PEG procedure
stoma
STERILE
All patients fasted for at least 6 h before PEG implantation. Intravenous cefazolin (1000 mg infusion) and analgesics with meperidine HCl (50 mg/ml) 0.8ml or tramadol HCl (100 mg/2 ml) 2 ml were given 30 min before the procedure. Oral cleaning with a sterile cotton swab by the nurse would be administered before the procedure.All patients received the pull method for PEG implantation with a 24-french gastrostomy tube (Percutaneous Endoscopic Gastrostomy Systems, Wilson Cook, Bloomington, Indiana, USA). The gastrostomy tube in the experimental group would be coated with Betadine (povidone solution 10%, Taiwan Veterans Pharmaceutical CO., LTD. Taiwan) via soaked sterile gauze before implantation, and the tube in the control group was coated with saline-soaked gauze only.We performed esophagogastroduodenoscopy before the PEG procedure. The stomach would be inflated by air to ensure the stomach’s anterior wall could attach to the abdominal wall. Then, we turned on the light and checked the transmission light source at the skin site on the belly. We used fingers to push the belly and tried to find the optimal stoma site. After the stoma site is decided, we use Betadine and 75% alcohol for skin disinfection. After local analgesics with xylocaine 5 ml, a stoma was created by sterile knife and trocar. The guided wire was sent in the trocar and grabbed by a snare. The snare was tied with a PEG tube, and the tube was pulled down through the mouth, into the stomach and out through the abdominal wall, then anchored with an external bolster. We also recorded the PEG procedure times.