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Betadine, povodine, or chlorhexadine

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Posted 2/20/2014 2:16 AM (GMT 0)
These three products were mentioned to me by an ostomy nurse trying to help me troubleshoot my problems over the phone. She thought my problem might be bacterial, due to not drying my pouch enough, but i blow it dry after every shower. I was wondering if anyone has tried any or all three, and what were your results.

Background:
My stoma is about nine months old now, wow, time flies. I have a temporary ileo as a result of colon cancer, had surgery in June. Until recently, I had very little problems with skin being sore. I use a convex wafer and have since I came home back at the end of June. Lately, the skin around the top (all across the top and down the side about and inch and a half by my navel) is so sore, itchy and generally painful, I almost can't stand it. I have even tried friars balsam around the tape. At first, I tried ordinary lotion thinking it was just dry skin. Then I tried the friars, and today I removed all of it around the tape and put on medicated polysporin with some pain reliever in it, but even that hasn't helped!
Posted 2/20/2014 2:29 AM (GMT 0)
Hmm, I've obviously never tried any of those things considering I'm only 3 weeks into my end ileo. But, I was just wondering how often you change your setup? Maybe frequent changing has cause irritation? Also, have you tried the "crusting" technique? This is when you put stoma powder down then a barrier wipe, do this 3 times to have a couple of layers built up then let it all dry and then attach everything. Just a couple of suggestions. Let us know what ends up working. good luck!
Posted 2/20/2014 2:43 AM (GMT 0)
Hi Jody - ok at work we use betadine and chlorahexadine to prep/clean the skin prior to procedures - and your surgeons likely used either one of these or something very similar all over your abdomen/groin/legs during sugery. Betadine is a brownish liquid, the chlorahexadine is pink. It tends to make patients kind of itchy when it's on and dry, so we clean it off ASAP.

I noticed that with my perm ileo surgery in Oct it was washed off me when I woke up from my surgery (back when I had the jpouch surgeries, I woke up with it on me and the nurses kindly washed it off within a few days).

Anytime a tape adhesive is on my skin, I get the red itchy border that sounds similar to yours. It is itchy, so I sympathize.

Have you tried switching wafers to see if another company's adhesive works for you? I use Coloplast - the wafers aren't tape and despite having very sensitive skin I have had no issues so far. If you call Coloplast they will send you freebies so you can try them out.

Let us know how it goes, and good luck :)
Posted 2/20/2014 2:51 AM (GMT 0)
@poucher. Thanks for letting me know. Hmm not sure I want to put anything on there that's going to make it even more drier than it is now. If it was just the border it might not be so bad, but it's sorta under the tape too. If I was having a reaction wouldn't it be all around ..not just the top?

@rabbit. Ok what is crusting? How do you mean put down stoma powder then a barrier wipe. Etc ...?

I've been changing every seven days, I think I should start changing every five or six.
Posted 2/22/2014 2:15 AM (GMT 0)
Hi Jody. We'll let Rabbit explain the "crusting" method but I'd like to address a couple things. If the irritation is under the peripheral tape, the tape surrounding the wafer, that's usually attended to differently from irritation right next to the stoma. If you're getting seven days with a wafer I think that's great and we can work on the adhesive thing once we know a little more. When you remove the wafer you need to avoid stretching the skin. Pushing the skin into the abdomen while holding the tape in the same position will eliminate or at least minimize stretching.
Let us know.
Mike
Posted 2/22/2014 2:53 AM (GMT 0)
Jody I think your ostomy nurse was a little confused... it is probably *fungal* and that is caused by having dampness trapped against your skin.

Get a basic anti-fungal powder from the pharmacy, something like this: http://www.walgreens.com/store/c/zeasorb-antifungal-powder/id=prod393159-product Make sure it has the active ingredient "Miconazole Nitrate".

The next time you do a change, sprinkle this powder on the sore skin. Let it sit for about 10 seconds, then gently wipe away the excess with a clean piece of paper towel or tissue. Even if it looks like the powder is gone from your skin, a small amount will stay behind in your pores and that's enough to fight the fungus. If you see improvement the next time you change, it's almost definitely fungal. You should continue using the anti-fungal powder with each change until the skin is healed and back to normal.

There's no need to "crust" with the anti-fungal powder since it's just medication for treating the skin, you don't need the powder to form a physical barrier. You can put friar's or barrier wipes on over it but you don't need to.

The last thing I'd say is that if the irritation is near the edge of the wafer tape, you might try trimming away that part of the wafer tape so that the skin can breathe and it will probably heal up more quickly. In most cases you really don't need all (or even any) of the tape from around the wafer.
Posted 2/22/2014 6:05 PM (GMT 0)
Hey, thanks for all these great suggestions. I really appreciate the help. My last two changes I had only used friars and put it under the tape as well. On Friday, yesterday, we did another change and I used both friars and eachin strip. Thursday, the afternoon before, things were pretty bad. I was so sore and itchy for two days. I used alcohol and wiped off all the friars I had around the top of the tape and applied medicated polysporin. When we did the change Friday everything looked good. I think the friars helped with under the tape and the polysporin helped with the edges. After my shower this morning, I blow dryed everything more then usual, hopefully that's part of my problem -- right now things are so much better then last wed and thurs. I'm thinking maybe I just need to do my pouch change a little more often then seven days.
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