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May 29, 2025

Help Needed: Daily Leaks with Skin-Level Ileostomy

Topic Explanation:
The discussion centers around a mother seeking advice for her daughter, who has a skin-level ileostomy following a car accident. The daughter experiences daily leaks due to the stoma's position and surrounding creases, which complicate the use of ostomy bags. Despite trying various products and techniques, including different types of bags, rings, paste, and a hernia belt, the leaks persist. The daughter is not strong enough for immediate revision surgery, and the mother is looking for solutions to manage the leaks until the planned reversal surgery.

Advice and Insights:

1. Skin Preparation:
- Use skin prep products, such as sprays or wipes, to help with adhesion and protect the skin.
- Consider using a barrier spray instead of wipes for better results.

2. Product Recommendations:
- Try Hollister Adapt Oval Convex barrier rings, which may fit better around the stoma's dips.
- Consider using Cera rings (referred to as ceramic rings) with a Hollister bag, as this combination showed improvement in skin condition.
- Explore the use of adhesive spray to improve bag adhesion.

3. Application Techniques:
- Use a barrier ring with a smaller inside diameter than the stoma to prevent leaks.
- Apply multiple layers of barrier prep and stoma powder to protect and heal the skin.
- Fill creases with strip paste to prevent leaks from moisture.

4. Alternative Solutions:
- Consult with the surgeon about the possibility of pulling the stoma out slightly without full revision surgery.
- Consider using a product like the Ostoform FlowAssist Seal, although experiences with it vary.
- Explore the use of fludroxycortide tape under medical supervision for skin healing.

5. General Tips:
- Avoid using soap; clean the area with warm water instead.
- Ensure the skin is dry before applying any products.
- Monitor the skin's condition and adjust products and techniques as needed to improve wear time and reduce irritation.
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