Infection Clinical Trial
Official title:
Efficacy of Gastrostomy Tube Coated With Povidone-iodine for Reducing Peristomal Infection Rate After PEG Insertion
Percutaneous endoscopic gastrostomy (PEG) was created to replace surgical gastrostomy in
patients who are needed long-term tube feeding. PEG has less severe complication rate or
mortality rate compared with traditional surgical gastrostomy. However, there are still some
mild complications which cannot be completely prevented and peristomal infection is the most
common one. Povidone-iodine (PVP-I) exhibits broad range of microbicidal activity via
increasing the solubility of iodine. In our study, the gastrostomy feeding tube will be
coated with a layer of Betadine before PEG technique.
Investigators expect gastrostomy feeding tube coated with Betadine will reduce the
oropharyngeal, esophageal and gastric bacteria colonization rate, followed by reducing
peristomal infection rate.
Percutaneous endoscopic gastrostomy (PEG), or placement of a gastrostomy tube with the aid of
an endoscope, was first reported by a pediatrist in 1980. It was created to replace surgical
gastrostomy and used widely in patients who are needed long-term tube feeding. There are
three kinds of PEG techniques, including pull method, push method and introducer method.
Among them, pull method is the most widely accepted technique due to its simplicity of
insertion.
PEG has less severe complication rate or mortality rate compared with traditional surgical
gastrostomy. However, there are still some mild complications which cannot be completely
prevented and peristomal infection is the most common one. The major cause of peristomal
infection is that oropharyngeal bacteria colonized gastrostomy feeding tube while undergoing
PEG placement with pull method or push method, then bacteria was brought to the stoma via
gastrostomy feeding tube and induced peristomal infection.
Povidone-iodine (PVP-I) is a stable chemical complex of polyvinylpyrrolidone (povidone, PVP)
and iodine. It exhibits broad range of microbicidal activity via increasing the solubility of
iodine. A retrospective study in Japan demonstrated that using Povidone-iodine gargling
solution before PEG technique reduced peristomal infection rate. Besides, many studies
demonstrated that gingival degerming by Povidone-iodine irrigation prior to extraction or
gingivectomy reduced the oral bacterial colonies and postoperative infection rate.
The investigators will use Betadine (10% Povidone iodine) as experimental drug. The
gastrostomy feeding tube will be coated with a layer of Betadine by aseptic gauze before PEG
technique. Investigators expect that gastrostomy feeding tube coated with Betadine will
reduce the oropharyngeal, esophageal and gastric bacteria colonization rate, followed by
reducing peristomal infection rate.
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