Ostomy system
An ostomy pouching system (also colloquially and incorrectly[citation needed] called a colostomy bag) is a medical prosthetic that provides a means for the collection of waste from a diverted biological system (colon, ileum, urinary); pouching systems are most commonly associated with colostomies, ileostomies, and urostomies.
Pouching systems usually consist of a mounting plate, commonly called a wafer or a baseplate, and a collection pouch that is attached mechanically or with an adhesive in an airtight seal. Ostomy pouching systems collect waste that is output from a stoma. The pouching system allows the stoma to drain into a sealed collection pouch, while protecting the surrounding skin from contamination. Pouching systems come in one- and two-piece designs; two-piece designs allow the changing and use of multiple pouches while retaining the wafer/baseplate for several days. The selection of systems varies greatly between individuals and is often based on personal preference and lifestyle.
Ostomy pouching systems are air- and water-tight and allow the wearer to lead an active normal lifestyle that can include all forms of sports and recreation.
Ostomy pouching systems are also sometimes referred to as an appliance, where the term appliance refers to a prosthesis, as a mechanical replacement for a biological function. Ostomy appliance users may in the below instruction video be introduced to the practical aspects of managing ostomy appliances. This includes tips to optimise performance of your appliance. Instruction video on how to attach modern ostomy appliances seen from a user perspective
Wafers/Baseplates
Most wafers/baseplates are manufactured using pectin or similar organic material and are available in a wide variety of sizes to accommodate a person's particular anatomy.
The internal opening must be the correct size to accommodate the individual's stoma while protecting the skin from contact with waste. The methods for sizing this opening varies depending on the type of wafer/baseplate; some pre-cut sizes are available, however most users normally customize the opening using scissors. Manufacturers have recently introduced moldable wafers than can be shaped by hand without the need for scissors.
Skin adhesion for modern wafers/baseplates are optimized on all the five parameters required in an adhesive: 1) absorption, 2) tack and adhesion, 3) flexibility, 4) erosion resistance and 5) ease of removal. A wafer/baseplate may last between 4 to 10 days before it needs to be replaced; this is highly dependent on the individual's lifestyle, ostomy type, and anatomy.
Pouches
The method of attachment to the wafer varies between manufactures and includes permanent (one-piece), press-on/click ("Tupperware" type), turning locking rings and the recently introduced "sticky" adhesive mounts. The two-piece arrangement allows pouches to be swapped without removing the wafer; for example, some people prefer to temporarily switch to a "mini-pouch" for swimming or other activities.
Pouches can be broken down into two basic types: open-end (drainable) and closed-end (disposable).
- Open-end pouches have a resealable end that can be opened to drain the contents of the pouch into a toilet. The end is traditionally sealed with a plastic clip, however many manufacturers now offer a velcro-type closure at the end that eliminates the need for the clip.
- Closed-end pouches must be removed and replaced with a new pouch.
The use of open-end vs. closed-end pouches is dependent on the frequency in which an individual needs to empty the contents, as well as economics.
Gas is created during digestion, and an airtight pouch will collect this and inflate. To prevent this some pouches are available with special charcoal filtered vents that will allow the gas to escape, and prevent ballooning at night.