You Should have a size guide with your stoma products. get a rough measurement maybe a few miller meters bigger and use the paste around the wafer and that seemed to work for me.
keep the template and you should be ok
Sounds like you must have an ileostomy? I always instruct my patients to cut the wafer approximately 1/8" larger than their stoma. This allows for it to expand and contract, as well as prevents the moisture from the stoma itself from wearing away the wafer. The caveat is though that if you have an ileostomy, its very important to cover that exposed skin with a paste product, like others have said either paste ring or tube paste.
You didn't mention what you were using for your irritated skin, but prior to applying the wafer, you could dust ostomy powder. It will stick to the wet irritated skin. Then coat over top that with a NON-STING barrier wipe or spray. Depending on the severity of the irritation, I do anywhere from 1-3 layers. Then put your wafer/paste on. This will coat the skin so it can heal. But your nurse is probably right that changing more frequently will be better because the powder/wipe mixture will cause the wafer to not last as long.
Best of luck in your journey!
Certified Wound and Ostomy Nurse
The amount of damage ostomy output creates really depends on how enzymatic the drainage is. Typically the higher up the bowel the ostomy is made-the more enzymes will be in the output. And more enzymes equal more damage. For instance a sigmoid colostomy (down near the rectum) won't have the enzymes that a high ileostomy (made from the small bowel) has. The lower in the gut the stoma is made, the more "normal" the stool should be, and the less costic to the skin (but there are always exceptions). So I think that is why Eakins work for some people and others are able to get away with just paste. Good thoughts! And I personally love the Cavilon wipes. Another one that I've found interesting is the Marathon skin protectant (I think Medline makes it). I just tested some on my hand and it stayed on for like 3 days! And that was through washing frequently of course.
Certified Wound and Ostomy Nurse
I highly recommend the ConvaTec Moldable Technology 2 piece system available in flat or convex. I was having all the same problems that you have described. I heard about this system and ordered a trial packet directly from the company. I tryed it out for 2 weeks and had virtually no problems with skin rashs, blow-outs, pancaking, leaks and odors. It was easy because there was no cutting or guesswork and it molds to your skin for a custom fit. You don't have to worry about adding any other skin barriors such as the Adapt rings because it is built into the system.
You have to see it to believe it and really understand what I am talking about. If you are ready for better, call ConvaTec and order a sample packet. YOU WILL NOT REGRET IT!!
I think we'll all find what's best from sharing our thoughts and experiences.
I'm enclosing an info sheet I give to all the new ostomates I visit in hospitals.
Please pay close attention to the "1/8 inch leeway" mentioned.
If you have the opening too close to the wafer there is the chance the wafer could cut your
stoma. On the other hand too large of a hole leaves your stoma prone to leakage. An 1/8
inch around the stoma is recommended by most manufacturers.
Here's that info sheet I give out:
Steps For Changing Your Pouch
Wash your hands well and have all equipment available.
***Gently*** remove the pouch. ***Push the skin away from the seal.***
***Do not pull the ostomy wafer away from your skin.***
Wash your stoma and the skin around it carefully with soapy water.
* Do not use a soap that has perfume or lotion added to it.
* Use mild soap, such as Ivory, Safeguard, or Dial.
Look carefully at your stoma and the skin around it for any changes.
***Allow your stoma area to dry completely***
before connecting the new pouch.
Trace the shape of your stoma onto the back of the new pouch and
barrier or wafer (wafers are part of a 2-piece pouch system).
* Use a stoma guide with different sizes and shapes, if you have one.
Or, draw the shape of your stoma on a piece of paper. You may want to cut
out your drawing and hold it up to your stoma to make sure it is the right
size and shape. The edges of the opening should be close to the stoma,
but they should not touch the stoma itself.
*** (leave 1/8" leeway).***
Trace this shape onto the back of your new pouch or wafer. Then cut the
wafer to the shape.
* The skin around your stoma should be completely dry and smooth.
There should be no wrinkles in the skin around the stoma.
(I use a hair dryer, on low setting, to completely dry)
Remove the backing from the pouch. Make sure the opening of the new
pouch is centered over the stoma and pressed firmly onto your skin.
* Hold your hand over the pouch and barrier for about 30 seconds after
you have placed it. This will help seal it better. Warming the skin also helps.
(Again, I use a hair dryer on low setting)
I hope this helps!