The ideal appliance will fit in a way that protects your skin while also providing a durable, and secure fit. Unfortunately, not every ostomate can achieve this balance so easily, so many will experience a breakdown of skin around the stoma.
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This happened to me a short while after getting my ostomy, as my new stoma was still shrinking down from its swollen state.
I was quite inexperienced, so rather than change my appliance more often, I’d try to get 5+ day wear time, which meant that as my stoma became smaller, it left room for my output to eat away at my skin.
As you can see from the photos below, I had fairly deep erosion of the skin, and it hurt a lot. At the time, I had used the “crusting technique”, which involves putting stoma powder on the exposed, raw part of my skin, dust it off and apply a barrier using either barrier wipes or cavilon spray.
You do this a few times to build up protection on the skin, and to allow the wafer to stick to something other than the powder. This technique does work for many people, but it worked very slowly for me.
More recently, as I’ve been in between wafer samples, I began to get more breakdown of the skin.
I attempted to remedy this using the crusting technique, but I wasn’t getting the results I wanted; so instead, I opted to simply use a barrier ring without any powder or barrier wipes.
The results impressed me, and my skin has probably never looked that good around the stoma.
And here’s another example of how quickly this method can heal damaged skin:
Now, I continue to use a barrier ring when I notice more breakdown of the skin. I may continue to use them more regularly, but they are quite expensive and I’m not done trying new appliances that might offer a better fit.
Here’s a video showing how I change my appliance, including how I use barrier rings.
I am a new osteomate. My home health-care ostomy RN is terrible. I have a double-barrel stoma. She has come one time. She rushed through it and my bag started leaking shortly after she left. The other care providers are not at all knowledgeable. I am very worried about the next wafer change. You have been a life-saver for me. I cannot thank you enough, but I am giving a small donation. Thank you so much, Eric, from the bottom of my heart.
Hi Sherry,
I’m so sorry that you’ve had that experience. Do you get a different nurse every visit, or is the same one?
Regular nurses generally don’t have the same knowledge to care for a stoma, especially a more complex one like a double-stoma.
Do you have access to, or can you request, a WOCN (wound, ostomy, and continence nurse)? They should be able to give you far better care.
Welcome Kailee! I’m a newbie ostomate myself, so many others with a wealth of experience here… But I’ll second @john68 suggestion to try a belt, if you haven’t already. I did find a huge improvement in my skin (due to fewer leaks) after I started wearing a belt. I try really hard to get a good fit, and I do use a ring under the wafer to help achieve that.