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How often do you change the wafer and the pouch?

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Posted 1/20/2010 3:02 PM (GMT 0)
Hello everyone

How often do you change the pouch and the wafer? I have had an ileostomy for about 3 weeks now and still feel like I don't have it right. I don't have any leaks or anything. Is it ok to keep the wafer on for 5 or 6 days? I noticed the last time I changed it I was getting a little red underneath. Is that because the wafer was on too long? Am I changing it too often? Should I be using a skin prep before putting the wafer on? I am using the stomahesive paste around the circle after cutting it into size, so around the stoma I am not that red, it is more around the outer area of the wafer.

I have been changing the pouch about every 3 days or so, then changing it the second time when I change the wafer. Is that basically what everyone else does?

Posted 1/20/2010 3:41 PM (GMT 0)
It all depends on you. If you can make it last, and dont get skin breakdown for a week, congratulations. Go with that.

When I had an end ileostomy, I was able to get a bag to stay about 3 days with a flat barrier. Then I got a loop, and I was changing my flat barrier bag about 5 times a day. I changed over to convex and can now get about 3 days wear time again.

You just need to find the combo that works for you. My first suggestion though would be to use Barrier Rings as opposed to the paste. That should help a good amount.

Good luck,
John
Posted 1/20/2010 8:39 PM (GMT 0)
I believe in 'less is more' so I only use a product when I need it.

We are all so very different, so it is really hard to give a strict time frame for changing...I do every Monday and Friday...and COULD do longer, but I find that I am very active so I could find some wafer breakdown with the longer times. I don't have any issues with changing that often and always have compliments from the WOCN about how nice my skin looks!

I also change the ostomy pouch everyday (I like filters that WORK) and it's the wafer I change twice a week.

An Eakin Seal (or equivalent) helps when you are new at this and keeps the skin around your stoma healthy so even if you are off a little the output won't burn the delicate skin. And is doesn't sting like paste:)
Posted 1/20/2010 9:24 PM (GMT 0)
So you put the seal on your skin first, around the stoma, and then you put the wafer over the seal? Does the seal come off every time you change the wafer or does it stay on and you just change the wafer? Do some seals work better than others? What is the wearability difference between a convex and a non convex wafer?
Posted 1/21/2010 2:58 AM (GMT 0)
A convex wafer makes the stoma 'pull up' ... it's for those of us who might have shorter stomas or funky shaped stomachs after surgery. Not everyone needs them. I would have 5 minutes wear time if I didn't use convexity!

I put a seal directly on the wafer then apply to my skin as one piece. Yes, they come off every time you change. I prefer Eakin Seals but all the manufacturers have their own...ask for samples!
Posted 1/22/2010 1:04 AM (GMT 0)
NascaRon, you said you use a Sure Seal over the wafer...what is that and how does it help if it is on top of the wafer? And I don't understand how an ostomy belt helps...doesn't the wafer stay in place becuase it is so sticky??

And thanks OHIO - I never thought of asking for samples!
Posted 1/22/2010 4:53 AM (GMT 0)
A convex wafer makes the stoma 'pull up' ... it's for those of us who might have shorter stomas or funky shaped stomachs after surgery. Not everyone needs them. I would have 5 minutes wear time if I didn't use convexity!

Me too... I am currently using the Hollister convex wafer. Unfortunately they recently changed something in their pouches and the filter leaks within 2 days. Does anyone know who else makes convex types?
Posted 1/22/2010 1:00 PM (GMT 0)
A Sure Seal goes over the wafer to provide a breathable/waterproof barrier....for those who hate wet wafers after showering it allows you to just wipe off with a towel!! It is also a great protection if you have a leak since it contains the liquid (and it works...I found out!)...I've been using them for quite a while and wouldn't go a day without one:)

Gaetano~welcome to the forum! I think most (if not all) manufacturers offer convexity. I use Convatec's...BUT as far a filters go...if your output is very liquid they will all fail at some point:(

if you go to www.UOAA.org you can find a list of all the manufacturers and request samples from the ones you want to try!
Posted 1/22/2010 5:43 PM (GMT 0)
Im wearing Hollister's convex as well. I change Oscar every three days. Everything comes off, we hang out for an hour or so nekkid...and then everything goes back on. I could go longer but whats the point? I know 3 days is good.

-Allie
Posted 1/22/2010 7:52 PM (GMT 0)
Hi..my son is using a coloplast two piece system. When he had his end ileostomy he had absolutely no issues with irritated skin or leaks and would sometimes go 14 days between flange changes. He would change the pouch every day or two....said he really did not like the idea of a dirty pouch. He also uses the sure seals over the flange. He says this helps a lot (stops the edges from starting to loosen off the skin) and gives him peace of mind. He now has a loop ileostomy which is two weeks old and so far not giving him problems. We have been told that when the stoma shrinks he may need to go to a convex flange since the stoma may pull in closer to the skin. He also uses the paste strips which he finds works the best for him.

Everyone is different. We were told that if the system is not leaking and the skin stays healthy that there is no time limit as to how long the flange can stay on. For us it starts coming off on it's own before he needs to take it off.
Posted 1/22/2010 8:21 PM (GMT 0)
I change mine roughly every 3 days.  I know I can get more time out of it, but I feel more confident about doing it this way.
Posted 1/23/2010 4:53 PM (GMT 0)

RoastedRedPeppers said...
NascaRon, you said you use a Sure Seal over the wafer...what is that and how does it help if it is on top of the wafer? And I don't understand how an ostomy belt helps...doesn't the wafer stay in place becuase it is so sticky??

And thanks OHIO - I never thought of asking for samples!

The belt helps to keep everything pressed down tighter. I have to use one. I still get leaks anyway, but it helps last a little longer. Even if there is a spot where it is not stuck down enough and there would be a leak, the belt makes it press tighter against the skin so the leak doesn't happen as quickly for me.
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