Need help healing open sore under stoma

Hello everyone, I know this question has been asked a lot, but I need some help to heal a small open sore under my stoma. I have tried the stoma powder crusting technique for a couple of months with no luck. Please let me know what has worked for you? Thanks for your help. Penguins7

I was recommended calamine lotion. I have tried it and it sure helps. Let it dry then do the powder and the crusting.

I've been told by an ostomy nurse to first clean and dry the skin underneath the stoma, then dab on some milk of magnesia, let it dry, and apply your wafer. And maybe try a different glue or adhesive ring if that is irritating the skin. Most likely, it's caused by the acid in your output and your wafer seal isn't very secure - try changing the wafer more frequently for a few weeks too.

I use Nystatin cream, then do the crusting. Best wishes and stay safe.

Hi Penguin7

When I have irritation or broken skin around the stoma, I use Anacept made by Anacapa Technologies. It is a greaseless, clear wound gel that I put on the skin around the stoma after showering, and it requires very little. I rub it in gently, allowing it to absorb into the skin, and then wipe it completely dry. Then I apply the barrier wipe (or barrier spray if that's your choice) to protect the skin before applying a SenSura Mio. I don't use a seal, only the barrier wipe protectant and then the SenSura Mio pouch. For me, less is more, and I have found this system to work efficiently for me. I have also found that this particular wound gel is fast in clearing up skin issues. I have found this to be the easiest, quickest, most efficient way to clear up skin irritation or wound. Hope you find a product that works for you.

PEACE

Dadnabbit

Thanks to all for the suggestions. I am going to try the Anasept with powder crusting technique and Duoderm skin patch and see if I can get this cleared up.   Stay well everyone.   Penguins7

Good morning.

A few options that may help your skin to heal:

1. During an appliance change out, clean and dry the sore, then leave it exposed for as long as possible to the air before putting your new appliance in place. Give the skin a chance to rest in between appliance wearings.

2. After cleaning and drying the wound/sore, apply over the sore a woven gauze pad/sponge saturated with a 50-50 solution of white vinegar (5% acetic acid) and distilled water, and let it set for 10 minutes. The acetic acid in the vinegar also kills a variety of bacteria. Let the skin dry fully after removal of the gauze.

3. Having seen a dermatologist for deep ulcerations under my ileostomy appliance, I was prescribed a topical 1% silver sulfadiazine (SSD) cream* as part of my healing protocol, along with the vinegar soaks, and the protocol has been nothing short of a minor miracle for healing my open wounds.

But, you may find just the vinegar/distilled water soak helps the wound heal.

Be well. Be better! :)

Lily17

*"Silver sulfadiazine, a sulfa drug, is used to prevent and treat infections of second- and third-degree burns. It kills a wide variety of bacteria."..."This medication is used with other treatments to help prevent and treat wound infections in patients with serious burns. Silver sulfadiazine works by stopping the growth of bacteria that may infect an open wound."

Hi Lily, learn something new every day. I changed my wafer again last night and no change in the healing of the sore. This sounds like a quick easy method with the vinegar. Thanks so much. Stay well. Penguins7

Hi, Penguins

The vinegar solution soak is unlikely to solve the issue overnight, but it's easy and inexpensive.   I'm hoping that it's helpful for your situation!    

Make it an amazing weekend!   : )

Lily17

I'm not sure what you are calling an open sore. If it's deeper than surface irritation, I would see my colorectal surgeon.

I've had many issues with irritation where nothing will adhere for any length of time. What works for me is keeping the wound free of output. Due to leakage, this is very difficult to do sometimes, requiring many appliance changes. Sometimes twice in a day.

I would first clean the peristomal area with an antiseptic skin cleanser like Hibiclens to kill any bacteria that might be lurking around. I only use it in the shower as I like to rinse well, and I only use it when necessary. Two or three changes should do it.

The peristomal area is also the perfect environment for yeast to grow. Try a very, very light dusting of any brand of 2% miconazole nitrate antifungal powder. Very light! You shouldn't be able to see it! Dab all over with your skin prep. Dab, but dab well!

Put on your appliance!

God bless and good luck!

Jo

Hi Penguins,

Sorry for coming to the party late... but where exactly is your open sore? When you say "under your stoma" do you mean under your barrier ring seal or under the barrier bandage area... or on the actual shaft of the stoma? Having a single open sore sort of rules out an allergic reaction to any barrier material or contact dermatitis. I'll hold off suggesting other possible causes until I better know the location.

Thanks,

Bob

Hey Bob, thanks for your reply. Located on the shaft of the stoma and hard to get at because it is located as you look down at the stoma on the under part area there. I have had it for a while and tried the powder crust technique and some ointments with no success. I wonder if a slight bit of seepage is keeping it from healing. The rest of my skin is flawless around the stoma area. Any help would be appreciated. It has been very quiet on site the last several weeks (almost boring) with your hiatus!! Good to have you back. Stay well. Penguins7

Try calamine lotion

Thanks Daandeers,   I will give it a try.   Stay well.   Penguins7

Hi penguins,

Hi penguins, Very interesting! I have something similar going on and haven't pulled the string and contacted any Docs about it yet. In my case, my stoma is "mushrooming" or "muffin-topping" on one side and is literally growing over the edge of my barrier. I'm not getting any leakage, but the skin on the shaft of my stoma under the "mushroom" lip on that side is not pretty. It appears a bit bloody and wet, but it's really hard to see exactly what's going on in there. I dry it as best I can before I put my new ring and barrier on, and it seals......but I don't like it. I've pinched the part of the mushroom that's overflowing the barrier edge to see how sensitive it is.......and there is feeling, but it's not overly sensitive. I think a quick slice with my knife would solve the issue, but I'm worried about the bleeding. My stoma seems to be one big blood vessel just waiting for me to mess with it. I'm thinking if I could remove the excess skin, it would allow some air to get at that shaft skin and give it a chance to heal. As you said, the rest of my stoma shaft and surrounding skin is perfect (for me). I'll see if I have more courage tomorrow when I change my barrier again, to just bite on a bullet and let my straight razor eat! I've asked around as to what type of surgeon I should be seeing about this, and I keep getting the same answer.....colorectal. But it's not about moving or disconnecting the stoma, just trimming one edge......so I'm not sure. I'm going to take my time with this one so I don't do something stupid. Now where did I put that darn razor............

Oh, shit........guess I got so carried away telling you about mine that we didn't talk about yours. Sorry about that. Seepage should be noticeable when you pull your barrier off. Not sure if you use a ring or not........but if you do.....the second you pull it off, look closely at the ring. You sometimes have to tilt the barrier a bit to see if there's any shiny spots on the ring material, which indicates a leak or a weep. The part of the ring that touches your skin will be dull in color, so if you see anything shiny, it's telling. Although I've tried a lot of things on open sores in the stoma area.....the only thing that really worked for me was letting air get to it. That's not always possible, depending on where it's located.....but even leaving your barrier off longer than normal when you change it, and using a hairdryer to keep a low stream of warm air moving on it will help. And if you're one of those lucky ones who can wear a barrier for 4, 5 or longer days.....you might want to change it daily, exposing it to as much air as you can......just until it starts to heal. Keep us posted on this...........I'm especially interested.

Thanks,

Bob

Hi, Penguins

You know, Bob asked a very pertinent question. My initial response to your query presumed a sore on the derma, not the shaft of the stoma. So...

My first (second, now?) thought is that perhaps the cut opening/edge of your appliance may be too close to the stoma and is rubbing and/or cutting into it frequently. I have had this happen, but the injury has been really minor and healed relatively quickly once I cut the opening of my appliance a little larger and paid really close attention to where I was positioning the appliance in relation to my stoma. Just over the last few months, I've noticed this issue. It confused me a bit at first, because most of us (ile)ostomates are told that a few months post-surgery, the size of our stoma will stop changing and settle into its "final" size. (Whether my stoma has actually changed size, again, 3+ years after my surgeries, I'm uncertain. It doesn't look like it has...so I'm guessing it's just...Operator Error. *chuckle*)

My second (third?) thought: are you very active, physically, where the appliance may shift ever-so-slightly in your movement and the cut edge of the appliance is "bumping up" against the stoma? Or, is there possibly undue pressure of anything against your stoma, maybe flattening it down so its surface has (greater) chance of contact with the cut edges of your appliance, creating injury? (Bob, these questions are for you, too. I think I remember reading that you're a very active person.)

The "mushrooming" also mentioned...could it be related to some of the sub-dermal intestine (in the abdominal cavity) working its way out through the stoma? If so, what is causing it? Good question for your doctors!

And maybe another ostomate will read all of the responses from the initial post, Penguins & Bob, and have another thought that leads to a solution for you. Be well, Gentlemen, and keep us posted on your progress!

Lily17