Stoma paste is a caulk-like substance used in ostomy care to ensure a tight seal between the skin barrier, often called the wafer, and the skin itself. Its primary goal is to prevent stoma effluent, or output, from coming into contact with the sensitive skin surrounding the stoma. Achieving a secure seal is the most effective defense against leakage and the skin irritation known as peristomal skin breakdown. This accessory helps extend the wear time of the pouching system, providing greater security and peace of mind.
Understanding the Function of Barrier Paste
Stoma paste is commonly misunderstood as a type of glue, but it is not a true adhesive for the skin barrier. Its actual function is to work as a filler or caulking agent to create a smooth and level surface. The skin around a stoma, known as the peristomal skin, often has irregularities such as creases, dips, or folds that prevent the flat wafer from lying completely flush against the abdomen.
These uneven areas create gaps that allow stoma output to seep underneath the skin barrier, leading to irritation and potentially compromising the seal. The paste fills these voids, effectively leveling the skin’s topography to provide a consistent surface for the wafer to adhere to securely. This barrier function protects the skin from the corrosive enzymes present in the stoma output. The paste may also contain alcohol, which can cause a temporary stinging sensation if applied to irritated or broken skin.
Preparing the Skin and the Paste
Proper preparation of the peristomal skin is a precondition for a reliable seal and comfortable wear time. The skin must be cleaned thoroughly using warm water only, avoiding any soaps, cleansers, or oils that contain moisturizers or residue-leaving agents. Residue from these products can severely interfere with the adhesive properties of the skin barrier, making a secure bond difficult to achieve.
After cleansing, the skin must be completely dry before applying any product, as ostomy adhesives do not adhere well to moisture. A soft towel can be used to gently pat the area dry, or a cool setting on a hairdryer can be used to ensure total dryness. The stoma paste itself can be stiff and difficult to dispense from the tube, so it is helpful to warm it slightly before application. Holding the tube in your hand for a few minutes or running it under warm tap water will soften the paste, making it much more pliable and easier to manipulate.
Techniques for Application and Sealing
The most effective use of stoma paste involves applying a very thin bead, as excessive application can actually weaken the overall adhesion of the wafer. One common application method is to apply a small ring of paste directly to the inner edge of the wafer opening, right where the skin barrier meets the stoma. This bead acts as a gasket or seal that is activated when the wafer is pressed onto the abdomen.
The alternate technique involves applying a thin ring of paste directly onto the skin immediately surrounding the stoma, or only to specific dips and creases on the peristomal skin. This targets the uneven areas directly, ensuring they are adequately filled and leveled. After applying the paste, you can use a clean, slightly moistened finger or a specialized applicator tool to gently smooth and blend the paste into the skin. Wetting the finger prevents the sticky paste from adhering to the skin.
Once the wafer is applied, gentle, firm pressure should be placed over the entire surface, especially around the stoma. This pressure causes the paste to rise slightly around the stoma, creating a ramp-like seal that diverts output away from the skin.
Removing Paste Residue Safely
When it is time to change the pouching system, the stoma paste residue will often lift away with the skin barrier itself. Any remaining residue on the skin should be removed with gentle care to protect the integrity of the peristomal skin. Specialized adhesive remover wipes or sprays are formulated to safely and easily lift away residual paste and adhesive without causing trauma.
If adhesive remover wipes are unavailable, warm water and a soft cloth can be used to gently wipe away the excess material. Avoid aggressive scrubbing or harsh friction, as this damages the protective outer layer of the skin. If a small amount of paste remains firmly adhered to the skin, it is safe to leave it in place rather than risk skin irritation by scrubbing excessively.