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| One-Piece Systems |
| Two-Piece Systems |
| Closed Pouches |
| Drainable Pouches |
| Urostomy Pouches |
| Skin Barrier Adhesives |
| Convex Products |
| Colostomy Irrigation |
| Filters |
| Accessory Products |
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| One-Piece Systems |
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| In a one-piece system, the skin barrier is already attached to the pouch. The one-piece is simple to apply — just peel and stick. One-piece products are available in all styles and quite often differing shapes. They can be found in closed, drainable (open-ended) and urostomy, with varying features from manufacturer to manufacturer. |
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| A one-piece pouch generally lies flat against the skin and may show less under clothing. Typically, they are slim and flexible providing great comfort while wearing. If a bulge or hernia happens to appear near the stoma, sometimes a better fit can be found with a one-piece pouch because of its flexibility. |
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| Two-Piece Systems |
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| A two-piece system can often be the most versatile. The skin barrier is separate from the pouch. The pieces either snap together with a flange (a part that looks like a plastic ring), or there are adhesive styles which actually stick together. It's easy to remove the pouch and discard it as often as desired without having to remove the adhesive from the skin every change. |
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| The versatility comes in where it's possible to have a quick change and wear different pouches depending on activity level. For example: Changing to a smaller pouch for sports or intimacy. These also are available in closed, drainable (open-ended) and urostomy, with varying features from manufacturer to manufacturer. If the pouch needs changing more frequently than the skin barrier, choose a two-piece system. |
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| Closed Pouches |
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| This type of pouch works best if the stoma output is infrequent and the pouch requires emptying only once or twice a day. Generally, anyone with a colostomy can use a closed pouch (although of course there are exceptions). Closed pouches can be used all the time or some people switch between a closed and drainable pouch. On occasions when say, an episode of diarrhea happens from something not agreeable, or from a bowel prep for a procedure that requires bowel cleansing, a drainable pouch might be better. |
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| Closed pouches do not have clamps or integrated closures. Basically, they are removed and then thrown away. Most closed pouches have filters to let gas out but not odor. |
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| Some people with a colostomy say they don't wear a pouch or they wear a tiny closed pouch called a stoma cap. Often this is because the person uses a procedure known as irrigation to control their bowels. |
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| Drainable Pouches |
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| Choose this type of pouch if there's discharge frequently throughout the day (such as with an ileostomy). Drainable pouches these days have options of a clamp style closure, which is separate from the pouch, or an integrated closure system, which is already attached. Either way, emptying the pouch is quick and easy. Drainable pouches are available in several lengths, and there are options to choose transparent or opaque. |
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| Filters are available on most drainable pouches. However, there are non-filtered styles available too. |
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| Urostomy Pouches |
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| All urostomy pouches have a drain valve/tap at the bottom of the pouch, so urine can be drained quickly, emptying the pouch. Each manufacturer will have a different tap on the bottom of the pouch. Some are like a household sink tap with flow and regulation, and some are like a straight tube with a cap. There are also transparent and opaque options for the pouch and sometimes capacity options depending on the manufacturer. |
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| At night, it's possible to connect the urostomy pouch to a bedside drainage collector. This increases the overall capacity and helps to avoid having to get up during the night to drain the pouch. Each manufacturer's drain valve/tap is different, and it's a good idea to see how they connect with various collectors. An adapter may be needed. |
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| Skin Barrier Adhesives |
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| This is the part of the system that sticks directly to the skin. Every manufacturer's formulation is different and some have several formulations within one product line. So, this can get confusing. The manufacturer may possibly be best to help decide what formulation may help. |
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| For instance, some skin barriers are designed for frequent changes and have less adhesive or reduced absorption. These are good for frequent changes or stool with low water content, so skin stripping when changing the barrier is reduced. Imagine removing an adhesive bandage from the skin very quickly and roughly; this gives a good idea of what skin stripping is. The stripping may in fact remove some layers of skin. |
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| Other skin barriers (known as 'extended wear') are designed to be more durable or longer lasting to withstand things like high heat/humidity, or fewer changes. Preference for the type may be a deciding factor or the type of output may guide the skin barrier choice. These generally are available in both one-piece and two-piece options as well. |
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| Some skin barrier adhesives are pre-cut, meaning no cutting is required to get the desired fit. And some are cut-to-fit or moldable, where a custom fit is required. |
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| Skin barriers are designed to stick to the skin and not cause irritation. If skin irritation develops, it might be a good idea to investigate what else is used in the pouch change process that may be causing this reaction. Sometimes soaps, wipes and medications can be to blame. |
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| Convex Products |
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| Sometimes leakages occur when the stoma sits at or below skin level or there's not enough support around the stoma to give a good product seal. The stoma drainage does not flow into the pouch and instead comes through the layer, like a gap, between the skin barrier and the skin. Depending on the drainage, this can cause skin irritation or even skin breakdown. So it needs to be investigated and fixed quickly. |
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| A convex product curves out towards the skin to fill in this gap. Convex products have a firm dish inside the skin barrier to give the stoma a gentle 'push' out, so the drainage then goes into the pouch. Again this varies from manufacturer to manufacturer. A good rule of thumb is to not start with something too deep or harsh as it can cause more problems. Start with something that gives a good result without undue pressure. The stoma care nurse may be the best expert to advise if this kind of product is needed and how to use it. |
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| Again the range of product choices available is extensive. Convex products are available in one-piece and two-piece for closed, drainable and urostomy pouches. |
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| Colostomy Irrigation |
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| Irrigation is similar to taking an enema through the stoma, but it requires special equipment and skills. An irrigation bag with a stoma cone and an irrigation sleeve is required. After irrigation, some people can use a stoma cap or a one-piece or two-piece closed pouch to simply cover and protect the stoma. Always check with the surgeon or stoma care nurse if this procedure sounds interesting before pursuing it as an option. |
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| Irrigation is not for everyone with a colostomy as it can depend on the type or location of the surgery, and the length of time to learn this procedure. However, if colostomy irrigation seems right for you, and it works well, some people find it gives them a lot of freedom. |
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| Filters |
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| On closed and drainable pouches, quite often filters are incorporated to vent unwanted gas from the pouch so it doesn't 'balloon' under clothing. Filters are generally comprised of membranes and plastics with a deodorizing material, usually charcoal, to get rid of odor and gas. The gas flows through the filter and gets deodorized before exiting through a small hole in the pouch. Again these vary from manufacturer to manufacturer in terms of performance and what works for one may not work for another. |
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| Accessory Products |
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| There are many accessory products available but not every product is available everywhere. These include a bewildering array of pastes, rings, seals, powders, belts, hernia supports, disposal bags, wet wipes, cleansers, lotions, removers, protectors and deodorizers. |
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| These are accessories meant to make life easier, but sometimes they can make life more complicated. You just need to judge each on its merit, with advice from your stoma nurse. |
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