Question

I have just recently undergone colostomy surgery and on my 3rdweek of recovery. During the first week, the stoma nurse at the hospital applied the ostomy bag, and the seal seemed to work wonderfully. Since I have been home I am constantly having an issue trying to ensure that the fit and seal are secure. Hence I have developed some skin irritation around my stoma. I have a recessed stoma and between my stoma nurse, regular care nurse, and myself we are not finding a solution. If you have any tips or things that I can try that would be much appreciated.  

Response

When you experience leakage the key to success is to pinpoint the source! Ensuring that the fit and seal around your stoma is secure, there are a number of tips to assist you in staying leak-free: Make sure your skin barrier fits properly. It doesn’t matter whether your stoma is large or small, or whether it protrudes or not, as long as the drainage flows into your pouch without leaking under the skin barrier. A proper fitting skin barrier/protective seal is the key to reducing leakage. It is important that the hole in the barrier fits the diameter and shape of your stoma exactly. There are various types of barriers/protective seals produced by the ostomy equipment manufacturers, that will help you customize your barrier equipment designed to help reduce leakage and protect the skin.

• In the box with your ostomy flange supply, the ostomy equipment manufacturers provide a template to measure the stoma. Measure your stoma with the template, and check to see if your current flange opening matches. If the hole is too large, this may be your leakage source.
• Apply the flange/skin barrier, making sure it fits where the skin and stoma meet.
• Verify that no skin is showing between the skin barrier and the stoma.

Take special care when removing your ostomy skin barrier. Improperly or rapidly removing of your skin barrier could cause skin stripping. The associated damage could lead to irritation, pain, and leaks. So, take your time, gentle and slow is best. Gently peel the barrier away from the skin, starting at the top and working downwards, while pressing against the surrounding skin. Change your ostomy pouch on a regular basis. It is important to change your pouch on a regular basis before it is susceptible to leakage. An overfilled or overweight pouch causes undue strain on your skin barrier attachment to the skin, which could lead to leakage. Pouching system wear time is based on personal preference, your unique stoma, and output. Do you have creases and folds that make it difficult to get a secure seal around your stoma? If the skin around your stoma has creases, folds, or other irregularities, it may be difficult to get a secure seal around your stoma. It may also be more difficult to achieve consistent contact between the uneven skin surface and your ostomy barrier. Difficulty obtaining a proper seal can create a risk of leakage. Make sure your ostomy pouch is secure during exercise or physical activity. If you are participating in sporting activities or other forms of exercise, you can wear certain clothing or accessories that can help ease your concerns. Many of the Ostomy equipment manufacturers provide services to help you find the right product mix for you. They have a specialist on staff who will assist in providing personalized support. Sometimes it’s a matter of trial and error. And so, after a session with one of their experts, they will make their suggestions, followed by mailing free samples to help you find the right ostomy products and accessories to ensure good skin health and help prevent leakage. A good starting point will be to go onto the website of the manufacturer of the product(s) you’re using currently, and make contact with one of their experts. Discuss your issues and request some of their suggested products for you to try. You can also connect with other ostomy equipment manufactures and request their expertise and products, in order to try other leakage prevention products they suggest, such as skin barrier rings, paste, and strips. Some of the ostomy equipment manufacturers provide personalized support programs that offer support and education (videos, etc.), when you need it, on their websites. Every stoma is unique, so you will need to determine what is best for you by working with your stoma care nurse, and your ostomy product manufacturer. This will assist you in keeping up with the latest products and research. Through a bit of trial and error, trying a mix of leakage prevention products, and personalizing your equipment, you will be successful in living leakage-free! Jo-Ann L. Tremblay
THE OSTOMY FACTOR Blog – joannltremblay.wordpress.com
FACEBOOK – Author Jo-Ann L. Tremblay
TWITTER @joanntremblay
Author of “The Self-Coaching Toolbox” , “Better With A Bag Than In A Bag” , “Another BAG Another DAY”, “BAGs Around the World”, Why Buttercup Wears a BAG!”, “The Sibs Gang Cave of the Golden Heart”
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Member OstomyCanada /Medical Lifestyle Advisory Committee Member- Ostomy Lifestyle Expert
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Website: jo-annltremblay.com     Our friends over at Nurses Specialized In Wound, Ostomy And Continence Canada (formerly called The Canadian Association for Enterostomal Therapy (CAET)) have renamed their handy look-up page on their website. It was formerly called “Find An ET Nurse” and is now called “Find a NSWOC“. Click on the image to the left or link here to go to their site.