i noticed my last 2 bag changes i have a small ulcer looking hole next to my stoma. it actuall hurts when removing bag cuz the stoma paste is right on it. its about half the size of a pencil eraser and not real deep. what is this??? i have been putting stomahesive powder on it at bag changes to see if that would hopefully heal it since it healed the spaces between my stoma and skin when it was new. any ideas about this and should i be concerned??? will it go away??

I had the same thing happen to me. When I went to see the ET nurse, I found out that I was making the opening too small for my stoma. Try cutting the hole so that it leaves 1/8" around the stoma or if you use the moldables, open the hole up much bigger than you've been doing it. The moldable always falls back and turtlenecks around the stoma, so you can make the opening large at first.

It should clear up before your next appliance change.

Caty

This message has been edited. Last edited by: Caty,

the ulcer is on the flat skin nex to the stoma, its not on the stoma itself. how would it being too small cause this ?

Cutting the hole in your wafer too small can restrict the blood flow to the surrounding area. It can also cause damage to the stoma itself. The moldable wafers are great because the edges are soft so you can roll it back a bit bigger than your stoma and then roll the edges back to form a snug but gentle fit around your stoma.

Keep a close eye on this because peristomal ulcers can be difficult to heal. Keep using the powder and seal it over with something like no-sting Cavilon spray or dab with a no-sting barrier wipe. Make sure it is well dried before applying your wafer.

Shower without your wafer on the days you have to do a full kit change. Aim the shower head at the skin around your stoma (not on it though) for several minutes. This is not only soothing to sore skin but will also increase the blood flow to the surrounding skin which in turn will encourage faster healing.

If this doesn't help then you may need to see your stoma nurse to see if she can recommend something. I had some really nasty and deep peristomal ulcers (pyoderma) shortly after I'd had my j-pouch removed and they took some months to heal. There was no healthy skin between them and Wee Willie which made keeping a wafer on almost impossible. In the end I had to pack the ulcers with a product called Promogran and then apply some Duoderm over the top before putting my wafer on. Even then I was changing my wafer up to 4 times a day before they finally started to heal.

It sounds as though yours should get better fairly quickly though because the ulcer isn't too deep. It's better to treat them early to prevent them becoming as bad as mine were.

Good luck and keep us posted.

Shell

I recently found out why I was having a problem after trying for months to get this one ulcer on the flat part of my belly, next to my stoma, to heal up. It never, EVER, occurred to me that I was causing my own problem because I am very meticulous when I change my appliance. At the time I visited the ET nurse, I watched her open the moldable wafer quite large and I commented on it. She said, "show me how large you've been making the opening." When I showed her, she said that that was way too small and "bingo" a light went off and I realized I had been making the opening too small for several months and causing friction to the skin so that the ulcer would never heal. The stoma needs room to move. Another thing I did was loosen up the belt a little. My ulcer was located on the right side of my belly, right where the belt hooked. I thought that was the problem until the ET nurse explained that I needed to make my wafer hole larger and that it probably had nothing to do with the belt. Things have healed up nicely now, but the area on that side of my belly is still a darker red than the rest of the area around the stoma and will probably take a long time to lighten up.

Caty

Hey guys,

That is so ironic that you guys started this thread, I was just hopping on the site to post a new thread regarding this same problem I am having, and quite honestly am getting a little worried about. I have a small "hole", which is probably an ulcer, that is located approximately 1" below my stoma. It started out small, and I think it started because some poo leaked on there and sat there for an extended period of time. Is this what causes the ulcers?

I talked to my ET nurse via the telly a few weeks ago, and just recommended the stomahesive powder and maybe a small patch of Eakin seal over it to let it heal. It has been fine, not getting any bigger, until this morning when I went to change. The hole is getting bigger, and it is red and raised around it, I think it's infected (and it hurts).

Should I just keep on changing my bag more often? I don' think the opening in the wafer is cut too small, it's bigger than my stoma, but yet close enough that it doesn't let the area right around the stoma get weepy. What do I do about the infection (peroxide, ointment)?

What can I do about this, please help?!

Hi Sammy,

There is a product that the ET nurse gave me to use on the ulcer. It is the thickness of a 1/8" piece of foam and gray in color. It's called "Safetac" something or other and several companies make it. She also told me that it had some sort of "silver" in it that would help fight any infection (if there was any) and heal things up nicely. It also cushions the ulcer while it's healing. She gave me a large square to take home and this product has helped a great deal. I seem to have a weak area next to my stoma from an after-surgery slipped stitch and that one spot gives me a bit of trouble. I have no leakage problems, though, just can't seem to get that last top layer of skin to grow and stay filled in at that spot. Anyway getting back to the foam, what I do is cut a small square to cover the ulcer, peel off the adhesive protection tape and place it adhesive side down on the ulcer, making sure the foam side is up. Do this after you apply your skin barrier stuff and have allowed the barrier stuff to dry thoroughly. After that just apply the wafer as usual, and by the next appliance change you should see a big difference in the size of the ulcer. Talk to your ET nurse about this product; I'm sure she knows about it. I wish I could give you more specifics, but she didn't give me the box only a piece of the stuff.

Good luck and I'm sure things will heal up for you real soon. You may need more than stoma powder at this point. Don't let the ulcer get too big; see the ET nurse.

Caty

Thanks Caty for the advice. I will mention this to the ET nurse, going to give her a call after the holiday weekend and try and see her this upcoming week. Like you said, I don't want this to get out of control.

Have a good weekend, and hope all is well with you.

Well folks, thank goodness tomorrow is Monday, the ulcer seems to be getting larger, and the wafer is having a hard time staying on because it is pussing and bleeding through the wafer. I have filled it with stoma powder, and put a disc of eakin seal over it, but i don't think that is helping. Keep your fingers crossed that this will get better for me!

Matt

Well gang, saw both my doc and the ET nurse. The ET nurse thinks it is caused by the bottom of my wafer digging into the skin. I guess this makes sense, since I use a Convatec 2 peice, and the wafer/flange is kind of hard compared to some other models. She gave me some Coloplast Asura brand, which is a one peice, and has a more plyable sticky back to it. It will take some getitng used to, but seems more quiet, less rustling, but will take a while for the whole confidence factor of using the Convatec for 2 years.

She also gave me some of that zinc white stuff to put in the wound. I will give these a whirl, and see how things go.

My doc also gave me a ton of antibiotics, but am wondering if I need them. He gave me Cipro, Flagyl, and Keflex. I am leary of taking any cause I know Cipro makes the out put almost water and frequent as all heck. Has anyone had any experience using oral antibiotics for a skin ulcer?

Thanks again for everyone's support.

Matt