One-piece or Two-piece Ostomy Appliances: Pros and Cons?

Replies
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602
JustMeRLB
Dec 18, 2023 7:45 am

Just wondering the pros and cons of one-piece vs. two-piece appliances. I have an ileostomy. I did order samples from Convatec and Coloplast. I am currently wearing a white one-piece drainable with filter from Hollister. I am not thrilled about the transparent front… hoping to get something opaque.
I am looking for your experiences with both.
Thanks!

Axl
Dec 18, 2023 11:01 am

Hi J

This is me

https://www.bbraun-asiapacific.com/en/products/b0/flexima-active-midi.html

 

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IGGIE
Dec 18, 2023 1:35 pm

I like the two-piece because it's easier to fit the base plate over the stoma; you can see better what you're doing. I always use a washer as well. I like the "Salts" washer with a collar; it makes the poo flow forward. You have to get the right size for your stoma. Mine is 29mm, so I get part number RC29. See photo. The base I use is concave as it helps to push the stoma forward. I use the Hollister 13505, which is precut to my stoma size of 29mm. As for the bag, I use the Hollister 18183 drainable bag, and it's not transparent. It's easy to open the end to empty, and I like to add water to wash it out, then let it drain out and close it up. I find I can do a bag change in 5 or 6 minutes. Regards, IGGIE

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eefyjig
Dec 18, 2023 1:44 pm

I like Hollister because the bags are 12 inches long. Mine is opaque but has a viewable window in front. This is very useful when I need to center the hole on my stoma or view my output for any reason.

https://www.ostomycaresupply.com/products/hollister-8962-premier-drainable-pouch-with-soft-convex-ceraplus-skin-barrier-tape-border-filter-lock-n-roll-closure-belt-tabs-beige-with-viewing-option-two-sided-comfort-panels-pre-sized-1-inch-25mm-box-of-5

 

 

ron in mich
Dec 18, 2023 1:46 pm

Hi RLB, I use Convatec 2pc. drainable system with an Eakin ring.

 
How to Manage Ostomy Leaks with LeeAnne Hayden | Hollister
warrior
Dec 18, 2023 3:18 pm

Hey there. I use a two-piece. I like that I can rotate the bag from a vertical position to a horizontal position for sleeping. I use a belt that attaches to the appliance and keeps it snug to my body.

 

The two-piece is a bit thicker than the one-piece, meaning the one-piece could go undetected with a shirt on. The two-piece shows up a little bulky, "sticks out."

 

It will take you some time to decide what is best for you.

All good comments about actual users above are great, and it's what works for them, for years.

Let me check on the part numbers, and you can see what I use.

Sensura Mio Click Convex Flip Barrier Pre-Cut -- 62185113

Brava Seal 12039

Elastic Barrier Strips -- 120700

Ostomy Pouch 11472, Drainable.

All from Coloplast.

What sold me on this was the starfish-5 finger design of the appliance.

It has like an octopus design that secures tightly when you have that bulge. Normal appliances have 4 corners and are flat.

This is convex with five hold-down areas. For me, this has been successful for 7 years. A snug fit indeed. Better fit in my opinion.

And the thin belt attaching to the appliance assures no leak, and elastic "C" strips reinforce no leaks.

I don't have the belt number, but it's made for this type of appliance, adjustable with hooks.

I have no reason to find anything else. And no, I don't work for Coloplast. ☺️

 

.

 

warrior
Dec 18, 2023 3:25 pm
Reply to IGGIE

This washer looks like a great idea.

In some ways, it protects the stoma and it aids in no pooling when lying down.

What a terrific idea.

Gonna look into it. Thanks.

Does it get put on first to the skin, then the barrier ring second?

Sounds about right.

Gin2024
Dec 18, 2023 4:26 pm

Yeah, I hate the transparent bags. Get rid of them. That's what they sent me home with from the hospital. I'm not wearing them anymore, and I'm getting a two-piece. I hate one-piece and I hate drainable. I think it's easier to have a two-piece for fitting and for changing out your pouch. I'm a very new ostomate, one week, so I don't know how much that might be valid, but that's what I think. Hope you find the right one for you too.

Gin2024
Dec 18, 2023 4:30 pm
Reply to warrior

Hi Warrior, it's Ginger. My son has been helping me get some supplies because I didn't get any from the hospital, and the ones I had at home as samples didn't work for my scenario. But what were you talking about? A washer? Do you mean those round, rubbery seals?

warrior
Dec 18, 2023 5:39 pm

Hi Ginger.

View the post from Iggie above. He has a picture of the washer gizmo. I never heard of it before.

But it sounds like a good addition to reduce leaks and get poop moving along.

warrior
Dec 18, 2023 5:43 pm
Reply to Gin2024

So, Ginger... instead of draining a pouch, you rather toss the pouch? Sounds expensive.

But I get the reason why...

Some folks reuse their pouch by rinsing them out.

Justbreathe
Dec 18, 2023 11:08 pm

3-year ileostomy here - love the one-piece. Very little bulk under clothing. When I came home from the hospital, an ill-advised/trained nurse came every 5 days to change a 2-piece and would push so hard on my stoma it hurt. I started using the one-piece almost immediately after that experience. I do like the clear pouch, I call it the peek-a-boo - you peek and you'll boo, but I like it because it makes for an easier view to fit over the stoma and I want to monitor output and stoma health and to make sure I know what's going on. I shower daily and also change about every other day and take naked showers on change day. I prefer the clamp spout as 2 different types of Velcro spouts leaked, although I did like their design for outspout. I rinse with water almost every time I empty and apply a dash of baby oil inside the pouch, which tends to coagulate loose output for easy exit. Whew - that's more information than even my family knows! jb

whackjob74
Dec 19, 2023 5:57 am

I am a fairly new ileo as well. I've tried the three main brands and one-piece vs. two-piece as well. I prefer the two-piece. Firstly, so I can attach the flange and see what I'm doing easier, and second, because I can turn the pouch to the side for when I'm doing sports and tuck it all into a stealth belt. Then I look a bit thicker through the middle but no worries about the bag hanging below my top while active. It also gives you the option to only change the bag if needed, and I have sensitive skin, so it helps ripping the flange off less often.

I have found that, for me, the Coloplast products work the best and use the Sensura Mio Click system, Brava barrier elastic strips, and a Hollister ring as it sticks to my skin better and the Coloplast ones didn't. I like how easy the bags are to drain and clean with the Velcro tabs. They also have the option of folding up to half size when needed. I can actually get as many as 12 days with the flange using the hot tub almost daily, showering, and doing sports. I get an average of 7 days between changes unless something goes awry.

IGGIE
Dec 19, 2023 11:09 am
Reply to warrior

G-Day Warrior, The Salts seal with Collar is the seal and the collar combined. Look at the photo. You put this on first, then the base plate, then the bag. Regards, IGGIE

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Justbreathe
Dec 19, 2023 11:30 am
Reply to whackjob74

Great example of how each of us differ in our needs and how helpful this website is to us all. I would definitely look into a 2-piece if I were active in sports or other activities - as you have pointed out - sadly (maybe not so sadly) at 80 the most active I get is plucking and bagging yellow or dead leaves off the bushes in my yard 🥴. JB

warrior
Dec 19, 2023 1:44 pm
Reply to IGGIE

Thanks Iggie. You da bomb😀

JustMeRLB
Dec 19, 2023 8:22 pm
Reply to whackjob74

I have 2 of those I received as samples. I was ready to try it today… but figured I will just have to remove it tomorrow at my WOCN appointment, so I figured I'd try it in a few days. I do like the little window and how the seal on the wafer and bag are mechanically locked in vs. the Tupperware lid type from Hollister lol. Coloplast also sent me the 2-piece that the bag sticks onto the wafer (like a command strip) that kind of scares me a bit… but who knows, I might try it. I have ordered samples from all 3 main companies. Looking forward to trying new things! (And also a little apprehensive)

Jayne
Dec 20, 2023 1:44 am

Hello everybody.

 

Choice of Appliances.

 

Hopefully, site management will not mind my choice of appliance contribution here... I believe, like the larger Nordic manufacturers, you may obtain samples with ease - worldwide - not just within the UK/Europe - and so make your own assessments.

 

BLACK or WHITE or skintone SILKY BAGS:

salts.co.uk is worth a visit because their bags are silky and come in white, black, or skin tone - so look good, as they are far less 'medical appliance-like' in appearance:

[They are aesthetically pleasing and complement cohesive underwear choices - so have a different appeal to others as well as ourselves!]

Work for guys as well as girls! [as in they are simple but not 'girlie'] and do not detract from one's female or male sex appeal 'cause one literally FEELS the difference when wearing them!

 

I wore Dansac innovative products for many years, for compared with the other Nordic brands in the late 70s/early 80s which did not 'fit' with my own self-image back then [I was sporty and had not gotten over vanity concerns]... the Dansac design and visual innovations and hence 'acceptance of ostomy' moved things on and I felt 'happier' with their pouches - For we ALL like to FEEL and LOOK our best... AND for me, I always like to be aware of new products and how there may be a better/different option - SO I like to be open to new elements of change going forward.

I would also like, for balance reasons, to mention that Coloplast are the only manufacturer - so far as I am aware - that have zinc within the ingredients of their skin wafer - a relevant point for aiding healing of sensitive or damaged abdominal skin around the stoma... and of course the range of other Nordic manufacturers who produce both one and two-piece appliances - all find favor at different times according to our circumstances - and personally, I do use a variety of appliances to best accommodate my needs/preferences [i.e., travel/intimacy/skin exacerbation variants, etc.].

 

So whilst I appreciate we all evolve into using something that works for us - we also may benefit from keeping our appreciation open of what becomes available over time.

 

My own motto is to be kind to oneself - and keep an open mind. - 'never settle for second best' - keep searching!

.

.. And yes, I can now smile, for I know, [understandably] some of you may think there goes Jayne... she is drawn by marketing ;-) ... BUT honestly, in the case of Salts Confidence bags - the proof lies within the product - they ARE different and ARE good [No investment in the company - promise!] ... One needs to FEEL them on to understand what is being said here.

[And neither are my recommendations being extra positive, or self-motivating - following my own negative experience with the TIEs implant].

Oh yes, and on a very practical note, the Confidence Salts bags have an excellent wafer/base plate design re flexibility and endurance [safe in the heat and good for movement and can withstand acid imbalance too in my experience]... but are NOT heavy or uncomfy].

 

To summarize product variants available:

The Salts Confidence range of black, white, or skintone bags come in drainable and closed options and also have different sizes of pouch capacity and also come with the viewable overlap, or not, as preferred. The company will also cut to template one's own bespoke size of aperture if one supplies the reference template * [hole for the perfect fit for one's stoma].

  • Hack / Hint:
  • It is easy to supply an accurate template for reference - just keep one of the peel-off backing sheets of your wafer if you currently cut a slightly irregular 'circle' for best fit... That way you know you get delivered what you have best sourced.

 

Choice is important for a healthy feel-good lifestyle IMHO [We DO deserve to help ourselves by sourcing and utilizing what suits us best] - for in so doing we can maintain our own love to help others as well as ourselves:

I like to be the best I can be - so from my perspective I thought I would share the range [closed and drainable] - and, for practicality without design compromise - one can order the version that allows one to inspect and see the stoma under the 'silky layer']

..... So ..... Just in case folk are not aware of the ENTIRE Salts range - which, until one has handled these particular 'Confident B' bags and actually experienced how they feel to the touch and seen them on, maybe they have 'escaped' your radar of possibilities ....

In respect of confidence and feel-good factor alone, - they ARE a quality product that stands on its own merit, and they hold their own when compared with the big brands that dominate the market.

 

Waves from the UK

Best wishes

Jayne

whackjob74
Dec 21, 2023 1:35 am
Reply to JustMeRLB

I have tried the ones that stick to the wafer without a ring and it stayed stuck really well, but I found that it stuck out/didn't lie as flat for me as the ones with the ring. I have a hernia and need as low profile as possible lol. It's definitely worth trying them all out to see what you like best. You can ask your WOCN for different ones at your appointment as well as they usually have samples. Worst case, you don't like it and after a day or two, take it off and go back to something you like better!

amymariefred
Dec 29, 2023 2:39 am

I am three months post-ileo. I was sent home from the hospital with a 2-piece Hollister setup with a barrier ring and cut-to-size wafers. The first set of bags were clear to monitor output, but then I switched to opaque after my follow-up appointment. I've tried Convatec's moldable wafers, but I hate their bags. Love the moldable tech, but the bags weren't my favorite. I tried Coloplast Mio Click and couldn't get it to attach properly, but loved the bags. I tried a Mio Flex Maxi, which has a lower profile. I like that setup. I still use a Hollister barrier ring. I've read about stoma paste instead of a barrier ring, but I haven't ventured there yet. Hoping for a reversal in the next few months. 

Ask for lots of samples from all of the companies. I got three rounds from Convatec and Coloplast. Try lots of combinations before settling. That's my best recommendation. Good luck!