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Can’t keep the wafer attached

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Ostomies
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Posted 12/25/2019 7:23 PM (GMT -7)
I had an Ileostomy in October and required emergency surgery that night for a prolapse. Again in December, another emergency surgery, this one required removal of a foot of ileum.

Since day one, I have been unable to keep the wafer attached. Sometimes three or four in a day with multiple leaks and failures every week. I have pronounced scoliosis and a plate and screws in my neck. Even with the help of a home health nurse, the wafer comes off because of all the skin wrinkles from the scoliosis. I’m extremely thin and now in constant discomfort from my skin being damaged by all the wafer changes. Does anyone have any suggestions? I’m already using mastisol and wide barrier strips. I purchased an over the door mirror to help since I can’t bend my neck to see the wafer.

My doctor, ostomy nurse at the hospital and local ostomy association never mentioned that the sclerosis and limits of my neck would make this process almost hopeless. I had to cancel going to my only nephews wedding in January. I got sold a bill of goods and can use help.
Posted 12/26/2019 8:41 AM (GMT -7)
We have a member here who swears by a product called benzoin tincture.
Check out this quote and give it a try.

polishdan said...
rose
Friar's and BCT are the same. Friars is only available in Canada. BCT is Geritrex Benzoin Compound Tincture and is available in the US. Both are first aid products. When applied and dried they are sticky and waterproof. They help wafer adhesion and protect the skin. WOCN's are not familiar with either product. I really wonder why. My process when I change...Remove the wafer and shave with electric beard trimmer. When you remove the wafer the BCT comes off with the wafer leaving no residue. Any hair stands up. Clean with water and paper towel only. No adhesive removers, soap, or anything else. Dry with hair dryer. Apply BCT with q-tip to the whole wafer area. No powder or anything else. Dry again and apply wafer. The first time with BCT you may need to remove any prior residue. Use alcohol. No residue. I use select-a-size paper towel and cut the whole roll in half. Makes a nice pad to clean with. Friar's is available from Rogier in Canada. Geritrex is available from www.drugsdepot.com . Search for C2540383. $4.49 plus shipping.
I have been using it for several years with no leaks....none.

Is your ileo a loop or an end? My loop was very difficult to manage.
Posted 12/26/2019 8:50 AM (GMT -7)
OSTOMY APPLIANCE
STANDING POSITION IN FRONT OF SINK
CHECK LIST
- Hand mirror - Skin prep?
- Pouch - Blow dryer
- Wafer - Stoma powder?
- Sure seal - Tincture of Benzoin
- Q tips - Rubbing alcohol
- Few folds of toilet tissue - Warm, wet face cloth
- Paper towel - M-9 deodorant drops
- Zip lock bag - Few squares of gauze
- Ball point pen - Ostomy belt
Choose a time of day when the stoma is inactive. For me it’s the first thing in the morning.
I lay all of the above items out just like an operating-room nurse would do in the hospital. I don’t want to be hunting around for anything.
Prepare wafer. I cut hole to desired size. Remove release paper and heat gummy side for THREE seconds with blow dryer.
Prepare Sure Seal. Remove the release film on ONE side of seal and heat for THREE seconds with blow dryer.
Mate the heated sides of wafer with the Sure Seal.
With forefinger, pull enough Sure Seal through the wafer hole to form a “turtle neck”.
Now place wafer aside.
I place a fold of toilet tissue on the leading edge of the sink and lean on it with my abdomen just in case there are any spills. I don’t step back from this leaning position until I am ready to apply my pouch.
Remove old wafer and pouch from abdomen and place in sink.
Place hand mirror in sink and adjust for viewing.
Clean skin around stoma with dry toilet tissue.
Continue to clean skin around stoma with alcohol until all residue is removed. BLOW-DRY SKIN.
Keep your eyes on the mirror. No drips are allowed. If there is a drip of any kind dab with gauze. BLOW-DRY! BLOW-DRY!
Using a Q-tip apply a coating of Tincture of Benzoin to surrounding skin. BLOW-DRY.
Keep watching the mirror for drips.
Apply a second coating of Tincture of Benzoin to skin. BLOW-DRY.
Now heat the wafer and pouch that you’ve already prepared with blow dryer. THREE seconds is enough.
Place wafer over stoma and remove release paper.
Use M-9 if available.
Close end of pouch and done! 7 days guaranteed. It’s important for the wafer to stay in position for at least 5-6 days to allow the skin to heal and to allow the adhesive to break down naturally.
RAW SKIN is another matter. I would not use alcohol on raw skin because of the burning sensation. In the case of raw skin I would use a skin prep such as non-sting Nephew & Son. Somehow, someway, it is important to get the skin squeaky clean.
And then, I would continue with the directions using the Tincture of Benzoin. If skin is raw the Benzoin will sting, but it’s worth the few minutes of discomfort.
The Benzoin is anti-septic and provides a very sticky base for the wafer.
Posted 6/1/2020 9:15 PM (GMT -7)
Calamine lotion dabbed on and allowed to dry will help relieve irritated skin then apply the benzoin (sparingly) using gauze or a q-tip. Wish you well!
Posted 6/10/2020 4:38 PM (GMT -7)
I am sure you have already tried this but just putting it out there in case not....
After I put on appliance I heat with blow dryer all around. Then I get a washcloth wet and very very warm and put in a ziplock bag. One nurse told me to heat in the microwave but our water is pretty hot so I just run wash cloth under hot water.
I then lay down on bed with washcloth in bag on my stoma and press down on appliance. I sit for at least 10-15 minutes.
Hope that helps. I realize your situation is much differently and hope you can find solution soon.
Posted 8/23/2020 8:48 AM (GMT -7)
I use Smith and Nephew Skin Prep. I apply Stomahesive paste around the opening of the wafer and set it aside. After I have washed and dried the area (using a hair blower on low) I wipe around the area with the skin prep. It’s like a little alcohol wipe. Then I dry the area again and then apply the wafer. (Always make sure your skin is totally dry Both times before moving on to the next step.) Be sure to press the firm part of the wafer firmly and run your fingers around it to make sure it has stuck to the skin. Your skin will be slightly warm from the blower and that helps the rubbery adhesive to stick. Then remove the rest of the paper that is attached to the sticky, band aid type adhesive and press tightly to the skin. I take the top part of the adhesive and pull it upward and then stick it to the skin. Then I take the lower adhesive and pull it down and stick it to the skin. I am always standing when I do this. This holds the adhesive tight to the skin.

I always make sure that the pouch does not become too full. That’s an accident waiting to happen. I hope this helps you.

Sherrine
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