Department of Surgery, Bagcilar Training and Research Hospital, Istanbul, Turkey.
Department of Surgery, New York University Langone Medical Center, New York, New York.
Dis Colon Rectum. 2019 Oct;62(10):1259-1262. doi: 10.1097/DCR.0000000000001453.
The vacuum-assisted drainage has many applications in managing complex wound healing. It quickens the recovery period by its hyperemic effect on the exposed zone, decreasing bacterial colonization, preventing tissue edema, and promoting granulation of the wound. However, its use in anastomotic leak after IPAA is scarcely studied, especially because a proprietary endoluminal vacuum-assisted closure system was removed from the US market.
We applied a hand-crafted endoluminal vacuum-assisted closure system using the existing standard wound vacuum-assisted closure supplies to 2 patients who developed an anastomotic leak with a presacral abscess after completion proctectomy with J-pouch construction.
We changed the endoluminal vacuum-assisted closure drain every 2 to 3 days, and both patients had substantial improvements in their abscess cavity after the seventh and ninth applications.
Anastomotic leak at the IPAA traditionally takes up to a year to heal, which causes a significant toll on the psychosocial life of the patient and delayed stoma closure. Therefore, we believe that facilitating the healing process by using our hand-crafted endoluminal vacuum-assisted closure drain might provide a great value to patients' quality of life.
真空辅助引流在处理复杂的伤口愈合方面有许多应用。它通过对暴露区域的充血作用、减少细菌定植、防止组织水肿和促进伤口肉芽形成，加速了恢复过程。然而，它在 IPAA 后吻合口漏中的应用几乎没有研究，特别是因为一种专有的腔内真空辅助闭合系统已从美国市场撤出。
我们使用现有的标准伤口真空辅助闭合用品为 2 名在完成 J 袋成形直肠切除术后出现吻合口漏和直肠前脓肿的患者应用了手工制作的腔内真空辅助闭合系统。
我们每 2-3 天更换一次腔内真空辅助闭合引流管，第 7 次和第 9 次应用后，两名患者的脓肿腔都有了明显的改善。
传统上，IPAA 后的吻合口漏需要长达一年的时间才能愈合，这对患者的社会心理生活造成了重大影响，并延迟了造口关闭。因此，我们相信使用我们手工制作的腔内真空辅助闭合引流管来促进愈合过程可能会为患者的生活质量带来巨大价值。
