Do I Need to Always Use the Crusting Method?

Ileostomy for about 3 months and going to have it longer. I dunno how long since I've got complications.

Some history:

I had one bad episode at the beginning where we didn't know about the crusting method and nobody told us. We were sticking it directly onto my skin. I rashed up and my skin broke up and was weeping. We couldn't get a bag to stick, my wife was paining me trying and she broke down crying cause she didn't want to keep hurting me. Went to the local ER, and this doctor pained the crap outta me trying to stick a bag using benzoin compound that's 77 rubbing alcohol. Had me screaming and bag still didn't stick. Told me, well there isn't anything else I can do for you. Drove an hour to get to bigger hospital that had ostomy nurses. One tried and failed. Then they had a team working on it. They managed to get it to stick for 9 hours. My home health nurse came out and pained the crap outta me but couldn't make it stick. So I ended up just laying on my stomach with something under me to catch the poo for a couple days while I healed up and the crusting method started working. Haven't had any problems since. Crusting has been working great.

My question:

But do I have to do this as long as I have it?

My system:

Every time I change it out, we clean it, shave it if needed, dry it real good, then powder and skin barrier times 3. I also wear a belt to hold it. 2 piece Hollister system wax rings. I also wear perforated medical tape to extend life, sorta like the ostomy barrier stickers but they're too expensive to keep using. And this last me 4 to 5 days usually.

Pic of me in ICU Feb 25 just because damn that was a horrible experience. No pain meds because my blood pressure was too low due to blood loss during surgery. Cowboy style, just bite my wallet and hold on.

Thanks in advance!!

Hi DW,

I don't use the crusting always. If crusting has been working so well for you, why would you want to change up your routine?

The crusting method is used to make it possible for your appliance to stick to raw or irritated skin. If your skin is not irritated anymore and is healthy, there is no reason to continue to 'crust'. In fact, your appliance will stick better to just plain healthy skin. As long as you are cutting your flange to the exact size needed and you don't have any more skin problems, you should be good. But, if you want to prevent the possibility of skin problems returning, I'd recommend you start using a barrier ring. It will protect your skin and prevent leakage, and you also won't have to be as careful in cutting your appliance, as the barrier will fill in any gaps.

Terry

Because it just takes a long time to do it and I'm very high output and my wife always screams OMG when I start erupting lol

By barrier ring, do you mean the wax ring? I use that now and not the paste.

you are only 3 months out it takes time to heal nothing heals fast and everyone heals at different pace even your own body they had to move mine from one side of my body to the other i had one side heal awsome but i had to switch sides and it was hell on healing

well for me i wore hollister products for long time and had problems for years they would only stick on for hour, i had ditch scars and many surgries so lots of oh well suck it up butter cup its what you got they didnt come out with a waffer that fit me for a long time

just about a year ago coloplast came up with one that fits my round belly cause i wasnt flat belly i was more round so the flat square didnt work well i pasted,glues heat treatment, med taped duct taped to get a seal years later they gave me drysol to get my skin to dry upit works really good as long as you wait for it to dry then put yourself togther

Hi Diver,

The answer to your question is... it depends. When you remove your barrier now... what does your skin look like? After you clean up, is the skin still red and irritated... or nice and normal? If normal, then you can stop the crusting. If not, you should probably try to figure out why it's not. The crusting method is a temporary way to calm irritated skin that got that way from contact with your output (i.e., a leak) or something that caused temporary irritation. It's not really a long-term solution unless you can't figure out what's going on and correct it. So the first thing you need to do is figure out if your problem is gone... or just being kept manageable by the crusting. Let us know.

;O)

Skin is irritated/weeping.....crust.
Skin looks ok...no crusting.
If your skin is always red when you change, you may be having a reaction to the adhesive and may need to change products.

Funny you mention the reaction thing. Started using Coloplast first and when I went to wound care they said I may be having a reaction to the Coloplast stuff and told me to change to something else. I changed to Hollister and haven't had those problems since!

Bob, you are a wealth of information, my brother. I'm going to try not crusting next go around. My skin has been nice and normal ever since I had that major bad experience. Just been afraid to not crust anymore, but it's really a pain in the ass for the wife and I to do it each and every time. I'll let you know how it goes. Gonna be about a week before I'll know anything. Thanks, brother!!!

My ostomy nurse said you only have to do crusting if your skin is reacting to the adhesive. Like if the skin around your stoma is red and sore or itchy. The last two times I've changed my bag, she didn't have me treat my skin at all because it was not red. So I was able to place the appliance directly on my skin. So far it's held up and my skin is fine. (Although today my skin is a little itchy.)

Lee

From what our wound care person told us, crusting is used for skin excoriations. If there are none, then it's not needed. Hope that helps. Also, using a barrier helps to prevent that so much! Recommend!

I was allergic to Coloplast products. Switched to Convatec and my skin is beautiful now with 3 days of use. Everybody is different though.