Hello,
I am 2.5 weeks post distal loop colostomy due to Crohn's and poor transit time. I have some purple (not red or warm) discoloration around the stoma from 12 to 3 o'clock, and it's a bit tender. I was placed on antibiotics just in case. I was wondering what everyone's thoughts were on whether it's from skin irritation or something else? Thank you.
G-Day Amillman,
Is your hole in the base too tight around the stoma?
If it is, cut the hole just a little bigger and use a sealing washer to make up the difference.
Regards, IGGIE
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Are you in a convex wafer? If so, with some people, it does and can leave a bruise.
I wear a flat wafer, but the peristomal area is convex.
I would go to your doctor and have my skin checked after my surgery turned purple, and they had to go in and redo it because it was failing.
It might still be bruising with a flat wafer. You might try a different brand of appliance. Look for one with a flexible wafer. Call and get samples.
Advice to see your doctor is good, but it sounds like he has already seen this, which is why you are on antibiotics. But watch for worsening or spread.
I've seen my doctor and ostomy nurse. The stoma itself is functioning well with good color; I don't think they are concerned about it failing. I think the shape of the wafer is probably the issue. I will try a flexible wafer or ring and see what happens. Thank you all for your help.
Hey Amillman, good to hear your skin is not an issue. Not all convex wafers are equal. I use a soft convex bag from Hollister that has a lot of flexibility. If you opt to try convex, and with your peristomal area being convex you may want to, soft convex is a good choice.
Hey there, so wafers only come in flat or convex. If you are in a convex, you shouldn't be only 2 weeks out of surgery. That's way too much pressure to be around a new stoma. You're still really swollen, and you have stitches. There are a lot of reasons a convex should not be used right now. And also, as Iggie said, get it checked out by your surgeon who just did the surgery and not by the ostomy nurse.
I disagree. My stoma nurse put me in a convex wafer immediately after surgery. I woke up with a convex wafer on my urostomy and suffered no ill effects. It was a flexible convex wafer, and I suspect that flexibility is a key difference in the tolerability of the wafer. Had I not been placed in a convex wafer, I would have had far more leak problems than I did. If you need convexity, you don't have a choice.
I feel this might be the issue. If I'm not able to put on a convex wafer, would the solution be a sealing washer? I'm using Hollister 57 mm flat Ceraplus wafer for a 2-piece system.
I'd add a sealing washer regardless. These have been indispensable for me.
But I'd still try a more flexible wafer. More flexibility means you can move more freely without putting too much pressure on your skin.
Susan, she never should have. One, you just had surgery; you don't even know how your stoma is going to be or if you will even need a convex wafer. Another thing, your stoma is beyond swollen, you have stitches on the inside and around the stoma. The last thing you need is pressure pushing around your new stoma and pushing your freshly stitched stoma out, causing the stitches to break, snap, or tear, which will end up causing you to prolapse or retract. Also, another thing is the wafer is way too hard to be around the stoma and on the skin. You should be in a flat wafer until you heal, then find out what and how your stoma is going to be and if you need a convex later than you do. But it never should have been done right after surgery, just like an ostomy nurse should never come to change your bag the next day right after you had surgery; there is no point, as you are at one of your most swollen points. I have never let an ostomy nurse try to change my bag 12 hours later after surgery or the next day. There is no need and no point, which my doctor was beyond relieved to know I kicked her out. Because ostomy nurses don't know what the heck they are doing at all.
I like you, but you are wrong about ostomy nurses. Some of them are probably incompetent, but not all of them. Mine were great.
The bag I'm referring to was the one they put on when the surgery was done and I was still unconscious. Surely you don't mean to suggest that I should have been left bagless.
And my urostomy was flush with my skin level from the start. Blame my urologist. But it was an immediate leak issue, and she acted to prevent me from having skin issues on top of everything else. In the end, the stoma retracted below skin level, and we had to switch me to a Coloplast deep convex to stop the leaks. I shudder to think how bad my skin would have been in a flat wafer.
That nurse gave me great instruction and advice. It was a good starting point in general, and I appreciated her very much. Yes, I have learned a lot here, but I got a solid grounding in the basics from my ostomy nurse.
You won't know the solution until you try. All I know is when I tried a convex wafer/bag (I use 1-piece setups), it bruised right around my stoma and would be very sore. Almost instant relief when I'd take the stuff off to shower. Then, back to painful when I put a new one on. I went back to a flat wafer/bag and never had it again.
SusanT, I completely disagree. Ostomy nurses do not know what they should know. I have met five different ones, and every last one of them was clueless. Let's see, one sent me home with a stoma that was starting to turn black, and it ended up dying, which I repeatedly told her something was wrong. Two other nurses didn't know how to handle one of my retracted stomas and were taking notes from me. Another one tried to slather cream around my stomach before and after putting on the wafer. Another one tried ripping off my wafer without adhesive remover, then tried cleaning around the skin with an oily wipe, and I can go on and on. Oh, and another one put on an ostomy ring wrong and cut off the circulation to my stoma and put me in the hospital for a week, and all these ostomy nurses had over ten years of experience, some reaching seventeen years. And this is in two different states and different hospitals and medical buildings. So none of these ostomy nurses were connected in any way. They literally read off a pamphlet. We know more than they do, and a lot of it is common sense. And no, you should have never been put in a convex bag coming out of surgery at all. Or just having it done, you should have been in a flat one-piece clear bag. And every brand makes one. You switch to convex after you know how your stoma is going to be. Not fresh out of surgery, not with stitches, and you should not be putting pressure like that around the stoma right after surgery.
Not only is my ostomy nurse a great nurse, but she calls me regularly to see how I am doing.
IGGIE
I've never had much luck either, Beth. Whenever I've reached out to an ostomy nurse when I had an issue, I wound up having more luck fixing it myself.
SusanT, one or two would be a bad nurse, not a full-page list.
It's true we know more than they do; they will make it worse, put you in horrible situations that could have been avoided, and we are the ones that have to deal with the fallout from their mess-ups. What's sad is that it's actually common sense, such as you don't put a convex wafer on someone whose stoma is sitting in a roll; it doesn't work, or when you are retracted to skin level and below, you do not put on two barrier rings, especially when the whole point is to get the output in the bag, or you do not put on oily ointment when you know the bag doesn't stick to it, and the list goes on. Common sense.
My nurses have been brilliant and have told me most of what I know. The main deficit was in preventing pancaking, but then again, none of the tips on here have helped me prevent that either.
Like any profession, competence varies. I would always recommend a new ostomate start with an ostomy nurse and adapt from there because they may get lucky like I did.
