title: Design and experimental evaluation of an anti-leak feeding tube.
abstract: BACKGROUND
  Enteral feeding via gastrostomy or jejunostomy tube is often required to adequately treat patients with cancer, gastrointestinal disorders, and cerebral vascular accident. Although sufficient to provide adequate caloric intake, the present design of a gastrostomy tube is inadequate. Leakage of gastric contents onto the skin is commonplace prompting emergency department visits and skin damage that requires costly nonoperative and operative intervention. We introduce a new gastrostomy tube design and prototype that inhibits leakage by using an adjustable external retaining member, which compresses against the feeding tube shaft thereby preventing dynamic friction.
  
  
  METHODS
  A conventional external retaining member of a 22 French gastrostomy tube was tested against a novel compression-fitting external retaining member. Each gastrostomy tube was clamped to a scale and the external retaining member moved to slide along the tubing at a constant rate, and the applied frictional force was recorded. Thirty repetitions were performed.
  
  
  RESULTS
  The experimental prototype generated ×2.5-3 the frictional force preventing tube excursion. Mean (standard deviation) forces were 18 (3) versus 46 (4) ounces (n = 10, P = 2.57E-13) and 15 (4) versus 48 (4) ounces (n = 10, P = 1.90E-13) for conventional and experimental designs, respectively. Simulated in situ environment mean forces were 19 (3) versus 39 (3) ounces (n = 10, P = 3.30E-11) for conventional and experimental designs, respectively.
  
  
  CONCLUSIONS
  The experimental design created an increased static frictional force that inhibited the movement of the external retaining member against the gastrostomy tube. Clinical implementation is the next step to evaluate for reduced feeding tube morbidity and healthcare expenses by preventing leakage of gastric contents.
authors: Division of Plastic & Reconstructive Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: Gutwein@iupui.edu.
authors: Luke G
authors: LG
authors: Gutwein
authors: Medical Tool & Technology, LLC, Hawthorne, Florida.
authors: Richard D
authors: RD
authors: Helmig
authors: Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Clinton D
authors: CD
authors: Bahler
authors: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors: Kfir
authors: K
authors: Ben-David
authors: Department of Surgery, University of Florida College of Medicine, Gainesville, Florida.
authors: Kevin E
authors: KE
authors: Behrns
mesh_terms: D004750:Enteral Nutrition; D004867:Equipment Design; D006801:Humans
keywords: Feeding tube; Gastrostomy tube; Percutaneous endoscopic gastrostomy tube