Percutaneous endoscopic gastrostomy evaluation of device materials: are we "failsafe"?

The development of the percutaneous endoscopic gastrostomy (PEG) tube for enteral access was a revolutionary technological advance. This device has undergone some minor modification over the past 30 years but remains very similar to the original PEG tube design. Use of the PEG tube for gastric enteral feeding access continues to increase yearly both in pediatric and adult populations. One of the difficulties noted with PEG tube use in daily clinical practice is the ultimate degradation of the PEG tube wall material, leading to tube cracking, tearing, and leaking, requiring replacement of the gastrostomy tube. Historically, the predominant polymer material used for PEG tube composition was silicone. More recently, polyurethane has been examined as a potential, more durable material for PEG tube composition. Copolymers, or combinations of silicone and polyurethane and other polymer materials, are currently under investigation as the answer for the development of a bioinert, tissue-friendly, durable, PEG tube composition material.