Sores and Rash Update

Thank you Jimswife. All was very clear and it will help me. Another question: do you use a protective skin barrier (the wipes)every time on entire area that is covered? I have used it only when using powder or tincture.

Your sharing has truly widened my knowledge.

Herb†

Hi, Herb, The Hollister flange which is the part that is on your skin that the bag attaches to (the system Jim uses is two piece)Edgepark Item #51125276 I think if you enter that number in the search you will find the specific flange. It has a matching bag number #51401545. It seems that the larger area being covered has helped Jim plus the part that attaches to your tummy is a paper like material that doesn't seem to irritate his skin. The Eakins that Jim has are rings Edgepark item#51839002. The Eakins seals are stretched to a size that is just about 1/4" beyond the largest edge of the stoma area. Jim is using a precut 1 5/8" flange so his Eakins is made just about 1/4" larger than the 1 5/8" opening in the flange. He applies it to the flange so that once his skin is prepped with the barrier adhesive wipes etc he can just put the entire flange, eakins on it right onto the belly over the stoma area. I know this may sound confusing and i wish I could draw what I am trying to tell you. Basically we make the flange and Eakins into one piece then apply it to the belly around the stoma leaving that approx 1/4" distance around the perimeter of the stoma or "innie". Hold it in place for a moment BTW, put a 4x4 gauze square over the opening as we all know they start squirting at inopportune moments! Then take the paper backing off the flange and hold it in place until it sticks well. Once this is done, apply the bag. It sounds MUCH more complicated than it is. Since we've used the Eakins and the skin cleaning method no more sores/raw areas etc plus the newer precut flange with the paper backing. BTW, check what size precut you need when you order. Jim uses the size above which comes in red boxes. Herb, this is all a big learning process for all of us and I know you will do fine. It just frustrates when you can't get the right size, or leaks etc. I hope this helped some. If not private message me and we can find a way to get more info to you.

Hi Jim's wife:
What you are saying seems like it definately fits what I am dealing with however, the terms and procedures are hard for me to picture. If you can please bare with me: my stoma sounds just like Jim's it is a slight inny but basically is even with surface: does the Eakin Cohesive skin barriers go on first and then you apply bag over the top of it? I have a box of 5 Small Skin Barriers that are 4" x 4" (839004), do you cut stoma hole and apply this barrier on and then put bag over it? I also have two Eakin cohesive seals (839002) that are 2 inch disks of which I am not sure how to use just guessing again: cut stoma hole apply and then put bag over it?

I am not sure what the Hollister flang is? I looked in my Edgepark catelogue could not find picture.

I am not sure they have really pinned down exactly what is happening --- I did have an infection that we took care of; then it looked like I was allergic to the outside adhesive on Hollister extended wear --- now breakout seems to be related to urine getting on skin in area where the barrier erodes.

I have used Hollister extended wear until breakout, then have gone to Coloplast standard wear, and it was bag where we have traced rash to where skin barrier naturally erodes and urine gets on skin. So your explanation of procedure used on Jim seems to be that which I need to understand.

Hi, Herb hoping your rash is getting better. I've seen where some folks have fungus and infections. I caught Jim's problem before it had progressed. I think I listed in this thread the manner that we use to change the flange etc. Since Jim's stoma is not a rosebud above the skin but an "innie" where the urine flows wild and freely out of his "second navel" (that's what it looks like) skin irritations are a reality for him. We put am Eakins seal around the opening in the flange about 1/4" from the edge of the opening. This allows the urine to flow into the bag, prevents a lot of skin contact with the urine and allows for no leaks. He also uses Hollister flanges that have a larger area of coverage with a paper like surround with the center part being precut with a smaller area of the "rubbery" type adhesive. When removing the flange the paper type area is always wet with water to start removing it and the skin is pulled back from the flange not the flange from the skin. One time we did that *I always say we since due to the location on Jim's belly it is hard for him to reach and change alone* and it pulled skin off. NOT a good moment! I just caked the skin and within the 3 days it was good again. Alittle pink but not raw and open. Jim changes every three days due to the urine eroding the Easkins seal. he can go a tad longer but always ends up leaking and, of course, it's never say at noon...nope something like 3 a.m. so it wakes him up. Since he can have up to 20 of bags/flanges monthly it works out well for him. Thanksfully! Hope this helps a little bit. We found the paper type surround was what helped most with skin irritation.
Below is what is in Jim's orders from Edgepark hope this helps some. Try a sample to see if the added area of coverage plus the soft adhesive collar helps. It did for Jim.


1 5/8" pre-cut flexible 5" x 5" tan wafer, 10
Soft adhesive tan collar for maximum comfortLow-profile flange
Provides superior skin protection
2-1/4" flange (57 mm), 5" x 5"
1-5/8" stoma
10/pk



Item #: 51125276 Qty
Manufacturer: ConvaTec (51)
HCPC: A4414
Sold By: Box of 10

SO true, and yes 3 days are my limit with short term bags but as you said need to be treating rash so if I could get 6 days again not sure I am ready to extended time. Thanks again.

Thanks Mike all your advice very helpful. I think our current direction of thinking it is skin contact with urine, attempts will be around efforts to keep skin as isolated as possible from urine. Just not sure at this point whether one can keep skin totally isolated from urine for skin barrier do slowly erode which allows urine to get on skin and additives to absorb may help but again not sure if they can elinate skin contact. Yes holding funnel and rubbing meds in, very agile there young man.