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May 19, 2024

Is This a Good Enough Seal?

This topic is about a person who recently had colostomy surgery and is trying to figure out how to achieve a leak-free seal with their ostomy appliance. They are using a 2-piece Hollister system with Skin-Tac but are unsure if the small amount of seepage they see is normal or if they need to adjust their technique or products.

Here are some helpful tips and insights shared by others:

1. Moldable barrier rings:
- Many people find them to be a "game changer."
- A recommended brand is Coloplast Brava moldable rings, with a 2-inch diameter and 1/16-inch thickness.
- One method is to cut one side of the ring, stretch it to fit snugly around the stoma, and then apply the wafer over it.
- Another method is to place the ring on a convex wafer first and then apply the combined unit, which works for some users.

2. Wafer hole and ring placement:
- Cut the wafer opening larger than the stoma and let the ring, not the wafer, hug the stoma.
- Ensure the ring touches the stoma base with no gaps; it's okay if the ring ends overlap or have a small gap.

3. Convexity considerations:
- If seepage continues or if the abdomen is soft or flabby, consider switching to a convex wafer (Hollister or another brand) with the ring for better pressure and fit.

4. Skin-Tac technique:
- Place the ring first, then wipe Skin-Tac from the ring’s outer edge outward to where the wafer tape will sit.
- Allow Skin-Tac to dry for maximum stickiness; you can lift and smooth out tape wrinkles because Skin-Tac remains sticky.

5. Warming the appliance:
- Warm the wafer with a hair dryer on low after removing the paper backing and adding the ring to improve adhesion.

6. Wear time and change schedule:
- A typical leak-free wear time is 7–8 days with the ring and wafer.
- Always change before failure; the frequency depends on the viscosity of the output, as liquid erodes barriers faster.

7. Additional mechanical support:
- Use an ostomy belt with the Hollister 2-piece system to keep the wafer pressed against the ring even if adhesion weakens.

8. Stoma/output variables:
- Oblong stomas, side-shooting stomas, and liquid output can accelerate seal breakdown; using a ring and making timely changes can help counteract this.

9. Night-time positioning:
- Avoid sleeping positions that allow output to pool around the stoma, such as lying flat on your back, as prolonged contact can soften the ring and wafer.

10. Reassurance:
- One person mentioned they would be happy if their wafer looked as good as the poster’s, suggesting that only minimal seepage is visible.
See full discusison
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