After the original surgical incision has healed, the dressing procedure for the stoma is routinely done by the nursing personnel in accordance with the physician’s orders.

Generally, a minimal number of dry, sterile, gauze compresses are placed around the tube. The clamped end of the gastrostomy tube may be coiled on top of the dressing. A semipermeable surgical dressing such as OpSite may also be used to protect the skin from breakdown.

a. Equipment. 

(1) Basin of warm, soapy solution.

(2) Basin of warm water.

(3) Chux pads.

(4) Wash cloth.

(5) Towel.

(6) Paper bag or Chux pad (for discarded materials).

(7) Sterile 4 x 4 gauze compresses, or a surgical dressing such as OpSite.

(8) OpSite or similar surgical dressing.

b. Procedure. 

(1) Assemble the equipment.

(2) Explain the procedure to the patient and screen the patient for privacy. Assist the patient into a comfortable position in bed. Turn the bed covers back to hip level and open the pajamas to expose the gastrostomy dressing.

(3) Place a paper bag or Chux pad at the foot of the bed. Place a Chux pad at the upper left side of the patient.

(4) Wash your hands.

(5) While supporting the gastrostomy tube with one hand to prevent tension on the tube, remove the old dressing. Inspect it for character, color, and odor of drainage before discarding it into the paper bag.

(6) Inspect the skin around the stoma (peristomal) for irritation or breakdown.

(7) Wash the peristomal area with the washcloths and soap solution. Rinse thoroughly and pat dry with a towel. Note any complaints from the patient of soreness or tenderness in the peristomal area.

(8) Apply a dry dressing. OpSite or sterile 4 x 4 gauze compresses may be used.

NOTE: If using gauze dressings, use surgical net or montgomery straps instead of tape to secure the dressing. Frequent application and removal of tape will cause skin breakdown.

(9) Coil the clamped end of the tube on the surface of the dressing. Be sure there is no tension on the tube.

(10) Make the patient comfortable.

(11) Remove dressing equipment and discard waste. Wash hands.

(12) Record procedure, observations of skin condition, and patient tolerance in the Nursing Notes.