Question: Managing Ileostomy Adhesion Issues at 84 Years Old

I am 84 years old and have been living with an ileostomy for about 29 years. Recently, a skin sag developed below my stoma, causing problems with the adhesion of my appliance. I use the ConvaTec SUR-FIT Natura Stomahesive Flexible wafer and Coloplast Brava strip paste to manage the sagging. I also apply 3M Medipore H Surgical tape for extra support, resulting in a wide area covered by surgical tapes. Do you have any suggestions for reducing the extent of this area?

Response: Optimizing Ileostomy Management in Elderly Patients

Your situation presents a common challenge for long-term ostomates, especially as skin changes with age. Here are some recommendations to improve appliance adhesion and reduce the extent of tape usage:

  1. Try a Convex Flange: A convex flange might be more effective for your condition. Convexity in ostomy supplies is designed to provide an optimal seal around the stoma, especially useful for irregular skin contours like yours. It curves inward toward the stoma, ensuring a secure and firm attachment.
  2. Contact Manufacturer for Samples: Reach out to ConvaTec’s customer service and request a sample of their convex flange/system. Trying different styles of convexity may help you find the most suitable fit. If ConvaTec’s options don’t work, don’t hesitate to contact other ostomy manufacturers for samples.
  3. Utilize Online Resources: Use the Peristomal Skin Assessment Guide at psag-consumer.wocn.org to assess your ostomy issue and explore suitable solutions.
  4. Consult a Professional: Consider consulting with a Nurses Specialized in Wound, Ostomy, and Continence (NSWOC) for personalized advice. NSWOCs are trained to deal with complex ostomy care situations and can offer tailored solutions.
  5. Experiment with Different Products: The various ostomy manufacturers produce high-quality and varied products. It’s worth trying different products to find the one that suits your specific needs and skin type.
  6. Adjust Your Routine: Re-evaluate your current appliance application routine. Sometimes minor adjustments in how you prepare your skin or apply the appliance can make a significant difference.

Your persistence and proactive approach to managing your ileostomy are commendable. With the right products and support, it’s possible to find a more comfortable and less cumbersome solution to your adhesion challenges.

Jo-Ann L. Tremblay
THE OSTOMY FACTOR Blog – joannltremblay.wordpress.com
Ostomy Lifestyle Expert Member of Ostomy Canada Society
Medical Lifestyle Advisory Committee Member
Arteast
jo-annltremblay.com

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