Which appliance is best? Part 2

Now that you have examined your stoma and your belly (see part 1), I’ll guide you through the different kinds of appliances out there so you can figure out which one is best for you.  You must, of course, try things out so you know what works for you.  It’s like finding a great pair of jeans at the store; they won’t necessarily look good or feel comfortable once you try them on!  Here are the main appliance categories that stoma product manufacturers offer:

1.      1-piece versus 2-piece

The flange is the part that sticks to your body; it can also be called a protective collar.   This piece can sometimes be separate from the bag itself that clips into it sort of like a Tupperware lid.  The advantage of a 2-piece system is the easier application of the flange because you can see your stoma.  It’s also possible to change out the bag more aften if you wish.  The 1-piece system is an all-in-one which means that the flange is already attached to the bag.  The advantages of a 1-piece system is that it’s less visible under clothing because it’s not as thick (as a 2-piece), is more flexible and generally less expensive.

2.      Pre-cut versus uncut flange

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If the size of your stoma is unchanging and it’s perfectly round, you can opt for pre-cut flanges; manufacturers offer a variety of sizes.  However, if your stoma changes in size, if it’s oval or has an irregular shape, you must cut the flange opening to size every time to best customize it just for you.  There are also mouldable flanges that have stretchable openings but your stoma has to protrude quite a lot for them to fit well.

3.      Flat versus convex flange

The flange can be almost flush with your skin’s surface or it can dip in a little and be convex.  The height and shape of your stoma determine which kind you need.  If your stoma sticks out and the surrounding skin is smooth and flat with no wrinkles or unevenness, a flat flange should work.  However, if your stoma doesn’t stick out much, is flush with your belly’s skin or sits below skin level a convex flange is often required.  A convex flange presses gently into the skin around your stoma to make the stoma pop out a little.  The convex shape can also fill in a dimple around your stoma, stabilize flaccid skin and/or smooth out skin folds.  Both flat and convex flanges come in 1-piece or 2-piece models.

4.      Flexible versus convex flanges

The above-mentioned convex flanges are available in many different degrees of rigidity, shape and depth depending on the manufacturer.  There’s also a more pliant version that even if it’s domed bends and unbends as your body moves.  These products also come in 1- and 2- piece systems.

5.      Bags: drainable versus closed and more…

Urostomates will need a drainable pouch and be hooked up to a larger urine bag for nighttime wear.  For stool, there are more options; long or shorter bags; bags with a clamp or a Velcro closure; and even, closed, disposable (single use) bags.  The best bag will depend on each person’s body shape and quantity, consistency and frequency of output.  There are also bags with filters that are relatively effective at allowing gas to escape without causing any odour.  Every style of bag comes in your choice of opaque or transparent; neither is better than the other.  It’s up to you to decide if you want to see the contents of your bag or not.

Different appliances can be combined with a panoply of accessories – a subject I’ll save for later.  If you think you’re not wearing the best stoma system for you, I advise you to consult with a stoma therapist who can evaluate your stoma and your lifestyle to help you choose a better product.  You can also try products by requesting samples by contacting various manufacturers through their websites.  There is an appliance to fit every need and preference.  Let me get back to my jeans example.  Shop, try on and compare jeans before choosing the pair that fits best.

Clinical Nurse and stomatherapist

Translated from French by Jane Loignon

Brought by : ANA