An ostomy pouching system is a

prosthetic In medicine, a prosthesis (: prostheses; from ), or a prosthetic implant, is an artificial device that replaces a missing body part, which may be lost through physical trauma, disease, or a condition present at birth (Congenital, congenital disord ...

medical device A medical device is any device intended to be used for medical purposes. Significant potential for hazards are inherent when using a device for medical purposes and thus medical devices must be proved safe and effective with reasonable assura ...

that provides a means for the collection of waste from a surgically diverted biological system ( colon,

ileum The ileum () is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may ...

bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...

) and the creation of a

stoma In botany, a stoma (: stomata, from Greek language, Greek ''στόμα'', "mouth"), also called a stomate (: stomates), is a pore found in the Epidermis (botany), epidermis of leaves, stems, and other organs, that controls the rate of gas exc ...

. Pouching systems are most commonly associated with colostomies, ileostomies, and urostomies. Pouching systems usually consist of a collection pouch, a barrier on the skin, and connect with the stoma itself, which is the part of the body that has been diverted to the skin. The system may be a one-piece system consisting only of a bag or, in some instances involve a device placed on the skin with a collection pouch that is attached mechanically or with an

adhesive Adhesive, also known as glue, cement, mucilage, or paste, is any non-metallic substance applied to one or both surfaces of two separate items that binds them together and resists their separation. The use of adhesives offers certain advantage ...

in an

airtight A hermetic seal is any type of sealing that makes a given object airtight (preventing the passage of air, oxygen, or other gases). The term originally applied to airtight glass containers but, as technology advanced, it applied to a larger c ...

seal, known as a two-piece system. The system used varies between individuals and is often based on the medical reason, personal preference and lifestyle.

Uses

Ostomy pouching systems collect

waste Waste are unwanted or unusable materials. Waste is any substance discarded after primary use, or is worthless, defective and of no use. A by-product, by contrast is a joint product of relatively minor Value (economics), economic value. A wast ...

that is output from a stoma. The pouching system allows the stoma to drain into a sealed collection pouch, while protecting the surrounding

skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...

from

contamination Contamination is the presence of a constituent, impurity, or some other undesirable element that renders something unsuitable, unfit or harmful for the physical body, natural environment, workplace, etc. Types of contamination Within the scien ...

. They are used to maintain independence, so that a wearer can continue to lead an active lifestyle that can include all forms of sports and recreation.

Surface barriers

Ostomy barriers sit on the skin and separate the ostomy pouch from the internal conduit. They are not always present. These barriers, also called flanges, wafers, or baseplates are manufactured using

pectin Pectin ( ': "congealed" and "curdled") is a heteropolysaccharide, a structural polymer contained in the primary lamella, in the middle lamella, and in the cell walls of terrestrial plants. The principal chemical component of pectin is galact ...

or similar organic material and are available in a wide variety of sizes to accommodate a person's particular anatomy. The internal opening must be the correct size to accommodate the individual's

while protecting the skin from contact with waste. The methods for sizing this opening vary depending on the type of wafer/baseplate; some pre-cut sizes are available, some users customize the opening using

scissors Scissors are hand-operated shearing tools. A pair of scissors consists of a pair of blades pivoted so that the sharpened edges slide against each other when the handles (bows) opposite to the pivot are closed. Scissors are used for cutting var ...

. Manufacturers have recently introduced moldable wafers that can be shaped by hand without the need for scissors. Skin adhesion for modern wafers/baseplates/flanges are optimized on all the five parameters required in an adhesive: *

absorption Absorption may refer to: Chemistry and biology *Absorption (biology), digestion **Absorption (small intestine) *Absorption (chemistry), diffusion of particles of gas or liquid into liquid or solid materials *Absorption (skin), a route by which su ...

* tack and adhesion * flexibility *

erosion Erosion is the action of surface processes (such as Surface runoff, water flow or wind) that removes soil, Rock (geology), rock, or dissolved material from one location on the Earth's crust#Crust, Earth's crust and then sediment transport, tran ...

resistance * ease of removal. In addition, barriers with adhesive border can provide additional security that the system stays in place. Using a barrier film spray before applying a new flange will improve adhesion, soothe irritated skin and protect the skin from irritation. A barrier may last between one and many days before it needs to be replaced; this is highly dependent on the individual's lifestyle, ostomy type, and anatomy.

Pouches

The method of attachment to the barrier varies between manufactures and includes permanent (one-piece), press-on/click ("

Tupperware Tupperware is an American company that manufactures and internationally distributes preparation, storage, and serving containers for the kitchen and home. It was founded in 1942 by Earl Tupper, who developed his first bell-shaped container and ...

" type), turning locking rings and "sticky" adhesive mounts. The two-piece arrangement allows pouches to be exchanged without removing the wafer; for example, some people prefer to temporarily switch to a "mini-pouch" for swimming, intimate and other short-term activities. Mini-pouches are suitable for minimum usage only. Pouches can be divided into two basic types: open-end (drainable) and closed-end (disposable). * Open-end pouches have a resealable end that can be opened to drain the contents of the pouch into a

toilet A toilet is a piece of sanitary hardware that collects human waste (urine and feces) and sometimes toilet paper, usually for disposal. Flush toilets use water, while dry or non-flush toilets do not. They can be designed for a sitting p ...

. The end is sealed with either a

Velcro Velcro IP Holdings LLC, trading as Velcro Companies and commonly referred to as Velcro (pronounced ), is a British privately held company, founded by Swiss electrical engineer George de Mestral in the 1950s. It is the original manufacturer of ho ...

-type closure or a simple clip. * Closed-end pouches can be removed and replaced with a new pouch once the bag is full or the pouch can be emptied and rinsed. The flange or wafer does not need to be replaced. The use of open-end vs. closed-end pouches is dependent on the frequency in which an individual needs to empty the contents, as well as

economics Economics () is a behavioral science that studies the Production (economics), production, distribution (economics), distribution, and Consumption (economics), consumption of goods and services. Economics focuses on the behaviour and interac ...

Gas Gas is a state of matter that has neither a fixed volume nor a fixed shape and is a compressible fluid. A ''pure gas'' is made up of individual atoms (e.g. a noble gas like neon) or molecules of either a single type of atom ( elements such as ...

is created during

digestion Digestion is the breakdown of large insoluble food compounds into small water-soluble components so that they can be absorbed into the blood plasma. In certain organisms, these smaller substances are absorbed through the small intestine into th ...

, and an airtight pouch will collect this and inflate. To prevent this some pouches are available with special charcoal filtered vents that will allow the gas to escape, and prevent ballooning at night. Some odor can be expelled through the charcoal filter especially if sufficient deodorant is not used in the pouch. Pouch covers are helpful to disguise the plastic pouch when it is exposed when reaching or other physical activity. These are usually made of cloth and can be decorative or plain to blend in with clothing. Various sources stock sizes for most manufacturers pouches. There are flexible elastic pouch belts available for extreme physical activity but some of these require the pouch to be worn sideways so it does not fill properly and the tight fit causes pancaking of the effluent.

Routine care

People with colostomies must wear an ostomy pouching system to collect intestinal waste. Ordinarily the pouch must be emptied or changed a couple of times a day depending on the frequency of activity; in general the further from the

anus In mammals, invertebrates and most fish, the anus (: anuses or ani; from Latin, 'ring' or 'circle') is the external body orifice at the ''exit'' end of the digestive tract (bowel), i.e. the opposite end from the mouth. Its function is to facil ...

(i.e., the further 'up' the intestinal tract) the ostomy is located the greater the output and more frequent the need to empty or change the pouch. People with colostomies who have ostomies of the

sigmoid colon The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about in length. The loop is typically shaped like a Greek letter sigma (ς) or Latin letter S (thus ''s ...

descending colon In the anatomy of humans and homologous primates, the descending colon is the part of the colon extending from the left colic flexure to the level of the iliac crest (whereupon it transitions into the sigmoid colon). The function of the descen ...

may have the option of irrigation, which allows for the person to not wear a pouch, but rather just a gauze cap over the stoma, and to schedule irrigation for times that are convenient. To irrigate, a

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

is placed inside the stoma, and flushed with water, which allows the feces to come out of the body into an irrigation sleeve. Most colostomates irrigate once a day or every other day, though this depends on the person, their food intake, and their health.

Impact

Ostomy systems often take some time for a person to adjust to, including requiring time to learn how to use them and change the pouch, as well as psychologically adjust. The time taken to adjust may last for more than a year. Because of embarrassment or stigma associated with an ostomy system, a person who has an ostomy system can experience

social isolation Social isolation is a state of complete or near-complete lack of contact between an individual and society. It differs from loneliness, which reflects temporary and involuntary lack of contact with other humans in the world. Social isolation c ...

, depression, and change in

sexual function Sexual function is how the body reacts in different stages of the sexual response cycle. It is defined as the ability of an individual to react sexually or to experience sexual pleasure. Assessment Relevant aspects of sexual function are describ ...

as well as physical complications such as weight change. In various online ostomy groups and ostomy societies, ostomates share their experiences and help each other. One of the largest is MeetAnOstoMate, a community where people with similar experiences share information, ask questions, and receive support.

References

External links

United Ostomy Associations of America
{{Stomas Gastroenterology Medical equipment Prosthetics Incontinence Danish inventions