Skin Barriers, Stoma Care & Ostomy Supplies

How do I Choose the Best Ostomy Supplies?

Certain medical conditions may require treatments that change the way the body gets rid of waste. An ostomy is a surgical procedure that makes an opening in the body to redirect stool or urine. Depending on the exact type of surgery, the end of the small or large bowel or ureter will protrude through the abdominal wall. This protrusion is called a stoma. As a result of an ostomy, a pouch system will be needed to collect the waste that comes out through the stoma. A typical ostomy pouch system includes a skin barrier or wafer and a pouch as well as certain accessories to get the best fit. The pouch is fitted over and around the stoma and attaches to the abdomen with the skin barrier. The skin barrier, or wafer, is also made to protect the skin from the output of the stoma. Urostomy pouches are made specifically for urine collection, an ileostomy pouch is made to be used with the small intestine, and a colostomy pouch is made for collection of the stool from the large intestine, or colon.

There are two main types of ostomy systems. The one piece system is where the skin barrier and pouch come as a single unit. The two piece system has the skin barrier and pouch as separate pieces but they are attached and used together. Pouches can be either open or closed, depending on personal preference. Open-ended or drainable pouches have a re-sealable end that is used to drain its contents into a toilet or similar disposal. This type needs a closing device, such as a clamp or tail clip, and is left on while being emptied. A closed pouch is sealed at the bottom and is completely disposed of when it is full. Many pouches are made with cloth covers on one or both sides for discretion and enhanced comfort.

A one piece system may be simpler to use than a two piece system, but the entire unit must be changed when the pouch is full. With a two piece system, the skin barrier or wafer is designed to stay on the skin for longer periods. Therefore, it does not need to be changed as often as the pouch. Both components need to be made by the same manufacturer as well as chosen from the same product line to fit together for the best results. Some are interchangeable, so be sure to read all the details pertaining to which ones fit together the best. Some skin barriers are designed to swell up, or turtleneck, to better protect the stoma and the surrounding skin. Many manufacturers make sizing easy by using simple colors and codes to match their skin barriers and pouches so the components lock into place securely. In many cases, each color stands for an exact size so the system can be matched by either color or opening dimensions.

How do I Choose the Best Ostomy Skin Barriers?

There are a variety of options in skin barriers and wafers when choosing a two piece system. There are rigid skin barriers as well as moldable ones. There are convex as well as flat ones. A convex design is good for those who have a flush or retracted stoma. These shaped plastic discs are inserted inside the flange of certain two piece systems to make a tighter seal. Many skin barriers that have an adhesive backing will need to be removed occasionally. There are also skin barriers without an adhesive backing, and others with or without a perimeter of tape. It is important to understand the differences between the systems and then discuss them with your medical provider. There are some that are made for individuals with sensitive skin or limited dexterity. These barriers eliminate pressure on the tender area of the abdomen. There are also cut to fit openings for uniquely shaped stomas for a customized fit. Many others have a pre-cut opening. Some are considered extended wear skin barriers that protect the skin from irritation over an extended period of time and allow it to breathe.

How do I Care for an Ostomy Site?

Following the directions of a physician is the first step to ensure proper care of an ostomy site. Caring for an ostomy site mainly depends on cleaning the site and replacing the ostomy bag on a regular basis. Neglecting to do this could lead to gastrointestinal infection and/or distress. Whether the ostomy is meant to be temporary or permanent, self-care for the site is a routine that all individuals must follow to ensure good health.

The main goal of self-care is to make sure the ostomy site does not become irritated. An irritated ostomy site could make relieving the waste fairly uncomfortable. The best way to help prevent irritation is to clean the area every time the ostomy bag is changed. After removing the bag, it is necessary to correctly clean the ostomy site, the surrounding skin, and the stoma. If soap is used, it must be thoroughly rinsed off of the skin so there is no residue left behind. While the abdomen and ostomy are exposed, the site must be inspected for any signs of discoloration, inflammation or bleeding. These are all signs of improper care.

Another part of ostomy care is correctly using and changing the ostomy bag, besides being attentive to the site during the cleaning step. The two main types of ostomy bags, open and closed, need to be replaced in regular intervals. Since the pouch is held onto the skin with an adhesive, it is necessary to remove the bag slowly to prevent skin irritation and accidental release of the fecal matter or urine. After cleaning, make sure the new bag is in the correct position and firmly in place. Not following proper cleaning directions can lead to complications besides bleeding and irritation. It can also cause infection because the bacteria in fecal matter can transfer to the healing ostomy. This infection may require medications or even hospitalization.

Hulet Smith, OT
Rehabmart Co-Founder & CEO

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