Dwell time and functional failure in percutaneous endoscopic gastrostomy tubes: a prospective randomized-controlled comparison between silicon polymer and polyurethane percutaneous endoscopic gastrostomy tubes.
BACKGROUND
Silicone percutaneous endoscopic gastros-tomy (PEG) tubes are associated with more short-term complications and possibly fail sooner than those made of polyurethane. Understanding the deterioration and long-term complications leading to tube failure has important clinical and cost implications.


OBJECTIVE
To compare dwell time and patterns of failure ofsilicone polymer and polyurethane PEG tubes.


METHODS
Participants randomized to receive a siliconepolymer (n = 76) or polyurethane (n = 62) PEG werevisited monthly for 540 days, until death or tube removal. Tube and exit site characteristics and reasons for removal were recorded.


RESULTS
Tube failure occurred in 25% of silicone PEGs and 12.9% of polyurethane PEGs. Mean tube survival for silicone PEGs was 377.2 days (CI: 326-428) and for polyurethane 436.8 days (CI: 383-490; P = 0.13). A greater proportion of silicone PEGs developed intralumenal colonization and altered tube integrity than polyurethane (P < 0.001). Silicone PEGs blocked more frequently (P < 0.005) and were removed because of irreversible blockage more often than polyurethane PEGs (P < 0.05). Silicone PEGs with reversible blockage and tube integrity changes had a significantly greater probability of failure than silicone tubes without these changes (P < 0.005 and P < 0.05, respectively).


CONCLUSIONS
Observations over time indicate that sili-cone PEGs are more susceptible than polyurethane PEGs to tube deterioration, resulting in substantially increased management demands to sustain patients' feeding and medication schedules.
Blacka
J
J
Baxter Healthcare Pty Ltd.
Donoghue
J
J
Sutherland
M
M
Martincich
I
I
Mitten-Lewis
S
S
Morris
P
P
Meredith
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D004866:Equipment Contamination; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005658:Fungi; D005774:Gastrostomy / Q000295:instrumentation*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D011140:Polyurethanes; D011446:Prospective Studies; D012826:Silicone Elastomers; D013997:Time Factors
D011140:Polyurethanes; D012826:Silicone Elastomers