Hi, newbie here. Please understand that as I ask you for advice.
I have an inverted abdomen around my stoma and the seal rings adhere to the skin barrier floating flange, but leave a large area of skin around the stoma that is not protected. In other words, it seems that the seal ring is not doing a dang thing and that the system is not working as expected. Does anyone have any experience in how to protect the skin surrounding the stoma when the seal just adheres to the skin barrier and floats?
Since I don't know your exact circumstance, I'll give you some tips that may work for you. The most common problem with anything not sticking is improper skin prep.
1: Wash the area with yellow Dial soap...it must be Dial and it must be original Dial! 95% of soaps have oils and/or perfumes.
2: Use a wipe on "Skin Prep", I use Coloplast #2041. Be aware that different skin types may require a different prep. Trial and error is the only way to determine for sure what brand works for you.
3: Use a convex skin barrier, with the hole cut to match your stoma size leaving just a slight clearance. The same concept applies for the brand of barrier as for the skin prep. Different skin types may react differently with different brands. You will have to try them all unless you get lucky on the first try.
4: You can warm the ring with a hair dryer before you put it on. This works very well for most folks. Change your barrier before it leaks to keep the skin healthy. Red, raw, "weeping" skin will not hold a seal with any product. Is your skin in good shape?
5: Contact every ostomy supply maker and request a sample of EVERYTHING. They are happy to send them and you can try different combos to find out what works best on your skin.
Good luck! Post your progress here if this info doesn't help and we'll adjust as required. Regards, MMSH
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Are you using a flange for inverted stomas? I use Ivory soap. After I wash, prep, and put the flange on, I will put the belt on a little tighter than normal to help with the seal. Sometimes, I use the hair dryer to help heat the adhesive.
I would look into a convex wafer, and visit with your WOC nurse wouldn't be a bad thing either. Those guys know quite a bit, sometimes they can at least send you in the right direction. As others have said, it can turn into a trial and error thing, keep trying, you'll find what works for you.
I use Convatec products for a long time. I use a 1-piece and never had a problem. Why not try a 1-piece? If you want, I can send you a sample to try and see if you like it better.
Maybe you got a bad box of flanges? What about contacting the manufacturer and letting them know you might have a deformed box of supplies. They may send you replacements.
Hi all,
I've struggled with the same problems. A convex wafer is really helpful. I think that will be very helpful. I also use an Eakin ring and cut it into pieces to build up areas that need more filler and little to none elsewhere.
Feel free to private message me if you want to know specifically what products have worked for me.
Good luck, soon it will be so simple you'll forget all the trials and tribulations.
Laurie
I had a deeply inverted colostomy stoma, and the thing that worked best for me was this:
First, I applied a barrier wipe, then built up the surrounding area with stoma paste (which is like putty), and smoothed this out to a flat, slick surface by stroking it with a finger dipped in water. Then used half a barrier ring on top of the (puttied-over) divot in my belly skin where leaks happened most often. Then placed a flat wafer atop all that. Adding a snug wafer belt gave added security if I was going to be moving around a lot. I got to the point where I rarely had a leak and the seal was pretty durable. My stoma nurse was surprised I was able to get that thing to seal well at all.
Now I have an ileostomy with a normal, slightly small-ish stoma. I do a barrier wipe, then a full barrier ring, then a convex wafer with adhesive paste around the wafer opening; this gives me a great seal. But I don't think the convexity really helped with the inverted stoma - that shape is intended to cause a stoma to pooch out a little more above the surface of the wafer. There is no stoma to pooch with the inversion, and the convexity of the wafer irritated the skin around the stoma mouth, which always (in my experience) remained tender from output.
Sadly, I never found a good way to protect that area (the broken skin of the inversion around the stoma mouth). If you have damaged skin where you need to place the wafer, there is a helpful technique called encrustation (barrier wipe the area, sprinkle stoma powder over the damp skin, dab down the powder with another wipe and let a crust form. Repeat this again if the skin is very rough or sore. The best wipes for this IMX are Cavilon brand - they are sponge pads that hold a lot of barrier film liquid in them and make the dabbing/encrustation easy.
This protects excoriated skin and helps it to heal while wearing a pouching system. I tried this for a while also inside the mouth of the inversion, but it helped only briefly, until an hour or two of output washed it away, so that was a pointless exercise. I'm glad to have a normal ileostomy now; it is much easier to maintain and less painful than the inverted stoma was.
I wish you all the best in dealing with yours.
Convex bag may be the answer....I use a barrier ring, barrier paste....think of it as a gasket and caulk......and hold that sucker in place at least 60 seconds after applying to dry skin.....the key is the seal.....I leaked so many times during my first 6 months of this thing and boy was it a mess.......it will get better.....if you have access to an ostomy nurse, seek help..........I rarely leak anymore....only when it is laziness and neglect....good luck...it does get better
Wow, I wasn't able to get back here. I do so appreciate your responses and your sharing of your experiences. I had to have a second ostomy surgery to reconfigure the site. Then, I had to have a third surgery because of large granulomas at the site of each "absorbable" suture. (The surgeon removed the sutures.) I've had 3 silver nitrate treatments (chemical burning off the granulomas). And, I am still (since March 28th) working with my ostomy nurse to find an application method that prevents leakage around the stoma. This has been quite an "adventure". Again, thank you for responding.
One more thing...make absolutely sure the skin is dry. I was changing my bag during shower time (damp skin, steamy room) it would last a couple days but not 3+ days like many talk about. Recently had changed from paste to wax ring still no improvement till I had to change it in the middle of the day. It seems to last much longer. Good luck and let us know what works! It's always a struggle! Good question, I now plan to try Dial soap:)
