Loop Colostomy 3 weeks ago, struggling with small leaks a centimeter under plate

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Northwestern

Hi,
I hope someone here can help me:

I have a loop colostomy that I got about 3 weeks ago and I always get small leaks that goes about a centimeter under the bag plate. I struggle a bit with red skin and pain from that. My stoma doesn’t stick out much and at the bottom where the downward going opening is, it hardly sticks out at all. And under that the skin has separated from the stoma which is suspect is part of the reason for the leaks. 

 

I now use Salts Soft Convex bags on a Salts barrier ring that I form so that it lies flush against the stoma (obviously impossible at the bottom, but I don’t just get leaks there but all the way around the stoma) and I use a barrier film on the skin. 

I’ve used Salts flat bags before and I see no difference after starting with the convex ones really. I tried with Coloplast protective rings last night, but got an even bigger leak today. I change bags daily.

I have an appointment with an ostomy nurse next week, but I thought I’d ask here to hear if anyone had any ideas because this when thing is rather uncomfortable at the moment

crappycolondiaries

Sounds like your skin isn’t super happy. Have they measured the Stoma? Since you are 3 weeks out from surgery the size may have changed. Can you send you ostomy nurse a picture to look at so you’re not miserable all week? Do you have any stoma paste on hand? Is there dip in the skin under the bottom of your stoma at all? What type of skin prep are you doing? When you change it are you standing or lying down?

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Beachboy

Hello.  Sounds like you need surgical revision.  Surgeon can pull stoma out a bit, then re-sew it in its new position. 

When you bathe,  Be sure and use soap that contains no dyes, perfumes, or lotions.  Clean, totally dry skin is the goal.  I use Cetaphil bar soap.

Don't use a barrier film unless your peristomal skin is getting irritated.

Use a blow dryer set on low to preheat the wafer before applying it to your skin.  

After you put wafer on,  lightly press down on the wafer for 2 minutes,  Then put on an Ostomy support belt and wear it for an hour.  

Contact different Qotomy supply companies.  Talk with an Ostomy nurse.  They will recommend products based on your unique situation.  Then send you free samples to try out.

Good Luck

Northwestern
Reply to crappycolondiaries

My stoma is about 35mm wide, but unfortunately it isn´t perfectly round, there are some bumps etc, but I but the barrier ring as flush as I can against it all the way round every bag change.

I´ve sent them a picture and thety said to use convex bags, but that doesn´t seem to be doing anything at all.

I do have some stoma paste! There´s a quite deep dip that bleeds a bit sometimes where the stoma separates from the skin. I put some silver bandage strips down there and that seems to help a bit with keeping it clean, but it´s hard to keep a tight seal around that. The leaks happen all the way around the stoma however.

I use a barrier film from 3M that I apply with some sticks. I have tried using stoma powder and also the crusting thing, but I couldn´t get the ring/bag to stick when using those.

Sitting and/or standing up when changing

Northwestern
Reply to Beachboy

Thanks for all the advice! Unfortunately I do/have tried all these things already (except surgical revision) :(

 

My skin is already irritated, I didn´t use barrier film before it was.

 

Thanks!

 
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Beth22
Reply to Northwestern

Hi there,

I have had retractions many of them .. I will tell you that if your already low and retracted using a barrier ring is going to make things worse.. that's putting height around and already low stoma and taking away length to get output in the bag.. think of it like climbing a wall... So in the end your gonna leak more . Beachboy is right if you are retracted that low and have tried everything you would need a revision. A regular barrier wipe isn't going to help unfortunately..they do have a thing called marathon and 3m advanced skin protectant those would be a good try to try and protect the skin but if your constantly leaking it needs to be fixed  the skin that's separating from your stoma and  skin it's called a mucus separation .I have had a couple of those as well best thing is to contact your surgeon and ostomy nurse isn't going to be much of help in this case. They will tell you a convex bag, a barrier ring which with a retracted stoma isnt going  work , paste which isn't meant for leaking but for dips and grooves in thr skin, powder and skin barrier wipe .. I would say save the trip and your time and just  contact your surgeon don't put anything in the mucus separation until your surgeon says to and or what  .. I never put anything on mine it will heal over time. I am sorry your going through this is does really suck 

Beachboy

Keep us posted on your progress.  Unfortunately a surgical revision is probably the only permanent solution.  I used to be unhappy because my stoma sticks out too much.  But after reading other folks struggle with a stoma that is too low to the skin... I'm not complaining anymore.  Best of luck to you.

Northwestern
Reply to Beth22

There's no way for me to just contact the surgeon. In our system that must go through the stoma nurse or possibly my regular physician first. These things usually take some time (unless there's an emergency).

Yeah, I was thinking that about those rings too, but it's kind of hard to just use the bag when the stoma is in such an irregular shape. There are some convex rings available though, might work better with those and a flat bag.

 

Thanks!

 

Thanks, 

Northwestern
Reply to Beachboy

Thanks! There´s probably a lot of issues with every kind of stoma, but yeah, I do wish mine was a bit easier to work with

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