Need tips for longer-lasting wafer seal & skin protection?

I am new to this. Ileostomy created March 14th after bowel resection for Crohn's. Needless to say, the phrase "shit happens" has taken on a whole new meaning with me these days! I am having trouble getting a good seal on my wafer and am only getting one to two days before it starts leaking. Anyone have any tips on getting the wafer to last a bit longer?
Also, my skin is very irritated under the wafer...what have you all found best for skin protection?

Hi

I had to have a second op to move my ileostomy to the other side of the abdomen as I had loads of complications. I still only get 2-3 days before having to change it, but to me this is better than my 10 times a day! So unfortunately, I have no tips on that one, but as for your skin, the best thing I have found is sunlight/sunbeds. Not often, but every 2 weeks I have a 6-minute sunbed which clears my skin straight up! This may help your wafer to stick for longer if your skin is in good condition.

What kind of a system do you use? For many years, I used a two-piece system by Hollister. A couple of years ago, I switched to a two-piece system by Convatec. What a difference! I went from one or two days to up to 5-6 days now. The difference is unbelievable. Before applying the wafer, try heating it with a hairdryer on high for several seconds. It will help with the adhesion of the wafer.

X_

I have to use a one-piece now as my skin reacted with all the two pieces that were available :0( I now get bad psoriasis, which is the cause of not much sticking. The sunbed/sun really helps. x

I currently am using the two-piece Hollister. Even though my stoma isn't retracted, I find the convex wafer works best for me. I changed yesterday and tried the hairdryer so we will see if that helps... I may have to try another brand... The only problem is I have to use a high output bag and I've looked online and not everyone makes one.
Unfortunately, I cannot get in the sun or tanning bed because I have lupus. I purchased some of the powder and put some of that on my skin before changing... Hopefully it will help!
Thanks for the tips!

I know that Convatec does make a high output appliance that is used with the two-piece system. I have used it on occasion.

X_

Do you use the Convatec moldable wafer?

Do you use the Convatec moldable wafer?

First, you might have to figure out where it is leaking, not so much as to why. We have to develop a forensic investigative approach so that we can develop a system that is more or less bulletproof. I know of a woman with an ileo on another site who spent time in a bathtub with a naked stoma (no appliance) to see what is exactly happening when there is activity.

Not that you have to do the same; I didn't.

In general, less is usually more. The more steps that are involved in application usually translates into more likely to fail, leak, or breach.

For irritated skin, other than open air for general healing, I like witch hazel. It will sting, but I find it moisturizes without leaving a residue.

When applying your gear/system/appliance, you can also use stoma powder on the more irritated areas. A little dusting, then barrier wipe/spray. If you have wipes, dab it onto the powder. Once your skin is looking better, you can stop using the powder.

As part of your routine, you might want to consider using the barrier wipe/spray. It helps protect your skin as well as give your appliance something to stick to.

Then there is one piece or two. Convex or flat. And the use of a seal. A seal is like a washer or gasket. When it comes to paste, you want to think caulk to fill in crevices, not glue.

Don't be afraid to experiment. All of the companies are more than happy to provide samples.

I have had an occasional problem prior to the flange lasting the expected week; if it is minor, I will use paste to seal the place where it leaks and then instead of the gauze as described above, I use waterproof tape. Waterproof tape is a bit harder on the skin but works great. Consequently, it is seldom that I have to replace the appliance prior to a week.

I found that skin irritation tends to be as a result of having your skin come in contact with your output. I use a barrier ring which I apply to the flange but make it slightly smaller than the opening for the stoma, then apply paste around the barrier ring which reinforces the contact to the skin. Also note that the stoma opening should fit exactly; too large and I found that you will have problems.

Don't hesitate to contact me should you have any questions.

Regards,
Ed

As for securing the clip, I have always used a rubber band.

X_

Jamie251,

If you are asking me, the answer is yes.

X_

I have the best results using the Cymed Micro Skin one-piece pouching system in conjunction with a Hollister mouldable sealing washer. The setup must be applied to clean, dry skin. I also use a skin barrier each time.
Using a hair dryer to warm up the skin, as well as the sealing washer, really helps with adhesion. After 18 months of trying other systems, I found this one to be the best and most comfortable. I routinely change it every six days with no problems during the wear time.
Free samples can be obtained from Cymed. I highly recommend them. Their motto is "Life Without Limitations".

I've found it's very important to figure out why you are leaking.... there are two kinds of leaks.

One is a leak between the wafer (on the bottom, next to your skin) and the other is between the wafer and the bag. I'm assuming you have a two-piece system.

For the wafer, you have to be sure your skin is clean and dry before you apply the wafer. Warming the wafer helps activate the adhesive.

If your skin is irritated or has broken down, use some ostomy powder, lightly dusted (brush off most) and then dap skin prep on the dusted areas. Some people do two "layers" of this. Powder, prep, powder, prep. Then apply the wafer.

I'm assuming you've "sized" your wafer well... 1/8" clearance only around the stoma. Stomas aren't perfectly round, yours may be oval.

Use the Eakin ring on your skin around the stoma. I warm mine as well, then tuck it in snugly around the stoma, then press the wafer over it. Have you ever changed a faucet on a sink? It's like "plumbers putty" between the porcelain sink and the tailpiece (drain). Same idea. When you peel back the paper backing, smooth out any wrinkles.

Once the wafer is on, snap on the bag. Make sure you feel/hear a little snap. Squeeze all around. Then take your thumbs and press the wafer all around the stoma to make sure it's nice and snug around your skin.

Then put your hands over everything for at least 1 minute to warm all the adhesives and make sure everything is glued on snugly.

Do you use a belt? This will help hold the weight of the bag up. Make sure you empty your bag when it's no more than 1/3 full. This will also help keep the weight of the bag down and won't pull on your skin.

These are my tips/routine. I had skin breakdown the first week. Then it cleared up and I've been lucky ever since.

Change your wafer 2x a week, and your bag every day. Do it in the morning before you've eaten when the stoma is least active.

My stoma is sometimes active anyway, so I keep a 4x4 gauze pad handy, dampened with water. I "wrap" it around my stoma like a little scarf if I'm not "ready" to apply the wafer right away after cleaning. The scarf catches any minor leakage and keeps the skin you've carefully prepped clean and dry.

Good luck!

I love Cymed! Wish I could afford them. They are absolutely hands down the best! I say if you can get the Cymed products, make the switch today! I got some samples from them and the difference was unbelievable. I did not even feel the appliance and my stoma actually started to shrink a little bit. Hopefully, I'll be able to have a job soon and can afford Cymed.

Thank you all for the tips...on my last change I used a moldable barrier ring and it seems to be helping with leaking so far. However, my stoma appears swollen (twice as large as it was), and it is not the bright red color it was...it is more of a light pink. Is it possible that things are too tight? I am still having output (a lot of it and very watery), so I don't think there is a blockage...any ideas?

Convatec makes an adhesive that is great! ... 800.422.8811 Give them a call. It comes in a blue and white pack.... And, they also have a remover that comes in a pack... Good luck!

The Convatec two-piece with a moldable barrier over a Coloplast Brava moldable ring has helped me go from just hours to four or five days without a leak. Leaking may be caused by skin wrinkles and damaged/irritated skin under the barrier. To help fix the wound, we apply aloe directly from the leaf of the aloe plant. After drying with a hairdryer, we use stomahesive powder followed by Cavilon no-sting wipes. Then, another layer of powder followed again by the Cavilon wipe and a blast from the hairdryer. Stretch the skin tight and apply the moldable barrier. Attach the pouch and place a washcloth soaked with warm water over the pouch for about 45 seconds. Attach a belt and you should be good to go. My wife and I have been monkeying with this for nearly a year now, and this is the best solution we've come up with. Above all, keep smiling!

I go with a kind of a brute force method...one-piece drainable (Convatec 400528? I think?) cut to fit with paste stomahesive around the opening...usually I do this before bed or a nap to let it "set" for at least an hour. I can usually get 6 to 8 days (depending on my level of activity) from this, but generally change out after 6 or 7. Couple of leaks (one at work, one at a friend's house) taught me not to let things go too long.

I've had problems with the wafer cutting into my skin and leaving a constant sore around the stoma. Are you applying it correctly? The reason I ask is because I was not taught the correct way of applying mine and for 1.5 years I was always hurting. I was shown to fold the moldable part down instead of up which creates somewhat of a cup. I happened to see a demonstration online and tried folding the moldable wafer the opposite way that I was using it. I have been pain-free for 4 weeks now. No more leakage and output on my skin. I also use an Eakin ring for added protection.

Well, that is something to celebrate! Always a blessing not to be in pain.

I used to have a big problem with leakage, and my output is watery most of the time. I get best results with a two-piece from Coloplast, and I use a protective sheet under the flange which is very, very sticky. I use a protective wipe, then I spray on a protective spray, and Ostofix forty tapes. I warm up the flange, the tapes, and the protective sheet under my thighs while I'm either drying off from my bath or just changing, as they stick better when warm. Removing ALL the old adhesive helps too, and making sure the spray has completely dried before replacing the bag.

(When I insert a message like this, the topic of moldable wafers continues. With the message deleted, the last part of the thread is replaced by a different topic.)

I've had a colostomy for 10 months now and it wasn't so intuitive from the beginning. It took some trial and error as I too had trouble with leakage especially since the stoma is close to my midline incision scar and it's not exactly flat.

What I've found to be indispensable is the Stomapaste to use as a filler under the wafer. I've even begun to use it around the stoma (apply it to the wafer) and now have no stinging or irritated skin due to the wafer lifting up around the stoma.

Hope this helps!

Anybody tried Crazy Glue?
I'll bet you it will last for weeks, and even then removal might be impossible.
And I wouldn't like to use nail polish remover on the skin around the stoma.
OK, a crazy idea, just wondering.

Please note I am being facetious. Do not try this at home. For use by professionals only on a closed circuit.

Ed

I used Eakin and Skin Tac, which is an adhesive.

I was having problems keeping my system sealed. I finally went to a wound nurse who showed me that, as my scar is very deep, I could just move the hole from the center of my flange to the side. You still must incorporate the hole somehow though. She just drew the hole around the center hole, only at an offset. I now have much better luck with my Hollister 2-piece - getting 3-4 days out of it. For me, I found the 2-piece to stick better than 1-piece units and I take the bag off to take a shower and rinse it out in the shower. I pat the base dry and stick the bag back on in the shower to avoid any accidents. Hope this helps.

They have strips that can be used for extra adhesive. They work well. Make sure they fit e.g. round for round or square. They have bag inserts that can be flushed. I use Mio which works well. Good luck. Any more help I will be glad to share.

For me, barriers ring fit real close around stoma applied first, then same with appliance has given me 7 days if I choose between changes... Also, use adhesive wipe after ring is on. Let it dry completely, put on appliance, and for extra security, blast around the flange area with warm hair dryer and get on with your day feeling great. Hope it helps. You could also use adhesive strips around the flange area if you like as well.