Urostomy: How do you care for skin under the wafer?

Posted by katydid77 @katydid77, May 8 6:37am

Could someone shed light on how to care for skin under the wafer? My husband had surgery last November and we are still learning about care of the skin. I know the skin needs to be left open to the air when possible but since there is constant drainage I don’t know how to go about it. This group has been so helpful.

Good question, @katydid77. I'm calling in fellow members to help answer, like @engelee @bcstew @jshollett @mlmcg @candywocrn @amyp304 @jimmy2248 @formydad and @nickkarenl

How is his skin about the stoma? Is it irritated?

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Hi @katydid77, The best way to care for your peri-stomal skin is with water. When you remove your pouching system, clean the skin really well with warm water. Then pat the area dry before placing your wafer back on your skin. Try to avoid soaps with lotions added. If your skin is irritated, you can try some stoma powder and skin protectant under the wafer before applying to help. Here is a link to an article on tips for skin care around your stoma: https://connect.mayoclinic.org/page/living-with-an-ostomy/newsfeed-post/peristomal-skin-care/

There is also a great website that you can use to help diagnose issues that may arise with the skin around your stoma. It is called the Peristomal Skin Assessment, https://psag-consumer.wocn.org/#home.

What tips do others have to maintain healthy skin around their stoma?

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He should be getting wafer prep moist pads from your supplier (I use 180Medical for my ostomy supplies – they are excellent).
When he removes the wafer and pouch for a redressing, he should shower, use a mild loofa to prep the area (the stoma can handle this – just not aggressive rubbing) and then dry very thoroughly. After drying, use the prep pad to introduce a roughed up area around the stoma. Keeping it dry is the most important practice. The area to keep very dry should be about 4" – 5" in diameter to make sure the wafer surroundiing area is totally dry.
Take the adhesive papers off of the wafer and press hard all around (both the outer adhesive area plus the circular cushion pad right around the stoma).
That should do it.

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I used to have skin problems especially when it is very hot and humid. Now every time I have to change my ostomies ( I have 2) I take a shower without wafers, just open. At one point I soap up with Ivory soap and wash each stoma. After the shower ( hopefully without leaks don’t drink several hours before changing.) when the stoma is quiets and area clean AND DRY I apply 2 Sensicare adhesive wipes to the area. No stoma powder etc. The important thing is to make sure skin is DRY when wafer applied . When really hot, you do have to make adjustments in lifestyle and avoid heat,direct sun.

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@engelee

I used to have skin problems especially when it is very hot and humid. Now every time I have to change my ostomies ( I have 2) I take a shower without wafers, just open. At one point I soap up with Ivory soap and wash each stoma. After the shower ( hopefully without leaks don’t drink several hours before changing.) when the stoma is quiets and area clean AND DRY I apply 2 Sensicare adhesive wipes to the area. No stoma powder etc. The important thing is to make sure skin is DRY when wafer applied . When really hot, you do have to make adjustments in lifestyle and avoid heat,direct sun.

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Thanks @engelee. Do we need to give the adhesive wipe time to dry also before applying the wafer? His skin has not broken down yet but is very irritated. We have been using the wipes and he showers without the wafer when it is time to change it.

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@jshollett

He should be getting wafer prep moist pads from your supplier (I use 180Medical for my ostomy supplies – they are excellent).
When he removes the wafer and pouch for a redressing, he should shower, use a mild loofa to prep the area (the stoma can handle this – just not aggressive rubbing) and then dry very thoroughly. After drying, use the prep pad to introduce a roughed up area around the stoma. Keeping it dry is the most important practice. The area to keep very dry should be about 4" – 5" in diameter to make sure the wafer surroundiing area is totally dry.
Take the adhesive papers off of the wafer and press hard all around (both the outer adhesive area plus the circular cushion pad right around the stoma).
That should do it.

Jump to this post

Thank you for your reply @jshollett. I did not know about using a loofa. We have finally (we hope) learned how to apply the wafer and to get it to be leak-free for more than two days. We found that eliminating the barrier ring and using a Coloplast convex wafer works best for his anatomy. I hope the ring is not a necessary item to protect the stoma.

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@candywocrn

Hi @katydid77, The best way to care for your peri-stomal skin is with water. When you remove your pouching system, clean the skin really well with warm water. Then pat the area dry before placing your wafer back on your skin. Try to avoid soaps with lotions added. If your skin is irritated, you can try some stoma powder and skin protectant under the wafer before applying to help. Here is a link to an article on tips for skin care around your stoma: https://connect.mayoclinic.org/page/living-with-an-ostomy/newsfeed-post/peristomal-skin-care/

There is also a great website that you can use to help diagnose issues that may arise with the skin around your stoma. It is called the Peristomal Skin Assessment, https://psag-consumer.wocn.org/#home.

What tips do others have to maintain healthy skin around their stoma?

Jump to this post

@candywocrn, thanks for the links. We appreciate all the help.

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@colleenyoung

Good question, @katydid77. I'm calling in fellow members to help answer, like @engelee @bcstew @jshollett @mlmcg @candywocrn @amyp304 @jimmy2248 @formydad and @nickkarenl

How is his skin about the stoma? Is it irritated?

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Yes it is, but so far, no lesions or fungus. Thanks for helping.

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@katydid77

Thank you for your reply @jshollett. I did not know about using a loofa. We have finally (we hope) learned how to apply the wafer and to get it to be leak-free for more than two days. We found that eliminating the barrier ring and using a Coloplast convex wafer works best for his anatomy. I hope the ring is not a necessary item to protect the stoma.

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Yes. I just wave a 4×4 over it for about 30 seconds

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@katydid77

Thank you for your reply @jshollett. I did not know about using a loofa. We have finally (we hope) learned how to apply the wafer and to get it to be leak-free for more than two days. We found that eliminating the barrier ring and using a Coloplast convex wafer works best for his anatomy. I hope the ring is not a necessary item to protect the stoma.

Jump to this post

I would be worried about a loofa. I think it’s an unnecessary action with potential problems if any part of it is loose

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I would like to help you as I have had serious skin problems my self after my coloscopy last year. Also the stoma is flat/concave so I need to use a barrier ring in order to make a good seal around the stoma. However I am not sure what you are referring to when you say the 'wafer'. Are you talking about what I call the 'flange' to which the bag is attached? I have read the other replies you have had and it is all good advice. Do you have an Ostomy specialist that can look at your particular problem and advise what would work best? Do not ignore the skin problem it will get worse.

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@bcstew

I would like to help you as I have had serious skin problems my self after my coloscopy last year. Also the stoma is flat/concave so I need to use a barrier ring in order to make a good seal around the stoma. However I am not sure what you are referring to when you say the 'wafer'. Are you talking about what I call the 'flange' to which the bag is attached? I have read the other replies you have had and it is all good advice. Do you have an Ostomy specialist that can look at your particular problem and advise what would work best? Do not ignore the skin problem it will get worse.

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I am calling the part attached to the pouch as the wafer. This is a one piece pouch. Maybe it is a flange on a two piece. ??? We are Mayo Clinic patients so yes, there is an ostomy nurse. We are located over an hour from the clinic so we go for an appointment only when required. Thank you for your concern. Everyone has been helpful and appreciated.

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After a shower and gentle soap cleaning I do 2 things that has helped me. First , I use a portable hair dryer to dry the stoma area. Then after I apply the apparatus I use Hy-Tape ( very skin sensitive, and friendly, but sticks really well) . I use this as a supplement to the barrier and put a piece about 2 inches long at the top, bottom and sides of the flange. I play tennis 3-4 days/ week, I shower 3-4 times / week and live in Hawaii witth 80+ temp. My device last 6-7 days.

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@dragonass

After a shower and gentle soap cleaning I do 2 things that has helped me. First , I use a portable hair dryer to dry the stoma area. Then after I apply the apparatus I use Hy-Tape ( very skin sensitive, and friendly, but sticks really well) . I use this as a supplement to the barrier and put a piece about 2 inches long at the top, bottom and sides of the flange. I play tennis 3-4 days/ week, I shower 3-4 times / week and live in Hawaii witth 80+ temp. My device last 6-7 days.

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@Dragoness. Thanks for your input. It’s amazing you have found a way to be active and yet have success. Are you using a two piece pouch? Since I last posted here we have had a visit with the ostomy nurse at Mayo Clinic Jacksonville. We now use a one piece, deep convex pouch. We use no barrier ring or extra tapes of any kind. We change it every four or five days and have (knock on wood) had no problems with leakage. We have a new lease on life.

Our Nurse, Kathy, has us using over the counter Flonase as an anti inflammatory on the skin and it was magic. Simply spray the skin with a light coat after drying from the shower, let that dry or use the hair dryer on cool setting, and apply the pouch. This has been a seven month learning experience. For clarification, my husband has a UROSTOMY so urine has been the issue.

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Hi I also had a urosotomy in Nov 2019. After about a month or so I also developed a nasty rash under my wafer. The VNA nurse felt I was allergic to the adhesive on the wafer. So I changed companies and now I use Convatec. I use a 2 piece system. My Dr prescribed a medicated powder for under the wafer which helped to get rid of the rash. But be patient, it takes a long time to clear up. Now I am very careful when I change my bag to make sure everything is dry and I also haven't tried going in a swimming pool or the ocean cause I fear getting the wafer wet and having another rash from it on the skin. I hope this is helpful?

Liked by katydid77

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