Skin Prep and Barrier Cream for Stoma Care: Need Advice

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527
Bluejay
Nov 14, 2023 5:10 am

I have had a lot of trouble with leaks. My doctor, instead of fixing my hernia, cut 6 inches off my small intestine. And she didn't do it right, so now my stoma is either at skin level or below skin level. When it is working, it sticks out a bit. So now I cannot wear those rings anymore, because they are too thick and leak underneath them. So now I wear stoma paste around my stoma. Anyway, my question is this: My skin is in bad shape. I bought the 3M Cavilon durable barrier cream. https://www.canmeddirect.ca/3m-3392c-ea-cavilon-durable-barrier-cream-fragrance-free-resist-wash-off-92-grams.html. It says that tape will stick to it, but I am worried it won't. So I was thinking I could put skin prep on top of it to help make my bag stick on more securely. But I am also worried that the skin prep might not stick to it. I don't have a lot of money trying everything out to see if it works or not. So if someone that might use this product or has any info that might help me, then please get a hold of me. Thank you, everyone, for whatever help and time you take for helping me. Take care and have a nice day.

Axl
Nov 14, 2023 6:51 am

Hi Bluejay

Have you tried the Cavilon No Sting Barrier Spray? The appliance sticks to it with no problem; a lot of folks here have used it. Spray it on, less is more. Spray it on the back of your hand first to get the hang of it; it dries instantly. It's a good place to start.

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Beachboy
Nov 14, 2023 12:53 pm

Hey Bluejay,

That sucks. Did your surgeon explain why 6 inches were cut off? Was your hernia fixed? Look into convex wafers. They push down on your skin, exposing more of the stoma. What type of ostomy do you have? If you have not already, call Hollister and other medical manufacturers of ostomy products. They offer free samples and have stoma nurses on staff to help you.

Justbreathe
Nov 14, 2023 2:22 pm

Zeroing in on the correct products for yourself is one of the most difficult and important things we ostomates are "stuck" with learning. It takes time and patience, leaks and rashes to overcome - and helpful advice, so you have come to the right place for answers. Keep in mind we are all different in terms of skin, belly size, dips and valleys, scar tissue, hair growth, and countless other issues. So, although advice is most helpful, it is not the same for each of us. We must become super analysts - or as I fondly call myself - an analyst.

During the last three years, as an ileo-ostomate, through trial and error, I have come to realize there are some interactions between chemicals in ostomy products.

For example, I had always used a dash of stoma powder around the stoma and out about 1”, followed by tapping a barrier wipe on top until dry, staying within the area where rubber meets the road (wax & belly). Then I place my pouch on top and press to seal with a warm hand for 2 minutes - my pouches come with an attached outlying adhesive tape with a plastic shield. The plastic shield must be removed to expose the tape adhesive. Tip: Before placing the pouch, I fold down the adhesive shield about 1” in each direction for easy removal once the pouch is placed. This procedure has worked very well for me. For removal day, I use adhesive remover wipes - left on for a few minutes for easy removal. Tip: while I wait for it to set in, I prepare my products by laying them out on my bed. I then return to the throne to remove my old pouch and use toilet tissue and remover wipe to release old wax from the area around the stoma. Then I hop into the shower - a wonderful full body naked wash for all body parts and ye ole' stoma - the very cleanest I will feel all day for sure!!! My stoma is pretty quiet in the early a.m. before it awakens to coffee!

For placing products, I lay down in bed at an angle with a pillow propped against the headboard - this allows my stomach to flatten as much as possible as gravity wins in the end.

Now for the recently discovered negative “product interaction”. I had read on this site positive results about the spray adhesive remover. I thought it was a great idea! I ordered some from my supplier and loved it, but here is what I have since discovered. If a barrier wipe is tapped in the area where tape is placed, the adhesive spray remover has some type of interaction making the tape gooey and almost impossible to unlatch - then trying to further assist with using an adhesive remover wipe made for a mess that took me half an hour to clean up. The bottom line is I cannot get barrier wipe on adhesive tape area when applying a new pouch.

IMPORTANT TO NOTE: (know the different names) DO NOT GET THE BARRIER WIPE OR STOMA POWDER ON ADHESIVE AREA

SKIN BARRIER WIPE

ADHESIVE REMOVER WIPE

ADHESIVE REMOVER SPRAY

 

 

 

PeteGeo
Nov 14, 2023 9:17 pm

I had a similar challenge when my stoma and I were first getting to know each other. My stoma nurse refers to him as a short spouter! He doesn't protrude much above the skin, and the way he's healed means the hole points upwards toward my body and skin.

At first, I was told to use a little stoma powder and a barrier ring. Eventually, I gave up with stoma powder as I had to “dust off” nearly all of it to get any form of adhesion. They kept telling me to use a barrier ring, even though I felt it wasn't working for me due to the thickness/low profile of my output jet (!) and initial uneven dip around my stoma. Then, for weeks, I still found I couldn't get the ring to stick well (whether applied directly to the stoma or to the baseplate, as some folk on here find works for them). No matter what I tried, output got under the ring, and my skin was sore, red, and bleeding, and the post-surgery separation continued. Around 8 weeks, I did research and came across barrier wipes, ordered some samples, and found they really helped reduce soreness, itch, and everything… and worked even better without the ring. I also now use a hard convex; with my stoma area body shape, I found even the normal convex was buckling a bit and allowing output onto the skin. So, hard convex combined with a clip-on support belt, and the barrier wipes have become my routine now. I use the wipes directly around the stoma after a good clean and dry, then waft my mirror over for a few seconds to dry the barrier film. Then, I apply the base plate (which I've learned to warm by placing down the front of my shorts against my skin while I get my supplies ready and clean post-bag removal to help adhesion prior to applying). Keeping a hand on it for thirty seconds to help stick.

I've not had trouble with barrier film and adhesive remover mixing, but I just use the wipe to apply the film, then discard the wipe itself before air drying and applying the bag. For me, I've also found standing for bag change best to improve adhesion and fit with my body shape. Pretty much healed now, no itch, and the separation finally healed (now over three months post-surgery).

Wipes - I tried samples from many companies and settled on StoCare's (which I found I could get from Amazon while waiting for a prescription update that took way too long due to miscommunications).

Good luck and hope you find what works for you. This wonderful community shows we're all so different, and there's no one answer.

 
How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister
gentlejohn
Nov 15, 2023 1:34 am

This is a situation for a stoma nurse before your skin gets worse.

Hisbiscus
Nov 16, 2023 6:25 am

Hi,

I had hernia surgery with mesh, and they decided not to make a new stoma and kept the one I had. When I came out of surgery, my stoma was flat and only sticks out here and there. It's mostly like yours, flat and skin level. I was furious! Anyhow, after struggling with flat stoma bags and rings and leakage, my nurses suggested a convex pouch. The convex is working perfectly! It makes the stoma stick out. I'm using a hard deep convex pouch from Convatec called Active Life. I'm able to use the Hollister CeraRing with that because the hard convexity of the pouch pushes my stoma outward into the pouch. I'm no longer using barrier wipes because I felt that they were too sticky and built up, although some need them. I attach my rings to the hole on the pouch instead of around my stoma because with a flat stoma, it's too hard to judge if you have them on right.
I'm sorry your doctor did not fix your hernia.
You can call Convatec, and they have stoma nurses who will do a virtual visit for free. This way, they can see the stoma and suggest what pouch to use. They will even send free samples. I'm thinking you're going to need convex pouches.