The area of skin surrounding your stoma may sometimes be come sore or irritated for a number of reasons. This is a common problem but should not continue. If you are experiencing problems with sore skin do read the tips below but please contact your Stoma Care Nurse as there are a number of solutions, products and accessories that can be used to tackle the problem.
The following are some tips to help maintain healthy skin:
Only use warm water to clean around your stoma—Soaps and baby wipes can irritate your skin or affect how your pouch sticks.
Keep an eye on the size of your stoma—if it changes then the hole in the bag that your stoma goes through should be altered.
Whilst supporting the skin with one hand gently remove the bag with the other. Gently dry your skin before putting on a new bag.
If you have hair growing around the stoma then it is best to shave it off just using fresh warm water and a new razor. Try to avoid using shaving creams or soap as this can irritate the skin.
Shape of Stoma has Changed
Your stoma may change shape dramatically in the few weeks post surgery, usually becoming smaller but at later stages it may also alter. When you place the template from your stoma bag over your stoma it should fit fairly snugly with just a couple of millimetres of skin showing. It is even more important to make sure any sore skin is covered—remember that the base of your bag is made from the same materiel used to dress wounds. However you do not want to make the template too small as the edges of the baseplate can then dig into your stoma. If you are unsure about changing the template size then see your stoma care nurse.
Lumps and Bumps
You may find that you have small nodules developing around the stoma. These are fairly commonplace and can be prone to bleeding but they may affect how your bag sticks to your skin. Sometimes blood or fluid from these nodules can get onto back of the baseplate preventing it from sticking. You need to make sure the parastomal skin is clean and dry as you put the baseplate on, also try to avoid brushing past the nodules. If the bleeding becomes more than normal or your skin continues being sore then contact your stoma Care Nurse.
Has Abdomen Changed Shape
Your abdomen may change shape for a number of reasons including gaining or losing weight, the formation of scar tissue following your operation, or swelling occurring near your stoma because of a hernia. All these changes can cause different dips and creases that your bag may not be moulding into. It is worth seeing your Stoma Care Nurse as she can assess you for the need of other bags or accessories to prevent any leaks.
This usually affects people with a colostomys. As the faeces/poo exits the stoma it seems to remain stuck over the stoma instead of dropping down into the bag and eventually causes leakage and sore skin under the baseplate. Please refer to the ‘tips to help with pancaking.’
Has The Output Changed?
If the output from your stoma becomes loose/watery it has a greater chance of causing a leak from beneath the base plate. The output can change for a number of reasons, for example; a change in diet/medication, commencing chemotherapy or radiotherapy, diarrhoea from an infection and dealing with stressful situations. Please refer to the nutrition guide to help control the output.
Also contact your Stoma Care Nurse who may be able to suggest certain medication you can take and other products that may help.
Has The Skin Been Irritated?
The skin may show signs of a rash sometimes in a small area and other times beneath the whole baseplate. Often if it covers the whole area then it can in dictate an irritation to the type of bag that you are currently using and you may need to change it but please consult your Stoma Care Nurse about this. Small areas of rash may indicate an irritation to any soaps etc that are used in the cleaning process or it may be where hair is being pulled out by the base plate. There may be a problem because of a fungal or bacterial infection. If there is not an obvious reason for the irritation then please consult your Stoma Care Nurse.
Please remember that you shouldn’t have to put up with sore skin or leaks and if you continue to have problems please contact your Stoma Care Nurse or phone Oakmed on the freephone helpline 0800 592786
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