Choosing the Right Skin Barrier for Your Ostomy

Post Reviewed By Expert

This post was reviewed by our Director of Clinical Excellence and Oversight.

Whether you’re selecting supplies for a home improvement project or managing an ostomy, getting the details right is the key to success. To ensure the job gets done correctly, you’ll need to understand what tools to use and how to use them correctly. If you live with an ostomy, including a colostomy, ileostomy, or urostomy, there’s a lot to think about, including how to choose the right skin barrier for your ostomy system.

The skin barrier is the part of the ostomy pouching system that attaches to the skin to hold the ostomy system in place. It is also known as a “wafer” when it is part of a 2-piece ostomy system. The skin barrier or wafer is an essential element of your ostomy pouching system and can have a big impact on your comfort. The skin barrier or wafer can also impact the ability of your ostomy pouching system to do what it’s designed to do—safely and securely collect waste as it leaves your body—so this is one tool you won’t want to leave to chance.

The Big Picture

An ostomy is a surgery that creates a stoma, an opening in the skin that leads from the intestines, to allow urine or feces to leave the body. Ostomy surgery is done to bypass an organ (like the bladder or colon) that no longer functions as it should due to disease or injury. The need for an ostomy can be temporary, for example having an ostomy for a few months following bowel surgery. Or a person may have a permanent re-routing of their elimination system.

doctor and patient

Whether temporary or permanent, the waste (effluent). from an ostomy is collected in a bag or pouch that is attached to the opening on the abdomen. The ostomy pouch holds the waste and helps protect the skin. Ostomy pouches are designed either as a single piece that includes a pouch and attached skin barrier, or as a two-piece system with a separate pouch and barrier.

One-piece drainable and urostomy pouches can be drained, which means you empty the pouch without detaching it. Two-piece systems allow the pouch to be detached from the skin barrier to be emptied or changed. The ostomy pouching system is usually changed about every three to four days. Some people need to change more frequently and some can wear their system five to seven days. Each person’s need is individual. If you find you need more frequent changes than usual, consult a member of your healthcare team. You may need to consider a new type of ostomy pouching system.

Ostomy Therapies Provided by Home Care Delivered

If your skin looks good and you are not leaking, you’ll know you’re using the right type of ostomy skin barrier for a good fit.

The Skinny on Skin Barriers

The skin barrier or wafer is arguably the most important part of your ostomy pouching system. It adheres to the skin around the stoma to protect it from urine or feces while providing a safe and secure seal. If the skin barrier erodes, or if the ostomy appliance does not fit properly for any reason, chemical irritation from the waste material can lead to a breakdown of the skin around the stoma.

    Though the exact formula varies by brand, ostomy skin barriers are made up of a few similar ingredients:

    • Tackifiers that provide the initial stick, like a pressure-sensitive adhesive
    • Polymers for a strong bond to the skin
    • Hydrocolloids for absorption
    ostomy supplies

    Ostomy skin barriers come in “standard” and “extended” wear designs. Standard wear ostomy skin barriers are more effective for formed stool and have longer wear times. They may be best for individuals living with a colostomy. However, standard wear skin barriers generally have less resistance to urine and liquid stool. They tend to break down (“melt out”) with higher volumes of effluent, which can result in unwanted skin exposure.

    Extended wear ostomy skin barriers can provide greater resistance. Some contain substances that absorb moisture from the waste. This causes the barrier to puff up around the stoma, resulting in a better seal. Extended wear products typically have better “tacking” and adhesive capacity. Extended wear is often the choice for those living with an ileostomy or urostomy, where the output is liquid.

    Another thing to keep in mind is that ostomy skin barriers vary according to shape. One option is a convex ostomy pouching system that is curved, or dome-shaped. This delivers a gentle push to the belly, which moves the stoma up and outward, allowing the waste to move directly into the pouch, rather than under the skin barrier. Soft convex skin barriers are typically used on people with firmer abdomens who require convexity. Firm convex barriers are best for softer abdomens.

    Is My Skin Barrier Working?

    How do you know if the ostomy skin barrier you’re using is working? According to the United Ostomy Associations of America, “If your skin looks good and you are not leaking, you’ll know you’re using the right type of ostomy skin barrier for a good fit.” Don’t be afraid to try a different system if what you’re using is not delivering the results, or comfort, you expect.

    Once you’ve discussed your needs with your doctor or ostomy nurse, we will be glad to help you start the simple process of enrolling. That way, you can receive your ostomy supplies regularly at home, delivered to your doorstep in a discrete brown box with no-cost shipping! Call 866-904-0815 and you’ll reach a member of our customer care team who can advise you about ostomy products including skin barriers and will help with your private insurance, Medicare, or Medicaid policy paperwork. When it is time to reorder, we also offer online and text-to-order options. Or simply enter your phone number on the bottom left of the screen and we’ll give you a call.

    Info Alert!

    Don’t be afraid to try a different system if what you’re using is not delivering the results, or the comfort, you expect.

    Anyone who says living with an ostomy is simple has probably never tried it. The HCD team understands the issues and the complexity and we’re here to provide the information and products that can make the whole thing easier, and a lot less stressful! We also have additional resources that can help you live well with your ostomy. Check out our blogs Oh, the Places You’ll Go! Traveling with an Ostomy and Taking Charge of Your Health When You Have an Ostomy: A Practical Guide for more information.

    For your ostomy pouching systems, skin barriers, and accessories contact the team at HCD today.

    Disclaimer:

    Unless otherwise noted, the recommendations in this document were obtained from the sources indicated. Be advised that information contained herein is intended to serve as a useful reference for informational purposes only. HCD cannot be held responsible for the continued accuracy of or for any errors or omissions in the information. All trademarks and registered trademarks are the property of their respective owners.

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