Comprehensive Guide To Colostomies And Ileostomies (Question & Answer Format)

What are the features, advantages, and disadvantages of Disposable Pouching System?

Features:
• System designed to be thrown away after removal. Typically made of lightweight plastic film, which is available in transparent or opaque material. Disposable pouches can be closed-end, or drainable, and part of either one-piece or two-piece pouching systems. May have plastic or fabric backing.

Advantages:
• Odor resistant.
• May be worn in the bath, shower, and swimming pool.
• Cleaning usually not necessary.
• Drainable pouches are typically changed every 3-7 days. Closed pouches are discarded and replaced when 1/3 to 1/2 full of feces/effluent.
• Convenient, easy to carry, and dispose of.
• Various sizes/capacity.

Disadvantages:
• May be more expensive than reusable pouching systems over time.
• May require removing stool and then cleaning the end “tail” of the pouch for odor control.

What are the features, advantages, and disadvantages of Reusable Pouching System?

Features:
• Pouch which can be washed and reapplied multiple times. Typically made of vinyl or thick plastic film. Reusable pouches can be closed-end (if used with a liner), or drainable. May be a one-piece or two-piece system comprised of a pouch, also referred to as a skin barrier or wafer.

Advantages:
• Washable.
• Able to reuse multiple times.
• Some can be used without an adhesive.

Disadvantages:
• Can retain odors.
• Limited number of manufacturers.
• Initial cost may be more expensive than a disposable pouching system.
• May require more time to clean.
• Might require a belt and/or adhesive.

What are the features, advantages, and disadvantages of One-piece Pouching System?

Features:
• The skin barrier and pouch are attached together during manufacturing. Available in drainable and closed styles, with and without filters.

Advantages:
• Many styles are flexible and conform to abdominal contours.
• Low profile.
• No chance for leakage between skin barrier and pouch as in two-piece systems.
• May be less costly than a two-piece system.
• May be easier to learn to use.
• Often used when abdominal plane contours are uneven, as it can provide greater flexibility than a two-piece system.

Disadvantages:
• Cannot reposition once applied.
• Cannot burp for gas.
• Cannot change the pouch without changing the entire system.
• Some have less support for loose peristomal skin.

What are the features, advantages, and disadvantages of Two-piece Pouching System?

Features:
• The skin barrier and pouch are made separately with rigid to semi-rigid rings or with an adhesive coupling system which allows the pouch to be attached to the skin barrier.

Advantages:
• Can provide support to loose peristomal skin.
• Can switch between drainable and closed-end pouches without removing the skin barrier.
• Can change the position of the pouch with patient’s position changes (especially for bedbound patients) to facilitate better drainage.

Disadvantages:
• Need dexterity and strength to assure attachment of pouch to skin barrier.
• Higher profile.
• More costly than a one-piece pouch.
• Less flexible than a one-piece pouching system and does not mold well to the body contours.

What are the features, advantages, and disadvantages of Pouching System With Adhesive Flange?

Features:
• The skin barrier and pouch are made separately and designed to stick together without a rigid flange.

Advantages:
• Can change pouch for disposal, emptying, or rinsing without removing the skin barrier.
• Low profile.
• Flexibility similar to a one-piece system.
• May be easier to apply than pouching systems with a flange, for those with poor dexterity.
• May be used when abdominal plane contours are uneven, such as with a peristomal hernia.

Disadvantages:
• Less support for flabby peristomal skin.
• Limited number of times pouch can be reattached (dependent on the manufacturer).
• Must have the coordination to apply properly on the skin barrier.
• Cannot reuse pouch if adhesive area becomes soiled.
• May be more difficult for visually impaired to use.

What are the features, advantages, and disadvantages of Transparent Pouch?

Features:
• Pouch made of clear film.

Advantages:
• Can see stoma for easy application of pouching system.
• Able to monitor stoma and effluent appearance, especially in the early postoperative period.

Disadvantages:
• Appearance of feces/effluent in the pouch may be unpleasant for the patient and/or the significant other.

What are the features, advantages, and disadvantages of Opaque Pouch?

Features:
• Pouch made of colored film (typically white or beige).

Advantages:
• Cosmetically appealing, unable to see stoma or stool.
• More discreet under light-colored clothing.

Disadvantages:
• May be more difficult to apply when part of a one-piece pouching system.

What are the features, advantages, and disadvantages of Drainable Pouch?

Features:
• Pouch with an opening at the bottom. A clamp or integrated closure is used to keep the pouch closed until it is time to empty.

Advantages:
• Able to empty frequently.
• Cost-effective.
• Long and shorter lengths are available.
• Available with and without filter for gas release.

Disadvantages:
• Risk of spillage.
• Can require some skill to drain successfully without spillage of stool.
• Need dexterity and strength to manage various closures.
• Some versions may be too long for comfort or body size.
• Rinsing/cleaning of the pouch may be needed or preferred by some patients.

What are the features, advantages, and disadvantages of Closed End Pouch?

Features:
• Also called a closed or non-drainable pouch. A pouch without an opening or clamp. It must be removed/discarded when 1/3 to 1/2 full.

Advantages:
• Low profile.
• More discreet for intimate situations.
• Generally shorter than drainable pouches.
• May be easier to use than drainable for some people.
• Available with and without filters for gas release.

Disadvantages:
• Smaller pouch capacity.
• Not practical if having frequent stools or large amounts of fecal/effluent output.

What are the features, advantages, and disadvantages of High Output Pouch?

Features:
• A drainable pouch which accommodates larger amounts of output. Has a drainage spout at the end of the pouch.

Advantages:
• Used for frequent or high-volume fecal output.
• Does not need to be emptied as often.
• If stool is liquid, it can be attached to a bedside drainage bag/container.

Disadvantages:
• More expensive than smaller drainable pouches, but insurance reimbursement is available.
• Larger size may make it difficult to conceal.
• When connected to bedside drainage bag, tubing and/or pouch can potentially twist and kink, so the tubing should be anchored well and monitored to ensure adequate drainage.

What are the features, advantages, and disadvantages of Disposable Liners?

Features:
• Absorbent pad or liner placed inside the pouch.

Advantages:
• Absorbs moisture from loose stools.
• May prolong wear time of pouch.
• Can be removed and discarded without removing pouch.

Disadvantages:
• May not be covered by insurance.
• Adds cost to pouching system.
• May not accommodate high output from an ileostomy.

What are the features, advantages, and disadvantages of Gas Filters?

Features:
• Device placed on the pouch to allow gas to escape without letting odor out.

Advantages:
• Decreases ballooning of pouch.

Disadvantages:
• Can become blocked with stool.
• May not be effective if pouch is not kept flat against the skin.
• Some require replacement which can add to cost.

What are the features, advantages, and disadvantages of Irrigation?

Features:
• Procedure to instill water into the colon through the stoma to stimulate evacuation of feces.

Advantages:
• May eliminate the need to wear a pouch.
• Can regulate bowel movements.

Disadvantages:
• Time-consuming.
• Requires equipment.
• Not all patients are candidates for irrigation.

What are the features, advantages, and disadvantages of Belts?

Features:
• Elastic belt attached to the pouch or skin barrier to provide additional support.

Advantages:
• Provides additional support to the pouching system, especially if the peristomal skin is flabby or if there is a peristomal hernia.
• May prolong wear time.

Disadvantages:
• Some people find belts uncomfortable or restrictive.
• Not all pouching systems have belt tabs.

What are the features, advantages, and disadvantages of Ostomy Support Garments?

Features:
• Clothing or underwear made with a pouch pocket to support the pouch.

Advantages:
• Provides support.
• Can be discreet under clothing.

Disadvantages:
• Added cost.
• May not be covered by insurance.

What are the features, advantages, and disadvantages of Adhesive Remover?

Features:
• Solvent available as gel, wipe, or liquid.

Advantages:
• Aids in the removal of tape, skin adhesives, and residue. May be helpful to the patient with sensitive skin to reduce trauma from the removal of the pouching system.

Disadvantages:
• Rinsing is typically required to remove residue before pouch application to prevent chemical dermatitis or non-adherence of the next pouch.

What are the features, advantages, and disadvantages of Paste?

Features:
• Pectin based product used to help prevent leakage of stoma drainage under the skin barrier.

Advantages:
• Can be used to fill in uneven areas and/or as a caulking around the inner edge of the skin barrier to prevent leakage under the skin barrier.
• Used to increase the seal of the skin barrier to the contours of the abdominal surface.
• Fills in small creases and depressions and evens out skin contours under a skin barrier.
• Used appropriately, will offer a quick seal for the pouching system until the skin barrier adhesive is pressed into place.

Disadvantages:
• Patients often think this is adhesive paste and use it inappropriately.
• Patients often use too much.
• Requires dexterity for application to either peristomal skin or skin barrier. May sting when applied to irritated peristomal skin.
• May help with improving the fit of the barrier.
• Is not substantial enough to fill in large creases. Does not hold up well when exposed to urinary or ileal effluent.

What are the features, advantages, and disadvantages of Skin Barrier Rings, Strips, And Paste?

Features:
• Used to fill in creases and depressions and even out skin contours under a skin barrier.

Advantages:
• Can be used to improve the fit of the skin barrier.
• Increases wear time of skin barrier.
• Can be stretched and molded to fit around the stoma.
• Can be layered to fill in deeper creases and depressions.

Disadvantages:
• Patients often use too much.
• Requires dexterity for application to either peristomal skin or skin barrier.
• May sting when applied to irritated peristomal skin.
• Will erode over time, especially with exposure to urine.

What are the features, advantages, and disadvantages of Skin Sealants?

Features:
• Liquid applied to peristomal skin to create a protective barrier.

Advantages:
• Protects skin from stoma drainage.
• Increases wear time of skin barrier.
• Dries quickly.

Disadvantages:
• May sting when applied to irritated skin.
• Should not be used under extended wear skin barriers as they can interfere with the adherence of the skin barrier.

What are the features, advantages, and disadvantages of Skin Barrier Extenders?

Features:
• Additional adhesive applied around the skin barrier to prevent edge roll and increase the wear time.

Advantages:
• Can be used to increase the wear time of the skin barrier.
• Can be used when additional support is needed, e.g., with a hernia.

Disadvantages:
• May cause additional skin trauma upon removal.
• May cause skin irritation.

What are the features, advantages, and disadvantages of Skin Barriers?

Features:
• Adhesive applied to the peristomal skin to attach the pouch to the abdomen.

Advantages:
• Protects skin from stoma drainage.
• Increases wear time of pouching system.

Disadvantages:
• May cause skin irritation or allergy.
• May not adhere well if not applied to clean, dry skin.

What are the features, advantages, and disadvantages of Flat Skin Barrier?

Features:
• Skin barrier with no convexity.

Advantages:
• Used when the stoma protrudes above the skin level.

Disadvantages:
• Not suitable for flush or retracted stomas.

What are the features, advantages, and disadvantages of Convex Skin Barrier?

Features:
• Skin barrier with a raised area around the stoma opening.

Advantages:
• Used when the stoma is flush or retracted.
• Helps to push the peristomal skin down and allows the stoma to protrude into the pouch.

Disadvantages:
• May cause trauma to the stoma if not used correctly.

What are the features, advantages, and disadvantages of Soft Convexity?

Features:
• Gentle curve to the skin barrier.

Advantages:
• Provides a gentle push to the peristomal skin.

Disadvantages:
• May not provide enough support for very retracted stomas.

What are the features, advantages, and disadvantages of Firm Convexity?

Features:
• More pronounced curve to the skin barrier.

Advantages:
• Provides more support to the peristomal skin.

Disadvantages:
• May cause trauma to the stoma if not used correctly.

What are the features, advantages, and disadvantages of Adjustable Convexity?

Features:
• Convexity can be adjusted by the user.

Advantages:
• Can be customized to fit the needs of the patient.

Disadvantages:
• May require more skill to adjust correctly.

What are the features, advantages, and disadvantages of Stoma Caps?

Features:
• Small, closed pouch used for short periods.

Advantages:
• Low profile.
• Used for special occasions or during intimate moments.

Disadvantages:
• Not suitable for regular use due to small size.

What are the features, advantages, and disadvantages of Urostomy Pouches?

Features:
• Pouch designed for urine.

Advantages:
• Has an anti-reflux valve to prevent urine from washing over the stoma.
• Can be connected to a bedside drainage bag.

Disadvantages:
• Requires regular emptying.

What are the features, advantages, and disadvantages of Mini-Pouches?

Features:
• Small, drainable pouch.

Advantages:
• Low profile.
• Suitable for stomas with minimal output.

Disadvantages:
• Not suitable for stomas with regular or high output.

What are the features, advantages, and disadvantages of Night Drainage Bags?

Features:
• Large capacity bag used for overnight drainage.

Advantages:
• Allows for uninterrupted sleep.
• Suitable for urostomies or high-output ileostomies.

Disadvantages:
• Requires regular cleaning.

What are the features, advantages, and disadvantages of Pouch Covers?

Features:
• Cloth cover that fits over the pouch.

Advantages:
• Provides a comfortable barrier between the pouch and the skin.
• Can be more discreet under clothing.

Disadvantages:
• Adds bulk to the pouching system.

What are the features, advantages, and disadvantages of Deodorants?

Features:
• Liquid or tablet added to the pouch to neutralize odor.

Advantages:
• Reduces odor.

Disadvantages:
• Some people may be sensitive to the ingredients.

What are the features, advantages, and disadvantages of Lubricants?

Features:
• Liquid added to the pouch to prevent pancaking.

Advantages:
• Helps stool to move to the bottom of the pouch.

Disadvantages:
• May reduce wear time of the pouching system.

What are the features, advantages, and disadvantages of Bedside Drainage Containers?

Features:
• Large capacity container used for overnight drainage.

Advantages:
• Suitable for urostomies or high-output ileostomies.
• Can be placed on the floor or hung on the bed rail.

Disadvantages:
• Requires regular cleaning.

What are the features, advantages, and disadvantages of Irrigation Supplies?

Features:
• Supplies used for colostomy irrigation.

Advantages:
• Allows for scheduled bowel movements.
• May eliminate the need for a pouch.

Disadvantages:
• Time-consuming.
• Requires equipment.
• Not all colostomates are candidates for irrigation.

What are the features, advantages, and disadvantages of Stoma Measuring Guides?

Features:
• Tool used to measure the stoma to ensure a proper fit of the skin barrier.

Advantages:
• Ensures a proper fit of the skin barrier.

Disadvantages:
• None listed.

What are the features, advantages, and disadvantages of Tape?

Features:
• Adhesive used to secure the pouching system to the abdomen.

Advantages:
• Provides additional security.

Disadvantages:
• May cause skin irritation or allergy.

What are the features, advantages, and disadvantages of Pouch Clamps?

Features:
• Device used to close the bottom of a drainable pouch.

Advantages:
• Reusable.

Disadvantages:
• Can be uncomfortable if it digs into the skin.
• May not provide a secure closure if not applied correctly.

What are the features, advantages, and disadvantages of Integrated Closures?

Features:
• Closure that is part of the pouch.

Advantages:
• No separate parts to lose.

Disadvantages:
• May not provide a secure closure if not applied correctly.

What are the features, advantages, and disadvantages of Filters?

Features:
• Device used to release gas from the pouch.

Advantages:
• Prevents ballooning of the pouch.

Disadvantages:
• Can become blocked with stool.
• May not work if not kept flat against the skin.