How Do You Use Silver Nitrate Sticks?

After having first PEG and then two balloon PEGs, I have a Mic-Key. I've always had problems with granulations. When I first got a Mic-Key, the two granulations I had went away without doing anything. Now I have three. I tried using a nitrate stick on one, but I must not have done it correctly. How much water do you put on the stick and how long do you hold it on the granulation?
Thanks, Patti

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I usually just put the tip onto the granulation, continuing to dab until it is fully covered. I never use water. The granulations then fall off by the next day. It is kind of painful, stinging for most of the day but once it's gone, it's gone.

Teresa

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Thank you, Teresa. I will try that today.

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Gran,

I don't wet the tips either. I find a useful technique is to roll the stick between your thumb and index finger. Rolling the side of the tip (of the nitrate stick)on the granulated tissue. Less is more. You can aways go over the area again. Try to avoid your healthy tissue.

Good luck,
Shannon

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It also helps to apply a ring of petroleum jelly on the healthy tissue around granulation tissue as a barrier to keep the caustic silver nitrate away from the healthy skin.

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I agree it is really important to put a barrier on healthy skin around stoma. In addition to vasoline, zinc oxide works well. :)

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While I have treated Brigid's granulation at home with silver nitrate (I have a tube of 100 sticks in her medicine cabinet as we speak) and we have used halcinonide cream as well - we recently were introduced to another method to treat the granulation. For Brigid, the GT grew back as soon as the SN treated area healed, and while the halcinonide was better, it was still not great. Last week, she was in the hospital, and the surgeon ordered Nasonex AQ spray (yes, the nasal spray for allergies) to be applied to her stomas. 2 sprays to the stomas 2x a day, and within less than 48 hours - the GT was gone. No discomfort to Brigid, and so far, it has been the most effective treatment we have seen.

The added benefit, according to the surgeon, is that if there is any suspicion that what you are seeing is herniated gastric mucosa, and not GT, you'll know within 24 hours - the mucosa will not change at all with the Nasonex, if it is GT it'll start to shrink.

You learn something new every day...

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Yeah dont use water....just dab the stick to the granulation and keep dabbing all over until the granulation turns dark and the silver nitrate stick isn't black any longer!

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I want to thank everyone for their input. I did use the SN (w/o water!) on one of them and it worked this time. The Nasonex AQ Spray is interesting. I happen to use Rhinocort for my nose. I wonder if that would work - can't hurt to try it, I guess. If it doesn't, will call my doc and get Nasonex.

Thanks again, everyone! Patti

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