Stoma care: using Mepilex instead of gauze

The question of keeping Namine’s tracheostomy stoma covered was raised in my mind. Since decannulation, we’ve kept it covered with gauze. It seems like she’s coughing when she has the gauze on, but when we take it off, she doesn’t cough as much or at all. So I called the ENT department at Children’s Hospital…

I explained, once I actually got to talk to a real, live human, that the critical care docs in the PICU told us that Namine’s stoma should at all times remain covered. However, they told us to use a large band-aid. Now, we have a problem here. Namine is allergic to all adhesive. She gets bad rashes from the sticky leads they use at the hospital. That’s something unavoidable, however. If we could use something different, something not sticky, that would be better.

I don’t remember whose idea it was (as much as I’d like to take credit, it wasn’t me), but someone proposed using gauze and trach ties. (The gauze they put on at the hospital after the initial decannulation was held in place with tape.) That seemed like the perfect solution. Except now, it seems like Namine is coughing with the gauze on. So I asked ENT, is it possible that she’s breathing in particles from the gauze through her stoma? Why yes, they said, that does sound plausible. (I find it interesting that this seemed like the first time this has ever come up.)

So the next logical question is, to my mind, what can we use in place of gauze, if anything adhesive is out of the question? The answer came back, use Mepilex. As described by its manufacturer, Mepilex is an absorbent, atraumatic dressing made from polyurethane foam. Basically, it’s foam you put on or around a wound. We used it it pad the area around Namine’s stoma, between her skin and the wings of the trach tube. So I cut a large piece of Mepilex out and put it over the stoma, securing it with trach ties.

It seems to be working pretty well so far, and she hasn’t coughed once since I put it on her.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.