Hi,
I'm a registered nurse that has just started working on a general surgery unit. I don't have that much experience with changing ileostomy appliances. I had one patient the other night whose ileo appliance is always leaking. Sometimes her appliance is changed 1-3 times in a 24-hour period. We use Eakin to fill in any skin depression in order to increase the seal... The problem is that every time we change her appliance, I run into a lot of problems when trying to clean peristomal skin and removing the previous Eakin. It sticks onto the skin like cement, particularly the last layers. During the last appliance change, I couldn't even remove all the Eakin as it was too painful for the patient. Her peristomal skin is always irritated due to the constant leaking from the appliance. To remove the Eakin, I try to wet the area well with a damp 4 x 4 gauze, as well as the remove wipes, and I try to take off as much as I can with a tongue depressor. I'm wondering if there is anything else I can do to make the process faster, easier, and less painful for the patient. I spent nearly 45 minutes trying to remove all the Eakin, and it wasn't even a lot. My patient is actually not eating right now... She's receiving TPN and lipids through a PICC line because she also has a cutaneous bowel fistula that also leaks green bile fluid not too far from her ileostomy stoma. So the fluid that she is putting out from her stoma is also just bile fluid... so very irritating to the skin and more easily leaks. I'm wondering if the mixture of the stoma output with the Eakin makes the old Eakin more difficult to remove.
Anyways... sorry for such the long explanation... I'm wondering if anyone has any advice on how to deal with such a challenge...
Thanks in advance.
Marianne
I'm a registered nurse that has just started working on a general surgery unit. I don't have that much experience with changing ileostomy appliances. I had one patient the other night whose ileo appliance is always leaking. Sometimes her appliance is changed 1-3 times in a 24-hour period. We use Eakin to fill in any skin depression in order to increase the seal... The problem is that every time we change her appliance, I run into a lot of problems when trying to clean peristomal skin and removing the previous Eakin. It sticks onto the skin like cement, particularly the last layers. During the last appliance change, I couldn't even remove all the Eakin as it was too painful for the patient. Her peristomal skin is always irritated due to the constant leaking from the appliance. To remove the Eakin, I try to wet the area well with a damp 4 x 4 gauze, as well as the remove wipes, and I try to take off as much as I can with a tongue depressor. I'm wondering if there is anything else I can do to make the process faster, easier, and less painful for the patient. I spent nearly 45 minutes trying to remove all the Eakin, and it wasn't even a lot. My patient is actually not eating right now... She's receiving TPN and lipids through a PICC line because she also has a cutaneous bowel fistula that also leaks green bile fluid not too far from her ileostomy stoma. So the fluid that she is putting out from her stoma is also just bile fluid... so very irritating to the skin and more easily leaks. I'm wondering if the mixture of the stoma output with the Eakin makes the old Eakin more difficult to remove.
Anyways... sorry for such the long explanation... I'm wondering if anyone has any advice on how to deal with such a challenge...
Thanks in advance.
Marianne