Frustrated with Barrier Rings and Considering Switching to One-Piece

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554
MsPriss
Aug 28, 2024 3:05 am

Okay, so frankly, I only tried the Brava moldable barrier ring because they sent me samples, and I regret it.

I tried the barrier ring, and first off, it smelled—maybe because there was a leak around it, I don't know.

The next one, I didn't use the ring because I wasn't happy with it. I had my first real leak under the wafer that time—I think it's because I changed the adhesive attaching bag halfway through, and pulling the bag off loosened it. I should either get one piece or clicky two-piece. Adhesive two-piece isn't worth the trouble.

So I had some irritation, so I used the Cavilon spray and tried a barrier ring again. Well, I just took that one off; the seal was not good under the ring (did the spray not dry all the way? Did it keep it from sealing?), the irritation was still there, maybe even worse.

So now I used a Hollister barrier wipe and made sure it was dry, and I just went back to the wafer without the barrier ring. Why did I even try that?

Also, I'm trying a one-piece (that I got as a sample), and so far, loving it. I think I may switch to one-pieces if this works out.

Beachboy
Aug 28, 2024 6:06 am

Interesting. I use a Brava moldable ring. 2-inch diameter, 1/16 thick. I have a colostomy, so sealing isn't a problem.

I use the ring for comfort and time-saving. I cut the wafer hole much bigger than my stoma. I don't even test fit it. I apply the molded ring around my stoma's base. Slap on the wafer... good to go for another week. It also prevents pressure irritation from hernia support belts.

I tried Hollister rings, but they tore too easily.

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MsPriss
Aug 28, 2024 11:31 am
Reply to Beachboy

Wow, I wonder why I'm having such trouble with it! I wonder if it's something I'm doing wrong! 

I have a colostomy as well. My output is very thick, so it often pancakes and “hangs out” right around my stoma for a little bit. I'm trying to drink more water to encourage a little better consistency. 

Justbreathe
Aug 28, 2024 11:43 am

Ileostomy here… Don't quite understand your issue with the barrier ring… For me, the barrier ring is a buffer in that it keeps seepage from going beyond the ring. For me, there is always seepage on the ring, which I believe to be normal… as opposed to a full-on leak, which goes beyond the barrier ring… and I change my setup every other day so the seepage does not exceed the barrier ring, resulting in a leak… 🤔🤷‍♀️

Just saw your reply re: colostomy as opposed to ileostomy… and I sometimes have pancaking as well - 2 comments

  1. Make sure you have a bit of air in your pouch
  2. A dab of baby oil (just a dab) inside the pouch will help to move contents downward (like a Teflon lining) and gravity wins… jb
MsPriss
Aug 28, 2024 11:58 am
Reply to Justbreathe

I feel like I only tried it twice, thinking it would help me get a better seal. The first time, it was awful to remove and it smelled bad. But it was comfortable, so I wanted to try it again.

The second time, it didn't stick to me at all and allowed me to leak right under it. 

The seepage under the ring irritates my skin, which is why to me it's a leak. 

 

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Justbreathe
Aug 28, 2024 12:27 pm
Reply to MsPriss

I hear ya… It has taken me a very long time to figure things out, but comments on this site have been so helpful. I have tried all sorts of bags, rings, powder, tape, wipes, etc., and have finally come to what I think is the best for me. You too will get there.
My only other goal was always to minimize requirements as I feel “less is more.” All the options can drive me crazy (which would be a short trip), and I say to myself KISS (“keep it simple, stupid”).


I am now down to 1 clear Convatec pouch with clip closure, 1 barrier wipe, and some tissue nearby on change day.

To remove the pouch, I use spray remover on pouch tape, remover wipes around the stoma, a Walmart plastic bag for trash, and then take a totally naked shower. jb 😘

MsPriss
Aug 28, 2024 2:17 pm
Reply to Justbreathe

Same, I'm trying to keep it as simple as possible. I did use remover spray (sample, Brava) to get the barrier ring off—the first time it was really attached to me. The second one I used was not, just at the edge, which makes me think I had a problem with application.

I use doggie bags; we use them when we scoop the cat box and for my bag changes. I also like totally naked showers! I don't change any other way now….

I'm trying just a one-piece Coloplast Sensura Mio (which I am loving so far), and I used a Hollister Adapt barrier wipe before application (which I made SURE was completely dry!). I'm really hoping this does work for me. If it does, I'm just switching to one piece in the future. I had no idea how uncomfortable that flange was for the adhesive. I think a clip-on two-piece would be better than the adhesive one, for me at least.

IGGIE
Aug 28, 2024 2:29 pm
Reply to MsPriss

G-Day MsPriss, if you're showering naked, make sure you dry the area around the stoma 100%. Any moisture and you're not going to get anything to stick. Regards, IGGIE

MsPriss
Aug 28, 2024 2:41 pm
Reply to IGGIE

Thanks! Yes - I've been using the hair dryer.

I did more hair dryer this past time, and waited longer. 

Beth22
Aug 28, 2024 2:42 pm

Hey there,

I had issues with the Brava rings too, my stoma doesn't like them lol. I went to Hollister's slim barrier rings and so far she has been ok with it.

Justbreathe
Aug 28, 2024 6:08 pm
Reply to MsPriss

I had issues with not being able to remove appliances as tape would stick and pull. I had some issues with a rash on my skin as well. Over time, I came to realize that some items may cause different issues. For instance, I believe some skin barrier wipes may not allow certain sprays or remover wipes to do their jobs, and they are not friends, and the middleman was my skin! Another problem is possibly not letting the remover do its job… it does need a few minutes, so give it time….jb

MsPriss
Aug 28, 2024 7:59 pm
Reply to Justbreathe

I can tell you the Brava remover spray works fantastically. It's weird how fast it works (on the Brava rings, at least). Ring pulling at my skin and not letting go - quick spray - peels right off.

Works great, I guess, although that time it did leave residue. I used a wipe later.

For now, my remover wipes and sprays are used in the shower before washing with soap and copious amounts of water, with some gentle rubbing with a washcloth.

That said, the barrier wipes and spray—obviously, I'm new to all of them (new to all of this, really).

Beachboy
Aug 28, 2024 8:22 pm
Reply to MsPriss

I get quite a bit of pancaking and firm, sticky output. If it's stuck, I manipulate it downward toward the pouch bottom. I gently roll the plastic side of the bag, which spreads out the pancake. For me, it's never been a problem. I have no peristomal skin irritation or pressure damage (from hernia belt use).

I wear nitrile gloves. Take the ring out of the plastic box, leaving the plastic backing on. Put the ring between my thighs for a minute to warm it up. Remove the plastic backing. Cut through one side of the ring with scissors. Gently manipulate the ring so it's straight, not round. Starting in the middle, I use both thumbs and forefingers to squeeze and lightly spread the ring width. Then move over a little and continue doing this till I reach the end. Then I go back to the middle of the ring and repeat until I reach the other end. You gotta be careful, slowly remove fingers stuck to the ring with each press. Then I squeeze any areas that look a little thick. I use a ruler and measure the molded ring. Six inches of ring length will go around my stoma, leaving no gap where the ends come together.

Starting at the bottom of my stoma, and at the center of the molded ring, I fit the ring to my stoma. Put the edge of the ring right where my skin and stoma meet (stoma base).

Continue fitting the ring around my stoma, lightly pressing it onto my skin. Then do the other side. At the top of my stoma, the two ends meet. I take off the gloves. Then use a finger to lightly push down the ring all around. Next, I put on the wafer. Note: Doesn't matter if ring ends overlap, or there's a little gap. When done, put on a hernia belt for an hour. Note: Before I pull the backing off the wafer, I hold the wafer against my back for a minute to warm it up.

Taking off the wafer a week later, I look at the seal area. Usually, I have a 100% seal, no sign of leaks or adhesive failure.

I use Hollister lubricating deodorizer. Helps a little with pancaking.

Beachboy
Aug 28, 2024 8:35 pm
Reply to MsPriss

Make sure your soap has no dyes, lotions, or fragrance. These things will interfere with adhesion. I use Cetaphil soap.

I use spray adhesive remover to lift the fabric tape. Don't pull on the tape. Gently lift an edge, hold it, and use your other hand's finger to push the skin down. Once I have all the fabric tape loose, I use a Hollister remover wipe.

I cut the wipe packet's top edge off, then dump the excess liquid in the packet down between the wafer and my skin at the top of my stoma. The main wafer seal comes loose at the top. Then, remove the wipe from the packet and gently push it into the sides and bottom of the wafer seal. Take your time. Don't pull up. Push the skin down with your finger while holding the wafer firm.

The wafer comes off easily for me this way, and I only use one remover packet.

Emad
Sep 01, 2024 12:57 am

I had a problem when I first started with the rings. The directions tell you to put the ring around your stomach, then put on the barrier. It never worked right for me. I heat the ring up for about 15-20 seconds with my hairdryer. Then I put it on the barrier and press it together tightly (I use the papers from the ring over it and press with a small flat plastic lid so it doesn't stick to the lid). Then I put the barrier on. Haven't had any problems since. I do pat dry with a paper towel right before I put on the barrier to make sure the stoma doesn't have any wet mucus on it. I like the 1-piece better, too.

holtgrim62
Sep 01, 2024 2:21 am

I don't like the two-piece, they are too big and bulky, sticking with the one-piece bags.

I guess I had some pancaking, I'm not sure what it was when it all seemed stuck, as I am very new to this. But I worked it out. Seems okay now.

holtgrim62
Sep 01, 2024 2:34 am

I don't like the two pieces. They are too big and bulky.

I'm sticking with one piece.

holtgrim62
Sep 01, 2024 2:39 am
Reply to Beachboy

I seem to have pancaking too. I'm new to this, so I didn't know what it was. But I managed to work it down okay. Hope I'm doing it right.

Nurses in the hospital never said anything about pancaking, and the only ostomy nurse in this area is getting ready to retire.

Am I doing it right, just trying to massage it down?

Audrey Warren
Sep 01, 2024 2:51 am
Reply to holtgrim62

Yes. My output does not drop into the bag, and I've always "manipulated" it. After I'm done, I rinse the bag out several times with very warm water. If necessary, I dry it with a hair dryer.

Beachboy
Sep 01, 2024 3:07 am
Reply to holtgrim62

There's no "right" way to push output downward. Just be careful you don't poke the stoma too hard. After a few weeks, you'll be a pro at it. Try squeezing and rolling the plastic (not rolling the bag up). I sometimes hold the drain up, open it, and shoot in lubricating deodorizer. Reseal the drain. Then work the lube upward. Helps break up the sticky stuff.

Nice thing about a 2-piece wafer/bag system: you can remove a pancaked bag, carefully clean the flange if necessary. Don't dig output out of the wafer. Once the flange is clean, snap on a new bag. Then rinse out the pancaked bag. Get a used water bottle, fill it, then rinse the bag over the toilet. Repeat till clean. Lay the bag on a paper towel to dry.

MsPriss
Sep 01, 2024 3:30 am
Reply to Beachboy

Oh, I've already got that, okay - I pinch the filter to make sure none goes upward, then I gently trace around the stoma in a downward fashion. If it's all the way to the edge, I start there, but otherwise to the sides of the stoma, treating it very gently.

I rinse with water when I do bag changes. The water goes up to the bottom or halfway up the stoma, but not all the way - any further could get the dang filter wet.

I can't seem to get the hang of changing bags with two-pieces with adhesive coupling, so I've ordered some samples with mechanical coupling to try.

Audrey Warren
Sep 01, 2024 12:08 pm

I should have added that I also pour warm water into the bag and swish it around to help break up the pancaking.

rlevineia
Sep 01, 2024 2:07 pm
Reply to MsPriss

Reading all your replies & have a question. Are you overweight? I know a nice obese woman w/ the same issues. Skin folds are a challenge. I used Hollister rings for a short time, as I prolapsed. They leaked & I was only 140 lbs. Switched to Convatec Natura Sur-Fit moldable w/ flexible collar - per Ostomy RN. Their tape is stronger than Hollister's & won't leak or fray apart. Rings reduce wafer adhesion.

Rancher
Sep 01, 2024 10:27 pm

I saw that you used the Brava moldable ring. I just went to their website and they have 3 different types.

Brava moldable. Brava protective ring. Brava protective ring convex.

Sometimes this is very confusing. But the Brava protective rings look like they work better?

baltimorewill
Sep 02, 2024 12:06 am

Hi

I used my phone to take a picture of my stoma, used a small ruler to scale the picture for printing on photo paper, cut it out, and put it on top of my stoma to check. (I have an odd oval-shaped stoma), giving me a template. Now onto your subject. Sprays and wipes form a protective layer on top of the skin. You are adhering to this surface, not your skin, cutting into your wear time. New barriers from different companies are designed to apply directly to the skin and are designed to protect and become part of your skin. Rings and paste are great seals. I use a hair dryer on a low setting to activate the adhesive properties of the barriers and rings. About 1 minute. Some are designed, if needed, to be cut to fit snugly against the stoma. For me, I like the thin ones. Hollister, New Image, Convatech, Durahesive, Coloplast Sensura, Mia—all these companies will take your calls and help you solve any issues you have. Your surgeon's office will have a stoma nurse available, and some supply companies have stoma nurses. You will know you have put your barrier on right when you don't know it is there. It becomes part of you.

Mommad
Sep 02, 2024 3:12 am

I have a colostomy, and I use a Coloplast one-piece convex bag. I have never had any leaks. I don't use rings. I just cut the wafer 1mm larger than the stoma. In the off chance some liquid gets under and irritates the skin, I also use Cavilon. If the area is being stubborn, I use the Tegaderm film for a couple of days, and it clears right up.

GrammieRed
Sep 02, 2024 12:41 pm

Hi MsPriss :)

Do you warm up the barrier ring before applying it? This will soften it and you'll get better adherence.

I have an ileo, so a good seal is imperative. I've tried different rings, but the best for me are Eakin Seals. I also use the Coloplast 2-piece click. In 15 years, the pouch has never fallen off.

How is the one-piece holding up for you? I've always wondered how well they work.

MsPriss
Sep 02, 2024 1:56 pm
Reply to GrammieRed

Yes, with either the hair dryer and/or just my hands.

I am trying the Eakin seals with much better success than the Brava seals.

The Convatec one I have tried has the barrier built in, it's moldable (not cut to seal) and I love it. I love, love, love that appliance. However, I've had an issue with wrinkling on the outer edge of the flange, which was painful. I think it was my application.

The Coloplast one-piece is bulkier, and the bag is not as soft and flexible. The Convatec one is soft, it disappears on my body, just hugs it, and I have gotten the best seal with their moldable seal/built-in barrier ring. I like the feel of the Coloplast bag fabric, but it's stiffer and heavier, and it doesn't conform to the shape of my body and lie completely flat.

MsPriss
Sep 02, 2024 1:57 pm
Reply to GrammieRed

As far as liking the one-piece, it's all I reach for - I have a whole box of two-piece, but when it comes time to change, I'm digging around for the one-piece samples. I definitely prefer them.

I am trying to get samples of a mechanical two-piece system with the Convatec moldable fit - we'll see.

grammalin
Sep 02, 2024 4:07 pm
Reply to holtgrim62

I use Hollister two-piece and have pancaking. Do you think a one-piece would work better? I use lubricant, tried tissues, etc.