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Skin issues that don't improve

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Posted 7/2/2009 4:14 AM (GMT 0)

Hi. So I'm new here and could desperatley use any advice anyone has to offer. I have only had my ileostomy for seven weeks and of those seven weeks my skin has been highly irritated for about five. I have used nystatin powder and covered it with skin prep to help my bag stick. I was on diflucan for close to three weeks to no avail. This made the nurses/dermatolgists think that maybe my problem wasn't yeast but contact dermititis so the dermatologist gave me a steroid gel and told me to stop with the nystatin powder. Problem is, my skin started "weeping" like crazy and has developed little blister looking bumps. The bag wouldn't stick at all because my skin stayed so wet. (I have had serious issues getting my bag to stick since my skin has gotten so bad. I am content to make it 24 hours, happy to make it 36, and almost nervous when I get close to 48 for fear I am about to "spring a leak".). So now on the little area of skin that looks better I use the steroid gel and I apply the nystatin powder to the rest of my skin. I really think if I could have the reversal and get rid of this  bag my skin would heal. I did start using a bag with a smaller radius and the skin that is no longer covered has improved. I just don't know what to do with everying else. I am sooo tired of all of this, and I know that I won't have my next surgery for about 2 weeks minimum so I need something to try to help my skin with in the mean time. Any suggestions? 

Oh, and just a note, I do have psoriasis and have sensitive skin as well. This has caused added complications with trying to diagnose my problem(s). I really don't think this is a skin allergy but can't be sure. Also, several nurses have seemed to think that I have leaks that are causing skin irritation but I just don't think this is the case. When I have leaks, I can feel my skin start to itch even worse and normally I see, well, something. Anyway, is there any possibility that I do have leaks and I just can't tell? Sorry to ramble...

Posted 7/2/2009 5:24 AM (GMT 0)
I got a very bad rash- thought it was fungal but we are not sure even now. IT spread from the wafer tape out about 3 inches around the whole stoma. IT was weeping and nothing would stick - a living nightmare. I took Diflucan for 7 days - meanwhile:

The nurse decided to tried these absorbent wound pads called Versiva ( made by Convatec). She made a hole and put it over the stoma, then she took the wafer and put an Eakin seal on it and applied the wafer to the Versiva. So now there is not tape or durahesive of any kind touching my skin only the absorbent pad.

Hold tight down so the eakin melts to the wafer. Now how to keep the absorbent pad down..... Use non allergenic tape all around the Versiva pad. If there is a smal leak the Versiva will absorbed it.

In my case the tape held for 2 days max. However, once the weepiness subsided, the rash became better and the tape lasted longer.

This did help to heal the rash. Now that it is better we are trying to figure out it is allergic or fungal.
I am now using Convatec wafers ( with Stomahesive- that is not as durable) that contain no tape with a Eakin seal and non allergenic tape just for extra security. My nurse said that some people are allergic to the Durahesive on the the other wafers.

i know how frustrating this is. I still have 2months before takedown so My fingers are crossed for clear skin.
Posted 7/2/2009 12:29 PM (GMT 0)
Thanks for the information!

Just wondering, could anyone explain Eakin seals a little better to me? I hear them referred to all the time, but no one from my doctors office has ever mentioned anything about them. I've looked them up online but am still a little confused as to how they work.
Posted 7/3/2009 1:32 PM (GMT 0)
indecisive1--welcome to the forum! Sorry you are having such problems with your temporary ostomy sad

An Eakin Seal is a round disc with a hole in the middle of it...like a donut...I cannot tell you what it is made of but it does wonders!! I personally use it in donut form, but some use pieces, make 'snakes' from it or cut it and use strips, it just depends on what works for you. It is applied right around the opening that goes around your stoma and does the same job as paste to fill the area and prevent irritation. The difference between paste and an ES is that the seal can protect the skin and paste is more like 'caulk' and just fills the holes...I find that the ES doesn't break down and does a good job with my skin. I do get around 5 days of solid wear time and can go longer if needed.

Reading your post it sounds like the irritation is not just around the stoma but under the 'paper' that holds the wafer, too. Is that right? Some things you can try is to cut the paper part off ( I cut all but a little bit off and my pouch holds fine), try another brand and lastly see another dermatologist/WOC nurse. Sometimes two people just see things differently enough to solve the problem. You shouldn't have to live with this situation and the quicker you can determine the reason it's happening the quicker your can get treatment...don't mess around with skin issues!

There are brands that do not have any paper on the wafer...I think Coloplast's extended wear doesn't...and there are some that are better for sensitive skin. I am sure others will be along with their suggestions, too. Keep us posted on how things are going.
Posted 7/3/2009 5:23 PM (GMT 0)
Hi soon after having my op in jan i got burns all over my stomach due to leakage i ended up in A&E they cleaned the area and put an eakin seal on then got some sheets of DUO DERM cut a hole in the middle to fit over eakin seal so if it was to leak would protect the skin the rest of the sheets were placed over my stomach Duo derm is apparently used on burn victims but its brilliant and my skin had gone from red raw and shiny to near enough normal within 2 days Hollister do these sheets hope this helps you a bit Bev x

Posted 7/6/2009 3:51 AM (GMT 0)
Thanks so much for your suggestions. I'm still trying to figure out exactly what to do. I have been using a different type of bag for the last few days, but they haven't been sticking very well. I've already gone through four or five bags in less than three days. Yikes. I think I will go back to my old bags for a while and see what happens.

Just a couple more questions... has anyone ever had a fungal infection that did not respond to diflucan (I actually used fluconazole... i think it's just generic... maybe?) and nystatin? I've been treating my skin like it was a fungal infection but it has begun weeping like crazy yet again. I'm starting to think that it's not fungas and yet it doesn't respond to steroid medication either. My dad even asked if it could be bacterial. Has anyone heard of/ had this?
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