How to Choose an Ostomy Pouching System
Basically a heavy-duty plastic bag with an opening, an ostomy pouch's round opening fits over the stoma (the end of the large or small intestine or the ureter that protrudes through the ostomy, or opening made in the abdominal wall during ostomy surgeries) so that bodily waste matter can be collected and then disposed of as needed. Choosing the best ostomy pouching system depends upon individual requirements and what type of ostomy surgery was performed. Here is a brief overview of various ostomy surgeries to help you narrow your search:
Colostomy
An opening is made for the large intestine, and a portion of the intestine or rectum is typically removed, with the remaining intestine made to protrude through the abdominal wall as a stoma. A temporary colostomy is intended to let the lower portion of the intestines rest or heal, and may have one or two openings, while a permanent colostomy generally involves the removal of part of the colon, most commonly the rectum.
Descending or Sigmoid Colostomy
The end (stoma) of the sigmoid or descending colon is brought to the opening made in the abdomen in this most common ostomy surgery. The opening, or ostomy is usually placed on the lower left side of the abdomen.
Transverse and Loop Colostomy
Resulting in one or two openings made in the transverse colon, with the ostomies generally located in the upper abdomen in the middle or right side. A Loop colostomy is also usually made in the transverse colon, often with two openings. Whenever there are two openings created in any colostomy, one is generally for mucus, while the other is for stool.
Ascending Colostomy
More rare than the other colostomy surgeries, an ascending colostomy creates an opening in the ascending part of the colon, with the opening located on the right side of the abdomen.
Ileostomy
An opening is made in the small intestine, most commonly at the end of the ileum, with the end/stoma brought out to protrude through the abdominal wall.
Urostomy
Generally indicated in cases where normal urine drainage through the bladder and urethra has been made impossible, such as after extensive surgery or with obstruction, urostomies create an opening for the urinary system through various techniques. Ileal conduit urinary diversion surgically resects ureters from the bladder, with a created ureteroenteric anastomosis to empty the urine into a detached ileum section, resulting in the ileum being made to protrude as the stoma outside of the body, for collecting the urine in an ostomy pouch.
Ostomy Pouching System Types
Whether you use a one-piece or two-piece pouching system, both types include a skin wafer or barrier that is specially designed to protect the skin from the waste output, reducing the risk of infection and irritation. These ostomy wafers come in various inner diameter (ID) and outer diameter (OD) sizes to perfectly fit individual requirements. Every ostomy pouching system also includes a collection pouch that attaches to the stoma on the abdomen via the barrier wafer, collecting the bodily waste until the individual removes and changes the pouch.
While the following information describes the most commonly used ostomy pouching system types, there are also many varied styles among those systems. Barrier wafers can be flat or convex, rigid or flexible. They may have adhesive backing, or may require a taping system. Making your ostomy pouch system choice should be based on your own personal needs, with input and help from your doctor.
One-Piece Ostomy Pouch Systems
One-piece ostomy systems offer more simplicity than two-piece systems, but do require changing the entire unit, which includes the barrier wafer, when the pouch is changed.
Two-Piece Ostomy Pouch Systems
Two-piece ostomy systems are able to be changed leaving the barrier wafer in place on the abdomen. Part of a flange unit, the two-piece systems highlight a closing ring that attaches mechanically to a mating piece on the flange, with the wafer being part of that flange. Many two-piece systems feature a pressure fit snap ring to make sure the system is properly in place.
Colostomy and Ileostomy Ostomy Pouch Systems
With the ability to be both open-ended or closed, colostomy and ileostomy pouching systems offer a wide variety of choices for unique and personal needs. Open-ended ostomy pouches are drainable and stay attached to the body when they need to be drained. They require some kind of closing device like a clamp or tail clip to stay closed when they are not being emptied. More commonly used by individuals who have regular elimination patterns, or who can irrigate, closed-end pouches are completely sealed at the bottom and must be discarded after every use.
Irrigation Ostomy Pouch Systems
Similar to an enema, some individuals are able to use an irrigation procedure to directly clean waste out of the intestines through the stoma. Consisting of an irrigation pouch or bag, a connecting tube or catheter, a stoma cone and an irrigation sleeve, this procedure is often used to help reduce the need to wear the pouch.
Urinary Ostomy Pouch Systems
Available in both one-piece and two-piece ostomy systems, different styles offer different choices dependent upon the user. Specially designed valves or spouts can adapt to be used as a leg bag or to a drain tube that connects to a specified drainage bag, bottle or pouch.
Ostomy Accessories
There are many ostomy supplies that can help to make your experience with ostomy surgery and using ostomy pouches a much improved one. Here are some of the most commonly used ostomy accessories:
Ostomy Belts
Used to keep the ostomy pouch in place, these special belts comfortably wrap around the abdomen and have attachments to connect with the loops found on certain kinds of pouches. They can also be used as an alternative to adhesives, or can help maintain an adequate seal when a convex barrier wafer is used.
Pouch Covers
While some ostomy pouches already include built-in cloth covers, they can also be purchased separately. Generally constructed with a cotton blend backing, pouch covers are specially designed to easily fit over the pouch and offer another layer of protection and comfort for the skin. They are also used to minimize the pouch's existence during intimate experiences.
Ostomy Tape and Adhesive Removers
Sometimes used to help keep the ostomy pouches and/or barrier wafers fully supported and firmly in place, ostomy tape also helps to keep the stoma site from getting wet. The tape comes in a variety of materials to more perfectly suit the varying needs of different skin sensitivities. Special adhesive removers help to clean off any adhesive that remains on the skin after using adhesive wafers or tapes.
Convex Inserts
Usually constructed of plastic, these convex-shaped discs are used to insert inside the flange of some two-piece ostomy pouching systems.
Skin Barrier Products
Skin barrier paste is used to help fill in crevices, folds and other surface or shape irregularities of the abdominal wall around the stoma, creating a better seal with the barrier wafer. Skin barrier liquids, powders and wipes aid in the protection of the skin around the stoma, and under the wafer, reducing or eliminating irritation caused by digestive products or adhesives. Liquids, wipes and powders can all enhance adhesion of the wafer, while the paste is better used as a 'caulking' material.
Other helpful ostomy accessories include special deodorants, absorbents, filters and venting devices, appliance cleaners, specialized ostomy underwear, stoma hole cutters and pouch clamps.
Rehabmart also offers a wide selection of superior quality ostomy supplies such as belts, barrier creams and powders, special taping systems and more from respected manufacturers that include Independence Medical, McKesson Medical Surgical and Gulf Coast Pharmaceuticals.
Hulet Smith, OT
Rehabmart Co-Founder & CEO
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