Can you confirm if I'm doing the crusting technique correctly for my mom?? I dab a barrier film pad on the irritated skin, then put some powder over that and blow off the excess, then dab the pad. I end with the pad and let dry before putting on wafer. I just want to confirm, am I supposed to let dry between the pad and powder and pad again? I only let dry as the very last step.
You put the powder directly on the clean dry s skin, then dab with the barrier/skin protection wipe. Then repeat the process up to 3 times building up the crust. Let dry between applications. Then apply your wafer/pouch as usual . It's called the crusting method.
Hi Daughter, like DLG said, put the powder on your skin first, then dab with the pad. Let it dry and do again and make sure you end with the pad, not powder. I used to do this with my loop ileo when my skin was constantly irritated.
Do you apply a barrier ring? ;I found powder and barrier wipe to be insufficient without the final barrier ring which I apply to the bag-not my skin - in preparation I precut bag, shower with no bag, while damp then place 2 folded sheets of toilet paper over damp skin and stoma keeping it covered head to my bed for a reclining position - now ;it's powder around stoma and outward a bit - then barrier wipe tapped on top wait to dry then apply precut bag with attached barrier ring to my skin ;- this along with showering naked and changing every other day sometimes two days helped tremendously- the days in between I shower with bag attached. jb
We started to use the ring back around Easter time but didn't use it the last time we did appliance change. (Hence why I think she got a little irritation.) Several months ago, we started to use a ring to fill in the gap because mom's stoma got smaller and there was a tiny bit of space where stool was getting on skin. We were using a Convatec moldable appliance that fits stomas that start at 22mm and goes up to 30 something. My mom's stoma was measuring at about 22mm. Stoma nurse said we weren't getting the benefit of moldable with the size we were using so she recommended a smaller size that started at 13mm and went up to 22. Moms stool was too pasty/thick and with the smaller size, it was leaking underneath wafer. We didn't have that issue with other size.A different nurse at Convatec advised us to go back to original size of wafer that starts at 22 mm and use a ring for the tiny gap. Everything was going well with ring for all these months.I was applying it directly on the skin. I think maybe I did it too snug last week and there was a tiny drop of blood when taking it down. Mom decided she wanted to not use ring and see what happened. It wasn't bad but a tiny little area is irritated so I think we need to go back to using the rings but i need to be more precise applying it. Hopefully i made sense in this post.
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Thank you for everything you said!! My mom tells me all the time how lucky she is to have me. And I feel so blessed to have her. Thank you for explaining the dot of blood is normal. I was a bit concerned with that.
My WOCN emphasized making certain that the area around the stoma is absolutely dry before applying the ring. A piece of soft gauze can be used to get it totally dry. She also advised applying the ring directly onto the skin so as to get it as close as possible surrounding the stoma. I used to apply the ring to the pouch wafer but have had better luck applying it to the skin.
The bag doesn't stick well at all if there is much of the powder. As said by others, dry the area, then put on a bit of powder in the irritated areas (I use Adapt stoma powder). I then tap the powder in the bottle down and squeeze the bottle so the air jet is aimed at the powder around the stoma. It blows the extra away while leaving a thin layer. Then I lightly dab a folded barrier wipe on that area and work my way with it all the way around the stoma area where the appliance will be. Let it dry really good before applying the appliance. If the irritation is bad, I re-do just that area with a little more powder, blow it off, then dab the barrier wipe just on that area again and dry.
It may depend on which brand of powder and what brand of appliance is used but Hollister says you can put their barrier rings or bags on right over the powder. Obviously, you don’t want a bunch of extra powder on but apply the powder, remove the excess, and apply your setup. I just use the powder bottle itself(hold it straight up and powder won’t come out) to blow the excess off with. Then, heat the sticky parts up with a hairdryer and everything attaches nice and tight.
While everything is off (and with a prayer to the stoma gods for flow to be quiet), letting the skin have air before doing anything is kind of like a miracle cure.
Even 5 minutes is good, but 10-20 minutes can make a huge difference. You can come up with ways to capture rogue output if you are creative, even having her stand over the toilet if she can manage that. Putting some TP in the toilet helps to keep it from splashing.