Ordering ostomy supplies can be really overwhelming. There are so many different companies, styles, and products to chose from. Luckily most companies will send you free samples of their products for you to try – but putting in a real order can be stressful if you are not confident you’ve found the right products. I personally have changed what type of bag I use multiple times and ordered products I never used again because they didn’t work well with my skin, or some other issue. To help you have a better working knowledge of the products at your disposal, I thought I would share an in depth look at what I use. I am going to highlight both my stock orders and what I keep in my daily bag that travels everywhere with me.
As I previously mentioned companies want to work with you to help in the transition period after surgery (or any other time you have an issue, such as skin irritation or leaks.) I talk to my case manager at my supplier Edgepark regularly when I need an overnight sample. Convatec and Coloplast also have incredible support lines and have even shipped products to a vacation address when I ran low on a trip! Utilize these services and take advantage of the high quality, free samples they have.
When I first had my bag placed I was told to use flat wafers, but I suffered from miserable leaks for weeks! I suffered over a month of terrible skin irritation, pain, and embarrassing bag changes in public. It wasn’t until a Coloplast ostomy nurse talked to me about convex wafers that I found success. I then ordered a selection of samples from each of the top three companies (Convatec, Coloplast, and Hollister) in order to find my perfect pouch.
What do I order?
Which leads me to my first product review…. ostomy pouches! This is probably what I struggled with the most, and honestly still fool around with new bags when companies release new lines. Like I said before, I didn’t realize the source of my leaks was from wearing the wrong type of pouch. So let’s break down all the different kinds available.
Flat wafers are exactly as the sound, the whole mechanism that attaches to your skin is flat. Most ostomates do well with such wafers. The rule is that if your stoma sticks out from the skin 1″ or greater, a flat wafer will be just fine. The wafer and pouch are generally attached to each other, so we call this a “1-piece system.” There are endless amounts of different types to try. Each company has at least three different style options (and some have even more.) 1-piece systems require a stoma ring, which I will discuss further down.
Remember when I said most ostomates do ok with a flat wafer? Well, I am one of the interesting ostomates that does have a 1″ stoma tall stoma, but I also have a small opening at the base of my stoma that releases output. I am therefore in need of a more specialized wafer, called a “convex wafer.” As you can see in the photo, it has a sort of hump that helps with this problem. Ostomates with shorter stomas or prolapsed stomas often require convexity as well.
Convex bags come in two forms – 1-piece or 2-piece systems. I order both types and interchange them as needed. I will give you a perfect example of why you may need more than one option. As you can see in the photo, the 2-piece has a pre-cut hole that measures my standard stoma size (1″ in diameter) and the 1-piece system is a cut-to-fit, meaning I measure my stoma and it accommodates size variation. Right after surgery I had frequent fluctuation in the diameter of my stoma, but since then it has been uniform in size for months. I had all but thought to stop ordering cut-to-fit bags… but luckily I had a few left over because yesterday my stoma began swelling. I had to take off the bag I had on and replace it with a larger hole because the 1″ pre-cut hole was actually cutting into the stoma. So I learned a valuable lesson, that I am now sharing with you now, ALWAYS carry a cut-to-fit in case of emergencies.
The cut-to-fit bags I order are also translucent (or see-through), which means you can see the output and stoma very clearly. While this may sound “gross” or freak some people out, I have found it very useful whenever I am not feeling well, at a doctor appointment, or in the hospital. It allows myself, nurses, and physicians to get an accurate depiction of my health. I order opaque (or covered) 2-piece pouches and wear these when I am doing well and don’t want to observe my poop.
A great function of the 2-piece system is that you can replace the bag without removing the wafer from your skin. This allows for longer wafer wear and less skin irritation. There are two ways a 2-piece system can attach. One, through a “click” method and other a “stick” method. I feel more comfortable and secure with the click, but it really is personal preference. Like most ostomy supplies!
Leakage cONTROL/SKIN PREP
I quickly mentioned 1-piece systems need a stoma ring to help contain leaks. You can also use stoma paste instead of a ring, but I personally do not like it. I find the paste difficult to mold. (But as I will say again and again, it’s all trial and error when it comes to personal preference.) I have tried almost every ring available from the different companies and different widths within them. Overall I am the most impressed with the leakage control of the Hollister Adapt CeraRing. Some rings have latex in them which is dangerous for me, and actually causes my skin to burn away. Luckily this line does not and instead is infused with ceramide which feels very comfortable next to the skin. The slim design is my favorite because it allows the wafer to be close to the skin.
My holy grail of products I found is the Brava Elastic Barrier Strips. I use two each bag change to place around the edge of my wafer. It extends how large an area is covered and keeps the edges of the wafer secured to my skin. Since using these strips, in conjunction with the convex wafers, I have not had an uncontrollable leak. 20 come in a box, but since I use two with each bag change I order them fairly frequently.
To assist in the overall success of a bag sticking to my skin I use an adhesive barrier. I prefer to use a SkinTac wipe prior to attaching my wafer. I will warn that it is very good at its job and can make your fingers sticky if you put it on without gloves. But simply washing your hands will remove the residue. It can also burn if the skin is irritated or raw. Other barrier wipes and sprays claim to be “sting-free”, but I find those don’t usually assist in sticking as well. So I suffer through the few seconds of stinging, then place the wafer on and I am usually ok. I would avoid this if the skin is broken in anyway though.
Speaking of broken skin… every ostomate should have stoma powder. It is not something used with every bag change, but when you need it you will be very unhappy if you are out. Granted I have had my ostomy for 10 months and I am still on my first bottle. It takes a little to go a long way. The best advice I received on how to use the powder is to apply a fine layer on the broken stomal skin, dab with a wet cloth, and then two more layers, each time dabbing with a wet rag between layers. You create a sort of crust that should even out the damaged skin to the level of the healthy skin around it.
In the photo above you will see my chosen adhesive remover method. I love these wipes because they truly work! They take all the residue and built up gunk from around you bag attachment and are actually sting-free. I even use them to remove the adhesive build up after EKG tests, IV sites, or port covers. A single wipe does the job in most cases. Some ostomates use the sprays, but I prefer the little wipes.
What’s in my daily ostomy bag?
I carry an ostomy bag with the essentials for a bag change everywhere I go. While it is mostly made up of a sample of the previously discussed products, there are other necessities.
I carry 4-5 ostomy pouching systems with me. Some 2-piece and at least two 1-piece cut-to-fit. I fit enough stoma rings to match how many bags I have. I never leave without a bottle of stoma powder, my different prep/removal wipes, and the extenders.
I find it important to also have things in case you are doing a bag change in public. A simple zip lock bag to hold the old pouch and disinfectant body wipes are a must! The brands aren’t important, just whichever form you use make sure it doesn’t irritate your skin.
In order to accurately measure your stoma, you will need a stoma size guide. My stoma nurse gave me one when I first had surgery, but I am sure you can order them through your supplier if you need a replacement. Simply place the guide around your stoma until you find the best fit. Then use a permanent marker to trace it out over your cut-to-fit bag. Lastly, use surgical scissors to carefully and smoothly cut out the hole.
I hope this break-down has been useful to you. Remember, utilize samples before putting in a full order, there is use for different types of bags at different times, and trial and error is the best way to determine what works for your body!
Good luck and happy shopping.