Ostomy

Understanding Ostomy Devices

Choosing an ostomy system should be based on your awareness of the procedure (read Understanding Ostomy) and subsequent needs. Also the ostomate needs to beaware of the types of ostomy products that are available and the differences between them. The basic requirement in ostomy products is an ostomy skin barrier and a collection pouch. There are two choices in these.

One-Piece Ostomy System

In a one-piece ostomy system, the ostomy pouch and ostomy skin barrier are joined and sold as a single piece. Being one unit, it is easier to fix the ostomy bag to the stoma. The one-piece ostomy system makes convenient ostomy supplies for those with dexterity limitations because there is no need for frequent fixing of ostomy pouch to barrier. The one-piece ostomy system is less visible under clothing so this makes it ideal for wear with tight-fitting clothes. Another advantage is that since it is a one-piece system, the user feels more secure when wearing it because there are less chances of the ostomy bag coming off from the flange. Generally, the one-piece costs less than a two-piece ostomy system hence, it is more affordable. However, there are a few disadvantages to this ostomy system. Each time the ostomy pouch needs replacing, the entire unit must be changed. This can take its toll on the skin of the user making it tender and irritable. Every time the pouch needs to be emptied out, the entire system must be removed and re-attached. This involves spending more time on correct positioning of the ostomy bag around the pouch and also incurs use of more ostomy supplies like skin barrier paste, tape, adhesive removers, etc.

Two-Piece Ostomy System

In a two-piece ostomy system, the ostomy pouch is separate from the skin barrier. The ostomy bag and barrier are available as two separate units either to be purchased separately or as a two-piece kit. The barrier must be fixed to the stoma first after which the ostomy pouch is attached to the barrier using adhesive or through a plastic coupling ring. Because the two items are individual buys, the user has a vast choice in skin barriers and can also choose which ostomy bag to go with it – small or big, depending on the activity. If going swimming, involved in some sporting activities or partying, then a small bag would be convenient. This gives the wearer flexibility and more options. A two-piece ostomy system also makes it easy for the user to change bag fast during output removal time. The old, filled bag just needs to be disengaged and a new one attached. The skin barrier need not be removed daily. It needs changing only once in 2 to 4 days. This protects the skin from constant irritation.

However, a two-piece ostomy system has its drawbacks, too. It costs more than a one-piece ostomy supplies and is also not as discreet. It is bulky under the clothing and visible if worn under tight-fitting clothes. Since they are separate units, the wearer is always worried about the ostomy bag coming away from the skin barrier and therefore, there is less sense of security. And if there is leakage and the output settles in behind the skin barrier, there is no way of finding that out immediately. It will be visible only when the barrier is removed for changing. This increases risk of skin irritation and infection.

Both these ostomy products can have either drainable pouch or closed pouch. After the one-piece ostomy system and two-piece ostomy system, you are faced with choices in ostomy skin barrier, ostomy stoma supplies, etc.

Ostomy Skin Barrier

The ostomy skin barrier is the device that fixes to the skin surrounding the stoma and to which the ostomy bag is attached. You will often hear ostomy skin barriers referred variously as wafer, flange, device or appliance. A flange is technically the plastic device on the barrier that connects to the ostomy bag. Ostomy skin barriers are designed to be standard-wear, extended-wear and sometimes extra extended-wear.

The ostomy barrier adheres to the peristomal skin and provides a snug fit around the stoma to ensure no leakage. Just after surgery, the stoma will appear swollen and enlarged and is usually pink or red in color. It will gradually shrink in size over the next few weeks. Therefore, when buying your ostomy medical supplies in the first few weeks the stoma has to be measured regularly as its size will keep changing. Gradually, frequency of measurement will lessen. The better the fitting of the barrier, the lesser the chances of leakage, infections and irritability.

Standard-wear ostomy skin barriers are more suitable as part of colostomy supplies. The extended wear ostomy type, also known as Flextend barrier, is apt for ostomates with ileostomy or urostomy who are likely to be more at risk to skin irritation and infection because of the nature of the output. Because of its spread-out design, extended wear ostomy skin barrier provides extra protection from skin irritation.

When buying ostomy skin barriers you will have to decide between three types of openings -cut-to-fit, pre-cut and moldable.

• Cut-to-fit: In the cut-to-fit type ostomy supplies, the skin barrier has to be cut as per the stoma’s unique size. Before buying a cut-to-fit flange, measure the stoma size. You must buy an ostomy skin barrier with a flange that is at least 1/2" (13mm) larger than the widest diameter of the stoma. If you don’t get the size you want then opt for the next size. Then trace the stoma size in the center of the white release paper at the back of the skin barrier. Keep the small starter hole in the center of your tracing. Cut along the traced line with a pair of scissors. Ostomy skin barriers from ConVatecSUR-FIT Natura are a good example of ostomy supplies skin barriers which need to be cut to fit the stoma opening.
• Pre-cut: In the pre-cut wafer ostomy supplies, no cutting is required since it has already been cut. So this type is ready to go. Just open the box of your ostomy products, take out the wafer and start using. But from the wide choices in size you have to select the one that best fits your stoma. Look for a barrier with a pre-cut stoma opening the same size as the largest diameter of the stoma. The opening should not be enlarged. We have leading brands in pre-cut ostomy skin barriers including SenSuraMio, Premier, Microskin, Assura, UltraLite and NewImage.
• Moldable: The moldable ostomy skin barrier is designed to settle snugly around the stoma providing a close fit. The moldable design gives additional protection to the ostomy bag from leakage. It fills in the cracks and crevices thus protecting the skin from irritation and extending wear time.

Ostomy skin barriers can also be convex or flat. A flat barrier, like the name suggests, lies flat on the skin without any bulge. It is suitable for those with a regular shape stoma. A convex type has some protrusion on its back. Someone with irregular stoma shape and skin contours can opt for the convex type ostomy supplies to provide a more secure seal and better wear time. Ostomy supplies are incomplete without the relevant ostomy products such as ostomy accessories, adhesives and removers, odor removers, ostomy powder, paste and protectants, irrigation and drainage supplies as well as ostomy belts.

Ostomy belts are developed to support your ostomy appliance by holding up the bag and keeping the ostomy pouch system in place. With a belt, the ostomate is worry free knowing it will not allow the bag to weigh down the appliance.

Which Ostomy System to Choose?

Choosing the ostomy product best for you will depend on your needs. Because there is such a variety available of ostomy supplies, you can pick the exact right type.

• For those with an active lifestyle who need something super discreet and highly secure then closed ostomy pouches or mini ostomy pouches would be a good choice. They would also need ostomy bags with strong waterproof adhesives.
• For those intimate days, mini ostomy bags and ostomy pouch covers will work well.
• For ostomates who tend to perspire a lot, odor concerns can be high. To avoid embarrassing situations, go for ostomy pouch deodorizers, ostomy bag filters and ostomy odor protectants which deodorize all types of ostomy care products.
• Denver PleurX Drainage Kit effectively manages repeated pleural effusions and malignant ascites. The kit has indwelling catheter and vacuum bottles and allows the patient to drain fluid within 3-5 minutes sitting at home.
• Ostomy barrier wipes and sprays as well as flexible conformable skin barriers will offer comfort to ostomates built heavily. Ostomy paste will add protection by filling in the folds and scars around the stoma to create a tight seal and prevent leakage.
• Pediatric ostomates will be able to get ostomy supplies created keeping in mind their soft, gentle skin and active lifestyle. There are also ostomy barriers and ostomy pouches for post-operative system needs.

Guides for Ostomy Care

• Travelling With Ostomy
• The Right Nutrition – Ostomy Food
• Ostomy Pouching Systems
• Intimacy and Your Ostomy: Yes You Can!!
• Exercising with Your Ostomy: Just Do It!!