Oropharyngeal bacteria can be brought through the abdominal wall during percutaneous endoscopic gastrostomy.
Peristomal infection is one of the most frequent complications in patients who undergo the procedure.
Dr Yutaka Suzuki and colleagues from Japan determined whether covering the gastrostomy tube with a sheath that could be detached in the stomach could help prevent peristomal infection.
The investigative team evaluated 449 patients with swallowing dysfunction from 3 community hospitals.
The team assessed 206 patients who underwent non-covered percutaneous endoscopic gastrostomy from 2000 to 2002.
A further 243 patients undergoing covered percutaneous endoscopic gastrostomy between 2002 and 2004 were assessed.
The investigators adjusted for hospital, age, gender, and underlying diseases.
|C-reactive protein at day 3 was lower after covered percutaneous endoscopic gastrostomy|
|World Journal of Surgery|
The team found that covering the percutaneous endoscopic gastrostomy significantly reduced peristomal purulent infection vs with non-covered tubes.
Body temperature, white blood cell count were significantly lower or shorter in patients treated with covered percutaneous endoscopic gastrostomy.
The team noted that C-reactive protein at day 3 was lower after covered percutaneous endoscopic gastrostomy placement.
Duration of antibiotics usage was also significantly lower in patients treated with covered tubes.
Staphylococcus aureus and Pseudomonas aeruginosa were detected less frequently in peristomal lesions with covered percutaneous endoscopic gastrostomy.
Moreover, 28 patients treated with covered percutaneous endoscopic gastrostomy received no antibiotic therapy.
The investigators observed that 27 of them had no signs of peristomal infection.
Dr Suzuki's team commented, “These results suggest that covering the percutaneous endoscopic gastrostomy tube, with or without providing antibiotic therapy, may prevent peristomal infection in spite of the presence of oropharyngeal bacterial flora after percutaneous endoscopic gastrostomy.”