Choosing Between One-Piece and Two-Piece Systems

I recently received some free samples and am very curious about the two-piece system (I'm currently using the one-piece I got out of the hospital; searching around for different options because of bag leakage issues).

What's the major difference between the two? Pros/cons? Your preference and why?

Hope you all are doing well....

Thank you for any advice in advance,

Linda Jean

Good question. I don't get the 2-piece bags unless a person is using a closed pouch and disposing them with each output. But, I've never tried them so maybe I'm missing out. &zwj

I gave up the one piece in favor of the two piece because, when you're fitting the one piece onto your stoma, you can't see what you're doing, but with the two piece I can place the skin barrier over the stoma easily, then attach the pouch once the skin barrier is on.  I also like the so-called floating flange that Hollister has because with it I don't have to press down upon my belly when applying it.  My thumb fits under the flange while I'm pressing; much less uncomfortable.

I am with HenryM on being able to see what is going on when applying the wafer application because you can see the piece getting seated around your stoma and ensures a better placement and you can press on it to get a good seal. An extra advantage is some of the bags have filters and when they get wet they allow smells to get through. You can change just the bag and not the entire application for a small issue. The pros of the one-piece is it fits closer to your body compared to the two-piece but there are ways to work around that with how a person dresses. I use the Coloplast Mio two-piece and it has a locking ring to hold the bag in place.

Also check into using the moldable rings and paste to help reduce leaks, they improve sealing the area between the stoma opening and the wafer hole to reduce output getting into your skin and causing the glue to start to fail.

Hope this helps

I find the 2-piece much easier to apply, as Henry says it's easier to see where your stoma fits neatly through the hole, and I also fit my mouldable seal to the baseplate before I apply. I find this much quicker than applying the seal to my skin then fitting the baseplate. Also, sometimes if threatened with pancaking, I can remove the pouch over the toilet and clear any heavy output and wipe clean and reapply the pouch. Also, on the initial fitting of the baseplate, there's more room to fit flange extensions before the pouch is fitted. I comfortably do a removal clean up and refit, providing no hiccups, on average 6 to 8 minutes. I personally couldn't go back to the 1-piece, but each to their own. There will be many who find advantages in using the 1-piece. Also, in an emergency at work, I have quickly removed a full pouch and fitted a new one. Best wishes whatever you use.

My Ostomy Journey: Keyla | Hollister

I may have to order some samples and give them a try.

Interesting replies....I have a vague memory of a two-piece system being applied by a home health care nurse....it was painful as he pressed on my belly to make it stick...that's my only memory...this whole ostomy (ileostomy) experience, for me, is very similar to giving childbirth - it has pretty much been blurred from my memory - With good reason I say! But now still confused about the ole' waist-waste bags!

Just breathe

Hi all, I use a 2pc. Convatec system. Like Henry and others said, I can place the wafer perfectly around my stoma and then snap on the drainable pouch.

I usually use the one-piece when I just came out of the hospital. When I was introduced to the 2pc by my nurse (2010) after I complained about using the 1pc as I hated it, I said goodbye to it. The 2pc is easier to manage and I like the fact that it is disposable. The wafer fits perfectly over the stoma as you can see it. Give the 2pc a try, I'm sure you will like it better.

I'm a two-piece girl too. For many of the same reasons already stated. I've actually repaired a flange fit before applying the bag. I never would have seen it in a one-piece system. I also prefer a convex wafer with the cloth-like edges. I don't have a perfect plane to work with, and I have a lot more success.

I am here to agree with those who favor the two-piece gear. I've been going through what seems like an endless experiment to find the gear that will hold back leaking around the stoma opening.

This week's experiment is with a one-piece Convatec. And this thing is impossible to get centered perfectly on my stoma, so frustrating! With the two-piece systems, you see exactly what you are doing as you attach the wafer. The accuracy is very important to me.

Never tried the one-piece because of the blind placement over the stoma. My heartiest recommendation is to get samples and try everything. I stuck with the system the nurse ordered because I didn't know any better. After nearly a year of "situations" (blowouts, leaks, etc.), I sampled the 2pc Sensura Mio. I hope they never change this product; it works for me! Two-piece, click-to-lock pouch to flange and go!

Hi, one or two pieces is a personal preference... for some. I've had my ostomy for over 55 years, and back in the dark ages, there were no real choices... I was only 15 at the time and used a plastic disc with a hole in it for the wafer. We covered that with a rubber-like wafer and used a flammable glue to glue the rubber to the disc, and then the disc to our skin. We had to wait until it dried, or it would burn the skin. And the reusable pouch was rubber and was difficult to clean and get rid of odors. So glad those days are over, and we ostomates have lots to choose from. I'm with Henry and the other two-piece proponents for several reasons. It's easier to place the wafer where you want it to go. I use Convatec's moldable wafer, and it actually does "hug the stoma." Before gently pressing it around the stoma, there is plenty of room to spray some stomahesive powder to help close up any gaps. You can't do that with a one-piece. Some info videos say the pouch is difficult to snap on, but only if you haven't read the directions. Before snapping the pouch on, you need to wet the tracks (I use my finger) so they fill with water, and then the pouch snaps easily onto the wafer. I think I've been with Convatec for more than 20 years now, only updating to both convex (uneven belly) and going with the moldable version. You can always call them and request samples. Best of luck... Marsha.

If you have a colostomy, I would go with the two-piece. I have had a colostomy for 21 years. The most liberating thing ever was when I found ostomy liners. They are flushable bags that you place inside the ostomy bag. Then you flush the liner when needed and replace it with a new one. One brand is Colomajic. The next thing I did was begin to irrigate. It depends on if you have an ileostomy or colostomy.

I think I use the same flange, and it's the first thing to work for me.

I prefer the two-piece units. I have found that most all of the vent/filters on any bags seem to get plugged and no longer vent after just a few hours. I'm guessing that stool, or any moisture in the bag, is the culprit. So I started using ColoMajic bag liners. Those things only work with two-piece systems and seem to keep the vent from getting plugged.

Hello :)

I have only ever used, in my 42 years, a two-piece system. I've tried open-ended pouches and closed-ended pouches, and I prefer the latter. I have it down to a science (42 years of practice... lol) when changing my appliance and actually snap the appliances together first before placing them on my belly. I prefer the closed-ended because it's much easier than cleaning the open-ended and less messy. Now, saying that, I time my trips to the bathroom... for example, I wouldn't go empty it just after a big meal... this could get really messy if you're not super comfortable and quick at managing emptying the output. And if not, a two-piece open pouch system might work better. I use the Coloplast Assura two-piece click system closed-ended Mini pouch.

Ok. How are these 2-piece systems for a person that has to move a lot? As in bending, stooping, kneeling, climbing up and down on a ladder, etc?

I think they're about the same. I've never had mine pop off. You have to be very intentional to separate the pieces. Think old school Tupperware.

I've only used a two-piece Convatec Natura Durahesive for 38 years. I have an ileostomy. I water ski, and when I fall, sometimes I hit the water hard and have never had a problem with it coming off. I am a very active person, so I need a system that I can feel confident will stay secure. Other than what the other folks said about the two-piece, I like the option of pulling off my regular 10" length pouch and putting on a mini closed-end pouch for intimate times. And when sex is over, I put the longer one back on.

Thanks everyone. I see my ostomy nurse on Thursday and will discuss it with her.

Hello, nice to meet you! My own experience is that the two-piece was less comfortable, the one-piece being slimmer and softer. I think also the one-piece is less obvious when wearing clothes. After listening to everyone else's experience, however, I am inclined to look into the two-piece appliance. I only had experience with the two-piece for a short time after the hospital. The thing is, I finally have this one-piece Coloplast that is working well for me without leaks or blowouts, and more days before changing bags. Good luck, hope you find the right choice for you!

I am using the 2-piece system. It's what they gave me in the hospital. I am 5 weeks post-surgery. However, after getting home, I chose the closed mini bag that is 7" not 12". The 12" bag laid on my thigh and was super annoying.
And the thought of removing the one-piece all the time seemed daunting, however, I have not used it.
I am open to pros and cons of the one-piece??

Thanks.

I tried the two-piece a while back and didn't like it. Everything collected at the top and was messy when changing. I went back to the Sensura Mio deep convex one-piece. I change twice a week.

I use the Sensura Mio 2-piece system along with a diagonal or horizontal support belt. During the day, I wear the belt and the two-piece system lets me change the position of the bag at any time. I have had one incident where I got up from the table and the bag popped off because it hit the underside of the table. If the filter on the bag clogs, I can change it out quickly. I can usually go 5-8 days (showering every day) between changes. This has been a big help in order to avoid any skin issues.

Give all these ideas a try. You'll only figure out what works best by trying different options. I've found that being confident in the security of your appliance is most important for me.

Good luck and good health to you!

SharkFan

I guess my next question is if using a drainable bag, like I do, what's the advantage to using a two-piece? I don't have a problem with getting everything to fit around my stoma just right. I can see if there's a problem with pancaking and being able to clean the bag out, but doesn't that get output all over where the bag attaches to the base plate thingy?

I don't remove mine between changes, unless I'm swimming. Then I'll loosen it enough to rotate it into a horizontal position, and snap it back down. The edges never get dirty, even if I lift it completely. Then I can put my neoprene stealth belt on and swim all day.

I'm active in every way you listed, plus I Nordic walk, and hike with a light - 16-20 lb - pack. I'm aiming for 5 miles but until I switched couldn't get past one or two miles before sweating and twisting caused the disk to fail. One-piece pouches failed every time. I switched to two-piece and again, failure. I absolutely could not get a strong lasting seal. I got soooooo frustrated, then depressed. When my primary care doctor sent me to an ostomy nurse practitioner. I walked in crying, no joke.

She fitted me with a Coloplast convex Sensura Mio drainable 2 piece with a lockring, and increased the thickness of the Hollister Adapt CeraRing. Also, instead of putting the ring up against the stoma like I'd been doing, she put it on the convex wafer, then made sure my skin was super-dry before sticking the wafer down. She used pieces of another ring to fill the scar-tunnel that with movement had been causing the seals to fail. Then she added ring extender tape around the wafer, and an elastic belt to make sure nothing shifts.

Problems solved! I went out and hiked 2.5 miles of sweaty hills, not a leak at any point! That was 2 months and many miles of hiking, shifting boxes, step climbing and twisting, and haven't suffered the first failure. Great!! Easy to empty on trail, and longer lasting, too. Definitely - try it!

I use the one piece for both of my stomas.

Assura Inspire Soft Seal Convex Ileostomy bag (Coloplast)

Assura Soft Seal Multichamber Convex Urostomy (Coloplast)

I did try a sample of a two-piece for the ileostomy a few years ago, not sure now what I wasn't too keen on, maybe it felt uncomfortable pressing down on it to stick/click. But I carried on from then with the one piece.

When I have been to some of the Stoma Meets, seminars, many people were saying they prefer the two-piece.