234 Is a Mepitel Covered Vacumn Sponge a Viable Alternative to Endosponge for Endoscopic Vacuum Therapy Management of Oesophageal Perforation and Upper GI Anastomotic Leak?

Abstract Aim Endoscopic Vacuum therapy (Endovac) is an established method of managing Oesophageal Perforations and Upper GI anastomotic leaks as shown by Livingstone et al 2021. The technique used for Endovac varies between centres. The Royal Liverpool University Hospital (RLUH) favours a Ryles tubes with Vacuum sponge secured around it an alternative to Endo sponge. This technique requires a change every 3 days due to granulation. We aimed to find if covering the V.A.C. sponge with a Mepitel dressing would allow for less Endovac changes, and if it was safe and cost effective. Method Patient undergoing Endovac at the RLUH from concept of Mepitel covered Endovac (MCE) technique 1/10/2024 - 01/07/2025 were assessed for site of placement, time between changes and complications due to Mepitel. Comparison of costings for the MCE compared to Endo-Sponge. Results 11 patients underwent Endovac therapy. 5/11 patients had MCE for at least part of their treatment. 13 MCEs in total with 12/13 intraluminal. The average length of time of MEC in situ 4.5 days (1-8). No complications secondary to MCE use. Cost of Endo-Sponge £250, Cost Ryles £8.99, V.A.C Granufoam small £25.03, Mepitel £2.90 Conclusions MCE has been successfully used as a intraluminal device allowing marginally longer time between Endovac changes. It appears to be a safe technique with no complications and is cost effective when compared to Endo-sponge. This is currently a small data set though and more cases will need to be reviewed to assess the ideal length of time between MCE changes.