• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Use of a Vacuum-Assisted Wound Closure Device to Treat Colorectal Leaks: An Institutional Experience

Use of a Vacuum-Assisted Wound Closure Device to Treat Colorectal Leaks: An Institutional Experience

Seagal Dauglas, MS, IV1, Christopher Melton, MSIII1, Leeds Steven, MD2, Fleshman James, MD2, Walter Peters, MD2, Katerina Wells, MD2. 1Texas A&M Health Sciences, 2Baylor University Medical Center, Dept. of Surgery

Objective of the technology or device: Anastomotic leak is one of the most challenging complications resulting from gastrointestinal surgery, as it is associated with significant patient morbidity and mortality.   The anastomoses created following low anterior resections have among the highest associated leak rates with long-term sequelae of poor function or need for fecal diversion.  The two main goals of treating anastomotic leaks and perforations are to effectively drain the septic focus and to permanently close the defect allowing for the restoration of intestinal continuity.  Vacuum-assisted closure for treatment of external wounds has been successfully used for over 20 years.  Endoscopic vacuum-assisted therapy (E-VAC) is an emerging technique used to treat anastomotic leaks as an alternative to the traditional therapies such as catheter drainage and fecal diversion.

Description of the technology and method of its use or application: The E-VAC therapy uses similar principles as the external vacuum assisted closure therapy. Negative pressure is applied to a defect in and intestinal lumen through the use of a silastic tube inserted into a traditional VAC sponge. It is theorized that this approach removes microorganisms from the wound cavity, reduces interstitial edema through improvement of microcirculation, and promotes wound closure through increased granulation and re-epithelialization.  We have used this technique to treat anastomotic leaks and perforations to accelerate healing of anastomotic defects and prevent long-term complications.

Preliminary results: Over the study period, 35 patients were retrospectively identified to have undergone E-VAC therapy for the treatment of anastomotic leak or rectal perforation. Thirty-day mortality rate was 0%. Patients underwent a median of 4 treatments (range 3-6 treatments) at an mean interval of 4 days for a mean treatment duration of 15.1 days +/- 11.2 days.  A protective ostomy was employed in 91.4% (n=32) patients with 8.6% (n=3) not requiring protective ostomy. Of the patients requiring protective ostomy, 59.4% underwent protective ostomy at the time of index operation and 40.3% required protective ostomy following EVAC therapy initiation. EVAC success, defined as salvaged anastomosis and avoidance of additional intervention during the patient’s hospital stay was 62.9% (n=22). Of those patients who failed EVAC therapy as a primary curative intervention, 45.5% (n=5) still saw long term success at median follow up of 7 mo. (range 3-11 mo.), defined as salvaged anastomosis and/or reversal of ostomy through the application of traditional therapies. Among patients with leaks rising from coloanal anastomoses (n=8), EVAC was successful as a curative intervention in 50% (n=4) patients. Of those who failed EVAC therapy, 50% (n=2) still experienced long-term success. The most common cause of treatment failure for was a persistent leak (n=6).

Conclusions/Future Direction: E-VAC therapy has a high success rate in the treatment of anastomotic leaks and perforations and holds promise as an effective adjunctive therapy. However in order to establish E-VAC therapy as a standard of care, greater experience and further studies in the form randomized clinical trials with long-term follow up are needed to determine the efficacy of this novel technique.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 91277

Program Number: ETP887

Presentation Session: Emerging Technology iPoster Session (Non CME)

Presentation Type: Poster

82

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals