title: Techniques for preventing and managing tube-related complications.
abstract: BACKGROUND
  The management of jejunostomy and gastrostomy tubes that are not well stabilized and leak effluent around the insertion site present significant challenges to WOC nursing practice. The result is often peritubular skin erosion, patient discomfort, and high-volume fluid losses that are not measurable.
  
  
  METHODS
  WOC nursing was consulted when a 70-year-old woman with a jejunostomy tube experienced leakage, skin erosion, and pain. A novel technique for tube stabilization and local treatment of the peritubular skin was successful in stabilizing her jejunostomy tube, protecting the skin surrounding the tube, relieving associated pain, and enabling accurate measurement of output from the tube. Alternative strategies for stabilization and treatment are discussed.
  
  
  CONCLUSIONS
  The outcomes of patients who have been treated with these strategies has been improved comfort since they do not feel any tube movement and decreased pain since the skin is protected from the caustic effluent and remains healthy and intact.
authors.affiliation: Brigham and Women's Hospital, Nursing Office, Boston, Massachusetts, USA. 02115Ifleischer@partners.org
authors.forename: Ilene
authors.initials: I
authors.lastname: Fleischer
authors.forename: Diane
authors.initials: D
authors.lastname: Bryant
mesh_terms: D000368:Aged; D005260:Female; D005774:Gastrostomy / Q000451:nursing*; D006801:Humans; D007582:Jejunostomy / Q000295:instrumentation* / Q000451:nursing*; D011183:Postoperative Complications / Q000451:nursing*