Adhesion issues

Hi folks

Permanent ileostomy since November 2022. Went through the usual teething problems, sampled everything and eventually settled on the Sensura Mio Click two-piece system. I've been wearing that for about 6-8 months now, I guess. Up until recently it was... ok. Good days and bad days, occasional blowouts, same as everyone else. The wafer stays on 2-4 days (being replaced at the first itch regardless of how long it's been on), with a pouch change every day or so (they don't have the greatest filters and tend to get a bit smelly).

But since late last year, I've been having problems with adhesion. I use skin barrier wipes. I'm very careful to gently clean with warm water only, making sure I've removed any residue from the previous appliance, and dry thoroughly (paper towels as last step just to make darn sure). I pre-warm the wafer (i.e. jam it in my armpit) while I'm getting everything else ready. As soon as it's applied, I quickly use the bottle-cap trick to ensure a good seal around the stoma, slap a new pouch on top and then hold everything firmly in place for a few minutes while I tidy away with my other hand.

And still the darn things don't want to stick nicely. I don't know if my skin-chemistry has changed (meds have been updated), or I'm sweating more than I used to. The only way I have any success at the moment is to immediately clip on a support belt (hate those things!), cinched up pretty tight, and go lie face-down on the bed (still with my hand holding firmly) for 10-15 minutes. Leave the belt on for the next couple of hours, then everything will be OK for a couple of days. If I'm lucky.

I've also had some luck with using wide strips of dressing tape overlapping the top of the wafer to hold the edges down, but these tend to irritate my skin on removal.

My previously employer very generously made me available to the wider market recently, so I'm able to deal with everything at home at least. But with any luck I'll get another job shortly, and I'm having panic attacks thinking about how I'll manage an unscheduled bag-change in the bathroom at a WeWork in London!

At this point I'm almost ready to go back to the Hollister kit despite the issues I had with it - I don't really like that elastoplast-style wafer, but it stuck better than the Sensura does.

Coloplast offers an extended-wear flange and I've requested a sample, hopefully the adhesive is a little more... sticky.

Anybody else had similar experiences?

I have a permanent ileostomy and use Coloplast convex Mia Sensura drainable one-piece with belt tabs worn with a belt. I'm not mad about the belt, but it's the only way I have managed to keep my pouch adhered and securely in place. Most times I wear it for up to 5 days. I could go longer but  prefer not to. I also use half a barrier ring where my tummy is uneven, plus I use two curved Coloplast Brava elastic tapes around the plate. A fellow ostomate whom I met in hospital always wipes his stoma area with Friars balsam which is sticky. I've tried Friars balsam and yes, it did help for sure.  However, if you have any scratches, etc it will sting like crazy but only for a second or two. No harm in trying, it's cheap enough.  Come to think of it, my wound nurse also always used Friars balsam when dressing an abdominal wound I had. Good luck. 

Hello kenpem.

If you have read many of my previous posts you will be aware that I got fed up with the wafers coming off and started to make my own baseplates.
These are stuck on with 'Probond' prosthetic glue, which I am sure would be just as effective if it was applied to the 'normal' wafers.

I do use a belt to hold things in place, but they irritated me so much that I bought some of that material that they use for wetsuits.  I cannot recall the name of the stuff but it works very well to relieve the irritation of the narrower elastic belts.

I hope this helps in some way.
Best wishes

Bill
PS: I've just remembered that the material is called Neoprene!

Permanent ileostomy.

Kenn Butt.

Mio 2 piece drainable appliance.

Elastic strips.

Belt support.

I get abt 5 days wear. The belt is critical to longer appliance wear.

They also offer wrap belts. .I used both.....small price to pay in lieu of

blow out changes. 

gotta have the strips and belt.  this works for me. also use hair dryer instead of arm pit warming.

Is your skin irritated? If not, try not using the barrier wipes. If your meds have changed, that could be the issue. Have you tried a barrier ring? Since you mentioned that you get better wear time from another brand, I don’t understand why a person wouldn’t be using that product. 🤷‍♂️ I’d much rather have my not so favorite appliance on and not worry about leaks rather than deal with leaks/blowouts more often. 

I had some issues with the sensura mio barrier rings not sticking well to my skin either. I use the 2 piece click system but switched to the hollister barrier ring and use the skin barrier wipes to help my skin not get irritated.  I add the sensura elastic strips on the outer edges as well. The mixing of the two brands of products was the magic combo for me. Try swapping out things and see if you can still use the coloplast system that way instead of switching completely.

What Alex said. The barrier wipes actually shorten the wear time for me. And hair dryer on the tummy, then warm the barrier and seal. Works well on my Hollister gear.

I've never had much luck without a belt. But remove the belt for special occasions, otherwise I like the security and you get used to it.