Using Stoma Paste with Convex Pouch: Tips for Success?

I've had my ileostomy for 3 weeks now. I'm using the Sensura Mio. It's a convex pouch. I have a stoma that is almost flush with my skin and the ostomy is pointing south. It's been hard finding the right appliance that will work. I use stoma powder and skin barrier several layers for crusting because my skin is still irritated, then a barrier ring, then the appliance. I still have skin issues and when I change my appliance, I can see output on the barrier ring. I'm wondering if I should stop using the barrier ring and instead use stoma paste, then the appliance. I have the one from Coloplast because it's alcohol-free. I started to use it last change but it was so thick I couldn't get it around my stoma. Anyone have success with just stoma paste and an appliance? If so, what's the trick to getting the paste on?

Hi, I apply stoma paste on the flange around the edge of the stoma hole. Pat it down all the way around with a bit of water using your finger. After the flange is applied, just remove any extra that has come through the hole. I then use my fingers to press the flange down inside the hole. The warmth of your fingers sets it. I've never had a problem. Good luck.

Angela

Hi newbie,

Sorry, but I'm not understanding your question. Are you saying the barrier ring is too thick to get around your stoma, or the stoma paste? I use Hollister products, but neither their barrier rings nor their stoma paste is hard or thick.....hence me not understanding your question. The Hollister stoma paste is like caulk......it's the consistency of toothpaste.....so very easy to apply. And the rings are harder, but still very moldable.

I assume you're saying when you take off your barrier you find output is getting between your skin and the ring.....not between the ring and your barrier/appliance....right? With your stoma output hole facing downward......is it facing the barrier ring directly.....or is it pointing slightly over the ring? If you're outputting directly at the base of the ring, where the ring contacts the skin, you need to direct the output up and over the ring. I just saw a product on here that does that a few weeks ago.....I'll try to find it.

The one thing you mentioned that caught my eye was the crusting with stoma powder and skin protectant. I know everyone recommends you do that when your skin is irritated.....but if the area is too crusty......your ring won't stick to it. The ring can't stick to a crumbly crust.......nothing can. So if you're putting on more than two layers of stoma powder and protectant....it's going to be too crusty for the ring to stick to. If your skin is that irritated you might want to look at the non-adhesive barriers from Nu-Hope, which are designed specifically for such skin conditions.

Regards,

Bob

Bob and Angela made good comments.

If you use a barrier ring, have you tried pinching it into a wedge shape on the side closest to the appliance before application? This helps allow the effluent to flow over instead of under the ring.

Also, you may try a cyanoacrylate product called Marathon instead of crusting. Apply only a light layer (avoid the temptation to apply multiple layers as it will then flake off).

If you do go with the paste, remember it is more difficult to remove from the skin after pouch removal. Gentle patience with cleansing is needed.

Best wishes!

Sarah Beth Rogers, RN CWCN, CWON

I meant the stoma paste was too thick. I have some Hollister stoma paste but because it contains alcohol, I can't use it. It's pure torture putting that paste on irritated skin. So I got some paste from Coloplast that's alcohol-free, but it's so hard and sticky I can't get it to come out like Hollister paste. nbsp
Yes, when I take off the barrier, output is between the skin and ring. The stoma hole is facing slightly over the ring. I have to work to get it to do that; otherwise, it would face down. nbsp
Maybe you're right and I'm crusting too much, but my skin hurts so bad. I'll look at the Nu-Hope product you mentioned. Thanks!

I'm not understanding how to pinch into a wedge because my ostomy is facing down and it's hard enough to get it to barely peek out above the barrier ring. Can you explain this more? Also, do you know where I can get that Marathon product? Amazon is expensive and won't have it until April 24. I looked at Medline and the free sample link isn't working. I'll call them in the morning and try. Thanks.  

Hi Newbie, how close to your stoma are you cutting the wafer? I don't leave hardly any skin exposed. The edge of the barrier ring is right next to my stoma, about less than an eighth of an inch. Also, when my skin is irritated, I put some paste on a Q-tip and spread it on the sore spot, and that works for me.

Hi newbie

You had your ileo 3 weeks ago and I'm puzzled as to why your surgeon made your stomach flush with your skin? That is going to cause management problems, I'm afraid. I hope I'm wrong. Check with an ET nurse.