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 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 Spoonie Threads co-founder, gives her advice on best practices for taking care of feeding tubes and G-buttons after surgery.
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:
- 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.
- Disconnect the Feeding Cord: When not in use, disconnect the feeding tube or G-button.
Secure the G button: Use a waistband, 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.
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:
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.
Featured: Spoonie Threads G-tube pads in Royal, Navy and Black
Spoonie Threads g-tube or g-button pads have sensory friendly seams. The
gentle velcro closure sits beneath the g-tube and is easy to open and close. The
outer surface made from soft, water-resistant polyurethane laminate (PUL). The
inner layer made from absorbent terrycloth and the skin-facing surface made from moisture-wicking microfleece.
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.
featured: Desitin Diaper Rash Cream
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-tube 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 Waistband or Wrap
A waistband, 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.
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
Spoonie Threads Clothing Designed for Feeding Tubes
Spoonie Threads 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:
Want to know more about G-buttons and Feeding Tubes?
St. Jude's Children's Hospital: What is Gastrostomy?
WebMD Feeding Tubes
Living With Tube Feeding
Feeding Tube Awareness
The Oley Foundation
Inside Out Care
Swallowing Disorder Foundation
Pediatric Feeding and Swallowing Associates
FirstStages Feeding Specialists
Pediatric Feeding Association