How much margin for stoma with cut-to fit?

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NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

How much margin for stoma with cut-to fit?

Postby NHMike » Sat Dec 02, 2017 5:39 pm

I took a picture of my stoma last bag change with a ruler next to it and have printed it out so that it's to size. So I want to make a template and am wondering how much margin to use for the template? Millimeters or inches will work.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: How much margin for stoma with cut-to fit?

Postby NHMike » Sat Dec 02, 2017 7:54 pm

I found an answer at https://www.meetanostomate.org/phpBB2/v ... php?t=5816

1/8 inch. That site seems pretty good for discussing Stoma issues but it will take me a bit of time to explore it.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

Aqx99
Posts: 279
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: How much margin for stoma with cut-to fit?

Postby Aqx99 » Sat Dec 02, 2017 9:48 pm

1/8th is the typical measurement, though there are exceptions. My ostomy nurse has me cut my hole much larger because of how my stoma lies flush with the skin. My output was going straight under the wafer when it was cut close, so she has me cut a 2 inch circle out and protect my exposed skin with paste. Everything is trial and error when it comes to your ostomy set up. Every single stoma is different and has different needs to make the pouch work.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL (Siemens Chemiluminescent Method)
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 Diagnosed w/ precursor ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL (Roche ECLIA Method)
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL (Roche ECLIA Method)
1/23/18 Reversal

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: How much margin for stoma with cut-to fit?

Postby NHMike » Sat Dec 02, 2017 10:38 pm

Aqx99 wrote:1/8th is the typical measurement, though there are exceptions. My ostomy nurse has me cut my hole much larger because of how my stoma lies flush with the skin. My output was going straight under the wafer when it was cut close, so she has me cut a 2 inch circle out and protect my exposed skin with paste. Everything is trial and error when it comes to your ostomy set up. Every single stoma is different and has different needs to make the pouch work.


The flange on mine is 2 1/4 inches so a 2-inch circle wouldn't leave much of the wafer sticky part to attach to the skin. My stoma is currently an oval about 1.5 inches wide and 3/4 inch high and it was cut relatively close - 1/8 inches last time. So I'll give this one a try. The tracing looks like a walnut right now. I'm also planning to go to three days per change to decrease the amount of irritation. Changing the bag is a pain but it's a good feeling after a change.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: How much margin for stoma with cut-to fit?

Postby NHMike » Sat Dec 02, 2017 10:41 pm

I did some analysis on the HLA Allels. HLA is short for Human Leukocyte Antigens and they appear to have effects on a wide variety of diseases. But I think that we only get six of them so you have a wide variety of who is resistant or can recover from individual diseases.

I wasn't able to find detailed frequency information on HLA-C*0802 but I did find that HLA-A*1101 is pretty common in East Asians.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: How much margin for stoma with cut-to fit?

Postby NHMike » Sun Dec 03, 2017 9:40 am

1/8 inch was too little. I need 1/4 using this approach
as a frontal view is deceptive to overall sizing. The fit today was tight. If it doesn’t work out, then I’ll change it tomorrow morning or sooner if it’s a big problem. The change took 20 minutes thus time. Not my best but far from my worst.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

MissMolly
Posts: 444
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: How much margin for stoma with cut-to fit?

Postby MissMolly » Sun Dec 03, 2017 10:46 am

Mike:
Do not be overly concerned of providing a strict 1/8 th inch allowance around the stoma.

Remember that stomas move in the course of a day. Aromas move in and out (retract and protract) in length, in concert with normal intestinal motility. Stomas also expand and contract in width, as bloodflow and interstitial fluids ebbs and flows.

Keep a flexible mindset when making your template. I keep to a 1/4 inch leeway when cutting my wafer. I use Cavilon Skin Protectant as part of my paristomal skin care routine, protecting the exposed paristomal skin from the caustic digestive enzymes. Ann (aqx99) has shared that she uses a dab of ostomy paste as a sauve on the exposed paristomal skin to minimize skin irritation.

A wafer trimmed too close has its own risks. The edges of the water can cut into the stoma and cause bleeding and trauma. A highly active aroma can be restricted by a wafer that is trimmed too close.

You may want to explore moldable wafers - offered by ConvaTech and Hollister. Moldable waters employ extended hydrocolloid material that encircles the aroma like a turtleneck. Moldable wafers are especially effective with stomas that protrude 3/4 inch to one inch. The moldable wafer has the advantage of no exposed paristomal skin - and, by extension, low incidence of skin irritation.

I endorse your decision to change your wafer more frequently. Changing the wafer every 3 days will give you opportunity to inspect the skin more frequently and to take a “naked” shower (a shower without wearing an Ostomy wafer, freely airing the skin). Removing a wafer in and of itself does not increase skin irritation. Take care to push the skin away from the wafer using your finger tips. Avoid pulling the wafer away from the skin. Pulling the wafer can irritate the skin by wisking away the outer epithelial layer of skin.

Many individuals with permanent ileostomies wear an elastic tube garment to hold the ostomy pouch close to the body when engaging in sports. Women’s maternity belly tubes are comparable. A valuable resource for undergarments designed specifically for individuals with an ostomy is a company named “Comfizz.” Comfizz is a family-owned company in England that has earned NIH recognition for their quality and product designs.
I have worn their camisole top and boy shorts for several years and highly recommend them.

www.comfizz.com

Best wishes,
Karen
Devoted daughter to my father, diagnosed with stage 2 colon cancer Nov-2014.
Dear friend to Bella Piazza, former CC member.
I have a permanent ileostomy and offer advice on living with an ostomy.
I have been on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression and recurrent infection x 4 years. I transitioned to Hospice Sept-2016, but it was not yet my time. I am back on Palliative Care and live a simple life due to frail health.

heiders33
Posts: 43
Joined: Sat Nov 04, 2017 11:08 am

Re: How much margin for stoma with cut-to fit?

Postby heiders33 » Sun Dec 03, 2017 11:57 am

Karen,

What product number is the moldable wafer from Hollister? I have tried so many different pouching systems with Hollister and Coloplast, and I continue to have irritated skin around the stoma. I wrap the Brava ring around the stoma and I cut the wafer pretty close but not too close, like you say. However, I'm at a loss to figure out which system is best for me. It seems like they all work about the same. My stoma protrudes about 3/4 of an inch.
35 year-old female
May 2017: Dx at T3N2M0
June-July 2017: 28 days of chemo/radiation
September 2017: LAR surgery with loop ileostomy
October 2017: started six rounds of mop-up XELOX

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: How much margin for stoma with cut-to fit?

Postby NHMike » Sun Dec 03, 2017 12:40 pm

MissMolly wrote:Mike:
Do not be overly concerned of providing a strict 1/8 th inch allowance around the stoma.

Remember that stomas move in the course of a day. Aromas move in and out (retract and protract) in length, in concert with normal intestinal motility. Stomas also expand and contract in width, as bloodflow and interstitial fluids ebbs and flows.

Keep a flexible mindset when making your template. I keep to a 1/4 inch leeway when cutting my wafer. I use Cavilon Skin Protectant as part of my paristomal skin care routine, protecting the exposed paristomal skin from the caustic digestive enzymes. Ann (aqx99) has shared that she uses a dab of ostomy paste as a sauve on the exposed paristomal skin to minimize skin irritation.

A wafer trimmed too close has its own risks. The edges of the water can cut into the stoma and cause bleeding and trauma. A highly active aroma can be restricted by a wafer that is trimmed too close.

You may want to explore moldable wafers - offered by ConvaTech and Hollister. Moldable waters employ extended hydrocolloid material that encircles the aroma like a turtleneck. Moldable wafers are especially effective with stomas that protrude 3/4 inch to one inch. The moldable wafer has the advantage of no exposed paristomal skin - and, by extension, low incidence of skin irritation.

I endorse your decision to change your wafer more frequently. Changing the wafer every 3 days will give you opportunity to inspect the skin more frequently and to take a “naked” shower (a shower without wearing an Ostomy wafer, freely airing the skin). Removing a wafer in and of itself does not increase skin irritation. Take care to push the skin away from the wafer using your finger tips. Avoid pulling the wafer away from the skin. Pulling the wafer can irritate the skin by wisking away the outer epithelial layer of skin.

Many individuals with permanent ileostomies wear an elastic tube garment to hold the ostomy pouch close to the body when engaging in sports. Women’s maternity belly tubes are comparable. A valuable resource for undergarments designed specifically for individuals with an ostomy is a company named “Comfizz.” Comfizz is a family-owned company in England that has earned NIH recognition for their quality and product designs.
I have worn their camisole top and boy shorts for several years and highly recommend them.

http://www.comfizz.com

Best wishes,
Karen


I saw the Moldable Wafers on Convatec's site but the descriptions aren't all that great in describing what they do. I have a bunch of other things to look at at MeetAnOstoMate forums. I'm going to see the Ostomy Nurse this week and maybe we can chat - or even better, show me some products.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

Aqx99
Posts: 279
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: How much margin for stoma with cut-to fit?

Postby Aqx99 » Sun Dec 03, 2017 1:30 pm

NHMike wrote:
Aqx99 wrote:1/8th is the typical measurement, though there are exceptions. My ostomy nurse has me cut my hole much larger because of how my stoma lies flush with the skin. My output was going straight under the wafer when it was cut close, so she has me cut a 2 inch circle out and protect my exposed skin with paste. Everything is trial and error when it comes to your ostomy set up. Every single stoma is different and has different needs to make the pouch work.


The flange on mine is 2 1/4 inches so a 2-inch circle wouldn't leave much of the wafer sticky part to attach to the skin. My stoma is currently an oval about 1.5 inches wide and 3/4 inch high and it was cut relatively close - 1/8 inches last time. So I'll give this one a try. The tracing looks like a walnut right now. I'm also planning to go to three days per change to decrease the amount of irritation. Changing the bag is a pain but it's a good feeling after a change.


Mine is also 2 1/4, but it sticks just fine. I change it every 4 days. I also use an Eakin ring to help seal up where I have creases in my belly that allow output to pool under the wafer. If you are having leaking, I suggest examining your wafer after taking it off to see if you can find where the leak is getting through. You should not have irritation under the wafer at all, it should be normal skin.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL (Siemens Chemiluminescent Method)
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 Diagnosed w/ precursor ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL (Roche ECLIA Method)
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL (Roche ECLIA Method)
1/23/18 Reversal

heiders33
Posts: 43
Joined: Sat Nov 04, 2017 11:08 am

Re: How much margin for stoma with cut-to fit?

Postby heiders33 » Sun Dec 03, 2017 1:47 pm

I just requested a free sample of the Eakin Ring and the moldable wafers from Convatec's website. I have a feeling this may be the solution to my problems.
35 year-old female
May 2017: Dx at T3N2M0
June-July 2017: 28 days of chemo/radiation
September 2017: LAR surgery with loop ileostomy
October 2017: started six rounds of mop-up XELOX

User avatar
susie0915
Posts: 551
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: How much margin for stoma with cut-to fit?

Postby susie0915 » Sun Dec 03, 2017 2:18 pm

MissMolly wrote:Mike:
Do not be overly concerned of providing a strict 1/8 th inch allowance around the stoma.

Remember that stomas move in the course of a day. Aromas move in and out (retract and protract) in length, in concert with normal intestinal motility. Stomas also expand and contract in width, as bloodflow and interstitial fluids ebbs and flows.

Keep a flexible mindset when making your template. I keep to a 1/4 inch leeway when cutting my wafer. I use Cavilon Skin Protectant as part of my paristomal skin care routine, protecting the exposed paristomal skin from the caustic digestive enzymes. Ann (aqx99) has shared that she uses a dab of ostomy paste as a sauve on the exposed paristomal skin to minimize skin irritation.

A wafer trimmed too close has its own risks. The edges of the water can cut into the stoma and cause bleeding and trauma. A highly active aroma can be restricted by a wafer that is trimmed too close.

You may want to explore moldable wafers - offered by ConvaTech and Hollister. Moldable waters employ extended hydrocolloid material that encircles the aroma like a turtleneck. Moldable wafers are especially effective with stomas that protrude 3/4 inch to one inch. The moldable wafer has the advantage of no exposed paristomal skin - and, by extension, low incidence of skin irritation.

I endorse your decision to change your wafer more frequently. Changing the wafer every 3 days will give you opportunity to inspect the skin more frequently and to take a “naked” shower (a shower without wearing an Ostomy wafer, freely airing the skin). Removing a wafer in and of itself does not increase skin irritation. Take care to push the skin away from the wafer using your finger tips. Avoid pulling the wafer away from the skin. Pulling the wafer can irritate the skin by wisking away the outer epithelial layer of skin.

Many individuals with permanent ileostomies wear an elastic tube garment to hold the ostomy pouch close to the body when engaging in sports. Women’s maternity belly tubes are comparable. A valuable resource for undergarments designed specifically for individuals with an ostomy is a company named “Comfizz.” Comfizz is a family-owned company in England that has earned NIH recognition for their quality and product designs.
I have worn their camisole top and boy shorts for several years and highly recommend them.


http://www.comfizz.com

Best wishes,
Karen

Karen,
I wish I would have found this forum when I had my ileostomy. Even though I only had it for a short time, I did have issues with my stoma bleeding. Every time I changed my bag once my stoma hit the air it would start bleeding. Sometimes blood in the bag. The nurse thought I may be cutting margins too close but that wasn't the case. It was weird. Was going to have another appointment with Ostomy nurse when I unexpectedly had a blockage and it my ileo was reversed during surgery. You offer so much help to everyone here that is trying to navigate the maintenance of the ileostomy and figure out what will work for them. Thank you for your shared experience and knowledge.
58 yr old mother of 3 Dx @ 55
5/15 DX T3N0MO/ 2A
6/15 5 wks of chemo/rad
7/15 sigmoidoscopy/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. 3 1/2 weeks in hospital,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod onc thinks scar tissue
monitored for autoimmune disorder/interstitial lung disease
7/17 no change lung nodule
10/17 Clear CT
11/17 CEA<.5

NHMike
Posts: 690
Joined: Fri Jul 21, 2017 3:43 am

Re: How much margin for stoma with cut-to fit?

Postby NHMike » Sun Dec 03, 2017 3:10 pm

Aqx99 wrote:
NHMike wrote:
Aqx99 wrote:1/8th is the typical measurement, though there are exceptions. My ostomy nurse has me cut my hole much larger because of how my stoma lies flush with the skin. My output was going straight under the wafer when it was cut close, so she has me cut a 2 inch circle out and protect my exposed skin with paste. Everything is trial and error when it comes to your ostomy set up. Every single stoma is different and has different needs to make the pouch work.


The flange on mine is 2 1/4 inches so a 2-inch circle wouldn't leave much of the wafer sticky part to attach to the skin. My stoma is currently an oval about 1.5 inches wide and 3/4 inch high and it was cut relatively close - 1/8 inches last time. So I'll give this one a try. The tracing looks like a walnut right now. I'm also planning to go to three days per change to decrease the amount of irritation. Changing the bag is a pain but it's a good feeling after a change.


Mine is also 2 1/4, but it sticks just fine. I change it every 4 days. I also use an Eakin ring to help seal up where I have creases in my belly that allow output to pool under the wafer. If you are having leaking, I suggest examining your wafer after taking it off to see if you can find where the leak is getting through. You should not have irritation under the wafer at all, it should be normal skin.


I haven't had leakage problems - just irritation.
6/23/17: ER rectal bleeding; Colonoscopy+Biopsy
7/13: Stage 3B rectal cancer. T3, N1b, M0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6 mm, 5 x 5 mm
7/31-9/8: Xeloda 3,400 mg/day+radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8. 11/30: 0.6
MSS, KRAS G12D
10/6: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 mm (-75%), 5 x 3 mm (-40%). 5.1 CM from AV
10/30: Surgery: LAR, Temp Ileostomy
Path report: Tumor regression grade: 0 (complete response).

Aqx99
Posts: 279
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: How much margin for stoma with cut-to fit?

Postby Aqx99 » Sun Dec 03, 2017 4:06 pm

NHMike wrote:I haven't had leakage problems - just irritation.


Irritation typically means a leak. When I first started, I had a red ring all the way around my stoma because my output was seeping under the wafer.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Diagnosis, Age 39
2/21/17 CEA 0.9 ng/mL (Siemens Chemiluminescent Method)
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 Diagnosed w/ precursor ovarian cancer
9/6/17 CA 125 11.1 U/mL
11/27/17 CEA 2.6 ng/mL (Roche ECLIA Method)
12/5/17 CT showed NED
12/13/17 CEA 2.9 ng/mL (Roche ECLIA Method)
1/23/18 Reversal

MissMolly
Posts: 444
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: How much margin for stoma with cut-to fit?

Postby MissMolly » Sun Dec 03, 2017 4:53 pm

Mike:
I will look at the Hollister and ConvaTech moldable wafers and get back to you with specific product numbers. You can then request product samples.

Moldable wafers provide a seamless extension of the hydrocolloid matrix (that constitutes a wafer) that extends upward from the plate of the wafer, snuggling the stoma like a turtleneck. Skin irritation is zero-nil as there is NO exposure of paristomal skin to ileostomy fecal output and no exposure to caustic digestive enzymes. A reliable moldable wafer might be just what you are needing to put an end to skin irritation.

In the interim, I would favor the use of Cavilon Liquid Skin Protectant (by 3M). Cavilon Liquid Skin Protectant is a staple accessory product used by almost everyone with a permanent ileostomy. I prefer the spray to the individual towelettes. A light spritz of Cavilon Liquid Skin Protectant does an amazing job of providing an effective skin barrier to the constant flow of liquid output and digestive enzymes. Cavilon provides an invisible shield second to none. Spray a light coating to clean, dry skin. Allow to air-dry for one minute. Then apply your ostomy wafer and Ekin adaptic ring or Brava adapting ring as you would normally do. Cavilon Liquid Skin protectant is available on Amazon or through your ostomy medical supply provider without a prescription. It retails about $8 for a 3 oz spray bottle (that will last 2 months, give or take).

For serious skin irritation or open/weepy skin, the “go to” product is Marathon Liquid Skin Protectant. Marathon Liquid Skin Protectant is specifically designed to heal skin excoriated by prolonged exposure to urine or ileostomy fecal output high in
concentrated digestive enzymes. It is pricey at $60 for four 1 oz
vials but it is worth every penny. Marathon Liquid Skin Protectant is classified as an advanced wound care product. Available on Amazon. I always keep a few vials of Marathon at
The ready in my Ostomy supply cabinet.

You may also want to try a one-piece system. One-piece systems (wafer and pouch are a single unit) have the advantage of having a more pliable and flexible wafer. The flexibility translates into a wafer that has a higher degree of intimate skin contact, moving as the body moves. The result is better wafer adhesion to the skin, less paristomal skin irritation, and fewer leaks. The Coloplast Mio is my personal favorite. The Mio Line has several product options.

Anyway, I will get back to you shortly with some product numbers for moldable wafers. I do not use a modable eafer for the reason that I have an ileostomy stoma that is only 1/4 inch high at best, and is often at skin level. Moldable wafers need a stoma at least 1/2 inch to 3/4 inch in height. The stoma height allows for the all-important turtleneck effect.

Believe me, I do understand the steep learning curve that comes with a temporary loop ileostomy. I can also appreciate why it is common for individuals with a loop ileostomy to come to view an ostomy and ostomy products with disdain and dread. The loop ileoatomy is the most challenging of the array of ostomies - with a flow of caustic liquid fecal material 24/7. It is enough to tax the attention and patience of anyone. Everyone on this
forum with a diverting loop ileostomy has my respect. The care and upkeep of a loop ileostomy requires an inordinate amount of time and attention. I am here to provide a helping hand, as best as I can.

You are doing a good job of making the best out of a difficult situation that is a loop ileostomy. Cheers.
Karen
Devoted daughter to my father, diagnosed with stage 2 colon cancer Nov-2014.
Dear friend to Bella Piazza, former CC member.
I have a permanent ileostomy and offer advice on living with an ostomy.
I have been on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression and recurrent infection x 4 years. I transitioned to Hospice Sept-2016, but it was not yet my time. I am back on Palliative Care and live a simple life due to frail health.


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