Appliance Saftey

[JackieRose]

There is nothing on this site under the heading of appliance saftey. I recall some time ago that I searched the American Chemical Society to find studies of safe skin barriers and found that the safest is stoma adhesive but Convatec has severely limited their use of this product.

I just started using the Cymed no-skin barrier-product that uses tegaderm. Does anyone know whether the same rule applies for ostomy care and wound care which is to change this product every 24 hours?

Thanks, JackieRose

[Button]

The recommended guidelines to change a Tegaderm every 24 hours applies in those circumstances where the Tegaderm is being used as a wound care dressing (ex. Covering a wound with weepy or serous drainage; covering an opening or break in the integrity of the skin). The rationale to change a Tegadem wound care dressing is to make sure that an infectious process does not worsen by enclosing the infection under the dressing.

Using a CyMed Micro-skin wafer (made of Tegaderm) over intact peristomal skin does not need to be changed every 24 hours.

I use CyMed Microskin 2 piece system. I change the wafer every 3 days.

If you are using the Micro-skin water and have peristomal skin issues (rash, weepy discharge, fungal infection) then changing the water every 24 hours would be prudent until the skin integrity has improved/normalized.
Karen

[JackieRose]

Thanks, Button/Karen. Why do you use a 2 piece system?

[JackieRose]

Thanks, Button/Karen.

Why do you use a 2 piece system? I ask this as a serious question.

I've been using a one piece Cymed (48400) for about 7 years) but every time Cymed changes their skin barrier which they have done several times I have a terrible problems. This last change was too much for me because I developed sores which were like solidified barrier rings on my back and arms and elsewhere. Finally I figured out that maybe I had a retracted stoma --I had emergency surgery almost 60 years ago, resulting from a perforated colon. My stoma which is an oval on an angle has been painful all my life. When I first tried a Cymed no barrier ring I got nothing but leakage until I made the opening much larger and then the appliance stayed on. No nurse or other professional has been able to help me and my medical records are not available. But my research indicates that I have an altered, loop ileostomy and an intact rectal stump.

Your posts have been of great help to me and I admire the time and effort you put into this and other sites

sincerely,
Jacq.

[Button]

Jackie:
CyMed makes the Micro-skin wafer available as a one-piece (wafer+pouch attached) and as a two-piece (wafer and pouch as separate units).

I use CyMed as a two-piece simply out of personal preference. CyMed makes a 6” mini pouch (which is a good fit for me as I am more child-sized then adult-sized). The 6” pouch is not available as a one-piece.

The adhesive coupling system is so low profile with the CyMed Micro-skin that I am equally happy with a CyMed two-piece as I am with a CyMed one piece.

I rotate the ostomy systems that I use, as a means of reducing skin irritate due to prolonged skin contact with any one manufacturer’s wafer composite. Not everyone needs to rotate products. I have frail skin integrity owing from long-term use of corticosteroids, so it behooves me to take a pre-emptive stance. Anyone else with particularly sensitive skin or having a fair skin complexion might also benefit from rotating between products.

The Coloplast Mio is the other brand that I use. In the Coloplast Mio I use a one-piece. I prefer a low-profile appliance. I prefer a thin, flexible wafer.

If you have a flush stoma to a stoma that dips below skin level, the CyMed Microskin one piece that you are using is a wise choice.

A convex configuration does not do well with a recessed stoma. A convex design needs some actual stoma - even if just a smidgen - as leverage to encourage additional stoma length.

A flat CyMed MicroSkin wafer (one piece or two piece adhesive coupling) or flat one-piece Coloplast Mio would be additional suggestions. And it sounds as though you have well-researched and sampled these options already for yourself. You are your own best teacher.

I agree with you that finding the “best fit” of an ostomy system can be more often process of self-discovery and self-directed hard work then is the case where a WOCN easily dispenses a wafer/pouch option that is the perfect one. I have had more success chatting on this forum and keeping abreast of new ostomy products here then I have had success in meeting with a WOCN.

So everyone, keep chatting and sharing on ostomy products and accessories. We are learning from one another.
Karen

[Mysticobra]

My two cent. Ain't much. But.
I use the Coloplast two peice.
I only use the two peice because I can't line up the stoma with the hole well.
I use precut wafers. They work perfectly. I am very very fortunate. It works well.
And the skin where the wafer is all the time seems to have toughened up over the short period I've had the ileo. About 3 and a half years.
Funny note.
I hope I don't get an allergy to these wafers. I get 20 a month through my insurance and I've been stockpiling. I only use two a week. I've had to use more occasionally. Blowouts. But 8 a month leaves me a stockpile.
But that's what I use. Also use the opague bag. Don't like the clear. I know what's in there. I don't want to see it.
I don't know how you guys get a one peice centered well enough because if I tried it I can't see if it's centered properly.
Richard.

[JackieRose]

Thanks, Mysticobra. I agree that it's difficult to get the wafer and stoma lined up. Usually I find that two piece appliances are just too cumbersome. In the past I didn't have the patience for Coloplast appliances but maybe I'll try again.

[Mysticobra]

Coloplast was what I wore immediately after surgery. And you know where your mind is after all that.
So I can't wear Coloplast because of it. Mental thing. I just remember them being hard.
When I used convetec it felt better. Still. Not used to wearing one but it was easier to adjust to.
Cymed.. Wafers are so sticky and thin. I have fumble fingers. I only get one shot and ruined more than I wanted so I never got to try it. They looked so comfortable too. Thin.
I'm just used to convetec. It works well. I've said many times how fortunate I am. And I am. It is so easy to change. I can count on less than one hand how many I've messed up putting them on. Maybe 3.
I'm gonna try Cymed and ask for samples again. I really want to try the system.
Richard.

[JackieRose]

You said originally that you used Coloplast. I guess you were thinking about your surgery. If you are going to try Cymed, I think you might consider a suggestion that a Convtec nurse made to me some years ago when I was having trouble centering a wafer:

Take a Convatec stoma adhesive wafer and mark two circles, the smaller being the smallest diameter of your stoma and the larger being the largest. Cut out the smaller circle then make a series of slits, about 8, around the smaller circle reaching as far as the larger circle. Then put on the appliance.

It could take some time but a centered stoma should eventually appear. The results might astound you, they did me.

[Raw-T-Luv]

I have had an ileostomy for 32 years. I have primarily used a Convatec 2 piece systems, however, the wafer material does not hold up long enough to go 3 days and I am allergic to the tape wafers. Approx. 5 years ago, I found the Coloplast Brava 10cmX10cm barrier sheets work great and I can stick any wafer type to them and I don't need any paste at all.

[JackieRose]

Thanks for your suggestions . I took Karen's advice to go back to the Cymed thick barrier appliance. I cut the opening larger and voila: the skin deposits have almost disappeared as well as the pain. I guess my body was telling me what the matter was. So thank you Cymed and special thanks to Karen. You were right again.

[Diane C]

Richard,

If you want to try Cymed again soon, ask for a sample ASAP. I used to love Cymed until I started irrigating my colostomy. I wasn't happy with an adhesive irrigation sleeve so had to stop using the product.

Now that I've switched to an ileostomy, I want to use Cymed MicroSkin again. Unfortunately, my visiting nurse who's caring for a post-surgical wound must order my products and claimed she can't order Cymed -- that Medicare won't cover it. I'm unsure if this is true and will find out when I stop having to go thru the nurse. However, I ordered a sample from Cymed in JANUARY. I was informed that it would take a while. I recently reminded Cymed and gave the company my order number. Never heard from them and it's almost April. Very disappointed.

Also, reading above, I see that some of the materials in Cymed products have changed? I'm curious about that. I loved the system although it takes some practice and agility to get the wafers on. It's a small company but the customer service and nurses were terrific. I hope that has not changed. It must be challenging to compete against the bigger ostomy manufacturers.

I'll be trying the Coloplast Sensura Mio Flip soon -- in a 1-piece. Currently use the Convatec 2-piece. Will report back. Gave up on filters with an ileostomy. They were useless. This is a big change for me -- and I still produce gas.

Diane C.

[JackieRose]

Dear Raw,
I must admit I didn't really understand your system. Could you explain it in more detail. Thanks.