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Gastrostomy Tips from a Pediatric Surgeon

by Berlin Schaubhut |

 by Dr. Julie Sanchez, founder at Abilitee Adaptive Wear

Dr. Julie Sanchez, Abilitee Adaptive Wear co-founder
Dr. Julie Sanchez is a general & pediatric surgeon in Austin, Texas. She received her medical degree from the University of Texas Southwestern Medical School, completed her residency in general surgery at SUNY Brooklyn/Kings County Hospital, and her fellowship in pediatric trauma at Johns Hopkins Hospital in Baltimore, MD. Dr. Sanchez is part of a successful surgical practice in Austin, TX affiliated with Dell Children’s Hospital and has recently joined UT Dell Medical School as an affiliate professor.
Gastrostomy is a surgical procedure where an opening, called a stoma, is placed in the stomach. A G-button or feeding tube (G-tube, J-tube, or GJ-tube) is placed to assist with feeding, administering medicine, or for other reasons. Dr. Julie Sanchez, a pediatric surgeon and Abilitee founder, gives her advice on best practices for taking care of feeding tubes and G-buttons after surgery. 

Abilitee Cath Clip

The first 6 weeks of having a G-button placed is the most critical time to allow the G-button tract and site to heal. The danger arises when the G-button is accidentally pulled out, and an attempt to replace the G-button is unsuccessful. An unsuccessful attempt to replace the G-button can create a false tract, or the stomach wall can detach. 

Preventing G-Tube dislodgement

Unfortunately, G-button’s getting pulled or dislodged is very common in children. It is common for G-button’s to get pulled out from tripping on the extension tubing or the feeding cord getting tangled. Your child can also pull the G-button out himself/herself. These are the best ways to prevent dislodgement of a G-button: 

1. Loop Extra Tubing: Loop the feeding cord or tube and clamp the spare feeding tube or cord close to the feeding bag to remove excess slack. 

featured: Abilitee Cath Clip in Orange

2. Disconnect the Feeding Cord: When not in use, disconnect the feeding tube or G-button.

3. Secure the G button: Use a belt or a wrap to keep the G-button in place if the child is on continuous feeds or if your child is very active. 

Abilitee G-tube Belt in Black
The Abilitee Feeding Tube fits around the waist and has a circular opening over the feeding tube site. This opening is large enough to fit most g-tube pads and gauze pads, and is covered by a flap secured with Velcro panels.
Featured: Abilitee Feeding Tube Belt in Black 
Our Infant Abdominal Access Belt provides comfort & security for little ones with hard-to-manage abdominal devices. The "secured wrap" design features a low-profile velcro closure, small flexible opening for tubes, and an exterior pocket for storing loose cords or tips. Breathable, antimicrobial material keeps the surgical site dry and reduces the risk of granulation or infection. Sensory-friendly construction and hidden seams provide extra comfort and reduce irritation. 
featured: Infant Abdominal Access Belt 
Infant Abdominal Access Belt for feeding-tubes and catheters

Preventing skin irritation at the G-Tube Site

Skin irritation (redness, dryness) and granulation tissue formation is common around G-button sites. Usually, skin irritation is caused by excess tension or friction. A G-button should sit comfortably on the skin with the ability to move freely. Here are some tips on how to prevent skin irritation:

1. Keep it Clean & Dry
Prevent skin irritation by keeping the G-button site clean and dry. G-button pads can help comfort your child’s skin and absorb drainage away from the skin. I recommend replacing the G-button pad daily and as needed when it is soiled. It is important to make sure the pad does not remain moist or damp. A moist G-button pad can contribute to further skin irritation and or skin breakdown.

Abilitee G-tube pad in Gray

Abilitee G-button pads have an outer surface made with a soft water-resistant polyurethane laminate (PUL) fabric. The skin-facing surface is made from moisture-wicking microfleece infused with SILVADUR™ antimicrobial silver ions which inhibit bacterial growth & control bad odors. 
Featured: Abilitee G-tube pad in Gray
2. Add a Skin Barrier
A good skin barrier will also help if the skin becomes irritated. Some examples of skin barriers include: Vaseline, Desitin, Calmoseptine, diaper rash butt paste, etc. You can buy all these over the counter at your local pharmacy.
Desitin diaper rash cream featured: Desitin Diaper Rash Cream
3. Prevent Granulation Tissue
Granulation tissue is new tissue and blood vessels that form on a wound when it heals. It is very common and the risk of granulation tissue increases under stress, such as a tight-fitting G-button or an ill child. The surrounding skin around granulation tissue is fragile and can ooze, bleed, drain, or cause the button to have a poor fit and leak. It is important to keep a properly fit G-button in place to prevent granulation tissue.
There are many ways to treat granulation tissue from ointments to cauterization. A G-button pad can help absorb some of the drainage and provide comfort. Again, it is important for the pad to be kept dry and change the pad when it is wet or moist to prevent further skin breakdown. 
Prevent G-button Leaking
A G-button can leak as a result of a malfunctioning valve, ruptured balloon, poor fit, or an inadequate amount of water in the balloon. It is important to check the water in the balloon when the G-button is leaking and once cleared by your surgeon after surgery: ensure the water is clear and has enough water per the G-button’s manufacturing instructions. The amount of water in the balloon can vary and will depend on the brand and size of the G-button. 
Use a G-button Belt or Wrap
A belt or wrap can help secure the button in place, providing comfort and helping reduce friction, which often leads to granulation tissue formation and skin irritation. 
Abilitee G-tube belt with Security Flap
The Abillitee Feeding Tube Belt can come with or without a security flap. The security flap is an extra panel of Velcro that helps loop and secure any excess tubing. This further protects the site and secures the feeding catheter, which can help to reduce friction that causes skin irritation and tissue granulation. 
featured: Abilitee Feeding Tube Belt with Security Flap in Black
This lightweight waistband hugs the body providing support and a streamlined look. The waistbands are made from soft, stretchy, and sweat-wicking material and come in Indigo, Hot Pink, Black, Charcoal, Beige
featured: Abilitee Stretch Waistband in Hot Pink
Abilitee Stretch Waistband in Hot Pink
 

Adaptive Clothing Designed for Feeding Tubes

Abilitee designs clothing specifically for children and adults that need abdominal access such as those with feeding tubes and g-buttons. This can help with managing the devices and adds a bit of style as well! Check out the entire collection or here are some of our favorites:
Tube & Cath Access Owl Backpack
Tube & Cath Access Owl Backpack Tube + Cath Access Backpack
Want to know more about G-buttons and Feeding Tubes?
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