|So you have the tube and you know how to use it, now you need to know how to take care of it. Keeping the site clean will help prevent the skin from breaking down around the tube and help prevent infection. Soap and water during a bath has always worked well for us. We have also been known to use some half-strength Hibiclens and a rinse with water. It just depends on your preference. For mid-day dressing changes, I use a baby wipe to clear the area of any “goo”.
Some people prefer to use the gauze dressings and others do not. We are in the “definitely use” group. Allison’s g-tube site has been intermittently leaky since she got it (there’s no rhyme or reason to it ~ some just leak worse than others) and so we always use a barrier cream (we use Sensicare, although you may use any cream based diaper rash ointment as well) around the stoma and then place gauze (split 2×2 ~ also known as an “iv sponge” ~ we use the Kendall Excilon because it is thicker and more absorbent) around that and then tape the gauze together to prevent them from falling off. There is a million different ways to do this, but this is what works for us.
Another mom once called me and said “Do you know what this is? It looks like her stomach tissue is coming out around her g-tube!” Two words: Granulation Tissue. It can be bothersome, but again, it just comes with the territory. This is extra tissue that grows around the opening ~ it’s generally bright pink and somewhat slimy looking and bleeds easily. There’s not a magic cure for it, but some swear by a secret recipe of Maalox and Desitin. Others use a steroid cream called triamcinolone (don’t quote me on the name). Still others just dive right into the silver nitrate sticks to burn it off. We’ve used all three; the first did nothing for Allison, the second made her itch and the third is what we have been doing lately.
Before I get started with the silver nitrate sticks (some doctors will write you a prescription for you to have these at home), I make sure to clean the site very well. I then apply a layer of petroleum jelly all the way up to the edge of the tissue I’m going to be burning off, but NOT ON THE GRANULATION TISSUE ITSELF. (This step is to protect the skin around the stoma from being burned as well as avoiding the dark stain that will remain from the silver nitrate.) I take a silver nitrate stick, quickly dip it in some water and then roll it on the granulation tissue. Sometimes Allison will say “ow”, but it is never something she cries over or reacts to. I might go through three or four sticks and then I take a q-tip (I use sterile, individually-wrapped, cotton tipped applicators) and dip it in water and then put it on the site. I use a baby wipe to clean up the area and remove the petroleum jelly; put my barrier cream on and the gauze. Because the site will likely bleed over the next day or two, I generally will do this at night, cover her tummy with an old washcloth and then put a onesie on her to hold it all in. You should start to see some improvement of the site within a few days. You can redo this process every 2-3 days until the tissue is gone. (Again, PLEASE consult your own health care provider before making any changes to your or your child’s care.)
Be a hero. Designate yourself as an organ donor.