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An alternative method to creating a leakproof seal around (almost) any stoma

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 bg99
(@bg99)
Joined: 6 years ago
Posts: 4
Topic starter  

An alternative method of securing a
leak proof seal around (almost) any stoma

- remove the old wafer (flange)  

- using a clean cloth and warm water only clean and dry the skin under the wafer

- cut a hole in the new wafer equal to (or slightly smaller than) the diameter of the stoma

- cut 6 to 8 radial slits each 6mm long in the wafer spaced equally around the stoma

- lightly dust the skin under the wafer using stoma powder and blow off excess

- using 1/3 to 1/1 of a full strip of paste form a ring to fit snugly around the base of the stoma

- using strip paste form a second ring around the

sticky side of the hole cut into the wafer   

- apply the pouch to the wafer and squeeze together to ensure a good seal

- use a finger to apply moderate pressure to the paste ring under the plastic pouch to provide a good seal

- frame the wafer completely using tape

- WEAR A STOMA SUPPORT BELT AT ALL TIMES YOU ARE NOT LYING DOWN -
ANY BELT WILL DO - FAILURE TO USE A BELT VIRTUALLY GUARANTEES THE (NEW) STOMA WILL FAIL!

 

-----------------------


I use a square Hollister convex wafer. It provides security for up to 14 days of wear time.  

Smith and Nephew SNU 64000040 Tape
Coloplast Strip Paste 2655
Hollister 15404 Skin Barrier (flange)
Hollister 18124 Pouch

------------------------------

Bryan
- Ulcerative Colitis & Migratory Phlebitis: Colectomy (1986)
- Rectum removed (1992)
- Additional surgeries
- Stroke (2017)  

=================

 


   
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VeganOstomy
(@veganostomy)
Admin
Joined: 10 years ago
Posts: 4206
 

Welcome, Bryan!

Thanks for sharing this! I hope it's helpful to other users. 

Just your friendly neighborhood ostomate.
~ Crohn's Disease ¦ Ileostomy ~


   
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(@zvitusk)
Joined: 7 years ago
Posts: 396
 

I am confused about your approach. It seems that you make a bunch of radial slits vertical to the stoma. It would seem to me that you are making teeth of a saw blade that can rip into the stoma at its base. You do require a protective layer of paste both above and below the wafer. This should prevent somewhat any damaging sawing . In addition,  you emphatically require a secure belt to prevent any movement of the wafer.

I can appreciate the elegance of your proposal. I just believe that the risk of any damage  whatsoever makes your proposal a bad idea. 

I thank you for making me think out of the box. It was fun. You are correct in thinking that there has got to be a better way . Keep trying.

Z


   
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Chris
(@chris)
Joined: 7 years ago
Posts: 143
 

Is that for an ileostomy? I may fall into the "almost any stoma" category unfortunately. 

I was pretty excited when I read the title however.

My stoma usually measures, with a guide, an oval 38mm by 35 mm. Sometimes after some pain when I take the wafer off its measuring 41mm round. I have to cut it HUGE to compensate for all that expansion, and make up for it with a ring.

Anyway, as I've mentioned before, I'm changing every 8 hours  (Thank god for Marshmallows!) So I was excited for this one, but I don't think that would work for mine. 

But 14 days.. man that's amazing.


   
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(@john68)
Joined: 7 years ago
Posts: 2031
 

Hi Brain, welcome to the site, have to ask how did you come up with this idea was it a case of having trouble and this was the method that you tried and it worked. I would have to say I agree with Zvitusk that those cut edges could harm the stoma. but on the other hand it works for you and that is what matters. My only concern would be may be if it was to be tried by another person that they could cause harm! We all find tips and tricks that work so not condemning yer method just not sure it would be for every one. :-) 

ileostomy 31st August 1994 for Crohns


   
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(@bubbles)
Joined: 6 years ago
Posts: 244
 

14 days WOW !  I feel myself getting stinky after 5 days how do you smell after 14 . Do you change the bag at all ? Just wondering. Glad it works for you . 


   
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VeganOstomy
(@veganostomy)
Admin
Joined: 10 years ago
Posts: 4206
 
Posted by: Zvitusk

I am confused about your approach. It seems that you make a bunch of radial slits vertical to the stoma. It would seem to me that you are making teeth of a saw blade that can rip into the stoma at its base.

Perhaps Bryan can post a photo, but I don't think these are supposed to be sharp cuts.

Just your friendly neighborhood ostomate.
~ Crohn's Disease ¦ Ileostomy ~


   
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(@cross)
Joined: 6 years ago
Posts: 12
 
posted by: Zvitusk

I am confused about your approach. It seems that you make a bunch of radial slits vertical to the stoma. It would seem to me that you are making teeth of a saw blade that can rip into the stoma at its base.

Have to agree with Zvitusk, as a I use a barrier ring to get up close to my prolapsed stoma because if I getting to close to the stoma with the wafer causes on and off pain. 

I use a barrier ring and wafer. Getting the barrier ring close to the stoma. After barrier ring and wafer are press well in place again the skin. I use Eakins no alcohol stoma paste next between wafer, ring and stoma filling the gap by gently pressing  into gap.  Some will come off but most stays in place for the 3 days wear.  I do this fill to cause a less burn issue.  My stoma nurse showed me this technique.

Cross  

 


   
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Chris
(@chris)
Joined: 7 years ago
Posts: 143
 

What's the difference between a ring and Eakin? I thought they were the same.


   
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Dona
 Dona
(@dona)
Joined: 7 years ago
Posts: 832
 

Hi Chris,

Eakins is a BRAND of barrier ring. There are others , like brava. They seem to be made of slightly different materials. Some work for some people and not for others.

The Eakins rings ( which I use) also come in a strip form which some people use to mold to an odd shaped stoma or fill in where there are crevices or voids.

They are always used with some type of wafer and are intended as an added seal. I think they help to absorb moisture.

Hope you are doing better and that  helps. to clarify this murky issue ( ha ha).

The different brands and nomenclature is really confusing!

Onset of severe Ulcerative Colitus Oct.2012. Subtotal colectomy with illiostomy July 2015; Peristomal hernia repair ( Sugarbaker, mesh, laparoscopic) May 2017.


   
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VeganOstomy
(@veganostomy)
Admin
Joined: 10 years ago
Posts: 4206
 

Dona is absolutely right - Eakin is a brand of barrier ring, but they do have their own formulation that has been around for a while. 

Their products are quite well known, but they aren't the best for everyone. 

Just your friendly neighborhood ostomate.
~ Crohn's Disease ¦ Ileostomy ~


   
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Chris
(@chris)
Joined: 7 years ago
Posts: 143
 

I have tried most of those ring companies actually, but I was confused by "Cross''" post.  I read it as... first a barrier ring on the skin, then the wafer, then an Eakin (which doesn't seem possible but right now I'm open to all suggestions) and somehow paste in between it all. I was just a little confused because it seems in that post that the "ring" and the "Eakin" are separate items. 

I would love clarification by Cross, or others if they think they know, on what that process is. Is the paste crammed in after a wafer is applied, for instance? I'm willing to try anything if it works for one.


   
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(@cross)
Joined: 6 years ago
Posts: 12
 

Chris,

Sorry for the confusion.  I use a Hollister Wafer, bag and barrier ring.  After barrier ring and wafer are in place their is a small gap between the stoma and the wafer where I apply Eakins alcohol free stoma paste.  Now my stoma pushes upward on the sides because it is prolapsed.  I suffer from burns so my ostomy nurse suggested the Eakin alcohol free stoma paste here because it doesn't burn, where I use as a gap filler only. Some actually come off because it can't hold well to the Hollister product.  Using Hollister stoma paste would work better but they have no alcohol free stoma paste.

NOTE:  Admin is correct, all brands have different formulas.  So use same brand for wafer, barrier ring, stoma paste, stomas powder and bag. 

I am only using the Eakin Alcohol Free Paste as a filler to help keep stool acid away until burn get better then I will use Hollister stoma paste which will stay in place and work better.

Hope this helps

Cross


   
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Chris
(@chris)
Joined: 7 years ago
Posts: 143
 

Thanks cross, it kinda does.

Still have a couple questions though, if I may.

1) how does you prolapsed stoma make things difficult for you? How does it act?

2) are you cutting the wafer really big and then attaching the barrier ring to the wafer and then pressing them both together into your skin?

3) you say after that you apply the paste. I'm picturing trying to cram paste around the edges of the stoma after the wafer is installed. Is that correct? If so, what do you use to cram it in the space, a q-tip? Furthermore, doesn't the moisture from the stoma stop the paste from adhering to the skin?

I find that any stoma some on any of these products make them slippery as hell and I just throw them out because they'll never stick.

I'm wondering if I have a prolapsed stoma. Mine swells rediculously. It's like it swells and pushes the barrier ring back leaving the skiing exposed, then it immediately shrinks again and the output goes directly on the skin.

Anyway, I'd be interested in hearing more about you process and situation.

Thanks


   
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(@cross)
Joined: 6 years ago
Posts: 12
 

Chris,

A prolapsed stoma is hernia ileostomy outside the body inside out.  Google "prolapsed stoma" and hit image button.

No, I don't oversize my wafer ring hole but make sure there is a slight gap around the stoma which I  fill the stoma paste after ring and then wafer is applied. When looking at pics note my stoma hangs out. 

After applying a small amount I smooth it out with a gloved finger.  Smoothing it into gap. You don't want to cram it.

Concerning moisture, I don't eat for a period of time before change unless I have a leak and normally change out every three days.  I wash with water really good around stoma then quickly get skin dry around stoma by blotting and fanning.  Quickly apply barrier ring with dry gloves and GENTLY press barrier ring down. Now if you get leak on barrier ring before applying wafer it will not get under barrier ring.  You can blot off slight leak on top on ring making sure it is dry.

It sounds like you have a slight swelled around your stoma which raises up with producing.  Mine is always raised (prolapsed) and when it produces pushes around wafer hole pushing it out more, too.

Water, unclean skin and soap residue are in enemy of  barrier rings and wafers.  I learned this from months of wafer failures in hospital and from the Specialist Ostomy Nurse whom I went to after hospital. As I said in past I use Ostozyme instead of soap but still wash down with water after using it.

I also wear a belt which adds strength holding wafer-bag rig against me which especially helps for the first 12 hours that the wafer cures against skin .

As the Admin has said in several post,  consulting a Ostomy Nurse Specialist may help with your burn issues.  The nurse can for example show you how to use the stoma powder, barrier wipe method on burns which has helped me after being shown how to do it.

Hope this answers your questions.

Cross

 


   
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Chris
(@chris)
Joined: 7 years ago
Posts: 143
 

I don't think that's what I have. I have been trying your method a bit however. Hard to when the sucker is active, which is most of the time for me, but morning changes have worked out. 

What do you think the difference is between what you do, and just applying paste to the wafer and pressing it on top of the ring on the skin?


   
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Marcie
(@shulmjs)
Joined: 7 years ago
Posts: 1510
 

Here is a NEW ONE for length of wear time of your barrier and seal.  I now AGAIN have  punumiona-sp- -- When I changed my pouch after 3 days (as always) there was so much flem from my lungs and head dripping, that went through. My skin and wafer was full of ecky slime. (talk about a science fiction horror show-YUCK) NEVER THOUGH OF THIS HUH???  Well having a cold etc. and you have the drippings of thick felm, be aware!!  it is slimy and loosens up you waffer/barrier.. Ahhhhhhh  the body fluids……………..  Pretty slippery!!

Just wanted you all to know if you do have the above, keep a check!!  Less stress of a fallen pouching system.. and when your sick, u sure don't want to deal with the extra work!!!:-)

2014 - 3 strangulations of colon, Ulcerative colitis, removal of colon, illiostomcy named woooh Nellie..


   
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sjlovestosing
(@sjlovestosing)
Joined: 6 years ago
Posts: 651
 

Marcie,

I am so sorry that you are dealing with all this. I will pray for you and hope your troubles end soon.  Be well!

Stella


   
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Marcie
(@shulmjs)
Joined: 7 years ago
Posts: 1510
 

Well thanks Stella.  I will get better..  Always do.  But when I changed my wafer, it was sliding off. :-0!!! lot of mucus………… I got lucky this time.. New one for me!! in more ways than one huh ?? beware!!!!!!!!!!!  

2014 - 3 strangulations of colon, Ulcerative colitis, removal of colon, illiostomcy named woooh Nellie..


   
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 bg99
(@bg99)
Joined: 6 years ago
Posts: 4
Topic starter  

Apologies for taking so long to respond. There have been a lot of difficulties this year as I am still adjusting to managing my ostomy after becoming legally blind.

The radial slits are very small; more like small nips with the end of the scissors. They simply allow the wafer hole to expand. See photos in link below (the slits, made by my son, are barely visible).

https://photos.app.goo.gl/LFznoaoSUospLzXf7


   
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