My last post was about the fact that almost all people who live with a PEG feeding tube also protect it with a bandage. I am one of them. Of course, as is so often the case in life, there are a few exceptions. But more about that later. Since such a bandage has to be changed regularly, I would like to show you my bandage-changing routine today.
How often to change?
The frequency of dressing changes depends crucially on how irritated the insertion site of the PEG tube is. If it is irritated, i.e. reddened and/or with heavy discharge of wound secretions, or even inflamed, the bandage should definitely be changed daily. If the insertion site is not irritated, you can go without changing the bandage for 2-3 days. At the latest, you should change the bandage if it has become damp after showering or heavy sweating (after which you usually shower anyway?). The moist bandage climate is otherwise not good for the wound.
Generally after showering
Unless I’m in bed for several days because I’m really ill, I generally only change my bandage after taking a shower. This has the advantage that the plaster is then soaked and can be removed more easily and “painlessly”. This is a particularly good tip for people who have a hairy belly (unfortunately, I sometimes belong to this group, too).
Clean and hygienic
Since the insertion site is effectively an open wound, my assistants always wear disposable gloves when changing the dressing. Before they touch the bandage, they also disinfect their hands. It is particularly important to work cleanly and hygienically. Otherwise, the insertion site can become infected very quickly. This is not only a lot of work, but also extremely painful.
Removing the old bandage
First of all, the old bandage must be removed, of course. My assistants first hold the PEG tube with one hand so that they do not accidentally pull on it when they remove the plaster and it still sticks to the tube a little. After that, it is important not to accidentally push the tube into the insertion canal. At least not yet. This is because there is often a build-up of secretions on the outside of the wound and on the tube. This must first be cleaned off with plenty of wound disinfectant (!). We use a sterile gauze pad for this.
Designated wound disinfectant
It is important to use a suitable wound disinfectant that is specifically designed for this purpose. Not hand disinfectant. Otherwise, it can burn like hell or, if used for a long time, damage the tube. By the way, when disinfecting and cleaning the wound, the more the better. When my assistant asks for the first time whether there was enough disinfection, my answer is always “No!” This may seem excessive. After all, the wound is then really wet. And I don’t mean damp, but really dripping wet. However, I have had to learn the hard way that this procedure is really fundamental. Since I have been so generously with it, I have no longer had any problems with inflammation of the insertion site.
Mobilization
After the insertion site and the tube have been cleaned well (for this, the outer holding plate is also opened and moved a little), the tube can be mobilized, as it is called in technical jargon. So we turn the feeding tube 360° in the wound. Then we push the tube a few times into the stomach and pull it carefully out again until it stops. This prevents the tube from growing tight. This would make it much more complicated to change the tube, which will be necessary sooner or later (see a post on this later).
New bandage
Then the new bandage is applied. We start with a dry and sterile slit gauze that is placed below the holding plate on the puncture site and around the tube of the probe. Personally, I prefer fleece compresses. With gauze compresses, I have had the experience that individual gauze threads tend to wrap around the tube and/or even get stuck in the wound secretions. This is quite impractical. I always place the slit of the slit compress in the same direction. This way, I prevent the feeding tube from getting stuck in the compress when removing the bandage, which could cause discomfort if someone is not paying attention.
After that, the holding plate of the feeding tube is covered with a gauze pad (also sterile). This prevents the plaster, which is then stuck over everything, from sticking too much to the tube itself.
You can do it!
Even if it looks like a lot of work here in writing (especially since I’ve added a few tips here and there), the whole procedure is pretty simple. Once you’ve done it a few times, it’s pretty easy. In the meantime, I’ve taught hundreds of non-medical people in three languages how to change my PEG bandage. So you’ll surely manage it too!
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