Ostomy Page List

The Concepts
»A 2-piece is usually the first type used by the Nurse. Stoma is accessible and pouch is disposable without changing the barrier. Pouch change count is not limited.
»A 1-piece barrier includes the pouch, and is often preferred by some for its thin profile and much lower barrier-fluid capacity. Barrier and pouch are always replaced together.

Chemistry & Mechanics
A stoma seal at barrier can leak without being seen, and naturally a reason to change the barrier. The first important steps are to figure out why it leaked and how to prevent it.
Why?
 a) barrier leak to skin around stoma, or
 b) pouch or barrier leak to outside.
The first is often measured with days, how many till pain arrives.
A leak happens by physically breaking the seal, or, the adhesive lets go.

Barrier composites vary by brand, and can react differently by chemical reactions from bath soap, shampoo, prep-wipes, stoma fluids, or your own skin emissions.
Remember - bathing & swimming are OK, 'tap water' can't normally break that seal.

Fluid Details
It may be 8—10pH, it hurts on your skin.


38mm
flange
6mm
gap
Coloplast #10504  2-piece
Pre-Cut 1" (25mm) for stoma
SenSura Mio Click Barrier
 
 

This shows 6× 7× 38mm donut,
4.5ml (1 teaspoon)around stoma. That is flange diameter and height, minus a cylindrical space for stoma.
A 50mm flange with a 25mm stoma is a 2+ teaspoon donut.
Important - regardless of pouch, this type of structure retains fluids until turned on its side. Lying on your back will submerge the stoma seal at bottom of fluid container.
Always use a 'Remover Wipe' or Spray when removing to avoid injury.   "marsi"
    medical adhesive-related skin injuries
Pouch Side

Coloplast #10551
After 1" Cut Out
2.4mm thick

Pouch

Coloplast #12262
0.3mm thick
This Pouch
can be Used
OneTime
Body Side
   
Coloplast #10551 Flat
2-piece, Cut-to-Fit
click

This is a Coloplast 2-piece system, a #10551 barrier with #12262 pouches. Its fluid retention is minimum, comparable with a 1-piece system.
Ileostomy brings fluids which can make a leak.  Higher alkalinity can reduce viscosity. It more easily seeps under barrier and is trapped, painfully contacting your skin and forcing a barrier replacement.
Brands may react differently to your actions, e.g; motion, bending, stretching, temperatures, bathing, swimming, soaps, shampoos, etc. When trying new devices make a list of good and bad to help you select devices, or make changes, or not.


Patrick Mullins
2018

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