Abstract:
Background: Silicone percutaneous endoscopic gastrostomy
(PEG) tubes are associated with more short-term
complications and possibly fail sooner than those made
of polyurethane. Understanding the deterioration and
long-term complications leading to tube failure has
important clinical and cost implications.
Aim: To compare dwell time and patterns of failure
ofsilicone polymer and polyurethane PEG tubes.
Methods: Participants randomized to receive a siliconepolymer
(n = 76) or polyurethane (n = 62) PEG
werevisited monthly for 540 days. until death or tube
removal. Tube and exit site characteristics and reasons
for removal were recorded.
Results: Tube failure occurred in 25% of silicone PEGs
and 12.9% of polyurethane PEGs. Mean tube survival
for silicone PEGs was 377.2 days (CI: 326-428) and
for polyurethane 436.8 days (CI: 383-490: P = 0.13).
A greater proportion of silicone PEGs developed
intralumenal colonization and altered tube integrity
than polyurethane (P < 0.001). Silicone PEGs blocked
more frequently (P < 0.005) and were removed
because of irreversible blockage more often than
polyurethane PEGs (P < 0.05). Silicone PEGs with
reversible blockage and tube integrity changes had a
significantly greater probability of failure than silicone
tubes without these changes (P < 0.005 and
P < 0.05, respectively).
Conclusions: Observations over time indicate that silicone
PEGs are more susceptible than polyurethane PEGs
to tube deterioration, resulting in substantially
increased management demands to sustain patients'
feeding and medication schedules.
