What is the main concern when granulation tissue forms at the PEG exit site?

• A. That it can cause more moisture accumulation under the external bolster, increasing the risk for skin breakdown
• B. It improves skin condition
• C. It reduces moisture
• D. It prevents infection

Answer: (A)

Granulation tissue at the PEG exit site signals healing, but it can create folds or pockets that trap moisture under the external bolster. The skin around a PEG is delicate, and moisture from gastric contents, leakage, or wound fluid macerates it, weakening the barrier and raising the risk of dermatitis and skin breakdown. The external bolster can seal in this moisture, allowing the damp environment to persist and promoting skin damage. This moisture-driven breakdown is the primary concern because it increases pain, infection risk, and overall skin compromise rather than improving skin condition, reducing moisture, or preventing infection. Effective care focuses on keeping the exit site dry and well-ventilated, ensuring the bolster fits properly, and addressing excessive granulation tissue as needed.