Gastrostomy (G, GJ, J) Complications — Erythema — Clinical Pathway: Inpatient

G, GJ, J Tube Complications Clinical Pathway — Inpatient

Erythema

Erythema (redness) of the peristomal skin is common and can be caused by a variety of reasons. The cause must be determined to prevent harm. Document the site with images in Epic Media tab. The table below outlines common causes.

Erythema Around Atoma

Potential Source Recommended Approach Comments
Tube fit is too tight or too loose
  1. Check the tube fit (tight vs. loose)
  2. Assess how the tube is secured.
Leaking  
Stoma granulation tissue  
Drainage onto skin
  1. Clean the site.
  2. Determine the source of the drainage.
  3. Contact the FLOC to discuss venting the tube depending on the tube type, volume and source of drainage.
    Job Aid: Venting Feeding Tubes Using the Chimney/Syringe Technique or the Farrell Valve System
  4. Apply a skin barrier to protect the skin with/out Mepilex® and/or stoma adhesive powder.
  • Common sources may include:
    • Granulation tissue slough/fibrinous exudate
    • Abscess
    • Pustule
    • Blister
    • Enteral feeds
    • Gastric contents
    • Bile
Irritant dermatitis
  •  
Cellulitis
  1. Complete a skin assessment including:
    • Tight/hard skin
    • Warm to touch with/out fever
    • Pattern of redness
  2. See Cellulitis Pathway

 
  • Notify FLOC if suspect cellulitis. Notify GT nurse immediately to assess the size/fit of the tube for potential upsizing.
  • Note: if the pattern of the redness is circumferential, cellulitis is an unlikely source.

Examples of Erythema

Mild Erythema
Moderate Erythema

Following Bedside Treatments

Monitor site and reassess. Allow at least 3 days for the redness to improve.

If erythema worsens or does not improve after 2-3 days, contact the FLOC on the appropriate service for further assessment.