Peg Site unable to heal- what to do?!

Specialties Wound

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I am hoping this is OK to post.

I am a LTC nurse caring for a patient with a perpetually leaking old PEG site. They have had the PEG removed and placed in a different area, and now, the old site refuses to close. It leaks to the point where you must use a towel when flushing his tube, as I am sure that 50% comes right back out of the old site.

The GI doctor is aware

The attending is aware

The ER was not amused when someone sent him out on a particuarly bad day. (The 'fountain' nearly hit the ceiling when they removed the dressing. Doc said to send them out)

Does anyone have any suggestions?

I have tried pressure dressings as was recommended by the GI- does nothing but hold soggy, stomach content laden gauze against healthy skin.

We tried some silver dressings when it got infected- which cleared up the infection, but did not help the leakage.

The doctors here for the most part are not involved in dressings, we generally come up with our own tx and run it by the physicians whenever they come in. I am at a loss- I do not know what to try. The only thing I found through Google was http://journals.lww.com/smajournalonline/Fulltext/2009/06000/Treatment_of_Persistently_Leaking_Post_PEG_Tube.10.aspx

What was the final solution, out of curiosity :)

Put an ostomy pouch over it

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