Constant leaking and detaching of ostomy pouches, need help with solutions

Spouse had surgery 9/8/16. He has a urostomy and temp ileal ostomy. Since surgery, we have had nothing but problems with the pouches attaching to the skin. Hospital, home wound nurses, and home health have all tried helping. Nothing is working. Constant leaking or detaching. Between both pouches, we change on an average of 4-5 times within a 24-hour period. Spouse's skin is not infected or blistered, but it kills him every time we need to change. He is receiving fluids for hydration. Could being dehydrated be the reason for the skin breaking down? Any suggestions or product lines? He has lost 54 lbs with this ordeal and has extra skin creases. I refer to them as love handles. Any help on this matter would be appreciated.

Hello and welcome to the forum. I do not have a urostomy, so I can't speak from firsthand experience about them. I do have lots of experience with a colostomy, and they should share common problems on wear time. The most important step for a reliable seal is site preparation. Wash the area with a soap that contains no oils or perfume. 95% of soaps have them. I suggest yellow Dial. Others may work, but I know firsthand about Dial. Use a good skin prep. This is a wipe-on "barrier" that dries tacky. Use an Eakin ring if possible. This replaces the old "paste". Cut the flange so it fits snugly. Warm it with a hairdryer before you put it on. If possible, change at bedtime so the whole works has several hours to stick while you are not active. If the above doesn't help, change the brand of flange you are using. Not all products work well with all skin types. Don't just keep trying the same setup, or you will get the same results. Most ostomy companies will provide you with a few free samples to try. Most have a helpline. Call them, explain what you are using, and ask what they have available. Try all of them until you find what works. Don't forget proper prep. Good luck and keep us posted on your progress. You will master this. We have all been in the same situation. Be patient, be vigilant, God bless.

Welcome to MAO.

Not much else to add as MMSH has given you great advice. The only question I have is, is his stoma flush with his skin because you may need to try a convex flange. This will help force the stoma out a bit so the output goes into the bag easier, rather than forced under the flange.

Hope to hear how you're doing.

Thank you for your advice. We are trying different one and two PC pouches. I use Dial soap and perform the same skin prep. My husband has a colostomy so much weight that he has rolls and creases when he stands up. His stoma is not flush with the skin. It sticks out about 1/2-3/4 of an inch. When lying down, I change the pouch and everything looks perfect. When he stands up, the flange barrier eventually, over an hour, slowly rises over the stoma, therefore the stoma looks like it's buried and eventually leaks. He has been so dehydrated that we are getting fluids at the infusion center.

We have done 8 days' worth now. Last Thursday, we placed a Coloplast Sensura Mio 2 PC and it lasted 44 hours. Saturday and Sunday, he did not receive fluids and the pouches did not stick. We are back to getting fluids every day this week until we see what happens. The doctor also gave him something to thicken bowels so the body can absorb nutrients. He now has a wound hole between his pouches, a ball of collective fluid. It does not help the leaky pouch situation. We are battling a bacterial infection now. I know this will all pass eventually. We are frustrated and lacking sleep for both of us. I am like a mother with a newborn going under the covers with a flashlight to see if there are any leaks while he is sleeping! Lol. I will be in touch. Thank you again for your help.

Hi Ostomyspouse

I really feel for you

The frustration and the sleepless night...

But you seem to be keeping your chin up - so well done and keep LOLing

I also use Sensura Mio and initially had some adhesion problems

I think the adhesive remover I used was leaving minute traces of oils maybe, as if I did a quick off, bathe and replace. (as you do for the ostomy nurse checkups) I would invariably have a leak the next day.

But using the same adhesive remover, I now wash the adhesive area very thoroughly with soap and water, then dry with a hand-held electric fan for some minutes.

I apply the new pouch standing up and leaning back so as to minimize my spare-tyre 'folds'. Then without bending, I leave the tidying up till later and lie on the bed for a 1/2 hour with my hand clamped on the adhesive area to apply warmth and pressure.

This is quite a palaver - BUT I now get a minimum of 7 days without leaks, and often 14 days or more.

I have an active job, and when there is to be a lot of carrying heavy gear around, I add supplemental strips of Microporous tape as 'belt and braces' and for peace of mind.

I always carry the tape anyway as it can hold things together until I get home if I'm out and about.

(FWIW I am in the UK, and use Sensura Mio bags, Sainsbury's Microporous tape, Wright's Traditional soap, and Coloplast Brava adhesive remover)

I hope this is of help to you or anyone else

Good luck and keep smiling through

Nick

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Try adding a belt to the Sensura Mio. I find a belt makes all the difference. The belt should be snug but not too tight that it harms the skin.

Thank you Nick! I will take your advice. Spouse has been receiving fluids for the last 2 weeks. Surprisingly, his skin has hydrated and our usage of pouches has gotten a little better. On his Ileal, we are using the Sensura Mio 2. PC click. As of today, we got 74 hrs out of it. The urostomy, we are still having trouble finding one that will stay on for a day or longer. I am constantly on the computer looking for pouch samples. A company called Braun from the UK area had several different lines. The gal I spoke to asked me questions and sent me a few samples. Lordy behold......it stayed on the urostomy for 23 hrs. Tried the other one but did not last as long. The quality of the product is equal to Coloplast. I spoke to her again today and told her I was pleased. She is sending me more to try before deciding. Very nice company rep. Someone else told us to stand when attaching the pouch. We will try that too. Will keep in touch. Thank you again for your advice and thoughts. Ostomyspouse

Microporous tape? I've got to look that one up as I haven't heard that term before, I don't think.

Well, it seems it is a paper tape. I have to watch out as I am allergic to some latex.