Feeding Tube Site Care 101

Stoma site problems are the most common complications associated with a feeding tube. Regular assessment of the site is the key to prevention!

DAILY:

1. Check for pain, redness, irritation and leakage around the stoma site.

• Rotate the external bolster ¼ turn (not with J-tubes). It should rotate freely.

2. Check the external bolster height in both sitting and supine (lying face-up) position.

• There should be at least the thickness of a dime between the bolster and the skin.
• Too loose can cause leakage.
• Too tight can cause irritation.

3. Clean the site, including underneath the external bolster, with mild soap and water.

4. Keep the area dry.

WEEKLY:

1. Check balloon volume (if applicable) to test for leaks.

• Deflate the balloon by withdrawing water, noting the amount.
  • If >5 mL of the amount placed has been lost, notify physician/replace tube.
• Re-inflate with recommended amount of sterile water.
  • Do not use air, which may seep out and deflate the balloon.
  • Do not use saline, which may clog the access port.

SKIN SITE SOLUTIONS:

If you notice leakage around the stoma site:

• Adjust the external bolster height and/or balloon volume as needed.
• Apply a skin protectant or moisture barrier.
• Use a short-term dressing to absorb drainage.
• Keep the head of the bed at 30-45 degrees during and one hour after feedings.
• Adjust the volume of feeding as needed.
• Replace the tube if the stoma size has changed.

Hypergranulation tissue (discolored, irritated and raised skin tissue around the stoma site)

• Prevent it by using only mild soap and water to clean the site. Half-strength hydrogen peroxide should only be used occasionally to clean crusty debris not removable by water & mild soap.
• Stabilize the tube to restrict movement that may further irritate the skin.
• Treatment includes foam dressings to apply pressure and absorb moisture, silver nitrate sticks, moisture barriers & steroid creams.

For more information, see related articles and tube feeding resources here:

• Taking the Stress Out of Changing Your Child’s G-Tube
• How to Clean ENFit Extension Sets
• Tube Feeding A Child: The G-Tube That Saved My Son’s Life & My Sanity
• Preventing Enteral Misconnections with ENFit® Connectors
• Recorded Webinar: The Complete Nurse’s Guide to Tube Feeding

This article is is tended for educational use only and does not replace the advice of a medical professional. If you have any questions or concerns regarding your enteral nutrition, contact your healthcare provider.