Other types of ostomy bags based on shapes of adhesive used:
Convex Bag
A convex stoma bag has a curved adhesive baseplate. The convex shape helps the stoma protrude more which improves the flow of waste into the bag and reduce leakage.
Flat Bag
These are more commonly used when the stoma protrudes naturally, and the skin around the stoma is flat and healthy.
Concave Bag
Some, but not many, companies offer a concave bag to adhere to the skin better when there is the presence of a hernia.
By following these steps, you can effectively manage your closed-end ostomy pouch, ensuring comfort and hygiene while minimizing risks of skin irritation or infection. Always consult with your healthcare provider for personalized advice tailored to your specific needs.
What is an ostomy bag and pouching system?
A pouching system collects output from an ileostomy or a colostomy bag. It protects the peristomal skin (the skin surrounding the stoma) and provides security by keeping the bag sealed to the skin.
It consists of an odor-proof ostomy bag that collects and holds waste which come out from the stoma, and an adhesive (called a skin barrier) that attaches to the skin around the stoma. The skin barrier will protect the skin around the stoma and adhere the bag to the skin. The bottom of the bag has a tail, which can be opened to drain collected stool, but otherwise stays sealed with an integrated pouch closure.
Ideally, your bag will remain attached to your abdomen for approximately 3-7 days (known as your wear time). Your bag is emptied approximately 4-5 times daily. You should empty your bag regularly and avoid waiting until it is completely full, which can cause the pouch to get heavy and loosen the seal, potentially causing a leak. Remember, everyone’s body type and skin are different and everyone can have different wear times.
How does an ostomy bag work?
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An opening is made in the skin barrier that matches the size and shape of the stoma. For example, if the stoma is round-shaped, the opening is round; if the stoma is oval-shaped, the opening is oval.
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When the skin barrier is applied it should fit to the skin stoma junction providing skin protection. An opening is made in the skin barrier of the pouching system that matches the size and shape of the stoma. For example, if the stoma is round-shaped, the opening is round; if the stoma is oval-shaped, the opening is oval.
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When the skin barrier is applied it should fit around the stoma and the skin junction for skin protection. As the stool drains from the stoma it will pass over the skin barrier into the ostomy bag and be contained until emptied. There are many types of pouching systems available. The ostomy nurse will help you find the best, most secure fit.
Understanding Ostomy Bags
One-piece System
Two-piece System
Closed End pouch
One-piece System
A one piece pouching system consists of an ostomy bag and the skin barrier. The skin barrier is attached to the bag as one piece.
1
Remove the Old Pouch
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Similar to the two-piece system, press gently on the skin around your stoma with one hand while peeling off the entire one-piece pouch with the other hand.
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Discard it in a plastic bag.
2
Clean the Skin
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Cleanse around your stoma with warm water and mild soap, then dry gently with a clean towel or paper towels.
3
Prepare the Skin
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Wipe around the stoma area with a skin wipe.
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Apply stoma powder if needed and allow it to air-dry for 1 to 2 minutes.
4
Measure Your Stoma
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Measure your stoma using a measuring card to ensure proper fit without direct contact.
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Cut out an opening in any adhesive barrier that comes with your one-piece system, ensuring it fits correctly around your stoma.
5
Apply New Pouch
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Position the new one-piece pouch over your stoma, ensuring it adheres securely to clean skin.
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Press down firmly around all edges to ensure a good seal.
6
Final Steps
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Dispose of any used materials properly.
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Wash your hands thoroughly after completing the procedure.
Two-piece System
A two-piece pouching system consists of an ostomy bag and a separate skin barrier, which acts as a flange. The bag can be attached and detached to the flange (or skin barrier) as needed. The skin barrier is placed on first and the bag snapped and/or attached to the skin barrier.
Getting Your Supplies Ready
Before starting, gather the following supplies:
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A new pouch (either a one-piece or two-piece system)
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A pouch clip (if applicable)
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Scissors
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Clean towel or paper towels
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Stoma powder
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Stoma paste or a ring seal
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Skin wipes
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Measuring card and pen
General Steps for Changing Your Ostomy Pouch
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Preparation: The bathroom is a suitable place to change your pouch. If necessary, empty your used pouch into the toilet.
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Prevent Infection: Wash your hands thoroughly with soap and water, ensuring to clean between your fingers and under your nails. Dry with a clean towel or paper towels.
1
Remove the Old Pouch
-
Similar to the two-piece system, press gently on the skin around your stoma with one hand while peeling off the entire one-piece pouch with the other hand.
-
Discard it in a plastic bag.
2
Clean the Skin
-
Cleanse around your stoma with warm water and mild soap, then dry gently with a clean towel or paper towels.
3
Prepare the Skin
-
Wipe around the stoma area with a skin wipe.
-
Apply stoma powder if needed and allow it to air-dry for 1 to 2 minutes.
4
Measure Your Stoma
-
Measure your stoma using a measuring card to ensure proper fit without direct contact.
-
Cut out an opening in any adhesive barrier that comes with your one-piece system, ensuring it fits correctly around your stoma.
5
Apply New Pouch
-
Position the new one-piece pouch over your stoma, ensuring it adheres securely to clean skin.
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Press down firmly around all edges to ensure a good seal.
6
Final Steps
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Dispose of any used materials properly.
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Wash your hands thoroughly after completing the procedure.
Closed End pouch
A pouch with no opening at the bottom and when stool has filled half of the pouch it is removed and discarded. Most people use a closed end pouch on a two piece pouching system to allow removal of the pouch and not the adhesive. Frequent adhesive removal can injure the skin around the stoma.
Changing a closed-end ostomy pouch involves specific steps to ensure proper hygiene and effective management of the stoma. Here’s a detailed procedure:
Supplies Needed
Before starting, gather the following supplies:
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A new closed-end pouch (either a one-piece or two-piece system)
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A pouch clip (if applicable)
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Scissors
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Clean towel or paper towels
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Stoma powder
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Stoma paste or a ring seal
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Skin wipes
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Measuring card and pen
1
Preparation
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Choose a clean and comfortable space, preferably in the bathroom.
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If the used pouch needs emptying, do so by pouring its contents into the toilet.
2
Hand Hygiene
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Wash your hands thoroughly with soap and water, ensuring to clean between fingers and under nails. Dry them with a clean towel or paper towels.
3
Remove the Old Pouch
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Gently press on the skin around your stoma with one hand while using the other hand to peel off the seal of the old pouch. If it is difficult to remove, consider using special adhesive remover pads.
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Once detached, place the old pouch in a plastic bag and discard it in the trash.
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Clean the Skin:
4
Clean the Skin
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Clean the skin around your stoma with warm water and mild soap. Pat dry using a clean cloth or paper towels.
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Wipe around the stoma with a special skin wipe or clean cloth.
5
Prepare the Skin
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Sprinkle some stoma powder on the area around the stoma to absorb moisture.
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Important: Allow the area to air-dry for 1 to 2 minutes to ensure proper adhesion of the new pouch.
6
Measure Your Stoma
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Use your measuring card to determine the size of your stoma. Avoid touching the card directly to your skin.
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Trace the circle size onto the back of your ring seal (if using).
7
Cutting the Seal
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Cut out the traced circle from the ring seal, ensuring that the edges are smooth to prevent irritation.
8
Applying Stoma Paste or Ring Seal
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If using a two-piece system, attach the new pouch to the ring seal.
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Apply stoma paste around the hole in the seal or place a special stoma ring around it.
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Position the seal evenly around your stoma and hold it in place for a few minutes. You can use a warm washcloth over it to help it adhere better.
9
Attach New Pouch
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If using a two-piece system, securely attach the new closed-end pouch to the ring seal.
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Use a pouch clip or Velcro closure to secure the pouch if applicable.
10
Final Steps
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Dispose of any used materials properly.
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Wash your hands again with warm soap and water after completing the procedure.