An ostomy is a surgically created opening, called a stoma, on the abdomen that allows bodily waste to exit the body after the urinary or digestive tract has been diverted. Ostomy products, often collectively referred to as a pouching system, are specialized medical devices designed to collect this effluent. These systems provide a sealed environment to prevent leakage and protect the skin, enabling individuals to manage their waste output effectively.
The Core Components of an Ostomy System
Every ostomy system is built around two primary components: the collection pouch and the skin barrier. The collection pouch functions as an odor-proof bag that gathers the output from the stoma. These pouches are generally made from multi-layered materials and are often categorized as either closed or drainable.
Closed pouches are designed for single use, making them suitable for individuals with more predictable, solid output. Drainable pouches feature an opening at the bottom secured by a clip or integrated closure, allowing the contents to be emptied and the pouch reused over several days.
The second core component is the skin barrier. This barrier is composed of a specialized hydrocolloid material that is gentle on the skin while providing strong adhesion. The skin barrier’s primary function is to protect the delicate peristomal skin from corrosive effluent.
The hydrocolloid material swells slightly when exposed to moisture, which helps to fill microscopic gaps and improve the seal against the skin. This protective layer holds the pouching system in place while safeguarding against skin irritation and breakdown.
Distinguishing System Types: One-Piece Versus Two-Piece
Ostomy systems are configured in two main ways, differing in how the pouch and the skin barrier are connected. A one-piece system integrates the skin barrier and the collection pouch into a single unit. When the pouch needs to be changed, the entire unit is removed and replaced.
This integrated design tends to be flatter and more flexible, offering a lower profile under clothing. The simplicity of a one-piece system is often beneficial for individuals with limited dexterity. However, the skin barrier must be changed every time the pouch is changed, requiring more frequent application and removal of adhesive from the peristomal skin.
Conversely, a two-piece system uses a separate skin barrier and a detachable pouch connected via a coupling mechanism. This allows the wearer to remove and replace the pouch without disturbing the sealed barrier.
The coupling mechanism provides flexibility for changing pouch sizes or types without having to strip the skin barrier. The two-piece design allows the skin barrier to remain in place for several days, promoting skin rest and reducing potential trauma from frequent adhesive removal. While the two-piece system may be slightly bulkier, its versatility and easier pouch changes make it a preferred option for many users.
Specialized Ostomy Accessories
Beyond the pouch and barrier, several specialized accessories are used to optimize the system’s performance and maintain skin health.
- Barrier rings or seals are moldable, pectin-based accessories used to fill in uneven skin contours around the stoma. They create a smooth surface and a tighter seal, preventing leakage underneath the skin barrier.
- Ostomy paste, a sealing agent, fills creases or dips next to the stoma, creating a uniform plane for the barrier to adhere to and extending wear time.
- Specialized adhesive removers (wipes or sprays) chemically break down the skin barrier’s adhesive bond without causing irritation.
- Protective skin wipes or barrier films are applied before the barrier to create a thin, breathable layer that shields the skin from the adhesive.
- Stoma powder is used only on irritated or weeping peristomal skin to absorb moisture, allowing the skin barrier to adhere securely to the damaged area for healing.
These products work together to ensure a comfortable, secure, and long-lasting seal.
How Ostomy Type Influences Product Selection
The type of ostomy surgery dictates the characteristics of the output, which is the primary factor influencing product selection. A colostomy, which diverts the large intestine, typically produces a more formed or semi-formed stool. Individuals with a colostomy often use closed-end pouches because the output is predictable and solid enough to be discarded less frequently.
An ileostomy diverts the small intestine, resulting in a continuous, liquid, and enzyme-rich output. Because this effluent is highly corrosive, an ileostomy requires a drainable pouch to be emptied multiple times daily and a skin barrier with advanced protective properties. The constant liquid output necessitates meticulous attention to the seal to prevent peristomal skin damage.
A urostomy diverts urine, requiring a specialized pouch with a drain tap or valve at the bottom for easy emptying. These pouches typically feature an anti-reflux valve to prevent urine from washing back over the stoma and causing infection. The choice between flat or convex skin barriers is influenced by the stoma itself; convex barriers provide gentle pressure to help a recessed or flush stoma protrude slightly into the pouch.