Hi there... The paste I am referring to is the Coloplast strip paste sticks. They come 10 in a box and are 4 1/4 in. long. I usually snip 3/4 of an inch off, but if the flange center hole you cut is larger, you might use the entire stick. I take what is left, roll it into a ball, and then roll it between the palms of my hands to make a piece long enough to encircle the cut-out hole on the flange. (This warms it up and makes it pliable)
The next step after cleaning the skin around the stoma with baby wipes (don't torment the skin with soap or getting it bone dry, it doesn't need it) and nipping off any hair that needs removal, spray the entire area with Cavilon barrier spray (I use it for every change) and without waiting for it to dry, I slip the flange with the attached paste on over the stoma and fix it in place. NOW for the final step, and if you don't want to bother with this, you might as well forget everything I just said... TAPE THE EDGES OF THE FLANGE AND LEAVE IT IN PLACE FOR 10 - 12 HOURS... THE REASON FOR THIS IS THAT 1.. IT REDUCES THE CHANCE OF THE FLANGE MOVING AND GETTING CREASED 2. IT WILL ASSIST THE PASTE IN CONTACTING WITH THE SKIN AND THUS CREEPING IN BOTH DIRECTIONS, IE. AWAY FROM THE STOMA AND THEREFORE HELP BOND THE FLANGE WITH THE SKIN AND MOST IMPORTANTLY IT WILL CREEP INTO THE SPACE BETWEEN THE EDGE OF THE FLANGE AND THE STOMA AND SIGNIFICANTLY REDUCE THE CHANCES OF A LEAK... ALSO... IF YOU ARE USING A 2-PART SYSTEM WITH A LOCK ON THE BAG.. TAPE THE LOCK SO IT CANNOT OPEN WHEN YOU ROLL OVER IN BED OR ACCIDENTALLY HIT IT... MOST OF MY "OH CRAP" MOMENTS HAPPEN BECAUSE THE LOCK IS COMPROMISED BECAUSE I EITHER FAILED TO TAPE IT OR LOCK IT IN THE FIRST PLACE... THE FLANGE SET UP GENERALLY DOES NOT LEAK... And on the occasion it does, it's generally because I was very active, cleaning, rummaging around in the bowels of my boat, or it was very warm and sweaty. In such a case, I normally would tape it because the edges of the flange would tend to break away from the skin... Post any questions you have... I will try to answer them... One last point, I stick to the paste sticks for two reasons. The fancy barrier rings are more expensive than the paste, and in my opinion, they do not provide the volume of material that I want to fill the space between the stoma and the edge of the flange. There is no problem in removing the flange after a week. Take both hands and lift it slowly. You should not have to use any paste remover to clean up under the flange, but you might want to remove some tape glue that will stick to your skin beyond the edges of the flange... And finally, EXPERIMENT with different products and suppliers and PROCEDURES... ET nurses are great, but listen to your common sense.. From person to person, your skin properties, stoma set up, discharge flow, availability of product varies considerably.