Max old ostomy system
From ShortGut - Wiki
Max's current ostomy system is described here.
His previous systems:
Updated 4/16/07: The system below worked well for Max for many months. However, it eventually became less reliable -- possibly when Max got fatter and more wriggly. We have since switched to the ConvaTec SUR-FIT Natura Durahesive Flexible Skin Barrier with flange and tape collar (the Durahesive is better than the Stomahesive for liquid output) Durahesive skin barrier (recommended in AustinRath's section -- the plastic part seems to really help the stretchy bandage do its job of keeping the system on), and this bag little ones drainable pouch, which we believe is the only compatible bag that fits cotton balls. So far, we've had good luck with this system lasting for several days.
Old Version (3/5/07): We use a ColoPlast ColoKids Assura AC Pediatric Skin Barrier with a Flange, Non-Convex, Part No 14308 -- it has that ubiquitous brown wafer (a bit harder than others) with a plastic flange on the top -- here is the link: Assura AC Pediatric, coupled with the bags that go with that product (we used to use a different Hollister bag with a spout for draining the stool, but have now switched to cotton balls and find that works great with the velcro pleat thing on these bags!).
We use spandex bandages, after being warned that ace bandages have latex and might lead to allergies with prolonged exposure. Following AustinRath's suggestions below, Yuko's Mom sewed some velcro on the bandages -- makes things much easier. Seems to hold up for at least a few washings so far. We cut a small hole in one end of the bandage -- as small as possible while still allowing you to get it around the flange. Loop the hole around the plastic flange (so it sits between the flange and the brown wafer. We do this before applying it (otherwise it can cause the barrier to pull off).
The first step is to clean the site with just water -- NO soap (we found that no matter how well we tried to rinse after using soap, skin barriers just would not stick very well afterward). If there is continuous output coming from the stoma during the bag change, we hold a tissue right on the stoma while we work around it. Then we use Cavillon no sting barrier skin protectant after cleaning the site. (If you are using stoma powder for broken down skin before applying the Cavilon, make sure to blow off any excess so that you are working with a smooth surface.) Cavilon forms a protective coating that should last 24 hours; it should not be used more often than this, or it can actually prevent the skin barrier from sticking properly. Wait several seconds for the Cavilon to dry. We put a ring of coloplast paste maybe 1/8" thick around the hole in the skin barrier (we usually do this in advance and have it ready, after the ace is attached), affix the skin barrier, and push down with a Q-tip on the coloplast paste area toward the stoma to form a good seal all around it. Hold your hand or a heel warmer on the skin barrier for a minute or two to help it affix well. Then wrap the spandex bandage once around the waist (with decent tension). This bandage thus applies constant pressure to the barrier wafer to keep it in place as he moves and wriggles. If stool leaks onto the bandage, treat the skin underneath it with diaper rash cream.
We try to keep Max happy through the bag change w/a syringe of nystatin and small toys. Christian's family uses a little tv that works wonders. Austin's family uses a toothbrush, which I just discovered keeps Max very happily occupied too!
