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G/GJ tubes: Using silver nitrate to treat granulation tissueGG/GJ tubes: Using silver nitrate to treat granulation tissueG/GJ tubes: Using silver nitrate to treat granulation tissueEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Abdomen;Stomach;Small IntestineDigestive systemNon-drug treatmentAdult (19+) CaregiversNA2019-07-30T04:00:00ZHolly Norgrove, RN, BScN8.6000000000000057.7000000000000489.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Silver nitrate can be used to help remove granulation tissue around your child's stoma. Learn more about silver nitrate and how to apply it to your child.<br></p><h2>What are G and GJ tubes?</h2><p>Gastrostomy tubes (G tubes) and gastrojejunostomy tubes (GJ tubes) are feeding devices. A G tube gives liquid nutrition, medication and other fluids directly into the stomach. A GJ tube gives liquid nutrition, medication and other fluids directly into the small intestine (the jejunum). Both G tubes and GJ tubes are placed in a surgical opening in your child's tummy (abdomen) called the stoma. The tunnel from the outside into the stomach is called the tract.</p><p>Despite your best efforts to keep your child’s skin around the stoma healthy, some common skin problems may occur. </p><p>If your child has issues with <a href="/Article?contentid=3019&language=English">persistent granulation tissue</a> around the stoma, your health-care team may suggest applying silver nitrate to the area. The first application should be done in a clinic or your doctor’s office, but you can continue the treatment on your own at home once you know how to apply the silver nitrate.</p><p>Silver nitrate is a more invasive treatment for granulation tissue; other treatment options, such as salt water soaks, are typically used before trying silver nitrate.</p><h2>Key points</h2><ul><li>Silver nitrate sticks are used to help treat and remove granulation tissue around your child’s stoma.</li><li>Do not use silver nitrate if your child has a sensitivity to silver.</li><li>Applying silver nitrate may be painful. Giving your child acetaminophen or ibuprofen before application may help your child stay comfortable.</li><li>Always protect your child’s healthy skin with a barrier cream before applying silver nitrate to the stoma.</li><li>Avoid using hypertonic saline soaks and antibiotic creams on the stoma if you are applying silver nitrate.</li><li>Contact your G tube specialist or doctor to check the stoma after two weeks of applying silver nitrate. </li></ul><h2>What are silver nitrate sticks?</h2><p>Silver nitrate sticks (also called silver nitrate applicators) have rounded tips covered in silver and are used to remove granulation tissue. Once activated by water, the silver burns the tissue, causing the granulation tissue to die and fall off. This will help heal your child’s skin.</p><p>Do not use this product if your child has a sensitivity or allergy to silver.</p><h2>Where can I get silver nitrate sticks?</h2><p>You can buy silver nitrate sticks at many pharmacies without a prescription. Call your local pharmacy ahead of time so they can order them for you.</p><h2>How to apply silver nitrate to a child’s stoma</h2><ol><li>Always wash your hands with soap and water before touching your child’s skin.</li><li>Clean the stoma with soap and water, and pat or let air dry.</li><li>Protect the healthy skin around the stoma by applying a barrier cream (for example, zinc oxide, diaper rash cream, or petroleum jelly).</li><li>Dip the silver nitrate stick into a small amount of sterile or distilled water. The water will activate the silver. Do not use salt water, or saline, because it will deactivate the silver and stop it from working. </li><li>Roll the tip of the stick only over the granulation tissue—avoid applying it to healthy skin. One stick is usually enough for each application. The tissue may turn a grayish-black colour—this is normal. This colour will disappear slowly over time.</li><li>If you accidentally get silver nitrate on healthy skin, wash that portion of skin with saline solution right away to stop its effects.</li><li>Wash your hands with soap and water when you are finished. </li></ol><p>Because antibiotic creams or ointments can reduce the effectiveness of silver nitrate, you should avoid using silver nitrate and antibiotic creams at the same time.</p><p>Applying silver nitrate to your child’s stoma may be painful. Give your child acetaminophen or ibuprofen before applying silver nitrate to help keep your child comfortable.</p><h2>At SickKids</h2><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Phone: 416-813-7177</p><p>Email: g.tubenurse@sickkids.ca</p><p>On weekends/afterhours, you may need to come to the Emergency Department for an alternate method of feed/fluids/medication administration.</p>

 

 

 

 

G/GJ tubes: Using silver nitrate to treat granulation tissue2909.00000000000G/GJ tubes: Using silver nitrate to treat granulation tissueG/GJ tubes: Using silver nitrate to treat granulation tissueGEnglishGastrointestinal;OtherChild (0-12 years);Teen (13-18 years)Abdomen;Stomach;Small IntestineDigestive systemNon-drug treatmentAdult (19+) CaregiversNA2019-07-30T04:00:00ZHolly Norgrove, RN, BScN8.6000000000000057.7000000000000489.000000000000Health (A-Z) - ProcedureHealth A-Z<p>Silver nitrate can be used to help remove granulation tissue around your child's stoma. Learn more about silver nitrate and how to apply it to your child.<br></p><h2>What are G and GJ tubes?</h2><p>Gastrostomy tubes (G tubes) and gastrojejunostomy tubes (GJ tubes) are feeding devices. A G tube gives liquid nutrition, medication and other fluids directly into the stomach. A GJ tube gives liquid nutrition, medication and other fluids directly into the small intestine (the jejunum). Both G tubes and GJ tubes are placed in a surgical opening in your child's tummy (abdomen) called the stoma. The tunnel from the outside into the stomach is called the tract.</p><p>Despite your best efforts to keep your child’s skin around the stoma healthy, some common skin problems may occur. </p><p>If your child has issues with <a href="/Article?contentid=3019&language=English">persistent granulation tissue</a> around the stoma, your health-care team may suggest applying silver nitrate to the area. The first application should be done in a clinic or your doctor’s office, but you can continue the treatment on your own at home once you know how to apply the silver nitrate.</p><p>Silver nitrate is a more invasive treatment for granulation tissue; other treatment options, such as salt water soaks, are typically used before trying silver nitrate.</p><h2>Key points</h2><ul><li>Silver nitrate sticks are used to help treat and remove granulation tissue around your child’s stoma.</li><li>Do not use silver nitrate if your child has a sensitivity to silver.</li><li>Applying silver nitrate may be painful. Giving your child acetaminophen or ibuprofen before application may help your child stay comfortable.</li><li>Always protect your child’s healthy skin with a barrier cream before applying silver nitrate to the stoma.</li><li>Avoid using hypertonic saline soaks and antibiotic creams on the stoma if you are applying silver nitrate.</li><li>Contact your G tube specialist or doctor to check the stoma after two weeks of applying silver nitrate. </li></ul><h2>What are silver nitrate sticks?</h2><p>Silver nitrate sticks (also called silver nitrate applicators) have rounded tips covered in silver and are used to remove granulation tissue. Once activated by water, the silver burns the tissue, causing the granulation tissue to die and fall off. This will help heal your child’s skin.</p><p>Do not use this product if your child has a sensitivity or allergy to silver.</p><h2>Where can I get silver nitrate sticks?</h2><p>You can buy silver nitrate sticks at many pharmacies without a prescription. Call your local pharmacy ahead of time so they can order them for you.</p><h2>How to apply silver nitrate to a child’s stoma</h2><ol><li>Always wash your hands with soap and water before touching your child’s skin.</li><li>Clean the stoma with soap and water, and pat or let air dry.</li><li>Protect the healthy skin around the stoma by applying a barrier cream (for example, zinc oxide, diaper rash cream, or petroleum jelly).</li><li>Dip the silver nitrate stick into a small amount of sterile or distilled water. The water will activate the silver. Do not use salt water, or saline, because it will deactivate the silver and stop it from working. </li><li>Roll the tip of the stick only over the granulation tissue—avoid applying it to healthy skin. One stick is usually enough for each application. The tissue may turn a grayish-black colour—this is normal. This colour will disappear slowly over time.</li><li>If you accidentally get silver nitrate on healthy skin, wash that portion of skin with saline solution right away to stop its effects.</li><li>Wash your hands with soap and water when you are finished. </li></ol><p>Because antibiotic creams or ointments can reduce the effectiveness of silver nitrate, you should avoid using silver nitrate and antibiotic creams at the same time.</p><p>Applying silver nitrate to your child’s stoma may be painful. Give your child acetaminophen or ibuprofen before applying silver nitrate to help keep your child comfortable.</p><h2>Stop hypertonic salt water soaks while using silver nitrate </h2><p>Because salt water stops silver nitrate from working, you should stop using <a href="/Article?contentid=2907&language=English">hypertonic salt water soaks</a> on your child while you are treating their granulation tissue with silver nitrate. Wait at least 12 hours before using hypertonic salt water soaks after applying the last treatment of silver nitrate on your child. </p><p>Your G tube specialist may recommend other dressings to use at the same time to help reduce redness and inflammation.</p><h2>How often to apply silver nitrate to your child’s stoma</h2><p>Your first application will be done in a clinic or at your doctor’s office, but afterwards, you can apply the silver nitrate at home. Silver nitrate is not for long-term use unless approved by your health-care team. </p><p>Your G tube specialist will recommend how often to apply silver nitrate. Usually it can be applied every two days for up to two weeks. After two weeks, the G tube specialist or doctor will check the stoma for improvements. They may decide to continue the silver nitrate longer.</p><h2>At SickKids</h2><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Phone: 416-813-7177</p><p>Email: g.tubenurse@sickkids.ca</p><p>On weekends/afterhours, you may need to come to the Emergency Department for an alternate method of feed/fluids/medication administration.</p>G/GJ tubes: Using silver nitrate to treat granulation tissueFalse

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