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May 22, 2013

Tips for Pouch Wear - Extending Usage and Techniques

This topic is all about finding ways to extend the wear time of ostomy pouches, which can be a big help for those with an ileostomy. The discussion includes different products, brands, and practical techniques that people have found useful. Here are some insights and advice shared by users:

1. Many people find that two-piece systems tend to last longer than one-piece products. Here are some combinations and their results:
- Hollister wafer with bags: 6–7 days with a seal, about 5 days without.
- ConvaTec Sur-Fit Natura system: 6–7 days, even with daily hot showers.
- ConvaTec Flexible Flange with a specific routine: 6–7 days.
- ConvaTec Durahesive with convex insert: 3–7 days in hot weather, 7–10 days in cooler weather.
- Coloplast SenSura Click with an Eakin seal: around 5 days, with more frequent changes in summer.

2. Eakin seals or rings are highly praised for extending wear time and protecting the skin, despite being a bit pricey.

3. Skin-care and removal tips include:
- Using Witch Hazel as a gentle cleanser.
- Alkare citrus-based adhesive remover wipes are preferred over petrol or alcohol-based ones.
- 3M Cavilon skin-protectant spray is good for sensitive skin.
- Rubbing alcohol can be used for quick adhesive removal, followed by a skin protector.
- Neutral, fragrance-free bar soaps are recommended, while moisturizers and perfumes should be avoided around the stoma.

4. Timing and technique tips:
- Changing pouches at night can help the wafer set better.
- Long, hot showers don't seem to affect wear time for many.
- Pressing the wafer firmly with warm fingers helps activate the adhesive.
- Flattening Stomahesive paste with a wet fingertip creates a smooth seal.
- Blowing a little air into the bag can ease coupling of a two-piece pouch.
- Rinsing the pouch with lukewarm water can reduce odor and buildup.

5. Seasonal and activity factors:
- Heavy sweating, swimming, or outdoor work in summer can reduce wear to 3–4 days.
- Winter conditions might allow up to 10 days, but most change at 7 days for skin care.

6. Common difficulties and solutions:
- Those needing daily changes often find watery output erodes the seal. Switching to two-piece systems with Eakin rings or paste can help.
- Persistent leakage or skin irritation should be assessed by a WOCN. Spray-on glue is not recommended for sensitive skin; specialized wafers and barrier rings are safer.

7. The general consensus is that choosing the right product, often a two-piece wafer with an Eakin seal, along with meticulous skin prep, firm application, and night-time changes, are key to extending wear time for most people with an ileostomy.
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