These instructions are for Children’s Hospital of Philadelphia (CHOP) patients who use a Hollister^® tube attachment device to hold their feeding tube in place.

Important Information:

• A Hollister tube attachment device is used to hold long feeding tubes in place. They are used with certain kinds of G tubes or GJ tubes, that have been inserted by a surgeon in an operating room. Securing the tube stops it from coming out and prevents movement of the tube at the stoma, or insertion site. The more the tube moves at the site, the larger the opening becomes. A larger opening causes leaking which can lead to redness and breakdown of the skin.   
• The Hollister should be changed every week, or sooner if it becomes too wet and loosens from the skin.  Use a new Hollister device with each change.  This will help it stick to the skin and decrease the risk of infection.

Instructions for removing the old Hollister device:

If possible, have a second person help with Hollister device changes to prevent the tube from coming out.

1. Wash hands with soap and water or clean with hand sanitizer.
2. Gather supplies:
   • Gentle soap
   • Water
   • Washcloth
   • Cotton swab (such as a Qtip^®)
   • Cavilon™ No Sting Barrier Film (for children over 1 month age)
   • New Hollister device
   • Scissors
3. Remove new Hollister device from package.
4. Place a small amount of gentle soap into a bowl of warm water.
5. Place cotton swabs in soapy water.
6. While squeezing the latch located on the old Hollister, push the strap backward. The strap should now be free from the latch.   
7. Have the second person hold the tube in place or keep the tube secured with one hand until the new Hollister has been placed.   
8. Using a washcloth, loosen the adhesive attached to the skin around the tube.  
9. Spread the Hollister apart at the slit and gently remove it, being careful not to pull on the tube.

Instructions for skin care:

1. Use a soapy washcloth to gently clean the area where the adhesive of the Hollister was attached to the skin. Do not use any lotions or oils.   
2. Using a soapy cotton swab, clean areas closer to the tube. If the tube is new, there may be a small stitch used to secure the tube at the time of placement. This stitch should fall out with time. Do not remove the stitch while cleaning. Crusty drainage may be gently loosened with water.   
3. Dry all areas completely. Any areas left damp will irritate the skin.

Instructions for applying the new Hollister device:

1. If your child has an incision near the site of the tube, trim the Hollister so that the adhesive does not cover the incision. You may also trim the paper tape (border) for a better fit.
2. Apply skin barrier to the area where the Hollister will be in contact with the skin.
3. Peel up the center paper on the back of the Hollister, nearest to the opening for the tube. Do not peel the paper from the border.
    
4. Spread the Hollister at the slit and carefully slide it around the tube so the tube is positioned in the center hole and close to the latch.
    
5. Press the barrier firmly against the skin and smooth out any wrinkles for a more secure fit.
6. Remove the paper from the tape border on the back of the Hollister and press the tape to the skin.
7. Wrap the strap around the tube and push the strap into the slot located on the latch of the Hollister. Continue pushing the strap through the slot until the strap fits snugly around the tube. Do not make the strap too snug as it may cause a blockage of the tube. Tuck the strap into the slot on the exit side of the latch. Do not cut this strap.
    

If you have any questions about your child’s health, please contact your child’s healthcare provider. This document is intended only to provide general educational information and is not intended as medical advice or treatment. Please consult with your healthcare provider prior to use, as some of this information may need to be adapted for your child’s specific needs. It is the responsibility of your healthcare provider to advise you on the appropriate use of this information. If you/your child are not already a CHOP patient, this document does not create a doctor-patient relationship between you/your child and CHOP. CHOP is not responsible for any outcomes you/your child might experience from your use of this document. This document is provided "AS IS", WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, express or implied. If this document refers to any drugs or medical devices, it is the responsibility of your healthcare provider to check the FDA status prior to use. If this document includes references to drug dosing, please do not rely on this document. Your healthcare provider should check the package insert for each drug before use. Hyperlinks used within this document may not be translated into other languages.

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