Stoma Care

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This topic contains 17 replies, has 6 voices, and was last updated by Avatar of Ali France Ali France 5 years, 9 months ago.

Viewing 15 posts - 1 through 15 (of 18 total)
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  • November 23, 2012 at 1:00 pm #82
    Avatar of Damien Allen
    Damien Allen
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    Daily Stoma Care

     

    November 23, 2012 at 1:09 pm #83
    Avatar of Damien Allen
    Damien Allen
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    Hi, I thought I’d start a topic that many people will ask about and to see what is working for peeps. Myself I started washing my stoma 5 weeks after 2nd Stage just with warm water from spray of hand shower head. Please not eI am a special case for ILP with BK setup and the stoma is pretty much on the bone similar to OPRA way. At week 6 I got a travel (smaller) natural hair shaving brush and some natural Tea Tree liquid soap (Dr Bronners – Tea Tree Liquid Soap $9.95) and been using this morning and night to wash the stoma. I went for the Tea Tree Soap as is annatural antibacterial and literally two small drops is all that is needed and will last for long long time. I have had no reactions and very happy with it.

    January 25, 2013 at 11:59 am #150
    Avatar of Ali France
    Ali France
    Editor

    I am three weeks post 2nd stage surgery and I am finding the stoma care so easy so far. I am doing twice daily dressing myself. It doesn’t hurt a bit. I have only been taking paracetamol for pain relief and that is after intense physio sessions. Tomorrow I am discharged from the rehab hospital and I will start showering twice daily and using a new toothbrush twice a day to clean the stoma and the titanium. I am then going to use breast pads for any leakage. But I must say my leakage has been very minimal. I get more blood when I do more in the gym and that makes sense! Hope this info helps. Cheers, Ali

    January 26, 2013 at 2:55 pm #151
    Avatar of Bruce Behan
    Bruce Behan
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    Hi Ali.

    Why not try a shaving brush. Its bristles are softer than a tooth brush.

    January 31, 2013 at 9:13 pm #154
    Avatar of Ali France
    Ali France
    Editor

    I am having a lot of trouble with my stoma, 3.5 weeks post 2nd stage. It is very sore on the on the outside and feels very bruised. Has anyone else had any trouble with this. At first I thought it might be irritated by the bandaging??

    Love to hear your thoughts. Ali

    February 1, 2013 at 10:09 am #155
    Avatar of Glenn Bedwell
    Glenn Bedwell
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    Hello Ali, I suggest you have the stoma checked by your doctor, you may have a skin infection causing the pain. It happened to me a few weeks ago and was painful whenever I stood up after sitting for a while, but was OK walking around. A weeks worth of antibiotic fixed it.

    Rgds Glenn

    February 2, 2013 at 10:53 am #156
    Avatar of Damien Allen
    Damien Allen
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    Hi Ali, are you restricting the amount you do on leg. Less is more at first. The big advantage with ILP is to be up and walking very quickly but OI takes time and the bone and implant still be doing its thing. Also basic mechanics is that the exit point from bone that is close to your stoma takes on more pressure and needs time to settle. Take note of what Glenn has experience and no harm in getting the area checked, but more likely that you body is still settling. I did have what you described at first as well but it settled down in about a month, however that was more likely due to bone being chipped out at 2nd Stage for my BK setup. Take care, things will improve in time :)

    February 2, 2013 at 11:36 am #157
    Avatar of Ali France
    Ali France
    Editor

    Thankyou Glenn and Damien, I have been put on antibiotics so maybe it is infected…but its hard to know. A few people recommended using breast pads for a dressing when I left Sydney but I think with the heat up here at the moment they didn’t allow the wound to breath. So breast pads are out for me. I am now washing with betadine which I think is better than the detol soap that was recommended by Munjed. I guess its trial and error. I am also impatient! Thanks for your advice. Damien, we should catch up for a coffee in the city sometime soon. Do you get a lunch break??

    Another osseo friend gave me this advice (for the benefit of new patients really);

    You’ve basically got a body piecing and as long as its kept dry, well as dry as it possibly can be. We did a search for packing gauze(detex packing gauze), it’s a long ribbon 2.5cm wide and a meter long. Only wrap it round the abutment loosely to let the air ventilate around the wound.
    I found it uncomfortable varying in how much just depending on healing, how much I walked on my legs, how the skin was pushing on the top part of the abutment(as you look down at it) and still now any pressure around it still causes discomfort. I use hibi scrub or clorohexadine scrub with a soft bristled tooth bush only on the metal when that nasty crust forms on the abutment. Then I wrap some tissue next to the stoma to catch any water that may have gone in, ten minutes or so then dress with the gauze.

     

    February 2, 2013 at 4:11 pm #158
    Avatar of Damien Allen
    Damien Allen
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    Your welcome Ali, I can back up what your friend said. I used the 2.5cm wide ribbon gauze…. i have a heap of these and when my delayed gear due to the floods arrives can give these to you. But I found just using standard square 10cm x 10cm gauze rolled up with, put some saline on and wrap around the abutment easier and did the job as well if not better. Also at nights after cleaning the area I would lay on bed for at least an hour and let the area dry and let the natural healing do its thing. With this it healed much quicker and also any minor over-granulation cleared up. For cleaning I am using Dr Bronners Tea Tree Liquid Soap. Only about twice a week though. Rest of time i simple use the jet of water from hand shower to cleanse the area or simple use a small shaving lather brush to clean the area. Again not too much. Not had any issues and always nice and clean. However what works for some may not work for others depending on skin type. Oh I have basically skin on bone around my abutment so also different to other ILPs with this.

    February 28, 2013 at 7:54 pm #160
    Avatar of Ali France
    Ali France
    Editor

    The stoma is still bleeding and ouzing quite a bit (I think I am about 5 weeks post surgery) but am told that women get a lot more of this than men…another cross we women have to bear!!!! I think i am also overdoing it a bit. Its hard not to be on the leg all day, because it makes life easier! but I am getting so tired as a result. Cheers

    March 1, 2013 at 7:00 am #164
    Avatar of Phill Coulson
    Phill Coulson
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    Hi Ali, I could write a book on the stoma problems I had and the remedies Ive tried but in a nut shell I think the the problem comes down to the thigh being large, heavy and wobbly causing friction and irritation around the implant.

    The solution that has worked best for me is making a dish shaped support for the distal end of the leg, think doughnut with a dish shape which supports the area.

    I also use a non stick dressing called adaptive? (i think) which has non stick properties then a strip of gauze tape and pull the silicone shield close to the stoma.

    I have found using Pimafucort ointment works well for overgranulation as well (often used on babies umbilical area) better than silver  nitrate sticks which are pretty harsh.

    Don’t forget that you are still relatively early on in the process and itll take time for the stoma to fully mature.

    I’m now doing 6 to 8 thousand steps a day without to much trouble with the occasional 15 thousand step day.

    Good luck with your rehab.

    Phill

    March 2, 2013 at 8:41 am #165
    Avatar of Damien Allen
    Damien Allen
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    Phil what you say makes allot of sense… I have been lucky in this regard as my stoma is on bone and there is no movement. It healed very quickly and had zero issues… touch would. Ali I also get tired and by end of week pooped sometimes… it will take time to build up to a full day of activity. I have a box full of bandages if you want them, out of office this week… but in the week after.

    March 4, 2013 at 3:47 pm #166
    Avatar of Carol Millar
    Carol Millar
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    Hi all.  I had OI (with a difference) done in November 2013. I had a total hip, femur and osseointegrated implant fitted so I dont have my own bone at all.  6 weeks after the op my stoma looked amazing and had attached itself to the abutment beautifully. Now, 4 months later, the skin seems to be retracting up and the roughness of the abutment is clearly visible.  It oozes and bleeds daily and I have to change the dressings 3 times a day.  The doctor is confident that there is no infection, but not quite sure what more to do.  I am the first of this kind done here in South Africa. Phil, where could I get a silicone shield from, as this may also help.  As you say, the thigh is large and there is a lot of soft tissue there which is obviously moving a lot around the abutment. I have attached a pic for you to see.

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    March 5, 2013 at 6:42 am #168
    Avatar of Damien Allen
    Damien Allen
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    Hey Phil, see the attached.. a silicon tube like this could support the area around the stoma… i chose your favourite colour as well ;)

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    March 6, 2013 at 9:13 am #170
    Avatar of Phill Coulson
    Phill Coulson
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    Hi Carol, I had the prosthetist take a mould of my stump with plaster of paris then make a bit of cosmesis that the stump fits in, when standing it gently supports the surrounding flesh. Its shaped like a shallow bowl. It absorbs the wobble and stops it transferring to the stoma. You could also try a stump shrinker, athletic tights or stocking to try and stabalise the thigh and stop the wobble and subsequent irritation.

    The other option I looked at was inserting a thin tube sleeve into the stoma that was smooth and compatible so the stoma had less friction, my stoma had retracted up off the special coating onto titanium.

    Something similar to Damiens pick above might work.  Ive trialed and error ed with the stoma since the op in May and have only in the last six weeks  made good progress, but I have high expectations and exercise a lot.

     

     

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