Appliance Changes Without Barrier Ring or Spray: Seeking Advice

Those following my recent thread about irritated stoma skin will know the logic behind this request.

Eakin seals made a mess of the skin around the stoma. A perfect red circle. You heard of ring around the collar? This is rind around the stoma. 🤦‍♂️😲.

I tried an appliance change last

week, going without protective

spray or barrier ring. To my surprise, I got 1-2 days wear time.

Even with dry irritated stoma skin.

Yep. That's a fact.

After seeing a stoma nurse, I went back to using the spray and seal.

It isn't working well at all.

It's 4:30 a.m. I replaced the appliance after a Domeboro soak and air drying skin. Attached ring prior to spray with appliance. This was at midnight. Got less than 3 hrs wear time and caught the epic blowout just in time. Showered bagless for over an hour, now air drying area. Yes, 3:30 it happened.

SOB! It's a Monday start, no one wants.

I am waiting on supplies.

The question begs:

Has anyone gone barrier-less—just using the flange, no ring? And the belt attached to flange?

This is the bare essential I'm calling because the barrier ring—now Brava—has been used since Thursday, which blew out that night. (Thank stoma nurse).

And the flange alone—which one week ago—is proven to hold better with protective skin.

Sounds desperate? You bet your front butt it is.

Is anyone in the same boat? Mine is sinking. 🤬😡😖

I use a skin prep wipe and have not had bad skin since. I also use a ring though ( Salts with aloe).

Thanks... yeah, I would get to that eventually. But start off with red inflamed skin that had bled last week, and that's an entirely different issue to keep from leaks, breaches, and blowouts.

It's my understanding that salt rings are not available in the U.S.

Cera rings, I'm told, are the next choice. Thank Xnine.

😥Sorry you are suffering through this…wish I had something helpful to suggest.
Since we are all different, we each resort to our own devices. I've had one bad rash early on that surrounded my entire stoma. The stoma nurse said to dust with stoma powder and tap on barrier wipe—it was gone very soon after doing this. My other pain reliever is Vicks VapoRub. I have used it immediately surrounding my stoma raw peristomal skin. Stickability would be lost beyond that. It does give temporary relief, so if you could apply it to the irritated area and wait a bit, then shower, it may be helpful. Maybe a ginormous gauze patch with a center hole, some t.p. over the stoma, a shower cap, and a nap…good luck, hope you can find relief soon! jb

You’re waiting on supplies? Does that happen often?

How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister

Yeah, you worked with Kas on donations. Spoke to her and she's sending various barrier rings which I will compensate her for.

With Edge Park, my supplier, it will take over a week for supplies. I don't have that time to wait. Don't know if you ever suffered anything like this, but the base plate flange won't stick very long; leaking is problematic, which insults the already irritated skin. Fun times.

Samantha Stevens—Bewitched—wouldn't need to wait for supplies. Wiggle her nose and poof, it arrives.

Not that lucky though.

Thanks. I appreciate the fix idea. For others, this info is helpful.

So whoever replies can keep suggestions in mind. Footnote it!

I recall w30bob mentioning Domeboro soaks. Hibiscus also agreed they helped. My nurse Friday said not to use it.

It did help though, so I am on the fence again about using that.

Stoma powder is for after it heals, to powder on later when healed.

Nurse suggested Nyostate.

She messed up on the script.

Stating "use as directed" won't fly with the pharmacy. Denied it.

SOB! I put the call in Friday after seeing that nurse. Still waiting on her reply.

2 days no treatment! Warrior on warpath when I get that bitch on the phone.

Shower felt good.

Got up to pee at 3:30 and was peeing from another source. Underside of bag trickle down leg. A big WTF? moment.

Big surprise there. Just got lucky no bed sheets were involved in this breach. Whew!

Try barrier strips on and around the stoma then put the wafer on top of the strips. No skin irritation and wafer lasts a full 7 days

Thanks... that is interesting. You are talking about those C strip extenders placed on the skin which is highly red and inflamed to act as a guard? Then follow suit with a barrier ring and flange with bag?

In theory, that sounds like a decent alternative. Those strips are highly adhesive too.

Update on the nurse who I just called: apologized several times for not calling into the pharmacy.

(Yeah, that helps—thanks.)

Now she will.

I have one freaking flange plate left!!! Plenty of bags and Brava seals. I told her this. She offered me supplies today... thinking the Mio flange is causing an issue when in the last 8 years using it, I never had this issue before.

Then she suggested a hernia is causing this. GTFO! Grabbing at straws now. Fudge that.

Waiting on medicine. Going bagless while at home. Probably be home like this for a while. Captive to my stoma.

This is where George Carlin's famous gig about the ten words you can't say on TV starts. 👍

Hey there. If you are better off not using a barrier ring, then do so. You don't have to use a barrier ring or yes if you don't want to and if it's not working. I spent the first 2 years not using a barrier ring, just the wafer. You use what is right and what works for you. Have you tried Marathon or 3M Advanced Skin Protectant? Edge doing what they are doing doesn't surprise me at all.

Trial and error, Beth. Last week, no barrier ring, just the flange worked for a day or two. Last night it blew at 3:30 this morning. I didn't use any protective spray. My skin just doesn't make good use of it as opposed to not using it.

I let it dry.

...but this blowout today puzzles me. It should have held. The skin is very tender now. Not bleeding but sore to touch.

Protective sprays I had issues with years ago. I stopped using them... skin was good then.

Didn't need them, still believe that, which might be stupid thinking now.

Edge park is good to me. I didn't place any new orders with them yet. Waiting on rings from Kas.

Then...will proceed. This is going to be a huge time suck.

Over 20 years, I have accumulated a great deal of extra everything. I would note that if you have enough time in advance, many items can be ordered off of AliExpress from no-name Chinese suppliers for a few bucks.

If you need a box of rings, I can send you one. I was stuck on vacation almost 20 years ago overseas when flights shut down, and it took me an extra week to get home. Someone helped me out, but I am across the country, so it might take a while.

Just to clarify - stoma powder is what cleared up a nasty rash I had…was not used afterward…I never use it anymore but have it on hand in case a rash shows its ugly bumpy face!!! jb

Sorry to hear you are going through this Warrior.  I had similar problems with peristomal skin, and it wasn't until I tried the Salts Aloe rings that it finally cleared up.  Maybe you U.S. ostomates need to start lobbying Salts to get access to their products.  It would be a huge market for them, so you might be successful.

Terry

Hi Warrior, I use the Coloplast 1 pc convex, drainable bag - #16733.  We had tried using barrier rings in the hospital because my first couple of changes the skin was raw and weepy, but they weren't helping.  Now, I don't use a barrier ring, I just try to cut the hole to fit my stoma exactly.  My stoma nurse is a huge fan of 'less is more'.  I use SkinTac wipes as a barrier film - and blowdry it - right before I put on the pouch - Stoma nurse thinks this is unnecessary but she said it probably doesn't hurt either.  I was doing great for a few months but last week I developed a raw spot at the bottom of the stoma where it meets the skin (bag change on Wed morning.  I tried to use the stoma powder and crust it - one layer - then did my usual routine, it didn't work.  The sore didn't get worse but it didn't get any better. So, on Sunday morning's bag change I tried a double crusting layer but kept the rest of the routine the same.  I don't feel any soreness when I mess with my pouch so I am crossing fingers.

Hi Warrior,

I feel very fortunate in that I've been able to use just barrier wipes and my flange. I did have to change from a one piece to two piece and  from  Coloplast to Hollister because the adhesive from Coloplast bothered me. But other than that, I've been very lucky.

You've been through a lot, and I'm sorry to hear your issues are continuing.  I wish I had something to offer, only just good thoughts and hope things get better. 

Hey jb..you got lucky using it for the time needed. I am looking at the bottle of Stomahesive by Convatec. Directions are simple but say nothing about rash treatment. "Compromised skin" must mean that.

They don't mention a protective spray after brushing off excessive powder. Huh? They do say fill the gap between stoma and barrier ring.

Stoma nurse said use this AFTER skin heals. She also said not to use Domeboro.

We know warming up the seal and wafer helps adhesion, yet I was not offered that at the visit with the nurse.

Cold installation is very risky.

I find quite a bit of conflicting direction between our members and a nurse, plus written directions on their products.

Whatever work requires trial and error.

We all know Eakin seals are toxic to most people, not all.

We know salt rings and Cera rings help better than other brands for irritated skin.

Some people don't use a barrier ring, which I can understand. Others require it.

Pros and cons to everything.

Conflict assured. Thanks for answering. You got good skin. Got a good appliance.

The few, the proud, the Stomarines!

After the Domboro soak, wash it with soap and rinse well. The Domboro residue may be causing issues with the seal. I used to do the soak and then wash it really well afterward. Maybe try stopping the soaks and just use soap and water for a while. You know, sometimes less might be better, at least until you figure out what's going on. I say the Eakin started it though because you say it's a ring around the stoma. Just change daily for a while. We are all so different in how we react to things, you know?

It really sucks when something sets off our skin like this.

Crusting with a skin prep wipe and stoma powder is the only thing that heals my occasional open spot. If it's very raw or very big, I'll do a triple application, starting and ending with the barrier wipe. Takes time to dry between, but very effective.

I do not use a ring; I have not had my stoma long, though.

When they sent me my first insurance order, they sent rings without even discussing it. I didn't use them.

As mine has changed, it now has a valley on one side.

Paste works, but it's a mess to remove.

Convex bag alone works.

Flat bag requires paste or a 1/2 ring (on the valley side).

Sometimes I use a convex bag, sometimes I use paste with it (I try to avoid it). Sometimes I use a flat bag with paste. Sometimes I use a flat bag with a convex Cera-ring.

I'm considering going back to flat bags and using Cera-rings instead of convex bags; I'm not sure. I do like them, but my insurance only covers 20, and I use closed one-piece bags and get 60 per month, so…

Can you screenshot me a pic of the barrier strips? 

Sorry to hear about your skin issues. I use Convatec moldable 2-piece, no rings, and just Convatec skin barrier spray. I've only had an issue once in 4 years and was told to use Benadryl spray on the raw skin, then stoma powder, and then spray barrier. I put it on as I changed my appliance. On day 3, I changed again and the skin was back to normal. If you are in need of supplies, I'm not far and can FedEx to you. Send me a PM if you want me to send...

 warrior, I used to place a barrier ring under my barrier but never could get more than four days before I had to change the ring. The Brava barrier ring worked best for me but the hydrocolloid would swell up after 4 days and start pushing up on the barrier — may happen sooner with ileostomy. I now place the ring on top of the barrier and around the stoma. I use the Marlen Ultraseal Barrier Ring since it doesn't swell up very fast. I do use the  sensura mio flex barrier. This is the setup that gives me 7 - 8 days of wear time

Thanks for the info

For the occasional open spot, I use a blast of Flonase... yes, the puffers that asthmatics use. Wash and dry thoroughly, then, before applying anything else, give the affected area a little blast. The steroids in the Flonase work quickly.

I see. So you sandwiched two barriers if I read that right, and it lasted four days. "A double hamburger please, no onions."

You are having it your way. Trial and error is the best approach.

Yeah, not sure that would work as an ileo.

It's amazing, isn't it? Just because we have a stoma, the difference of having one makes a big difference too.

Ileos like myself do have it harder with that liquid output. And draining? At least eight times a day. You guys can irrigate.

That alone is a blessing.

Re: rings? Brava worked well, but gonna try a few sent to me.

I am getting better adhesion these last two days. Maybe the Brava has healing powers. Never should have switched from Brava to Eakin. Lesson learned. Got something good? Stay with it.

Thank you everyone for all the  help and suggestions I am receiving.  All of you are helping me so much. Mentally and physically ❗️

Hey .. I'm calling the police.. u stole my lines!! 🤣😁👍 (my sentiments exactly)

What did I say?  Lol😂

Hope you are feeling great today❗️