Abstract: The particle therapy system includes a particle beam generator for generating a particle beam; an irradiation nozzle arranged in a treatment room and irradiating a target with the particle beam; a particle beam transport system communicating the particle beam generator with the irradiation nozzle; an X-ray imaging device arranged in the treatment room and imaging the position of the target through irradiation with X-rays; a dosimeter arranged at a position passed by the particle beam in the irradiation nozzle; and a control apparatus performing control to exclude the measurement result of the X-rays from the measurement result obtained using the dosimeter when the X-rays are emitted during treatment.

Abstract: A nuclear medicine (NM) multi-head imaging system is provided that includes a gantry, plural detector units, and at least one processor. The gantry defines a bore configured to accept an object to be imaged. The plural detector units are mounted to the gantry. Each detector unit defines a corresponding view oriented toward a center of the bore, and is configured to acquire imaging information over a sweep range. The at least one processor is configured to dynamically determine at least one boundary of an acquisition range corresponding to an uptake value of the object to be imaged for at least one of the detector units. The acquisition range is smaller than sweep range. The at least one processor is also configured to control the at least one detector unit to acquire imaging information over the acquisition range.

Abstract: Disclosed herein is an X-ray imaging system, comprising: a first X-ray source; an image sensor, spaced apart from the first X-ray source; a table configured to be positioned between the first X-ray source and the image sensor and configured to accommodate a person for imaging in the X-ray imaging system; and a fiducial marker system; wherein the fiducial marker system comprises three markers, centers of the three markers not being collinear; wherein at least one of the three markers is distinct. The X-ray imaging system may be used to model the 3D shape and track the 3D motion of an object (e.g., a surgical instrument) in the person.

Abstract: An ultrasound diagnosis apparatus includes: a transmitting and receiving unit that transmits and receives an ultrasound wave to and from a subject; a first image data generating unit that generates first image data based on a first parameter, from a reception signal received by the transmitting and receiving unit; a second image data generating unit that generates second image data having an image taking region of which at least a part overlaps with that of the first image data and being based on a second parameter that is different from the first parameter, from a reception signal received by the transmitting and receiving unit; and an image processing unit that calculates a feature amount from at least such a part of the second image data that overlaps with the first image data and corrects the overlapping part of the first image data on a basis of the calculated feature amount.

Abstract: An ultrasonic imaging device selectively obtains an accurate image of a target part inside an object or an image of a wide part inside the object through an ultrasonic probe by operating a focus adjustment unit. The ultrasonic imaging device includes an ultrasonic probe the front of which is equipped with a probe lens, and a focus adjustment unit mounted to the ultrasonic probe so as to selectively defocus the probe lens. The focus adjustment unit includes a focus adjustment portion arranged in the front of the probe lens, and a pressing portion connected to the focus adjustment portion so as to vary a curvature of the focus adjustment portion by external force.

Abstract: An ultrasonic probe includes, a transducer transmitting and receiving ultrasonic waves, and converting ultrasonic signals into voltage signals and vice versa, a first circuit configured to transmit pulse voltage signals to the transducer and receive the voltage signals from the transducer, a second circuit configured to convert the voltage signals received from the first circuit into digital values from analog values, a battery unit configured to supply electric power to the first circuit and the second circuit, and a substrate being provided with the transducer, the first circuit and the second circuit, the first circuit being disposed on a first surface of the substrate, and the second circuit being disposed on a second surface opposite to the first surface of the substrate.

Abstract: An ultrasonic diagnosis apparatus is provided. The ultrasonic diagnosis apparatus includes an ultrasonic probe configured to transmit ultrasonic push pulses to a biological tissue of a test object and further configured to transmit measuring ultrasonic pulses to the biological tissue subjected to the transmitted push pulses in order to measure an elasticity of the biological tissue, a respiration detection part configured to detect respiration of the test object, and a notification part which, based on the detection by the respiration detection part, is configured to give notification allowing a transmission timing of the push pulses to be recognized.

Abstract: A method and system for analyzing stiffness in a volume of tissue, the method including: emitting acoustic waveforms toward the volume of tissue with an array of ultrasound transmitters; detecting, with an array of ultrasound receivers, a set of acoustic signals derived from acoustic waveforms transmitted through the volume of tissue; generating, from the set of acoustic signals, a sound speed map and an acoustic attenuation map of a region of the volume of tissue, generating a stiffness map derived from combination of a set of sound speed parameter values of the sound speed map and a corresponding set of acoustic attenuation parameter values of the acoustic attenuation map, the stiffness map representing the distribution of the stiffness parameter across the region; and at a display in communication with the computer processor, rendering a stiffness image of the volume of tissue, based upon the stiffness map.

Abstract: An ultrasonic signal processing method includes: acquiring pieces of element data output from each element included in an ultrasonic probe including multiple elements configured to transmit an ultrasonic wave to a subject, receive an ultrasonic wave reflected by the subject and output an ultrasonic detection signal; determining element data to be preserved, according to depth information on a reception echo at an acquisition time of the element data, among the pieces of element data of each of the acquired elements; and preserving the element data determined to be preserved.

Abstract: In this ultrasound diagnostic device and ultrasound diagnostic image data processing method, an element data determination unit compares a pre-set threshold value with the average value of the amplitude values in the element direction of the element data calculated by an average value calculation unit in the element direction, and an RF data calculation unit performs a process in which the element data of which the absolute value of the amplitude value is the maximum is adopted as the RF data without phasing addition when the average value (Aa) is greater than the threshold value. Meanwhile, when the average value (Ab) is equal to or lower than the threshold value, the RF data calculation unit performs a process in which the average values of all the amplitude values in the element direction of the element data are adopted as the RF data without phasing addition.

Abstract: A method for eliminating background noises in shear waves and the respective ultrasonic imaging system, the method includes: transmitting a push pulse along a push pulse vector; transmitting a first group of focus track pulses at a first group of a plurality of locations far away from the push pulse vector; receiving a first group of focus echo signals in response to the first group of focus track pulses; and processing the first group of focus echo signals to determine a first group of tissue displacement information varying with time.

Abstract: The present invention provides a skin surface sampling device in which a supply tube and a recovery tube are housed in an elongated hand-holdable tubular sleeve, the sleeve having upper and lower ends positioned along a longitudinal axis and the lower end being provided with a sampling head; in which: the supply tube is adapted to convey liquid from a liquid source to the sampling head; the recovery tube is adapted to convey liquid from the sampling head to a liquid collection vessel; the sampling head has a planar surface adapted for application to the surface of the skin to form a contact therewith during sampling; the planar surface has a liquid entry port adapted for liquid communication with the supply tube and a liquid exit port adapted for liquid communication with the recovery tube; and characterized in that: the liquid entry port and the liquid exit port are connected via a guide channel which is adapted to guide liquid from the liquid entry port, along the surface of the skin for the elution of mate

Abstract: The invention relates to a biopsy device comprising a needle extending longitudinally from a proximal end to a distal end and including a channel extending there through. At least one section (6) of the needle (3) is provided with a curved shape, so that tissues that normally would be out or reach of conventional needles can be targeted.

Abstract: A biopsy device includes an elongate member and a tissue anchor. The elongate member has a lumen and a sample receiving notch. The sample receiving notch has a proximal end wall, a distal end wall, and a floor between the proximal end wall and the distal end wall. The proximal end wall has a vacuum hole in fluid communication with the lumen. The tissue anchor has a plurality of cantilever portions. Each cantilever portion of the plurality of cantilever portions has a curved end, with a tip of the curved end configured to extend toward the floor of the sample receiving notch.

Abstract: A biopsy device includes a tubular member, a hollow shaft and an elongated fiber body having at least one optical fiber. The hollow shaft has a laterally (sidewardly) facing notch in its distal portion. The tubular member is movable relative to the shaft, between a first position in which the notch is covered by the tubular member, and a second position in which the notch is not covered by the tubular member. The shaft is movable between a first position in which the distal end of the optical fiber is located at the distal end of the shaft with the elongated fiber body extending through the notch, and a second position in which the distal end of the at least one optical fiber is located proximally to the notch.

Abstract: A tool for deploying an anchor sleeve onto an implantable device includes handle and base members, which may be fitted together by an operator. The operator may select the handle member from a plurality thereof included in a kit; and the base member, also included in the kit, includes a rail segment with which a gripping portion of the selected handle member may be engaged, for example, via guidance from a marked portion of the base member. Once engaged, a deployment tip of the base member is located to move a mounted anchor sleeve from a tubular member of the handle member and onto a body of the device. The tubular member of some tools has a laterally offset distal end portion, on which the corresponding anchor sleeve is mounted; thus, kits including this type of handle member, may include a converter for the base member to facilitate engagement therewith.

Abstract: A device for fracturing calcifications in heart valves characterized by a stabilizer assembly and an impactor assembly assembled on and deployed by a delivery system, wherein said delivery system is operable to cause relative motion between said impactor assembly and said stabilizer assembly with sufficient energy so as to fracture a calcification located in tissue which is sandwiched between said stabilizer assembly and said impactor assembly, wherein said impactor assembly and said stabilizer assembly have shaped impact delivery portions of which the footprint on the valve leaflets is shaped in accordance with a shape of desired fracture sites.

Abstract: In a surgical tool, the treatment tool piece operating joint includes a first operating rotation member which is coupled to the moving member and is rotated around a predetermined rotation center; a second operating rotation member which is coupled to the first operating rotation member so as to relatively rotate around a rotation center coaxial with the second bending rotary shaft in a rotation direction opposite to a rotation direction of the first operating rotation member or around a rotation center that is a position closer to the first bending rotary shaft than the second bending rotary shaft in a rotation direction opposite to a rotation direction of the first operating rotation member; and a link which converts a rotational force of the second operating rotation member into the operation of the treatment tool piece.

Abstract: A surgical device for use in combination with a percutaneous elongate shaft defining a longitudinal axis. The shaft comprises a distal end and a proximal end, the distal end comprising an attachment mechanism. A surgical end effector is selectively attachable in vivo and detachable in vivo to the attachment mechanism of the percutaneous elongate shaft. A percutaneous elongate loader comprises an articulating distal end. The distal end comprises a tube with an opening at the distal tip, the tube being dimensioned to receive the surgical end effector. The distal end further comprises an engagement feature capable of frictionally holding the surgical end effector in the tube during in vivo attachment to and in vivo detachment from the percutaneous elongate shaft.

Abstract: Methods and devices for providing improved ultrasound visibility of medical devices intended for intravascular use are described. The inclusion of gas/solid boundary regions within a medical devices improves the resolution of the device under ultrasound visualization. Gas/solid boundary regions may be provided through the use of embedded gas-filled microlumens, microwells, or enclosed pockets within the medical device.

Abstract: A left atrial appendage occlusion device includes a deformable wire having a proximal portion and a distal portion, wherein the deformable wire is configured to form a first predetermined expanded shape and a second predetermined relaxed shape; a distal anchor that includes a plurality of hooks or barbs extending from a point at an overall distal end of the deformable wire, the distal anchor being configured to attach the device to an interior wall of the left atrial appendage; and a sheet attached to the proximal portion of the deformable wire.

Abstract: The present invention provides, in certain aspects, medical devices deliverable into passageways and other open spaces in the body. In one embodiment, the invention provides a fistula plug for delivery into a fistula tract. This fistula plug includes an elongate plug body, and a removable core material that is received in the plug body and effective to increase the column strength of the plug body. The plug body may be formed with one or more of a variety of biocompatible materials including some that are naturally derived and some that are non-naturally derived. The present invention also provides apparatuses and methods for delivering these and other medical devices into the body. One such apparatus includes a fistula plug having a plug body, and a removable delivery device received in the plug body, wherein the delivery device is effective to deliver the plug body into a fistula tract when advanced therethrough.

Abstract: A method of preventing ingress of material into the left atrium of a heart includes providing a delivery sheath, advancing the sheath distal end through an opening between the right atrium and the left atrium of the heart, providing an expandable cage, delivering the expandable cage to the left atrium, and expanding the expandable cage within the left atrium. The expandable cage includes a proximal end, a distal end, and a plurality of supports extending therebetween. The expandable cage also includes a first membrane provided at its proximal end and a second membrane provided at its distal end. The expandable cage has a collapsed configuration so that it can be received within the lumen of the delivery sheath, and an expanded configuration for deployment within the heart. When expanded, the first membrane is positioned at an opening between the left and right atria of the heart, and the second membrane is positioned at the ostium of the left atrial appendage.

Abstract: The present invention provides a retraction device for retraction of an organ within the abdominal cavity, comprising: a. at least one first anchoring means reversibly attached to a first anchoring point within said abdominal cavity; b. at least one second anchoring means reversibly attached to a second anchoring point within said abdominal cavity; and, c. at least one supporting member, defining a predetermined geometrical structure, interconnecting said first anchoring means and said second anchoring means, at least partially support said organ; wherein said at least one supporting member is characterized by a substantially rigid structure, such that said at least one supporting member is substantially not deformed in any direction outside the plane defining said supporting member when a mechanical force is applied, by said organ, on said rigid structure of said supporting member when said organ is retracted via said retraction device.

Abstract: A clip is provided for managing access through tissue. The clip is placed around an opening in tissue, although the opening may alternatively be formed after the clip is deployed. The clip can expand when medical devices are introduced through the clip and through the opening. When the medical devices are removed, the clip closed automatically to substantially close the opening.

Abstract: Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues, organs, anatomical structures, grafts or other structures within the body of human or animal subjects for the purpose of treating a diseases or disorders and/or for cosmetic or reconstructive purposes and/or for research and development purposes or other purposes.

Abstract: Methods are disclosed for attaching a suture to a bone. One exemplary method includes passing a portion of a suture through a bone so that a first portion of the suture extends from a first opening in the bone and a second portion of the suture extends from a second opening in the bone, passing the second portion of the suture through a portion of a suture anchor body in a proximal to distal direction, the suture anchor body having a proximal end and a distal end, passing the second portion of the suture alongside an outer surface of the suture anchor body in a distal to proximal direction, and then inserting the suture anchor into the bone through one of the first and second openings, the distal end being inserted first through the opening.

Abstract: A method for closing a tissue puncture, where the method includes tensioning a suture loop disposed within a vascular tissue of a patient, the suture loop having two free ends and a knot disposed on one of the free end. Those two free ends are disposed through a suture snare comprising a snare. Following detachment of the suture snare from the two free ends, the knot is advanced to close the suture loop and a cutting member is advance towards the knot and the two free ends are cut.

Abstract: Knot pushers and suture cutter apparatuses to be used arthroscopically, for example, in an arthroscopic knee surgery may be operated with a single control to both lock the suture within the distal end of the apparatus and cut the suture once the knot has been pushed to the appropriate location. The apparatus may include a safety lock preventing deployment of the cutter until the safety lock (e.g., cutter release) has been released.

Abstract: Devices are provided for a suturing device used during laparoscopic surgical procedures. A suturing needle includes a shaft forming a rod axis; a curved body having a piercing tip at a first end and a base at a second end; and an arm extending radially from the shaft to the base of the curved body such that the curved body is positioned in a plane orthogonal to the rod axis of the shaft and rotatable about the shaft in the plane orthogonal to the rod axis. The suturing device includes a housing, a suturing needle, one or more sutures, a suture magazine configured to hold the one or more sutures, and a drive system, whereby the drive system may actuate the suturing needle to rotate in the plane orthogonal to the drive system, allowing the suturing needle to drive in to and out of tissue to apply a suture.

Abstract: A wound closure device includes outer and inner members. The inner member is configured for receipt of a suture passer and is pivotably coupled to the outer member. The inner member is pivotable relative to the outer member between a first position, wherein the inner member is coaxially disposed relative to the outer member, a second position, wherein the distal end of the inner member extends outwardly from the outer member in a first direction and the proximal end of the inner member extends outwardly from the outer member in a second, opposite direction, and a third position, wherein the distal end of the inner member extends outwardly from the outer member in the second direction and the proximal end of the inner member extends outwardly from the outer member in the first direction.

Abstract: A suturing assembly including a first puncture element including a sharp distal end for puncturing tissue, a second puncture element including a sharp distal end for puncturing tissue, the distal ends of the first and second puncture elements being spaced from each other by a gap, and a spacer arranged for sliding distally and proximally on at least one of the first and second puncture elements.

Abstract: A medical tube is disclosed, which can include a main body in which a distal portion of a tubular proximal separable piece is detachably connected to a proximal portion of a tubular distal separable piece; and a state maintaining mechanism for maintaining a connected state of the distal separable piece and the proximal separable piece. In addition, the main body is inserted into a body starting from the distal separable piece side, and is disposed inside the body in a state in which a distal end and a proximal end thereof are exposed outside of the body. In addition, the state maintaining mechanism can include a string which is disposed inside the main body and interlocks the distal separable piece and the proximal separable piece, and the connected state can be released by cutting the string.

Abstract: A method for bunion repair using a suture passing K-wire configured to easily pass through bone tunnels with suture trailing. The suture passing K-wire includes a tapered guide pin with a multi-diameter shaft (i.e., comprising at least two regions or sections that have different diameters) and a loop which is securely attached to an end of the guide pin (i.e., to the smaller diameter section of the guide pin). The reconstruction system may be formed of a pair of buttons connected by a flexible strand. The procedure offers indirect placement of buttons and a minimally invasive approach.

Abstract: A tissue-fastening tool indwelling device includes: a sheath; a needle tube having a needle tip and disposed to be retractable from a distal end of a lumen of the sheath; a tissue-fastening tool having a restoring force to a curved shape with distal and proximal end side regions and disposed inside the needle tube in a stretched state; and a stylet coupled to a proximal end portion of the tissue-fastening tool in the needle tube. The stylet has a first state in which the stylet is advanced straight with respect to the needle tube and the sheath until the entire distal end side region of the tissue-fastening tool protrudes from the needle tube, and a second state in which the stylet is advanced while being rotated until a proximal end of the proximal end side region of the tissue-fastening tool protrudes from the needle tube.

Abstract: A method for closing a wound in tissue is provided which includes providing a surgical fastener having a plurality of reactive members of a specific binding pair attached on a surface of the surgical fastener, and providing tissue with a plurality of complementary reactive members of the specific binding pair, wherein upon contact of the reactive members on the surface of the surgical fastener with the complimentary reactive members on the tissue, covalent bonds are formed between the reactive members and the complementary reactive members, thus adhering the device to the tissue.

Abstract: A surgical fastener applying apparatus includes an end effector assembly having an anvil assembly and a cartridge assembly. The anvil assembly and/or the cartridge assembly is movable relative to the other between open and closed positions. The cartridge assembly is configured to retain a plurality of surgical fasteners therein. A fluid-actuated drive assembly including a distal piston member is configured to oscillate between proximal and distal positions. The distal piston member includes a base and a rack extending distally from the base and slidably disposed within the cartridge assembly. A drive beam is configured for translation through the cartridge assembly to eject the surgical fasteners from the cartridge assembly. A pawl assembly couples the drive beam to the rack such that the drive beam is incrementally advanced along the rack and through the cartridge assembly as the distal piston member oscillates between the proximal position and the distal position.

Abstract: In one embodiment, a medical device includes an elongate member and a tissue anchor. The elongate member defines a lumen. The elongate member has a retention member disposed within the lumen. The tissue anchor has a first arm portion, a second arm portion, and a base portion extending between the first arm portion and the second arm portion. The tissue anchor has a first configuration and a second configuration. The first arm portion is substantially linear when the tissue anchor is in its first configuration and the first arm portion is non-linear when the tissue anchor is in its second configuration. The tissue anchor is biased to its second configuration. The tissue anchor is configured to be disposed within the lumen defined by the elongate member such that the retention member engages the tissue anchor to help retain the tissue anchor in its first configuration.

Abstract: A surgical stapler, a cartridge for a surgical stapler, a cutting mechanism for a surgical stapler, and a method of applying surgical staples in a patient are disclosed herein. The stapler may have an anvil movably coupled to a support jaw between a clamped configuration and a closed configuration. The cartridge may be configured to fit within an envelope diameter and to removably house a plurality of B-form staples, at least one of the plurality of B-form staples having a base length and a leg length, the leg length at least 53% of the envelope diameter. The cartridge may have slots shaped to house at least a second one of the plurality of staples at an angle oblique to the first one of the plurality of staples.

Abstract: Embodiments of the present invention encompass systems and methods to prevent complications from atrial fibrillation by preventing or reducing the likelihood of blood flow out of the left atrial appendage, to eliminate a possible source of aberrant electrical circuits, or both. Accordingly, techniques are provided for delivering ligature loops or closure means to the left atrial appendage, and to other anatomical structures of a patient which may be desirable in other surgical procedures.

Abstract: An apparatus for introducing an implant into a hollow anatomical structure. The apparatus comprises a storage unit having an exit opening and defining a chamber in communication with the exit opening; an elongate, self-expanding vascular implant having an expanded condition and stored within the chamber in the expanded condition, proximal of the exit opening; and a pushrod having a distal end aligned with and proximal of the exit opening. The pushrod is pre-assembled to a distal end of the implant. Associated methods, and other apparatus and methods, are also disclosed.

Abstract: A hemostatic equipment has a pallet and an inflatable pillar. The pallet has a holder used for a patient to hold, providing foolproof effect in an operation direction to ensure that the inflatable pillar may enter a nasal cavity of a patient in a correct direction. The inflatable pillar has a head exposed with a pressing surface for pressing a bleeding site inside a nasal cavity of a patient to stop bleeding.

Abstract: The present invention relates in general to anchoring systems for occluder devices, and more specifically, to an anchoring system and method for implanting an occluder device within a left atrial appendage (“LAA”) of the heart. The anchoring system is configured so that an anchor penetrates the inner endocardium layer, middle myocardium layer, and outer epicardium layer of an LAA wall. The purpose of the present invention is to provide an occluder device anchor that has a low risk of embolization and/or causing injury to neighboring valve structures. An additional purpose of the present invention is to provide an anchoring system and method for implanting an occluder device within the LAA that allows for the occluder device to be retrievable after initial placement, reusable, and repositionable for an optimal final placement within the LAA.

Abstract: Medical device used to cause hemostasis of blood vessels using a clip arrangement delivered to a target region through an endoscope. Method for using the device to cause hemostasis of a blood vessel through an endoscope. Medical device including a reversibly closeable clip, a locking arrangement, a control wire, a sheath, and a handle with an actuating trigger. Through the endoscope, hemostatic clipping device that is fully reversible and lockable. Hemostatic clip that reversibly targets and clips bleeding ulcers.

Abstract: An orthopedic bone cutter for cutting bone and tissue is described. The cutting device comprises a support frame having a plurality of radially extending struts to which a cutting shell is removably connected thereto. The frame serves as a universal support structure that provides added mechanical support and stability to which various embodiments of cutting shells may be connected thereto. The bone cutter of the present invention is designed such that the cutting shell may comprise a variety of embodiments that enable the removal of bone and tissue. Embodiments of the cutting shell may comprise at least a partially hemispherical shape in which a plurality of cutting surfaces may extend. In addition, the cutting shell may comprise a plurality of removal cutting blade inserts that are received within slots that extend through the shell thickness.

Abstract: A device for fracturing calcifications in heart valves includes a stabilizer assembly (20) for use with an impactor assembly (10). Relative motion between the impactor assembly (10) and the stabilizer assembly (20) with sufficient energy fractures a calcification located in tissue which is sandwiched between the stabilizer assembly (20) and the impactor assembly (10). The stabilizer assembly (20) includes a plurality of distal stabilizer struts (28) connected by stabilizer loops (30) which extend proximally backwards.

Abstract: Systems and methods can remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.

Abstract: A device for treating the human or animal brain with shockwaves has a shockwave transducer coupled to a position sensor for detecting the position of the shockwave transducer. The device is adapted to evaluate the signals of the position sensor to calculate the position of the focus spot of the shockwave transducer. Furthermore, a mapping device is provided for mapping the movement of the focus spot over a plurality of positions together with the applied shockwave dose at each of the positions. The applied shockwave dose may be indicated on a color display.

Abstract: A medical instrument with a hollow shaft and at the distal end a tool actuated via a spring-loaded pull cable, wherein the tool is rotatable about the longitudinal axis of the shaft and is mounted such that it can be angled with respect to the longitudinal axis of the shaft. Actuation of the pull cable and rotation and angled positioning of the tool take place via separate drives, which are arranged on a handle. An anti-twist means protects the pull cable against torsion.

Abstract: Systems, methods, and apparatuses for debriding a tissue site are described. The system includes a manifold and a cover adapted to form a sealed space over the tissue site for providing negative pressure. The system also includes a debridement tool positioned between the manifold and the tissue site. The debridement tool having a tissue-facing surface and a plurality of holes separated from each other by walls. The walls have transverse surfaces extending between the tissue-facing surface and an opposite surface that form cutting edges. The holes have a perforation shape factor that allows the holes to collapse from a relaxed position to a contracted position in response to the application and removal of negative pressure from the sealed space. The cutting edges debride the tissue site in response to movement between the relaxed position and the contracted position.