Issues with Coloplast One-Piece Application

I had been doing pretty well applying my Coloplast one-piece (even though I only had three quick lessons before being turned loose). But the last two, I'm having a problem with it??? coming up around the stoma? I use skin barrier spray, then paste (I'm horrible with rings), then apply the bag. I don't know what's changed. I had a blowout last night. Thankfully, the belt I bought kept it contained, so it wasn't on my clothes or sheets. Still, it is pretty upsetting. I've had Pablo Party Pooper for four weeks today. I don't know what's changed or what I'm doing wrong, and I cannot afford to be changing bags any more than the every three days I'm doing now. Please help me. It's becoming very discouraging.

Merry Christmas, all. I hope everyone has a blessed one.

Thank you.

Merry Christmas, Bumnomore,

Someone had posted that Coloplast recommends not using anything more than just the bag and wafer as it is. At the time, I was trying barrier rings (which left a dark "pressure mark" after the first use, so I stopped using them), paste (which washed away pretty quickly after the first few bag rinses), and two different adhesives. When I read the post, I was skeptical but thought I'd try it. To my surprise, not using anything other than Cavilon liquid barrier film, the wafer stayed adhered just as well as with the adhesives. I know there are a lot of circumstances where other products become necessary, but maybe try just a good coating of barrier and just the wafer. Perhaps the paste is causing the leak by reducing the adhesion of the wafer around the stoma.

Have you measured your stoma recently? It can change size, and that can cause problems.

Blowouts can be very upsetting, but it all cleans up with some time and patience.

Make sure you are not cleaning your peristomal area with anything that may have oils or lotions in it. Baby wipes are notorious for that. Warm water and plain soap are good, or a cleaning wipe for ostomies. Let the skin dry completely, then put on your spray, paste, and flange. You might also try warming the flange up to at least body temperature before applying it. Either put it against your body for a few minutes or use a hair dryer on a low setting. You can try lying down with slight pressure for several minutes to ensure good adhesion to the skin.

Switching to a two-piece appliance may work better for you. The flange tends to be a little more rigid (depending on the brand) and thus sturdier, lasting a longer time. Trying different brands, as some work better with your skin than others, may help as well.

You're pretty new, and it's a learning curve, so be patient with yourself. It takes time to figure out what works best for you.

Best wishes and Merry Christmas to you!

ETA: Coloplast one-piece never stuck on me for more than 5 minutes! But a two-piece Coloplast flange, once warmed up to body temperature, will stay on me for 7 days easily! But YMMV

After Hubz came home from the hospital with no demonstrations, just a verbal description of steps and a bag of random items.

We found Ostomates on YouTube who actually showed bag changes, along with ostomy nurses demonstrating various techniques. For us, having the visuals really helped!

Good luck, and Happy Merry Everything!

My Ostomy Journey: Bruce | Hollister

Yes ma'am. I measure it every other time, and it has not changed sizes. It is sinking into the skin and then coming back out. It is so frustrating; the learning curve is reeeeeally curved. I've tried the convex but do not really like it.

I might not be familiar with their one piece having belt hooks. 🤔 What sort of belt are you using? I use a fabric wrap whenever I need to be sure about possible leaks.

My advice is to use the fewest products. I've been pretty lucky the past couple of months, not needing any paste or rings. I rarely have "blowouts," but yeah, I will have some seeping around the stoma, but it will eventually start coming out to an edge after a few days.

My typical application consists of cleaning with non-moisturizing soap in the shower. After towel drying, I use 2 squares of TP to soak up any moisture off the stoma and parastomal skin, one square at a time, then use a hair dryer around the stoma and the wafer, then land it before the stoma waterworks touches the adhesive edges, pressing it on for about a minute. I also use a Stoma Guard that adds pressure. It has a channel that allows stool to come up without pressing inward and under the wafer. I use a swim wrap over this to keep the Velcro from catching on my clothing. I also have a little hernia, which is why I use the guard. I don't use the guard at night, though.

👍

I put the bag in my armpit while I do everything else. I don't use soap. I just use water to clean the area because I'm afraid no matter what soap I use, it's going to affect the “sticking.” It will look good and stuck, but I always check it when I go to the bathroom, and it's bowed up around the edges. It's only been 4 weeks, and I'm already tired of this. I have stage IV rectal cancer. It was very low and invaded both sphincters. I have been in pain for around 3 years. So when I was diagnosed in August last year and the chemo and radiation didn't make it go away, they said surgery was the only option. Besides getting the cancer out, they all told me the pain would stop. I'm still waiting to get to that part of the movie. Now I have mental pain to go with my physical pain. I'm tired. Ugh. Sorry I'm throwing a pity party in public.

The first blowout happened when I didn't use anything but the bag. So now I'm scared to do that again. The belt is actually a wrap. It sounds much like yours. I feel like everything is dry when I apply the paste. I don't use a whole lot but just enough to try and smooth out the skin. I don't know if I have a hernia, but the stoma is on a large? medium? sized mound. It does seem to not be there when I'm lying down, so I wonder if it is a hernia. Everyone keeps asking me how I'm doing mentally. I tell them I think I'm doing great until there's a blowout or it's not sealing properly, then I'm mentally defeated. I don't know how y'all deal with this day in and day out. Also, kind of off topic, but do you ever get over the ick factor? It is just so disgusting to me at times. And it's ridiculous since I have been a paramedic as well as working in a vet clinic now. It's not like I am unfamiliar with sh!$. Ugh.

Unfortunately, there is no silver bullet answer to it. Everyone has to try various things that get us through. Just when you think you've got it, a new season challenges you. Then your trusty brand changes its designs or materials. 🤷‍♂️

Sorry to hear you're struggling. You mentioned your stoma retracts to skin level. A stoma should protrude 3/4 of an inch at its lowest shape, above skin level. A stoma retracting to skin level and below will allow output to flow under the wafer. If you continue to have leak issues, consult a surgeon about revision surgery to pull your stoma out more. Sticking out too much is far better than too little.

I have a colostomy, with output that is pasty and relatively thick. I rarely have liquid output.

I use Cetaphil soap. It has no lotions, dyes, or fragrance. In 3 years of use, I've never had a leak or blowout. It's important to have clean, dry skin prior to putting on a new wafer.

I use a Hollister 2-piece system. I like being able to snap off a soiled bag and snap on a new one in less than a minute. Burping the bag is easy too. Bags are tough. I've had some very full bags that looked like a brick and some gassy ones that looked ready to blow any second, but they held.

The "Ick" factor. Have an ostomy? Get used to shit. At first, I was put off by the little treasures populating my bag. But it's easy to get used to. Emptying a bag, I've gotten crap on my fingers, thighs, Mr. Penis, the floor, pants, underwear, and... the ceiling... okay, kidding about the ceiling. But still... it is what it is. For many of us, an ostomy saved our lives. A little poop won't ruin our day.

Try using a hard convex wafer and a soft convex wafer. They push your skin down to give the stoma more clearance. Experiment to find what works best for you. All ostomy supply manufacturers offer free samples and phone consultations with ostomy nurses. Look them up on the internet.

Discovering ostomy products best suited to your unique situation takes time and patience. Like the fairy tale mentions: "Gotta kiss a lot of frogs..... to find a prince."

Good luck and Merry Christmas.

Hi again, and I hope Pablo is letting you enjoy a peaceful holiday!

Hubz has a loop colostomy that stays flush or even below skin level when lying down. When he stands, gravity allows a bulge to form that can get pretty large, though we've been assured it's normal and always retracts when he lies down.

Because of this, he has made a few adjustments. He has to lie down to place the new wafer, and without a protruding stoma, it's a challenge to get it centered.

The various convex wafers didn't help, so he went to a Hollister 2-piece drainable pouch with no filter. He can better see the placement of the wafer, then attach the pouch afterward.

There's no filter because keeping a layer of air in the bag helps give space for output to fall away from the stoma, preventing output from being pushed out sideways under the wafer (called pancaking).

What seems to help fill any space between the wafer and stoma (when retracted) is a barrier ring that's overlapped on the side of the belly button to double thickness. These rings are easily stretched and shaped and can be attached to the skin first or the wafer first. Because the shape is an odd oval, he attaches it to the cut wafer first.

Another key is placement. He needs both hands to center the wafer but has to do this lying down when retracted. We got an ad (maybe through Ostomy101?) for a mirror designed for wound care and ostomy care and decided to give it a try. The lighting and positioning are great, but the flexible arm would need to be longer for larger people, but still okay for Hubz.

https://medimirror.com/

He's not very active right now as he feels pretty crappy from the cancer infusions, so I'm not sure how this setup would hold up under physical activity, but he's only had 3 or 4 leaks that were caught early since August, so he's pretty happy and confident when we do leave the house.

Not sure if any of this might help your situation. These adjustments were all learned from others on various sites, especially this one! Hang in there. Things definitely get better!!🎄

As an alternative to that mirror... we got a bedside tablet holder. Added a mirror tile and a selfie light. Quite a bit more trouble than ordering the device you found, but we didn't know about that. It has a wide range of adjustability and would work for someone of any size.

It is a gooseneck with a solid base... not easy to find, but worth the effort. The picture is similar; I couldn't find the exact thing.

🔒 Login to see image

That's great to see! The mirror we found is a recently launched product, I believe.

I had been looking through past posts a while back, but I only saw recommendations for using a full-length mirror on a stand and angling the top up over the area. He tried placement with a handheld mirror, but all adhesives are exposed at that stage, so if he wasn't centered, he had to remove the stuck wafer. I'm here and glad to help, but he needs tools to be able to do this as well. His stoma is kind of close to the bellybutton, so he has little room for error. Thanks for posting about the tablet stand!

I found this presentation about leaks and thought it could help you, Bumnomore (and others):

https://youtu.be/vz8rSbDl8PY?si=IPaO7dKKhDdKYSyo

I have a flush stoma and never considered a surgical correction. With peristalsis, it does retract quite often. I've never had any luck with convex wafers but had to try several different brands to find one that really worked. One piece is horrible for me, but two pieces are much better. I especially like the Coloplast SenSura Mio flange (star-shaped); it lasts a really long time. I don't/can't wear a belt, and I never use any extras (paste, powder, rings) unless there is some skin breakdown, which is very rare.

I do have some issues with blowouts and leakage, but it mostly depends on the consistency of stool. I have a colostomy.

Just to say, everyone is so different, and unfortunately, there is no one fix.

Excellent review on leaks and various products! Thank you!