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A COMMON DELEMMA...WHAT ABOUT MY SKIN? Liz
O’Connor, RNET, Metro One of the most frequent challenges in caring for an ostomy is the periodic skin irritation. Fortunately, most of these are not severe. Following are some DO’s and DON’T ‘s. Perhaps they will help. DO’s - Do change a pouch when it leaks. The effluent from the ostomy can be very irritating if left on the skin... - Do be sure that your pouch fits properly. (It should be 1 to 1/8 inch from your stoma. If it is leaking frequently, you probably need a visit to your Enterostomal Therapist to re-evaluate your situation. A pouch might work for years. A factor like weight change with resultant creases might cause undermining of the pouch.) Retracted stomas might cause similar difficulties. - Do be aware that in the summer, when you perspire more the pouch might require more frequent changing. This is normal. - Do be conscious of some of the standard treatments you can try. FOR SLIGHT IRRITATION: Apply a coat of and antacid (like Maalox TC or similar product.) Let it dry. (The aluminum in it toughens skin.) Sprinkle on a light coat of karaya powder. Brush off excess. (Karaya powder is very healing.) Top this with Skin Prep, Skin shield or similar product to seal powder. Apply pouch as usual. TREATMENT MIGHT HAVE TO BE DONE AT SEVERAL CHANGES IN A ROW. So be aware that some people are sensitive to tapes. If you have a rash under the tape line, try eliminating it for a while or try paper tape that allows the skin to breathe. You can also sometimes trim the backing on your pouch to allow a specific area of skin to be exposed to air and heal. - Do be conscious that you can develop little white pimples around the stoma. These are usually yeast and can be cleared up if you get a prescription from your doctor for Mycostatin powder. - Do be Aware that for more severe irritation you will probably need a prescription for Kenalog Spray (if not allergic to Cortisone). This forms a grease-like film and must be topped with Skin Prep, Skin Shield etc., for the pouch to stick
WONDERS OF MILK OF MAGNESIA Because of its alkaline properties, Milk of Magnesia (MM) is beneficial to skin which has been burned by hydrochloric acids and enzymes from intestinal secretions. Hygienic care of the skin for all types of ostomies is very important. Use alcohol to remove all soap film after washing the adhesive solvent off. Alcohol will also kill any latent intestinal bacteria, which can multiply under the faceplate. Then rub a light film of MM over the skin around the stoma that is normally covered by the faceplate. Enzymes can penetrate so deeply into the surface of the skin that neither soap nor alcohol can remove them, but MM will neutralize them. Rub it gently into the skin. If the enzymes are there, MM will curdle like cottage cheese. If so, rinse it off with warm water, pat the skin dry, and apply a new film of MM. Let dry completely and apply Skin Prep, tincture of Benzoic ( plain), Karaya Powder, or whatever you use, and proceed as usual. Products similar to Digel and Amphogen can be used instead of MM and Karaya powder is healing to the skin. When the skin is dry, the faceplate can be applied. 79 |