The button: replacement gastrostomy device.

Abstract

EDIATRIC NURSES in hospitals, ambulatory care clinics, schools, and long-term care facilities are seeing more children with the Button (BARD Interventional Products, Tewksbury, MA) Replacement Gastrostomy Device? instead of gastrostomy tubes. The Button was developed to eliminate many of the common problems, complications, and constraints associated with conventional gastrostomy tubes and other feeding devices. Developed by a pediatric surgeon and first reported in 1984 (Gauderer, Picha, & Izant), this device has been tested and modified to maximize clinical usefulness. It can be used as a feeding device as well as a temporary plug to maintain a gastric stoma when a feeding device is not needed. When used as a feeding device, there are similarities between the Button and a conventional gastrostomy tube, but there are some significant differences pediatric nurses must understand. Conventional gastrostomy tube care and feeding have been addressed by many authors (American Journal of Nursing, 1983; Nelson & Hallgren, 1989; Paarlberg & Balint, 1985; Perez, Beckom, Jebara, Lewis, & Patenaude, 1984; Steele, 1985), and many nurses are familiar with problems associated with these tubes. Skin irritation, tube migration, monthly changing, and the awkwardness of a long tube protruding from the stomach have been the focus of nursing interventions for many patients with conventional gastrostomy tubes. Although the Button offers solutions to these problems, others are presented. Advantages and disadvantages of the Button are summarized in Table 1. THE PRODUCT The Button is a self-retaining, silicone rubber skin level device commercially available through BARD Interventional Products. It has an outer flat safety plug at the skin surface and a mushroomlike dome