Which combination of strategies can reduce gastrostomy exit-site leakage?

• A. Exit site care
• B. Proper outer bumper placement
• C. Prevention of tension on the tube
• D. All of the above

Answer: (D)

Managing gastrostomy exit-site leakage comes from protecting the skin around the stoma, stabilizing the tube to prevent movement, and minimizing traction on the tube. Exit-site care keeps the skin clean and dry, reduces infection risk, and supports a good seal around the tube, which reduces skin breakdown and leakage. Proper outer bumper placement ensures the external bumper sits at the right distance against the abdomen—neither too tight nor too loose—so the tube stays positioned without rubbing or pulling, helping maintain a tight seal at the stoma. Preventing tension on the tube addresses the mechanical pull that can widen the tract and create a path for gastric contents to leak onto the skin. When you combine careful exit-site care, correct bumper positioning, and minimizing tube tension, you tackle the main factors that cause leakage and reinforce the barrier around the stoma.