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A Little Help Here........How To Deal With Red Weeping Skin?

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Fri Nov 20, 2020 11:04 am

Hi Gang,

  We've discussed this at least a million times, but you know how the search is on here..........  So, what's the agreed-on best way to get red irritated weepy (wet) skin around the stoma and under the barrier under control as quickly as possible?  For me it's been to let air get to it.....but sometimes that's not possible, like when the skin is at the base of the stoma.  My skin went from really good to 5 alarm fire in 2 days.  It's for a variety of reasons that I'm addressing, having to deal with excess skin around my stoma and getting a poor seal with my barrier ring......so some of the irritation is from leakage, and some is just from who knows what.  But what's important is that I get it under control quickly so I don't burn thru ostomy supplies at a really rapid rate, and that I stop the skin from getting worse.  

 This morning I did the standard thing.........wash, dry, ostomy powder, protector wipe, repeat ostomy powder and protector wipe.  That stops the weeping long enough to get my ring and barrier on, but I'm sure it's not pretty under there.  I'll be changing my barrier every morning now, but wanted to look at other suggestions and couldn't quickly find them using the search.  

 So let me know what works for you.  

thanks,

bob

Fri Nov 20, 2020 11:30 am

I never had it really bad but once I had a case of diaper rash and used a skin prep and it cleared in a couple days. No-sting skin-prep by smith&nephew I expect there are other brands out there. I have heard of Calomine lotion and even egg whites but never tried them. I think dry is most important but you know that. An other thing is to change your ring and barrier as soon as you feel something wrong. Anyway good luck take care.

Fri Nov 20, 2020 12:02 pm

Hello Bob,

It sounds to me like you are doing everything correctly.  Therefore, I suggest that you condider locating/confering with an Enterstomal Therapist (ET)

for advice. I believe that most larger hospitals hav ETs on staff. I live near Cleveland and I know that the Cleveland Clinic has ET's on staff.

I have found that certified ET'S are well-trained and knowledgeable about ostomy issues and concerns. Hope this is helpful. Best wishes.

Mike from Lakewood, Ohio

Fri Nov 20, 2020 2:23 pm

Hi CC,

  Wow.........never heard of a Enterstomal Therapist!  Is that different from an Ostomy Nurse or a Stoma Care nurse?  I need to go look that one up.  I've been to the Cleveland Clinic.........drove there from Maryland after waiting in my local hospital for a bed up at Hopkins that was promised but never materialized.  Took around 9 hours I believe.  Wonderful place though.  I called them to let them know I was coming and they were waiting at the front door when I got there.  Looked like the Prize Patrol Van crew waiting for me.  They also took first class care of me when I was there!  Highly recommened! 

Ok........off I go to find ET!!  Err........I mean AN ET....not the extra terrestrial dude.

Thanks,

bob

Fri Nov 20, 2020 2:27 pm

Hi Bob there is a cream they use on babies and in nursing homes when they get real gaulded. It is called butt cream it heals and forms a barrier. Of course you know using a cream you have to use the powder and the skin prep. Hope you get it under control soon. Best wishes and stay safe 0

Fri Nov 20, 2020 3:51 pm
w30bob wrote:

Hi CC,

  Wow.........never heard of a Enterstomal Therapist!  Is that different from an Ostomy Nurse or a Stoma Care nurse?  I need to go look that one up.  I've been to the Cleveland Clinic.........drove there from Maryland after waiting in my local hospital for a bed up at Hopkins that was promised but never materialized.  Took around 9 hours I believe.  Wonderful place though.  I called them to let them know I was coming and they were waiting at the front door when I got there.  Looked like the Prize Patrol Van crew waiting for me.  They also took first class care of me when I was there!  Highly recommened! 

Ok........off I go to find ET!!  Err........I mean AN ET....not the extra terrestrial dude.

Thanks,

bob

Enterstomal therapist could be an R.N. or a non-nurse professional who had received special clinical training to provide guidance to an ostomate.

My E.T. happened to be a lab technician who received special education & training.

She  happened to also  be an ostomate and was a wonderful help to me following my surgery.

I had my surgery at Cleveland Clinic. I actually live ten minutes from Cleveland Clinic in the suburb of Lakewood, Ohio. 

 

 

 

 

Sat Nov 21, 2020 11:01 am

Hi Bob when you take your wafer or barrier off look at the sticky side around the hole and see if one area is more eroded away than the rest of it and add extra barrier ring in that spot, i have a dip around the bottom of my stoma so i add an extra piece of ring in that area and that helped me.  good luck

Sat Nov 21, 2020 11:10 am
ron in mich wrote:

Hi Bob when you take your wafer or barrier off look at the sticky side around the hole and see if one area is more eroded away than the rest of it and add extra barrier ring in that spot, i have a dip around the bottom of my stoma so i add an extra piece of ring in that area and that helped me.  good luck


Good suggestion Ron...

Sat Nov 21, 2020 1:20 pm
ron in mich wrote:

Hi Bob when you take your wafer or barrier off look at the sticky side around the hole and see if one area is more eroded away than the rest of it and add extra barrier ring in that spot, i have a dip around the bottom of my stoma so i add an extra piece of ring in that area and that helped me.  good luck


Hi Ron,

 Great piece of advice!  In my case the problem.....well, there's 2 problems, but the larger problem that causes the leakage is because the hole in my stoma that stuff comes out of isn't straight out facing forward.  My output exits almost directly to my right, and my stoma is an oval or ellipse.  So if my stoma is a tight fit inside the barrier ID my output shoots right into the ID of my barrier.  And that exit hole is flush with my skin, not above it.  So my output is always impacting the side of the barrier ring and the side of the barrier.  If the barrier swells any then the ID gets smaller and the output shoots directly under the ring and works its way past it....and I have a leak.  The current convex barrier I've been using is now too small, as my stoma has grown a bit.....so using that barrier just forces the stoma to shoot output right under my ring.  I can't leave a lot of space between the ring and my stoma hole or the skin in that region will get ugly quickly.  So I've switched to a larger flat barrier and a convex ring, and cut the barrier just a bit bigger so the output hits the side of the barrier and ring and hopefully deflects upward and out instead of being forced under the ring material. 

  I never have a problem with the ring ever sticking to my skin to the point it's hard to remove or leaves residue behind.  In my case it sticks just well enough to work, but removing it is never an issue.  I'm going to meet with a colorectal surgeon hopefully next week to discuss options.  The reason my stoma is growing is because the opposite side of the oval (away from the hole) is overgrowing and sort of muffin-topping....and the skin under the muffin-top never dries.......so adhesion isn't great there.  Luckily output rarely ever makes it over to that side, but I need to get my stoma trimmed up and get it looking more normal so that skin can dry.  So I've got a couple issues I'm working simultaneously here........the joys of being an ostomate. Funny they never mentioned any of this BEFORE my operation.  Go figure.  

 

Thanks for the replies guys.........much appreciated!!!

regards,

bob

Sat Nov 21, 2020 2:02 pm

Maybe you need to look into using paste and not a ring. Someone using paste can shed some light on this as I have never used paste.

Sat Nov 21, 2020 4:45 pm

Hi Bob.  Did you try the crushed prednisone tablet that Mggy34 told us about?  Seems like it's worth a try.

Good luck,

Mike

Axl
Sun Nov 22, 2020 6:17 am

This works very well for me, so well I use it as a preventative. I've never used the wipes just the spray.

https://www.amazon.com/3m-Cavilon-No-Sting-Barrier-Film/dp/B000HY6T7M

 

 






 

Sun Nov 22, 2020 11:05 am

Hi Bob what you describe is what my old stoma was like before i had resection surgery a couple years ago my exit was at about eleven oclock at skin level and my leakage started there and worked down to the bottom of my stoma where it has a dip in the skin and i would use a peice of eakin seal which lasted longer than the wafer material, towards the end before surgery i was lucky to get 3 days wear time and when the skin would get raw i would put a layer of paste on it spread like peanut butter and let it dry then my flat wafer. Maube your consultation with the surgeon and possible moving your stoma to the left side if he says it too short to pull out more to get a better spout isnt an option.  good luck

Sun Nov 22, 2020 5:22 pm
xnine wrote:

Maybe you need to look into using paste and not a ring. Someone using paste can shed some light on this as I have never used paste.


Hi, Bob~

Like you, I have an oval stoma and am forever hand-cutting my appliances to fit.  (Small price to be on this side of the turf.)

I have never used a barrier ring;  I'm a Paste Girl.  I use the Hollister Adapt paste, and squeeze about a 2-3 mm-thick bead from the tube directly onto the edge of the oval cutout in my appliance - the bead is just as wide as the tube opening, maybe a tad more - then place it over/around my stoma.  It stings a bit, at first, because this paste does have alcohol in it.  (Coloplast has a Brava alcohol-free paste.)  But, I find that the more viscous nature of the paste more easily fills in the little crevices in the skin right around my stoma.  And, the alcohol helps with keeping any nasty bacteria on the skin in check.

The pastes with alcohol take longer to "set up", stiffen - and if you need to change out your appliance within about 6-8 hours, you may find the paste still gooey, and difficult to remove from your skin.  To help the paste with alcohol "set up" when I've finished changing out my appliance, I run my finger numerous times, lightly, over/around the edge of the opening in the appliance, to help push the paste into the crevices of the skin, and create a (hopefully) leak-proof seal.  Then, I lie under a heating pad placed over my appliance for about an hour, and that is the big trick in getting the paste to "set up" - the heat, set on Medium or High.  Yes, it takes more time than other change out options but, again, the more viscous nature of the paste makes it more prone to pulling away from the skin with physical activity, until it has set up.

I spend about 2-2 1/2 hours changing out my appliance, twice a week.  It's a pain, but I also know it's a trade-off.  I don't feel that the thicker, more solid barrier ring would work as well for my situtation with the no-longer-smooth, broken-down, scarred skin next to my stoma.

I keep the Coloplast Brava alcohol-free paste in my "patch bag" for whenever I may have a leak at work, out & about, and can't change out my appliance until I get home.  The alcohol-free paste comes away from the skin more cleanly, so is my preferred paste when I know an appliance change out is fairly imminent.

Lily17~

 

Wed Nov 25, 2020 9:34 am

I have had alot of problem but I do agree calomine does help

Wed Nov 25, 2020 6:57 pm
xnine wrote:

Maybe you need to look into using paste and not a ring. Someone using paste can shed some light on this as I have never used paste.


Hi X,

  I've tried using paste.  And I fully expected it to work better than the ring. But unfortunately the paste dissolved very quickly and made quite a mess.  I've tried it a couple times from just filling small voids to fully replacing my ring with it, and it failed every time.  The rings, at least from Hollister, are for me much more durable.  I've never had a ring disintegrate on me, while paste has.  I'm guessing it does work for others, so it must be my liquidy output.....or sheer volume of output......or both.  But I think I used the rest of the tube to make a Mr Bill doll (from SNL)......so I did find a use for it!

;0)

bob

Wed Nov 25, 2020 7:04 pm
iMacG5 wrote:

Hi Bob.  Did you try the crushed prednisone tablet that Mggy34 told us about?  Seems like it's worth a try.

Good luck,

Mike


Hi Mike,

  Prednisone and I have had quite a love-hate relationship over the years, and if I never seen another cute little white Prednisone tablet again it will still be too soon.  But the suggestion is a good one.....and one that I will try.  Once I convince myself to take the lid off that Prednisone container......that I swore I'd never do again.  Right now I'm doing ok..........I have the leaking stopped and will see the Chop Doc on Dec 8th.  Woo-Hoo.  

regards,

bob

Wed Nov 25, 2020 7:21 pm
Lily17 wrote:


Hi, Bob~

Like you, I have an oval stoma and am forever hand-cutting my appliances to fit.  (Small price to be on this side of the turf.)

I have never used a barrier ring;  I'm a Paste Girl.  I use the Hollister Adapt paste, and squeeze about a 2-3 mm-thick bead from the tube directly onto the edge of the oval cutout in my appliance - the bead is just as wide as the tube opening, maybe a tad more - then place it over/around my stoma.  It stings a bit, at first, because this paste does have alcohol in it.  (Coloplast has a Brava alcohol-free paste.)  But, I find that the more viscous nature of the paste more easily fills in the little crevices in the skin right around my stoma.  And, the alcohol helps with keeping any nasty bacteria on the skin in check.

The pastes with alcohol take longer to "set up", stiffen - and if you need to change out your appliance within about 6-8 hours, you may find the paste still gooey, and difficult to remove from your skin.  To help the paste with alcohol "set up" when I've finished changing out my appliance, I run my finger numerous times, lightly, over/around the edge of the opening in the appliance, to help push the paste into the crevices of the skin, and create a (hopefully) leak-proof seal.  Then, I lie under a heating pad placed over my appliance for about an hour, and that is the big trick in getting the paste to "set up" - the heat, set on Medium or High.  Yes, it takes more time than other change out options but, again, the more viscous nature of the paste makes it more prone to pulling away from the skin with physical activity, until it has set up.

I spend about 2-2 1/2 hours changing out my appliance, twice a week.  It's a pain, but I also know it's a trade-off.  I don't feel that the thicker, more solid barrier ring would work as well for my situtation with the no-longer-smooth, broken-down, scarred skin next to my stoma.

I keep the Coloplast Brava alcohol-free paste in my "patch bag" for whenever I may have a leak at work, out & about, and can't change out my appliance until I get home.  The alcohol-free paste comes away from the skin more cleanly, so is my preferred paste when I know an appliance change out is fairly imminent.

Lily17~

 

Hi Lily,

  Great post........and interesting.  As I said above in my reply to X....the paste never worked for me. But I've never cured it the way you do.  I change my barrier every other day, and it takes me about 15 minutes from start to finish.  I hear what you say about the paste filling in voids better than the ring, but I think if you try a ring you'll be surprised.  When I remove my barrier and look at the surface of the ring I can see every detail of my skin, including pores and hair indentations that I missed when I trimmed.  The ring does feel stiffer than the paste, but your body heat allows it to "flow out" more that you probably think it can, and you'll see it really does what it's supposed to do.  I was certainly surprised when I first used one.  

  You also jogged my memory about the paste.  It sticks to everything and is a pain in the butt if you get it on your fingers.  I remember messing with it (and the mess it made) now that you reminded me.  The way you cure it probably makes it much more successful...........but I just don't have that kind of time in the morning.  But I do cup my hand around my barrier and hit it with warm air from my hair dryer for 30 seconds or so........then I fully cover the barrier with my closed hand for a full minute.  After that I run my finger around the outside of the portion of the barrier closest to my stoma, slap the bag on......and I'm gone.  If you want to see what I mean about how well a ring sticks just stick a ring and barrier on the other side of your abdomen and remove it the next morning.  If you need one I've got some Hollister barriers in my junk box that are too small for me that you can have...and I've got tons of rings.  Just shoot me your address via PM and I'll mail them to ya.  You might be surprised.  

regards,

bob

Thu Nov 26, 2020 5:48 pm

This might be a stupid question/idea but please be patient.  Suppose you used half a ring just around the output side of the stoma.  That might push the skin there into your body while having less effect on the opposite side.  Then, if you apply a custom fitted hernia belt it might allow more space for the output to navigate its way down.  

I have a colostomy so it's probably different.

Good luck,

Mike 

Fri Nov 27, 2020 4:33 pm

Hi Bob ... Have no idea if the red and weepy skin might be from a yeast type bacteria, but for years I have always used Lotrimin powder (it is usually used for athlete's foot or, yes, jock itch) ... I apply that to cleaned skin, crust that and then apply stoma powder, crust that and then apply my barrier ring.  I have not had skin issues for years now ... so even if my skin looks absolutey fine, I still use the Lotrimin Powder.  Hope this helps. 

 

Paula

Fri Nov 27, 2020 5:13 pm

I use compound tincture of benzoin for irritation on skin. 

Fri Nov 27, 2020 7:37 pm

Hi Bob,

First I want to thank you for the info you gave on rehydration. I have an ongoing problem with being dehydrated, and go for IV fluids when needed which has been often since summer. Even had a chest port for over 3 yrs and did IV fluids at home, until I got a blood infection and ended up in the hospital with MSSA.

I have GI issues as well, with small bowel bacterial overgrowth, so never eat sugar, but lots of salt. When you suggested sugar absorbed better, I told my Nutrionalist about it and recommended honey, more nutritional than sugar, and digests higher in the small bowel. I also add the rehydration drops and a few drops of flavored green tea extract, because the honey was so over powering sweet to me. 

Do far it seems to be working as far as I can tell, not getting up with leg and foot cramps at night either.

 

Now, as for your skin problem. I use a Hollister convex ring on a flat Coloplast barrier. I had hernia and prolapsed repair about a year ago, and after that I had a problem with stoma retracting more. Not below skin level but enough to cause itching and red rashes. The ring works well, but had a problem with itching for a day or so after changing. After that no itching, go figure. I started using a product called Thorawoks instead of barrier wipes. Pat on like using a wipe, but no need for powder. Only been using for a few changes, but do far, so good.

Hope this helps

Elaine

Nurse
Thu Dec 31, 2020 10:51 am

Good Morning, this is my first reply to a message but wanted to see if a new product I found might help in your situation.  There is a new ring that has come out from a company called Ostoform.  It is similar to a regular ring from any of the big companies but one BIG difference.  It has a little flexible plastic diverter attached for people who have there OS (opening of stoma) facing down or to an angle. This would take the place of your current ring and it seems to be a thickness between a regular and slim/thin ring

Look up www.ostoform.com or
_________________
Certified Wound/ostomy/continence nurse BSN RN

Thu Dec 31, 2020 11:58 am

Hi DisneyRn,

  Wow...........where have you been hiding........that's a great idea!  Will definitely get one to try.  I'm always amazed there's ostomy stuff out there I've never seen or heard of.  Thanks much for that info!!!

regards,

bob

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