What is a cecostomy?
A cecostomy is an opening from the outside of the body on the abdomen to the cecum, the first part of the large intestine. A cecostomy tube (C-tube) is placed through the abdomen into the cecum to help your child empty their bowel and decrease the incidence of fecal incontinence (soiling). C-tubes are inserted using image guidance.
Please see Cecostomy tube insertion using image guidance and Cecostomy tube: Common problems for more information.
Dressing covering the cecostomy site
After the C-tube is first inserted, your child will need to have a dressing covering the site for two weeks. The first dressing must stay on for 24 hours. After this, you will need to change the dressing once a day or more often if it gets wet or soiled. You will do this for 14 days or until the retention suture is cut. A nurse will show you how to change the dressing before your child goes home.
Changing the dressing daily helps you to monitor for any signs of infection.
Your child cannot go into the water while they have the dressing on, so avoid swimming and baths. They can have a sponge bath or shower, but the dressing must always stay dry. If the dressing gets wet, it needs to be changed.
Retention suture
When the interventional radiologist inserts the tube into your child’s cecum, they will also place a small piece of medical wire attached to a thread (retention suture) to hold the cecum against the wall of the abdomen. Until the retention suture is ready to be cut, your child cannot get wet, and they cannot have a bath or go swimming. Instead, you can sponge bathe your child.
How do you change your child’s dressing?
You will need the following:
- a clean face cloth
- warm water
- soap
- a clean cloth for drying the skin
- two squares of gauze that are 5 cm (2 inches) by 5 cm (2 inches) in size
- scissors
- one piece of tape about 10 cm (4 inches) long
- extra tape
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Wash your hands.
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Remove the old dressing around the C-tube. The retention suture bundle will be between the two pieces of gauze. Be careful not to pull the bundle when removing the dressing, as it is attached to your child.
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Look at the skin under the dressing for any signs of redness, swelling, liquid drainage, tissue growth or bleeding. A small amount of yellow-green liquid at the site is normal.
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Wet half of the face cloth in clean warm water. Put soap on the wet part of the cloth and gently clean the skin around the C-tube. Starting at the insertion site, wash the skin in a circular motion, moving away from the tube.
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Using the other half of the face cloth, rinse the skin well with clean warm water. Pat the skin dry with a clean cloth. It is important to make sure the skin area around the C-tube is dry before putting the new dressing on. Moist areas can lead to infection and granulation tissue (inflammation and extra tissue that forms around the C-tube).
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If there is liquid leaking out from around the C-tube that makes the skin burn and feel itchy, then protect the skin with a zinc-based barrier ointment. You can use ointments such as Zincofax or Ihle’s paste.
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Change the position of the tube by moving it clockwise around the insertion site. For example, if the tube is positioned at 12 o’clock on day 1, then move it to 3 o’clock on day 2, 6 o’clock on day 3 and 9 o’clock on day 4, etc. This helps to create a round hole. Use tape to hold the C-tube to the skin on your child’s stomach.
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Cut the shape of a "Y" in one gauze piece. Leave the second gauze piece intact.
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Place the gauze with the Y-cut on your child’s skin around the C-tube. Fit the gauze around the C-tube so that the tube and retention suture come through the opening.
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Put the second piece of gauze over the first piece of gauze.
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Stick the gauze down with the 10-cm (4-inch) piece of tape.
How long will your child need a dressing?
It takes about two weeks for the cecostomy site to heal. After that, your child no longer needs a dressing.
Removing the retention suture
After two weeks, the retention suture is no longer needed. You will be given a date and time to have the retention suture cut. During this appointment, the skin around the tube will be assessed for infection.
At SickKids
If you have any questions or concerns about your child after they are discharged home, please call the Image Guided Therapy (IGT) clinic at (416) 813-7654 ext. 201804. Speak to the IGT clinic nurse during working hours or leave a non-urgent message.
If you have concerns and it is after working hours, see your child’s primary health-care provider or go to the nearest Emergency Department.
