Wound, Ostomy, Gastrostomy & Cecostomy Tube Care

Wounds

Our pediatric wound care is individualized for each patient’s unique needs. Our team’s principle goal is to minimize the pain and anxiety associated with the treatment of a child’s wounds. With this goal in mind, we use a variety of advanced wound care products to limit the number of dressing changes. Fewer dressing changes decreases pain and anxiety for both the child and the parent. We stabilize our wound dressings with non-adhesive products, such as flexible netting and elastic wraps. This limits or eliminates the need to remove tape, which is often painful for children. All efforts are made to use wound care products that are covered by your insurance plan.

Ostomies

The APNs have taken care of children with ostomies of all ages, from premature infants to teenagers and young adults. The team has experience managing a range of complications, including:

• Skin irritation/breakdown
• Candida/fungal rash
• Prolapsed stomas
• Wounds around or near the stoma

The team also has experience offering pouching alternatives when standard pouching techniques fail.

Our outpatient clinics are stocked with a variety of Hollister products, but our APNs are also familiar with other ostomy companies. They will assist with ordering necessary ostomy supplies.

To learn more about ostomy care, download the Ostomy Care Guide (English or Español).

Gastrostomy Tubes (G-Tubes)

Lurie Children’s pediatric surgeons perform many gastrostomy operations each year. To meet the needs of the children with gastrostomy tubes throughout the metropolitan Chicago area, our APNs are trained in G-tube care, and are available at many of our outpatient locations.

Our outpatient centers are fully stocked with Kimberly Clark Mic gastrostomy tubes (size 12 Fr and 14 Fr), Kimberly Clark Mic-Key low profile feeding tube (size 12 Fr and 14 Fr) and AMT Mini One balloon tubes (12 Fr and 14 Fr). The G-tube trained APN at each location can teach parents how to change their child’s tube every four months. Those parents who are not comfortable changing the tube may bring their child to one of the clinics every four months for a tube change.

Some of the common complications the APNs are familiar with include:

The treatment of hypergranulation tissue

• Leaking GT
• Cellulitis
• Inappropriate tube fit
• Skin breakdown
• Wound dehiscence

Learn more about G-tubes, and learn more about G-tube care by downloading our guide for parents (English or Español).

Cecostomy Tubes for Bowel Management

A cecostomy is an opening created through the abdominal wall into the cecum (the first part of the large intestine) for treatment of constipation and fecal incontinence. A cecostomy requires an operation to create the opening from the abdominal wall to the intestine. There are several operations that are performed to create that opening. A generic term that describes them all is ACE, which stands for Antegrade Colonic Enemas. They are also referred to as a MACE. Malone Antegrade Colonic Enema. This is a specific operation originally described by Dr. Malone, using the appendix to access the colon. The operation can be done however without the appendix for those people who no longer have their appendix. So we prefer to use the term ACE or cecostomy.

An enema given through a cecostomy has two major advantages over an enema given rectally. First, since they are easier to administer, older children and adults can give them without help. Second, they clean the entire large intestine of stool. Patients irrigate through the cecostomy every 24 hours and are accident-free between enemas. As patients develop confidence that they will not have an embarrassing accident, they often pursue interests previously avoided, such as sports, activities or staying for longer periods of time at the homes of friends.

If you are interested in discussing this procedure, your first appointment would be with one of the surgeons. They will explain the procedure in more detail.

After the operation, the APNs help manage the tube and determine the irrigation solution needed to maintain cleanliness between irrigations. Since the irrigation solution may need to be changed as your child grows, it is important to have an APN dedicated to assisting with their care.

To learn more about bowel management without a cecostomy, read about our Colorectal Center.