MIC Gastrostomy Feeding Tubes are recommended for patients who require long-term feeding, are unable to tolerate oral feeding, have a low risk of aspiration, require gastric decompression, and/or medicine administration directly into the stomach. MIC Gastrostomy feeding tubes can be inserted surgically, percutaneously under fluoroscopic or endoscopic supervision, or as a replacement for an existing device with an established stoma tract.

Features

• Medication port
• Gamma Sterilized
• Recessed distal tip
• Material: Silicone
• Radiopaque stripe
• Universal feeding port connector
• SECUR-LOK external retention ring
• Inflatable silicone internal retention balloon

Indications for Use

Avanos series of MIC gastrostomy feeding tubes is recommended for patients who require long-term feeding, are unable to tolerate oral feeding, have a low risk of aspiration, require gastric decompression, and/or drug administration directly into the stomach.

Contraindications

Contraindications for placement of a gastrostomy feeding tube include, but are not limited to:

• Colonic interposition, Ascites, Portal hypertension, Peritonitis, Uncorrected coagulopathy, Uncertainty as to gastrostomy tract direction and length (abdominal wall thickness), Lack of adherence of the stomach to the abdominal wall (replacement only), Lack of established gastrostomy tract (replacement only), Evidence of infection around stoma site (replacement only), Presence of multiple stoma fistulous tracts (replacement only).

Complications

The following complications may be associated with any gastrostomy feeding tube:

• Nausea, vomiting, abdominal bloating or diarrhea, Aspiration, Peristomal pain, Abscess, wound infection and skin breakdown, Pressure necrosis, Hypergranulation tissue, Intraperitoneal leakage, Buried bumper syndrome, Peristomal leakage, Balloon failure or tube dislodgement, Tube clog, Gastrointestinal bleeding and/or ulceration, Gastric outlet obstruction, Ileus or gastroparesis, Bowel and gastric volvulus.
• Other complications such as abdominal organ injury may be associated with the procedure to place the feeding tube.

Placement

The Avanos family of gastrostomy feeding tubes may be placed in the following ways:

• Surgically
• Percutaneously under fluoroscopic (radiologic) guidance
• Percutaneously under endoscopic guidance
• A replacement to an existing device using an established stoma tract

Warning: A gastropexy must be performed to affix the stomach to the anterior abdominal wall, the feeding tube insertion site identified and stoma tract dilated prior to initial tube insertion to ensure patient safety and comfort.

Warning: Do not use the retention balloon of the feeding tube as a gastropexy device. The balloon may burst and fail to attach the stomach to the anterior abdominal wall.

Warning: The insertion site for infants and children should be high on the greater curvature to prevent occlusion of the pylorus when the balloon is inflated.

Balloon Maintenance

Precise balloon life cannot be predicted. Silicone balloons generally last 1–8 months, but the life span of the balloon varies according to several factors. These factors may include medications, volume of water used to inflate the balloon, gastric pH, and tube care.

Check the water volume in the balloon once a week.

• Insert a male Luer syringe into the Balloon Inflation Port (BAL.) and withdraw the fluid while holding the tube in place. Compare the amount of water in the syringe to the amount recommended or the amount initially prescribed and documented in the patient record. If the amount is less than recommended or prescribed, refill the balloon with the water initially removed, then draw up and add the amount needed to bring the balloon volume up to the recommended and prescribed amount of water. Be aware as you deflate the balloon there may be some gastric contents that can leak from around the tube. Document the fluid volume, the amount of volume to be replaced (if any), the date and time.
• Wait 10–20 minutes and repeat the procedure. The balloon is leaking if it has lost fluid, and the tube should be replaced. A deflated or ruptured balloon could cause the tube to dislodge or be displaced. If the balloon is ruptured, it will need to be replaced. Secure the tube into position using tape, then follow facility protocol and/or call the physician for instructions.
• Caution: Refill the balloon using sterile or distilled water, not air or saline. Saline can crystallize and clog the balloon valve or lumen, and air may seep out and cause the balloon to collapse. Be sure to use the recommended amount of water as over-inflation can obstruct the lumen or decrease balloon life and under-inflation will not secure the tube properly.

Daily Care & Maintenance Check List

• Assess the patient for any signs of pain, pressure or discomfort.
• Assess the stoma site for any signs of infection, such as redness, irritation, edema, swelling, tenderness, warmth, rashes, purulent, or gastrointestinal drainage. Assess the patient for any signs of pressure necrosis, skin breakdown, or hypergranulation tissue.
• Clean the stoma site using warm water and mild soap.
• Use a circular motion moving from the tube outwards.
• Rinse thoroughly and dry well.
• Assess the tube for any abnormalities such as damage, clogging, or abnormal discoloration.
• Clean the feeding tube using warm water and mild soap being careful not to pull or manipulate the tube excessively.
• Rinse thoroughly and dry well.
• Clean the gastric and balloon inflation ports. Use a cotton tip applicator or soft cloth to remove all residual formula and medication.
• Rotate the tube 360 degrees plus a quarter turn daily.
• Verify that the external bolster rests 1–2 mm above the skin.
• Flush the feeding tube as described in the General Flushing Guidelines section above.

MRI Safety Information

The MIC Gastrostomy Feeding Tubes are MR Safe.

Warning

Do not reuse, reprocess, or resterilize this medical device. Reuse, reprocessing, or resterilization may

• For enteral nutrition and/or enteral medication only
• Adversely affect the known biocompatibility characteristics of the device
• Compromise the structural integrity of the device
• Lead to the device not performing as intended, or
• Create a risk of contamination and cause the transmission of infectious diseases resulting in patient injury, illness, or death.