I have a patient with a recessed stoma and haven't been able to get a wafer to stay longer than 12-13 hours. We have tried, Stoma paste, eakins seal, different types of wafers and brands. Any suggestions!?
Like "Here for the Party" I also have problems with my skin barrier not sticking. I am using a convex skin barrier along with stomahesive powder and protective barrier wipes along with Eakins cohesive slims and nothing is working. Everything is leaking under the skin barrier and its REALLY tearing up my skin. Do you have any suggestions? I am at my wits end!
Duoderm acts like a second skin and will even stick to wounds and skin that is oozing. I use the Duoderm on my skin around my stoma when the skin decides it wants to be obstinate. It can be cut into any type of shape that is needed and comes in sheets of 4"x4". My stoma is recessed due to my weight, so I use deep convex wafer bags. I also always use either an eakin seal or a seal that is comparable. The Hollister karaya seals work really well also. I DO NOT change my bag while taking a shower. This has made a huge difference for me. The expanding and shrinking of my skin because of the water absorption WILL compromise the seal of my bag, so I change the bag after I get done with my shower on my 7th or 10th day, depending on how well the bag and seal are holding up.
I have had Crohn's for 26 years and my ileo for 21 years. I am a wound care nurse assistant and telemetry technician in the ICU at my local hospital. I would be glad to help anyone who needs advice, (see your doctor or ET nurse for medical care, of course though) helpful tips, or tricks. Trying to find the right appliances can be a daunting task if you are just starting out, as there are a ton of choices out there to choose from. I highly recommend visiting the Coloplast, Inc. website and using their BodyCheck test. I recommend this to all of my patients as well as giving them a brochure that explains what it is. It is a GREAT resource tool! :)
I don't have enough expertise to answer the first part of your post so I'll defer that to someone else.
As to skin irritation, what type of barrier spray or wipe are you using, and what type of cream/ointment do you apply? My favorites for my stoma are Cavilon No Sting Barrier Film (available in wipes and spray) followed up with Coloplast Critic-Aid Clear Moisture Barrier Ointment Skin Protectant ("For Minor to Severe Skin Irritation Due to Incontinence").
If and when I get granulation tissue (granulomas) on my stoma, I treat those with silver nitrate sticks which you can actually buy on amazon.com, but if you've never used them before it's probably best to have a Dr. show you how to do it the first time as it is chemical cauterization. There is also a new product on the market for granulomas called "Granulotion." I was one of their product testers while they were in development and it definitely works, so if you'd rather use a cream for that, I recommend Granulotion.
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