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Jan 28, 2010

New Ostomy User Seeking Advice on Barrier Issues

This topic is about helping a new ostomy user who is experiencing leakage under the barrier of their one-piece pouch system. They are looking for practical advice to prevent stool from seeping under the barrier, which starts to loosen the appliance after 1-2 days. Here are some helpful tips and insights shared by others:

1. **Fit of the Opening**
- Always use the manufacturer's measuring guide to ensure a proper fit.
- If your stoma size is between template sizes, cut the hole slightly larger and use a seal or paste to fill any gaps.

2. **Switch from Paste to Molded Seal/Ring**
- Consider using products like Hollister Adapt rings, Dansac seals, Salts “Dermacol,” or Eakin seals. Many users find these more effective than paste alone.

3. **Convexity for Flush or Retracted Stomas**
- Try using a convex wafer or a two-piece convex system to help push the stoma forward and keep output away from the edge.

4. **Eakin Seal Technique**
- Warm the Eakin or Adapt ring with a hair dryer on low for about 30 seconds before molding it evenly around the stoma.
- Use a tapered wooden dowel or thumb joint to pre-shape the opening.
- Hold your palm over the applied wafer for a minute to let body heat set the bond.

5. **Skin Preparation and Application Tips**
- Ensure your skin is hair-free, oil-free, and completely dry before application.
- Use odor- and oil-free soap and avoid wipes that leave residue.
- Some people use Tincture of Benzoin, Karaya powder, and Allkare protective barrier wipes, while others find plain dry skin works best.

6. **Accessories for Added Security**
- Consider using a Hollister 1-inch elastic belt clipped to the wafer for gentle pressure.
- Stoma belts are compatible with most brands and can provide additional support.

7. **Alternatives and Suppliers**
- Companies like Edgepark, Hollister, Dansac, Salts, and Convatec often provide samples upon request.

8. **Change Schedule Experience**
- With a well-fitted convex wafer and warmed seal, some users can wear the flange for 4-7 days, only changing the pouch as needed.

9. **Key Reminders**
- Remember that paste is a caulking, not an adhesive, so use it sparingly or consider replacing it with rings.
- Determine whether your stoma is protruding or flush, as this will affect the choice of convexity and ring placement.
- Be prepared for some trial and error, as different combinations work for different people, but many have found success with these methods.
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