Need advice for uneven skin causing leaks

Hi everyone, I am new to this site. It's so nice to be with my "people!" I've had my permanent ostomy since 2015 (my decision - j-pouch failure.) I remember using certain products to build up areas of uneven skin with my temporary stoma in 2010. That loop ostomy was a bear to deal with! I've been having seepage under my ring in one particular area where there is a slight dip in my skin next to my stoma. I change my appliance every other day because of the seepage. If I eat a lot of fiber and my stoma is very active, it's a recipe for a blowout. Does anyone need to attend to dips in their skin when putting on their appliances and, if so, would you share the products that you use? I know I could get more wear out of each bag change if I could fix this issue. Thanks in advance! Lori

Welcome Lori. I use Coloplast Sensura Mio Convex 2-piece system. I apply the Coloplast alcohol-free Brava paste around the hole in the wafer before applying it to me. I also use a hair dryer on the wafer to heat it up and make it stick better. I have had no issues with the slight dip in my skin next to my stoma. I change my wafer once a week. I hope you find something that works for you. Good luck.

Hi and welcome to the site, I also have a dip in my skin at the bottom so I use a piece of Eakin seal or some paste that I apply to the Convatec wafer. My problem is sleeping on my side and that area wears out first. I usually get 3 days wear time and change the morning of the fourth day.

Welcome Lori!

Sally, I tried the Sensura Mio and found it to be too small for me. I eat a lot and emptied too frequently. Otherwise, I loved the look and the peekaboo window. I'm also leery of a two-piece. I'm active and concerned that the bag will pull away from the wafer. Has this ever happened to you? You use Brava paste and no barrier ring? I may try that. Thanks!

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

Thanks, Abe!

In two years, that has never happened to me.

That is what I figured out, Ron. I can cut up an Eakin Seal to put a piece under the wafer to build it up if there is a dip. Much easier and cleaner than using paste. If it needs more build up, I sometimes use two pieces of the Eakin to seal better.

I often have the problem of output being just brown water and the Pearls or Absorbagel really helps by making it thicker. As any plumber will tell you, water will always find a way out through the tiniest crack, crevice, or pinhole.

Magoo

Ok, I'll contact Coloplast for a two-piece free sample to try.

Thanks,

Lori

Hi Ron, thanks for the suggestion. I don't have Eakin seals but I do have some Brava Adapt rings leftover from a previous order. I will use part of the ring to build up that area that dips and see if that makes a difference. Does that area wear out on your appliance when you sleep on either side?

Hi Lori, it sounds like you are getting some good advice and I can't really add to it. Just wanted to say welcome to the site!

Terry

Thank you, Terry!

When I get a leak, it's generally on the left or right, in the middle. You have to bend down during your day and it seems that this bending and creasing the wafer when I bend down erodes these two areas... two sides, in the middle. Sleeping on your side will give the chance for a leak. I reinforce both sides with an extra cut strip of the Eakinalong each side, up close to the Stoma. I can often get a whole week before the acidic output erodes the problem area.

Hi, yes it does erode on my right side and down to the bottom edge.

Give me a shout if you haven't resolved this issue. I may be of some help.

Dave

Hi Dave, I'm still experimenting with products. A week ago, I filled in a crease with an extra little piece of a barrier ring, used it with my Sensura Mio sample one-piece bag and had a major blowout during the night. Ironically, I've had leaks every time I've tried the Sensura Mio (it might be other factors, fiber, etc.) Obviously, I want so much to like this bag - I keep giving it another go! This morning, I'm trying my usual Hollister bag with a Brava moldable ring. I'm hesitant to fill in the creases on either side of my stoma with anything else since this ring is new to me and I don't want to introduce too many variables. My stoma is also just barely above the surface of my skin which doesn't help. Any suggestions you have are much appreciated. Everyone's been so helpful. I'm on a quest! Lori

Hi!

I also have uneven skin around my stoma, the lower area dips in and if my stoma becomes active, the skin can pull away from the flange a little, causing stool to leak under.

I have found that if I take half of a Convatec Slim Seal and form it onto the flange where my skin dips in and then apply it to the stoma, I have no leaks.

I can get about 4 days with no leaks doing this. I hope that helps you!

Thank you so much for your reply! Just to be sure because I'm not 100% sure of the terminology - you put half of the seal onto the base of your flange or directly onto your skin? I'm still experimenting because I'm still leaking and this is all after a visit with an ostomy nurse. I agree that the activity of the stoma can cause leaks. I have what I believe are reactivity of gallstones so I'm having pain after eating, intense activity of my stoma and, possibly but I'm no doctor so I can't be sure, a difference in the quality of my output. All of this along with dips in the skin around my stoma, and this is a recipe for disaster. Now I'm leaking all the time. I'll get to the bottom of it eventually but support like yours and everybody else is getting me through. Non-stoma people can't quite get it, understandably so.

Hello,

I'd suggest trying different ring brands. Some breakdown faster than others. Fortis Medical Products has a great one that doesn't break down too fast.

You may want to consider a convex wafer. I use the Coloplast light convex and it solved my issue. I prefer rings over paste, but whatever works is what you should use.

Good luck!

Traci

Thanks, Traci. I've been using Safe 'n Simple flat barrier rings with convex one-piece bags. I'm now trying Hollister's and Coloplast's convex barrier rings with my convex bags and so far, so good.

Hello,

I have two dips on each side and I do exactly as Ron mentioned and it has worked wonders! I do not add a whole barrier, I just build it up where the dips are and it works spectacular!

I will have a leak here and there if laying on my side, but that is more due to my hernia now....

Use an extra piece of ring to build up that area. For example, cut a ring into 4 quarters like a pie. Leave protective plastic on it so it does not dry out. Take 1 piece of cut ring, remove plastic, and place it in the dip/void. Then put the full ring on top. See if filling that dip helps.

I didn't want to post until I was sure of success - I didn't want to jinx myself - but I've found much improvement using my usual convex bag plus a Hollister Adapt Convex barrier ring. The ring completely fills in the skin dips around my stoma. I had tried my regular ring with a piece of Adapt strip and that worked, but if I need to do a quick emergency change while I'm out, I want as few "ingredients" as possible and the bag plus the convex barrier ring fit the bill. Thanks again to you all for your invaluable input!

You're so very welcome! Most of the tricks and tips that I've learned have been over the years. Yes, that's right, use a half of a seal. Warm it up in your hand and then flatten it around the hole on the flange. I press it in, right up to the edge on the bottom, because that's where my skin dips in. Then once I place the flange on my stoma, I lightly push in around the area close to my stoma against my skin and make sure it's stuck before I put my bag on. Then after my bag is on, I sit for 15 minutes or so to make sure it stays. Another trick is wearing briefs with a little compression in them. They help keep the bag pretty flat and add pressure to help with leakage. I also like a little air inside my bag, it helps the stool to drop down into the bag and decreases pancaking which also decreases leaks. Good luck and if you need any more help feel free to reach out