Tips for Extended Wear Time with Hollister Product

Good day everyone

I was wondering if someone could provide me with tips on the following

Sometimes when I change my flange, my stoma is quite flat - and the output is either watery or very thick (ileo with anti-diarrhea meds) so that means that the flange stays on maybe for an hour or so and then comes right off or it opens at one side or top or bottom

My stoma is close to the wound and the flange has a tendency to roll up on the one side so they don't stay on long - maybe 2 days

If anyone could help me, I would appreciate it - my skin is a mess and I'm tired of doing laundry so often

I have the Medical Spray Adhesive from Hollister but I don't think that I am using it right - tips on this would help too

I've had to put on 4 different flanges today and it's driving me nuts

Please help LOL

Dry on dry works best for me. I use Ivory soap with no additives and nothing on my skin. It seems anything I add keeps my flange from sticking well. I occasionally have an issue with itching. Aloe vera plant - a small piece crushed - rubbed on the surrounding skin works best for me - air dry completely. My stoma is pretty flat and sinks a bit occasionally. I hold a cloth over the attached flange (press lightly) and keep the skin warm until there is time for the adhesive to stick well to my skin - at least 15 minutes - to ensure a good bond with my skin. The flange lasts anywhere from a couple of days to a week.

That being said, I have not had to deal with any wounds or open sores. I am sure it would be different and should be treated differently. I hope this helps someone. The frustration can be overwhelming when things don't go well. My surgery was in Aug 2010. So I am still pretty new to 'stoma stuff' and always looking for advice.

This site is where I have learned everything. I came home with no information and no external help source. Thanks to all of you.

Hi Tess, thick and watery output is usual for me and I put this down to a varied diet. What isn't normal is your leakage and skin problems. Have you considered that the brand of appliance you are using may not be right for you? For me, having an ileostomy was a way of getting back to normality and fortunately this has been the case. If your flange is fully secure, your diet is not an issue so concentrate on that. Various barriers are available, as you probably know, but I would concentrate on getting a good tight fit around the stoma with the right brand of appliance for you. With a good fitting flange, barriers should not be necessary. Yes, do all the right prep like ensuring the skin is completely dry, warm the flange before fitting and even add a quick dry barrier like 3M or Cavilon etc., but leaks should not be a worry at this point. I swear by 2-piece appliances as I think it is impossible to get any kinks in the baseplate/flange as they are more rigid and you can also see you have good alignment around the stoma before securing your bag in place. By the way, I use Coloplast Assura 2-piece and have had no problems, just keep things simple!

I tried the Coloplast product but I seem to be allergic to their flanges. I used to get 5 to 7 days of wear time with the Hollister product and have been very happy with it. I really don't know what has changed. This time, I said screw it and did all the usual prep but put the Eakin seal around Stephan (what I call my stoma) and then I attached the flange to the Eakin. So far, so good. But every piece of advice always helps. Thanks.

Why not try using a support belt around your waist (the type people use with back problems)? Cut a hole in it the size of the plastic ring part of the flange. Then pull the pouch through the hole. Wrap the belt around your waist and then fasten it with Velcro or the like. This should help keep the flange on. You can order proper belts if you like, but they could be around $40 (about $75).
This is the type of belt that people use for hernias, etc.
Try it out. It could solve your problem. Let us all know how you get on.

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I use Covetec flange. Clean area around stoma. I use Skin Tac, then put Karaya gum powder on and spread it around. Spray Skin Prep, apply more powder, spray Skin Prep again. Make sure final application is dry. Put paste around stoma and spread it out a little. Put paste on and put a little paste around the flange stoma opening. Spread it a little and let it dry. Put the flange on and press around the stoma opening, holding the flange. Peel the paper off and work adhesive on both sides. Press hard on top, bottom, and sides of the flange. Then put the belt on. This certainly helped me. Let me know how or if you try this.
Toughangel

Hi Tess;
Boy, are you living my experience!
First, let me assure you that you are doing nothing wrong - I too end up changing my appliance every day or two. In my case, due to a less than 3/16" opening - so NO flange seals correctly (I just have to keep my mantra - this is reversible to keep sane.)
Let's address the open sores - I have them too.
1) Calamine lotion - use a washed finger/glove to paint a thin coat of calamine on the inflamed area - dry well (hair blower on cool) - repeat if weeping seeps through the first coat and then put on the flange.
2) Maalox is said to work similarly - but I was warned to make sure it is not the flavored (mint) type.

Above two solutions from the Ostomy/wound care nurses in Sydney.

My local Home care nurses added a real saver - ConvaTec makes "DuoDERM" (extra thin, ref. # 187957) - cut out small, rounded-edged pieces of this product and apply to dry, clean skin - the Hollister 14803 flange will stick to this product, and thus the worst of my sores are protected.

So, may I also suggest, if you are using the so-called "flexible" flanges to switch to the harder (but less skin irritating for me) Hollister 14803 - yes, you have to cut out the opening instead of stretching to fit - but something in the harder surface is less irritating to my skin.
Also, if like myself your stoma has retracted, try the Adapt flange to make a better seal.
Hope all who have skin sores try these solutions! Trial and error is what my ostomy nurses told me to be the only solution when we are having issues with our appliances!
Blessings - painmed

I second the belt idea. My stoma was very low on the left side until I started wearing a belt. Now my stoma sticks out more overall. Also, use an adapt barrier ring to help prevent leaking.
KBD

Have you tried Convatec products? My ostomy nurse started me off with them, and I have tried others just because they offered to send me samples. Honestly, I will only use Convatec because I have never had any problems. I change once a week and forget about it. Their customer service is excellent!

Actually, I just got a sample pack from Convatec - it has their new mouldable flange product and it is convex. However, the fabric part of their flange is huge and will sit in the open surgical wound that is healing, so I can't try them yet. I am a very small girl - only 5'6" and 94 lbs - so the Hollister flange is just about the right size for me. Have you ever cut the sides of the Convatec flanges to fit your body?

Tess,

I had the same issue with my first ileostomy. I had an active mucus fistula that gave me all sorts of trouble.

I am on my second ileostomy now and it happens to be about 3 inches above the original. I played with all sorts of products until I found the right fit. I use a Convatec one-piece convex. I also use a skin barrier and paste.

After a few years without skin issues, I started getting sores. It took a while and after a slight diet change (it took forever to nail it down to oranges of all things), they started to dissipate. In the meantime, there were a few different products I used (which have already been mentioned), but one in particular helped me. I'm sorry, but I can't remember the brand name right now, but it was a thin clear film roughly the shape of the circular flange and the square paper adhesive attached.

I found that using that thin film and cutting it as well as the paper adhesive and even an edge of the flange to give me just enough clearance to fit around the wound below solved both issues.

The wound didn't seep into the adhesive and the extra thin film helped with the sores. When I did change the appliance, I used to make extra time to allow a product like Polysporin Quick Drying Antibacterial Cream (calamine worked too). Allowing it to dry before you reapply your appliance helps a lot.

I know the temptation to rush getting the old one off and the new one on to get on with your day is tempting, but a few extra minutes of pampering the skin around your stoma will help a lot.

Hope this helps.

Life is good!

Michael

Thanks for the info - but the wound that I have is the surgical wound from my operation, it has been slow to heal - it is not an open sore - so I really don't need tips for that kind of thing - but I do thank everyone for their help.