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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
We have a new resident that has a colostomy. I have never seen one like this as there is no stoma. We are having a hard time keeping the appliance on. Do you have any suggestions?

What your resident has is most likely an inverted stoma. Some of the companies that make appliances (colostomy bags) make a bag called a “convexed” bag. 

See if your medical supplier can send you some samples of the convexed bags. These sort of resemble a shallow funnel, and fit tightly around the hole in the skin. 

Use the tape and sticky area around the bag to hold the appliance tightly against the skin, allowing for a better seal. Also, wash the area with a mild soap and water, or a non-perfumed baby wipe (no aloe or moisturizers!). Removing the oil from the skin also helps keep the appliance secured. Any creams, skin prep or aloe will keep the appliance from sticking well, and will most likely cause leaking around the appliance.

Heating the appliance (with a cool blow dryer) after you have put it on or using a thin application of paste made for adhering colostomy bags around the hole in the bag also will help. 

Above all, remember to change the appliance at a time when you expect little or no output, such as late in the evening, after the last meal of the day or early morning before eating. This will give you the best luck with keeping the appliance in place for the time desired. 

Although you might love to leave the bag on forever if it is sticking, I would recommend changing the appliance every seven days. The skin under the wafer, and around the stoma, needs to be inspected and cleaned. So after seven days, change it! 

Try applying it at the same time of day that the last bag was applied successfully. You also can ask your wound care nurse or a supply company for recommendations.
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