Struggling with Stoma Placement: Surgeon's Mistake, Need Advice

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Lmcmahon

Hi, I am a new ostomate. Colostomy done 1/15/19 and my surgeon never did stoma placement markings. I am now dealing with a stoma that points down and I struggle with a burning rash around the stoma because I have thick output that pancakes and goes under the wafer. Also, I am 134 pounds but have had twins and have lost a lot of weight, so I have lots of extra skin and creases. I have been struggling and trying all the different products with no luck. I saw my surgeon yesterday walking to another room and I said hello. She asked how I was doing and I showed her how I am struggling with keeping my wafer on more than 2 days. She looked at it and said, "Oh shoot." She screwed up from not marking the placement, and this was a scheduled surgery. I had about 8 weeks from the time she convinced me to have the surgery done. Can this be fixed? My stoma opening is at the bottom and output will always hit my skin because I can't seem to lift it up even with the adapter rings, belts, etc. Any advice?

AMrfd

I do have something similar where my stoma likes to play peek-a-boo. It disappears inside my skin and makes a mess just like you described. My home care guy that helped me when I first got home suggested that Hollister company makes a Skin Barrier number 14803. It has kind of a funnel cone shape to the back of it that presses the seal closer around my stoma. It has helped a lot. The other name on the box is New Image by Hollister. If you can try some of those, it could help the situation. It did mine.

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vdahl

Yes, you can have the stoma revised. I had a similar thing happen when I had my initial loop ileostomy. The active side of my stoma was down on the bottom and nearly recessed. To make things worse, the inactive part stuck way up falling over the bottom. You're right, the skin could never heal. I dealt with it and tried everything I could from 2.2.17 to 6.11.18 when they removed the colon and revised the stoma. It's a pretty little rosebud now.

You have to be your own advocate!

Be well, Vicki

Donspen

I don't know what style wafer you are using. You sound like you need a convex style wafer and barrier ring. Get it cut to fit first until your stoma swelling goes down. This will push your stoma up. The barrier ring will help to form a dam and seal to stop the waste from going under your skin. Use calamine lotion and stoma powder to do what is called crusting. Put the calamine on, let it dry, and then blow off excess powder. I would also recommend an adhesive spray. This will help everything before you put the wafer on. I like to use a heating pad on the wafer and pouch for about five minutes while applying pressure.

Past Member

Hi. I just had to respond to your post. You have, unfortunately, the exact same problem I have. The only difference is that I did have stoma placement markings..and it didn't help one bit. I also had lost a lot of weight and had some extra skin on my belly from pregnancy. The idiot surgeon basically pulled up the skin tight from the bottom and left the extra roll of skin right on top of the stoma, which is why it points down. It's a perfect S shape, actually. The skin goes over the stoma and then sags down again on the other side and then slightly up again. Big S of loose skin on my belly. I also tried everything on the market. As you found out...nothing works. Nothing! The only way to fix it would be another surgery to reposition the stoma. Not a fun alternative. What saved my sanity was discovering irrigation. You can probably do that as well. After you get that down, it doesn't matter if the skin barrier pulls away (which it always will.) because there is no output to get under it. Problem solved. I don't even have to wear a skin barrier and pouch anymore. Just a stoma cap. Like putting on a round bandaid. Irrigation also solves the pancaking business too, which is a major hassle! Do try irrigation.. You won't be sorry. I guarantee it! Good luck.

 
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Past Member

Exactly the same situation here. I'm fairly new to this also. Ileostomy in Nov 2018 that was supposed to be in place one month is now going to be in place for 6 months minimum and will most likely be turned into a colostomy next year. Anyway, the magic bullet for me was Sensura Mio convex system with Brava 2-inch thin barrier rings (paste just didn't work for me), crescent barrier extensions (lifesavers!), and a belt to apply slight inward pressure to make the stoma protrude more. Still have frustrating days where things go wrong, but they are very few and far between now. Hope things turn around for you. I know it's terribly frustrating.