clinical question for ileostomy

How do you change an ileostomy appliance on a stoma that has a plastic bar (stoma bridge)? How do you get the wafer to fit around this bar?
Thanks, Chris
Chris 27229: Do your have access to an Ostomy or wound nurse?? These are nurses who are certified in wound and stoma care. I have had patients who have the "stay bar" in place and we ended up cutting a custom wafer to fit. The ostomy nurse who we consulted had extra extensions to the wafers that fit better than the one we custom fit, so that is why I suggest that service. This is a very challenging type of ostomy and it is important to find the right wafer that will fit to prevent skin breakdown around the stoma. When our patient returned for a follow-up visit the surgeon removed the stay-bar and then we were able to use a normal size wafer. Good luck!!