Ostomy pouching system
Encyclopedia
An ostomy pouching system (also colloquially called a bag) is a medical device
prosthetic that provides a means for the collection of waste from a surgically diverted biological system (colon
, ileum
, urinary) and the creation of a stoma
. Pouching systems are most commonly associated with colostomies
, ileostomies
, and urostomies
.
Pouching systems usually consist of a collection pouch bag
, known as a one-piece system or, in some instances involves a mounting plate, commonly called a wafer or a baseplate, and a collection pouch
that is attached mechanically or with an adhesive
in
an airtight seal, known as a two-piece system. The selection of systems varies greatly between individuals and is often based on personal preference and lifestyle. Ostomy pouching systems collect waste
that is output from a stoma. The pouching system allows the stoma to drain into a sealed collection pouch, while protecting the surrounding skin
from contamination
.
Ostomy pouching systems are air- and water-tight and allow the wearer to lead an active normal lifestyle that can include all forms of sports and recreation.
Ostomy pouching systems are also sometimes referred to as an appliance
, where the term appliance refers to a prosthesis, as a mechanical replacement for a biological function.
Most wafers/baseplates are manufactured using pectin
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 stoma
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, however most users normally customize the opening using scissors
. Manufacturers have recently introduced moldable wafers than can be shaped by hand without the need for scissors.
Skin adhesion for modern wafers/baseplates are optimized on all the five parameters required in an adhesive:
A wafer/baseplate may last between four to ten days before it needs to be replaced; this is highly dependent on the individual's lifestyle, ostomy type, and anatomy.
For maximum hygiene and to reduce risk of infection, a one-piece (open-end) bag should be changed every twenty-four hours. A two-piece bag's base plate should be changed weekly with the bag changed every twenty-four hours.
The method of attachment to the wafer varies between manufactures and includes permanent (one-piece), press-on/click ("Tupperware
" type), turning locking rings and the recently introduced "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 broken down into two basic types: open-end (drainable) and closed-end (disposable).
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
.
Gas
is created during digestion
, 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.
Medical device
A medical device is a product which is used for medical purposes in patients, in diagnosis, therapy or surgery . Whereas medicinal products achieve their principal action by pharmacological, metabolic or immunological means. Medical devices act by other means like physical, mechanical, thermal,...
prosthetic that provides a means for the collection of waste from a surgically diverted biological system (colon
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...
, ileum
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 be used instead of ileum.The ileum follows the duodenum...
, urinary) and the creation of a stoma
Stoma (medicine)
A stoma is an opening , either natural or surgically created, which connects a portion of the body cavity to the outside environment...
. Pouching systems are most commonly associated with colostomies
Colostomy
A colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel...
, ileostomies
Ileostomy
An ileostomy is a surgical opening constructed by bringing the end or loop of small intestine out onto the surface of the skin. Intestinal waste passes out of the ileostomy and is collected in an external pouching system stuck to the skin...
, and urostomies
Urostomy
A urostomy is a stoma for the urinary system. A urostomy is made to avail for urinary diversion in cases where drainage of urine through the bladder and urethra is not possible, e.g...
.
Pouching systems usually consist of a collection pouch bag
Bag
- Types of flexible containers :* Antistatic bag, used for shipping electronic components* Bag-In-Box* Bin bag, garbage bag, or trash bag* Book bag* Bulk bag, a name for a flexible intermediate bulk container* Burn bag* Diplomatic bag* Duffel bag...
, known as a one-piece system or, in some instances involves a mounting plate, commonly called a wafer or a baseplate, and a collection pouch
Pouch
Pouch may refer to:* A small bag such as a pocket, teabag, money pouch, sporran, etc* Cadaver pouch, body bag * Diplomatic pouch* Electric heating pouch, medical apparatus, electric heating device for curative treatment...
that is attached mechanically or with an adhesive
Adhesive
An adhesive, or glue, is a mixture in a liquid or semi-liquid state that adheres or bonds items together. Adhesives may come from either natural or synthetic sources. The types of materials that can be bonded are vast but they are especially useful for bonding thin materials...
in
an airtight seal, known as a two-piece system. The selection of systems varies greatly between individuals and is often based on personal preference and lifestyle. Ostomy pouching systems collect waste
Waste
Waste is unwanted or useless materials. In biology, waste is any of the many unwanted substances or toxins that are expelled from living organisms, metabolic waste; such as urea, sweat or feces. Litter is waste which has been disposed of improperly...
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
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
from contamination
Contamination
Contamination is the presence of a minor and unwanted constituent in material, physical body, natural environment, at a workplace, etc.-Specifics:"Contamination" also has more specific meanings in science:...
.
Ostomy pouching systems are air- and water-tight and allow the wearer to lead an active normal lifestyle that can include all forms of sports and recreation.
Ostomy pouching systems are also sometimes referred to as an appliance
Prosthesis
In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...
, where the term appliance refers to a prosthesis, as a mechanical replacement for a biological function.
Wafers/Baseplates
Most wafers/baseplates are manufactured using pectin
Pectin
Pectin is a structural heteropolysaccharide contained in the primary cell walls of terrestrial plants. It was first isolated and described in 1825 by Henri Braconnot...
or similar organic material and are available in a wide variety of sizes to accommodate a person's particular anatomy
Anatomy
Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...
.
The internal opening must be the correct size to accommodate the individual's stoma
Stoma (medicine)
A stoma is an opening , either natural or surgically created, which connects a portion of the body cavity to the outside environment...
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, however most users normally customize the opening using scissors
Scissors
Scissors are hand-operated cutting instruments. They consist of a pair of metal blades pivoted so that the sharpened edges slide against each other when the handles opposite to the pivot are closed. Scissors are used for cutting various thin materials, such as paper, cardboard, metal foil, thin...
. Manufacturers have recently introduced moldable wafers than can be shaped by hand without the need for scissors.
Skin adhesion for modern wafers/baseplates are optimized on all the five parameters required in an adhesive:
- absorptionAbsorption (skin)Skin absorption is a route by which substances can enter the body through the skin. Along with inhalation, ingestion and injection, dermal absorption is a route of exposure for toxic substances and route of administration for medication...
- tack and adhesion
- flexibility
- erosionErosionErosion is when materials are removed from the surface and changed into something else. It only works by hydraulic actions and transport of solids in the natural environment, and leads to the deposition of these materials elsewhere...
resistance - ease of removal.
A wafer/baseplate may last between four to ten 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 wafer varies between manufactures and includes permanent (one-piece), press-on/click ("Tupperware
Tupperware
Tupperware is the name of a home products line that includes preparation, storage, containment, and serving products for the kitchen and home, which were first introduced to the public in 1946....
" type), turning locking rings and the recently introduced "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 broken down 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 toiletToiletA toilet is a sanitation fixture used primarily for the disposal of human excrement, often found in a small room referred to as a toilet/bathroom/lavatory...
. The end is sealed VelcroVelcroVelcro is the brand name of the first commercially marketed fabric hook-and-loop fastener, invented in 1948 by the Swiss electrical engineer George de Mestral...
-type closure at the end that eliminates the need for a clip. - Closed-end pouches must be removed and replaced with a new pouch once the bag is full. This system can cause extreme damage to the skin area under the adhesive due to the frequency of removal and re-application.
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
Economics is the social science that analyzes the production, distribution, and consumption of goods and services. The term economics comes from the Ancient Greek from + , hence "rules of the house"...
.
Gas
Flatulence
Flatulence is the expulsion through the rectum of a mixture of gases that are byproducts of the digestion process of mammals and other animals. The medical term for the mixture of gases is flatus, informally known as a fart, or simply gas...
is created during digestion
Digestion
Digestion is the mechanical and chemical breakdown of food into smaller components that are more easily absorbed into a blood stream, for instance. Digestion is a form of catabolism: a breakdown of large food molecules to smaller ones....
, and an airtight pouch will collect this and inflate. To prevent this some pouches are available with special charcoal filtered
Activated carbon
Activated carbon, also called activated charcoal, activated coal or carbo activatus, is a form of carbon that has been processed to make it extremely porous and thus to have a very large surface area available for adsorption or chemical reactions.The word activated in the name is sometimes replaced...
vents that will allow the gas to escape, and prevent ballooning at night.