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Crohn's Disease Forum » Surgery » Stoma Subforum » Skin getting sore and red around stoma and how to stop leaks?


 
02-09-2014, 10:23 PM   #1
AussieMumma
 
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Skin getting sore and red around stoma and how to stop leaks?

The skin around my stoma is getting very sore, red and rash like. Obviously because my 'output' is leaking through to my skin. Really not sure what to do about this. Firstly, how to make the red skin better? Antiseptic? Something else?
Then, secondly, how to stop it from leaking through to my skin. I tried cutting a smaller hole for the stoma this morning, but this backfired and I had my first ever leak..the output partially going underneath the wafer and leaking through.. If that makes sense?
I use a 2 piece hollister bag, with the little barrier ring (sorry, forgotten what they are called). Any tips appreciated!
02-09-2014, 11:53 PM   #2
nogutsnoglory
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The best thing is to let the skin heal naturally because any products make it hard for the barrier to adhere to your skin. I sometimes use skin ointment and let it sit a little and then swab it off so it gets a chance to absorb a bit. The surface needs to be pretty dry for good adherence.

I would suggest seeing your stoma nurse. Let them make a custom fit and keep the trace of the baseplate as a model to cut out future ones. A opening with 1/8 of inch skin showing is ideal so you are snug but not choking the stoma. A ring is great and press dins on all sides so the heat helps it adhere well. Also you can try using paste.
02-09-2014, 11:58 PM   #3
vonfunk
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I would recommend getting stoma powder, to dust on before attaching the appliance the appliance. Dust it on when the skin is dry, and lightly brush off the excess with a piece of gauze. That will help with the irritation. You should be able to get a sample from Hollister or Coloplast, the samples tend to last for awhile. I've actually never purchased any, once a year I would call Coloplast & Hollister and asked for a sample from each of them. a very, very light dusting of corn starch should help until the powder arrives.

As far as the leaking. I've had issues with output getting under the wafer near the end of the appliance lifespan. My only suggestion is making the barrier ring/paste thinner and more spread out and pressing down on the appliance for a few minutes. I found that if I used too much paste it would leak sooner. When I was using the barrier rings, I usually would cut them in half and treat it as if it was a strip of paste. That might help the seal a bit better. There are barrier wipes that you can get samples for, that you wipe on and let dry before attaching the appliance, but I've not used them.
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02-10-2014, 05:49 AM   #4
UnXmas
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My stoma nurse gave me this, though I haven't needed it as I haven't had skin problems: http://www.charterhealthcare.co.uk/p...rier_wipe.html

I have thankfully had very few leaks, but when I had diarrhoea and it did leak I used these: http://www.charterhealthcare.co.uk/p...stic_tape.html These were great - the leaks I had started very slowly, so I could see them leaking under the adhesive part before it got to the point where it could get on my clothes, so as long as I checked it regularly, I could catch a leak before it made any mess. But overnight I wouldn't be able to check it often enough (well, I could have set an alarm to wake me up every few hours, but I like my sleep, so... ). This tape meant I could last through the night even if it started leaking.

Edit: I just realised the tape probably isn't going to help you, as it doesn't keep it off all the skin.

Last edited by UnXmas; 02-10-2014 at 07:27 AM.
02-10-2014, 06:11 AM   #5
Absentminded
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I had loads of leaks when I first came home after getting my Stoma, but one of my amazing friends from the Crohn's group I go to came round and sorted me out with loads of products.

I used to use ConvaTec Orahesive protective powder if there was any redness from leaking output. It works like a miracle, dust it on, blow off the excess and then dab over the area with a barrier wipe, I used Skin Safe protective film wipes. The powder can stop the bag from sticking, but the wipe will help it stick.

Warming up the baseplate really helped, I used to use a hair dryer to warm it up just before I stuck it on.

I also used to use really big, deep barrier rings from hollister, adapt barrier rings 98mm, along with ConvaTec Orabase paste which I would squeeze around the opening of the baseplate. Once the baseplate was on, I used a belt to hold it in place for 30 minutes, pressed the baseplate down really well with my fingers and then heated it again with the hair dryer (not too much.)

Around the edge of the baseplate I used Bullen Flange retention strips, they're super sticky. I also used to wear specialist underwear, which made me feel really secure and comfortable.

After that first nightmare week I didn't have another leak for the while of the 3 months I had my Stoma. You'll find the products that suit you and soon you'll be loving life with your Stoma :-)


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02-10-2014, 05:57 PM   #6
AussieMumma
 
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Argh, did a change this morning and still, more leaking.. Output had seeped all the way around the edge of the stoma by going under the barrier ring. Have tried cutting a smaller hole for my stoma this morning and really flattening out the barrier ring. Have no idea if this will make any difference. I am wondering if I maybe need the convex rings? Do you think this might make any difference?
Thanks for all your help and suggestions!
02-10-2014, 06:49 PM   #7
nogutsnoglory
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How far does your stoma stick out from the skin? You may benefit from a convex barrier if you don't protrude enough.
02-11-2014, 02:54 AM   #8
AussieMumma
 
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Maybe 1-2cm, but the hole is at the bottom, facing downwards and really close to my skin, which I think is the problem! Cutting the hole smaller made no difference, because I took the whole lot off and after only 5 hours of wear, output had leaked all the way around the barrier. It never seems to leak all the way through to my clothes or anything (only once) but my skin is really getting red raw from all this leaking. I called my stoma nurse from the hospital and left a message. Hope she calls me back tomorrow. I also am getting samples sent from Hollister including powder, paste and a convex barrier ring. Sigh.. Happy to try any other suggestions?
02-11-2014, 03:01 AM   #9
Absentminded
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That sounds just like my Stoma, it pointed down and the output came out onto my skin.

I used the click convex baseplates from coloplast, I think the Assura or SenSura ones, (I really liked the bag locking mechanism on them too, they held together really securely) and they helped quite a bit. I did find that I needed to change everything every other day at the very least as my output would eat through everything.

I'm sorry you're having such a tough time, hopefully you'll find something you get on with in the samples and your Stoma nurse had some ideas! X


02-11-2014, 03:04 AM   #10
AussieMumma
 
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It would be SO much more convenient if the hole was in the middle and not pointing down! Blah! I am going to try and get some samples of those baseplates you mentioned, thanks
02-11-2014, 05:43 AM   #11
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I used to be in the same boat as you and it made me so worried about going out and leaking in public.my stoma nurse suggested salts convex bags and I haven't had a leak since they've been brilliant hopefully you solve the problem soon x
02-11-2014, 06:38 AM   #12
AussieMumma
 
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Kat did you have a similar sounding stoma to me? Oh my god I just had another leak tonight! This is getting ridiculous!
02-11-2014, 06:45 AM   #13
AussieMumma
 
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I have just sent an email to see if I can get some samples from Salts.. Fingers crossed!
02-11-2014, 06:56 AM   #14
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Yes the hole is pointing down slightly and as soon as I put a bag on it would leak out the bottom of the seal within a couple of hours.good luck with salts
02-11-2014, 07:23 AM   #15
Absentminded
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Another tip, I used to eat loads of marshmallows and jelly babies, it thickens up your output (I guess it's the gelatin) also I found that if I ate 5 or 6 marshmallows 20 minutes or so before changing my bag my output would stop altogether for a good half an hour, making it really easy to change my bag and get everything on properly.


02-11-2014, 10:00 AM   #16
nogutsnoglory
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Get samples from every company and when you call them your issue so they send you their best products for your stoma. It sounds like convex barrier and a belt might help you to put pressure on the stoma to stick out a bit. You can also try ring and paste around stoma together.
02-11-2014, 11:14 PM   #17
AussieMumma
 
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Thanks for the advice! I just talked to my stoma nurse, I have an appointment to go in tomorrow to figure out what to do. She said it's quite common for the stoma to change size etc in the first few weeks, so what might have worked in the hospital may not work now. Looking forward to getting it all sorted out!
02-13-2014, 04:57 AM   #18
AussieMumma
 
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My stoma nurse has ordered me powder to help heal the rash and also convex wafers and has instructed me to wear the belt (annoying). So far it seems to be working (I can't feel the stinging from leakage I felt before) but the real test will be when I do my next wafer change! Hoping I can lose the belt, but will see how we go.
02-13-2014, 05:58 AM   #19
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Yay I hope this works for you it's such a weight off your mind to not be worrying about leaks x
02-13-2014, 05:38 PM   #20
nogutsnoglory
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Convex wafer may be enough and you can also try convex barrier rings. You may want to experiment using the belt only when you go out for protection but maybe at home you won't need it.
02-13-2014, 05:57 PM   #21
AussieMumma
 
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Thanks Can you use convex wafer and convex barrier ring together? Or just one or the other?
02-13-2014, 06:28 PM   #22
nogutsnoglory
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I believe you can use both but too much convexity can cause leakage too especially without the belt so id ask your nurse or experiment on a day you can afford to change quick if you need to.
02-14-2014, 05:50 AM   #23
UnXmas
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Have you tried washers? I know that was something the nurses said I could use if I started getting leaks. I haven't had cause to investigate them, but I think I was told you can either get ones that you fix to an ordinary bag, or you can get bags that have them built in. (Sorry - I don't think I'm explaining this very well!)
02-14-2014, 09:20 AM   #24
nogutsnoglory
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What's a washer? I saw it in the catalogue but don't understand it. Is it just another name for a barrier ring?
02-14-2014, 09:31 AM   #25
UnXmas
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What's a washer? I saw it in the catalogue but don't understand it. Is it just another name for a barrier ring?
It could well be. It's the same idea as the washers used on taps. Something like this: http://www.charterhealthcare.co.uk/p...able_ring.html
02-14-2014, 06:06 PM   #26
Absentminded
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Yep, that's the same as a barrier ring :-)

Edited to add: I tried the Coloplast ones and really didn't like them, the ring just seemed to disintegrate. I much preferred the Eakin Slims or the Hollister Adapt barrier rings.
02-14-2014, 06:40 PM   #27
AussieMumma
 
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Did my first change after seeing the nurse. Damn, there was a small amount of leakage onto my skin.. Only very small compared to before, but this was even with the annoying belt! Argh! Giving the convex barrier ring a go today (I have no choice seeing as my new supplies haven't arrived). I also have a tube of paste that I got as a sample.. Anyone use the paste and can tell me the best way to apply?
02-14-2014, 10:05 PM   #28
nogutsnoglory
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I have been having more success by putting a ring of paste around the stoma then the ring and barrier on top. If there is any gap between the barrier and stoma I add more paste there.
02-14-2014, 10:26 PM   #29
AussieMumma
 
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Thanks! I will try that next change
02-14-2014, 11:49 PM   #30
nogutsnoglory
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Just note if you have raw skin which you do it will burn for a while. I think most pastes have alcohol.
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