Effects of 3 Different Methods of Care on the Peristomal Skin Integrity of Children with Percutaneous Endoscopic Gastrostomy Tubes: A Prospective Randomized Controlled Trial.

Abstract

There are a limited number of studies examining the effects of products used in stoma care. This study compares the effects of 3 different methods of care on the peristomal skin integrity of children with percutaneous endoscopic gastrostomy (PEG) tubes. In this randomized controlled study, 60 children were allocated to the 3 study groups (group 1: hydrogel, group 2: soap and water, group 3: saline solution). Dressings were changed daily for all groups during the first week, then weekly for group 1 and daily for groups 2 and 3. The evaluations were performed using a PEG Region Peristomal Skin Integrity Observation Form and devices measuring stoma region pH, moisture, and temperature. One evaluation was performed in a hospital and 4 during home visits in the first month after PEG insertion. Moisture levels in the stoma region were normal in the saline solution group, high in the hydrogel group, and low in the soap and water group (P < .05). Complications potentially affecting peristomal skin integrity in the stoma region (erythema, drainage, hemorrhage, hypergranulation tissue) were observed most frequently in the soap and water group (5%-45%) and least frequently in the hydrogel group (15%-25%). However, there was no statistically significant difference among the groups with respect to these complications (P > .05). Because the dressing requires 6 times fewer changes per month, and wound site infection in the stoma site is minimized, the use of glycerin hydrogel should be considered for inclusion in pediatric stoma care procedures.