Okay, I've resorted to using construction glue

[Shamrock4806]

Oh yes, a good bag on.

Didn't realize the benefits of alcohol plays in the part of most otosmy paste, it's drying effect, using a much stickier no alcohol no sting paste mainly. I missed a spot using iodine (contains alcohol) on damaged skin and I can feel it itching a little. Will cover better next time.

Day two of my contraption and it seems good.


Spoke too soon, replaced the contraption and used iodine (contains alcohol) again and realized again why I use a non-alcohol based paste, it kept on stinging and wouldn't stop. So I ripped it off and scrubbed in the shower and replaced using the thin paste + sheet + convex in its original condition.

I'm suffering still but it's a lot less than before.

Iodine is now off the list.

Edit: pain is gone, all is normal. No more iodine or if used for anti-septic purposes, it needs to be scrubbed off and dried well before proceeding, it should NOT remain on the skin.

[Old_guy]

Hi. I was thinking convex for two reasons.

1. In looking for samples from Hollister and Coloplast, using their online questionnaire, both suggested convex bags.

2. I'm wondering if a bit extra seal pressure around the stoma would make a better seal. I know you have experienced otherwise. But I'm thinking this way because I had been using 4" rings with little success and had some 2" rings that had better success. Nor a resounding success, but better. Which leads to a question: I hear of ring stacking but, so far, have not seen why one would do that. Would stacking cause further pressure for a better seal?

[Shamrock4806]

Hi. I was thinking convex for two reasons.

1. In looking for samples from Hollister and Coloplast, using their online questionnaire, both suggested convex bags.

2. I'm wondering if a bit extra seal pressure around the stoma would make a better seal. I know you have experienced otherwise. But I'm thinking this way because I had been using 4" rings with little success and had some 2" rings that had better success. Nor a resounding success, but better. Which leads to a question: I hear of ring stacking but, so far, have not seen why one would do that. Would stacking cause further pressure for a better seal?

So your not getting a good seal, that's the problem. Why your considering a convex with a belt.

No doubt there is increased pressure using a convex + belt which could attribute to having a more secure appliance. But a lot has to do with holding power into the skin surrounding the stoma, because even with a convex I still had leaks if I didn't make sure a good bond occured and skin covered right up to the stoma, which it's rather easy to get wrong or sloppy with a ring in my experience.

Rings melt so stacking them isn't going to bring you the pressure your looking for in lew of a convex wafer.

If you make that convex choice I recommend Coloplast for their four hook and wider belt + their convex. The one piece bag (like mine) is likely what you should start out with first before moving onto a possible two piece system.

I bend my convex and the belt hooks into a v shape so it fits into the belly fold better, this has been the best I've been able to do .

Okay, what is the condition of the skin surrounding your stoma?

You said there is a belly fold right?

Is the stoma recessed, flush, partially flush or sticking out quite a bit?

Are you laying flat most of the time or moving around, bending over etc.? Sitting up or in a chair quite a bit? Driving?

Explain your current product(s) and your application procedure in detail.

Thanks.


To let you know I'm sort of only a one year newbie at this myself and have been using convex with a stiff wafer and a belt for my near flush stoma.

My problem is I have a belly fold, so I'm folding the convex in half horizontally to weaken it a bit so it fits and flexes better. I also put a thin pre coat of non sting paste first to ensure it bonds good to the skin, then a protective sheet in top, then a little more paste to marry and take care of unevenness between that and the wafer/bag convex one piece. I have had only a tiny ring of slightly damaged skin around the stoma, even a few times it was completely healed, but driving around moves my body and likely shifting things to cause leaks which are tiny, but annoying.

I think near/flush stomas with a belly fold combined with an active lifestyle has to be one of the hardest problems to solve, but I keep throwing myself at it.

I can help you get very close, but I'm not currently at perfection yet, but trying.

[Old_guy]

Actually, the skin just below the stoma only has a slight fold while laying flat. Then it folds when sitting or squatting. At the moment we are using Hollister 8331 one piece bags. The record with no leaks is four days. I've been thrown in the deep end and the most my application has lasted was a bit over 24 hours. I've tried stretching and scrunching the skin while installing the bag. The stoma sticks out a bit over 1/4", so it sticks out beyond the base of the bag, with a ring, just a little bit. I apply a thin layer of stoma paste around the hole of the bag before putting it on the ring. Then I press and press trying to mush everything together and onto the skin. Then I get a warm rice bag and have her lay flat with that for 20 minutes. I try to get a good seal of the ring to the skin, but I'm thinking the way the skin fold below the stoma to the wound really must change with movement for that is where most of the leaks occur, right into the wound. Really only considering a convex system if it can remain secure with only the adhesive because a belt would go right over the wound.

[Shamrock4806]

Actually, the skin just below the stoma only has a slight fold while laying flat. Then it folds when sitting or squatting. At the moment we are using Hollister 8331 one piece bags. The record with no leaks is four days. I've been thrown in the deep end and the most my application has lasted was a bit over 24 hours. I've tried stretching and scrunching the skin while installing the bag. The stoma sticks out a bit over 1/4", so it sticks out beyond the base of the bag, with a ring, just a little bit. I apply a thin layer of stoma paste around the hole of the bag before putting it on the ring. Then I press and press trying to mush everything together and onto the skin. Then I get a warm rice bag and have her lay flat with that for 20 minutes. I try to get a good seal of the ring to the skin, but I'm thinking the way the skin fold below the stoma to the wound really must change with movement for that is where most of the leaks occur, right into the wound. Really only considering a convex system if it can remain secure with only the adhesive because a belt would go right over the wound.

Is this "wound" a result of surgery etc. or it is it a burn caused by the leak? Because it's difficult to secure to or over a large wound (say a surgery scar) while it's healing as the skin is moving and will pull off the bag causing leaks in my experience. If this is the case then laying flat on nearly all the time and orienting the bag to the side for drainage may be required until it does heal up better and you can reassess.

Again the idea with a convex is the bottom of the wafer section (+ bag if a one piece) is slightly curved as to fit snugger around the stoma and combined with a belt, place pressure around the stoma to get it to stick out a little. Likely does give a tighter seal and less resistant to movement issues. But it's the bonding of the paste, ring etc that matters most.

The belt attaches around the waist and connects to the right and left sides of the wafer. So if the wound is below the stoma then it shouldn't interfere with it any.

I think in your case if your draining vertically, that a convex would be better suited. So yes try a convex but the belt comes along for the ride. Also so does extra adhesive strips as the wafer adhesive doesn't always stick to the skin (because of the convex) so you need those to go around to help contain a leak and keep things in place better.

I see one problem your having and that's applying the paste to the wafer instead of to the skin. You just can't trust that pressing it is going to do as expected and get all nice and snuggly against the stoma. Or that it will stick for that matter. I know you feel your pressed for time, because the stoma could go active on you and ruin things, but that bonding around the stoma to the skin about a half an inch around is vital for success.

Your likely changing the appliance if a leak occurs. It should be removed if a leak occurs or a burning stinging sensation is felt, however time is required for the stoma to quit spewing as it's oils and water etc that makes the skin not bondable. Paste and rings are resistant to water and oils thus not going to bond with the skin if skin is not washed and clean and very dry.

So time sitting in the shower or on a toilet with a handheld bidet may be required to wash away output until stoma has settled down. When it does then you give a final moisturizer soap wash, rinse and pat towel dry and head to your bed or changing table.

Then a blow dryer set on low to speed up the skin drying process and make sure skin is very dry to the finger tip touch, almost rough and chapped a little, then some stoma powder and then skin protectant etc..depending upon the damage to the skin around the stoma. I don't know much about this wound your describing so I'll need more details.

Then you use a small flat stick like a tongue depressor but smaller and apply the paste with a downward pressure around the stoma and right next to it. A thin protective layer out a half an inch around as a first coat to ensure a bond and the skin is protected. You'll know if the paste is sticking or not by how it sticks. Remove, discard and dry out again and retry until it does.

Then once that's done you put a slightly thicker bead slightly away from the stoma to take care of any unevenness and then squash the wafer on. You don't want the stoma covered over. Next it does take time for the paste etc to dry and set up so it seems your doing that procedure properly.

She will have to remain laying flat or not bend over until you get a convex system in place.

You may want to try bending and weakening the flat (or convex) wafer right where her belly fold is, then crunch a little and get it to fit snugger. Remain like that until the paste sets up.

Try to go for a 50/50 balance, a sort of halfway point between bending completely over and standing straight up. When sleeping she should remain on her back with pillows or slightly elevated or on her right side in a more fetal position. Walking straight up or bending backwards is a no go, a slight hunched over approach is maintained as not to try not to disturb the bond and cause a leak.

So provide more details about this wound and what it looks like, how far out from the stoma etc. Is it bleeding? Are there lumps? Scabs? Red and irritated skin only? Mild pink or very red?

Are you cutting the hole in the wafer correctly? It needs to be slightly larger than the stoma and the stoma may not be round, but oval..also deburring the sharpies, pushing the hole edge in a bit and lining it up correctly is key also.

I use Flonaze (the nose spray) as a skin protectant, because it has an antihistamine, I spray into the cap and pour it around the dry stoma and spread it to cover adhesive areas. Thicker inside and thinner outside. It takes the pain away right away and makes the skin baby smooth for easier removal later. It also protects better with a leak, I feel a irritation but not burning initially so that lets me know to take care of it and lessons the damage if I'm out and about. The key here is thicker coating of skin protectant next to the stoma for maximum protection from a leak. The outer areas get a thin coating as to protect against adhesive irritation only. But drying out well is absolutely vital.

Eating small nutritious meals frequently and in the morning and early afternoon with only a small snack at night seems to work well. Less nighttime bathroom visits and sleep caused blowouts. (A belt and convex will help here). One has to time their bag changes also, usually 3-5 days or so depending upon activity and heat sweat. Sweating will cause a bag to come off, so maintain a good cool environment..want to take a bag off, take a long hot shower.

Lukewarm showers with the bag covered in plastic bag with a bit of waterproof tape (medical) along the top seems to work..a convex belt helps with this as you can stick the bag into the belt and just tape the top. But bank that the next day you'll need a bag change and a real hot shower.

[Shamrock4806]

Okay back to my story.

I'm back to the Flonaze, thin no sting paste, protective sheet, more paste and normal convex (but bent a little) plus belt system like before..

After two days of driving it hurts like hell.

3.5 more hours and I'll be home ripping this damn thing off and taking a nice long soothing hot shower.

I was having mixed results with my contraption method and nothing showing for longevity and handling long drives/sitting. My problem appears shear stress related. It does go away if I put the seat back, so perhaps one of those extra wide waist bands with the hole for the pouch in them is in order. Keep my belly flat etc.

A fresh new bag and a good night's sleep.

[Mysticobra]

What is it that you do that requires all the driving?
Richard.

[Shamrock4806]

What is it that you do that requires all the driving?
Richard.

Just retired and having fun.

[Mysticobra]

Ok.

I have a permanent and driving doesn't bother it.

[Shamrock4806]

Actually, the skin just below the stoma only has a slight fold while laying flat. Then it folds when sitting or squatting. At the moment we are using Hollister 8331 one piece bags. The record with no leaks is four days. I've been thrown in the deep end and the most my application has lasted was a bit over 24 hours. I've tried stretching and scrunching the skin while installing the bag. The stoma sticks out a bit over 1/4", so it sticks out beyond the base of the bag, with a ring, just a little bit. I apply a thin layer of stoma paste around the hole of the bag before putting it on the ring. Then I press and press trying to mush everything together and onto the skin. Then I get a warm rice bag and have her lay flat with that for 20 minutes. I try to get a good seal of the ring to the skin, but I'm thinking the way the skin fold below the stoma to the wound really must change with movement for that is where most of the leaks occur, right into the wound. Really only considering a convex system if it can remain secure with only the adhesive because a belt would go right over the wound.

Okay she still needs to remain in bed or assisted into standing straight up without bending over or sitting up.

With a open wound a belt is out of the question until the wound is healed. So since a convex needs a belt you can't use a convex just yet.

So she needs to drain the bag sideways and I suggest popping in an antacid where the stoma is, allowing the output to pool there (pancaking we call it) as the antacid will neutralize the acid and thus tiny leaks that are not escaping the confinement shouldn't be hurting or causing the skin to get inflamed and thus loosen even more paste etc and make the leak larger until it does escape the confines of the containment.

Of course one needs to make sure the adhesion is excellent and also extra seals around the outside using extra adhesive strips or tape.