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Sore Skin Problems
Ileostomy & Colostomy

1) Prevent Leaks

A common cause of leakage is a poorly fitting stoma appliance, usually cut too big which allows output to worm its way onto the peristomal skin. Make sure you measure your stoma on a regular basis, using the templates that are generally supplied with your bags (there's a size chart with holes that you can put over your stoma to measure it).

New ostomists may notice their stoma shrinks over the first few weeks of having it as the swelling from surgery reduces. Measuring regularly will help to keep the bag fitting snugly. Remember also to measure your stoma if you're putting on, or losing weight, as this can affect your stoma size too.

Sometimes the spout of the stoma is a little short, or retracts into the skin a bit, and the output drains poorly causing leaks. In such instances, it's worthwhile checking with your stoma nurse to see if a convex appliance which is curved to push your peristomal skin in, and your stoma out, is more appropriate.

2) Don't change your bag too often

Pulling off the flange & changing your bag too frequently can irritate your skin a lot. However not everyone feels comfortable changing their 1-piece bag every two or three days, so perhaps you could look into getting a 2-piece system where the backing plate and the bag is separate. The backing plate can stay on for a few days, and the bag itself can be replaced daily for freshness.

3) Don't use perfumed soaps or wipes

The peristomal skin can be quite sensitive, so use a gentle fragrance-free soap if you need to. I prefer to use warm water and the lint-free disposable dry wipes supplied by my delivery company. I reserve the fragranced wet wipes for cleaning my hands only. It's perfectly OK to shower or bathe without your appliance on. Again, I'd tend to avoid heavily perfumed shower gels and bubble baths and stick to plain water if this is your preference.

When washing, don't scrub too hard. The stoma is apt to bleeding because its blood supply is very good and close to the surface. Gently wipe and pat dry the peristomal skin before applying a new pouch.

4) Shaving

Men with hairy tummies often shave round their stoma so the appliance gets adhesion. Try not to 'dry shave' or use cheap blunt razors as this can cause a shaving rash or folliculitis which can become inflamed and sore.

Products to help sore skin

There are a great many products out there that help maintain peristomal skin health. If you have skin problems, it's best to get it looked at by a stoma nurse in the first instance as they can rule out skin problems secondary to IBD. However, the following list might give you an idea what to ask about.

Barrier cream: a skin barrier cream to use on areas that are frequently in contact with acidic body fluids. Forms a protective barrier against irritation.

Protective rings: a circular hydrocolloidal disc with a hole in the middle to fit your stoma, and goes under the bag to form an added layer of skin protection. Also swells to fill any peristomal gaps and crevices where output might creep.

Stoma paste: a protective hydrocolloidal paste that will give extra adhesion under the base plate or fill in gaps where output might creep. It can come in tubes like toothpaste, or in a more solid plasticine-like strip form where you roll it and mould it to your needs.

Stoma powder: Also used for dentures! A powder that can be sprinkled on wet, sore skin to dry it out and increase adhesion with the baseplate. Almost like stoma talc!

Skin wipes: A wipe that will dry to form a protective layer over the skin on which you can apply your bag

Orabase paste (by Convatec): A topical healing paste which can be applied to broken skin and certain peristomal skin conditions, e.g pyoderma gangrenosum to help it heal up. I use mine on a peristomal fistula and my PG when it flares up.

Medical adhesive removal spray: a convenient spray which will painlessly unstick your bag from your tummy, minimising skin irritation from a bag change. Also very useful for removal of painful adhesive dressings!

Convex appliances: curved appliance baseplates that push a flush stoma out and help to minimise leakage

 


 

These are just a few ideas. Remember your stoma nurse should be the first point of call and will be able to help you with prescriptions and appliances that match your particular skin needs.


· Kez on September 24 2011 Print
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The comments and articles posted on this site are the opinions and personal experiences of the author. They are not intended to replace or override the advice images or diagnosis of a qualified medical practitioner. Nothing contained herein constitutes medical advice of any kind . Crohn's Zone accepts no responsibility for actions taken as a result of messages, opinions or articles from this site or its contributors. ALWAYS consult a doctor regarding medical queries.

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