Bleeding Apply gentle pressure to site.

Stabilize the tube.

If granulation tissue is present, treat appropriately.

Irritant dermatitis Protect skin with skin barrier (e.g., Stomahesive wafer, paste, or powder [ConvaTec, Skillman, New Jersey], Allevyn [Smith and

Nephew, London, UK; Memphis, TN], iLEX paste [Medicon Biolab Technologies, Inc., Grafton, Massachusetts], or hydrocolloid dressing).

Use foam dressing (e.g., Hydrasorb [ConvaTec, Skillman, New Jersey], Allevyn [Smith and Nephew, London, UK; Memphis,

TN],) rather than gauze to “wick” moisture away from skin.

Assess for sensitivity to products/latex.

Candida albicans Apply topical antifungal to skin.

Control leakage.

Dry skin completely after cleaning.

Patient should also be assessed for oral thrush.

Clogged tube Flush well after medications with 5 mL lukewarm water.

A small amount (3–5 mL) of carbonated soda or cranberry juice may also be poured into the tube. Allow to set for 10 min, then

flush with water.

Infection G-tube site infections are uncommon; cellulitis is treated with systemic antibiotics.

Data from Association of Women’s Health, Obstetric and Neonatal Nurses, National Association of Neonatal Nurses. Evidence-Based Clinical Practice Guideline: Neonatal

Skin Care. Washington, DC: AWHONN; 2001; Borkowski S. Gastrostomy surgery and tubes. Sutureline. 2000;8:1; Borkowski S. Gastrostomy tube stabilization and security.

Sutureline. 2005;13:8; Borokowski S. Pediatric stomas, tubes, and appliances. Pediatr Clin North Am. 1998;45:1419; Colwell JC. A practical guide for the management of pediatric gastrostomy tubes based on 14 years of experience. J Wound Ostomy Continence Nurs. 2004;31:193; Craven DP, Fowler JS, Foster ME. Management of a neonate with

necrotizing enterocolitis and eight prolapsed stomas in a dehisced wound. J Wound Ostomy Continence Nurs. 1999;26:214; Garvin G. Caring for children with ostomies and

wounds. In: Wise B, McKenna C, Garvin G, et al., eds. Nursing Care of the General Pediatric Surgical Patient. Gaithersburg, MD: Aspen; 2000:261; Metcalfe P, Schwarz R.

Bladder exstrophy: neonatal care and surgical approaches. Wound Ostomy Continence Nurs. 2004;31:284; Rogers VE. Managing preemie stomas: more than just the pouch. J

Wound Ostomy Continence Nurs. 2003;30:100; Wound Ostomy and Continence Nurses Society. Pediatric Ostomy Care: Best Practice for Clinicians. Mount Laurel, NJ: Wound

Ostomy and Continence Nurses Society, 2011.