The skin surrounding your stoma must be protected as far as possible from faeces (or urine), hence the need for a correctly fitted, comfortable appliance which should be leak- and odour-proof. As a new ostomate it makes sense for you to learn as much as possible about the selection and use of appliances and new developments. Most hospitals have a stoma care nurse (or stomal therapist) who specialises in ostomy care and you will find her or him to be an invaluable help to you. You will be shown procedures which you will quickly master. Whilst you are still in hospital, following your surgery, the management of your appliance may seem to be a major consideration in your day but once you return home you will quickly find that you forget about it for long periods of time whilst you pursue your normal routines of work, recreation or sleep. Only when the pouch needs emptying will you give it a thought and even then, to deal with that is but a minor chore.
There are a large number of ostomy appliances available (free) manufactured by different Companies. Your stoma nurse will advise you on these, and which she considers the best for you in the hospital or your early days at home. Later she may suggest another type or later still you may like to experiment with other products yourself when you see the types available. These are generally on display at Ostomy Society meetings and seminars, or free samples may be obtained from the Companies which advertise in the N Z Ostomate. This 4-monthly magazine is available free at the place where you collect your appliances.
Your stoma nurse will teach you how to change your appliance and will call at your home for a while after your discharge from hospital to give you further help and advice. If you have a spouse or close friend it is sometimes a good idea to involve them in appliance changing at some stage, so they will know what to do in an emergency or sickness. However the main aim for all ostomates should be to acquire the ability as quickly as possible to change the appliance themselves. This gives a greater feeling of independence, a necessity for complete recovery.
There is a wide range of appliances available and all are light weight, odour-proof and inconspicuous. Many pouches contain an integral filter which can be activated or left untouched. Flatus or wind is deodorised through this filter.
The composition of the backing which adheres straight onto the skin (often referred to as the wafer, flange or base plate), provides excellent skin protection provided it is neatly fitting around the stoma.
Appliances may be “one piece” or “two piece”’ and drainable or non drainable.
A “one piece” system is designed to adhere straight onto the skin and is composed of the collection bag, seal and outer adhesive ring in an all-inone unit. A “two piece” system is where the wafer is separate from the bag. This might be used by someone who wishes to change the wafer only twice a week, but can empty and/or change the bag as required.
A closed or non-drainable system is used when someone has a colostomy and the bowel is moving only once or twice a day.
A drainable system has a clip at the bottom (colostomy and ileostomy) or a tap (urostomy). The bag is designed to be emptied when about one third full.
A person who is able to irrigate only needs a small stoma cap or plug; these are very compact and are changed at each irrigation.
A urostomy appliance may be a one or two piece system, but differs in that it has a tap at the bottom, plus a one-way valve incorporated into the pouch so that urine drains to the bottom and the stoma is not continually bathed in urine. Night drainage bags are available and can be easily attached.