title: New "introducer" PEG-gastropexy with T fasteners: a pilot study.
abstract: BACKGROUND
  Enteral feeding is indicated for patients unable to maintain appropriate oral intake, and percutaneous endoscopic gastrostomy (PEG) is the most adequate long-term enteral access. Peristomal infections are the most common complications of PEG, occurring in up to 8% of patients, despite the use of prophylactic antibiotics. The "introducer" PEG-gastropexy technique avoids PEG tube passage through the oral cavity, preventing microorganisms' dislodgment to the peristomal site.
  
  
  OBJECTIVE
  To compare the incidence of peristomal wound infection at 7-day post-procedure after conventional "pull" technique versus a new "introducer" PEG-gastropexy kit. Secondary outcomes included success rates, procedure time, and other complications.
  
  
  METHODS
  Eighteen patients referred for PEG placement between June and December 2010 were randomly assigned to "pull" PEG with antibiotics or "introducer" PEG-gastropexy technique without antibiotics.
  
  
  RESULTS
  Overall success rate for both methods was 100%, although mean procedure duration was higher in the "introducer" PEG-gastropexy group (12.6 versus 6.4 minutes, P = 0.0166). Infection scores were slightly higher in patients who underwent "pull" PEG with antibiotics compared with "introducer" PEG-gastropexy without antibiotics (1.33 ± 0.83 versus 0.75 ± 0.67, P = 0.29).
  
  
  CONCLUSIONS
  Although procedure duration was longer in the "introducer" PEG-gastropexy, infection scores were marginally higher in the "pull" PEG technique.
authors.affiliation: Hospital Israelita Albert Einstein, São Paulo, Brasil. fernandaprata@terra.com.br
authors.forename: Fernanda Prata
authors.initials: FP
authors.lastname: Martins
authors.forename: Maris Celia Batista de
authors.initials: MC
authors.lastname: Sousa
authors.forename: Angelo Paulo
authors.initials: AP
authors.lastname: Ferrari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D059485:Gastropexy / Q000295:instrumentation*; D005774:Gastrostomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013530:Surgical Wound Infection / Q000517:prevention & control*