Have voicemailed our wound/ostomy resource nurse for advice. The necrotic skin has peeled already.
Karen, you mean change the WHOLE appliance every 3 days?? YIKES! The first change took me an hour and a half! I should explain just how his appliance works. He has catheter fasteners attached to his skin right next to where the tubes come out, to anchor them in place. The tubes are long enough to attach to a urine leg bag on each side. I am putting a gauze dressing over the insertion points, and covering the whole thing with Opsite, so he can shower. The problem with this is the Opsite sticks to the catheter fastener, which peels away from the skin as you lift the Opsite, and you have to work very, very carefully to keep from dislodging the tubes. I expect now that the new ones are in place, we'll be in better shape for dressing changes, as the adhesive on the old ones was pretty much melted, and not holding anymore. Don't have any stoma powder right now, just the spray, though the powder sounds like an excellent idea.
Urine leaks have stopped, BTW. (THANK GOD!) They replaced his tubes with new ones. Just a small amt. of discharge now from local skin infection at the tube insertion point.
He goes for chemo again tomorrow. They gave him the wrong chemo drug for this form of cancer (small cell bladder ca.) and guess what?? IT WORKED! He's passing urine through his penis again! Doubt they'll take the tubes out though, not yet, anyway.
I'll make sure he gets really good skin care to the tube sites until the chemo is out of his body.
Sad case. He's only 34, and has young children. Needless to say, his wife is devastated by the dx.