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How to get a better seal? "Burns" around my stoma

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Posted 2/23/2012 12:55 AM (GMT 0)
Hi all,

I've been wearing the same pouching system for a while now after trying just about everything, and I've finally found something that works for me and my sensitive skin. I wear a two piece convex hollister (though my stoma does stick out at least a half inch...it leaks without a convex wafer--sigh), with eakin seals. I usually either use nystatin powder with barrier wipes to seal it in(I have chronic fungal infections) or Friar's Balsam (I usually alternate each change) under the wafer.

However, recently (for the past 6 weeks or so) I've been noticing a slight "burn" on the lower right quadrant of the edge of my stoma. It's a thin spot, which used to just clear up with a better seal on the next pouch change. Now it seems to be there all the time, and I've tried a ton of stuff: thicker eakin seals, a smaller pouch opening, Friars, more frequent pouch changes....I am running out of ideas.

Does anyone have any input on what could be causing this? I don't want the irritated skin to get worse. Thanks in advance, all of you :) You're the best.

Posted 2/23/2012 12:59 AM (GMT 0)
i had a thread talking about burns and ways to better pouch yourself, check it out if you dont end up getting too many responses. theres a ton of responses in there.

https://www.healingwell.com/community/default.aspx?f=33&m=2341889

i hear ya though, it sure is a pain.........im using a convex with powder and an eakin and an ostomy belt...and my burn is finally clearing up.

good luck!
Posted 2/23/2012 5:16 AM (GMT 0)
Convex makes a product that I love called stomahesive. I use it all the time, it fills in any gaps and you can use it with the eakin seal.
Posted 2/23/2012 11:29 AM (GMT 0)
80's those eakins started working against me. Plus if you use them you are supposed to really flatten them. My stoma nurse said that the poop has to sort of hop up to get over the thicker eakins and instead can leak down under. Even with an Eakin Slim pressed really flat, it did not help. I am now in hollister convex and my stoma sticks out 1/2 inch too! I cut the hole closer and use the stomahesive paste instead of the eakin and I am getting now 3 or 4 days of wear time.

My original system was the 2 pc convatec stomahesive wafer and bag but due to adding some pounds, I now need the hollister convexity that you use. Try the stomahesive paste rather than the eakin. Roni had issues with the eakin too I think. See the thread he referenced.

Good luck. Rosemary

PS DId the friars balsam on the burn right under the stoma hurt at first? Then did it heal it as Dan's does using the friars?
Posted 2/23/2012 2:13 PM (GMT 0)
How is your skin with Duoderm? A small piece might protect that area without hurting it's healing...
Posted 2/23/2012 5:05 PM (GMT 0)
The stickiness of the duoderm might hurt when you go to remove it? I'm a firm believer in creating a crust with the stoma powder and cavilon (what I use). It works for me and gives things a chance to heal and usually does so quickly. Of course, in order to stay healed you have to keep the output off the skin which is where I run into problems since I can't get a pouch to fit me correctly at this time.
Posted 2/24/2012 1:40 AM (GMT 0)
I don't know if I could get the duoderm to stick, since it's literally right at the edge of my stoma (sometimes it's hard to tell if the skin is actually red and weepy or if it's just my stoma). I have the same issue as allbluezoo, and it could heal if I just kept the output off the skin, but since it's the lower quadrant of my stoma, that's always where a teeny tiny bit of leakage starts. I don't want to change any more often (I am currently doing every 3 days) because I don't want to anger the skin around the outside of my pouch or waste these expensive products!!! (I have insurance but still have stupid copays).
Posted 2/24/2012 2:31 AM (GMT 0)
80'S CHICK:

Sorry to hear about the "burn."

Not sure if this will help you, but, I had same "burnt" skin issue last week right next to stoma! Except in lower left quadrant where my stoma points...I had, up to that point, been putting eakin seal on wafer first, then putting eakin seal/wafer onto skin..

Last change, put eakin seal on skin, and made sure "burned" spot was covered..then, put wafer (w/paste) on top of that...changed this morning.."burned" spot was almost gone...

Do you use any paste? I have been using convatec's version..but, have ordered a sample of hollister "karalya(?)? paste..it's supposed to be good for "sensitive" skin...

This is always hard to troubleshoot..next time you are changing, take a long look at the "lay of the land" (so to speak)...is that one spot lower than rest of your skin around stoma? are other spots higher? REason being, after a couple of days have passed, the "uneveness" of the muscle/skin/etc. may cause that portion to pull away from wafer....

Thanks to ESOR's comments, I'll be trying some adapt barrier rings..I think the eakin seals are tough on the skin without extra skin prep on...the adapt rings are supposed to be easier on skin also.

Hope all goes well!
jimmy
Posted 2/24/2012 3:00 AM (GMT 0)
jimmy,

Glad you liked my suggestions, but I tried the adapt barrier ring on one part of my skin not near the stoma, just as a test patch and it stuck WAY too much. It would have just torn that burned skin I was trying to heal under my stoma OR it would have stuck on and I would get it off sometime like around next July. Those adapt barrier rings are sooooo sticky. may just be the way things went for me and my test patch of skin, but be careful. Try one on the other side of your stomach first.

The Eakins I found to be very soothing but then like I said they stopped working and I went to the Stomahesive paste. Good luck and let me know how you do.

Rosemary
Posted 2/24/2012 3:07 AM (GMT 0)
What is Duoderm by the way? Rosemary
Posted 2/24/2012 3:17 AM (GMT 0)
80's Just a question,

Have you gained any weight since you got your stoma?

Only reason I am asking is that that is the reason that I have a burn under my stoma where the effluent comes out. I was down to 99 lbs way under weight when I got my stoma. Now am at 130 closer to the 125 I should weigh. I was up to 139 so have done pretty good getting some weight off. BUT that is what changed the "lay of the land" for me around my stoma.

Mine too sticks out a 1/2 inch and seems like it did originally too, but now the landscape around my stoma is different with the weight gain.

I also wonder are other people's ileo stoma's more than a 1/2 in stick-out length? Seems like if they made them a bit longer then we would "grow into them" as we regained the weight we needed to, certainly not criticizing my stoma doc as he saved my life, but it's just a question on my mind. OR maybe they don't make them longer so we won't accidentally bump them on anything?


Rosemary
Posted 2/24/2012 11:39 AM (GMT 0)
Thanks for your input guys!

I am currently wearing an adapt ring in hopes that that might change things...I'll keep you all posted tomorrow when I change.

Rosemary, yes, I've gone from 92 pounds when I had surgery to 135 now. I know that probably plays a part. But even with the weight gain, I'm not overweight and have fairly flat skin around my stoma. I agree that I wonder why they don't err on the side of too long for the stoma, since convex stomas are such a problem.

I will try the stomahesive paste with the next change. Should I put that on WITH an eakin seal/adapt ring, or alone?
Posted 2/24/2012 1:41 PM (GMT 0)
Duoderm is like a second skin, very similar to tegaderm that they cover IV sites with in the hospital.

I started using the adapt barrier ring (thanks Rosemary!) And I am loving it, I don't find that it it too sticky and I love that is fits down right around my Stella. This time around I also used the Stomahesive where the adapt ring starts to go downhill to fill in any gaps that may occur when my Stella contracts and tries to hide. I put this pouch on yesterday morning with all that and so far no problems, not even any drainage from the abcess seeping out anywhere!
Posted 2/25/2012 8:47 AM (GMT 0)
80's chick:

You can use the paste with either eakin seal/adapt ring, or use paste all by itself...

Not sure how long the paste will last for you...I've had paste disappear within a day (probably done wrong..LOL!). Or, last several days...eventually it falls away..and, your next layer of protection is either the wafer plus the seal/barrier ring if you have those....some people re-apply the paste (that will stop a leak)..but, I haven't tried that yet....and, lastly, the skin prep can provide a barrier to fluids for a spell (just long enough to get to change day!).
Posted 2/25/2012 1:35 PM (GMT 0)
I use duoderm over my pyoderma gangrenosum, and that is an open, nasty ulcer. The wound does fine under the duoderm, but I do put cream over the wound first. I have heard of people applying the powder and then the duoderm. I change my appliance almost every day to apply the cream, and even with that, I have no problems pulling off the duoderm. It is made for longer wear time though.

You can also get the extra thin duoderm instead of the hydrocolloid, thicker, version. The thin stuff was awesome, and I got mine from my supply company. I cut the duoderm sheet into fourths, put one of the fourths right over my stoma pattern and draw the correct patern in a 1/4 semi-circle. It fits snug around my stoma just like the appliance itself.
Posted 2/25/2012 10:13 PM (GMT 0)
I just seen a stoma specialist for a recessed stoma and she gave me sween cream and told me to use colopast paste w/0 alcohol instead of rings and she put a belt on me so tight I hate it...BUT it is working! I can keep a wafer on for 3 days instead of daily and my stoma is prolapsed from belt. I still am using powder and skin barrier. I wish they had sent me to her 6 wks ago, my stoma is temp. and my skin is horrible! Good Luck!
Posted 2/25/2012 11:50 PM (GMT 0)
I am horribly allergic to Convatec, so I can't use it.

This morning when I changed everything I put on an eakin slim with some coloplast paste (that's all I had on hand) to fill in where the "burn" is. I used Friar's Balsam under the entire wafer, including where the irritation is. I will cross my fingers that I'll help!!
Posted 2/26/2012 3:47 AM (GMT 0)
Duoderm wow would that come off? If it is like what they anchor IV's with that stuff would stick forever.

Hmmmmmm 80's yeah your weight gain sounds just like mine, but you are younger and that is likely why the weight did not go to your belly as did mine.

Let us know how the Friar's goes. Rosemary
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