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Need tips on getting the wafer to stick

Posted by Jamie251, on Wed Apr 03, 2013 11:30 am
I am new to this. Ileostomy created March 14th after bowel resection for crohn's. needless to say, the phrase "shit happens" has taken on a whole new meaning with me these days!  i am having trouble getting a good seal on my wafer and am only getting one to two days before it starts leaking. Anyone have any tips on getting the wafer to last a bit longer?
Also, my skin is very irritated under the wafer...what have you all found best for skin protection?
Reply by shan1989, on Wed Apr 03, 2013 12:26 pm
Hi

I had to have a second op to move my ileostomy to other side of abdomen as had loads of complications. I still only get 2-3 days before having to change it but to me thisis better than my 10 timesa day! So unfortunately i have no tips on that one but as for your skin, the best thing i have found is sunlight/sunbeds. not often but every 2 weeks i have a 6 minute sunbed which clears my skin straight up! this may help your wafer to stick for longer if your skin is in good condition Smile
Reply by Xerxes, on Wed Apr 03, 2013 8:46 pm
What kind of a system do you use? for many years I used a two piece system by Hollister. A couple of years ago I switched to a two piece system by Convatec. What a difference. I went from one or two days then up to 5-6 days now. The difference is unbelievable. Before applying the wafer try heating it with a hair dryer on high for several seconds. It will help with the adhesion of the wafer.

X_
Reply by shan1989, on Thu Apr 04, 2013 3:54 am
I have to use a one piece now as my skin reacted with all the two pieces that were available :0( I know get bad psoriasis which is the cause of not much sticking, the sunbed/sun really helps x
Reply by Jamie251, on Thu Apr 04, 2013 12:32 pm
I currently am using the two piece hollister. Even though my stoma isn't retracted, i find the convex wafer works best for me. I changed yesterday and tried the hairdryer so we will see if that helps...i may have to try another brand...only problem is i have to use a high output bag and i've looked online and not everyone makes one.
Unfortunately, i can not get in the sun or tanning bed because I have lupus. I purchased some of the powder and put some of that on my skin before changing...hopefully it will help!
Thanks for the tips!
Reply by Xerxes, on Fri Apr 05, 2013 5:24 pm
I know that Convatec does make a high output appliance that is used with the two piece system. I have used it on occasion.

X_
Reply by Jamie251, on Fri Apr 05, 2013 7:46 pm
Do you use the convatec moldable wafer?
Reply by Jamie251, on Fri Apr 05, 2013 7:46 pm
Do you use the convatec moldable wafer?
Past Member
Reply by Past Member, on Sat Apr 06, 2013 4:31 pm
First, you might have to figure out where it is leaking, not so much as to why. we have to develop a forensic investigative approach so that we can develop a system that is more or less bulletproof. i know of a woman w/ an ileo on another site who spent time in a bathtub with a naked stoma (no appliance) to see what is exactly happening when there is activity.

Not that you have to do the same; i didn't.

In general, less is usually more. the more steps that are involved in application usually translates in more likely to fail, leak or breach.

for irritated skin, other than open air for general healing, i like witch hazel. it will sting, but i find it moisturizes without leaving a residue.

When applying your gear/system/appliance, you can also use stoma powder on the more irritated areas. a little dusting, then barrier wipe/spray. if you have wipes, dab it onto the powder. Once your skin is looking better, you can stop using the powder.

As part of your routine, you might want to consider using the barrier wipe/spray. it helps protect your skin as well as give your appliance something to stick to.

Then there is one piece or two. convex or flat. and the use of a seal.  A seal is like a washer or gasket. when it comes to paste, you want to think caulk to fill in crevices, not glue.

Don't be afraid to experiment. all of the companies are more than happy to provide samples.
Reply by Anoniem18, on Sat Apr 06, 2013 9:18 pm
Reply by Anoniem18, on Sat Apr 06, 2013 9:42 pm
I have had an occasional problem prior to the flange lasting the expected week; if it is minor I will use paste to seal the place where it leaks and then instead of the gauze as descibed above I use waterproof tape. Waterproof tape is a bit harder on the skin but works great. Consequently it is seldom that I have to replace the appliance prior to a week.
I found that skin irritation tends to be as a result of having your skin come in contact with your output. I use a barrier ring which I apply to the flange but make it slightly smaller than the opening for the stoma, than apply paste around the barrier ring which reinforces the contact to the skin. Also note that the stoma opening should fit exactly; too large and I found that you will have problems
Don't hesitate to contact me should you have any questions.
Regards,
Ed
Reply by Xerxes, on Sun Apr 07, 2013 3:36 pm
As for securing the clip, I have always used a rubber band.

X_
Reply by Xerxes, on Sun Apr 07, 2013 3:37 pm
Jamie251,

If you are asking me, the answer is yes.

X_
Reply by TB Cat, on Mon Apr 08, 2013 2:10 am
I have the best results using Cymed Micro Skin one piece pouching system in conjunction with a Hollister mouldable sealing washer. The setup must be applied to clean dry skin. I also use skin barrier each time.
Using a hair dryer to warm up the skin as well as the sealing washer really helps the adhesion. After 18 months of trying other systems, I found this one the best and most comfortable. I routinely change every six days with no problems during the wear time.
Free samples can be obtained from Cymed. I recommend them highly. Their motto is "Life Without Limitations"
Reply by Kimbaby57, on Mon Apr 08, 2013 9:51 am
I've found it's very important to figure out WHY you are leaking.... there are two kinds of leaks.

One is a leak between the wafer (on the bottom, next to your skin) and the other is between the wafer and the bag.  I'm assuming you have a two piece system.

For the wafer, you have to be sure your skin is clean and DRY before you apply the wafer.  Warming the wafter helps activate the adhesive.

If your skin is irritated or has broken down, use some ostomy powder, lightly dusted (brush off most) and then dap skin prep on the dusted areas.  Some people do two "layers" of this.  Powder, prep, powder, prep.   Then apply the wafer.

I'm assuming you've "sized" your wafer well... 1/8" clearance ONLY around the stoma.  Stomas aren't perfectly round, yours may be oval.  

Use the Eakin ring on your skin around the stoma.  I warm mine as well, then tuck it in snuggly around the stoma, then press the wafer over it.   Have you ever changed a faucet on a sink?   It's like "plumbers putty" between the porcelain sink and the tail piece (drain).  Same idea.  When you peel back the paper backing, smooth out any wrinkles.  

Once the wafer is on, snap on the bag.  Make sure you feel/hear a little snap.  Squeeze all around.  Then take your thumbs and press the wafter all around the stoma to make sure it's nice and snug around your skin.

Then put your hands over everything for at least 1 minute to warm all the adhesives and make sure everything is glued on snugly.

Do you use a belt?   This will help hold the weight of the bag up.   Make sure you empty your bag when it's no more than 1/3 full.   This will also help keep the weight of the bag down and won't pull on your skin.

These are my tips/routine.   I had skin breakdown the first week.  Then it cleared up and I've been lucky ever since.

Change your wafter 2x week, and your bag every day.  Do it in the morning before you've eaten when the the stoma is least active.

My stoma is sometimes active anyway, so I keep a 4x4 gauze pad handy, dampened with water.  I "wrap" it around my stoma like a little scarf if I'm not "ready" to apply the wafter right away after cleaning.  The scarf catches any minor leakage and keeps the skin you've carefully prepped clean and dry.  

Good luck!
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