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Leakage around a tube used for feeding is not something that is normal . In order to protect the skin around the tube , you ’ ll have to first determine why there is leakage .
One of the causes of skin breakdown around an insertion site could be the enlargement of the insertion site due to poor tube stabilization with the resultant leakage of gastric contents . 1
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Here are three scenarios and how you can to try to solve the situation :
1 . If the tube that ’ s being utilized has an internal bumper and an external bumper , check to ensure that the internal bumper is against the gastric wall and that the external bumper is resting tension-free on the external abdominal wall . This can be done by pulling on the tube gently in an upward
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direction , then sliding the external bumper to rest against the skin without excessive pressure .
2 . If the tube has an internal balloon and an external bumper , check to see how much fluid is in the inflated balloon and refill the balloon using the appropriate amount of sterile water . The manufacturer ’ s guidelines should be referenced for normal balloon inflation
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amounts and should be checked weekly . 1
3 . If there are no external stabilizers visible , you can stabilize the tube using a commercial tube stabilizer or a tube-stabilizing taping technique using waterproof tape .
Daily care of the peri-tubular skin involves cleansing with soap and water , rinsing with water , and patting dry . 1 An appropriate barrier ( zincbased , antifungal or a nonalcohol skin sealant ) should be applied to the skin if there has been leakage with resultant moisture or irritant skin changes . A thin gauze or foam dressing can be used to collect any leakage and changed when wet . If the external stabilizer is moved to do the skin cleansing it should be slid back into place once complete . 1
If leakage and skin irritation continue , request to have the patient ’ s provider re-evaluate .
Reference 1 Wound , Ostomy and Continence Nurse Society , Core Curriculum Ostomy Management , Second Edition , 2022 , Philadelphia , PA : Wolters Kluwer . Pgs . 306-308
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