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Percutaneous endoscopic gastrostomy and peristomal infection: an avoidable complication with the use of a minimum

Renato Borges Fagundes1, João Carlos Cantarelli, Kalil Fontana

  • 1Gastroenterology Department of Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria, Brazil. fagundesrb@gmail.com

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|August 23, 2011
PubMed
Abstract

Insights

Minimizing skin incision (SI) during percutaneous endoscopic gastrostomy (PEG) significantly reduces peristomal infection risk. Prophylactic antibiotics (PA) did not show a similar benefit in preventing this common PEG complication.

Area of Science:

  • Gastroenterology
  • Surgical Procedures
  • Infection Control

Background:

  • Percutaneous endoscopic gastrostomy (PEG) is a common procedure.
  • While generally safe, PEG carries risks, with peristomal infection being the most frequent complication.

Purpose of the Study:

  • To investigate the relationship between peristomal infection rates and the size of the skin incision (SI).
  • To assess the impact of prophylactic antibiotics (PA) on peristomal infection following PEG.
  • To analyze outcomes in patients undergoing PEG based on SI size and PA use.

Main Methods:

  • A retrospective review of 120 patients who underwent PEG.
  • Patients were categorized into three groups based on skin incision size (≤5 mm or 10 mm) and prophylactic antibiotic use.
  • Statistical analysis was performed to determine associations between SI, PA, and peristomal infection.

Main Results:

  • Peristomal infection rates were 12.8% for SI 10 mm and 2.2% for SI ≤5 mm (without PA).
  • No infections were observed in the group with SI ≤5 mm and with PA.
  • A larger SI (>5 mm) was significantly associated with increased risk of peristomal infection (OR 10.5, P=0.01).

Conclusions:

  • Reducing skin incision size during PEG is crucial for minimizing peristomal infection.
  • Prophylactic antibiotics did not demonstrate a significant effect on reducing peristomal infection rates in this study.
  • Optimal surgical technique, specifically minimal skin incision, is key to preventing PEG-related infections.

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