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Posted 9/28/2015 2:40 PM (GMT 0)
Hi all,

I've been having issues with keeping my peristomal skin guarded from output since practically day 1 of having my loop ileo. Convex wafers seem to be helping a lot, but last time I went to my WOCN, she put on a smaller size wafer that fit over a small section of my stoma.

When I changed my appliance this morning, that section bled like hell. I understand she was trying to protect the skin around my stoma, but I don't see how this is much better. At the same time, since I've had my ileostomy for only four weeks now, I don't feel totally qualified to confidently question her method.

Any thoughts/info/advice would be greatly appreciated!

Thanks.
Posted 9/28/2015 6:35 PM (GMT 0)
It's probably still healing and a little blood is normal. I mean, if you were bleeding like a stuck pig, then it's possible the wafer cut into the stoma. It can be a tricky thing to keep the skin healthy in the beginning since things are still adjusting. I'm almost three months out and my stoma is still shifting its shape.

Try paste or the Brava strips in the meanwhile. You can't protect it completely until a stable wafer opening is determined, but you can at least lessen the damage.
Posted 9/29/2015 6:07 PM (GMT 0)
Is it uncomfortable? I notice when I have everything setup right, I don't feel any discomfort at all. Bleeding on the stoma is not uncommon at all...
Posted 9/29/2015 7:28 PM (GMT 0)
Thanks! I'm going to try out the protective strips. I already use paste and that helps a ton.

I think the wafer that was on previously was covering my distal loop and just squishing the stoma in general. I'm wondering if the blood was coming out of the distal loop. Although I know this new wafer was used to help some peristomal skin heal, its still a little concerning that this wafer was applied by a WOCN!

My appliance is pretty comfortable now that i have a slightly larger wafer, unless i press on the edges of the wafer and my skin is still *slightly* sensitive to pressure in a couple of places (where I was having skin issues before).
Posted 10/1/2015 7:34 PM (GMT 0)
I'm sure your WOCN tried to provide the very best for you but it's not always automatic. The skin next to the stoma WILL get damaged by output. It MUST be protected and that should be in the form of Cavilon or other barrier film, Eakin or similar seal, paste and the wafer. Not all of these but the appropriate combination. Bare skin WILL get damaged. A sharp edge on a tight "cut to fit" wafer will probably cause bleeding. I use Convatec moldable stuff with half an Eakin seal and Cavilon film. We're different and I suggest you take advantage of all the samples out there. You nurse will probably be happy to help.
Good luck and please keep us posted.
Michael A
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