In most cases, when a G-tube is no longer needed, it can simply be removed. The site will slowly close on its own over a period of about two weeks. Usually all that is needed is a bit of gauze to catch any initial leakage. Barrier cream can be used around the site to protect the skin from any leakage.
Sometimes, the stoma or site does not close easily on its own. This may be more likely to occur when a child has a G-tube for a long period of time, if the child has had lots of problems with the site, or if the child has certain medical conditions that make healing more difficult. In this case, a surgeon may surgically close the site in a short outpatient surgery.
Typically, doctors will wait for a period of 2 to 8 weeks before performing surgery to try to allow the site to close on its own. If leakage is substantial or the child’s skin is becoming severely irritated, call the doctor right away since surgery may need to be performed earlier. It may be wise to have a surgical consult at the time of removal to make sure a plan is in place.
Example of a Surgical Site Closure Process
Step 1: Pre-Removal
G-tube button prior to removal. Clean and no granulation tissue.
Step 2: Stoma 1 week after Mic-Key button removal
In this instance, a Pediatric Surgery nurse used a silver nitrate stick inside the stoma immediately after removal. The family continued to silver nitrate at home with silver nitrate sticks given with permission from the pediatric surgery nurse. The stoma was covered with barrier cream, gauze, and tape. The stoma seemed to be closing, but after 4 weeks there was still a pinhole that was leaking when eating/drinking. Surgery was scheduled to close the hole and inner lining of stomach.
Step 3: Gauze covering the incision the day after surgery
Step 4: Incision the day after surgery
3 strips of gauze soaked in betadine to prevent infection. The incision was covered with gauze until 3 days after surgery.
Step 5: Three days after the surgery
The betadine gauze was removed. It was simple to remove, just pull gently and the strips come right out.
Step 6: Incision Closure
The incision already started to close on its own 8 hours after pulling the strips. The incision was kept clean and dry and covered with gauze for one more day, but after that there was no need to cover the incision.