A Proactive Approach to Peristomal Skin Care

Brian, a bladder cancer survivor, discusses his approach to peristomal skin care, which includes educating yourself, choosing the right ostomy products, and seeking advice from stoma nurses. 

Find out how Brian keeps his peristomal skin healthy.

Brian lives in the UK and in March of 2011 he was diagnosed with bladder cancer. Three months later, he underwent surgery to remove his bladder and create a urostomy. On the plus side, Brian's retirement coincided with his procedure, so he didn't need to worry about returning to work. Still, he knew a lot of change was ahead. 

A loving husband, father, and grandfather – as well as a “do it yourself” enthusiast, hiking fanatic, and keen gardener – Brian has adapted to urostomy life incredibly well. He feels there's very little he can't do. One thing that has helped Brian thrive is his logical and proactive approach to peristomal skin health. We caught up with him to talk about his skin care routine and how it has changed over time. 

Choosing an ostomy pouching system 

Brian had never heard of a urostomy until his bladder cancer diagnosis. His health care providers gave him three options: lots of cancer treatment, a neo bladder (i.e., a replacement bladder constructed from small intestine), or a urostomy. Brian just wanted the cancer out of him as soon as possible, so he chose a urostomy. 

He had the chance to see stoma nurses ahead of the surgery. They explained all about the different types of urostomy pouches, and he went home with a fake stoma and some bags to try. Brian chose a two-piece system because he felt that changing the skin barrier less frequently would reduce the possibility of skin damage. He remembers that the nurses did not discuss peristomal skin complications (PSCs) with him prior to his surgery. 

Experiencing peristomal skin complications 

Following his recovery, Brian became an active member of the urostomy community in the UK, attending Urostomy Association support group meetings and information days. One of the information days focused on peristomal skin health. He learned about PSCs and the huge impact they can have on a person's quality of life, both physically and mentally. He was shocked by some of the photos of PSCs that he saw, which made him even more determined to avoid them. 

Unfortunately, Brian started experiencing sore skin directly around his stoma. It was red and itchy, but impossible to scratch because it was underneath his skin barrier. He compares his peristomal skin issues to optimal growing conditions in gardening. “It comes back to the gardening idea and propagating things,” he says. “You've got a warm, moist area and a plastic bag over it – which does not really contribute to healthy skin." 

Finding ostomy products that support healthy skin 

Brian thought the hole in his skin barrier might need resizing but he wasn't sure, so he contacted his stoma nurse. She came out to help him resize it, and a mere one millimeter made all the difference. In less than a week, his skin was back to normal. 

Brian tried lots of different ostomy bags and accessory products, but he eventually settled into a routine of using adhesive remover spray, an adhesive remover wipe, a barrier wipe, and a two-piece pouching system. This combination served him well for many years. 

Thanks to the continual advancements in stoma care products, Brian now uses CeraPlus™ Ostomy Products. As a result, he's been able to reduce the number of products he uses. Nowadays, he simply removes his bag with adhesive remover to prevent skin stripping and then applies his two-piece bag. Before going to bed, he cleans his stoma – as mucous can add odor and block the drainage tap in his urostomy pouch – and changes to a higher capacity bag for overnight. 
 
Continuing to try new things and ask questions 

Brian feels incredibly fortunate that he's only experienced the one PSC, and he considers this proof that he's doing something right. He would urge anyone dealing with PSCs to reach out to a stoma nurse immediately – so there's no opportunity for the condition to get worse.  

When it comes to ostomy products and care routines, he believes the most important thing an ostomate can do is be willing to adapt and try new things. He also tells others to not be afraid of asking questions – in peer-to-peer groups, via helplines, or when talking to their stoma nurses. “There is life after stoma surgery, as much as there was before,” says Brian. “Live it to the fullest!"