Is the adhesive baseplate fitting sufficiently snug and tight around the stoma?
Your stoma can change in size over time. After surgery it is initially likely to get smaller. If your baseplate is not sitting snuggly around the stoma you are likely to develop leakage.
Solution
Firstly, make checking your template size part of your regular routine. If you are confident that the size of the opening in your baseplate is correct, but are still struggling to get a snug fit you may want to consider products such as the Brava® Protective Seal, or talk to your stoma nurse about using a soft convex...
Is the skin around the stoma uneven?
The skin around the stoma may often be uneven due to dips, creases or folds. The number and depth of these can vary from person to person.
Uneven skin can compromise the fit of your appliance, which may cause leakage leading to skin irritation. Even small creases in the skin can enable output to leak under the adhesive and come into contact with the skin surface.
It’s important that you check the adhesive for signs of output leakage on a regular basis, as well as checking the condition of the skin around your ostomy when you remove your baseplate / bag.
Did the leak occur while you were doing an unusual movement?
Perhaps you were squatting, or bending, or twisting your torso. This movement itself should not be causing leakage, but it could be a sign that your ostomy appliance is having trouble following your body movements.
Solution
Consider using a frame or tape like the Brava® Elastic tape to secure the edges of the adhesive plate a little more. You can also talk to your stoma care nurse about using a soft convex baseplate, which will help your appliance follow your body movement.
Leakage while doing sports and activities
Depending on fit and body shape, some movements might simply be a little too vigorous for the ostomy appliance to withstand on its own.
Solution
Elastic tape could help, but for more strenuous movement an ostomy belt may be the more secure solution, if that is an option for your system.
Is the skin beneath the adhesive baseplate pale and moist?
This could be a sign of maceration, a skin condition caused by excessive moisture, similar to the pruning that happens to your fingertips after a long bath. If this is the case, the leakage might have happened because the moist skin surface makes it harder for the adhesive to stick.
Solution
Make sure the skin is completely dry before applying a new appliance. You may also consider changing the type of adhesive you use to one with a longer wear time.
How does the skin around your ostomy look ?
If the skin around your stoma is completely healthy it should look just like the skin on the corresponding area on the other side of your abdomen. If it is redder than usual or is sore or itchy, there may be several causes.
If output is leaking under the adhesive it may cause skin irritation. The solution may be to even out the skin for an improved fit with a supporting product such as a protective seal or paste. You may also need a different type of baseplate.
If the skin beneath the appliance is wet or is broken down in any way, the cause can be a build-up of moisture. A supporting product to dry the moisture away such as a powder may help to reduce this. It may help if you clean your skin more thoroughly before applying your baseplate.
Remember to do a BodyCheck
The BodyCheck online tool takes just 5 minutes and will help you assess your body profile and the most suitable appliance. Using it regularly will also help you to keep an eye on any changes in your body profile.
Changing your ostomy solution frequently enough is key to maintaining healthy skin. Here is a handy rule of thumb:
- One-piece solutions should be changed at least once a day.
- 2-piece appliance solutions should be changed every second day, and the pouch section should be changed daily.
Remember! If a bulge appears or you have doubts about the appearance of your stoma or the area around it, you should contact your ostomy care nurse.
Feel free to contact us, or take the Ostomy Check if you would like advice on dealing with these issues.
