surface of the first component different from the first surface for attaching the first component to the wound such that the second component can be released from the first component to allow the first component to take the first shape to apply a pressure to portions of the skin surrounding the wound to close the wound.

Abstract: An adhesive bandage is provided with a support cup having an annular marking formed on a periphery of an outer surface; a circular cushion member fitted in the support cup; a sliding cup; a sliding disc in the sliding cup and engaged the cushion member, the sliding disc being capable of sliding into the support cup; and a resilient main body including a transparent dome for concealing the sliding cup, the cushion member, the sliding disc, and the support cup, a first adhesive strip extending from a periphery of the dome; a second adhesive strip, opposite the first adhesive strip, extending from the periphery of the dome; a hook and loop fabric fastener on ends of the first and second adhesive strips.

Abstract: Scar formation is inhibited by simultaneously applying a vertical force and a lateral compression to the wound site during the healing process. Apparatus for applying such simultaneous forces comprise a backing and a tissue displacement device. The backing holds the tissue displacement device over the wound. The tissue displacement device may be expanded to both apply the vertical force against the wound and to draw the backing radially or laterally inward to apply the desired compression forces to the wound.

Abstract: A dressing for covering a wound. The dressing including: a first component having a first shape; a second component releasably attached to a first surface of the first component to maintain the first component in a second shape different from the first shape; and an adhesive disposed on a surface of the first component different from the first surface for attaching the first component to the wound such that the second component can be released from the first component to allow the first component to take the first shape to apply a pressure to portions of the skin surrounding the wound to close the wound; wherein the second component is a mechanical device.

Abstract: An energy delivery system for controlling blood loss is provided. The system includes an energy-activated patch configured for placement on tissue. The patch includes an energy-delivering layer configured to deliver energy to the tissue. The system also includes an energy source in operative engagement with the energy-activated patch for energizing the energy-delivering layer.

Abstract: A pad of elastomeric material having a softness of typically no more than about durometer 50 Shore 00. The pad may carry adhesive and/or a housing for adhering the pad to a surface, either manually, or by adhesive tape, or another strap. Such a pad exhibits hemostatic and leak prevention properties against needle puncture holes in the skin or the wall of a hollow medical device. Particularly, hemostasis may be prevented with low pressure application of the pad to the skin. The pad may be previously applied to the skin of the patient or a wall of a medical device such as tubing or a solution bag, and the needle may then penetrate both the pad and the skin or medical device wall, to make a resealable puncture with leakage reduction and hemostasis when the needle is withdrawn.

Abstract: The invention relates to medical devices, in particular body support bandages and orthoses, for the human or animal body having at least one element, which generates or provides supporting force, compression or introduction of pressure, and which comprises or consists of shape memory material.

Abstract: An apparatus for promoting the clotting of blood and controlling bleeding comprises a receptacle for retaining blood clotting material in particulate form therein. A pad for controlling bleeding comprises a mesh structure and a support attached to the mesh structure to facilitate the application of pressure to the pad and the wound. A bandage applicable to a bleeding wound comprises a mesh structure and a flexible substrate attached to the mesh structure, the substrate being a cloth or plastic member that may be adhesively attachable to cover a wound. In any embodiment, at least a portion of the receptacle or mesh structure is defined by a mesh having openings therein, and at least a portion of the particulate blood clotting material is in direct contact with blood. The mesh may include a zeolite powder impregnated or otherwise incorporated therein.

Abstract: A method for closing a puncture wound on skin. The method including: adhering a first surface of a first member having an unrestrained shape to the skin and over the puncture; and subsequent to the adhering, removing a second member for restraining the first member in a restrained shape from the first member. Where at least a normal force is applied to the puncture wound due to the removal of the second member from the first member which causes the first member to change towards the unrestrained shape. The removing can further cause a force substantially perpendicular to the normal force which tends to close the puncture wound.

Abstract: This invention discloses a therapeutic post-injury pressure glove and a method to produce the same. The pressure glove is configured to apply pressure onto a plurality of pressure-receiving regions of an injured hand such that each pressure-receiving region receives a pressure within an upper bound and a lower bound determined therefor. In one embodiment, the pressure glove comprises a plurality of custom pressure-applying fabric portions each of which is configured to direct a pressure onto one of the pressure-receiving regions. A suitable fabric specific for each fabric portion is selected so that adequate pressure is provided on a wounded area while maintaining a low pressure on an intact part of the hand. The pressure glove is fabricated with a size less than the hand's size by a reduction factor. The reduction factor and the set of selected fabrics are determined via obtaining a computed pressure distribution.

Abstract: A method of closing a wound with a dressing. The method including: restraining at least a portion of the dressing corresponding to the wound into a first shape; adhering first and second portions of the dressing across the wound; removing the restraint from the dressing while the first and second portions are adhered to the skin by removing a member from the dressing to allow at least the portion to move towards a second shape and apply a force tending to close the wound.

Abstract: A hemostatic device includes a flexible band adapted to be wrapped around a patient's limb at a site on the limb where bleeding is to be stopped, a portion for securing the band in a wrapped state to the limb, a curved plate which is made of a material more rigid than the band and at least a portion of which is curved toward the inner peripheral side thereof, a main balloon which is provided on the inner peripheral side of the curved plate and which inflates when a fluid is introduced therein, and a pressing member which is provided between the curved plate and the main balloon so that at least a portion thereof overlaps with the balloon and which is adapted for pressing against the balloon. The device provides an excellent hemostatic effect and prevents numbness and poor circulation in areas peripheral to the site of attachment.

Abstract: The invention provides a wound dressing or therapy compress (100) containing a fill material (108) permanently loaded with an antimicrobial silver. The dressing or compress comprises a flexible upper backing (104) and a lower shell (102) fastened to one another, and each of which comprises a synthetic fabric. The lower shell is fluid-permeable and is adapted to be placed in direct or covered contact with a wound or tissue to be treated. The backing may be either fluid permeable or non-permeable, as desired, to allow for the release or retention of moisture. The shell and backing are joined to one another to form a plurality of fill material enclosures (106) therebetween, each such fill material enclosure containing a zeolite fill material which is permanently loaded with antimicrobial silver. The presence of the silver within the fill material promotes a germ and microbial free environment approximate the shell and within the dressing or compress.

Abstract: A bandage for applying to a human or animal body, includes a two-dimensional tape material as base structure with a longitudinal extent, made of a textile material with a first side and a second side, wherein a cushion layer is provided on one of the two sides, at least over part of the longitudinal extent of the base structure, wherein the cushion layer is composed of threads and/or fibers which are part of the textile base structure, i.e. which are introduced into and/or drawn out of the textile base structure.

Abstract: An apparatus for promoting the clotting of blood and controlling bleeding comprises a receptacle for retaining molecular sieve material in particulate form therein. A pad for controlling bleeding comprises a mesh structure and a rigid or semi-rigid support attached to the mesh structure to facilitate the application of pressure to the pad and the wound. A bandage applicable to a bleeding wound comprises a mesh structure and a flexible substrate attached to the mesh structure, the substrate being a cloth or plastic member that may be adhesively attached to cover a wound. In any embodiment, at least a portion of the receptacle or mesh structure is defined by a mesh having openings therein, and at least a portion of the particulate molecular sieve material is in direct contact with blood.

Abstract: The invention relates to a variable tension chest support for use by patients having undergone thoracic surgery. The chest support may be worn directly on the skin of a patient and comprises a band of stretchable material and one or more grips which are wholly or partially concealed within pockets with which the patient may alter the tension of the chest encircling band. The device allows a patient to modify the level of tension applied to the chest, thus managing the recovery process, while providing a basic level of support at all times the support is in use.

Abstract: High-pressure bleeding wounds (and other bleeding wounds) may be treated by applying direct pressure directly in the bleeding wound, such as by applying a back pressure in a confined space around and in the wound. Certain substances and articles may be inserted into the wound, and the wound may be enclosed with that substance or article (such as a hemostatic substance, which may be polymeric), by swelling on contact with molecules (such as water molecules in the blood) encountered in the wound, generates the desired pressure to stop or at least reduce the bleeding without the detrimental effects of a tourniquet. Clot-inducing substances may be introduced into the wound contemporaneously with direct pressure application directly in the wound. Compressible and non-compressible wounds are treated. Treatment stops bleeding without producing pressure injury or ischemic damage. Medical devices using this technology are provided, including removable, biodegradable, medic-administrable devices.

Abstract: The methods, procedures, kits, and devices described herein assist with the healing process of tissue that was previously or simultaneously treated for a therapeutic or cosmetic effect. The methods, procedures, kits, and devices described herein can also provide temporary simulated results of a cosmetic procedure to allow for visual assessment to select the type of procedure or for treatment planning in advance of the surgical procedure.

Abstract: A hemostatic device includes a flexible band adapted to be wrapped around a patient's limb at a site on the limb where bleeding is to be stopped, a portion for securing the band in a wrapped state to the limb, a curved plate which is made of a material more rigid than the band and at least a portion of which is curved toward the inner peripheral side thereof, a main balloon which is provided on the inner peripheral side of the curved plate and which inflates when a fluid is introduced therein, and a pressing member which is provided between the curved plate and the main balloon so that at least a portion thereof overlaps with the balloon and which is adapted for pressing against the balloon. The device provides an excellent hemostatic effect and prevents numbness and poor circulation in areas peripheral to the site of attachment.

Abstract: A wound dressing comprising a sealed enclosure having at least one compartment; a plurality of spaced apart pillar-like structures positioned within the at least one compartment; and means for evacuating air from the at least one compartment, wherein the evacuation of air from the at least one compartment causes a reduction in the distance between at least two of the pillar-like structures.

Abstract: A method to stop bleeding at a puncture site of an artery on a wrist of a patient comprises wrapping a flexible band of a hemostatic device around the wrist of the patient, wherein the hemostatic device also includes a curved plate, a balloon and a marker used to position the balloon at the puncture site, and wherein the flexible band, the curved plate and the balloon are substantially transparent. The wrapping of the flexible band around the wrist of the patient involves wrapping the flexible band around the wrist of the patient while the balloon is in an uninflated state. The wrapping can also take place while an introducer sheath is in place at the puncture site. The method also involves using the marker to position balloon relative to the puncture site such that the balloon overlies the puncture site, introducing a fluid into the balloon and inflating the balloon, and maintaining inflation of the balloon and compression against the puncture site.

Abstract: Reduced-pressure medical dressings, systems, and methods involve a dressing with a first barrier layer that desolidifies when exposed to a fluid—typically a liquid—to form a treatment aperture in the first barrier that is used to deliver reduced pressure to a tissue site. The first barrier layer is formed from a desolidifying material. The system includes a drape covering a second surface of a manifold and a portion of the patient's epidermis to provide a substantially sealed space containing a manifold and the first barrier layer. Other systems, dressings, and methods are also disclosed.