Help Needed: Correct Steps for Adhesive Removal in Wafer Change

Hi all. So my mom has had her colostomy for three years today!! I made a post a couple of days ago regarding the edges of her wafer lifting up (which is not normal for her).

After talking to our supplier yesterday and speaking to an ostomy client specialist who is a retired nurse, she mentioned the possibility of a thin residue that could be left on her skin and prevent the wafer from staying secure. This got me thinking; I did change my routine of how I do a wafer change. I'm not using adhesive remover wipes to wipe the entire area anymore.

So I prefer to use adhesive remover sprays to remove the appliance rather than wipes. Once I remove the appliance, I also would follow up with an adhesive remover wipe near the stoma where the Eakin seal was to remove any residue from the seal. However, I previously used to use adhesive remover wipes over the entire area where the wafer was. My supplier is going to send me a few different wipes and products to try, but I already have some adhesive remover wipes in my house.

However, I'm having a brain fart. I can't remember the steps. Should adhesive remover wipes be applied before or after rinsing with water? If you rinse with water first, does the area need to be completely dry before using the wipe? Maybe this is what I'm doing wrong lately?

I changed mom's wafer today. I decided to eliminate soap in cleansing the area and only use warm water. I also used the adhesive remover wipe today but just want to clarify the correct steps for further wafer changes.

Thank you!!

Hello, daughter.

Great work helping your mother.

You can use the adhesive remover any way you like; just make sure you thoroughly wash and wipe all the remover away with water when done. I only use warm water and thoroughly dry the area before applying the appliance. I use a hair dryer to quickly dry the area. Just keep the dryer at a distance; be very careful not to harm or burn the stoma. Also, get some flange extenders; they are a great addition.

Remover, wash, dry, apply.

Thank you for the kind words and the explanation! This is very helpful. So I kind of did it backwards this morning. Lol. I removed the appliance, washed the area, made sure the area was dried, then applied the adhesive remover wipe before applying the new wafer. Next time and in the future, I will make sure I use the adhesive remover wipe, then rinse with water. I'm hoping it was just me messing up the order, and now that I'm going to do it with the remover, then wash, it will be okay.

I tried the hydrocolloid strips from Convatec, but they became so sticky and tacky. Is there a certain one you recommend?

I use "Coloplast Brava elastic tape"; they are great. They are semi-circle in shape; two will secure the complete perimeter on the appliance. However, I just use one. I cut it in half and use one piece at the top and one at the bottom for extra security, but use them as you wish.

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I'm sorry, but I am going to disagree with Axl. When you remove your bag, there is normally a little poo left on the stoma, and that's why I always wash with water first. Once dry, I then wipe the adhesive off with a wipe. Then, when that's dry, I spray a barrier spray where everything is going to have to stick. Now, dry that off 100% and fit your seal, then your base, and last, the bag.

Regards, IGGIE

Words of Encouragement from Ostomy Advocates I Hollister

Thank you for the recommendation!

Iggie,

This makes perfect sense. You are right; there is sometimes poop on the stomach, so rinsing with water first does make sense. Thank you! This is very helpful. I am going to see how this wafer change holds up now that I used an adhesive remover pad as an extra step. Fingers crossed 🤞🏻

Hmm, who knew there could be so much variation in technique?

I use adhesive remover, either spray or wipes, at the edge of the wafer as I'm pulling it off. I was taught to do this to protect the skin from damage caused by pulling off the wafer.

There often is a little poop at the stoma that I wipe off with a paper towel. I use the adhesive remover to make sure all adhesive is off. I also roll residue off where it is thicker.

Then I wash the whole area with water and dry thoroughly.

You can use water before adhesive remover if you want, but always follow with water to be sure all the adhesive remover is off the skin. Residual adhesive remover could cause the wafer not to stick. I had that problem before.

I've been doing it like Iggie does it because of the little bit of poo left. So I wash, dry, then use adhesive remover wipe, dry, barrier wipe, dry, and then put on the bag.

Out of curiosity, how do you get your wafer off with water and not damage the skin?

That part is completely blowing my mind. I can see the other variations as personal preference, but it never occurred to me to not start with adhesive remover.

Thank you for letting me know about your experience with residue adhesive remover causing the wafer to not stick!

I'm just playing around with different options and seeing what will work.

Susan, I could be interpreting this wrong, but I thought Dwild-Wa was explaining the steps he does once the wafer has already been removed, like how he cleans and prepares the skin.

Wash, dry, adhesive remover wipe, dry, barrier wipe, dry, then put on bag …

For my mom, I always started with the adhesive remover spray to remove the appliance, but I felt wipes were better at removing residue.

I'm confused too. I use two adhesive remover wipes: the first one, liquid from the packet, to begin loosening the appliance, and then the wipe to finish loosening everything. The second one, I use the wipe to remove any residue around my stoma. Then I get into the shower, so I'm throwing a wrench into this by saying, again, I prefer to use soap and water, not just water. I just wouldn't feel like it was really clean with just water, and water won't cut through sweat. So, maybe I'm the outlier here, but it's what I was taught, and it works for me. Then again, I don't use barrier wipes unless my skin is broken down. I get out of the shower and dry everything off completely, then apply my barrier ring and new pouch. One thing my favorite ostomy nurse used to say is 'less is more' when it comes to ostomy products, and that many people use way more stuff than necessary or even advisable.

Terry

What kind of adhesive remover is she using? Some adhesive removers (like Uni-solve) have oil in them, which is bad! I spray my flange off with Brava Adhesive Remover Spray and then remove the remaining gum with a Brava Adhesive Remover Wipe. But it is critical that I always wipe off any excess cleansers with a paper towel. I make sure that the entire area is dry and void of any excess film. She can also try “C” strips around her base. We live and we learn!

After the wafer is off, I don't really use adhesive remover anymore. I just clean the area with water. So my first step after removing the wafer is cleaning with water.

Daughter is correct; I was talking about the method I use once the bag is off.

Yes, I use a spray adhesive when removing the bag, but once the bag is off, then start with water, then adhesive remover, then barrier spray, and fit your products after everything is 100% dry.

IGGIE

I use adhesive remover wipes while in the shower. First, I wash the area, use the wipe, and wash it again. Mild soap like Cetaphil works well.

Hi Susan

When I first started out, I used to just rip the bag off. The stoma nurse saw me do this at my first visit with her and nearly had a stroke. Now I use remover. 🤣

Terry,

Just like you, an ostomy nurse did tell me less is more. Like last year, I tried to eliminate mom using Eakin seals, but then she got a rash because there was a tiny bit of skin exposed where stool got on. The nurse then told me it's good to eliminate if you don't actually need it and only use it if there is really a need.

I also used soap every single time we did a wafer change in the last three years because that's how I was taught. Yesterday was the first time I eliminated soap. I was just getting desperate to try anything. So far, so good. The wafer is still on well and not lifting up. I have this strange feeling we were having an issue with the wafer lifting at the edges because I wasn't using an adhesive remover wipe over her skin. I am going to keep an eye on it. Fingers crossed I fixed the issue.

Thank you for the recommendation of Cetaphil! I will keep that in mind.

I am using Esenta adhesive remover spray to remove the wafer.

We are using Medline adhesive remover wipes to clean near the stoma where the Eakin seals are. When Mom came home from the hospital, she had a visiting nurse who used Medline supplies. They gave us Medline wipes, and I thought they were better than the Convatec wipes provided as a free sample. So I bought the Medline wipes off Amazon. When I called 180 Medical two days ago, they said Mom can actually get adhesive remover spray and wipes with her insurance. But I'm not sure if 180 Medical will give her Medline wipes if these continue to work. These wipes are acetone-free. I'm not sure what that means.

I agree, and I use them the same way. :)

LOL @your ostomy nurse's reaction to you just pulling off the bag.

I did that once early on and actually broke the skin, so I was actively bleeding. Never did that again!

I have had an ostomy since 2012 and have been through hell and back in my journey to find what works. Here is how I have streamlined what does work for me.

I get everything I need laid out before I start.

I use Brava adhesive remover spray to help lift the flange off and not tear at the skin. Also, push down on the skin as you lift the flange. It helps keep it from damaging your precious skin.

Once the appliance has been removed, I finish cleaning the skin and around the stoma with a Brava adhesive remover wipe. If there was any leakage, I may use a piece of TP first to lift that off.

Once the area is nice and clean from the adhesive remover wipe, I simply prepare to apply the new appliance. No washing is needed, and especially not with soap! Some soaps have moisturizers that keep pouches from sticking, or the soap is too harsh on that skin. Also, no baby wipes! They have moisturizers that keep the appliance from staying put. I have been doing it this way for years now.

Also, as I have an ostomy in the middle of my abdomen, I sit on the toilet for the change to make it easier. I warm the new flange under my armpit before applying to make it stick better and stand up to apply so my skin is smooth.

Hope some of this helps:)

My fingers are crossed for you! I don't think I mentioned that I only use Ivory soap, never anything with moisturizers or scent added. Then just make sure you are rinsing really well, and of course, drying well.

Terry

Yes! I have always used these! I love them!

Use the water after the wipe. You want to clean off the adhesive remover. Then dry and apply the new wafer.

I use these, one on the left and another on the right, joining together where they meet at the bottom. Then, just to make sure, I also use waterproof surgical tape around their edges. Generally, I can wear my bag for 6 to 7 days. I use the Coloplast bag with tabs used with a belt to hold it all in place. Rather safe than sorry, as I've had many leaks in the past, but mostly when I had a colostomy that hung out like a (I won't say what lol) until it totally prolapsed and I ended up being rushed into the hospital while cradling my intestines on my lap. I then had surgery to revise my colostomy to an ileostomy, which is far easier and, touch wood, so far hasn't given me any trouble.

Hi,

I have a colostomy and a flush stoma. I use Coloplast products, and this is the procedure. So far, it's worked for me.

Use adhesive remover spray along the edge of the wafer and gently ease it off.

Wipe off any stoma content that is still there with sterilized cotton or gauze.

Wash the entire area around the stoma using cotton and normal saline solution, then wipe it dry.

Clean and wipe the area again with colloid wipes and wipe off with cotton.

Apply Comfeel cream generously over the whole region to be covered and let it remain for a couple of minutes while you prepare the flange or wafer, paste and all.

Wipe the cream off thoroughly and dust with ostomy powder.

Spray with Brava spray.

Press the flange over the stoma firmly and hold for a while.

Apply Brava semi-circular tape around the edges. It protects from leaks.

Attach the ostomy bag... and it's done 🙂

So far, thank God, I have not had any major seepage and no skin abrasion issues.

Susan.  Gently pull your skin away with one hand & peel the flange back w/ the other hand.  Reduces peristomal skin damage.  Wipe/ rinse poop, remove adhesive, wet wipe, dry, crust & apply flange