Leaking Skin Barrier- Floating Flange and Tape

[GerryW]

I am only getting 3 -4 days use out of Hollister 14202’s before urine starts to penetrate the adhesive tape. I amholding my hand on the appliance for about 2 minutes to help the adhesive to set and am using a support belt. I need to get better reliability before I return to work next week. Any suggestions appreciated. 14202 Lot#5J102.

Kingston and the 1000 Islands

[GerryW]

Maybe a double bead of barrier paste instead of just one (shown) that I use right now???

Kingston and the 1000 Islands

[Jack Moon]

Gerry, I sent you a private message. We have a member that would like to assist you via telephone.
Please check your messages.
Thanks,
Jack

[GerryW]

Thank-you for putting me in touch with other external pouch users. I have learned a lot and hope to see occasional events here in Kingston for ostomates to meet and share.
I am making progress trying different products to find the most reliable for me.
Key things that I have learned:
** Not to use paste because my skin is smooth. Paste on the wafer reduces the adhesive area and can cause early failure.
** Wafer removal in the shower works great.
** I’m currently using a stoma guard and have got 6 days sofar on a wafer. The guard prevents my belt from pressing on the wafer. It also prevents restriction of flow down into the pouch.
** More drying time prior to wafer application for better adhesion.
** A light dusting of stoma powder, then wiped off with a dry tissue, seems to help adhesion and prevent skin redness under the wafer.
** Some wafers are waterproof. Manufacturer told me I can use my hot tub and pool again!

Kingston and the 1000 Islands

[KIOWA]

Hey Gerry. When I thought I might have to have my bladder removed and recycled (which fortunately didn;t have to happen) I called Hollister to prepare ahead of time. They were extremely helpful. I actually used their system although I did not have a stoma to put it on. I just put ot pn my belly button and filled the container with water. I did all sorts of things to see ;under what conditions it would leak. I called Hollister when I had a problem and they walked me through it. I can only add that from what I have leared from others with this system that it can take a while before the body adapts and it takes a while to get down to that perfect system. People I have talked to never have reached 100% reliability but I have never had a100% reliability with my own natural bladder. I wish you the best. Keep us informed.

[GerryW]

I am now getting 5-7 days out of my pouching system. Main reasons for this were:
** drying longer before adhering new wafer
** using larger wafer (Hollister 14603 works for me) which lets me put pressure directly on adhesive portion with fingers through pouch attachment during installation.

I notice also that the Hollisters leave less adhesive residue than other wafers that I have tried sofar and their cloth portion outside of the adhesive ring gives a warning of impending leakage.

Only remaining concern is that I can’t go swimming or in my hot tub any more. I’ve tried products that supposedly keep water out like ‘Sure Seal Rings’ but invariably, water gets under the flange around the pouch snap-on ring, dampens the wafer fabric causing $$$ failure $$$ in about 24 hours. I’m open to any solutions…. missing the pool.

Kingston and the 1000 Islands

[Gene]

Hello Gerry,

I use the Coloplast system and I used to have the same problem with the flange not adhering properly. The following are the steps I take when removing the old flange and putting on the new one:
REMOVAL
1. I use alcohol based adhesive remover pads purchased at the local drug store to assist with flange removal and ensure area is really clean after flange is removed.
2. Next I spray an antibacterial agent called Sproam onto a 2 inch square gauze pad and wipe the area around the stoma.
3. I then use a wet J-cloth to clean off the antibacterial agent.
4. I then dry the area using a blow dryer with a diffuser attachment. I found for me this was most important to have the area dry.
INSTALLING NEW FLANGE
1.I apply a small amount of hydrocortisone cream around the stoma to help with minor skin irritations.
2.Next I place a Brava moldable ring over the stoma and then apply the flange making sure my stomach is extended and pressing firmly over the whole area to ensure a good bond.
3.I apply a small amount of Stomahesive powder around the stoma (even it out with a Q-tip) and then place the bag onto the flange. I use a Brava support belt attached to the flange.

This sounds like a lot of stuff to go through but it only takes about 15 minutes from start to finish after you get organized. My wife has been a huge support for me and helps me with the process.

I once had my flange on for 2 weeks just to see how long I could go. Now I change it every seven or eight days. I’ve been able to use the hot tub and go swimming as much as I want between changes with no sign of adhesive loosening or impending leakage.

I had my surgery on Dec. 18th of last year. It took about six months of trying different things. This method is really working well for me.

Gene

[GerryW]

Two weeks! Wow.
I’m afraid to go more than 5 days with my system because I’ve got a bit of irritation around the stoma after 6 days. Takes about 3 days to recover with the use of barrier spray.
I’ll take another look at Coloplast.
One benefit of Hollister is that I don’t get any adhesive residue.
Thanks!

Kingston and the 1000 Islands

[Gene]

I have virtually no irritation with this method, a minor red spot or two under the stoma. Hopefully you’ll find something that works well for you.

[GerryW]

I’ve kept a database of products and wear times since January. I’ll check out results for Coloplast samples and give one another try now that I’ve had more experience with changes.

Kingston and the 1000 Islands

[GerryW]

Thanks Gene and Kiowa for your feedback! I wish that I could use a plastic surround wafer like the Coloplast that you use, Gene, but the plastic tends to lift on me when I am working, causing leaks, so I use a cloth surround type which conforms better to my shape. I will keep some hydrocortisone cream handy to cure any skin irritation that might start before it becomes a problem. I don’t need to use a barrier ring or paste because my skin is smooth without any low spots to fill.
I had my RC with an IC option back in January 2016. I now average 4 days per wafer sometimes less in hot/humid summer weather when the wafer gets damp from sweat.

I am currently using Hollister 2 piece 14603 because it leaves no adhesive residue and dampness in the tape surround warns me of an impending leak.

I can use a smaller wafer, but I think that the larger one has more adhesive area for longer life and I can also press it easier around the stoma with my fingers during application.

I use the two piece to keep cost down because I usually use two wafers per one pouch.

Five days is now my optimum wear time. Longer than that, and I get some skin irritation around my stoma. I found that using a hair dryer to dry my skin and warm the wafer and make it more flexible and tacky before application and using a barrier spray like 3M Cavilon or Sureprep helps prevent skin irritatation and heals skin damage in 3-5 days.
My only remaining concern is that I cannot go swimming any more because I need the flexibility of a cloth-surround wafer for adhesion.

Kingston and the 1000 Islands

[Gene]

Hello Gerry,

Hope you’re doing well. I noticed a picture of a stoma guard in one of your earlier posts. I have one but it’s pretty cumbersome. Where did you purchase yours?

[GerryW]

Hi, Gene!
Two years in, and I am feeling good and used to my new routine. Still, however, searching for an appliance that will not fail in my hot tub or swimming pool….. a minor inconvienience in the grand scheme of things.
I was given the Convatec Stoma Guard by my ET nurse before I left the hospital. I only wear it now when there is danger of getting bumped. I have found that, in my experience, the stoma guard or a brief test with suspender vs belt did not make any difference in appliance reliability.
Regardless, I always use a support strap with my appliance to provide support to help prevent a hernia around the stoma.
Attached is a pic of my current appliance replacement ‘kit’.

Kingston and the 1000 Islands

[Gene]

Hi Gerry,

Thanks for your quick post. Glad to hear you’re doing OK. I hope you find something that will get you back in the water!

The main reason I wanted a stoma guard was to allow drainage into the pouch while wearing a belt for dress up occasions. The stoma guard I have does that, I was interested in something a little less awkward than the one I have. There doesn’t seem to be much information available on stoma guards anywhere. I’ll try finding something by Convatec.

[Author]

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