Negative Pressure Wound Therapy - Seal Leaking

Hello there. I had a colostomy a month ago, and my surgical wound wasn't healing, so they put a VAC therapy on it. It's a Smith & Nephew VAC. The problem is with my abdomen wound, my tummy isn't very flat, and I have a crease at the very bottom. This is where the seal keeps leaking.
I feel dreadful having to constantly call the nurses out every day, sometimes at night too. They are at a loss at what to do, and I know because of this, it's interrupting the healing of my wound.
I can't plan to go out anywhere, and I'm at that stage now where I want to try and get back to normal.
I'm really beginning to get to the end of my tether with it. Has anyone else had problems with this, or can anyone give me advice?
I shower carefully, in fact, just take washes now, but that doesn't make any difference.
It's getting me down
Thanks.

Hey there Lydia.. I, in fact, had to have a wound vac too..! They do aid in faster healing.. And yes, when my wound got smaller and more shallow, it was harder to keep a seal on it.. I too had to call the nurse numerous times.. And it is not a pleasant experience to unpack and repack that wound.. I am sorry (hugs)!!.. There are different types of seals they can use.. I don't have a flat tummy either :S.. There is one that they use on ankles and hard to reach places.. It has a longer foam strip.. So that the seal can be placed in another position instead of inside the incision mark!!. It can be placed to the side... Not sure if that makes sense... But ask your nurse if maybe she can find something for you.. Hope that helps in some small way!!!
Hang in there !!!

J.J

JJ thanks, certainly will. That sounds really good and I'm willing to try anything right now. My wound depth has gone down from 8cm to 4cm in 4 weeks though, so at least I'm seeing progress.

Thanks for your help. Really appreciated xxxx

I recall that in the first month, I was desperate because my bags kept falling off, or the excrement would pile up behind the wafer and push the bag away. I ended up back in the hospital with a hemorrhage from my vagina, which had been torn open during my colostomy. It had fused to my rectum during radiation (I had anal cancer) and the surgeon had a difficult time separating them. He also had a hard time separating the rectum from the spine, where it had also attached itself.

Anyway, while I was in the hospital, the ostomy nurse came and changed my bag system from a one-piece to a two-piece. I have no idea if that would help you, but it helped me immensely. The adhesive seems much thicker and stronger on my new system.

Now my only problem is that my stoma has shrunk, so the wafers, which are moldable, have too large an opening, and fecal matter sometimes leaks behind the adhesive, but only a tiny bit, enough to cause some skin irritation, but not the desperate, end-of-my-tether sort of insanity as before.

Also, my daughter ordered (on eBay) some Stomahesive strips that are moldable adhesive strips you can use to build up the areas under your wafer that are not flat. I did have a bit of success with those, but the best solution was changing the entire bag system to one with a more moldable, thick adhesive. It conforms much better to my very uneven tummy.

Why are we so lumpy after these operations? I have a giant bulge on my lower left now. This is very annoying... but not nearly as horrific as what you're going through. I hope it's solved soon.

My ostomy is permanent. Is yours?

Lydia... I am so happy that your wound is closing so quickly...!!! And you are welcome for the help... Let me know how things go... Really hope the nurse can figure out what I was talking about and that you can continue with the wound vac!! It's helping!!!

Take care (hugs)
J.J

Hey Lydia, my belly isn't flat, but I am using Coloplast Sensura. Maybe you need a base plate. I am using Coloplast 15537. Oh, sorry, I am ileo, but I shower and take the pouch off to give it air. It happened to me, I got an ulcer on my second time around with reversal. I was using some padding, oh and some Coloplast looked like a little net, like honey. Please shower with no pouch. I have to be so careful, but I don't really care what will be, will be. Are you getting stoma nurses? They are wonderful. I reckon you need to try a shallow base plate, one or two pieces. It's up to you. What about the stoma powder? Maybe when stoma-free, use a hairdryer. I heard it helps. Oh, I know Eakin seals, darling. You aren't an ostomate if you don't have these crazy problems. Just my saying. Sensura from Coloplast, shallow base plate. XX Mare from Aust. Good luck, darlz.

Hi,

I'm Marsha, and I've had a "lumpy" tummy since I had surgery when I was 15. I had an incisional hernia at the bottom of my incision where a drain had been placed. That took months to heal, from the inside out. I lived with the hernia for 3 years until I had my permanent surgery. The repair job left me with a very puckered abdomen, but it didn't affect my ostomy. However, after having two children, and gaining and losing weight, my stoma retracts (pulls in under) and so I sometimes have difficulty getting a good seal. I use stomahesive paste around the opening in the wafer, and that seals up the uneven areas. I also use a two-piece system, which makes it easy to check on the stoma and apply more paste or powder if needed. I know there are other materials out there to build up the uneven areas. Experimenting is the best advice I can give you......and sometimes I have to poke myself to remember to do the same. One of the problems that I seem to have is digesting high fiber foods. They basically come out like they went in (corn kernels) and that material can wedge between the wafer and the skin causing leaks. I've had to reduce the amount of fiber I eat at any given time.....just for the comfort factor. I don't blame it on my ostomy however......as all my friends (60+) are complaining of something.....!

Good luck.

Marsha

I am not sure if I am answering the right question (that doesn't make any sense, does it).

Anyway, in regards to wounds, the aloe vera plant is excellent for helping in wound healing, like a surgical scar. Break off a stem, peel back the outside skin of the plant (gooey bit), and rub it on a cut, burn, etc. Wrap the remainder of the stem in plastic cling wrap and place it in the fridge to stop drying out. If you plant a stem in some soil, it will grow into a full plant.

Aloe vera would probably soothe the skin under the flange of the pouch, but the pouch would not stick.

I use a cohesive seal under the flange of the pouch to protect my skin. The seal is like a larger tap washer that I place over the stoma, then I place the pouch on.

The seal is soft but not as soft as paste. To get a good fit with the seal around the stoma, I cut the seal in half first, then I place one half around the bottom of the stoma. Then I place the other half around the top of the stoma. So the first half is like a "U" around the stoma, and when I place the second half like an "n" around the top of the stoma, it creates a good seal so nothing leaks under the seal when the pouch is being worn.

The seal is called Cohesive, made by Eakin ref# 939002. I wear a one-piece drainable pouch Alterna made by Coloplast, and the flange that adheres to the skin is very soft and comfortable.

I hope this may help someone.

Lydia,
A seal may be achieved by using any number of manufacturer's soft, pliable (like silly putty) strips or seals. Coloplast, Convatec, and Hollister make them. Ask your Home Health nurses to bring some out and mold it to fill in the lower crease to create a flat surface to which a seal may be achieved with the negative pressure wound therapy device drape.
John H. RN Enterostomal Therapist