What is the incidence range for the complication caused by excessive external bolster tightening?

• A. 0.3% to 2.4%
• B. 5% to 10%
• C. 0.01% to 0.1%
• D. 10% to 20%

Answer: (A)

Excessive tightening of the external bolster around a gastrostomy tube can squeeze the skin and underlying tissue enough to cut off blood flow, causing localized skin damage or breakdown at the stoma. This complication occurs relatively infrequently, with reported incidence around 0.3% to 2.4% of patients, reflecting that it’s a real but not common issue. The reason that range fits is that while proper bolster snugness is important to prevent leakage, sustained high pressure from overtightening risks ischemia and tissue injury, especially in areas with thinner skin or compromised skin integrity. Regular skin checks and adjusting the bolster to distribute pressure more evenly help prevent this problem. Other high or ultra-low incidence figures don’t match typical clinical data for this specific complication.