Patient/caregiver was educated on precautions to be observed while cutting the wafer/skin barrier as follows:

  1. Cutting the wafer too big or towards the edge can compromise the adhesive along the edge of wafer and result in poor attachment to the skin around the stoma. This can result in leakage of stool on to the skin, resulting in irritation of skin and injury. This can lead to the bag coming loose resulting in accidents. Also, do not cut the wafer to fit your stoma too close. The wafers could swell along the line of cut after coming into contact with the moisture from the stoma output. Swelling of the wafer cut too close to the stoma can constrict the stoma, resulting in discomfort and difficulty of stool draining into the bag, necessitating a bag change. Frequent bag changes contribute to early exhaustion of supplies and economic burden for individuals to order for replacement. Cutting the wafer/skin barrier to aptly fit the stoma is key for good attachment of the bag, prevent accidents & other complications, and longer lasting supplies. So, allow some room for the wafer around the stoma. A rough measure could be cutting the wafer to an additional 1/8th inch of stoma measurement. The swelling of the wafer along with the barrier ring used could fill in this room between the edges of stoma and the wafer cut to help a good fix, thus preventing leakage of stool on to the skin around.
  2. Make sure you use ostomy scissors to cut the wafer to the desired size. Ostomy scissors typically have smaller blades with curved edges and rounded tips. The smaller blades with curved edges make it easy to cut the wafer along the circle drawn denoting your ileostomy size. Make sure the tip of the scissors are not sharp, especially if you are using a one piece ileostomy device. If proper caution is not exercised, the sharp tip of the scissors could pierce through the wall of the ileostomy bag, while attempting to cut the wafer to the desired size and thereby, damage the bag. Using an ostomy scissors with rounded tips helps prevent piercing the ileostomy bag and contributes to maintaining the integrity of ileostomy bag.