rectal tube/malecot

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Specializes in IV therpay, CVICU, Med/Surg ICU, BMT ICU.

I recently transfer positions to a smaller hospital where they use a malecot tube as a rectal tube. My location has no P&P for the use of this tube specifically. I am looking for evidenced based practice guidelines as far a maintenance and the length that this tube can remain in place. I am unable to find any. Truly in todays health care should we even be using tubes for "off-labeled" use when there are no care practice guidelines out there. Plus there are rectal tubes on the market so why use a tube that you have no idea what the long term effects are because it has never been studied

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I've heard of physicians using tubes for off label use in trauma/critical care situations.

How exactly would a malecot tube be used as a rectal tube?

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Specializes in IV therpay, CVICU, Med/Surg ICU, BMT ICU.

Its inserted into the rectum with a finger and lube, and because of its design it just stays in place (well most of the time). A foley bag is connected to it to collect the drainage. It then can be irrigated through the sampling port on the foley bag if the stool is to thick

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Its inserted into the rectum with a finger and lube, and because of its design it just stays in place (well most of the time). A foley bag is connected to it to collect the drainage. It then can be irrigated through the sampling port on the foley bag if the stool is to thick

Interesting... I can see how it would be useful for a patient with acute diarrhea and skin integrity issues, but I imagine it would be very hard to keep the tube patent if the patient is having formed/semi formed stools. In my experiences I've only seen flexi-seals used... I've got mixed feelings about them.

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i've seen them for post-surgical drainage...the winged end seems to keep the orifice dilated enough to facilitate drainage.

used frequently for fistulas as well.

they're used in many ways at the discretion of ea surgeon...

thus the reason for no evidence based practice?

leslie

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Specializes in Psychiatric..

Ouch, yikes,

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Specializes in IV therpay, CVICU, Med/Surg ICU, BMT ICU.

Actually keeping them patent really isn't that difficult. You just have to flush it a few timesa shift when it get really thick. I seem to pull them out when I am repositioning the patient. They do great for skin integrity. My problem is what is the long term affect of inserting these since it is an off labeled use. Nothing is known or studied. There are at least two true rectal tubes on the market (actiflo and felxi-seal). I have limited experience with the flexi-seal but what I like about that brand tube is that it doesn't have the hard plastic piece inside the ballon that holds the lumen open like the actiflo does. I have mixed feelings about them to. I have to say they are all better thn the alternative which is cleaning your patient up frequently and dealing with skin breakdown. Which is what I had to do when I worked with Bone marrow transplant patients.

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Specializes in IV therpay, CVICU, Med/Surg ICU, BMT ICU.

OMG! Thank you.

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