Topic Explanation:

The discussion centers around a person who recently underwent a peristomal hernia/prolapse repair with mesh and is experiencing severe irritation, bleeding, and ulceration of the peristomal skin. They suspect a possible candida infection and are struggling with adhesion issues for their ostomy appliance. They are considering using Cica-Care silicone gel sheets, a medical-grade silicone product, to help heal the skin and improve adhesion. They are seeking advice on the use of silicone products around the stoma, particularly regarding the safety and effectiveness of using silicone from non-medical sources like hardware stores.

Advice and Insights:

1. Medical vs. Non-Medical Grade Silicone:
- Medical-grade silicone is essential as it is tested for contaminants that could be harmful. Hardware store silicone is not pure and may contain harmful substances.
- Food-grade silicone is better than hardware store silicone, but medical-grade is the safest option.

2. Testing Silicone on Skin:
- Before applying silicone around the stoma, test it on another part of the abdomen to check for skin compatibility. Some people may experience itching or irritation.

3. Consulting Healthcare Professionals:
- It is advisable to consult a stoma nurse or doctor for personalized advice and assessment of the irritated skin.
- A stoma nurse can provide guidance on managing candida and other skin issues.

4. Managing Candida and Skin Irritation:
- For candida, using athlete's foot powder lightly around the stoma, followed by stoma powder, can be helpful.
- Avoid products containing alcohol as they can worsen irritation.
- Changing the ostomy bag more frequently may help manage skin irritation.

5. Alternative Skin Protectants:
- Consider using advanced skin protectants like Marathon or Calvion 3M, which are designed for sensitive skin around stomas.

6. Crusting Method:
- The crusting method, which involves applying stoma powder and a barrier film, can be beneficial for managing irritated skin.

7. Use of Iodine:
- Iodine can be used as an alternative to alcohol-based products, though it may sting initially. It is suggested for those who cannot use alcohol-based products.