Alternatives to Skin Prep for Insurance Coverage Issues

Is there anything else to use other than Skin Prep? My insurance won't cover it anymore, Mike

Hi Mike, of course I use Hollister products and all I use is the glue remover and then wash with a soap that has no oils or perfumes and dry really well, I use a hair dryer on the Adapt seals on low for about 20 seconds and slap them on, then the wafer. I was told NOT to use skin prep with Hollister and now I get a week easily out of my flange, I just change the pouches about every third day. If you're not using Hollister, I don't know if this would work or not, I'd give it a try just to see what happens, Ed

Hi Mike, of course I use Hollister products, and all I use is the glue remover. Then I wash with a soap that has no oils or perfumes and dry really well. I use a hair dryer on the Adapt seals on low for about 20 seconds and slap them on, then the wafer. I was told NOT to use skin prep with Hollister, and now I get a week easily out of my flange. I just change the pouches about every third day. If you're not using Hollister, I don't know if this would work or not; I'd give it a try just to see what happens. Ed       Thanks Ed

I use Hollister products, but thought we needed to use the prep. What are adapt seals? I haven't heard of the glue remover either... Guess I need to look into all of these products you are referring to.

Hi Grammybec - Yes, Hollister recommends using no adhesive remover or skin prep. But I use them both because the Adapt ring (or Eakins seal, in my case) is so sticky - remnants of it stick to my skin, and because the skin prep reduces rash under the flange. The Adapt ring (or paste) or Eakins seal helps protect from any leakage under the flange (or barrier or wafer, whatever you want to call it).

Mike - I can't think of a product that would take the place of skin prep, but like Ed says, unless you are prone to rashes or your skin is really pockmarked, I don't see why you would even need skin prep with today's products.
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Living with Your Ostomy | Hollister

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  The seals are wonderful, and I was told about them by Convetec, who is my supplier.  I could not use the glue because it irritated my skin tremendously.

Regarding the Hollister Flange, if you have an ileostomy you dont want any skin showing after applying the flange as ileostomys are usually liquid and its very easy to get your discharge under the flange and trouble is just around the corner. By using the adapt rings you can manipulate them to the exact size of the stoma, (actually, a little size smaller than the stoma works wonders). As for skin prep, forget about it, just use the adhesive remover wipes and if you're not in a rush you can use a soap that has no oils or perfumes and dry well after. Also, if you use a hair dryer on low on the adapt rings for about 20 seconds before applying the rings they really stick nice, just make sure the stoma is nice and dry before applying the ring, at this point if the seal is fitting right and you are applying the wafer you don't have to worry about how centered the flange is as nothing can get by that seal, (at least it shouldn't), so don't be afraid to ask any questions, that's what we do here, good luck, Ed.
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Hi Mike, Tincture of Benzoin is basically the same thing as skin prep, and if you can find a bottle of it, I am sure it is a lot cheaper. You may ask your pharm to order it for you or search online. I use Hollister and do not use skin prep. The WOCN I had said that the substance making up the barrier device was meant to mesh with the skin, and if you used skin prep, it would prevent this from happening and result in the barrier not adhering as well. I don't like the Ekins seals because they melt and make a mesh on my skin and don't work as well as the Adapt seals. What works for one doesn't necessarily work for the other, but these are options you can consider.
Have a good one!
eddie
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What does an adapt seal look like? I use Eakin seals, and I still leak. The problem is my skin burns every time my colostomy goes, and I go all the time. I change my pouch about 8-10 times a day. Is that normal? All these years, I think it is, but maybe I'm wrong. Even though I drain all the time, should I be irrigating? I asked the doctors the last time I was in the emergency; they didn't know. Do you know?

Hi there - Adapt seals are the ones made by Hollister - very similar, but I find them much easier to work with - maybe less sticky or something, not sure, but the same principle as the Eakins.  

Isn't it unusual for a colostomy to be working so often? Changing 8-10 times a day, no wonder your skin is burning! Do you have a stoma nurse you can access? Because it doesn't sound quite right to me!

Take care
Rach xxxx

Hi Mike, I think 3M makes a wipe similar to Skin Prep, and my insurance covered it when I used it. I have gone back to Skin Prep since I started using Eakin seals and convex wafers. Try the website for the type of wafer you are using and see what is recommended, or ask your supplier when you reorder what your insurance covers. Good luck.

Mizy, I don't think 8 or 9 times a day is normal either. Apparently, your wafer is leaking, and that is what is making your skin sore. Have you tried other types of wafers? If your stoma is retracted, you may need a convex wafer, but whatever, keep trying until you get a proper fit. It isn't good for your skin to keep getting damaged. Good luck to you, too.
Pat

Ladies, I've been doing this for over 20 years, and I haven't got a clue what I'm doing anymore. A stoma nurse? What the hell is that? Every time I ask to see one, they don't exist here, apparently. One comes to town, but unless you know when, you're out of luck, and only if it's worth her while. And yes, I've tried other products, and I use convexity. I'm tired, getting old, and fed up. It's to the point that it burns so much that I want to scream, rip it right off, and run through work babbling. I'm sorry to sound trivial, but I'm at the end of my rope.

Hi Babes - it is NOT normal to have to change your pouch 8-10 times a day - no wonder your skin is breaking down and burning, and no wonder you are at the end of your rope... Can't believe that there is no one to help you nearby... any support groups you can get to and see a real person??

Let's start from the beginning as there must be something wrong somewhere...

• Have you phoned all the manufacturers and asked for their advice and gotten free product samples? They are all very helpful and knowledgeable and will try their best to find you something that will work, especially when they hear of your situation.
• Does the skin around the stoma (under the flange of the pouch) bleed when you take it off?
• Have you tried the tips like using a hairdryer to get the skin dry and warm?
• Have you tried dabbing calamine lotion on and drying with a hairdryer before applying the pouch?
• Is the hole you have cut in your pouch the right size?
• You have a colostomy - generally, I believe they tend to only work at certain times of day rather than all the time (please colostomates correct me if I am wrong?) - is yours working all the time?
• Is the stoma a regular size or irregular - does it stick out a lot or is it very small and retracts itself flush to your skin?
• Do you wear a belt to help keep it on?
• Do you use extra tape to help keep it on?
• Was there no help given to you when you first had your surgery - who taught you how to manage your stoma (I know it was a long time ago and products have changed immensely since...)

God hope that doesn't sound patronizing, not meant to, but you seem to be in a right old state and I can't bear to hear that from anyone...
Rach xxxx

I've been online and haven't found a group that didn't answer. Yes, mine retracts. Yes, I wear a belt; it will leak through it. Yes, I've dried the skin. I've measured even to the point I've tried a smaller size that didn't work. I will get a rash trying other means, and yes, it drains all the time. There, I think I've answered all of the above. I just don't know what else to do.

Hi again -

http://www.caet.ca/about.htm

Have a look at that link and try to contact them, preferably by phone if you can, and see if they can help you. It just seems so ridiculous that you cannot get any help. I am so sorry; I don't know what else to suggest for you.

Oooh, maybe one more thing - convex pouches? Have you tried those? xxxx

For a couple of weeks, I've had leaky problems, decided I must seek professional advice, rang the Stoma care team this morning, and my appointment is at 3:00 PM today!!! How about that for service? Can't beat the NHS in a crisis.

Hi, I am so sorry for your dilemma, and I agree, stoma nurse, what is that? I use a convex pouch also, and I eat in the morning, and it's off to the races all day long, and about three times at night until morning it stops until I eat again. Do you use a drainable pouch?

That is great service.  Say what you like about the NHS (or the Australian equivalent, Medicare), but at least our "socialized" healthcare services seem to work, unlike the North American systems, so it seems.  Nothing to pay for ostomy products and easy access to Stoma Nurses and Therapists.

Rule Britannia (and her colonies!).
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Should you be irrigating?  YES!  It is a great help if it is an option for you.  I can't even imagine having to dump a pouch 8-10 times a day.  I irrigate once every 24 hours, and some of the other folks posting here go up to 72 hours with no output between irrigations. (I'm not that lucky).  Still, I personally feel it beats having sh*t running out of your body on a continuous basis and is the ONE thing that makes a colostomy trump an ileostomy - that's meant to say I really have empathy for those with ileos.

As an alternative, have you tried Imodium?