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Question for barrier ring users

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Posted 6/13/2013 2:10 AM (GMT 0)
After you remove an old wafer, is it to be expected that there will be a little evidence of stool, eg a feint ring, on the underside of the flattened out ring material that was flush against the skin (albeit not to the outer edge of the ring- that would be a true leak) or should a perfect barrier ring show no evidence of stool underneath, period?

I am thinking about trying Eakin instead if Hollister rings, and/or buying that stomaplex "equalizer" product to try and push that barrier ring more solidly to the skin.
Posted 6/13/2013 2:19 AM (GMT 0)
If you see any stool on any part of the barrier ring.. you were leaking. So you need to change your appliance sooner OR you need to correct the area that was leaking.

Good detective work there Pro!

You can also try my method of putting the barrier ring on the wafer rather than on your skin. I find that I get a much better seal that way. In addition it allows me to have less "naked stoma" time when changing my appliance as I mash that barrier ring on the wafer before taking off my old system.

Lastly eakin has two kinds - regular eakins and eakin slims. Eakin slims are thinner like hollister adapt rings. There are also coloplast brava rings. They are thicker like regular eakins. For me they get all gooey and are very hard to clean off your skin. So I don't like them.
Posted 6/13/2013 2:29 AM (GMT 0)
I always have a bit of stool on mine as you describe... never beyond the inner 1/4" of the ring though. Sometimes I also have some stool mixed in with the Eakin residue that is left behind on my skin also for about 1/4" around my stoma. Regardless, once I pick the poopy Eakin residue off, my skin looks flawless. I don't consider this a leak. I consider it erosion of the barrier ring. As long as I change every 3-4 days all is well. Remember that part of the goal of a barrier ring is to absorb some of the moisture of the output and swell. It makes sense that some stool is going to get absorbed into it as well. The Convatec Rep that came to my ostomy association meeting said Eakin rings are also made of a material that neutralizes the acidity of output which helps protect the skin as well.

I used Coloplast strips and also Adapt rings in the initial months after surgery before switching to Eakins. I find the Eakins work the best for me. They almost melt onto my skin (which can make the residue a little harder to remove), but this is what makes them so effective in protecting my skin.
Posted 6/13/2013 2:54 PM (GMT 0)
Pro, I always had a little bit of output caked up directly around the stoma area observed during changes but it never caused any problems with skin irritation. I used the the method Ddd described above.

Note: I usually kept my wafer on for 7 days so that may have been the culprit.

Post Edited (Mossmi33) : 6/13/2013 8:57:03 AM (GMT-6)

Posted 6/14/2013 6:28 PM (GMT 0)
Thanks! Ddd and mossmi- the barrier ring against the wafer method is what ai have been doing all along. Well, I have been making a rope using 1/3 to 1/2 a barrier ring rolled up around the skin-side edge of the cutout in the wafer. Now that I have moved down to a smaller flange size (1" stoma diameter now), if I use an entire ring I am afraid I will cover up too much of the rigid adhesive part of the wafer.

blueheron- good to know that I am not alone in the stool showing under the barrier ring, though clearly sme view any such indication as a leak. I am not sure mine was just 1/4" in but I think so. Still, I think I should try some Eakin rings and see how they compare for longevity. I gather the Eakins stickiness in your case was clearly superior. When I change my Hollister wafer with the Hollister ring, it pulls off with the old ring intact, leaving no bits of ring to clean off. Given your experience, it sounds like it is worth having to deal with some leftover barrier ring since that means it must be resisting stoma acid better. Of course, many say the two rings are the same but clearly your case proves we all have unique reactions to different manufacturers.

Anyone- another question, perhaps a dumb one: there should be a donut collar, or "turtleneck", bulging up around the stoma through the gap between the wafer hole and the stoma, right? i ask this because that is how it normally is for me, but occasionally when a stoma nurse has cut my wafer they have made the hole so tight against the stoma that I can barely make out any collar. I assume a turtleneck around the stoma is good, but I realize also that when the stoma expands and contracts, the collar might not always keep a perfect fit and allow some stool "juice" to sneak by.

Post Edited (Probiotic) : 6/14/2013 12:35:28 PM (GMT-6)

Posted 6/15/2013 12:32 AM (GMT 0)
Yeah- it sounds like some consider this a leak but it doesn't seem like one to me. None of the stoma nurses that have helped me take my appliance/rings on and off have ever called this leaking either. They did say that my output erodes the rings quickly compared to some of their other patients and that I should never go longer than 4 days between changes though. I would consider it a leak if it breached the barrier ring or was significant enough where output pooled and caused skin irritation. In my case, output just gets on the inner 1/4 inch of the ring with no other consequences.

My Eakins pretty much peel entirely off without leaving residue... they just leave a little bit that needs to be picked off on the area right next to my stoma.

My barrier rings turtleneck up through the crack between my stoma and appliance exactly as you mention. Sometimes as much as a 1/4 inch. I think they are designed to do this. You are right though... output can still end up in the crack between the turtleneck and your stoma when the stoma contracts. That is another reason why I don't consider a little bit of output under the inner sliver of Eakin as a leak. How can some not get in there when one's stoma contracts? Especially with fairly liquid output? My stoma expands and contracts like crazy and can change diameter quite a bit during peristalsis. If I tried to cut my appliance flush to my stoma I would most definitely strangle it once it expanded. Or if I happened to cut my wafer when my stoma was expanded, then a large space would be left when it constricted. It sounds like perhaps not everyone's stoma changes diameter to such a degree.

The good thing about the Eakins is that the turtleneck part gets really gooey for me after a day or so and that goo protects that space between the opening and my stoma too until it finally erodes away. I have started working a little bit of stoma paste into the crack between my Eakin and stoma too once I get my appliance on (this is only possible with a two-piece). This helps caulk the area until the Eakin has a chance to swell. Eventually the paste and Eakin sort of melt together and seem to protect the area really well.

The barrier ring brands varied so much for me. Adapts worked pretty well, but because they didn't get as gooey as the Eakin and meld to my skin, my stoma would eventually punch them back during peristalsis and exposed my skin to a small degree. The Coloplast strips and rings just completely eroded away. I had to change my appliance within two days of trying a Coloplast ring because there was basically no ring material at all left next to my stoma after that amount of time and my skin was getting burned.

You will get a feel for what works for you. I was so worried for the first couple of months after surgery. I kept thinking I was making my wafer hole too tight or too big. I remember calling my stoma nurse one day soon after getting home from surgery. I was so worried because I just changed my appliance and I could see the tiniest sliver of skin exposed next to my stoma through the transparent one-piece pouch. I thought maybe I would have to redo the whole thing. I pictured my output digesting that miniscule bit of skin and leaving a huge hole overnight. She assured me that this wouldn't happen so I left it on. She was absolutely right. The skin was fine. You will get a feel for what works for you and how meticulous you have to be. If the output that seeps under the inner sliver of your Eakin isn't causing any issues, don't worry about it. If it is, then experiment with something else.
Posted 6/15/2013 12:34 AM (GMT 0)
Oh yeah- I have better luck putting the Eakin right on my skin than on my wafer first. Here is my method.

http://ostomyoutdoors.com/2012/10/30/ring-around-the-stoma-my-best-defense-against-leaks/
Posted 6/16/2013 11:50 PM (GMT 0)
I've had very small amounts leak next to the stoma. It never goes very far. I used to be concerned about it but it's never caused any skin problems. This happens nearly every time. It happened when I was using a ring and now when I'm not.
Posted 6/17/2013 2:01 AM (GMT 0)
Thanks driver and wow, blueheron, terrific detail, and reassuring. Will definitely give Eakins a shot, although I am not sure they are fully compatable with Hollister wafers? Interesting how you mix paste in onto the barrier ring .. Will look into that too.
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