G-tube bolster dressing

What is a bolster dressing?

When do I change the bolster?

Change the bolster:

• every three days. 
• if it is dirty.
• if the tube is not secure.  

When changing the bolster, it is best to move it to a different spot on the belly.  This helps keep the tube from leaning on one side and making the opening larger.  This also protects the skin around the tube.

It may be easiest to plan the bolster change during your child’s bath time.  The site should still be cleaned every day.  Cleaning the site can be done without taking off the bolster.  
The tube should exit the skin and lay over the bolster dressing.  The tube should stay straight up from the tract so it does not lean.

How do I make and change the bolster?

Steps to make the bolster and secure the tube

1. Get supplies ready.

• Gauze that is 3 inches by 3 inches
• Half inch wide tape (4 pieces that are about 3 to 4 inches long).

2. Wash your hands with soap and water.

3. Make bolster.  You can make several of them up ahead to save time.  Put them in a plastic baggie.

• Stack 2 pieces of gauze and fold in thirds.
• Roll it tightly and tape it so it won’t unroll.  

4. Take off the old bolster dressing.

5. Clean the skin site if needed.

6. Gently spin the tube in the tract.  This helps the stop the tube from sticking to the skin.

7. Gently pull back on the tube until the mushroom or water balloon is snug against the stomach wall.

8. Put the bolster on the skin next to the tube.  Do not put bolster in the same spot on the belly. 

9. While holding the tube straight up, lay the tube over the bolster and begin to secure.

• Put 3 pieces of tape over the tube and bolster dressing.  Lay them in the same direction overlapping each piece a little bit.  The tape should not criss cross. 

10. Put one extra strip about 1 to 2 inches away from the bolster.  This is called a tension loop.

• Fold it around until the tape meets. 
• Put the ends of the tape onto the skin.
• This strip adds security to the tube and bolster.