Skin prep for ileostomy

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Chickspeed
Posts: 43
Joined: Sat Jun 17, 2017 5:16 am

Skin prep for ileostomy

Postby Chickspeed » Sat Jul 08, 2017 9:20 am

I am having some issues with leakage. Is there a good skin prep I can use to help protect my skin?
12/15/2016 Mod Diff tumour 5-6 cm 10-12 cm fr AV T3 tumour cea 1.4
12/29/2016 CT no spread ln normal
1/19/2017 MRI confirms mass and shows 3 enlarged LN (suspected to be infection draining)
3/6/2017 25 sessions chemoradiation
6/20/2017 LAR with temp loop ileo
7/10/2017 Path 20mm margins tumour 0.1 CM with microscopic invasion of submucosa
aug-dec 2017 6 rnds xeloda
1/9/2018 CT all clear
1/18/2018 Colonoscopy clear
3/27/2018 ileo reversal
CEA continues to be normal

Aqx99
Posts: 403
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Skin prep for ileostomy

Postby Aqx99 » Sat Jul 08, 2017 10:40 am

Do you have access to an ostomy nurse? They can help you find a better system if your current one isn't working. That being said, I use ConvaTec AllKare protective barrier wipes every time I change my pouch. I also use a convex wafer, since my stoma is flush with my skin.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Dx, Age 39
2/21/17 CEA 0.9
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Dx w/ovarian cancer
9/6/17 CA 125 11.1
11/27/17 CEA 2.6
12/5/17 CT NED
12/13/17 CEA 2.9
1/11/18 CA 125 8.6
1/23/18 Reversal
3/21/18 CT enlarged thymus
4/6/18 PET NED
7/10/18 CT NED
7/11/18 CEA 2.6
9/18 Bilateral Prophylactic Mastectomy

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Skin prep for ileostomy

Postby MissMolly » Sat Jul 08, 2017 12:24 pm

Chickspeed:
You likely have a temporary loop ileostomy. Know that this ostomy is the more difficult stoma to pouch successfully as compared to an end ileostomy or colostomy.

The best ostomy product to limit leaks is an adaptic ring- these go by the names of Ekin Cohesive Seal (by Convatech) and the Adapt Ring (by Hollister) and the Brava Ring (by Coloplast). An adaptive ring acts like a gasket in a water faucet. Very effective in minimizing dreaded leaks.

For skin protection I recommend Cavilon Liquid SkinPteo by Nexcare. It comes as a spray and as individual towelettes.

For advanced skin healing due to excoriation there is nothing better than Marathon Liquid Skin Protectant. Marathon is available on Amazon as is Cavilon.

Come over to the United Ostomy Association at www.ostomy.org
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Chickspeed
Posts: 43
Joined: Sat Jun 17, 2017 5:16 am

Re: Skin prep for ileostomy

Postby Chickspeed » Sat Jul 08, 2017 12:58 pm

I was told crusting will help with healing as well.

I use the following:
1st flovent (dr says it will help)
2nd stoma powder
3rd skin barrier spray

But I watched some youtube videos today that say use powder and skin prep pads to do crusting
but my output is unpredictabe.

Yes I have a temporary loop ileostomy
12/15/2016 Mod Diff tumour 5-6 cm 10-12 cm fr AV T3 tumour cea 1.4
12/29/2016 CT no spread ln normal
1/19/2017 MRI confirms mass and shows 3 enlarged LN (suspected to be infection draining)
3/6/2017 25 sessions chemoradiation
6/20/2017 LAR with temp loop ileo
7/10/2017 Path 20mm margins tumour 0.1 CM with microscopic invasion of submucosa
aug-dec 2017 6 rnds xeloda
1/9/2018 CT all clear
1/18/2018 Colonoscopy clear
3/27/2018 ileo reversal
CEA continues to be normal

User avatar
Sophy
Posts: 261
Joined: Fri May 27, 2011 2:46 am
Location: New Zealand

Re: Skin prep for ileostomy

Postby Sophy » Sun Jul 09, 2017 5:20 am

Chickspeed

you have my sympathy, I know it is difficult to deal with an ostomy, both the physical and mental adjustment.

I found the cavillon wipes and spray helped and the powder was good too. I have a reaction to plasters and the glue on the bag caused a constant painful rash wherever it touched.

I read advice here to get a little time of ileostomy inaction by 'stunning it with marshmallows and peanut butter followed by a glass of iced water' which sounds crazy but it worked - I found could get me about 15 minutes for drying out my skin without a bag attached.

Good advice from Miss Molly to check out ostomy.org and though I realised after a few days that if I did need it to be permanent then I would be able to learn to live with it and in the meantime it was helping to save my life. It was also great to have for chemo - no constipation or diarrhoea problems.

Hoping that things will get easier for you
Sophy
dx T3N1M0 Feb 2011 when children age 11, 7 and 2
Xeloda/rad March 11, LAR June 11 temp ileo
Xelox 6 rounds, NED
Lung mets Oct 13
Laser surgery Germany Jan 14. 3 mets left lung.
Laser surgery UK Jun and Aug 14 one met each lung, NED
Aug 14 Started Xeloda and Celebrex (ADAPT)
June 20 CT shows nodule, bronchoscopy confirms is scar tissue, still NED
Dec 20 stopping Xeloda continue celebrex, cimetedine
Aug 21,March 23 scans show still NED
March 2023 CURED - discharged from Oncology, no more scans or follow up

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Skin prep for ileostomy

Postby MissMolly » Sun Jul 09, 2017 8:30 am

Chickspeed:
Your surgeon's suggestion of a spray and spritz of Flovent is A-OK. Flovent is similar in action to Benadryl and will lessen skin inflammation due to irritation.

Skin irritation is more apt with a loop ileostomy due to the location of the stoma placement higher up the small intestine than an end ileostomy or colostomy. This means that the fecal output is more liquid in consistency and higher in caustic enzymes. Liquid output more easily undermines an ostomy wafer as a cause of dreaded leaks. Caustic digestive enzymes in contact with the skin are a source of genuine skin irritation and excoriation.

I highly recommend use of an Ekin Cohesive Seal (by ConvaTec) (or similar hydrocolloid ring by another manufacturer). The Ekin Cohesive Seal is a ring of hydrocolloid material that you can stretch and mold around the stoma. It acts like a gasket in a water faucet.

The Ekin Cohesive Seal is the Gold Standard in minimizing leaks. It is a go-to item for most people with an ileostomy and highly liquid fecal output.

The advice to visit with a stoma nurse or Wound Ostomy. CAre Nurse (WOCN) by Lisa is sound advice. There are a gazzilion ostomy products and your body and skin type and skin topography may do better with a different pouching system than the one you were sent home with. Hospitals tend to contract with one ostomy supply manufacturer in issuing products to new ostomy patients. You may find that there is a better "fit" of wafer and poaching system than what you were first issued by the hospital where you had your surgery. I was sent home with Hollister and switched gears to Coloplast and CyMed as my go to ostomy systems.

Finding what ostomy brand and products work best for you is an individual process. Working with a WOCN can be ever-so-helpful when you are new to an ostomy as they can narrow down product options and provide learned experience.

Another tip to lessen skin irritation: Do not pull the wafer away from the skin when removing. Pulling a wafer up and off of the skin damages the top epitheal layer of skin and leaves skin vulnerable to further damage. Instead, remove a wafer by pressing into the skin with your fingertips along the outer margin of the water, pressing down on the skin and pushing the skin away from the wafer. Work along the edge of the wafer, pushing the skin away from the wafer in small increments until the water is fully released.

You can also purchase sprays that loosen the heat-activated bond of the wager to the skin. A few sprays of a skin prep remover product and the wafer will fall off if the skin like Teflon. Skin prep remover sprays are sold under the manufacturer names of Torbot Skin Prep Remover and Safe 'n Simple Skin Prep remover. As the name implies, these spray formulations are designed to remove any accumulated build up of ostomy care product in the skin.

You are welcome to visit the United Ostomy Association forum and ask questions to seasoned ostomy veterans. Most people in the ostomy forum have permanent ostomies and years and years of experience - spanning an array of the common and the not-so-common stoma occurrences. The group also comes with a good sense of humor.

http://www.ostomy.org

Sending you best wishes for healthy and intact skin,
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

sadysue
Posts: 986
Joined: Tue Aug 02, 2011 6:59 pm
Location: Charleston, TN

Re: Skin prep for ileostomy

Postby sadysue » Wed Jul 12, 2017 1:39 pm

I used a no-sting skin prep. It worked great but unfortunately, I can't remember the manufacturer. It might have been convatec since I used a lot of their products. Good luck!
Rectal dx 4/2011 (Stage 3B - T3N1M0)
5FU/Rad - daily/6 wks ending 6/2011
Surgery 8/19/2011
Finished 8 rounds Folfox 2/2012
Ileo reverse and port out 3/2012
NED


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