Concave Stoma Help

[ShankUVeryMuch]

Hi All,

My stoma is new, surgery was April 1. I know that things will continue to change in the coming weeks, but I'm having a problem that I wondered if anyone has any suggestions to help with.

The stoma is concave and I'm using a Coloplast bag with convexity, so that's helping it to pop out a bit. My skin underneath the wafer is very bright red and bleeding at the moment. I've had to change the bag three times in the last 36 hours, which isn't helping.

The problem I'm having is that I was given barrier rings to use. The hospital was using the thicker (Adapt) ones and the stoma nurse at my doc's office switched me to a thinner ring. I cut the ring in half so that I can fit it well. Per her instruction, I'm placing the binder ring halves on the skin and right up next to the stoma edge. Then bag gets placed directly over the center. Everything seems to look in place when I put it all on.

But then, as my body heat reacts with the barrier ring, the ring starts to melt and come inside the wafer and crawl up the sides of the stoma itself. Once when I was in the hospital, it did this to the point of covering over the stoma and ultimately blocking it. Now that I've switched to the thinner ring, I don't feel that it's in danger of being blocked, but I know that by doing this, it's allowing the poo to pool under the wafer, making the skin problems worse.

The doc only gave me a few of the bags and if I don't get this right, I'm going to run out of bags and have to go back to the previous bag that isn't as convex as the new ones.

What am I doing wrong?

 

[ShankUVeryMuch]

Forgot to mention - I also use powder and spray (usually twice) between the wafer and the skin. I do have samples of the wipes, but have yet to try them.

 

[GutlessWonder86]

I'd call Coloplast and ask to speak to their wound care RN and if they don't have one, go back to the hospital where you had your surgery and make an appt. to see the wound care RN there.

Convatec has wound care RNs who answer the phones and help ostomates with their questions. They will even send you free samples for a month if you are new patient fresh from the hospital.

INFO for Convatec:
By phone: 1-800-422-8811

By email: [email protected]

Monday to Friday 9:00 am to 5:00 pm

 

[Jaano711]

I would contact the suppliers and ask for samples. I don't know if this would help, but I had a similar skin reaction from the adapt seals. I changed over to eakin seals and my skin settled down. there are lots of different seals available that will increase the convexity of your flange. There are also pastes that you can try. Your best bet is definitely to go to the stickies in this sub forum and to contact the suppliers in your country. They are usually really happy to give advice regarding what products they think would help, and will send you samples of these products. I would also ask them if you could get some samples of their barrier wipes or sprays. 3M do a good barrier wipe called cavillon. Just get a hold of some products and see what suits so that you can order what works.

Another tip for the red raw skin is to apply mercurochrome to the area or betadine, and then use a hair dryer to dry it before adding your barrier spray/ wipe. The mercurochrome works really well at drying the area out and healing the skin, AND it does not sting nearly as much as the betadine does. Mercurochrome should be available over the counter at your pharmacy.

Good Luck and happy sampling!

 

[annawato]

Hi ShankU. Sorry to hear you are having problems with your stoma. Its not unusual to have problems in the beginning, they do settle down with time.
I have a very high output stoma so skin issues are common for me - I find that paste works far better than the barrier rings for stopping output leaking on to your skin. It does squish up around the stoma when you first put it on but doesn't cause a blockage so don't worry. I use the convatec paste and while it does sting when you put it on that only lasts a minute or two. I put the paste in a ring directly onto the flange - its much easier than trying to put it onto yourself.
When I have raw bleeding skin I either use mercurochrome or Stoma powder. The stoma powder is applied to the raw area then dab some barrier wipe over it without wiping the powder off. I wipe the stoma powder off any skin that isn't raw as I have thought in the past that it may affect the stickiness of the flange. It doesn't cause a problem around the stoma though. You can build up a few layers like this if your stoma is behaving and it forms a sort of crust that helps protect the raw skin. Dry between layers with a hairdryer.
The stoma paste also helps heal the skin - you just have to put up with that first stinginess, although using the stoma powder helps with this.
Oops, just read you are already using the stoma powder.......
You could try not using it for a couple of changes when you get some paste as I find the paste really does help with healing. Hope this helps, and hang in there. Its really tough in the beginning I know.