800.765.8775

Feeding Tube Site Care 101

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist | Shield HealthCare
08/11/14  9:56 PM PST
feeding tube

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.

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.

Comments

2 Comments

  1. Deb mullen
    Posted March 14, 2017 at 8:58 am PST

    Should liquid be seen in tube between skin and clamp?

  2. Posted March 15, 2017 at 8:31 am PST

    Thanks for your question, Deb! It’s possible this could be just the venting of gas and along with it, some gastric fluids and/or formula. You may notice that it comes and goes as you move or cough. It may not be an issue but if you notice drainage onto the skin around the tube, it could be damaging to the skin. Otherwise it’s probably not an issue other than increased chance of damaging the tube over time if the liquid is acidic. Be sure to mention to your doctor on your next visit.

Post Comment