Stoma paste (sometimes called barrier paste or caulk) is an accessory product used in ostomy care to create a secure seal between the skin and the adhesive wafer. Its primary function is to act as a filler, smoothing out dips, creases, or uneven surfaces in the skin directly surrounding the stoma. This hydrocolloid-based substance prevents corrosive stoma output from undermining the wafer and reaching the sensitive peristomal skin. Gentle removal of the residue is necessary during a pouch change to ensure the new appliance adheres properly and to maintain skin health.
Initial Gentle Removal Techniques
After the main wafer is gently peeled away, stoma paste residue may remain on the skin surface. The first step is to use non-chemical, mechanical methods. Start by attempting to roll or gently peel the bulk of the paste off your skin with your fingers, using a light touch to avoid tugging the skin.
For remaining residue, apply a soft washcloth or gauze dampened with warm water. Gently wipe the area, using the moisture to help lift and loosen the paste. Avoid aggressive scrubbing, as friction can quickly lead to skin stripping or irritation, compromising the surface for the next appliance.
Some professionals suggest using a dry wipe or soft paper towel first to lift as much paste as possible before introducing water. A small amount of residue is acceptable to leave behind, as forceful removal often causes more skin damage than the residue itself. If the residue is stubborn, transition to a dedicated adhesive removal product rather than continuing to scrub with water.
Using Dedicated Adhesive Removers
When mechanical methods are insufficient, specialized commercial products like adhesive remover wipes or sprays can safely dissolve the residue. These products are formulated to break down the chemical bond of the paste and remaining wafer adhesive without causing trauma to the skin. Many modern removers are silicone-based, “no-sting,” and alcohol-free, making them safe for sensitive skin.
To use a spray, hold the nozzle a short distance from the skin and apply a light mist over the residue. If using a wipe, gently stroke it across the affected area to saturate the material. Allow the product a brief moment to work, chemically loosening the barrier material from the skin’s surface.
Once the paste has dissolved or softened, use the wipe or a clean, soft cloth to gently lift the residue away. Always read the product instructions, as some removers leave an oily film that must be washed off with mild soap and water. Newer silicone-based sprays are often designed to evaporate quickly, leaving no residue, which helps ensure the new appliance achieves a strong seal.
Before applying the new ostomy system, ensure all traces of the adhesive remover have either evaporated or been completely rinsed away. Any residual solvent or oily film can interfere with the hydrocolloid material of the new wafer, potentially leading to poor adhesion.
Post-Removal Skin Preparation
After removing all paste and adhesive residue, inspect and prepare the peristomal skin for the next pouching system. Carefully examine the skin surrounding the stoma for any signs of irritation, such as redness, rash, or broken skin. The peristomal skin should look similar to the skin on the opposite side of your abdomen.
The skin must be completely dry before applying new products, which is best achieved by gently patting the area with a soft, dry towel or gauze. Rubbing the skin can cause micro-abrasions and increase the risk of irritation. A thoroughly dried surface is necessary for the integrity of the next adhesive wafer.
If any skin areas appear moist or mildly irritated, lightly dust a specialized stoma powder onto the affected area to absorb excess moisture. This powder is typically sealed with a skin barrier wipe or spray, which forms a protective film before the new wafer is applied.