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

G, GJ, J Tube Complications Clinical Pathway — Inpatient

Irritant Dermatitis

Irritant dermatitis is irritation and inflammation of the peristomal skin, sometimes leading to denuding and/or erosion or ulceration of skin. This occurs when the skin comes in contact with leaking gastric contents or other irritating materials such as medications, feeds, etc.

Assessment for irritant dermatitis includes presence of:

  • Severe erythema
  • Denuding, ulceration, erosion
  • Fungal infection (peristomal candidiasis)

Irritant dermatitis will improve once the source of the leakage is identified and resolved. See guidance for leaking. If the patient has a contact dermatitis from a material (e.g., dressing, tape, ointment, creams) remove the irritating material and follow the steps below.

Irritant Dermatitis

Potential Source Recommended Approach Comments
Leaking gastric contents or other irritating materials (feeds, medications, etc.)
  • Document the site with images in Epic Media tab.

  • Mild/Moderate:
    1. Clean the site with soapy water, rinse, and blot to dry.
    2. Place a skin barrier
    3. Place a dry dressing around the stoma:
      1. Active leaking: dry Mepilex®
      2. Leaking has stopped: dry gauze or Mepilex dressing
    4. Monitor and reassess over 48 hours.
  • Mild/moderate: Contact the unit-based resource (CNS or skin champion) for assistance. If no unit-based resource available contact the appropriate service.

Severe Irritant Dermatitis

Irritant dermatitis example 1Irritant dermatitis example 2

Versus

Candida Fungal Infection

Candida fungal infection

Following Bedside Treatments

If the skin has not improved after 48 hours, notify the appropriate service.