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Oct 18, 2011

Need help with stoma skin lesion - allergic reaction to barrier wipes?

This topic is about dealing with severe skin issues around a stoma, which can be very painful and challenging to manage. The person experiencing this has a burning, weeping sore next to their stoma, possibly due to a product allergy. They are looking for ways to heal the sore and keep their ostomy pouch securely in place. Here are some helpful tips and advice:

1. Check the fit of your ostomy appliance.
- Use the stoma-sizing guide that comes with your supplies to cut the wafer hole so it fits snugly against the stoma, preventing output from reaching the skin.

2. Consider switching from creams to powders or gels.
- Use antibiotic or stoma powders to dry the area without affecting wafer adhesion.
- Silvasorb gel or silver-based dressings can help speed healing when applied to the sore, followed by powder and a barrier spray or wipe.
- Calamine lotion or plain Maalox can be applied in a thin layer and dried thoroughly before applying the wafer.

3. If wipes cause burning, choose "no-sting" or spray barriers.
- Products like 3M Cavilon Barrier Spray or Coloplast No-Sting Barrier Wipes are gentle options.

4. Use sealing accessories to prevent leaks.
- Barrier rings or convex flanges can create a tight seal around the stoma.
- Stomahesive pastes can fill gaps around the opening.
- 3M cloth tape around the wafer edge can provide extra security.

5. Consider alternative wafers or under-dressings for broken skin.
- Products like Convatec DuoDerm Extra-Thin or Coloplast thin film can be used over the sore, with wafers adhering well to these.

6. Manage moisture with absorbent layers.
- Use Aquacel or Aquacel-Silver under a cut-out piece of barrier film to absorb wound exudate while keeping the wafer dry.

7. Rule out possible medical conditions.
- Conditions like peristomal pyoderma gangrenosum or granuloma can mimic allergies. Seek professional assessment early for appropriate treatment.

8. Follow a gentle cleaning routine.
- Use plain water or non-alcohol, non-soap wipes, and let the skin air out and dry completely before reapplying any barrier.

9. If a fungal infection is suspected:
- Dry the skin with powder, apply a spray barrier, and keep the area dry. Consult a physician for prescription antifungal treatment if needed.

10. If the flange material causes a reaction:
- Try harder, cut-to-size plastic flanges instead of flexible ones, and avoid alcohol-based products.

11. Seek professional help.
- Consult an ostomy nurse, dermatologist, or contact manufacturer helplines for guidance on product selection and treatment options.
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