MY Personal Ostomy Skin Care Tips
Good Skin Care is Imperitive
No matter what kind of stoma you have, it is very important to take care of the skin surrounding it. I have seen several sites recommending plain water with a cotton pad. But I am a firm believer in antibacterial soap. Unless you are allergic to this type of soap, it will not hurt you in any way. I have always used Dial soap, whether it be a bar or liquid. Every time you change your pouch you need to thoroughly cleanse the area around your stoma. Use a soft cloth. Just soap up the cloth and gently scrub that area. The soap will not hurt your stoma. Once you have cleansed it, you might just pour a cup of clean water over the area to rinse it or use a clean wet cloth to wipe the soap off. ~the only other reason you might not want to do this is if you have extremely dry skin. Then, just dab it dry if you can without spillage, because if you have small blisters you do not want to burst these by "rubbing" dry.
Every stoma site is basicly the same, but different too. Some people have an inverted stoma, some have one that will protrude.My stoma was slightly protruding. Sometimes what I ate would cause it to invert slightly, and it was a little painful for me. The pain doesn't usually come from the stoma, but mostly from the exit tissue being pulled or pushed.
I found Hollister products to be the best for me. Since it has been awhile that I have had to wear a pouch, I had to do some recent research on some of their products. What I found to be helpful in any situation was the skin gel protectant. Not only did it protect my skin with each change, it aided in healing my skin of dermatitis. It does have alcohol in it, so it stings greatly. But the alcohol seemed to heal my problem. ~please see dermatitis photo Once you have dried the skin, lightly apply the protectant, wave it dry, then apply the pouch. We all know that you have to be quick at this. I would fold over 3-4 paper towels and lie them on the bathroom counter while doing all of this, and keeping somethig close by to dab any spillage quick so as to not re-intoroduce the skin to it's irritants. In the time that I had my ostomy, I met only a couple of people to talk about this with. They were generally people I come into contact with as a nurse's aid. I had one fellow who firmly believed that using wet tea bags to dab the skin with, "through" the tape of the pouch, helped to keep his skin unirritated. I tried this once or twice, and it did help with small irritations but not for big blistery ones. Allowing the blistering to heal without it being bursted is the best.
It is always best to consult your ostomy care nurse or physician first.
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DermatitisClick thumbnail to view full-size
Once your skin becomes irritated it is a well known fact that keeping an appliance on is near impossible. Using a pre-paste helps if the irritation isn't too bad. And, using 2 separate pieces was always best for me. I used the wafer (one piece), then applied my pouch over that. I have seen where most people use the one piece product that has the wafer as part of it. The only problem with this is that it is "one piece". When you cut out the size to fit , there is no safety. With using 2 separate pieces, you assure for leakage. I would cut that wafer as close to the stoma as I could without it having sharp edges. I could dampen my fingers and soften the edges to fit perfectly. And usually your stoma entrance isn't perfectly round, but you know your pouch opening is, so custom fitting the wafer first assures that there is minimal leakage. Then I would put the pouch (with karaya seal) on top of the wafer. I know that products are very expensive these days, but if you have insurance to cover this, make sure to speak with your physician and make him or her understand that you need BOTH products to insure healthy skin. Without this insurance you are going to go through more pouches anyhow. Right?
Another source of irritation is that darn plastic pouch. Years ago, way before all these nice coverlets came out, I was a home economics student who enjoyed sewing. And together with my grandma, we designed our own coverlets. I have found a few sites online where you can order them, but if you know someone who sews, ask them to do some for you. It isn't hard, and it's much cheaper. Simply take one of your pouches out and lay it on a piece of typing paper. Hold it fimly down and trace around the outside. This is one piece of the pattern. I came out about 1/2" and traced another outside line to leave room for hemming. Label this "front". You want to trace the entire pouch, top to bottom. The back side is the same, only you are going to measure and draw a circle slightly above the center that is the same size as the piece between your pouch adhesive side and where it attaches to the actual pouch . You will cut this circle out. I made about 4 copies of this pattern. I also chose material that was pleasing to my skin first and foremost ( a couple of different types- flannel too) and then pleasing to the eye also. Silk or silk-types are a bother. They slip slide on the pouch and don't stay in place, so find a nice cotton blend that is just as pretty. Just pin the patterns to doubled over material, all 4 if you like, both sides, and cut them out. Set aside the ones that won't have the center cut, and proceed to cut out your holes for the ones that do. Once you have this done, you want to take the ones with the center cut and do a close zig-zag stitch around the cut out on all of them. This will keep the material from fraying from a lot of use. Then take all pieces and put in a very small hem along the bottom piece of each of them where your clamp would go. Once you have the bottom hems put in, and the centers too, you want to then pair the fronts to the backs. Before sewing, of course, you want to flip them so that the showey material is facing. LEAVE THE BOTTOM PIECE THAT YOU HEMMED, UN SEWN. Simply sew the sides together then flip back out. You leave the bottom open for quick empties, that way you don't have to take off the entire cover. You just pull it up/fold it, pull out your clamp and do a quick empty.
I did not rinse the inside of my pouch with every empty. This leads to softening of the seal much quicker. It all depended on the consistency of the B.M. With an Ileostomy, it's generally thinner.
I have had contact with Verna G. of the koolostomy.com site and she has had some information changes, so please note the above changed web site of hers and good luck with the coverlets. I couldn't have done without them.
She is a very nice lady and will be happy to help you.
- stomacentralint : STOMA CENTRAL INTERNATIONAL
stomacentralint: STOMA CENTRAL INTERNATIONAL