How is a skin barrier applied?

When applying your skin barrier, it is very important that you measure your stoma using a stoma measuring guide before every barrier application. There should be NO skin showing between the skin barrier and the stoma: this helps prevent leakage and skin irritation. If you do observe any skin showing between your stoma and the opening of your current ostomy pouching system, it is recommended that you use a skin barrier with a smaller opening, or consider accessories to help with the optimal fit of your pouching system.

I have a gap between my stoma and the skin barrier opening on my pouch. Is there a way to remedy this?

The opening in a solid skin barrier should be the size of the stoma and should fit at the skin-stoma junction. Skin barrier rings and skin barrier paste are two accessory options that can be used to enhance the seal of the pouching system to help prevent leakage under the pouching system skin barrier. Continue reading to understand the difference between rings and paste.

What's the best way to apply a barrier ring?

Barrier rings are accessory items that may help protect the skin, fill in uneven skin areas or provide an alternative to skin barrier paste (a type of "caulk" used to fill gaps). Rings can be stretched to fit your stoma size and can be applied directly to clean, dry skin or to the adhesive side of your skin barrier. To understand the best way to apply a barrier ring, consult our care tips found here.

My stoma is irregularly shaped. Can barrier rings be customized?

Most people find that a Hollister 2-inch ring works best to stretch or shape for a customized fit around the stoma, no matter what size or shape the stoma may be. A 4-inch ring is also available and can be separated into smaller pieces and individually molded to provide a seal around the stoma. Another option is convex rings, which are available in round and oval shapes, to accommodate a variety of stoma shapes and sizes. These products can also be separated and molded together to improve the fit of the pouching system.

I've heard people talk about "paste." What is this and how is it used?

Paste is an adhesive hydrocolloid mixture available in a tube and is used to fill in uneven areas such as wrinkles or dips in the skin around the stoma to enhance the seal. Hollister paste can be applied to the inner edge of the skin barrier next to the opening that will be placed around the stoma. Some pastes contain alcohol which may cause a stinging sensation if there is any skin irritation present around the stoma. As an alternative to paste, barrier rings should be considered as they serve the same purpose, but rings do not contain alcohol. For full instructions, visit the paste care tip here.

The skin around my stoma is very moist and I worry that my pouching system will slip. What can I use to keep the skin dry?

If you are experiencing moisture around your stoma, an accessory item like stoma powder should be considered. Stoma powder is used to absorb excess moisture from broken skin around the stoma, which may help allow the skin barrier to adhere better. In order to use powder, ensure your skin is freshly washed and dried thoroughly. Apply a small amount of stoma powder to the area around the stoma. Gently brush away excess powder using your hand or a soft tissue. The stoma powder should stick only to the moist area and should not remain on dry, intact skin. Once you've brushed away the excess stoma powder, you can apply your pouching system. For full instructions, visit the stoma powder care tip here.

However, broken or irritated skin around the stoma is usually caused by one of the following issues:

• Leakage of stoma output onto the skin
• Improperly sized skin barrier opening (too large, too small, wrong shape)
• Sensitivity to one of the products used on the skin
• Removing the skin barrier incorrectly or too frequently, which can tear the outermost layer of the skin.

I work in a large office and have to empty my pouch in a public washroom. Sometimes there is excessive odor. What can you suggest to help lessen it?

In-pouch deodorant liquids are available to use to decrease or help eliminate odor. When a pouch is properly sealed, there should be no odor; however, there will be odor when emptying your pouch. In these instances, consider a lubricating deodorant. Lubricating deodorant is not a perfume or masking agent, but can be added directly into the pouching system to help neutralize odor, ease emptying of the pouch, and help to prevent pouch static and sticking. Lubricating deodorant should only be used with drainable and closed pouching systems and should be added to the pouch each time it is emptied. For full instructions, visit the lubricating deodorant care tip here.

I am very active and need to have extra security for my pouching system. Are there any products out there that can help?

There are a couple different options that can be used to enhance the security of the pouching system.

As an alternative to utilizing ostomy belts or barrier extenders, you may also consider using a pouching system that already has an adhesive border barrier (commonly referred to as a tape-bordered product).

Keep in mind that accessories are optional items that each serve a specific function. These should be used only when indicated or recommended by your WOC/ET Nurse or other healthcare professional.

Want to learn more or have a concern that wasn't mentioned here?

Hollister Secure Start services is here to help! Call us today at 1.888.808.7456.