Examination of failed polyurethane gastrostomy devices and comparison with samples incubated in vitro

Percutaneous endoscopic gastrostomy (PEG) devices provide a route for nourishment and medication to those unable to swallow. The disintegration and discoloration of a type of polyurethane PEG device was evaluated. Five ex vivo samples were obtained and they showed discoloration, pitting and environmental stress cracking (ESC). A group of unused PEG devices were exposed to a gastric acid and pepsinogen formulation at 37 degrees C for up to 6 weeks. An additional cohort was investigated for fungal colonization by incubating with a Candida culture preparation at 37 degrees C for up to 6 weeks. Candida was shown to grow on all PEG samples exposed to it. The samples incubated in Candida hardened and discoloured and showed pitting but no ESC. In contrast, the samples incubated in the gastric acid formulation tended to soften and showed ESC but no discoloration.