Emptying the Appliance
Closed (or non-drainable) One Piece System. After a motion is passed the appliance is removed, emptied and discarded.
Closed (or non-drainable) Two Piece System. After a motion is passed the bag is removed from the face plate, emptied and discarded. A clean bag is fitted onto the face plate.
Drainable Appliance, One Piece or Two Piece System. Simply sit on, stand at or kneel at the toilet, undo the clip (or, for urostomates, open the tap) and allow the contents to empty into the pan. Colostomates may prefer to rinse out the bag at this stage, but for ileostomates this is an optional extra which simply adds an unnecessary complication. Wipe the opening of the pouch with toilet paper and close the clip (or, for urostomates, the tap), flush the toilet and depart.
CHANGING THE APPLIANCE
A new ostomate will soon master the art of changing the appliance and taking good care of the skin. Prevention is the best method of keeping the skin healthy. If the appliance begins to leak under the adhesive, it must be changed. Patching does not work, since irritating faeces or urine under the appliance seal will damage the skin. On the other hand, too frequent changes don’t help as the skin may be damaged by repeated removal of adhesives.
Changing your appliance will be necessary when the skin around the stoma starts to feel uncomfortable or when a leakage occurs under the adhesive square. You will need access to the bathroom for about 15 minutes while you change your appliance and the first thing to do is to gather up all you will need in the way of tissues, fresh appliance etc. (see below). The interval between changes will be between one and six days.
Hear are some points to remember when practising good skin care and changing you appliance.
- Make sure all supplies are handy
(a) disposal bag or newspapers
(b) toilet tissue, gauze or Chux. (Do not use cotton wool as it may stick to the skin)
(c) warm water
(d) new appliance with belt and plate if used.
(e) extra care supplies if needed e.g adhesive paste
(f) measuring guide - the stoma nurse will show you how to cut a pattern for your stoma
- Using your measuring guide cut the correct shaped hole in the face plate.
- Empty old appliance (if drainable), remove and wrap in paper. Keep the clip if the bag is drainable
- Gently cleanse the stoma
- Use a rolled piece of gauze or tissue around the stoma to absorb faeces (ileostomates) or urine (urostomates) which may appear at the stoma before the new appliance is in place.
- Wash the skin around the stoma with warm water. If using soap, rinse off thoroughly. Dry the skin well, patting rather than rubbing.
- Apply skin preparations or other barriers, if used.
- Peel backing off the base plate and apply pouch. Do this whilst standing and stretch the skin if necessary to obtain a flat surface.
- Press the base plate well down and eliminate any wrinkles in the adhesive.
- For a two-piece system, fix the pouch onto the face plate and check that the pouch is clicked on properly.
- Close the clip if using a drainable appliance.
Appliances are available from your stoma nurse or hospital appliance supply department. They are supplied free.