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Another Peg Tube Question:

Hondo's picture
Hondo
Posts: 5717
Joined: Apr 2009

I have the long peg tube type with a clamp and it works very well except the skin under where the tube goes in is always raw looking, it bleeds sometimes and hurts but there are no infections. I showed this to the GI doctor and he said it is normal, it just don’t seam right to me. Is it normal to have raw looking skin that don’t heal and bleeding? It is hell when we have to ask the doctors a question and all they can do is to look at you crossed eyed. I get more information from the Nurse then the doctor these days. I am not sure how long this will last this way but hope I can get the button type next time as I head better things about it.

Thanks
Hondo

Kent Cass's picture
Kent Cass
Posts: 1746
Joined: Nov 2009

Can't say that I had what you describe where my tube went into me. In the past others have said the best one can do for cleansing the area is soap and water, I think- rather than the peroxide I used every day. You have a lot going on, though, Tim, past and present, so that might be factoring into it. Got mine a week, or so, before tx started, and by the time it did all was right as rain with my 1800s model G-tube (LOL). Hope it heals ASAP, Brother.

kcass

ToBeGolden's picture
ToBeGolden
Posts: 697
Joined: Aug 2010

I have been very fortunate and have not needed a PEG. So I can't answer your questions. But I wanted to say that I've read your long post about yourself in your personal history section. I find what you wrote very inspirational. I share most of your beliefs. Thank you for sharing your story. Rick.

Noellesmom
Posts: 1291
Joined: Aug 2010

By this point, you would think it would be healed, wouldn't you? I know Jim's certainly was. If you are not doing something to keep it from moving freely most of the time, that could be the problem.

When it wasn't in use, we kept Jim's held in place with a kind of stretchy netting the doctor's office provided: the home health people were amazed by it. I asked about it because it was a very hot summer and the HH folks told us to use an ace bandage type material and I was concerned about heat rash, itchiness and Jim's compliance in general.

The stretch netting was great. I'll try to find the name for it, Hondo.

NoDuck
Posts: 132
Joined: May 2012

Here's what we do with hubby's peg.

After his shower, he lets it air dry. We then take a peroxide wipe (the kind in the large pop-up cannister). I double it over and put it under the disk, then move it around and side to side. We like this because it not only cleans the skin but the back side of the disk. We use trach tube gauze 4x4s. It's thicker, softer and precut up the middle. It comes 2 squares to the pack. We put the first gauze pad on from the bottom putting the gauze under the disk at the base of the tube. The next gauze pad goes on from the top and on the outside of the disk. We then put one strand of paper tape top and bottom.

Hubby has very sensitive skin and experienced a lot of the raw angry looking skin too. This keeps the disk from spinning and irrating the skin. Since we started using the method above, he seldoms has any irritation. He does still have drainage, sometimes a little blood if he has an episode of trying to expel mucus.

I think the material Noelsmom may be referring to is stockingette. It's a mesh sleeve that can be cut in any length. We never used it for the peg but did for the picc line.

Hope this helps. He has only had the peg since 5/30/12 so we are no experts. We just experimented until we found something that worked for us. Good luck!

Deb

ratface's picture
ratface
Posts: 1234
Joined: Aug 2009

Hi Hondo, Yes the damn things can hurt bad sometimes. Those are gastric juices leaking out of there and that stuff is caustic to skin. Nothing like having acid on your wound around the clock. It has to be cleaned daily. Try moving the rubber bumper piece away from the skin about a quarter inch so that it's not constantly rubbing. It will move around that tube as it is only a rubber collar around the tube. You may have to turn it back and forth to get it going. You can then adjust it a comfortable place. Use some lubricant antiseptic gel on the raw skin and then put some gauze material around and under the bumper. They usally give you some of these with a slit cut in them to fit but if not just cut a slit in a pc of gauze. hang in there my friend.

yensid683
Posts: 225
Joined: Apr 2012

I have had similar experiences, the tube weeping a little blood and some sore of crud/gunk.

My RO nurse gave me some great tips on caring for the stoma. First, a little drainage is common. When we move or the tube moves, we stress the edges of the stoma and may crack the clot or whatever forms at the base of the tube.

I clean mine with gauze and saline, allowing it to air dry and then using a split gauze, I put it under the plates. I do have discomfort from time to time and my nurse recommended a product called 'calmoseptin', used for pressure sores.

I had been taping the tube to my skin and it was raw and irritated from the tape so she gave me a box of something called Spandage, a net bandage retainer which allows me to corral the tube without having to use any tape of any kind. I cut a piece that is about 12" long and slip it on like a T shirt. Net result, a relatively comfortable tube, no tape irritation, no issues with having to shave my stomach (hair in tape is so much fun)

I did ask about the seepage, I was concerned as it looked like pus, but was assured that it was fine, a little seepage is normal, keep it clean and don't forget to rotate the tube in the stoma to help it solidly form.

It sounds like your tube is just like mine and we have the same experience.

If it really concerns you, check with your dr, and perhaps not the GI. I consulted the GI when I first had troubles and they made no recommendations, when I brought my concerns to the RO nurse, she provided a great working solution.

Peter

D Lewis's picture
D Lewis
Posts: 1523
Joined: Jan 2010

I don't have a lot to add to the wisdom already written here, but I did want to say 'Hi.' It's always great to hear from you and to know you're still alive and kicking. My PEG tube was uncomfy and messy, but it was my friend. Hope yours heals a bit more. Thanks for all the support you've give me here.

Deb

George_Baltimore's picture
George_Baltimore
Posts: 303
Joined: Jun 2009

I've found that when mine gets that way, a little rotation so that the pressure of the projections under the flange are at a different point and a little Bacitracin applied under the flange works wonders in a short period of time. Good luck.

Billie67's picture
Billie67
Posts: 834
Joined: Jul 2012

My peg was only in for about 4 months but I had soreness the whole time. I also had redness and it would ooze a bit. I had GI, rad onc and RN look at it and they all said it wasn't infected just irritated. I used 4X4 split gauze and put it under the flange which did help a bit. They all told me plain soap and water with a good rinse was all I needed. I was given antibiotic ointment but told it wouldn't do too much since it wasn't infected. I tried it anyway and they were correct. Just make sure you turn it daily and keep it clean and dry, that's what they kept telling me. In the end I had to have it removed because my body just kept rejecting it, GI said it was foreign and my body didn't want it there. She said it was a sign of my body trying to heal around it and that as soon as it was removed I would heal very quickly and I did.
I hope with all of the advice on here that you'll find something that will work for you.
Billie

tuffenuff's picture
tuffenuff
Posts: 273
Joined: May 2012

since i have lost weight (26 pounds now) mine has a little drop of blood come out about one every other day. i think its loose now and moves around a little more. it does get sore on occasion. i asked the nurse and she said that it isnt uncommon.

Greend's picture
Greend
Posts: 679
Joined: Feb 2010

I think I have done almost everything mentioned above and after all this time mine still looks like raw meat, seeps a lot, bleeds at times and wants to "cake up" around the flange. I stopped taping it a long time ago and now let it air out. When I shower I clean around it and wipe it afterwards with a peroxide wipe. I have found that loosening the flangs helps at times. I'm supposed to be on number 4 but will loosen it to 4 1/2 or 5 for a day or two. I finally stopped treating it like a little baby after I found out it isn't as fragile as I once thought, also got tired of tape rash and pulling hairs when I used tape. :>)

I think you are doing fine and will adjust over time. Hope the weight is coming up.

Best to you,

Denny

patricke's picture
patricke
Posts: 463
Joined: Aug 2006

Hey Hondo, the skin around the entry to my PEG used to look red most of the time, and then I discovered Triamcinolone Acetonide Cream, 0.5%, after asking my doc, and a number of nurses for their suggestions, none of which worked. It had been prescribed for a skin problem that my daughter had, and she suggested that I try it. Well, by golly, it worked spiffily, and quickly de-reddened my skin. I also used to have a small amount of stuff that leaked around the tube at the enterance, for which I taped a 2 x 2 gauze pad around the tube, which worked well. I never had a bleeding problem. You might want to look into the button a bit before you opt for it, as I understand that it can have some maintenance problems associated with it too, but I could be wrong.

PATRICK

Hondo's picture
Hondo
Posts: 5717
Joined: Apr 2009

Well I guess I found something that I am normal at. I been doing everything your all have suggested my other problem is that I still work Full Time both in the Office and as a field Engineer. I sweat a lot and that does not help in trying to keep the area around the Peg dry.

Patrick I will look in on Triamcinolone Acetonide Cream and see what the doctor says about it.

Thanks for the help
Tim Hondo

tuffenuff's picture
tuffenuff
Posts: 273
Joined: May 2012

I started putting the sponge pads back under the bumper and it has stopped all sign of any blood or seepage and tightened up around the tube even more.

Hondo's picture
Hondo
Posts: 5717
Joined: Apr 2009

What type are they and where do you get the sponge pads from. Right now after I take a bath I am using my Wife blow dryer, it works great but can’t keep it with me all day.

Thanks
Hondo

SueBinBend
Posts: 6
Joined: Jul 2012

Hi Hondo,
My mom got her PEG in around July 18th. It was put in during her surgery, meaning she was laying down and her stomach wasn't protruding. She weighed only 113-114# when it was put in, and she gained her weight back quickly in the hospital and at home.
During this weight gain, her PEG tube was pushing on her outer skin, as well as the tissue leading into her stomach (this is the best way I can describe it). When we went back for her check-up (her treatment was done at OHSU, and we live in Bend, Oregon), the doctors' office loosened the tube by grabbing it with hemostats and pulling.
This relieved the pressure that was being put on her skin. Unfortunately the time the PEG tube was tight created a pressure wound. The exposed bloody tissue is the result of this pressure wound.
At our last visit (last week) the doctor's office tried to cauterize the tissue with silver nitrate, but it didn't work; the cauterized tissue just sloughed off. The doctors office said to put A&D ointment on the stoma after washing and drying the area daily, and to NOT cover it with gauze. The ointment will keep the gastric juices from reaching the skin/exposed tissue. If you put gauze on the area it can create a moist area, that's what our doctor told us.

Ever since the plastic "T" bar has been loosened, my mom's stoma has been less painful, but there is still tissue exposed. I am going to ask about getting it cauterized for real at our next appointment.

Hope this helps,
Sandra b

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