Question: Seeking Effective Solutions for Chronic Wet Red Fungal Infections Under Ostomy Appliances

I am struggling with chronic wet red fungal infections under my ostomy appliance. I’ve tried crusting with limited success, and while Tinactin provides some relief, the issue persists. I’ve heard about Arglaes (now Medline Ag + Powder) as a potential remedy but am unsure about its application. Could you provide guidance on managing this issue effectively?

Response: Strategies to Combat Fungal Infections in Ostomy Care

Thank you for reaching out with your concern about the persistent fungal infection under your ostomy appliance. Fungal infections, especially under ostomy appliances, can indeed be challenging due to the warm, dark, and moist environment they thrive in.

Key Strategies for Managing Fungal Infections:

1. Minimize Favorable Conditions for Fungal Growth: The fungus flourishes in warm, dark, and moist areas. It’s crucial to alter this environment:
   • Expose as much skin around the pouching system as possible while maintaining a secure seal. Consider trimming the tape edge or barrier.
   • Use an ostomy belt for additional support.
2. Effective Use of Antifungal Powder: Tinactin is a recommended choice. To enhance its effectiveness:
   • Wash the skin with an antifungal soap like Dexidan, ensuring thorough rinsing.
   • Apply Tinactin powder around the peristomal area, dust off excess to ensure good adhesion of the appliance.
   • Reapply Tinactin powder sparingly to the exposed skin at least twice daily.
3. Frequent Appliance Changes: Initially, you may need to change the appliance more frequently (daily or every two days) to allow for cleaning and reapplication of Tinactin.
4. Skin Assessment Guide: Utilize the Peristomal Skin Assessment Guide for a systematic approach to assess your skin and find solutions. Access it here: Peristomal Skin Assessment Guide.
5. Understanding Arglaes (Medline Ag + Powder):
   • It’s an antimicrobial silver powder dressing, effective against fungi and bacteria.
   • Use it similarly to other powders, focusing on weepy, affected areas.
   • Apply sparingly and dust off excess. Remember, it’s a single-use product.
6. Consultation with Healthcare Professionals: If your condition persists beyond 7-14 days despite these measures, it is advisable to consult an Ostomy Nurse (NSWOC or WOC) or your physician for a more tailored approach.

These suggestions aim to modify the environment under the ostomy appliance, combat the fungal growth effectively, and promote healing. Remember, maintaining hygiene and proper skin care is crucial in managing such infections.

Wishing you relief and recovery from this challenging condition.

Kind Regards,

Andrea Manson
RN, BSN, NSWOC, NCA
Retired Healthcare Professional