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Thursday, December 4, 2008

Gastrostomy tubes and feedings: A parent's guide

MIC gastrostomy tube

MIC gastrostomy tube

MIC gastrostomy tube dressing changes

General information

  • The gauze should be changed every 2 to 3 days.
  • Change more often if it gets wet.
  • If the child is taking daily tub baths, it should be changed after each bath since the gauze will be wet.

Supplies

  • 2x2 gauze or split gauze and tape.

Procedure

  • Clean around the tube with soap and water.
  • Apply one 2x2 gauze or split 2x2 under the plastic ring. Tape all 4 sides of the ring.
  • Use Coban or an Ace wrap if necessary for additional security. Measure a piece of Coban or elastic wrap 3 to 4 inches longer than the abdominal circumference. On each end cut 2-inch slits in the middle. Place slits overlapping on top of the bolster. Use velcro or tape to secure the wrap.
MIC-Key tube

MIC-Key tube

MIC-Key low profile gastrostomy tube dressing changes

  • The clear plastic type dressing over the MIC-key should be removed 5 days after surgery. Pulling or STRETCHING a corner of this dressing along the skin releases it from the skin easily.
  • No dressing is necessary around this tube. Clean with soap and water — or just water — daily. A 2x2 gauze may be used if there is some drainage.
  • Place a new dressing over the top of the MIC-key to prevent the tube from moving.
  • Elastic wraps are also helpful to stabilize the tube.

Follow-up appointments for dressing and/or tube changes

Malecot tubes

  • If your child has a Malecot tube with a drain tube attachment device, the first visit is one week after the operation. You will learn how to change the dressing. Call the surgeon's office to schedule the appointment.
  • The second appointment is 8 weeks after the operation. At that visit, the Malecot will be changed to a MIC-key.

IMPORTANT NOTE: The first tube change for patients with a Malecot is only done on Tuesdays at 1 or 1:30 p.m. This appointment may take 1 to 2 hours. After the tube is changed from the Malecot to the MIC-key, your child will have to go to radiology to check placement.

MIC-key tubes

  • If your child has a MIC-key placed at the time of the operation, the first visit is 2 weeks after the operation to have the incision and GT site checked.
  • MIC-keys are changed every 4 to 6 months. You will be taught how to change the tube.

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