New ileostomy- trouble getting secure seal

I don't have any great suggestions but I wanted you to know it did take my daugther time to figure out what worked. And in time, she did start going out.
My daughter found the Hollister New Image convex wafer worked the best for her. She used stomahesive. We would put the stomahesive around the wafer hole (even a bit over into the hole), wait a minute or so, and then she would put it on. For her, waiting that minute started to make the paste less gooey so it didn't mush so much when she pressed down on the wafer.
Unfortunately there is no one answer as everyone finds something that works for them. It will also get easier and faster changing the wafer as time goes on.
Good luck.

momrk,

Welcome to Healing Well. I'm glad you found us!

I had the exact same problem in the beginning, and here's what I did to fix it. I ordered wafers that are a size larger and cut the hole off to one side. I moved the stoma guide up and to the left a little when marking it, so that it moves the wafer a few centimeters away from my navel.

Once I put it on, I lay down and hold my hands over edges to warm them up and smooth them out. This can take a minute or two. Then, I wait to put on any clothes that are tight, like jeans, until I know I have a good seal.

The other thing that helps is to shave the hairs off the belly around the stoma and make sure the skin is completely dry.

Also, the paste is not an adhesive. I don't know why they call it Stomahesive! That just confuses us. Just put a small amount of it around the hole that you cut in the wafer. It will keep the output from getting onto the skin, which will prevent leaks.

I've had excellent results, 7+ days of wear time, with the Coloplast Assura Extended Wear wafer (item #2833) with matching pouch (item # 13986). I highly recommend them! The wafer has a built-in skin barrier, so it is meant to go onto dry skin.

I hope your son is doing well. The good news is that he is UC free for life!

momrk--welcome to the forum!  Don't get discouraged, you'll both get the hang of it...

Here's my 2 cents:

Be careful what you use to clean the area with.  Some soaps can leave a residue and that will cut the wear time.  I use Dial (hate the smell but have never had a problem), some use Neutrogena and I think Ivory is okay too.  His skin will be sensitive since you've had to change so much.  Once he can get a day to two you'll see improvement quickly.

LESS IS MORE.  Meaning that if you use too many products, you could cause less wear time.  I don't use skin prep.  It leaves a film on your skin and some wafers won't hold as well.  You could also take the wafer tape off without remover (maybe not so close post op tho) by holding the tape and pushing the skin.  Don't every try to pull off the tape...it will damage the skin.

I also use an Eakin Seal (in place of stoma paste).  My stoma area is uneven and it helps to fill in the "low" spot and keep a good seal.  It is just like stoma paste but it comes as a ring that can be moulded to the stoma's size/shape.  I apply mine right to the wafer and then put the combination on.  I also have a need for convexity (my stomach is funky with all the scars) not to mention my stoma is small. 

The area around my belly button dips in a lot (I don't have one, just a scare) and has a wrinkle.  For a while I would cut the wafer tape (almost half moon) so that area would be avoided.  Once my skin healed I left the whole piece, just position it strategically.  The wafer should still hold...just don't go too close the the important ring of the wafer.

You mentioned that the home health nurse has been helping you...do you have an Enterostomal Nurse you can get help from?  It might be worth a trip to the doc's office to see one.  I had great home nurses, but they don't have the knowledge and ET nurse does! 

Please let your son know that in a few weeks he will forget all these problems!!!  We've all had them and they are a distant memory now    Keep asking your questions and mention to your son to join too!!

Momrk:

I swear by the Eakin Seals as well. I wear a one piece and put it around the hole on the pouch. I then use a blow dryer and run it around it for about 30-45 seconds (don't leave it in one place). Then I put the pouch on and push and hold all around the stoma area. This gives me an excellent seal. I do my changes twice a week when I come out of the shower. I make sure to take the pouch off before I get in the shower so I can get it really clean. I don't worry about making a mess like some people do. I use the hand held shower messager to clean up and then I disinfect real well.

Before putting the pouch on, I also use a 3M Cavilon Barrier wipe.

Good luck!

Again, thanks to everyone - we employed some of these suggestions, and the current bag is doing well. Might set a record, haha! At least it has given us a break from feeling like we have to check it every two minutes. He has gone over 24 hours with this one, yea! Of course, there is no guarantee that we will get the next one right, and I feel like I will continue to check back here.

Your suggestions for specific products have all been very appreciated, as well as everyone's willingness to continue to help us trouble shoot. Thank you, thank you.

momrk-

I am glad you are having better luck lately with the ouch staying on your son! :)

Just wanted to also echo what flchurchlady said-

-I, too, have to cut the hole in my wafer off-center or it won't fit well
-I also use stomadhesive (aka paste), with great success. Just put it around the hole you cut (on the sticky side, of course ), and when you press the wafer onto the skin, the paste should literally seep out and around the stoma. It will not hurt the stoma. It will protect him from leaks!
-Assura Extended Wear wafers last really long for me! (I am fairly young -28- and active -I work out and am busy at my job!)

Good luck! Sounds like your son is adapting fast!!

-E

Hi,

Sorry to be slow to respond to the last group of posts; balky internet connection. We are having very good luck using Hollister convex bag with extra wafer. Putting the wafer on against the skin first, then putting the bag on on top with hole cut more oval and a little off center seems to have be helping a lot. Also, a nurse advised him to wear the belt which he hates, but is doing. The belt I guess is creating a lot of itching, and he is experimenting with how tight to have it. The last pouch stayed on for almost three days, and visiting nurse wanted it changed to check the level of skin irritation. All the earlier changes had really irritated the skin around the stoma. The current unit has been on since yesterday morning, and seems to be holding well. We are also trimming it around the navel which also helps.

We are using a pwder that has no alcohol, as the previous one had a little. This new powder is one we got from Hollister, but I would guess others make something similar.

I don't know which of the many things we are doing is the key one, but we really feel like we have some breathing room now. His energy is still pretty low, but hopefully that will return soon. I think everyone is feeling a bit less overwhelmed.

OHIO76, your advice about less is more was helpful and echoed what one of the nurses suggested. We used just the powder on the last change, primarily because of the skin irritation caused by previous changes. Most of the skin preps we had contained some alcohol and it was suggested that with the problems we were having with the seal plus the irritation it was causing, that omiting that step was worth a try.

LittleE, thanks also for your note- nice to hear from someone so close in age to my son.