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May 18, 2023

Best Convex Baseplate for Flush Stoma? Need Help to Avoid 3rd Surgery

This topic is about finding the best convex baseplate options and seal techniques for someone with a flush or retracting stoma. The person has been dealing with leaks and skin irritation due to their stoma being flush with or retracting into the skin. They are looking for advice to avoid another surgery and manage their condition better.

Here are some helpful insights and advice shared by others:

1. Surgical Revision:
- Many suggest that converting a flush stoma to one that protrudes a few centimeters is the most reliable solution. This can often be done through the existing opening without major surgery.
- It's important to know if previous revisions just "pulled out" the stoma or moved it to a new location, as poor site selection can lead to ongoing issues.
- Large hospitals or centers of excellence, along with WOC (Wound, Ostomy, and Continence) nurses, can help find surgeons who specialize in stoma revisions.

2. Convex Baseplates and Pouches:
- Some users have found success with specific products like the Hollister one-piece convex 85711 with an Adapt Thin Ring, and warming the ring first for better adhesion.
- Others recommend the Hollister two-piece convex wafer 13506 with a drainable pouch 18183, used with a Welland sealing washer and 3M Cavilon Sting-Free spray.
- The Coloplast SenSura Mio Deep Convex one-piece, product 16778, is also mentioned, with a belt to keep pressure for the first 10 minutes.
- It's noted that precise cutting of the starter hole is crucial—too small can trap output, too large can cause leaks.

3. Accessory Products and Application Tips:
- Barrier rings can be helpful for some, but others find that using fewer products can reduce leakage.
- Torbot brush-on liquid adhesive under a pre-cut baseplate with flange extenders can hold for a week, especially if kept warm before application.
- Skin prep is important: using adhesive remover wipes, rinsing with warm water, and drying thoroughly can help.
- Warming rings and baseplates before application improves adhesion.
- Keeping air in the pouch helps direct output downward, and staying hydrated keeps output thinner.
- An ostomy belt can help press the convexity into the abdomen initially.

4. Sampling and Support:
- Companies like Hollister, Coloplast, and Convatec offer free samples of different products, which can be requested through their customer service.
- Consulting with an experienced WOC/Ostomy nurse can provide valuable insights into managing skin fragility and finding suitable adhesives.
See full discusison
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