Percutaneous Endoscopic Gastrostomy and Peristomal Infection: An Avoidable Complication With the Use of a Minimum Skin Incision

Background: Percutaneous endoscopic gastrostomy (PEG) is a fast and simple method. Although considered safe, PEG is associated with many potential complications. Peristomal infection is the complication most frequently reported. Objective: To analyze patients who underwent PEG and the association of peristomal infection with the extent of skin incision (SI) and usage of prophylactic antibiotics (PA). Methods: A retrospective review of the records of 120 patients who underwent PEG was carried out. Patients were divided into 3 subgroups: (1) Patients with SI 10 mm/without PA, (2) Patients with SI up to 5 mm/without PA, and (3) Patients with SI up to 5 mm/with PA. Results: Peristomal infection occurred in 12.8% of patients from subgroup 1, and in 2.2% of patients from subgroup 2. There was no infection in subgroup 3. Peristomal infection was associated with the SI extent (P=0.01) and there was no association with PA (P=0.3). SI > 5 mm presented an odds ratio of 10.5 (95% confidence interval, 1.58-68.42) for the occurrence of peristomal infection. Conclusions: The use of PA did not seem to reduce peristomal infection rates. However, minimal SI was significantly associated with reduction of this complication.