Topic Explanation:
The discussion centers around a person who is eight weeks post-emergency colostomy due to a bowel resection leak. The stoma is positioned high on the stomach, above the belly button, and is irregularly shaped with bumps at specific positions. The individual is experiencing issues with the wafer not adhering properly, particularly around the belly button, and is seeking advice on how close to cut the wafer to the stoma without causing harm.
Advice and Insights:
1. Consult a Stoma Nurse:
- It is recommended to see a stoma nurse for professional advice and better management of the stoma.
2. Wafer Cutting and Application:
- Use the backing of the wafer as a stencil for cutting to ensure accuracy.
- Smooth the edges of the cut wafer with a finger to avoid rough edges.
- Some users cut the wafer slightly larger or smaller than the stoma, depending on personal preference.
- Ensure the skin is completely dry before applying the appliance.
3. Use of Barrier Rings and Paste:
- Consider using a full moldable ring for a better seal, as it can adjust to the stoma's shape.
- If using a half ring, ensure it is snug around the stoma to prevent gaps.
- Paste can be used to fill gaps and around the belly button to improve adhesion.
4. Additional Adhesion Tips:
- Extender strips can help hold down the edges of the wafer where there are folds or gaps.
- Warming the wafer before application can improve adhesion.
5. Moldable Wafers:
- Moldable wafers that stretch and conform to the stoma's shape can be beneficial for irregularly shaped stomas.
6. Managing Stoma and Skin Health:
- A 1 mm gap between the wafer and stoma is standard; the seal ring can touch the stoma without harm.
- Barrier wipes can protect the skin around the stoma.
- If experiencing thick output, a small amount of baby oil in the bag can prevent pancaking.
7. Personal Experiences and Adjustments:
- Users have shared personal experiences of adjusting to stoma care, emphasizing that it is a learning process.
- The stoma may change in size and shape over time, requiring adjustments in wafer cutting.
8. Product Recommendations:
- Some users recommend specific products like moldable rings, convex bags, and barrier strips for better protection and fit.
- Consider using fungal
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