title: A retrospective correlation of percutaneous feeding tube stoma length in sitting and supine positions compared with body mass index.
abstract: BACKGROUND
  Accurate knowledge of stoma tract length is important to prevent gastric ulcer formation, buried bumper syndrome, and peristomal leakage/infection. Current guidelines suggest 0.5-1.0 cm of play between the skin and external bolster. The aim of this study was to determine if stoma tract length changes from supine and sitting position and if this change is related to BMI.
  
  
  METHODS
  Patients undergoing percutaneous feeding tube change from November 2006 to September 2009 were enrolled. Correlations were made between BMI and stoma tract length in both sitting and supine positions.
  
  
  RESULTS
  Twenty-eight patients (24 percutaneous endoscopic gastrostomy [PEG], 4 direct percutaneous jejunal feeding tube) were included; 19 (68%) were female. The mean ± SD stoma length was 3.6 ± 0.9 cm in the supine position and 4.9 ± 1.4 cm in the sitting position. The mean ± SD stoma length change from supine to sitting position was 1.53 ± 0.9 cm. Mean ± SD BMI was 21.2 ± 4.5 (range, 14.9-33.8). Stoma length in the supine position (r = 0.65, P = .0002) and sitting position (r = 0.6, P = .0009) was strongly correlated with BMI. Change in stoma tract length was correlated with BMI (r = 0.43, P = .02).
  
  
  CONCLUSIONS
  Stoma tract length is strongly correlated with BMI in both the sitting and supine positions. PEG stoma tract length changes significantly from the supine and sitting position. To prevent complications, most patients should have a longer distance set between internal and external bolsters than is recommended.
authors.affiliation: University of Utah, Salt Lake City, UT 84095, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Steenblik
authors.forename: Kristen
authors.initials: K
authors.lastname: Hilden
authors.forename: John C
authors.initials: JC
authors.lastname: Fang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D004750:Enteral Nutrition / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D011187:Posture; D012189:Retrospective Studies; D016683:Supine Position; D054047:Surgical Stomas