Which of the following is the most comprehensive approach to reduce gastrostomy exit-site leakage?

• A. Exit-site care
• B. Outer bumper placement
• C. All of the above
• D. Prevention of tension

Answer: (C)

This item focuses on reducing gastrostomy exit-site leakage by addressing multiple factors that contribute to leakage. Leakage isn’t caused by one single issue; it often results from skin irritation and moisture at the exit site, movement of the tube at the skin, and traction pulling on the tract. A comprehensive approach handles all of these elements: proper exit-site care keeps the skin clean and dry, protects against maceration, and allows early detection of irritation or granulation; correct outer bumper placement stabilizes the tube at the skin, reducing unwanted movement that can push fluid or gastric contents out along the tract; and preventing tension minimizes traction on the tube, which can widen the stoma and drive leakage. When these strategies are used together, they address the main pathways that lead to leakage, making it the most effective overall plan.