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Healing the Skin around the Stoma - OSTOMY TIPS (w/ Video)

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VeganOstomy
(@veganostomy)
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Posted by: @dlkfiretruck

I have to ask if everyone gets pain with the flares of disease? I know I have a different type gut being shorter then short and with bowel wall thickening, but does everyone experience the pain??

Not everyone will have pain all the time, but it does depend on the severity of the illness and where. When I was diagnosed with Crohn's, I didn't have pain - that came as my illness got worse, and it was excruciating. ?

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


   
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(@Michelle)
Joined: 4 years ago
Posts: 1
 

I do home healthcare for a client and he is having an issue with skin breakdown around his stoma, we have tried the caking method as well as the moldable ring and it simply is not adhering which causes the output to sit on the skin longer and then it leaks. Are there any other options for him to try??


   
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VeganOstomy
(@veganostomy)
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@Michelle

Hi Michelle,

Do you have the option of consulting with a Stoma Nurse? Until you know why the skin is breaking down, it's hard to come up with any course of action. 

If they are having leaks then that needs to be controlled first. If the skin is weepy, there could also be the chance that a fungal infection may be at play, which needs to be treated on its own. 

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


   
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(@Kevin Dieffenbach)
Joined: 4 years ago
Posts: 4
 

Hi Eric,
I am new, my surgery was on October 17 2019. You have been more help than the ostomy nurse at the hospital!I
Has anyone tried to use 100% Aloe Vera gel on the damaged skin? It is suppose to absorb well into the skin without any residue. Maybe it would not interfere with the appliance staying on?
This process has been very hard, and you have made it a bit easier.
Thank you.


   
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VeganOstomy
(@veganostomy)
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@Kevin Dieffenbach

Hi Kevin,

Welcome and thank you for asking. 

I haven't personally used aloe on the skin under my wafer, nor have it heard of any stoma nurse recommending that, so I hesitate to recommend it. 

Barrier rings have helped me more than any other product in this regard, however, the cause of sore or raw skin would need to be addressed as there could be different ways to tackle the issue. 

Do you know what's causing your skin to be damaged? 

 

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


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

Welcome, Kevin! You are in good hands here. Eric is a gem and very knowledgeable.

I tend to use only the products that are specifically used for my ostomy. So, when I first had issues with my skin, I used a stoma barrier wipe with Holister's stoma powder. I was also given an antifungal powder by my ostomy nurse as it appeared that what I had around my stoma was some sort of fungus. This powder cleared up my issues. I also use Sensura Mio 1-piece from Coloplast, which helps to keep my skin healthy. Good luck in finding the right solution for yourself and keep coming back here. You'll find a great deal of info and support.

God bless,

Stella


   
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(@john68)
Joined: 7 years ago
Posts: 2022
 

Welcome Kevin, Good advice from above, as pointed out getting to the source of the problem is key, Eric has lots of help about skin condition on the site, I have come across a seal/ring from Salts which contains aloe Vera 

ileostomy 31st August 1994 for Crohns


   
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 LK
(@dlkfiretruck)
Joined: 7 years ago
Posts: 1460
 

Michelle, your client is lucky to have  you. Welcome to VO. Pat yourself on the back for going the mile for  your client!

Kevin,   same to you! Glad  you are here! 

When I was having skin irritation in the beginning and no stoma nurse, an hour away from the GI, basically on my own, and no Eric!  I have eczema, and very sensitive skin issues. The first thing I do is to take 3 connected squares of TP folded in half from side to side once. This  bakes it 1 1/2 squares.  Then from opposite corners, I fold that  in half, it will look   like two triangle flags, connected.   I wrap that around my stoma to catch the fluids it makes. I use 3 ply for this and found I leave less behind on the stoma as 2 ply when I need to change it. Eric suggests using gauze squares for this job.

 I found going back to the basics, taking my time with cleaning the  skin, water  only and a soft cloth, fanning it the dry with the plastic from the back of the wafer.  Adding the Barrier wipe, and or spray, fanning  it dry.  Spraying some on a wipe where the fold is   and protect around the edge of the skin where the stoma meets. Using one end of  a cottonless q-tip to gently push  my stoma thru the hole it helped make the difference for me. 

Also if you can, fold the wafer in half where the hole is, away from  your tummy, and put that on first to the lower part of the skin and stoma.  Them move the stoma thru with the q-tip,  and put the rest of the wafer on your tummy. Spend extra time gently pressing around the opening of the stoma hole you cut,  as soon as possible to make sure you adhere it first and as well as you can, then, work on pressing on the rest of the wafer then back to around  the hole a few times. I use a "warm" hot water bottle,  protecting the stoma with a dry wash cloth,  single layer.  As soon as I can, I lay down with it over the wafer to give press gently, extra encouragement to stick where I want it to stay. Make sure you also get the slightly thicker outer edge too. If you go to long and use too warm water  you risk swet forming under the wafer. I go about 5 min. fo the rest. Stay untill the area us cooler after the bottle us removed.

I use barrier wipes and spray because I like a slightly thicker layer of barrier simply because my  skin is so sensitive. I worry less that I  have removed what I just put on using the spray. Fan dry.  Now, however, I will use a square of TP folded into a triangle, then,  roll it as tightly as I  can from edge  to edge to form a tight point.  Push the stoma thru with the point, then place the rest of the wafer on your tummy. The TP makes the stoma dryer and is easier on the stoma then a tip.  Try not to get TP on the wafer but if you do it is up to you if you want to risk using it or not. I find it depends on the size of TP that touched  the  wafer,   you can judge that your self too. 

I rinse my bag every time I empty and then use 2-3  squares of TP,  triangle it over my index finger and wrap it around it.  Then slip that into the bag, finger and all. I wipe that bit of plastic that folds over on the opening. It is away from you, and I dry that first then the inside of the mouth, and as I pull it out I can easily get the corner edges clean and dried too. I hope this  is  helpfull to you both. Be well. 

Linda 

Linda


   
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(@dieffenk)
Joined: 4 years ago
Posts: 37
 

@veganostomy

Hi Eric, thanks for your reply. I am now using barrier rings and my peristoma skin seems to be getting better. I believe I was having some leakage.

i had a prostatectomy as well, and I continue to have drainage from that area. Did you or do you have this issue as well?

thanks again 

Kevin

Kevin Dieffenbach


   
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(@john68)
Joined: 7 years ago
Posts: 2022
 

Hi and welcome, I can’t advise on the second part of your post, but am glad to hear that barrier rings are making a difference. Lots of brands to choose from and different ways of using them. 

ileostomy 31st August 1994 for Crohns


   
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VeganOstomy
(@veganostomy)
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Posted by: @dieffenk

i had a prostatectomy as well, and I continue to have drainage from that area. Did you or do you have this issue as well?

Is the drainage from a surgical fistula? 

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


   
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(@dieffenk)
Joined: 4 years ago
Posts: 37
 

@veganostomy

Hi Eric, I meant to say I had a proctectomy and my drainage is from that area of where they closed the rectum and anus. I have since called the surgeon and they said I might always have this drainage or it could go away. ( I do not have a fistula at this time).

By the way I have tried today with the aloe vera  gel on my inflamed peristomal skin. I will let you know if it help healing.

Thanks,

Kevin

Kevin Dieffenbach


   
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VeganOstomy
(@veganostomy)
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@dieffenk

Ah, I thought that's what you might have been referring to. 

Good luck with the aloe! I'll be interested in knowing how that goes. 

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


   
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(@dieffenk)
Joined: 4 years ago
Posts: 37
 

@john68

Thank You John for the advice, appreciate it!

Kevin Dieffenbach


   
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(@Valarie)
Joined: 4 years ago
Posts: 1
 

When would I use the liquid skin protectant?


   
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VeganOstomy
(@veganostomy)
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@Valarie

Hi Valarie, this article may be helpful:  https://www.veganostomy.ca/guide-to-ostomy-barrier-wipes/

Skin protectants aren't usually required except under specific cases. I prefer wipes or I'll spray some proectant on a gauze pad and dab it on my skin, usually in conjunction with stoma powder.  

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


   
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(@Diane Adams)
Joined: 4 years ago
Posts: 4
 

Aloe (above 90%) is mentioned in these articles: https://www.coloplastcare.com/siteassets/2.-routines/r1_establishing-sound-routines/r1.8-arc-guide/master_arc_guide.pdf and https://pubmed.ncbi.nlm.nih.gov/28328276/
I have tried it and it seems to work very well.


   
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(@Bronwyn)
Joined: 4 years ago
Posts: 2
 

I use Marathon liquid skin protectant regularly as I get skin maceration but no leakage. I have an ileostomy and my stoma changes shape considerably depending on if lying down or standing up. It goes so low when lying on my left side that I can't wear a barrier. The skin protectant lasts 3 days on me.


   
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(@Joyce dillihay)
Joined: 4 years ago
Posts: 1
 

My son had his ostomy since oct 17,2019 and it has been really hard for him to keep the rash away and alot of leakage.what can i do?


   
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VeganOstomy
(@veganostomy)
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@Joyce dillihay

Hi Joyce, I'm sorry to hear that your son is having problems. Depending on what the rash is, it may need to be treated with a medicated product.

I would highly suggest having him see a stoma nurse to asses his skin.

Rashes can be an allergy, irritation, or fungal infection, it's important that he knows what's causing it so he can treat it effectively. 

Good luck. 

 

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


   
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