Minimizing irritation at insertion sites

By September 12, 2019 Newsletter

Feeding tubes deliver life-saving nutrition and fluids to people who may have trouble eating by mouth, but they are also prone to causing skin irritations at the tube insertion site, or stoma. In order to minimize irritations that can lead to more significant problems, here are some valuable tips:

Engage in basic daily care

It’s important to cleanse the stoma daily with soap and water and also give it some time exposed to open air. Additionally, because too much movement of the tube can cause irritation, secure the tube well, and catch and fix any leakage issues as quickly as possible. [1]

Prevent skin breakdown

The skin at the insertion site is vulnerable to breakdown, so it’s important for caregivers to minimize skin exposure to such things as stool, urine, or any gastric contents. This prevents irritation and infection. Many tube-users find that skin protectants or barrier ointments help prevent irritation. [2]

If general skin inflammation, dryness and/or rash is a problem, it’s recommended to use Hydrocortisone 0.5% cream, which is available over-the counter, or doctors can prescribe a stronger concentration (1%). [1]

Use skin protectants

Skin protectants place a protective barrier on the skin that protects it against water and the many irritants found in stool, urine, and other gastric secretions. These barrier products include ointments made from petrolatum, dimethicone, zinc oxide, and some oils. Skin protectants may take the form of a cream, paste, or ointment. Pastes and ointments are thicker and stay in place longer. [2]

Additionally, for sites that are weepy or moist, try using protective powders to absorb moisture, then cover them with a liquid barrier film product and finally add a skin protectant. [2]

The Oley Foundation recommends a variety of products. [3]

Vary taping techniques

Sometimes skin becomes irritated because you’ve been taping your tube in the same way every day. The Oley Foundation recommends you give your skin a rest by applying tape at different places every day. They even offer a visual aid with different taping techniques. [4]

Other suggestions including using skin prep before taping, to put a layer between the skin and the tape—though you’ll want to make sure the prep has dried before you apply the tape. [4]

Removing tape can also cause irritation, so try spraying an adhesive removal spray

beneath a small corner of the tape before pulling the entire thing off. [3] Or, apply a wet washcloth to the tape, soaking it through before removing. [1]

The Oley Foundation recommends a number of different tape types for sensitive skin, as well. [5]

Pouching may be necessary

Sometimes, the tube site can become enlarged or painful, requiring the tube to be taken out. In that case, you may need to apply an ostomy pouch to contain the drainage, which is known as pouching. This allows the skin and tract to heal. [2]

Q: What barrier protection products work best for you?

 

SOURCES

  1.  About Kids Health. “G/GJ tubes: Sensitivity and irritation.” https://www.aboutkidshealth.ca/Articlecontentid=3018&language=English
  2. The Oley Foundation. “Tips for Skin and Stoma.” https://oley.org/page/TipsForSkinandStoma
  3. The Oley Foundation. “Product Examples.” https://oley.org/page/TipsForSkinandStoma#Product%20Examples
  4. The Oley Foundation. “Taping Techniques.” http://oley.org/?page=TapingTechniques
  5. The Oley Foundation. “Tape for Sensitive Skin.” https://oley.org/page/tapeforsensitiveskin