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G-tube Care Notebook

Types of dressings

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There are three different types of dressings used for tube care: the split 2x2 gauze dressing, the bolster dressing and the gauze and tape dressing. Some dressings are used to help with drainage and other dressings help keep the tube stable.

Split 2x2 gauze dressing

This dressing is used when the tube has drainage. If there is no drainage at the site, then it is best to leave the site open to air.

Supplies needed

  • One 2x2-inch gauze pad with a slit cut to the middle. You can use pre-cut split gauze pads if available or make your own.
  • Washcloth or cotton-tipped swabs
  • Soap and water

Steps:

  1. Wash hands with soap and water.
  2. Remove the old dressing.
  3. Clean the skin (see above).
  4. Place one piece of the split 2x2-inch gauze dressing under the button or stabilization disk or bar.
  5. Use a small piece of tape, as needed, to keep the gauze in place.
  6. Change the dressing every day with site cares or more often if needed. 

Bolster dressing

This type of dressing is used for long indwelling tubes without a stabilization bar or disc. Bolster dressings are most commonly used for Pezzer tubes or Foley tubes. A bolster dressing is used:

  • When new tubes are placed
  • When a long indwelling tube without a stabilization bar or disc is in place

To help heal certain skin problems around the G-tube

This dressing will need to be changed only when the bolster is soiled or is not secure. It does not need to be changed every day. However, you should clean the skin around the tube daily with soap and water. It may be easiest to do the dressing change during your child’s bath time.

It is best to change the location of the bolster dressing with each dressing change. This keeps the tube from leaning the same way each time and making the hole larger. This also protects the skin around the tube. If the bolster dressing has been in the same location for three days without needing to be changed, then it’s time to change the location of the dressing.

Supplies needed

  • Two pieces of 3x3-inch gauze
  • Washcloth or cotton-tipped swabs
  • Soap and water
  •  ½-inch x 4-inch cut tape strips
  • 1-inch tape for tension loop

Steps

1. Wash hands with soap and water.   
2. Take 2 pieces of 3” x 3” gauze and fold in thirds the long way to make the bolster   
3. Roll it tightly and tape it so it
won’t unroll. You can make several
of them up to save time. 		  
4. Remove the old dressing.   
5. Clean the skin if you haven’t yet done so today
If the bolster dressing does not need to be changed – just clean the skin around the G-tube with soap and water daily. 		  
6. Place the bolster on the skin next to the G-tube. Be sure to hold the G-tube straight up. If the stitches have been taken out, check the tube placement. Do this by pulling gently so the balloon/ mushroom is snug against the stomach wall inside your child. This needs to be done only after the stitches are taken out. Have the G-tube lay over the bolster.
  • The tube should exit the skin and lay over the bolster dressing so it forms a 90 degree angle.
  
7. Put three pieces of ½” x 4” tape over the G-tube and bolster dressing. It is best to lay the pieces of tape next to each other in the same direction. This keeps the tube more secure.   

8. Make a tension loop. The tension loop adds security to the tube and dressing. If the G-tube is accidentally pulled on, it is better protected.

 

 
9. If there is drainage at the site, put a piece of gauze on next to the bolster dressing where the G-tube exits the skin. This piece of gauze can be taped in place. Change the gauze when wet or dirty.
 

Gauze and tape dressing

This type of dressing is used for long indwelling tubes without a stabilization bar or disc. Gauze and tape dressings are most commonly used for Pezzer tubes or Foley tubes. Gauze and tape dressing is used:

  • When new tubes are placed
  • When a long indwelling tube without a stabilization bar or disc is in place
  • To help heal certain skin problems around the tube

Supplies Needed

  • Two 6-inch long pieces of tape (1 inch wide, split lengthwise about 3 inches)
  • Washcloth or cotton-tipped swabs
  • Soap and water
  • Two pieces of 2x2-inch gauze pad with a slit cut to the middle. Pre-cut gauze pads may also be available for use.
  • It is best to rotate the direction of the tape with each dressing change. This keeps the tube from leaning the same way each time and making the hole larger. This also protects the skin around the tube.

Steps

1. Wash hands with soap and water.   
2. Remove the old dressing.  
3. Clean the skin  

4. Check the placement of the tube. This needs to be done only after the stitches are removed.

  • Gently push the tube into the stomach, twist the tube once or twice.
  • Pull the tube back until the balloon/mushroom is pulled snug up against the stomach wall.
 
 
5. Use one package of 2” x 2” gauze pads with a slit. Lay the gauze around the G-tube.

 
6. Take one piece of the split tape. Fold up the two narrow ends to make tabs. This piece of tape will look like a pair of pants.  
7. Position the tape so that the G-tube will be right at the split in the piece of tape.  
8. Be sure to hold the G-tube straight out from the skin. Pull gently so the balloon/mushroom is snug up against the stomach wall.  
9. Repeat step 8, but wrap the second split piece of tape the opposite way.

 
10. Make a tension loop. Use this loop for more protection of the G-tube.