What is it?
‘Seal’ refers to a product which helps prevent and stop leaks. They can also be called rings and washers.
Common selling points for seals are:
- Provides protection by preventing any harmful irritants from coming into contact with the skin
- Completely mouldable to ensure a perfect fit every time
- Longer wear time and increased security
- Suitable for use on damaged skin
- Will not lose adhesive qualities through handling
- Alcohol-free skin barrier material is designed to help avoid stinging on sensitive skin
- Designed to be removed from the skin without leaving adhesive residue on the skin
- Absorbs and swells, hugging the stoma; stretches further for a closer fit
- Can be used to fill skin dips and crevices, can be broken, layered or rolled as required
- Individually packaged in a user-friendly and easy-to-open snap lock tray
- Available in different sizes and thicknesses.
- Adheres to wet, excoriated skin so suitable for people living with an ileostomy or urostomy
Who uses it?
For those with uneven skin around their stoma, they find that getting and maintaining a secure seal is sometimes difficult. Seals can be used to even out the peristomal skin to ensure a leak proof surface. Usually found in those who have an ileostomy, it can also be helpful for urostomies too; as well as colostomies when they have looser output due to medication or illness.
How is it used?
A lot like paste, seals can be used in two similar ways.
Direct to bag:
- Remove the liner of the baseplate of cut pouch and remove the seal from its individual packet.
- Remove the seal liners and stretch to fit the opening cut in your stoma bag.
- IMPORTANT: Ensure the seal is fit as close to the cutting as possible.
- Wash and dry your skin thoroughly.
- Apply your skin barrier product as usual.
- Place stoma bag onto skin and hold for a couple of moments to ensure good adhesion.
Direct to skin:
- Clean and dry the surrounding skin.
- Release the seal from the individual container and remove the release liners.
- Using a mirror if you are new to this, you can see the shape you need to mould your seal to. You can either do this before applying or do this whilst placing.
- IMPORTANT: No skin directly around the stoma should be exposed.
- The seal should be pressed lightly onto your skin as to ensure it hugs your skin.
- Apply your stoma bag on top and let adhere for a couple of moments.
It’s best to use gentle pressure over your appliance after fitting it on top of the seal, for a few minutes. This will help the seal stick to your skin better, and will allow the wafer to stick better to the seal. This will help ensure a (hopeful) leak proof appliance.
And just because you get a whole ring, doesn’t mean you have to use the whole thing! You can easily tear them in half and use whatever you need. In this case, keep the liners and individual packet so you can keep them for next time.
And to make you aware: these seals do break down and often “melt” when they are worn for prolonged periods of time, or if you sweat a lot. This can be seen when you remove your pouch. With the new technology in the seals currently on the market, they should not stick to your skin and make it hard to remove – they should come away easily with remover spray. You will notice the seal will be wet after use; and the ‘melt’ that will occur is a good indication as to how much wear you can get out of a seal by how much it has broken down.
When is it used?
This product is usually used when despite using a good stoma bag, leaks still occur. This can be due to uneven skin, small dips around the stoma. When this happens, ostomates find that output leaks under the baseplate creating sore and broken skin due to the acidic nature of their output.
Whilst experimenting with supporting products to help find the correct product for the particular issue the patient might be having, seals can either be used as short-term or long-term. For some, they change from paste to seals or a different convexity of bag once they have tried some differences in their products. This is why sampling products is a great option – as things change and some of the circumstances change, samples reduce waste but unfortunately not overuse. This is a fine line, in which an expert hand of a SCN is helpful.
Most of the products on the market now are low or alcohol free to avoid burning or stinging of the skin. Some seals are made from a hydrocolloid which is friendly to skin and easy to remove.
I was about a month post op, at my first outpatient appointment with my SCN, when we discovered my leaks were due to a dip on the left of my stoma. This was from the fact my stitches around my stoma had pulled in on that one side. There was nothing wrong with this, nothing to fix it or prevent it. We decided that a ring would be a good option to try. We started on the Cohesive Slims but moved to the Brava Mouldable Seal soon after due to a reaction. And whilst the Brava seal worked well and healed my skin for the most part, it was melting far to quickly and I was getting some burning if it was applied incorrectly or if I mis measured my cutting.
In November 2016 – three months after surgery – I got to try a new product before it’s UK launch: Coloplast Brava Protective Seal. I soon fell in love with this – after one application, I saw a dramatic improvement in my peristomal skin; it was rash and soreness free for the first time in months. I was over the moon. I went on to do the testimony for this product for its UK launch the following year. I believe in this product so much.
And whilst I love this seal, I know that I could not be without a seal in my ostomy change routine. Without a seal, I would need to change my bag daily and ensure my cutting is perfect every single time, as well as using barrier too. I think if I was without a seal, my dependence on other products would increase and my confidence would decrease. So far, I have yet to be questioned about my seal with my GP but I would fight them on every product I use because for me, they are essential and I know when to use and not use.
- Dansac Seal
- Pelican Healthcare’s Eakin Cohesive Seal
- Salts Healthcare’s Salts Moudable Seal
- Salts Healthcare’s Salts Mouldable Seal with Aloe
- ConvaTec’s Stomahesive Seal
- Coloplast’s Brava Protective Seal
- CliniMed’s Hyperseal Washers with Manuka Honey
- Respond’s Astoa Mouldable Ring Seals
- Hollister’s Adapt Barrier Rings
NB: all products are available on the UK Drug Tariff and should be available on prescription. For those with a permenant stoma, they are entitled to stoma products under a Medical Exception Certificate, valid for 5 years. Some GP’s are governed by a Clinic Comissioning Group (CCG) Formulary – which dictates qualities and expected usage of products. It is worth enquiring about this, if needs be.
Do you have any questions or queries? Or just want to share your own experiences? You can leave me a reply here or leave comments via my social media accounts – on Twitter, find my blog page on Facebook and over on Instagram
VeganOstomy – A Mini Guide to Ostomy Supplies: Barrier Rings
Hollister Canada – Ostomy Care Tips: Adapt Barrier Rings
Disclaimer: The information in this post is based on product knowledge from product information direct from the manufacturer and also personal use of products within my own stoma care. All experiences given here are my own and should not be taken as medical advice. If you require advice or support about any aspect of your stoma care, please contact your SCN in the first instance or your GP.