Trimming Wafer Edges to Reduce Skin Contact - Thoughts?

Replies
27
Views
235
pamela.hill
Jan 29, 2025 7:35 pm

Hello everyone,

Just a thought 🤔 

Has anyone ever cut the outside of a wafer, so it sticks to less of the skin, so there's less to pull off?

Is there a reason why I should not do this?

 

aTraveler
Jan 29, 2025 7:52 pm

Are you talking about the tape boundary? If you are talking about the tape boundary, it's there for extra adhesion. If you get good adhesion with some removed then no problem. I actually use an appliance with no tape boundary 😉

Gray Logo for MeetAnOstoMate

Why Join MeetAnOstoMate?

If you care about your well-being, you deserve more than half-truths.

Here, you'll discover what no other source can offer - real insights and advice from fellow ostomates who truly understand your journey. This is a remarkable community of 38,709 members. And ... it's not only about ostomy.

Create an account and you will be amazed by the warmth of this community.

  38,709 members
warrior
Jan 29, 2025 7:56 pm

The question begs, why do that? Are you trying to reduce the area of stickiness? By doing so, you weaken it. It won't stay stuck long, perhaps inviting a leak.

Do you use any type of adhesive remover? I would not recommend reducing the diameter because of weakening the attachment.

My two cents.🤷‍♂️

Ben38
Jan 29, 2025 8:05 pm

Put simply, your poo would eat your skin alive if you cut wafers like that. Leaks would be the least of your problems; your skin would be so sore within days. Then it would start affecting the skin under the wafer, and you would have problems getting any bag to stay on. Then, infections and even sepsis are likely to occur.

warrior
Jan 29, 2025 8:11 pm

"Less to pull off" as a thought makes me think... pull? Ouch! 😲

With removal spray, mine almost falls off... no pulling really.

I'd never reduce that sealing area... if anything, increase it with those C-strip extenders.

Those are game changers.

She's only giving it a thought. Testing the waters here. Good topic for asking first. 😊

 

Words of Encouragement from Ostomy Advocates I Hollister

Play
Gracie Bella
Jan 29, 2025 8:29 pm
Reply to warrior

For a very long time, I had removal wipes, and I could not stand the smell. When I told my ostomy nurse, she said she could give me a different brand... Duh! I never thought to ask. I now have removal wipes that kind of smell like honeysuckle. The only thing is, it makes my skin feel really oily... But cleaning my skin usually does the trick.

warrior
Jan 29, 2025 8:36 pm
Reply to Gracie Bella

Did you ever try the spray adhesive remover? I don't think it smells at all. It's neat. And the appliance honestly just falls off within a few minutes.

I have issues with thumbs, hands that make using wipes... well... simply... doesn't work for me. I heard good reviews about using them. Nothing about an odor was mentioned.

SusanT
Jan 29, 2025 9:18 pm
Reply to warrior

I have adhesive remover wipes and spray. My ostomy nurse in the hospital sent me home with wipes, but I got a free sample of the spray and fell in love. I put wipes in my travel kit but use the spray at home. 

TerryLT
Jan 29, 2025 9:51 pm

I'm just not sure what you are asking here.  If you are talking about the part of the wafer that is closest to your stoma, cutting away from it will just leave exposed skin and an invitation for big time skin irritation/rawness.  If you are talking about cutting the outer part of the wafer, furthest from your stoma, then you aren't getting the full adhesive effect, and will most likely reduce your wear time and have a higher risk of leakage.  Either way, I would say the answer is no, don't do it.

Terry

Worzie
Jan 29, 2025 10:53 pm

When I used Hollister 2-piece, I first had huge wafers out of the hospital.  Obviously that was to cover the many stoma sizes.

Depending on what size your stoma is, you might consider going with a smaller wafer.  I was fortunate to move down but, my stoma is at the maximum size for the wafer.

I did this because I didn't want a giant plate of 💩 to move down the pouch.  

warrior
Jan 29, 2025 11:02 pm

I'm pretty sure she is concerned about the external size of the wafer to reduce any pull around the perimeter.

Outside perimeter edge. I guess it's somewhat square with tape on the edges.

Topic reads:

"Cutting outside the wafer."

Jayne
Jan 30, 2025 12:53 am
Reply to aTraveler

Also, something like Salts products, for example, the Comfort B range, has a 'sunburst outer part' which allows for flexibility if this is an issue for you, but you could also reduce it if you wished to.

J

SusanT
Jan 30, 2025 2:02 am

Actually if you just need to trim a small part off one edge due to a skin fold or something that will probably be ok. But see if you can switch to a smaller wafer first. Every bit you take off weakens the adhesion and risks leaks. 

I'd definitely think about trying other appliances or adding something like bonding cement to improve adhesion of a smaller wafer. 

If we've missed the problem then tell us what you're trying to fix by trimming the wafer. 

aTraveler
Jan 30, 2025 2:56 am

I am confused why so many say to not do this. Everyone is different which is why experimentation is important. I have used ConvaTec barriers with large tape boundaries and others with smaller tape boundaries — the smaller tape boundary actually worked best. For example, if the larger boundary extends into an uneven part of the skin where it is okay while sitting but loosens while standing or engaged in physical activities then that introduces an opening in the adhesion and it pulls further away with time. I read in one of the threads on this site where someone said they cut off the tape adhesion from their wafers and create a smaller tape boundary using pink tape. I currently use a coloplast appliance with no tape boundary.

To try it is not permanent, if it doesn't work you can always revert back on the application of the next appliance. Users shouldn't be afraid to experiment — especially new users who are afraid they might break something.

For example, I knew hydrogen peroxide inhibits bacteria growth, I also know as  effluent sits in a pouch the build-up of more and more bacteria causes the odor to intensify. I asked my home health nurse, after my release from the hospital, if I could use hydrogen peroxide in my pouch, she said she didn't know but I could try. I tried 5ml and it did not make much difference, I moved to 10 ml and it made a noticeable difference. I next did a little research to find out that hydrogen peroxide is decomposed before absorption in the intestine. Solutions of hydrogen peroxide displays poor penetration when applied to tissue means I don't have to worry about my stoma if it should come into contact with the peroxide. I next found out when injected into water, hydrogen peroxide releases a large amount of dissolved oxygen which has a strong oxidizing effect, destroying odors. Since I do things to make my output semi-solid I needed to add water to put the peroxide to work. More experimentation led to me settling on adding 3 ml of water to my pouch — Ileostomies with liquid effluent would not have to add water. This alone reduced my effluent odor about 75%. Further experimentation with a cotton ball containing essential oil drops has led to the odor from my pouch being almost negligible. Unfortunately nothing I could do was that effective with fish and garlic. 😮

I don't mind experimenting because I learn something even with failures. I think it's a good thing to see ostomates willing to experiment because they are able to learn why things work the way they do in their unique circumstances.

I have seen Bill with his DIY baseplate; Beth has experimented a lot because doctors did not aways have a solution for her; IGGIE with his Iggieclip. Bob and Warrior both were presented with challenging skin Irritations, that required them to experiment with various solutions. I even recently saw where someone made a pouch on their t-shirt using iron-on  tape — I intend to experiment with this since I can't sew. 😊

I apologize this post became so long but helping users experiment to understand how to effectively manage their stoma is something I am passionate about.

Gracie Bella
Jan 30, 2025 5:35 am
Reply to warrior

Totally agree with you there. My base plates do not have any tape - unlike my prior ConvaTec ones; I use flange extenders around mine just to make sure I have more adhesiveness.
I used to also use Hollister's adhesive spray, which I found incredible (except for the first time I tried to use it as I glued my fingers together....) - wish they had not stopped making them; but with my new bags, I don't think I need extra adhesive.

As long as I hold my bag down firmly for 15 minutes after applying it, I have no problems.

Gracie Bella
Jan 30, 2025 5:37 am
Reply to aTraveler

I agree with you that there's nothing wrong with trying something new. If it works, brilliant! If it does not, you go back to the drawing board!

Beachboy
Jan 30, 2025 9:08 am

I have a colostomy, 2 years post op.  Wear a Nu-Hope support belt all the time.

I use Hollister 2 piece.  I cut off the bottom fabric tape all the time.  Every time I sit, my lower belly flub pushes against the bottom of my wafer.  After a while, my skin becomes irritated and itchy.  Letting my skin breathe for a few days cures it.  

 

 

AlexT
Jan 30, 2025 5:28 pm

If you want to make your wafer smaller, you can. Just remember by doing so it’ll put more stress on what’s left and less “protective” area before a leak can get thru. If you use the remover spray, there shouldn’t be any “pulling” your wafer off. Mine literally comes off with gravity as the spray touches it. I agree if using wipes that you have to pull and kinda work your way down to get the wafer off. Personally, I’d want as much sticky stuff as possible for the reasons I said but good luck if you choose to alter your setup to your liking. 

aTraveler
Jan 30, 2025 6:28 pm
Reply to AlexT

These wafers are used on big and small tummies, round and flat surfaces, damaged and healed skin. They make allowances for stoma size but not all the other cases. Sometimes you can have too much of a good thing. There is no way you can make appliances that fit every unique anatomy. If a 2 inch tape adhesive boundary provides good adhesion then 3 inches might be better, better still 5 inches. But many would want to trim a 5 inch adhesive boundary even at the loss of adhesion. There are trade offs made by the manufacturers, namely effectiveness vs cost and supply vs demand. For some the tape boundary is not wide enough so they use extenders. Why don't manufacturers provide wafers with 5 inch tape boundaries and let you cut to fit like they do for stoma openings? It's a cost decision rather than a utility decision. To get these appliances to work for each unique case you have to experiment. In your unique case, perhaps, more is better but that is not always the case. In my case, I have never had a problem with bottom or side adhesion, it has always been the top. I discovered I could get a wafer with no tape boundary and place an extender across the top. BB mentions he trims his bottom. These adjustments came because of experimentation.

 

warrior
Jan 30, 2025 7:23 pm

Nothing wrong with experimenting. She has a colostomy...different situation than an ileo.

Until she chimes in with her reason to trim the outside perimeter, we should just wait and see.

All good answers. No wrong logic if it works.

Meanwhile, I'm gonna cut the 4th leg off my table, the 3rd leg off my tripod, and reduce tire pressure in tires because I want a smoother ride.

Just experimenting. Ensuring chaos. 😉

AlexT
Jan 30, 2025 8:27 pm
Reply to aTraveler

Not assuming anything. If you take product away, it leaves less product to stick and less of an area for a leak to penetrate. Obviously, if someone has to adjust a product to fit their body since ostomy bags are built to serve the masses and not individualized then that’s what someone has to do. I was just stating a couple things to think about before altering anything. A person may want to try it also when they are gonna be home and not on a work day, at the beach, etc or when they can’t attend to it if there’s an issue. Just things to think about. 

aTraveler
Jan 30, 2025 11:03 pm
Reply to AlexT

Got you, a bit presumptuous to put words in your mouth. I'll edit out the first sentence about "assuming".

The point I was trying to make is my disagreement with the assertion of "less of an area to penetrate"; sometimes it opens up more of an area to penetrate. I know it seems counterintuitive that less can be better but sometimes that is the case.

I respect your desire to give alternatives and pray you never stop because you and others have inspired me.

"I base most of my fashion taste on what doesn't itch."

  — Roseanne Roseannadanna 

Beachboy
Jan 30, 2025 11:38 pm
Reply to warrior

Just don't cut an inch off Mr Johnson. Whoa...

SusanT
Jan 31, 2025 2:37 am
Reply to Beachboy

Assumes he has an inch to spare. I would never... 

oldtimer
Jan 31, 2025 5:11 pm

Pam, yes, my son cuts the inside to proportion of the stoma, then also takes off a little of the outside sticky part. I am less than 5 foot 2 inches and it would be too large for me. The two-part Hollister product I use has served me well so far.

Also, and for anyone interested, we have devised a system that has not had me break out once.  Every couple of days when the wafer is changed, 1. use paper towel with warm water to loosen whatever there may be.  2.then  adhesive remover   3. then ivory soap with warm water and paper towel    4. then wipe with Peroxide   5. put on no sting skin barrier film   6 then wafer   7. finish with bag placement.

Beachboy
Feb 01, 2025 4:05 am
Reply to SusanT

Maybe I should have used millimeters? 😀

Dwild-WA
Feb 02, 2025 11:01 pm

I think this is a great idea, thinking outside the box so to speak! I have an innie so things are a bit different for me, and my current Convatec convex device is working pretty well, but seems to struggle when I take my walks. The part that unsticks itself is closest to my recessed stoma, so I end up with irritated skin. I’ve never thought about trimming the outside, and when I look at my bag, the top of the adhesive is only 1/4 inch above the ring, so I’m guessing it’s only the right & left sides that I could trim if I wanted to try that. Thanks for the thoughts!

Gracie Bella
Feb 02, 2025 11:13 pm

Hi Pamela,

Personally, I'd never want to trim any of my ostomy wafer off. I use the SenSura Mio convex extra deep two-piece system, and I use aloe vera flange extenders around the edge just to ensure extra adherence.
I wouldn't trim any of it off, as I (in the past with my previous ConvaTech bags) had enormous problems with my bag coming off at the most inconvenient moments (Murphy's Law, I think).

Plus, just pulling off is a terrible idea. Yes, if it comes off quite easily, it is no problem, but I use removal wipes to remove my bags and to clean off all the sticky adhesive from my skin. It gives me a slightly oily feel afterward, but gently cleaning my skin using unscented baby wipes takes care of the oily sensation, and I can then continue to apply a new wafer and bag.

All the best from New Zealand,
Gracie