A very difficult situation believe me but I thought I'd share with you my latest greatest method.
Products used.
Coloplast Sensura Mio convex one piece
Brava no sting paste
Stoma powder
Extra large moon shaped barrier strips
Silicon bath and shower project type waterproof gel tube (construction item)
Don't worry, the silicon never touches the skin or is exposed to it with fumes with this method. It's stronger than paste, flexible and a heck of lot cheaper and easier to apply when time is important for fast application
Preparation:
1: Precut wafer hole to match stoma, leave backing on for now. Seal up end. Horizontally weaken the wafer and especially the convex bubble so it's flexible and slightly curved.
2: Cut two barrier strips into 1/4 pieces and set aside.
3: Have a piece of smooth product cardboard to mix paste with a little stoma powder on and a flat wood or plastic stick. Toilet paper balls on the ready.
4: Remove old wafer and shower using a spare wood or plastic stick to sideways scrape off any stuck on glue etc. Do not use fingernails. Wash stoma area with nothing but liquid antibacterial soap. Wounds may sting a little but a lot less than alcohol or iodine. Do not use any other products around stoma area.
5: Dry off and go lay down at your preparation station. Do not do this while vertical. You'll need to rest while things set up. This is not a quick slap method due to being more involved and durable so it lasts 4-7 days a time.
6: Use dry toilet paper to dab stoma area dry, catch any slight leakage and blow dry the area extremely well. If any spew gets on the skin, you need to head back into the shower and wait it out until it's done then antibacterial soap wash one last time again. You need absolutely clean, dry, dust and oily free skin for the adhesives to bind well to wounds and skin. Spew contains oils and ruins adhesion. Time your bag changes by all means possible with a quiet stoma. With this method can assist in certain leakages to buy you time keeping the bag on as you'll see later. Wounds from leak burns you need to blow dry until a dry crust forms on it. Skin must be finger drag dry to the touch, not slippery or smooth. This is very important. The antibacterial soap should have killed any infection in wounds and hopefully stopped any weeping. (If weeping is occurring still then stoma powder followed by skin barrier dried well and just keep using a quick slap paste and wafer method everyday until the skin heals enough, do not use this method any further)
7: Put a small toilet paper ball in your belly button hole to level and cover with a 1/4 cut barrier strip. Place a full moon shaped barrier strip as shown here. Blow dry heat activate any barrier strips applied.
And another at the top (not shown) leaving a ring of skin exposed inside. It will be covered later. This is designed to protect the skin in case of a leak between the wafer.
8: Once stoma area is extremely dry and any wounds have a dry crust. You mix a little paste with stoma powder with the flat stick well onto the smooth cardboard, then grab a small ball and spread it next to the stoma pulling and pressing down and around spreading first from one side then the other 50/50 from where you first applied it. Focus on the wounds first and if it doesn't stick remove with toilet paper off the stick and discard. Blow dry and try again. Repeat this process until a THIN coat of paste extends about 1/2" away from the stoma.
8: Next quickly apply the 1/4 cut barrier strips curved part right next to the stoma pressing paste up close to the stoma and down onto the skin. Do not get the strips on top of the stoma, it extends out and will pull up causing a leak.
Press down well around stoma. You need a nice tight seal here. This layer is designed to protect the skin as much as possible.
(If your wondering why I'm not using a protective sheet, it's because it's often hard to cut a tight hole and because the sheet is one big piece, it tends to buckle more than using cut barrier strips. When the cut barrier strips I can get it right up and even push the paste a little to cover a tiny gap next to the stoma. Thus focusing on getting a tight seal better.)
9: Next apply a ring of paste around the stoma and on top of the barrier strips. It's designed to protect the stoma from the silicon construction gel and marry to the wafer.
10: Next peel the backing off your convex wafer and the outermost edge of the convex bubble apply a bead of the silicon gel. Press the whole mess on and be careful not to press too hard that paste covers the stoma. Hold on place to get things to bond. My silicon get sets in 30 minutes. Stoma powder mixed paste sets faster, undiluted paste likely longer, like a few hours. If you go vertical too soon, unset paste WILL run out and cause leaks. Why many use rings but in our case we need paste and very strong adhesive so the wafer will BEND when we sit or get up etc. and remain on on our belly folds.
10: Now just add two full sized extra large barrier strips to the wafer flange and under the hooks all around meeting at the bottom. One 1/4 barrier piece at the top to fill and prevent shower water from getting in. You should blow dry heat activate any barrier strips applied during this process, it also helps seal the edges from water leaking in.
Remain laying down and DO NOT apply a stoma belt until your ready to get up a few hours later when the paste has set up. This is because stoma belts pull down and cause unset paste to leak out, curves the wafer. You want a nice flat wafer with solid paste base underneath that when you bend over will bend horizontally along with your body. If the wafer is curved the other way, it will hinder the horizontal bending process. When you do apply your belt, it should be just slightly snug. I advise laying down or sleeping only on ones back as the belt or the body can cause the wafer to detach. I use pillows under each arm to train myself to stay on my back.
Now your likely wondering why the barrier strips under the wafer, well it's to protect the skin of there is a leak between the wafer and the barrier strips underneath. Combined with the exterior barrier strips, forms a pocket that contains spew until you can get home, wait out the stoma activity so it dies down and your not sitting in the shower for hours on end. Say goodbye to ruined beds and bedding! Most times you won't even feel the leak has occurred unless it starts dipping out a little somehow, but that's a lot better than a total blow out mess.
Now the only other place it will leak is around the stoma itself where the stoma paste and powder mix was applied. It will first start out as an itching feeling but sometimes it's caused by stress of the paste when bending too much and goes away. So it won't be a blow out type mess, just a little annoyance that grows in intensity so you can see you'll need to take action soon and can slightly suffer until your stoma quiets down enough to do a bag change. Sitting in the shower for hours totally sucks, especially when you run out of hot water. This is all fine unless you drink coffee then the burns may be extreme and even the tinyest leak will want you to tip the bag off right away.
So now you can bend a little, like when getting up and sitting, but don't overdo it. If your a heavy coffee drinker the burn feeling could be extreme as the body is just flushing acid out of the stoma. So quit coffee and switch to tea, however any caffeine is going to cause the stoma to have diarrhea. Why it's really important to follow an eating guide knowing what foods cause more liquid output and more solid output or cause diarrhea where it could be hours before the stoma quiets down.
With this method and our problem you want pea soup consistency of output as much as possible. Too liquid and it leaks easier as it gets into the cracks better. Too thick will cause pancaking and force itself under the paste to leak. Too many hard pieces can cause a clog or force the stoma to extend out and break the seal. Watch for pancaking and advert using a water bottle and lay down and massaging the stoma area until it dissolves. Do not push the output or squeeze the bag as that can cause a leak..
This is a very involved process costing more than a normal quick slap, but it's designed to be more durable and deal with our issue of belly folds with low stomas better. But it requires babying it, careful attention to diet etc. But it gives us relief from daily (or more for some ) wafer changes that can get quite expensive.
And when sleeping avoid big dinner meals (small frequent nutritional meals) and elevate ones upper body some so output flows to the bottom of the bag and not hang around the stoma where it can leak easily.
Good luck! 😊
