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Crohn's Disease Forum » Surgery » Stoma Subforum » Mouldable rings


 
02-20-2015, 04:24 AM   #1
Grotbags
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Mouldable rings

I use mouldable rings, great things they are too.
But, I find the ones I'm using which are Secuplast ones, don't last very long.
I could quite easily go two days between pouch changes, except the rings are starting to break down by the second day and I will have a wee red bit on my skin.
Have other stoma owners found some rings are more long lasting than others ?.
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02-20-2015, 06:33 AM   #2
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I use the Brava mouldable ring (coloplast) and find that when I take my pouch off in the morning they are sometimes beginning to break down around the edges, esp if my output has been particularly watery, some days are worse than others. I've never went two days between changes, I change mine every morning so for me they do the job.

I think you could probably get two days if your output is usually quite thick as I just assume the breakdown is due to water getting under the seal and breaking down the adhesive. If you go onto their website you can order some free samples, good luck.
02-20-2015, 06:39 AM   #3
Grotbags
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I tend to have watery output in the morning and thick in the evening, so it could just be that.
I think I'll try putting a liquid solidifier packet in, see if that stops the breaking down.
02-20-2015, 06:49 AM   #4
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I'm pretty much the same, it tends to be after dinner time it starts to thicken up, but during the day it can be pure liquid.
02-20-2015, 07:01 AM   #5
Grotbags
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Funny eh ?, maybe us Scots are just awkward like that
I've just requested samples of Coloplasts rings, they claim they are long lasting, but I see that's what your using with the same result as me.
Might as well give them a bash though.
02-20-2015, 09:01 AM   #6
nogutsnoglory
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Try Montreal Ostomy, I found they had the most durable rings.
02-23-2015, 06:14 PM   #7
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I use the Eakin Slims and my pouch changes are (1) voluntary and (2) every 4-5 days. The way I use them, they don't degrade at all and they do what they are meant to do: protect the peristomal skin and keep a "dip" at the bottom filled so it's not a source of leakage or excoriation.

My stoma is oval and oriented with the long side SW->NE when I'm looking down on it. It's also recessed at the bottom, so I use the Eakin Pelican convex cut-to-fit onesie. I mould the ring so that it perfectly fits the stoma edge, moulding in a "bump" for the dip. This goes on over the prep layers (Cavilon no-sting barrier wipe + Adapt powder in the dip). I fold one of the glossy cards from the packaging in half and use that to press down firmly all around the ring until the whole thing is flat and reasonably well stuck.

I cut the wafer with a 1 - 2mm clearance margin to allow for peristalsis. IOW, when the wafer goes on, I can see a rim of white all around between the hole and the stoma. I use a mirror; and the Eakin appliance has 2 viewing windows under the felted outer cover. The wafer goes on from the bottom up and I'm stretching the skin with one set of fingers while pressing the wafer down with the other.

Once the wafer is adhering all round, I use an egg-cup to press down firmly at the centre for about 30 seconds, while continuing to warm the wafer adhesive with my spare fingers. This warming is a must-do. Some people use a hairdryer. Pre-warming the wafer under your arm while doing the other prep works, too.

The final layer is two semi-circular Brava strips, one each side, at the edges of the wafer. The whole thing is waterproof and bomb-proof. I don't even take emergency supplies when I go out; only a couple of spare Brava strips, though I've never had to use them. I *do* use the little filter covers that come in the box with the Eakin appliances, to protect the filter in the shower. If I forget, the filter goes soggy and I'll sometimes get a "whiff". I can stop that by covering the filter and leaving it covered, which means I'll have to "burp" the bag several times a day.

If a barrier ring is breaking down, then something is wrong somewhere. That margin between the edge of the appliance hole and the stoma will swell up and "turtle-neck" the stoma as it becomes moist. It's meant to do that and it won't choke the stoma.

Tip :: When the bag comes off for a change, the ring should come away intact, with the wafer. Anything else, like ring coming off separately or in parts, means there's a problem with the way it's been applied. It's a pity the producers of these things don't give detailed instructions on use, instead of a sheet of tiny sketches that you need a magnifying glass to see. It would have saved me a lot of misery and failed experiments!
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02-24-2015, 05:04 AM   #8
Grotbags
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I don't have any problems with dips or odd shaped stoma, my stoma is pretty much round and the skin is nice and level.
I'd say I do pretty much what your describing, apart from the powder, I have to break the ring and remove a bit to get a tight seal as my stoma is smaller than the hole in the ring. I am now using a mirror to make sure I've gotten everything tight at the bottom.
I've never had any actual leaks , it's just at the edge of the ring, you can see it's starting to break down, and if I leave it two days, I quite often have a small sore bit right up against the stoma.
I'm seeing my stoma nurse next week, hopefully she will be able to suggest a different brand .
02-24-2015, 03:13 PM   #9
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My stoma is about average size, I think - 35cm on the long axis, 27cm on the short. In the past I tried the Hollister (Adapt) rings, which tended to crumble at the inner edge. They were also too thick (made the bag stick out noticeably). The Eakin Slim works better for me, being thinner and perhaps because of better compatibility with the adhesive on the Eakin pouch. Eakin also do a "mini" version, which has a much smaller starter hole.
When you get the small sore, have you tried using Head and Shoulders shampoo for washing when you change your wafer?
Good luck, anyway.
02-24-2015, 03:46 PM   #10
Grotbags
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Lol, no, I haven't used H&S, if it's a bad one, I use Calamine Lotion, but usually just changing the ring does the trick as they have Aloe Vera in them.
02-24-2015, 08:57 PM   #11
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My stoma is about average size, I think - 35cm on the long axis, 27cm on the short.
LOL, no, I am not a hippopotamus. Read "mm" for "cm".
02-25-2015, 03:30 AM   #12
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Calomime lotion comes in two bases: water (usually mixed by your chemist) or glycerine (usual form for a commercial product). The glycerine form won't work too well with a stoma ring because it will dissolve the paste. With the chemist's water-based brew, you must wait for it to dry to a powdery finish, brush off the excess powder and then dab the powdered area with a barrier wipe (or spray it, if you use a spray instead.)

The proper stoma powder is designed to be puffed scantily onto your raw spots. It soaks up moisture from the raw area and forms a protective skin. Your barrier ring will stick to it.

Head and Shoulders shampoo contains zinc salts, which do the good stuff with your raw patches. You need to use the plain blue stuff, no conditioners or extra features. I put a glob (about a tsp) in the middle of a folded, dry facecloth, plonk it on the stoma and then use a pair of decommissioned stretch briefs with the crotch cut out to hold it in place while I shower the rest of me, wash hair, etc. The last thing in my shower is to free the cloth and use the H&S for a thorough wash of the stoma and surrounding skin. It needs to be well rinsed off and patted dry before starting the prep for the appliance. It's brilliant.

I didn't invent this trick. btw. I picked it up on another forum. At first I was skeptical...then I was desperate...then I was convinced!
02-25-2015, 04:24 AM   #13
Grotbags
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Calamine lotion here is generally the water based one, that's certainly what I got from Boots, it did do the trick.
I use a barrier film and on the odd occasion, barrier cream, I've found the Brava cream to be the best as long as it's soaked in first, I then give a dry wipe just to make sure there's no residue.
My skins fine at the moment, but I'll certainly give the H&S a go if it flares up again.
I did laugh at the crotchless knickers, but actually a really good idea, I might try that when I pluck up the courage to shower without a pouch.
02-25-2015, 02:04 PM   #14
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I use "salts" mouldable seals. I have tried others but didn't like them as much. The salts ones are brilliant and you can get different sizes but I just use the small ones. I can get 4 days easily before it starts to break down. can go further although I don't like going past 4 days.
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02-25-2015, 11:50 PM   #15
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@Grotbags Looks like you're in Scotland. Do you have access to Trio Healthcare products? They have silicone barrier rings which DON'T breakdown because they aren't make of hydrocolloid but a special silicone.
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02-26-2015, 04:48 AM   #16
Grotbags
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I don't know, I'm at the nurse next week for a check up, I'll ask if we have them
02-26-2015, 04:56 AM   #17
Grotbags
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Well there you, just had a wee Google, and up they popped, two offices in UK, I've requested some samples
03-21-2015, 08:58 AM   #18
Grotbags
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I got some of those silicone seals, but unfortunately had a massive fail, when I took off my pouch 24hrs later, there was output all under the seal.
But I did get a phone call yesterday from Tri Ostomy and she thought it would be worth trying a convex seal.
They arrived in the post today, but I'm not so sure they will work with my one piece Mio pouch , which side goes on your skin ? The flat side I'm guessing, but not sure.
I don't have a retracted stoma btw, although it does go from being about 1mm tall, to an inch, it's fickle that way lol.
03-21-2015, 12:31 PM   #19
VeganOstomy
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That's disappointing

Try the convex - that "1mm" stoma could be an indication that convex would be preferred - apply with the convex side down on your skin (flat side sticks to the wafer).
03-21-2015, 01:03 PM   #20
Grotbags
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Ah ok, I shall give it a go.
03-22-2015, 09:01 AM   #21
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I use convex bags, and the majority of the time my stoma is prolapsed (the last time I measured, 15cm ). But it retracts completely about once every couple of days or so, so I need the convex. My first stoma retracted after I'd had it a while, and when leaks started my stoma nurses recommended a convex. The same happened with my second stoma. So when this third one retracted, I didn't bother seeing my stoma nurses, I just ordered myself some convex bags and the leaks stopped. At that point my stoma didn't prolapse, it wad retracted all the time. But it's been prolapsing for months now and using convex bags with it prolapsed most of the time has not caused me any problems.

However, I haven't seen a stoma nurse since I've been using convex bags with a stoma that isn't retracted, so I'm not sure what they'd say about it. (I'm kind of avoiding showing them my 15cm prolapse, since I don't want yet more medical problems, hospitals, etc. and it seems to be working fine.)

I had tried mouldable rings with my retracted stomas in the past before switching to convex bags, but for some reason they just didn't stop the leaks for me. I would have assumed I just wasn't applying the ring properly, except one time one of my stoma nurses put it on for me and it had started leaking by the time I got home from my appointment with her.
03-22-2015, 09:05 AM   #22
VeganOstomy
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You can't really use moldable rings if your stoma retracts. Mine will retract if I've got a partial blockage and I will leak EVERY TIME (my output is thick BTW).

The convex appliances are great if your stoma recesses often, but they aren't generally recommended without that problem because of the risk that the convexity could cause pressure sores. I think that for anyone just trying convex (without their nurses recommendation), they should go with "mild convexity" and move up from there - don't start with "deep convexity" unless a stoma nurse has told you to!
03-22-2015, 11:15 AM   #23
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You can't really use moldable rings if your stoma retracts. Mine will retract if I've got a partial blockage and I will leak EVERY TIME (my output is thick BTW).

The convex appliances are great if your stoma recesses often, but they aren't generally recommended without that problem because of the risk that the convexity could cause pressure sores. I think that for anyone just trying convex (without their nurses recommendation), they should go with "mild convexity" and move up from there - don't start with "deep convexity" unless a stoma nurse has told you to!
I'm confused: my stoma nurse gave me mouldable rings because my stoma had retracted.
03-22-2015, 12:28 PM   #24
VeganOstomy
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I'm confused: my stoma nurse gave me mouldable rings because my stoma had retracted.
For me, when my stoma retracts, the output gets under the barrier ring and creates a leak. I do NOT use convex wafers because the problem really only happens under certain circumstances (like when I don't drink enough).

If that's not causing you any issues, don't stop. Stoma care is more of a "whatever works" deal
03-22-2015, 03:21 PM   #25
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If that's not causing you any issues, don't stop. Stoma care is more of a "whatever works" deal
That's what my stoma nurse said when I told her my bag started leaking on the way home from the appointment where she'd put a mouldable ring on my bag to stop the leaks. I had wondered why she'd given me rings to stop the leaks when they obviously didn't. For some reason convex bags just seem to do the trick for me, I use ones with shallow convexity and my stoma retracts without leaking.
03-25-2015, 06:17 AM   #26
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You can't really use moldable rings if your stoma retracts. Mine will retract if I've got a partial blockage and I will leak EVERY TIME (my output is thick BTW).

The convex appliances are great if your stoma recesses often, but they aren't generally recommended without that problem because of the risk that the convexity could cause pressure sores. I think that for anyone just trying convex (without their nurses recommendation), they should go with "mild convexity" and move up from there - don't start with "deep convexity" unless a stoma nurse has told you to!
Are the pressure sores convex bags can cause on the stoma itself or the skin around it, and do you know what they look like? (Sorry if these are really dumb questions! I'm trying to work out whether the new red mark on my stoma that's bleeding a bit is normal or not.)
03-25-2015, 08:41 AM   #27
VeganOstomy
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Are the pressure sores convex bags can cause on the stoma itself or the skin around it, and do you know what they look like? (Sorry if these are really dumb questions! I'm trying to work out whether the new red mark on my stoma that's bleeding a bit is normal or not.)
The skin around the stoma. It's more common when people use accessory belts that are too tight.

http://www.eakin.eu/management-of-a-...pressure-ulcer

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03-25-2015, 09:06 AM   #28
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I checked with my stoma nurse yesterday about using the convex rings, " not with my type of stoma " was the advice.
Even though it goes small she said using convex products could damage it.
Glad I double checked before going ahead.
Back to the drawing board.
03-25-2015, 09:32 AM   #29
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The skin around the stoma. It's more common when people use accessory belts that are too tight.

http://www.eakin.eu/management-of-a-...pressure-ulcer

Sent from my SM-N910U
Thanks, that's not what I have then.
03-25-2015, 09:33 AM   #30
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I checked with my stoma nurse yesterday about using the convex rings, " not with my type of stoma " was the advice.
Even though it goes small she said using convex products could damage it.
Glad I double checked before going ahead.
Back to the drawing board.
Did she say how could they damage your stoma?
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