How does one remove old skin powder/ seal during wafer changes?

You really don't have to worry about getting it all off. Definitely don't scrub or it will irritate the skin.

Sometimes I will pick a bit of it off with dry paper towel (Eakin material sort of sticks to the paper towel) before jumping in the shower. A couple of products that work really well for me for this too are Safe and Simple Stoma wipes or Niltac adhesive remover wipes (these are currently only available at the Ostomy Secrets site). The Niltac wipes work especially well.

Excellent advice above

There are adhesive remover pads and my husband has a plastic bottle of it also. Hasn't had to use it in a long time...just be very gentle as suggested so you don't further irritate things. Not necessary to get off every little bit if it is stubbornly stuck to the skin as it will come off probably next change/shower.

Thanks everybody. We actually changed it before I saw any replies, and wrongly did scrub it off a bit (oops) and then we didnt even use the protective seal wipes after adding more powder, because it seems such a mess to get off. Now I see that I should have just left the old stuff on until the seal comes off on its own. I changed it just 2 days after the last change only because I was concerned by some itchiness and soreness and was worried that it was getting worse- but it looks about the same as it did last time, which was the first time that powder and seal was put on.

I was told the irritation, immediately adjacent the stoma (i.e. that skin would have been under the barrier ring) would have been caused by some slight leakage under the barrier ring. For the life of me I have never seen any signs of stool there though- but I guess some tiny leakage like that can be invisible? Would switching to a convex wafer help prevent this at all, I wonder? The stoma is now about 3/4" high (was originally just about an inch).

Yeah, I don't think you need a convex either.

Just wondering, do you put the barrier ring on your wafer or directly on the skin? As with all things ostomy different ways work for different people, you might want to switch to whichever way you AREN'T doing it so far. For me I like to put the barrier ring directly on my skin first -- this way I can adjust it and make sure it is riiiight up against the stoma and there is absolutely no exposed skin between the barrier ring and the stoma. I especially use a hand mirror to check that the underside is perfect. After that I apply my wafer over everything.

Thanks- good suggestions. @pluot- I was taught and have been doing the barrier ring right onto the wafer. When I remove the old wafer it seems that the barrier ring has turtle necked nicely, but I see your point about switching to whatever I have not been doing, in case there was even the slightest gap. Do you roll the barrier ring into a rope that you collar around the base of the stoma, or do you just stretch a piece of intact barrier ring around the stoma as some are taught to do? I gather some people even put an entire ring around as is like a donut, with the hole stretched... My first WOSn's told me that this can raise the wafer up too much and interfere with the seal but it seems there are a lot if variations in what is taught as best practice.

@B'Dereh- doesnt the barrier ring expand and contract even if the stoma expands and contracts, i.e. there should be no gap (?), at least in theory?

What do veterans here think of the skin seal wipes, on top of the powder? I certainly wont make the mistake again of scrubbing off old powder and/or seal... But if there is old seal still on the skin, there would be no point in adding new powder until it comes off on its own, right?

Post Edited (Probiotic) : 6/1/2013 9:22:05 PM (GMT-6)

Probiotic said...
Thanks- good suggestions. @pluot- I was taught and have been doing the barrier ring right onto the wafer. When I remove the old wafer it seems that the barrier ring has turtle necked nicely, but I see your point about switching to whatever I have not been doing, in case there was even the slightest gap. Do you roll the barrier ring into a rope that you collar around the base of the stoma, or do you just stretch a piece of intact barrier ring around the stoma as some are taught to do? I gather some people even put an entire ring around as is like a donut, with the hole stretched... My first WOSn's told me that this can raise the wafer up too much and interfere with the seal but it seems there are a lot if variations in what is taught as best practice.

Oh boy, I am definitely "some people" -- I use a whole barrier ring "like a donut" and slowly stretch it until the inner ring is about the size of my stoma, then lay it directly on my skin. If you jump ahead to 1:07 in this video you can see exactly how I do it: www.youtube.com/watch?v=26rpN2ECnQE I've never had an issue with it raising the wafer too high. My stomas have stuck up about 3/4" like yours so I don't think it would cause an issue. If I couldn't afford to use so many barrier rings maybe one of the other methods would work for me, but insurance provides and this has never caused a problem so I stick with it

Skin seal wipes = no sting skin prep? I use it with most changes just out of habit. I've done changes without it and it was fine too, but obviously you need it if you are crusting powder over areas of irritation. There's no need to re-crust over irritation that you can't see (ie if it's still covered by old powder). PS, as the irritation heals, if it reaches a point where it's ALMOST normal, but maybe still a little red or something, rather than crusting you can dust on a little powder, let it sit for 15 seconds, then wipe it all away with a piece of gauze or paper towel. A small amount of powder will be left behind in your pores that will help soak up moisture and protect the skin but won't require actual crusting. With the weather getting warmer and as I become more active I am going this route for all of my peristomal skin (dust on powder, wipe away 'completely') to absorb excess moisture and try to head off any fungal infections.