From the Research
A rectal tube or dugnitube should generally not remain in place for more than 29 days, as the complication rate for longer duration use is significantly higher than in the shorter duration group. The majority of patients had their fecal management system (FMS) inserted for less than 29 days, with a mean duration of 17.4 days [ 1 ]. Prolonged use of a rectal tube can lead to rectal mucosal damage, pressure injuries, and potential complications such as perforation or infection.
When considering the use of a rectal tube, it is essential to weigh the benefits against the potential risks and to monitor the patient closely for any signs of discomfort, bleeding, or mucosal damage during and after use. The tube works by providing a pathway for intestinal gas to escape, relieving distension and discomfort, but it should be considered a temporary intervention rather than a long-term solution for chronic conditions.
Alternative approaches for managing gas and distension should be explored for patients requiring ongoing management. For example, a study on faecal diversion system usage in an adult intensive care unit found that rectal tubes remained indwelling for a median of 5 days, with a range of 1-23 days [ 2 ]. However, the most recent and highest quality study on this topic is the 2014 study on the use of a fecal management system in acute care patients [ 1 ], which provides the most relevant guidance on the duration of rectal tube use.
Key considerations for the use of a rectal tube include:
- Proper lubrication with a water-soluble lubricant
- Ensuring the tube is properly secured but not taped tightly against the skin
- Monitoring the patient for any signs of discomfort, bleeding, or mucosal damage during and after use
- Considering alternative approaches for managing gas and distension for patients requiring ongoing management.
Overall, the use of a rectal tube should be carefully considered and monitored to minimize the risk of complications and ensure the best possible outcomes for patients.