Topic Explanation
The forum discussion centers around a user named Georgenelly who is experiencing significant difficulties with stoma care following an ileostomy. Georgenelly describes issues with getting ostomy bags to adhere properly, compounded by severe bleeding and pain around the stoma site. Despite multiple hospital visits, the problem persists, and Georgenelly is seeking advice on how to manage the wound and improve the adhesion of the ostomy bags.

Advice and Insights

1. Crusting Technique and Convex Wafers:
- Use the barrier wipe/stoma powder crusting technique to help manage the bleeding.
- Try using convex wafers and a hair dryer to dry the area around the stoma.

2. Stoma Measurement and Bag Fit:
- Ensure the stoma circumference is measured accurately, especially when the stoma is at its largest.
- Adjust the size of the hole in the wafer or bag to avoid it being too tight or too loose, which can cause bleeding or leaks.
- Consider using a barrier ring for additional cushioning.

3. Photographic Documentation:
- Take pictures of the stoma and the used appliance at different times to help healthcare providers understand the issue better.
- Share these pictures with a stoma nurse or the original surgeon for more informed advice.

4. Consulting a Stoma Nurse:
- If hospital visits have not resolved the issue, consult a stoma nurse for specialized care.
- Convatec offers free virtual visits with stoma nurses, which can be a helpful resource.

5. Adhesive and Barrier Products:
- Experiment with different barriers and adhesives once the skin is healed.
- Use stoma powder and skin prep before applying the barrier.
- Apply a barrier ring around the base of the stoma and use "Skin Tac" for additional adhesion.
- Warm the wafer with a hair dryer after application to improve adhesion.
- Consider using barrier extenders for extra security.

6. Product Recommendations:
- Coloplast's Brava Protective Seal is recommended for less residue.
- ConvaTec's Eakin seals are also suggested.
- Moldable barriers from ConvaTec and Hollister can help if the wafer hole is too tight.

7. Frequency of Wafer Changes:
- Change the wafer every 3-4 days to prevent skin irritation and bleeding.

8. Clarification and