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Crohn's Disease Forum » Surgery » Stoma Subforum » Getting a good seal


04-07-2011, 07:28 PM   #1
ameslouise
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Getting a good seal

Hi stoma buddies:

I am having trouble getting a good seal around my stoma. I am using stoma paste, but I can remember using it before when I had my temp. I have had two blow outs already. I think part of the problem is that I have to cut the flange so it doesn't cover my incision, which is still healing.

Do you all use stoma paste? If yes, any good tricks to applying it/using the right amount?

Any tips would be most appreciated.

Thanks! - Ames
04-08-2011, 08:48 PM   #2
CDDad
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Hi Ames,
I've never used paste, and everything I read says not to use it. They say it's not an adhesive, but used more like caulk - to fill in uneven areas.

The thing that worked so well for me, and made life good, is a simple ol Hollister Adapt ring.

I was also lucky that my incision was far enough away from my wafer so it did not interfere. Can you cut the wafer so it does not cover your incision?

I was just looking at my gear, and the distance from my stoma to the where the tape part of the flange begins is only an inch or so. Is your stoma that close to your incision?
If it was just the tape part of the flange covering my incision, I would just cut that part away.
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04-08-2011, 09:14 PM   #3
DanM
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I do not use paste when putting on a new skin plate. I've also had problems with bad seals. What I have found is that you need to make sure the skin is 110% dry, put a moderate amount of pressure on it for a couple of minutes and massage it a little as the material is heat sensitive... the warmer it gets, the better the seal.

Dan
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04-09-2011, 12:41 PM   #4
ameslouise
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Thanks for the advice. I may skip the paste now, since my stoma is pretty and very round.

Once my incision is 100% healed, I think I will be in better shape. I remember this happening last time, with it being so close to the incision. I have been cutting away the tape part of the flange so it doesn't interfere.

Thanks for the advice! - Ames
04-10-2011, 08:57 PM   #5
pain in the butt 2
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Having major trouble even with working with my stoma nurse. First of all my urostomy is now leaking sence my colostomy surgery. Its sort of caved in to were i have to pull my skin tight before putting on the flange and than the belt super tight to were its killing me. Than my colostomy bag doesnt want to seal cause the waffer part lands over my scar which causes an indent to were i dont get a good flat seal any advice please! please! please! and is it normal for me to be this crabby. I know ive changed and have become someone i dont like which is very crabby and mean. Has anyone else felt this way.
04-10-2011, 10:07 PM   #6
Nyx
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The only thing I can suggest for your flange is to suggest trying a concave one, so you get a better seal around your stoma. I don't have that problem, so I don't have personal experience, but I've read about it. Call the ostomy companies and ask them their opinion, and get them to send you some free samples. Also, you can always put some paste into the part where you don't get a great seal. That should help in the meantime. Another option is to cut your flange around your scar if it's not too close to your stoma and stick it on that way. I've also put tegaderm around the outside of my flange when I shower or go in the hot tub, it works great to keep moisture out. I imagine it would work the other way too.

So, you have a urostomy and a colostomy? You never have to get up to go to the bathroom! I think that's kind of cool....lol (I meant that comment in a good way, not a bad one...I hope I didn't offend!)

I think once you get your flange issues sorted, you'll feel much better and be not so crabby. Good luck to you!
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04-11-2011, 10:42 AM   #7
CDDad
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I don't know anything about the care and feeding of an urostomy, but an Adapt ring is key to my survival with my Hollister New Image equipment. Are you using Adapt or an Eakin ring? Or maybe you need some paste to caulk the indent around your scar.
04-11-2011, 12:00 PM   #8
pain in the butt 2
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Thanks Guys will try some paste for fill in. And Nyx I do use the concav ones the flat ones are worse for me. And it is cool now not to have to go jumping up in the middle of the night with my night bag attached to me when my bm flares would start, now I just get balloon bag of gas:0 but I bet when someone wants to down some water or beer right before they go to bed they might envey me and never offended anymore even about my spelling learned my lesson on that one and not sure what tegaderm is will that help me because once I get this all in order I want to go swimming.
04-11-2011, 12:45 PM   #9
ameslouise
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PITB2 - hope you get things sorted out in time to go swimming! There are so many products out there I am sure you will stumble on the right appliances. I also have issues with the flange over my scar, so I have been cutting the flange so it doesn't impair healing of my incision.

My incisioni is still weeping. I think I might have discharged my homecare nurse too soon!

I did get a convex sample yesterday and am using it today. So far so good!

- Amy
04-11-2011, 12:51 PM   #10
Terriernut
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Hi folks. I use the dansac one piece drainable. No cutting, as they come pre cut. I find it very easy to use, and I haven't had a single leak. Surgery was night of 22nd of Dec. I did try Dansac's mini's, and I did have the seal at the bottom blow out one morning at 3.30 am. That's it.

No paste or glue required either. Easy peasy!!! Give them a try girls and see if your life can get a bit easier. I sure hope it does!!!

Huggggsss!

Misty
04-11-2011, 10:51 PM   #11
Nyx
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Tegaderm is plastic tape they use to put over gauze so you can shower...I'm sure it has many brand names, but that's the one they have here.

http://www.youtube.com/watch?v=IF-gbRqj7C0

The one shown in the video is a patch, but it also comes in rolls so you can just cut it to fit around the outside of your flange.
04-12-2011, 09:42 AM   #12
ameslouise
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Oh, it's like the stuff the put over IVs in the hosp!
04-26-2011, 11:57 PM   #13
pain in the butt
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Sorry Ive been gone so long computer was down. thanks so much for the info.
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04-27-2011, 03:43 PM   #14
ameslouise
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Good seal is still eluding me.... just placed emergency order for some bags with convex wafer. Not sure what I was waiting for.

After today's blowout, I spent about 15 minutes with my bag off (Misty, this is about as close as I get to born free!!!) and watched the area around my stoma as my stoma bobbed up and down thru the natural motion of peristalsis. The area down and to the right (where my leaks have been) def looks a little indented. Plus, Bilbo kind of dips down over there when stuff comes out, so the output is kind of running under the seal there. PLUS, Bilbo is shy and doesn't stick out too much. All of these things seem to be leading to the leakage over there.

So.... will report back!

- Amy
04-27-2011, 03:49 PM   #15
Terriernut
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Ask the nurse for some powder to help! We were just talking about baths on another thread as well for healing the skin around stomas. I'm going to try it Amy. Joe was talking about some things that I'm gonna try as well. It's on the bad day thread.
Misty
who is not having a good day either! Must be the moon??
04-27-2011, 06:08 PM   #16
ameslouise
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Hang in there Misty!

I do have some powder. My skin is good and intact. It's just uneven!

It's a revolt of the stomas!!! Ahhhhh! Take cover!!!!
05-02-2011, 02:48 PM   #17
Sungirll
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Hi Ames! I have had my permanant stoma for about five years now - I use the Eakin seal - but only half a ring. When I had my temp loop ileostomy, I had a terrible mis-shapen stoma that leaked all the time. I had to use the concave flanges too, but I found that half an eakin seal rolled and shaped by your hands so it is very warm when you shape it around your stoma works wonders. Put the concave flange on after you get the Eakin shaped on your stoma and press down like crazy afterwards for about two minutes. The biggest trick - your skin has to be PERFECTLY clean and dry before you start this process. Use a blow dryer on cool low to be sure everything is SUPER DRY. Even the slightest bit of dampness can cause leaks. It took me a few months to perfect my stoma and flange cocktail, but now I can go for 5 to 7 days before I need to change my flange. If you are not using a two peice system - try that. It is easier to see the placement of the flange in relationship to the Eakin seal - be sure it turtlenecks up around the stoma.


And for swimming - try Cymed's Microderm Plus Platinum series. It is like a second skin for swimming. I spent the entrie weekend in my pool this past weekend. The product has been used by an olympic swimmer too! It works perfectly as long as it is applied to super clean, super dry skin. I am a Florida water girl and I cannot believe I suffered with no swimming for three years without the Cymed Microderm! It gave me back my summer life!

Hope you are leak free soon! Good luck!
05-04-2011, 07:05 PM   #18
ameslouise
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Thanks for that advice - many here use the Eakin seal and I was having a hard time picturing how it works, so I found this:

http://www.youtube.com/watch?v=5K0oNHDkn4g

I may try using the Eakin with a flat wafer, as I really do prefer a flat wafer to a concave - I find that the concave is more visible under my clothes.

But since I switched to the concave - everything is so far so good! I have been changing my bag every third day - but can go at least another day I think because the seal is totally intact when I remove it. I would love to go 5-7 days -that's great!

What kind of bag do you use, Sungirll? One or two piece and what brand?

- Amy
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