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Ingrown hair under wafer

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Posted 9/11/2018 4:30 AM (GMT 0)
Hi all,

Two years post-op with a permanent ileostomy here due to ulcerative colitis. None of the heavy nasty drugs worked. Everything has been going pretty great. Don't regret having the big surgery at all. I've gained too much weight back and have other health issues from that but as far as life with a stoma and a bag it really has been better than I'd ever hoped. It saved my life.

I've settled into a wafer and bag combo that works great for me and usually get 5-7 days from a wafer and 3 days or so per bag. I use convex wafers that I roll back with my fingers and it closes around the stoma. Also use a bag with no filter. Hate the filters. I'm a hairy guy and have to shave with a beard trimmer each time I change out but the only thing I use otherwise is benzoin tincture or some barrier goop to help things stick and cut down on irritation that occasionally pops up.

But...apparently I had a hair get ingrown a few weeks ago right underneath the wafer about 1/4 inch from the stoma. I guess it got infected as it seems to be getting worse with the last two wafer changes. Now it's turned into a little crater about the size of a pea and maybe half as deep. Boy, it stings! It's just after midnight now and I had to get up and change out the wafer because of the pain.

This is the first time I've dealt with this and I was digging through all my old supplies that I got when I started this adventure a few years ago. I found some stoma powder and sprinkled that on the open sore, tried to spread some skin barrier goop gently around this little pit of despair and put on another wafer. It's stinging less but I need to get this thing to start healing. I noticed tonight that it's really getting deeper and even the wafer is starting to conform to the hole. Eek.

Any ideas on something other than stoma powder that might help?

Thanks! Hope all are well!

Brent
Posted 9/11/2018 8:20 AM (GMT 0)
ExcuseMe: My advice - go see a WOCN immediately and get that taken care of. Do not let that little ulcer turn into a big ulcer. I have the same problem with hair. I wish I would have had hair removal done on my entire stomach before surgery - thought about it at the time, but felt too bad to go see a dermatologist.

As far as shaving, I would say, don't shave so the hair is like your face after a shave (e.g., very, very close). I gently glide a double-blade razor over the skin and don't get closer than 1/4" to the stoma. I've got other hairs night next to my stoma, and when they get long enough I use a blunt nose scissors to cut them. Also, when I use the eakin seal, it's easier to get to those hairs as they are all "globbed" together with the eakin seal.

I worried about the hairs for 1-2 years after surgery, but they are what they are. Lesson Learned - if you have the time, and are considering surgery, having all the hair removed from the abs would be a good idea. At least in the area(s) where your surgeon is considering putting the stoma.
Posted 9/11/2018 4:44 PM (GMT 0)
Definitely go see a wound care nurse. It took a good 6 weeks of treatment to heal one ulcer and now I have another. Seems to be a never ending cycle for me.
Posted 9/12/2018 9:12 PM (GMT 0)
My nearest ostomy/wound nurse is in another town and the appointment wouldn't be for another two weeks. I'm trying to avoid going as the last visit I made to them cost me around $300. They billed $700 to the insurance company for a 30 min consultation that required no treatment.

Other than stoma powder do any of you have any other tricks that might help this thing start to heal? In your experience what type of treatment does the wound care nurse give to help the ulcer heal?
Posted 9/14/2018 9:44 PM (GMT 0)
Would Duoderm help? I have a rash that is all over under my wafer. The ostomy nurse has me clean the area with just water, I dry it with a blow dryer and then put a 4x4 square of duoderm over the area. It's kind of a pain to cut the hole for my stoma but it is working to heal the rash. I was so uncomfortable with the rash under the wafer and after applying duoderm the first night, it felt so much better. I order these from Edgepark with I place my ostomy supply order. I get the extra thin patches. I have read they use these in nursing homes for people that have bedsores so it may work for you. Something to look into to. Good luck. I hope you find something that works.
Posted 9/14/2018 10:55 PM (GMT 0)
Thanks Woogy,

I did something similar. I changed out the wafer today and it seemed to be healing a little from the stoma powder. I sprayed some liquid neosporin on it as an anti-bacterial, blow dried it, and swabbed on lots of friar's balsam blow drying between each layer (ouch!). Then I cut a small piece of the transparent dressing I got at the grocery store and put that over the ulcer with the edge right up next to the stoma. Topped it with a swab of benzoin tincture all around where the wafer would sit, lightly blow dried, then stuck on the wafer.

It's a little more sore than usual but all in all better than it was the other day when it felt like I was being stabbed in the belly continuously. We'll see how the next few days go.

Thanks again all!
Posted 9/17/2018 2:05 PM (GMT 0)
Just checking in to see how your wound is doing? I hope it's getting better and less painful for you. smile
Posted 9/17/2018 4:53 PM (GMT 0)
Hi Woogy,

Yes! It's doing much better. It stung for a day then the wafer seemed to settle in and I haven't had any pain. I try to walk some for exercise everyday and that sometimes irritates things so I've avoided that for the last few days. I plan on changing the wafer out tomorrow to check on it and put on a fresh setup to get ready for a wedding trip. Never like having to change out everything in a hotel but it's inevitable sometimes.

I really liked using the transparent dressing to cover the sore spot. It seems to work very well and I plan on using them for any issues like this that pop up in the future. I got mine at a local grocery store where they sat with all the big band-aids, but I would think Walmart or a drug store might have them as well. And then of course there is Amazon. The ones I bought are only about 2.5" square and they were the largest I could find in the store, but I could see cutting a hole in it for the stoma and using it under the wafer to avoid irritation. I think it would work really well, maybe even replace the need for barrier wipes, although I'm not gonna give up my friar's balsam and benzoin tincture. I would probably want to find dressings that are a bit larger, though, to cover that whole area under the wafer.

Thanks for checking up on me!

Brent
Posted 9/17/2018 8:37 PM (GMT 0)
That's great news!!! I changed my wafer this morning and the rash I had looks like it's gone but I still put on a duoderm patch as a precaution. Even with this patch, I still use a small amount of barrier spray under it, another precaution. LOL I think the next change I do, I will try without and see if the rash returns. I hate to have to use these all the time if I don't have too.

I understand about not wanting to change in your wafer in a hotel. I don't like changing mine anywhere but home either. Probably because I have a system down now and everything is right there in my cabinet.

Have fun on your trip! smilewinkgrin
Posted 12/27/2018 12:59 PM (GMT 0)
Update on this wound underneath my wafer that is *still* healing. It eventually got worse growing to about the size of a quarter and I relented and eventually went to the wound clinic. They did a punch biopsy to make sure it wasn't an autoimmune reaction, specifically parastomal pyoderma gangrenosum. The biopsy came back negative and with some silver infused dressings as well as completely occluding the wound under the wafer with some cut down elastic barrier strips (I'm using coloplast brava) it has been healing fairly well. At the most recent change it was under the size of a dime with evidence of good healing around the edges.

It's proven to be a bit expensive having to change out the wafer so frequently...every 3 or 4 days...and the wound clinic visits have put a dent in the end of the year finances but I seem to be on the mend. I think having the proper dressing and being able to completely close it off has been the key to it healing up. At the beginning I tried crusting it over with stoma powder and I believe that made things worse. I mentioned before about using transparent dressings to occlude the wound but wasn't able to get the wafer to stick to them very well so the barrier strips have really done the trick.
Posted 1/6/2019 7:31 AM (GMT 0)
I'm glad your wound is starting to get better. Sucks you had to go to a wound clinic. I used one after my second surgery because my belly button incision want closing up. They really did help, but it was a pain to go back every week. I think I went for 4 weeks and then I was finally healed. I hope you heal much faster than I did. Lol
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