This is an example of a mail you would receive prior to your surgery:
It is important to never accept any skin problems as a "normal side effect" of having a stoma. The skin around your stoma should look exactly like the skin on the rest of your body! Of course, it is natural if your skin is slightly more pink right after you peel off the barrier – but if the pink colour is permanent, or you feel any sense of discomfort or itchiness, you should act as quickly as possible.
Why is this so important? If your skin becomes irritated, the barrier will not attach as well. This could lead to leakage, which leads to more severe irritation, and so on. You can avoid these recurring issues by taking these six steps to help bring your skin back to good health.
Six steps to keep the skin healthy:
1. Keep your skin clean and dry. Make sure your skin is clean and completely dry before you apply the barrier to your skin. If your stoma produces a little moisture, you can take a soft tissue to absorb the extra moisture before applying the barrier.
2. Cut carefully. The hole in the barrier should fit your stoma exactly.
3. Measure and check often – it's quite normal to have changes in both the shape of your body and your stoma, so it is really important to regularly check if your cutting template is the right size and shape for your stoma, especially if you have a hernia.
4. Make it stick! Use your hand to apply a little pressure to the barrier and smooth it out until you're certain there's full contact between the adhesive and your skin.
5. Change when in doubt. Change your pouching system as soon as you feel a sense of discomfort or itching.
6. Check the back when you remove your pouch from your skin, check not only your skin, but also the back side of the barrier. Do you see signs of ostomy output? This tells you there was leakage - and means you should try to get a better fit. If it's not possible to cut more precisely, maybe you need a mouldable ring to seal the opening better - or maybe you need a different type of barrier. Ask your nurse for recommendations. Is the barrier broken down or damaged? This could also be a sign of leakage, but it probably also means that you need to change your pouching system more often. Some stoma output can attack the barrier aggressively, and the best way to combat this is to simply change early to keep the skin healthy.