The first change of dressing should be performed 24 hours after PEG placement or earlier if indicated, for example if the site is bleeding (Loser et al. [90], Soscia and Friedman [175]). Until granulation of the stoma canal has taken place, the dressing should be changed daily using aseptic technique. The wound should be inspected for bleeding, erythema, secretion, induration, allergic skin reaction and so on (Loser et al. [90]). This will help to maintain skin integrity and detect any problems early, for example infection or skin breakdown.

After 24 hours and during the initial daily change of the dressing, the wound should be inspected and skin changes should be carefully noted. The site should be checked for bleeding, erythema, secretion or allergic skin reaction. For the first 10 days after the gastrostomy has been inserted, the site should be checked daily to ascertain skin integrity and detect any problems early, for example infection or skin breakdown. Most forms of local infection can be readily treated by cleaning the stoma site using aseptic technique and daily change of dressings (NNNG [127]). Antibiotics may be required in some instances. This procedure should be done by a nurse or nursing associate in hospital or by a suitably trained individual in the community (e.g. a community or practice nurse or a GP). For those patients who have a balloon gastrostomy inserted, the water content of the balloon should be topped up weekly to check the integrity of the balloon with the aim of preventing accidental dislodgement of the tube.

Care of the exit site should be performed daily to maintain skin integrity and detect any problems early, for example infection or skin breakdown. Most forms of local infection can be readily treated by cleaning the stoma site using aseptic technique and changing dressings daily (NNNG [127]). Antibiotics may be required in some instances.