Title: Effectiveness of betadine-coating gastrostomy tube to reduce peristomal infection after
percutaneous endoscopic gastrostomy: a randomized controlled trial
Version: 3 Date: 14 Jan 2023
Reviewer:  Michael Wilsey
Reviewer's report:
This is a randomized controlled trial to test the effectiveness of a povidone-iodine-coating
gastrostomy tube to reduce peristomal infection after percutaneous endoscopic gastrostomy.
This is the first study to assess the efficacy of Betadine coating for preventing PEG peristomal
infection. The paper’s premise is interesting and novel in the field of GI.  The methods and study
design are clear. The title properly reflects the subject of the paper, the paper seems appropriate,
and the key messages are short, accurate, and clear.
A few comments:
1.  Was a power analysis performed to detect differences in infection rates based on other
peristomal infection studies?
2.  Some centers use topical Betadine ointment application after PEG tube placement.  Based on
the current findings, would the authors consider commenting on evidence in the literature and
the potential utility of this intervention?
3. I wonder if the authors would consider their RCT a pilot study, as it is limited by a small sample
size, as a prelude to an appropriately powered study focusing on the efficacy of a povidone-
iodine coating gastrostomy tube to reduce peristomal infection rates.
Title: Effectiveness of betadine-coating gastrostomy tube to reduce peristomal infection after
percutaneous endoscopic gastrostomy: a randomized controlled trial
Version: 3 Date: 14 Jan 2023
Reviewer:  Michael Wilsey
Reviewer's report:
This is a randomized controlled trial to test the effectiveness of a povidone-iodine-coating
gastrostomy tube to reduce peristomal infection after percutaneous endoscopic gastrostomy.
This is the first study to assess the efficacy of Betadine coating for preventing PEG peristomal
infection. The paper’s premise is interesting and novel in the field of GI.  The methods and study
design are clear. The title properly reflects the subject of the paper, the paper seems appropriate,
and the key messages are short, accurate, and clear.
A few comments:
1.  Was a power analysis performed to detect differences in infection rates based on other
peristomal infection studies?
2.  Some centers use topical Betadine ointment application after PEG tube placement.  Based on
the current findings, would the authors consider commenting on evidence in the literature and
the potential utility of this intervention?
3. I wonder if the authors would consider their RCT a pilot study, as it is limited by a small sample
size, as a prelude to an appropriately powered study focusing on the efficacy of a povidone-
iodine coating gastrostomy tube to reduce peristomal infection rates.
Please review this paper.
user
Title: Effectiveness of betadine-coating gastrostomy tube to reduce peristomal infection after
percutaneous endoscopic gastrostomy: a randomized controlled trial
Version: 3 Date: 14 Jan 2023
Reviewer:  Michael Wilsey
Reviewer's report:
This is a randomized controlled trial to test the effectiveness of a povidone-iodine-coating
gastrostomy tube to reduce peristomal infection after percutaneous endoscopic gastrostomy.
This is the first study to assess the efficacy of Betadine coating for preventing PEG peristomal
infection. The paper’s premise is interesting and novel in the field of GI.  The methods and study
design are clear. The title properly reflects the subject of the paper, the paper seems appropriate,
and the key messages are short, accurate, and clear.
A few comments:
1.  Was a power analysis performed to detect differences in infection rates based on other
peristomal infection studies?
2.  Some centers use topical Betadine ointment application after PEG tube placement.  Based on
the current findings, would the authors consider commenting on evidence in the literature and
the potential utility of this intervention?
3. I wonder if the authors would consider their RCT a pilot study, as it is limited by a small sample
size, as a prelude to an appropriately powered study focusing on the efficacy of a povidone-
iodine coating gastrostomy tube to reduce peristomal infection rates.
assistant