skin barrier compared to cohesive skin seal

My 78 year old mother came home (to my home) with a colostomy on Monday.  We have had the misfortune of having a visiting nurse that seems to be a bit over reactive and not very helpful.  She changed my mother's wafer and rubbed her skin to irritation when cleaning the area rather than using an adhesive remover.  My mother now has an area of skin that appears to have cracked open and there are other areas that are simply red.  I have been trying to research how to manage the problem and I have come across some comments on Eakin comprehensive skin barriers and skin seals.  Is anyone able to tell me what the difference is between these two products and if one of these products should be used to help my mother's skin problem?

If so, how do I use it. 

 

Thank you for the information.  I actually did order some of the powder as well but I don't have any idea how to use it (i.e., in what order, etc.).  The only thing the hospital gave us was the stoma paste and we've had no real counseling on the colostomy.  We were shown how to do change it 1x and that was it.  So any information or instruction you can provide would be greatly appreciated.  For example, I don't know how often the bag "needs" to be changed, etc.  I've heard the wafer needs changing anywhere from 3 to 7 days but that's about all I know.  Thanks again for any information.

Hi Rosemarie!
Well i have an ileostomy, just a bag on the other side, my whole colon was taken out about 4 months ago after unsuccessful treatment for Ulcerative Colitis. I had some awesome ET nurses (Enterostomal...the ones who train you on your ostomy), and i learned alot, and you just pick up tricks as you go. But who wants to wait when i can just tell you what i know so far?

first of all, the bag changing...i would definitely do it every other day (not every day cuz you will only irritate teh skin more by continually pulling off wafers) while the skin is still irritated. I had alot of irritation, mainly cuz my skin reacted to the adhesive in the bag system i was using (you may want to experiment with different bags...you can go online and search under ostomy bags to find companies like Hollister (the company i use) who will send you free trials of bags so you dont have to buy them until you see how they work for you. There are 1 and 2-piece systems, just depends on how your skin lays, prevents leaks if the wafer lies flat. I have to add some Flextend Skin Barrier (just a sheet of adhesive like stuff) to even out my tummy ( i am way underweight due to 40 lb weight loss after surgery) so the wafer has a flat surface to stick to.

Making it stick- Definitely use some Cavilon spray or No-sting skin barrier (also spray on) to get things to stick better so it lessens the chance of a leak.

Paste-most pastes have alcohol in them that just BURN already irritated skin, not much you can do but find one that hurts the least...i use Adapt paste, much less painful generally, but sure does hurt at first...

Cutting the bag-fitting it- you want to make sure you get the wafer as close to the stoma as possible in order to prevent irritation/leaks, and be sure to use as much paste as you need to fill in the gap (miniscule as it may be) between the stoma and the skin...VERY important. Also, when you put the paste on, make sure you let it dry before you put the bag on it, so you can spread it out...you want to make sure the stoma has room to evacuate without pulling off a big glob of paste with it and compromising the seal...i just push it back with a wet q-tip around the outside of the wafer, next to the stoma, and i tap it down so i know there is paste preventing a leak down on the skin by the stoma.

Cleaning the skin-definitely only adhesive remover (which you still have to rub a bit, just do it slowly so you dont hurt the poor thing) or water...no soap or other products. Let air hit the skin for as long as you can...have some gauze or my fave, paper towel (TP is too flimsy) to catch anything that comes out while you are airing it...it needs the air like any part of your skin does...the more air it gets the better it will heal up...

I think that is it...if i remember more ill post again...any question be SURE to email me...i cant believe you didnt get proper training, what a crock! This is soooo important! [email protected]

~Eileen

Hi rosemarie!!!
Well i wish someone would have told me all this too, so no problem, any way i can help!

As to the paste, you put it on the inside of the wafer, the way the nurse did, i must have sounded all jumbled sorry. You put a relatively generous circle around the pre-cut whole where the stoma will fit through, then you slap it on the skin you have sprayed with skin-prep which only needs about 2 seconds to dry (skin barrier i guess you can use interchangeably, the term i mean. There is the spray stuff, awesome. Then there is the stuff i use to flatten the surface of my stomach, which is in a sheet and you cut to fit where you need it, not the same thing for sure though.). You want to put pressure on it for about 5 minutes, pushing the stuff that squeezes out around the stoma to the sides, and packing it down lightly to make sure it is a good barrier under the wafer...does that make better sense?

Lemme know if this helps!
~eileen

Thanks Eileen.  It makes sense.  Until this forum, I hadn't heard of a skin prep spray.  They told me to use the skin prep wipes. I learned about the skin barrier sheets on the internet and I'm sure that they would help my mom.  She has osteoporosis and so has pretty much lost her waist.  As a result, she has a few lines and folds where they normally wouldn't be.  She has psoriasis and her skin is very sensitive so I'm want to do my best to protect it as much as possible but I think I'm afraid of covering up the stoma in the process.  What is the difference between the skin prep "spray" versus "wipes"?  Have you ever used the protective powder?

Thanks again for sharing. 

Rosemarie

Thank you.  You've explained it very clear.  I understand how to use the powder and I think it will help.  Despite the open crack and redness that I saw in my mom's skin, she claims that it isn't uncomfortable and there is no burning so I guess that's a good sign.  I'll be changing the wafer again tomorrow and this time I have the adhesive remover and the powder so I think it will go much better this time.

Thank you so much for all of the information you have provided.  It has helped a great deal.