Ideally, during the ostomy procedure, the surgeon will create a stoma that protrudes beyond the skin of the abdomen (protruding stoma). This allows the skin barrier to be applied close to and around the outer edges of the stoma. For a patient with a protruding stoma, the goal is to help achieve a leak-proof seal at the stoma edge. This protects peristomal skin from effluent seeping underneath the skin barrier at the stoma edge and onto the peristomal skin.

While the protruding stoma is preferred and easiest to care for, some stomas are more difficult to manage. Two of these are a flush stoma and a retracted stoma.

Management Goal:
Leakproof adherence that protects peristomal skin from the damaging effects of urine and stool utilizing an appropriate pouching system that adequately contains and collects the volume and type of stomal output.

Unlike a protruding stoma, a flush stoma does not protrude beyond the skin of the abdomen. A flush stoma, as the name suggests, is flush with the skin covering the abdomen. Flush stomas may be the result of a surgeon's chosen technique, or may occur over time, even though a protruding stoma was originally created.

A flush stoma may require the use of a convex skin barrier. The convex shape of the barrier applies gentle pressure around the stoma edge, increasing the degree of stoma protrusion.

Management Goal:
Elimination of uneven skin surfaces to create a level surface onto which a convex pouching system may adhere and press into the surface area around the stoma to increase the degree of stomal protrusion.

A retracted stoma is recessed to slightly below the skin surface. Recessed stomas can occur over time due to internal surgical scarring, weight fluctuations, and other unforeseen events.

Like the flush stoma, a retracted stoma calls for the use of a convex skin barrier. This will assist in achieving greater stomal protrusiton and make adherence and conformity easier to achieve.

Management Goal:
Elimination of uneven skin surfaces to create a level surface onto which a convex pouching system may adhere and press into the surface area around the stoma to increase the degree of stomal protrusion.

Use Stomahesive^® Paste as a caulking device to improve skin barrier seal around the stoma.

Appropriate Application: Apply a thin ring of paste on the back of the skin barrier around the hole. Do not spread the paste. Wait one minute before applying the skin barrier.
Inappropriate Application: Do not apply like this!

Use Stomahesive® Powder when you have broken down and denuded skin. It helps increase wear time by absorbing moisture on denuded peristomal skin while helping prevent skin irritation. (Does not contain latex.)

Apply a light dusting around stoma or irritated skin
Pat over with protective barrier wipe

A donut-shaped ostomy accessory that can be molded to a variety of shapes. It acts as a moisture absorbing barrier, designed to provide an extra level of protection on irregular contours, around retracted stomas, and excoriated skin. The special moldable hydrocolloid barrier forms a gel that helps prevent skin damage by sealing the area between the stoma and skin barrier.

There are several ways to use Eakin Cohesive® Seals.* You can:

Stretch to fit around the stoma Remove the release paper from both sides of the seal and shape or stretch to fit. The seal may be cut and rejoined to fit around difficult sites. Then place the seal on the patient's body and carefully mold it, making sure you have a snug fit around the stoma.
Apply directly to the pouching system. Remove the release paper then mold to the desired shape directly on the skin barrier or pouching system.
Fill in uneven areas. Remove the release paper from both sides of the seal, break the seal into smaller pieces, and roll or mold. You can cut and rejoin the seal as necessary.

*See package inserts for complete instructions for use.