To Paste or Not to Paste – That is the Question
By Diane Mirlocca RN, WOCN, IIWCC
It is important that you use the correct pouching system to prevent leakage and skin breakdown AND as important to use the right ostomy accessories that meet your needs. Everyone needs accessories and a ‘well-turned-out’ ostomy system is no exception! Paste is one of those accessories. Should you use it? How should you apply it? How do you remove it? These are all important questions for consideration and this article will give you the answers.
What is Paste?
Paste is a protective substance used to seal the ostomy appliance to the skin, preventing leaks or gaps. Stoma paste acts as a barrier to prevent bowel movements from lying directly onto the skin that can cause skin breakdown. Stoma paste is not an adhesive; it is a filler, making the skin a flat surface that allows your pouching system to fit securely onto the skin. Think of it as “caulking”. Caulking is used every day to seal leaks or gaps when doing construction. Stoma paste is considered the “caulking” of an ostomy pouching system.
Are there different types of Paste?
Yes. Stoma paste comes in a squeezable tube, like toothpaste or as thick strips that and can be molded to fit the shape required. Examples of products available include Adapt (Hollister®), Ostomy Paste (Coloplast®), Stomadhesive® (Convatec™) and Brava® (Coloplast) comes in a tube or strip. Other forms of skin barriers are shaped as disks or rings. Adapt (Hollister®) has a wide selection of barrier disks: convex, CeraRing Convex, oval convex,and flat rings. Brava® (Coloplast) is a flat ring that comes in a wide variety of sizes. Eakin Cohesive® rings (Convatec) also come in a wide range of sizes. Your Nurse specializing in ostomy care will assist you with the decision as to whether you require paste and what type to use.
CAUTION: stoma paste may contain alcohol and will cause a burning sensation when applied to open irritated skin. Always check the manufacturer’s information paper insert inside the packaging before applying paste onto broken or reddened skin.
When would I Use Paste?
You don’t need to use paste if the skin around your stoma is smooth and flat—no creases, no dips or any indents around your stoma and/or you are not having leakage due to these unique anatomical features. Paste is only recommended to fill any areas on the skin surface to give a smooth, gap free and leak free barrier. If your Nurse specializing in ostomy care hasn’t recommended using paste, it is highly likely you don’t need it.
CAUTION: Paste is not recommended for persons with a urostomy (ileal conduit).
How do I apply Paste?
Apply the paste directly to the skin areas you need to fill to make a flat smooth surface that the pouch can adhere to. MORE IS NOT BETTER. Use the smallest and thinnest amount, carefully layering additional thin layers until the area is filled. If you are using a paste that contains alcohol WAIT one minute after applying to give the alcohol time to evaporate before applying your flange.
What about removal?
Remove your ostomy pouching system as you’ve been shown by your Nurse specializing in ostomy care. In some cases, you will notice some paste may remain on your skin. Allow the paste residue to dry completely as this will make removal much easier. Don’t wet the paste: it will absorb the moisture and become more difficult to remove. If you’re unable to remove all the paste, that’s OK, the paste is not damaging to your skin.
Hopefully, after reading this article, your questions about stoma paste have been answered. Looking for further information? Check out the following resources:
Wound, Ostomy and Continence Nurses Society. WOCN Society Clinical Guideline: Management of the Adult Patient with a Fecal or Urinary Ostomy-An Executive Summary. J Wound Ostomy Continence Nurs. 2018;45(1):50–58.
Black P. Accessories in stoma care nursing and residential care. Nursing and Residential Care. 2015;17(2): 68–70.
Black P. The correct use of stoma skin protectors and appliances. Nurs and Residential Care. 2014;16(3):130–134.