You may be aware of a situation called buried bumper but if you want to learn more or have no knowledge of this then please read below 🙂
It is known that some people may be prone to what is called ‘Buried Bumper Syndrome’ (where the internal disc of the PEG tube becomes buried and the stomach lining grows around it). To help prevent this developing, the PEG should be rotated daily and advanced weekly. This means holding the end of the tube and rotating it 360° (a complete circle) DAILY and pushing the tube approximately 4-5 cm into the stomach and pulling it back to the original position ONCE A WEEK.
This aspect of care is often forgotten by people caring for children with tubes and could potentially lead to a buried bumper. Buried bumper requires surgery to correct with a general anaesthetic possibly a laparotomy so needs to be avoided!
NB. we rotate from day 11 of insertion and advance from 4 weeks.
The PEG also needs cleaning daily with water.
HOW TO ADVANCE
- Gel hands and wear gloves
- Open the fixation catch (see Fig 1).
- Detach tube from groove in fixation plate (see Fig 2).
- Move plate away from skin (see Fig 3).
- Push 2-3cm of the tube into the stomach and rotate, gently pull back the tube to feel resistance (use lubrication if required)
- Place the fixation plate back to its original position. Re-insert tube in the groove (see Fig 4) and close the fixation catch (see Fig 5).
- The fixation plate should not be too tight or too loose.
As usual if you have any queries or questions please do not hesitate to ask one of us.
Jo, Karen and Rhoda