A low-cost pediatric gastrostomy securement system for resource-limited settings: a preliminary observational study

Purpose

The high cost of gastrostomy tubes (G-tubes) limits their use and availability in resource-limited settings, where Foley urinary catheters are commonly used as low-cost alternatives for pediatric feeding. However, when used as feeding tubes, Foley catheters are prone to complications due to inadequate securement. This study aims to clinically validate a novel, low-cost securement device designed to improve the safety and functionality of Foley catheters as a pediatric gastrostomy securement system in low-resource settings.

Methods

We developed a securement device for pediatric feeding tubes in resource-limited settings. The device was tested in 11 children (age 1–15 years) with Foley catheters at a long-term care hospital. Patients were monitored for 8–14 days during device use, with daily assessments for complications. Due to a design defect, the device was modified mid-study. Caregivers and medical staff completed pre- and post-study surveys about their experiences with previous securement methods and our device. The study was approved by the relevant ethics committees.

Results

The device was successfully used in most patients. 95% of staff and caregivers were able to feed children effectively while using the device, and 85% could do so independently. Additionally, 82% indicated that they would use it again. No major complications occurred. However, minor issues were reported, including leakage in 4 (36%) patients and device dismantling in 7 (64%) patients. Staff and caregiver ratings of their child’s pediatric gastrostomy securement system significantly increased after device use, particularly in terms of satisfaction, ease-of-use, and securement. Users liked the device’s ability to secure the excess length of the catheter but suggested improvements in durability and ease of installation.

Conclusion

The device shows potential as an effective pediatric gastrostomy solution for low-resource settings; it is functional, safe, and easy to use, but requires improvements in durability and ease of installation, which will be addressed in future advancements.

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