How to make a 2 piece illeostomy wafer last longer?

Replies
25
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1169
jalrein
Sep 14, 2022 4:14 pm

I have an ileostomy and I have a two-piece system that I change the wafer and bag every 2-3 days. I've read where people make their wafer last 10 days. How is this possible? After cutting out the stoma shape, the plastic around the stoma breaks down after 2-3 days so I change it. It just doesn't seem possible to me to make the wafer last much longer than that. It seems to me that the waste would then go under the wafer and burn up the skin. What am I missing?

AlexT
Sep 14, 2022 5:15 pm

Everyone is different. I have a colostomy and change mine every 4 days. I've gone 7 days but I wasn't working or doing anything at the time. For me, the 4 days is about right I think cause the last thing I want is a leak at work. When I do change, I notice that my wafer (the sticky part) has gone from the normal brownish color to an off-white or cream color. To me, that indicates the adhesion is starting to break down and it's time to change. No idea if that's a correct assumption but it's worked for me so far.

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eefyjig
Sep 14, 2022 5:26 pm

I'm also in awe of those who can make their systems last that long! I have an ileostomy, wear a one-piece system, and I change every other day, occasionally after two days. I eat a lot and find that, especially after eating fiber, my stoma works hard and moves around a lot, causing it to pull at my ring. I don't want to risk a leak, so my every other day routine works well. I'm lucky my insurance covers enough bags. I had to switch medical supply companies, though.

AlexT
Sep 14, 2022 5:31 pm
Reply to eefyjig

You must have a very high metabolism because you don't appear to eat a lot. Why eat all the fiber if it causes some issues?

HenryM
Sep 14, 2022 6:03 pm

Jalrein, I too have a two-piece system (Hollister).  I change every fourth day (i.e. a 3-day wearing schedule).  As Alex said, I can tell when I change that the wafer has maxed out and I do not wish to take any chances.  Better safe than sorry is very trite, but it definitely applies to ostomies.  

 
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jalrein
Sep 14, 2022 7:04 pm
Reply to HenryM

Thanks H. I wear 2 or 3 days and then it breaks down so I change. I'm just in amazement that people can wear their wafer for 10 days. People say that so often I just had to inquire....

jalrein
Sep 14, 2022 7:07 pm
Reply to eefyjig

Thank you E. We have the same ileostomy and like you, my insurance covers a lot of bags and wafers. Our difference is I have a 2-piece. I change every other day also, most of the time. Basically, I wear 2 days and change. I just find it so hard to fathom that people can get their wafer to last for 10 days. I've had mine for 2 years and I see people claim this all the time and I'm amazed.

TerryLT
Sep 14, 2022 8:45 pm

Hi Jalrein, I too have an ileostomy and go for six days and can push it to seven if necessary. It has been close to three years for me now, and when I was a new ostomate, I tried lots of different systems, one piece, two, Hollister, Coloplast, Convatec, etc. I tried flat and convex flanges. I usually managed three to four days between changes, but sometimes had mishaps and never found a system that I was totally comfortable and confident with...until I tried my current pouch. It's the Hollister one piece, soft convex, #8958. It has made an amazing difference for me and I won't use anything else. I have an active life, work out three times a week and swim. I do have a pretty set way in my 'change' routine. I always warm the flange (after removing the backing) with my blow dryer for 30 seconds, then hold the whole thing in place for 1 1/2 minutes, using a good amount of pressure with my whole hand. It sure works for me!

Terry

eefyjig
Sep 14, 2022 10:24 pm
Reply to AlexT

I had a pretty good metabolism before my ostomy, and I guess now I don't hold onto food for as long, so I don't hold onto the fat, either (ironic since I just lost my gallbladder. I don't know what's going to happen now.) I eat fiber because I love vegetables, and because I eat large amounts of the things I like, it can piss Spuey off. I mostly eat carefully, white rice, zucchini, carrots - low fiber - but sometimes I indulge in the wrong things and pay for it later. I'm an idiot. A forgetful idiot.

Xerxes
Sep 15, 2022 4:02 am

I have a two-piece system with an ileostomy. I get a max of 5 days without a change. It is very hard to believe that someone can go 10 days without changing unless, of course, they are not eating a thing.

Xerxes

Longroad78
Sep 15, 2022 4:46 am

A lot of times it is getting the right size and shape cut for your stoma on the wafer, the skin prep. product, and using the paste and moldable rings to fill in the gaps. Warming the wafer properly will allow it to stick better. Using a PVC pipe fitting to put pressure around the stoma to press the closest area of the skin near the stoma prevents gaps and seals around your stoma and the paste will push through the opening around your stoma and fill in gaps.

There are tricks to extend the wafer. I can go 5 days up to 12 but do not like to go that long because the glue will break down with sweat. The bag can go anywhere from 1 to 5 days but the carbon filter is one area of failure and the bag itself will break down with the output.

Each person is different so time frames do vary between each person.

Past Member
Sep 15, 2022 5:16 am

I've never believed the "10 days before changing" either, particularly with an ileostomy, I reckon after that amount of time the bag would be ready to walk off by itself! But good luck to them if they can get that long, still think they may reek to high heaven.

Years ago I used to get up to 5-6 days wear time but as I've got older my skin has changed and now it's never more than 3-4 days (always worn a 2-piece system).

Bill
Sep 15, 2022 7:32 am

Hello jalrein.

When I first had a stoma I used to have a lot of trouble with wafer-adhesion and some bags wouldn't even last the day! The number of accidents/incidents was just too much for me to carry on like that, so I began making and developing my own baseplates.

The best of these have evolved into a simple 7x10cm piece of upvc skirting with bevelled edges to stop chafing, with a 3.5cm waste pipe (to create the hole) 2.2cm long (to accommodate a 90% detachable bend which guides the output away from the stoma and into the bag/sleeve).

The devices are held on by two belts (to suit my needs) and kept in place with a medical adhesive (which used to be 7730 but now I'm using Probond). The manufacturers devices are stuck onto these baseplates and they last for months.

My preference has changed over the years since I have been irrigating, so I now use a Coloplast two-piece system that will take both irrigation sleeves and bags.

I realise that there won't be many people who want to or have the skills to make their own baseplates.  However, I thought I would just add my contribution to this conversation as an alternative perspective. 

Best wishes

Bill

PS: Upon re-reading my reply to this post I feel that I must clarify one aspect of my contribution. In my routine, the bags/sleeves etc last for months. However, I take the whole thing off everyday to clean the area around the stoma and have a bath. So, there is a sense in which I change everyday, it's just that I put the same devices back on after doing so. I hope that makes things clearer.

Best wishes

Bill 

  

TerryLT
Sep 15, 2022 8:19 pm
Reply to Xerxes

I always assume that those people who change every week to ten days must have colostomies. It seems unlikely that someone with an ileostomy could last that long. I think maybe some people don't realize the difference and have unrealistic expectations, when the fact is that the output with an ileo is far more caustic and is just naturally going to break down any adhesive faster.

Terry

Casper9
Sep 15, 2022 9:41 pm

I have an ileostomy. I've never gone 10 days but my usual is 7 days. That being said, it very much depends on the products I am using. I have tried several but I have had reactions to some and some that have leaked after only a day or 2. I now always use the 2-piece Convatec Natura and an Eakin ring and can routinely go 7 days before changing. I might even be able to go longer but I'm not going to chance it. I also use Attiva SG3 ostomy deodorant that keeps everything pretty stink-free.

Casper

tmn68
Sep 15, 2022 10:07 pm

I wear a 2-piece, I am not a big eater but average.
I am one of those people who only change every 7 days. With no problem, even though I spend a lot of time in a pool or at the river. I don't walk so that could be why I can go so long.

TerryLT
Sep 15, 2022 10:43 pm
Reply to Casper9

Yeah, I'm like you. I can go seven, but I think any longer is just too risky!

330i_
Sep 27, 2022 1:12 am

10 days? That's almost hard to believe. But in any case, I imagine that it's a combo of particular tricks/modifications to the process that they've learned, a job where they don't tend to sweat, one's particular abdomen shape.

Personally, most of my bags last about 2 days, going on 3 is risky, albeit 3 days is common if I'm just sitting at home. That short time is largely due to the fact I have an indentation from a surgical scar right down my middle. To make 'em last even that long, I spray film/adhesive on the area, of the bag itself, I mold about 1/3 of a second 'cohesive seal' into the whole one normally on the protective barrier, then I put a thin layer of 'Stomahesive Protective Paste' on that. Frankly, I don't know how often others make modifications to the process, but in my case it was very much necessary. Maybe that'd let each bag last upwards of 5 days for someone who doesn't have a divot? I'm sure there's other products out there that I'm just not aware of, too.

Doe1mama
Oct 16, 2022 12:44 pm
Reply to eefyjig

Your answer about the food you eat made me laugh. I think my husband and I sometimes become too complacent and although we know what he's about to eat will cause gas, we kind of ignore it because things have been going too well. And like you, we pay for it. I know I'm as much to blame as he is, but he was unable to eat much for so long that it's good to see him have an appetite and enjoy food again. We just have to remember smaller meals and stay diligent!!!!!

Ebony&Ivory
Oct 21, 2022 11:28 pm
Reply to TerryLT

My Hollister 2-piece lasts 3 days. Maybe I'll try warming it.

Ebony&Ivory
Oct 21, 2022 11:29 pm
Reply to TerryLT

My Hollister 2-piece lasts 3 days. Maybe I'll try warming it.

kb2720329
Oct 22, 2022 7:22 am
Reply to 330i_

My bags don't last more than 36-48 hours. I get them through an association so I have to try everything to make them last at least every second day. I am going crazy.

Hateinit
Oct 31, 2022 9:22 pm
Reply to TerryLT

Hi Delgrl, do you use any products under the flange, like powder, skin prep, paste, etc.?

TerryLT
Nov 01, 2022 8:22 pm
Reply to Hateinit

As long as my skin is healthy, which is usually the case, I don't use anything. Just really dry skin is the best surface for good adhesion. If I screwed up with my last appliance change, and didn't cut the wafer perfectly, I'll sometimes get a small area of irritated skin very close to the base of the stoma. Then I'll use a very little stoma powder, and a tiny swipe with a skin prep wipe. I think the key is to use as little as possible just to get a dry surface for the wafer to sit on.

Terry

TerryLT
Nov 01, 2022 8:25 pm
Reply to Ebony&Ivory

It made a really big difference for me, so good luck!

TerryLT
Jun 10, 2024 8:17 pm

How interesting to read this post from me, back in September of 2022. It was posted before I discovered my current setup, a Hollister one-piece, convex, with a Salts aloe barrier ring. I now go for a week easily between changes, even though I have an ileostomy. So, it is possible if you find the right combination of products to work for you.

Terry