title: [Nursing Experience With a Patient With Gastrostomy Leakage Resulting in Moisture-Associated Skin Damage].
abstract: Leakage is a common complication of gastrostomy. Exposure of the skin surrounding the gastrostomy tube to moisture or chemical irritants may cause moisture-associated skin damage (MASD) and seriously affect the patient's quality of life. This case study describes a nursing experience with gastrostomy leakage that resulted in MASD. An assessment conducted from July 29, 2015 to August 20, 2015 revealed that heavy gastronomy leakage had caused extensive skin erosion, ulceration, hyperplasia, and superficial infection. Simultaneously, the patient was required to conduct complex stoma care, which resulted in physical and psychological exhaustion. Changes in traditional tube and wound care were discussed on multiple occasions with an interdisciplinary healthcare team. Based on the evidence-based literature, we provide gastrostomy and MASD management strategies. Through team collaboration, we prevented gastric contents from contacting the patient's skin directly, improved patient comfort, controlled effluent and skin infections, maintained fluid and electrolyte balances, and acce-lerated the healing of the damaged skin. We recommend that healthcare professionals caring for patients with gastrostomy leakage be provided with early skin protection programs to learn the standard methods for identifying and correcting leakage factors, containing effluent, and adequately stabilizing the gastrostomy tube in order to reduce the impact on the patient's quality of life. In addition, patient education on tube and skin care should be provided to prevent the reoccurrence of complications.
authors.affiliation: MSN, RN, Wound Ostomy Continence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Taiwan, ROC.
authors.forename: Mei-Yu
authors.initials: MY
authors.lastname: Hsu
authors.affiliation: MSN, RN, Wound Ostomy Continence Nurse, Department of Nursing, Buddhist Tzu Chi General Hospital, Taiwan, ROC.
authors.forename: Hsiao-Hui
authors.initials: HH
authors.lastname: Hsu
authors.affiliation: MSN, RN, Supervisor, Department of Nursing, Buddhist Tzu Chi General Hospital, Taiwan, ROC. ji_lu@tzuchi.com.tw.
authors.forename: Ji-Yan
authors.initials: JY
authors.lastname: Lyu
mesh_terms: D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000451:nursing*; D012871:Skin Diseases / Q000451:nursing*
keywords:  complication ;  gastrostomy ;  leakage ;  moisture-associated skin damage ;  nursing experience 