Changing a Colostomy Appliance - Did I Skip a Crucial Step?

Hi all,

My mom has had her colostomy bag since Aug 2022. I help her change her wafer but I forgot a step the visiting nurse taught me a couple years ago and wondering if it matters.

After I removed the wafer this morning, I cleaned her stoma and her surrounding skin with soap and warm water. Soap had no moisturizer. But normally I rinse again with plain water and let that completely dry before moving on to next step. 

Today, I cleaned with the warm water with soap and let that dry but didn’t clean again with plain water. Does this matter? Will it cause a rash? Or make wafer become loose? Normally we go between 5-7 days between wafer changes. Not sure if I need to take off and redo it.

I took out the paperwork from hospital and according to that, it says “Cleanse stoma and peristomal skin with warm water/and or soap without moisturizer. Dry peristomal skin” It doesn’t mention rinsing with plain water. So now wondering if this step is necessary.

Any thoughts ?

Hello D

First of all well done for caring for your mother, the world could do with more like you. I'm sure the rinse with plain water is just an extra step in your procedure to ensure the area is clean of any soap residue, which could possibly cause a leak. I'm certain it won't cause any skin issue and there's no need for alarm or to change the appliance. I'm confident you will be fine, just keep an eye on it until your next change.

Thank you Axl!! I appreciate your kind words and your assurance that things will be just fine. 

G-Day Daughter, If it's of any help, I personally never use soap at all when changing my bag. For the last 3 years, all I use is warm water. Let that dry, then use an adhesive remover wipe or spray, and then after checking 100% that it's dry, I spray a barrier spray and let that dry with a small battery-operated fan. Fit the wafer and add the bag, all done. Your mother must be very proud of you for looking after her. Well done. Regards, IGGIE

You're a good Daughter! Your mom is getting a lot of time between bag changes so you must be doing a great job. I, like Iggie, don't use any soap anymore around my stoma, just lots of warm water to clean and then a hair blower on the area to make sure it's absolutely dry before I apply my new barrier ring and bag. I guess you'll know the results of your mom's last bag change when you go to take it off or if there's leaking before then. 

Living with Your Ostomy | Hollister

Relax, don't worry about it. As you can see from the comments, we all have our own ways and reasons for what we do or don't do when changing. I use soap with moisturizer in it as I have dry skin; it's right for me.

The worst thing that could happen is you get a leak and need to change the device sooner. 

Look for evidence of stool leaking under the flange. I use flange extenders to give me a better chance of spotting the leak before it makes a mess. 

You're fine, but it's best not to leave soap residue as that does dry out the skin and make it itchy.

You are a good daughter indeed!  As others have said, it will probably be fine.  Just make sure in future, to rinse any soap residue off the skin, and dry well.  My ostomy nurse always said that the best surface for an ostomy appliance to adhere, is simply clean, dry skin, no sprays, wipes, powders, etc.  As long as her skin is healthy, simple is better.

Terry

Thank you for the suggestion of not using soap at all. That's really good to know! I think I may try that.

My mom is very proud of me. She tells me all the time how blessed she is to have me. And I feel the same way about her.

Thank you so much for your reply and your sweet words! It's definitely good to know that you and other members here only use warm water to clean the stoma and skin around the stoma.

Thanks for your response. I am learning so much from this post. I guess you are right, everyone has their own way of doing things. You just have to find what works for you. Thanks so much!!!

This is very good information!!! I didn’t realize soap residue can dry out skin and make skin itchy. I will ask my mom if she feels itchy to keep an eye on things.

This is very good information!!! I didn’t realize soap residue can dry out skin and make skin itchy. I will ask my mom if she feels itchy to keep an eye on things.

Thanks so much Terry!! I feel so much better after posting this question and seeing all these responses. Thanks for the tip from your ostomy nurse!!

Thank you for the tip! I had never heard of flange extenders before.

I use warm water and ivory soap, then rinse well and pat dry. I've had a urostomy for 55 years and have never had my skin dry out. Flange extenders are crescent-shaped strips that go around the flange after applying the appliance to the skin. They help prevent leaks. I also use barrier rings that go on the flange before putting the flange on the skin.

Thank you so much for your reply!! After you described flange extenders, I think my mom got them as a sample awhile back. My mom also uses barrier rings as well.

Since she hasn't been using flange extenders regularly, she may not need them all the time. I'd be tempted to stick them on whenever you think there is greater potential for a leak. 

I currently use them all the time but 1) I'm new, 2) I've had some leak issues while learning, and 3) I needed a belt but didn't have one yet.

Now that I have a belt and a bit more confidence, I plan to try leaving the flange extenders off except when I feel the need. 

Thanks for the tip. This is good to keep in mind. Best wishes to you