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Dec 16, 2019

Persistent Red Weepy Skin - Seeking Solutions for Ostomy Issue

The topic at hand is about dealing with persistent red, weepy skin around the stoma, which is causing issues with moisture and adhesion under the wafer and Adapt ring of a Hollister two-piece ostomy system. The person experiencing this problem believes the moisture is due to skin exudate rather than stool. They have tried various methods to manage the situation, including advice from a wound nurse and experimenting with different products. Here are some insights and advice shared by others who have faced similar challenges:

1. Moisture-control and barriers:
- Marathon Liquid Skin Protectant can form an instant crust. Blow-dry it and change the pouch every few days until the skin heals.
- Smith & Nephew Skin-Prep wipes, when allowed to dry before applying the wafer, can last 4-6 days for long-term users.
- 3M Cavilon No-Sting barrier wipes or spray work well for some, though others may develop sensitivity.
- Liquid SkinTac or Torbot Bonding Cement can be painted as a thin ring to improve the edge seal.
- Cutting off the fabric tape flange and relying on the hydrocolloid ring with an ostomy belt can allow air to reach irritated areas.
- Eakin Cohesive Slims or Stomahesive can be applied precisely with a syringe to keep paste off healthy skin.
- Using a Convatec Sur-Fit Natura Durahesive wafer with an Eakin ring and 3M Micropore tape can extend wear time.
- Coloplast strip paste combined with Convatec powder can be gentler for some users.

2. Products for healing and drying skin:
- Zinc-oxide diaper rash ointment or any diaper cream with zinc can be applied, then washed off before pouching.
- Bard Natural Care Gel, which contains aloe and hyaluronic acid, can be used before any barrier layer.
- Cortisone 10 Maximum Strength liquid stick dries fast and requires no rinsing.
- Medical-grade Wound Honey, which is manuka-based, can be applied in a thin layer.
- Nystatin liquid, an antifungal, is already helping the person who started the discussion.
- Betamethasone or other topical steroids can be used for allergic reactions to tape.

3. Cleansing and rinses:
- A gentle wash with surgical soap followed by a rinse with homemade colloidal silver can be soothing. Avoid local tap water if it irritates.
- An Arm & Hammer baking-soda solution or a warm Epsom-salt rinse can calm the skin.
- Head & Shoulders shampoo, which contains zinc pyrithione, can be dabbed on and then rinsed off.

4. Absorb-and-air methods:
- On days spent at home, removing the wafer and placing absorbent bandages over the stoma area, changing them every couple of hours, can help form a crust in 1-2 days.
- Custom DIY baseplates held by two belts allow for quick removal and re-application for frequent airing out, with absorbent tissue placed underneath.
- If the output volume allows, leaving the pouch off for short periods can help dry the skin, with some managing several days.

5. General tips:
- "Less is more": minimizing layers can prevent moisture from being trapped.
- Change the appliance every 2–3 days while healing, as pushing wear-time can restart the cycle of irritation.
- After emptying the pouch, flush it with cold water using a hair-dye bottle and gently squeeze the bag to clear output around the stoma, keeping effluent away from the skin.
- Skin sensitivities can change over time, so it's important to keep patch-testing new products.
See full discusison
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