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.

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

The Pediatric Surgery nurse used a silver nitrate stick inside the stoma immediately after removal. We continued to silver nitrate at home with silver nitrate sticks we were given and with permission from pediatric surgery nurse. We also covered the stoma with barrier cream and kept it covered with gauze and tape. The stoma seemed to be closing, but after 4 weeks there was still a pinhole that was leaking when eating/drinking. We scheduled surgery 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. We continued to keep the incision covered with gauze until 3 days after surgery.

Step 5: Three days after the surgery

We removed the 3 strips of betadine gauze. It was simple to remove, just pull gently and they come right out.

Step 6: Incision Closure

The incision already started to close on its own 8 hours after pulling the strips. We continued to keep the incision clean and dry and covered with gauze for one more day (just my own preference), but after that there was no need to cover the incision.