Advice Needed on Ostoform Barrier Rings and Hydrofera Blue Dressings

My wife's ileostomy continues to defy all my attempts to reduce/stop leaks. The peristomal area is badly inflamed. I've tried different rings from Hollister, Coloplast, and Convatec. Convex, flat, ceramide-infused, some decent lifespans, but each had way too much inconsistency. The same exact product might work once for a two or three-day run, then fail within a few hours the next three times. Ours is recessed; yes, I've seen the stoma nurse; their fix lasted six hours (cyanoacrylate blue, fast hardening, equally fast to leak).

If you have experience with Ostoform or Hydrofera, please let me know what you can. Thanks.

Hi Walter, this must be so discouraging and frustrating for both of you. Is she using bags with convex wafers? This will help the stoma stick out more. Might she be allergic to latex? Safe n Simple has latex-free barrier rings.

I've tried the Ostoform with my colostomy with limited success. I like the little spout, but I don't like the barrier ring it's attached to and found I needed to put one of my regular barrier rings below it. That created a height problem.

It's probably worth getting a sample. I'm not a fan, but everyone is different.

I am currently trying the Adapt convex barrier rings. I think these are better, but the jury is still out. I'd encourage you to try that too.

G-Day Walter,

Now the damage is done, and the area is so broken down that it is difficult to get anything to stick. Have a talk with the surgeon and ask him to relocate the stoma to a new place, an area that is smooth and flat, and ask that the stoma sticks out at least 1 inch. I hope he can help your wife. Good luck.

Regards, IGGIE

Hi Walter,

I've never used the Hydrofera, but I have used the Ostoform. While an interesting idea, it didn't have any real benefit in my situation and I don't expect it would help much with a recessed stoma. You're going to have to get your wife's peristomal skin under control before you can really evaluate any type of fix. I'd start changing her barrier every day, and during each change apply a Domeboro soak (or any aluminum acetate topical astringent) for as long as possible before installing a new barrier. Thirty minutes would be ideal, but even ten minutes would help. The problem is there really aren't any products out there designed for stomas that are retracted. In that situation, there's really no way to keep output from getting under whatever is applied topically to the skin, be it a ring, barrier, etc.

What you could try after the soak and with the skin completely dry would be a breathable waterproof film dressing like Tegaderm. Apply it sticky side towards the skin and then put your barrier on top. Change the barrier the next day to assess how the film is working. If it looks good, repeat the process and try two days. If it only looks marginally better, then stick to one-day changes and continue with the soaks until the skin has healed.

Also consider what Iggie is saying, as it makes sense. As long as your wife's stoma is at or below skin level, she's going to be dealing with all this bullshit indefinitely. The only real fix is to have the surgeon pull the stoma out a bit and re-suture it. Most times it could almost be outpatient, but they want to keep you overnight just to be sure. Other times it's more involved if there are adhesions or other issues preventing them from simply pulling the stoma out a bit. So have the discussion with your surgeon. Let us know how your wife is progressing.

;O)

Living with Your Ostomy | Hollister

Thank you so much! This is super helpful, if only to tell me that it's not some failing on my part that I can't get it to stop. I've not heard of Domeboro, but I will look into it. My wife is adamant that she was told nothing but water near the stoma. I did try the hydrocolloid patch; it leaked pretty quickly, but it's worth a revisit. Thanks again!

Thanks, Iggie!

This is all great advice. I also have a below-skin-level stoma, and my skin issues have been almost nonstop. While I have a colostomy and my output is different from your wife's, I have found that the Dermabond stuff, or Tegaderm, I think I got mine from Coloplast, has really helped my skin recover. It is extremely thin and protects my skin so it can start to heal. It also doesn't hurt when you put it on the sore skin. My routine now is to soak with the Domeboro for 15 minutes, let it dry completely, then I put on skin protectant (either spray or wipe) and let it dry completely, then cut the Dermabond to fit the worst spots. I found that using one piece did not work with my curves and bends, so I cut half-circles and even quarter-circle size pieces, and the relief has been a godsend. Once that is on, I wipe again with skin protectant and let it dry; only then do I put on the one-piece convex bag I use. I have also found that cutting my refined carbs has helped immensely, though since yesterday was my birthday, I did have a piece of key lime pie and a piece of berry pie, so we'll see how I feel later today!!!!

I use the second skin barrier. I believe it comes in spray or small pads, which I use. You just wipe it around your stomach as far out as your adhesive from the wafer goes. So, no skin issues here.

This really helps, Dwild! Do I understand that you put the skin protectant spray as the final layer on top of the Tegaderm as a final step? Thanks!

You know, I've realized that no, I haven't been doing the skin protectant over the Tegaderm; I definitely do it before I put on the derma stuff. My skin has actually healed enough to do one day of no derma stuff (okay, I was in a big hurry), but I went back to using it the next time I changed. My new supplies are supposed to arrive today, but ever since I've been following the video nurse's advice, the bags have been holding better and a little longer.

Hi Rosen, could you elaborate on the second skin barrier? I'm seeing different things, but nothing that is a spray. If you could upload a picture, that would be ideal. Failing that, any kind of detail for a product ID? Thank you so much!