Cutting the Bag to Fit Without Paste: Experiences and Tips?

I have not experienced leakage in my six weeks of having a colostomy. Here's my question...

I have very smooth skin, an evenly circular stoma, but to date, I have been using paste as well. I have run a light bead of paste around my stoma before mounting my bag, and as I said, I've yet to experience any leakage.

I was at wound care and learned that my wound care nurse is also the only local stoma nurse in this little town. She recommended I stop using paste. I'm okay with this; paste can be a bit of a nightmare to use, I've found.

Can anyone share their experience of just cutting the bag to an accurate fit and not using paste or barrier rings? What do I need to be aware of and watch out for? Any cautionary tales?

If what you are doing is working - why change? If the paste is troublesome then try without, but if it ain't broke… you are lucky with no seepage - I say stick (yes I chose the word stick intentionally) with your current procedure… jb

Hi Rodr,

The benefit of both the ring and paste is they seal instantly, assuming you put them on properly. If you cut your barrier to use without a ring or paste, there will be a very small gap between your stoma and the barrier, as making the hole too small will hurt your stoma. This isn't a problem if your output isn't liquid and if your stoma protrudes a bit so your output falls down into the bag and not back on the stoma shaft. Your barrier will swell and make up any space left around your stoma, but it takes a bit of time and isn't instantaneous like using paste or a ring. So if you can keep the small space between your barrier and stoma clear of any liquid output for 10 or 15 minutes, you'll be fine, as the barrier will swell. If your stoma doesn't protrude and your output will flow right into the space between your stoma and barrier, you could have a problem, as the barrier will still swell, but there will be liquid between your stoma and barrier and your skin may get irritated. If your output is pretty thick and solid, you should be okay. Does that make sense?

;O)

Personally, I'd base what I use on two things. 1) If what you're using and having confidence in is working to the extent you'd like, why change? And, 2) how active you are. If you're at all active, I have no idea how an ostomy bag seals/sticks well enough to have no issues without using paste or a barrier ring.
I've never tried paste, but if it's a pain for you to deal with, maybe try a barrier ring as they may be easier to use yet have the same effectiveness as your paste.

I would go with your nurse's advice. Less is best; if you don't need something, don't use it. Just give it a go without the paste. If you start having leaks, then use it again.

We all have leaks at times, whatever we do or don't do. I'm living on borrowed time, lol. It's been over 10 years since my last one. I know it will happen again one of these days. It's just one of those things. I've never used paste myself. I've used seals for the last 5 years or so, as I always had sore skin around the stoma. Since using seals, that's stopped.

Hello Rodr24.
Thank you for inviting us to comment on this issue.
I agree with what others have said on this subject in that 'if it ain't broke-don't fix it'.
However, I am also of the opinion that we should continue experimenting  with everything we can to see if things can improve, if only by a JND (just noticeable difference).
Experience has taught me that stomas can change size and shape without warning. Mine did so suddenly and the wafer seriously cut into the sides of the stoma. This prompted me to look around for devices that might prevent it from happening again.
One of the best of these is the  Salts stoma collar from Salts Healthcare Ltd. There are many different sizes, so you need to know the size of your stoma before ordering. Salts are quite happy to send out free samples. I have often wondered why someone hasn't brought out a range of bags with a similar design.
Moving on, and bearing in mind this design, I searched the supermarket shelves for  a product container with a top that was similarly smooth and rounded at the base but sloped inwards so that it would hold the stoma almost to the end. I found such a shape on a plastic bottle of bubble bath. This was cut off the bottle and adapted to fit my stoma. So far, it has worked very well and has acted as a protection both from expansion of the stoma and from those pesky leaks onto the skin. Because the device 'hugs' the stoma throughout its height, the only output to remain is right at the tip of the stoma, so doesn't cause any leakage problems.

As I have said in a previous post; I look forward to the day that we can get these experimental devices made to precise dimensions via a 3D printer, but, until then, it's DIY all the way.
Best wishes

Bill 

G-Day Rodr, If I were you, I would try a barrier ring. Measure the stoma as best you can and get a ring that is a nice snug fit. But if you're happy to keep using the paste, then go for it. Regards, IGGIE

I did that for a while - no paste, no ring. I experienced a lot more leaks that way. I'd use either paste or a ring (I use a ring) and be happy.

My thanks to everyone for your responses.

I'm thinking of trying barrier rings. I'd really like to keep leaks as something I only read about.

Hi Rod24, if you don't want to take the chance of having a leak (which may be a tall order, as pretty much everyone will experience one at some point) then don't change anything. But, there are a couple of things to consider. I've never used paste but heard it can be a nightmare. Barrier rings are tidy and clean and easy to use. I went for ages using just the appliance with no barrier ring. It was fine from a leakage standpoint, but I decided to try barrier rings to prevent skin damage around my stoma. The added benefit I found was that the barrier ring gave me an extra two to three days of wear time, so it's a big bonus and I've stayed with it.

Terry