Health Library

Endoluminal Wound Vacuum Therapy

Why Would a Patient Need Endoluminal Wound Vacuum Therapy?

Doctors use endoluminal wound vacuum therapy to help heal injuries or tears in the gastrointestinal (GI) tract. This therapy works by providing continuous negative pressure (suction) on a wound, which keeps the wound clean and promotes healing.

This treatment is rare but may be used for the following conditions:

Leak from a staple or stitch line

If your child has had abdominal (belly) surgery during which their surgeon placed surgical staples, this staple line may develop a leak inside the GI tract. One type of abdominal surgery that can lead to a leak is esophageal anastomosis. This is when the surgeon stitches or staples two areas of the esophagus (food tube) together to correct a medical condition.

Puncture from a feeding tube

In some cases, a feeding tube can make a hole in the esophagus when it is placed or removed.

Doctors will use endoscopy to look at the leak or puncture. If the hole or tear is bigger than 3 cm, or if the leak goes all the way to the skin, then endoluminal wound vacuum therapy is not the best treatment option. Your doctor will recommend a different treatment.

How Does the Procedure Work?

Your child will go to sleep with general anesthesia for this procedure. The doctor attaches a piece of sponge the size of the wound to the end of a nasogastric (NG) tube. Then they put the NG tube into your child's nose or mouth and guide it through the digestive system to the hole or leak.

Using special tools, the doctor stitches the sponge in place. The sponge soaks up extra fluid and promotes healing.

The doctor attaches the other end of the NG tube to a suction machine. The machine continuously pulls the leaking fluid out of the body through the tube. While undergoing this therapy, the patient is in the hospital connected to the suction machine for a few weeks or months, depending on their condition.

The sponge typically stays in place for three to seven days before the doctor needs to replace it with a fresh piece of sponge. Replacing the sponge prevents tissue from growing over the sponge and decreases the chance of infection. This process is repeated until the leakage stops and the wound is healed. This can take a few weeks to several months.

In some cases where there is a narrowing of the area, the doctor also places luminal stents (hollow tubes) in your child's gastrointestinal tract. Stents can help move fluid away from the area of injury. This can also help promote faster healing.

Prognosis After an Endoluminal Wound Vacuum Therapy

After multiple rounds of this therapy, some people respond well, and their wound heals. If the leak does not stop and the area does not heal, your child will likely need another type of therapy.

Endoluminal wound vacuum therapy is used for complex conditions. Every person's condition and response are different. Your child's doctor will work with you to develop the best treatment and follow-up plan.