Stoma Appliances and Accessories.

There are many appliances that can be used in conunction with stomas. Many appliances will be similar in style, and efficency. All appliances need to meet the needs of the patient, and must be comfortable. Most modern appliances are carefully designed to be flat, ordourless, and rustle free, and most importanly unoticeable under ordinary clothing.  All appliances are made with the aim to keep the stoma leak proof, odourless, and to be unobtrusive.

The appliances will come in many shapes and sizes, therefore it is important that you find the appliances that suits you and your skin type, in order to work efficently.

The Appliance - Bag/Pouch.

Due to not being able to control when the stoma will work, it is likely that you will have to wear an appliance at all times, Therefore it is vital that you find a appliance that suits you, you're skin and you're lifestyle. There are two types of appliances that can be used, these are a one piece system and a two piece system. Both systems are very effective, and it just comes down to preference when choosing which system to have.Both types of systems are drainable, meaning that you can undo the tie or clip at the bottom of the bag and empty it as needed.


One Piece System

A one piece system is an appliance when the bag and adhesive skin barrier are together as one unit. The adhesives skin barrier can also be called a 'wafer'.  The wafer is placed around the stoma and is attatched to the skin. When the appliance is change the whole thing is removed. When a new appliance is applied it needs to be reattatched to the skin by the wafer.



Two - Piece System

 The two piece system conprises of 2 parts. A adhesive  'Flange' (which has the same purpose as a 'Wafer) that fits around the stoma and a bag that clips onto the flange. The two sections of this system are normally joined together by a "tupperware-type ring". Due to being in two parts, the bag does  not have to reattatched to the skin each time  it is changed. When changing this appliance the flange will stay put, and only the bag will be removed. When applying the new bag it just clips back onto the flange. The two piece system is normally used with patients with sore or sensitive skin, as constant changing on the wafer can cause slight damage or irritation to the skin. The bags used in this system are disposable or reuseable. Once the reusable bags/pouches are soiled they are removed, cleaned, dried and aired, then used again when neccessary.Most patients who use reusable bags will have 2 - 3 so that they rotate use.


As well as choosing the type of system for the appliance, you need to choose whether to have an open - ended bag or a close ended bag. The differences are explained below.


Open - Ended Appliance

This appliance has a clamp at the end of the bag, which opens and closes. This means that the bag can be emptied rather than removed and thrown away. This reduces the amount of changing of the wafer and the stoma bag, therefore reducing the risk of skin irritation and damage.  An open ended appliance is normally used with people who have undergone ascending colostomies and transverse colostomies, as the consistency of the stool in these colostomoies are either in liquid form or are loose.


Close - Ended Appliances

A close ended applicance are appliances that are removed when the bag is full, and then thrown away. These appliances are normally used by patients who have undergone descending colostomies or sigmoid colostomies. This is because they consistency of the stool that is discharge is firm or solid, therefore cannot be drained.


There are many other appliances that can be brought to make the aspect of stoma care more pleasent and easy to do.

Skin Barrier Products
Constant changing of stoma appliances can cause damage and irritation to the skin, therefore it is vital that you look after you're skin by using the skin barrier cream, wipes and solutions. The following numbered products help to protect the skin around the area of the wafer and under the site of the wafer. It is important that these products are applied to the skin when changing the stoma system, as faeces and digestive enzymes that are coming from the stoma can irritate and damage the skin.
1.Creams - Used for sensitive skin.
2.Gels - act as a film to prevent irritation and to give pprotection.
3.Powders - Protects sore/raw areas of skin.Effective as they do not inhibit adhesive wafer

Barrier Cream
Pastes are usefull as they allow the wafer to seal onto the skin better. The paste is applied to any folds or creases in the skin around and under the area of the wafer. This creates a smooth, flat, pouch surface, therefore when the wafer is applied, it can stick to a smoth surface, resulting in a stronger attatchment. Paste may sting on sore areas, so make sure some powder is applied before to protect the skin from irritation.
If patients feel as though they have got enough support for there stoma bag, they can wear a belt appliance. The belt appliance is very effective and easy to use. Firstly you attach the belt plate to the stoma bag, and then attatch the belt to the belt plate.  This appliance can be adjusted to fit any size.


In some cases the stoma bag can release  unplaeasent odours. To prevent this from happening you can use either an aerosol or a powder substance.
1. Aerosol - Abosorbs the odour. 1-2 sprays onto the stoma bag, or into the air before emptying or changing the appliance, can eliminate any odours.
2. Powder - It is used to deodourise the contents of the bag.  Places 2 -3 drops of the powder into the new stoma bag. This will gradually absorb the odour. Repeat this everytime you change the appliance.