Endoscopic vacuum-assisted closure system (E-VAC): case report and review of the literature

Wideochir Inne Tech Maloinwazyjne. 2015 Jul;10(2):299-310. doi: 10.5114/wiitm.2015.52080. Epub 2015 Jun 8.

Abstract

Negative pressure wound therapy (NPWT) has become a standard in the treatment of chronic and difficult healing wounds. Negative pressure wound therapy is applied to the wound via a special vacuum-sealed sponge. Nowadays, the endoscopic vacuum-assisted wound closure system (E-VAC) has been proven to be an important alternative in patients with upper and lower intestinal leakage not responding to standard endoscopic and/or surgical treatment procedures. Endoscopic vacuum-assisted wound closure system provides perfect wound drainage and closure of various kinds of defect and promotes tissue granulation. Our experience has shown that E-VAC may significantly improve the morbidity and mortality rate. Moreover, E-VAC may be useful in a multidisciplinary approach - from upper gastrointestinal to rectal surgery complications. On the other hand, major limitations of the E-VAC system are the necessity of repeated endoscopic interventions and constant presence of well-trained staff. Further, large-cohort studies need to be performed to establish the applicability and effectiveness of E-VAC before routine widespread use can be recommended.

Keywords: Endo-Sponge; endoscopic vacuum-assisted wound closure system; eosophageal leakage; pancreatico-gastric anastomotic insufficiency; rectal anastomotic leakage; vacuum-assisted wound closure therapy.

Publication types

  • Case Reports