Open-pore film drainage (OFD): a new multipurpose tool for endoscopic negative pressure therapy (ENPT)

Abstract

Background and study aims Endoscopic negative pressure therapy (ENPT) has been developed to treat gastrointestinal leakages. Up to now, ENPT has usually been performed with open-pore polyurethane foam drains (OPD). A big disadvantage of the OPDs is their large diameter. We have developed a new, small-bore open-pore film drainage (OFD). Herein we report our first experience in a case series of 16 patients. Patients and methods OFD is constructed with a drainage tube and a very thin double-layered open-pore drainage film (Suprasorb CNP, Drainage Film, Lohmann & Rauscher International, Germany). The distal end of the tube is wrapped with only one layer of film. OFD is placed into the gastrointestinal leakage site with common endoscopic techniques. The tube is connected to an electronic vacuum device and continuous negative pressure of –125 mmHg applied. Results From 2013 to 2016, 16 patients were treated with the new OFD device. In 10 patients, transmural intestinal defects (4 esophageal, 4 rectum/colon, 1 duodenal, 1 pancreatic cyst) were closed with ENPT in median time of 12 days (range 3 – 34 days). Five of the 10 patients were treated solely with OFD devices. In five patients ENPT started with ODP and changed to OFD when the cavity was shrunken to a channel with a small opening. In four patients postoperative gastric reflux was eliminated for 5 to 16 days. Conclusions Small-bore OFD opens up promising new treatment options within ENPT. OFD can be used in endoscopic closure management of intestinal leakages in the upper and lower gastrointestinal tract. Gastric reflux can be eliminated in an active manner. OFD can be inserted nasally. OFD may be an adequate substitute for OPD, especially when placement of the larger OPD is difficult.

Endoscopic negative pressure therapy (ENPT) for duodenal leakage – novel repair technique using open-pore film (OFD) and polyurethane-foam drainages (OPD)

“…They are fixed around the distal end of the laterally perforated drainage tube with a suture ( Fig. 2 ) 19 20 . Both materials can be combined, in which case, the foam is coated with the film 12 21 .…”

“…Novel small-bore, open-pore drainage devices for ENPT which pass through small openings have been developed ( Fig. 2 ) 11 12 13 20 . They consist of a 120-cm drainage tube (Ventrol, 12 Ch × 120 cm; Covidien Argyle, Dublin, Ireland) and a very thin, double-layered open-pore film (Suprasorb CNP, Drainage Film; Lohmann & Rauscher International GmbH & Co. KG, Rengsdorf, Germany).…”

Tips and tricks for endoscopic negative pressure therapy

“…This film can be used instead of polyurethane foam and can be wrapped as an open-pore drainage element around the opening of a drain tube. This allows very small caliber open-pore drains to be created with a diameter of just a few millimeters [ 15 ], which can be inserted easily into small openings. For treatment in the upper gastrointestinal tract, the OFD can be introduced transnasally like a feeding or stomach drainage tube.…”

Endoscopic negative pressure therapy of the upper gastrointestinal tract

“…Small-caliber, open-pore film drains (OFDs) have been developed using a very thin open-pore, double-layer, drainage film (Suprasorb® CNP Drainage Film, Lohmann & Rauscher International GmbH & Co, Rengsdorf, Germany), which is approved for negative pressure therapy of the abdomen [ 36 ]. The film is wrapped around the perforations in the tubes instead of the PUF (Fig.…”