Attaching an ostomy pouch

An ostomy pouch is made of a specially designed, heavy-duty plastic bag with an opening that fits around the stoma. Depending the style of pouch, the opening has adhesive or a plastic locking ring around it to connect it to the skin or skin barrier and prevent leaks. The pouch collects output from your stoma (urine with a urostomy, and stool with a colostomy or ileostomy). Avoiding leaks is important since the output can irritate skin, causing redness, itchiness and discomfort.

How often you change your ostomy pouch will depend on what kind of pouching system you’re using, but the basic steps are the same. As you become comfortable with your ostomy care routine, you will learn how long you can wear your ostomy pouching system before changing.
 

  1. First, wash your hands with warm, soapy water and dry thoroughly.
     
  2. You may want to place a towel under your clothing and beneath the stoma area. Consider laying out all of your ostomy pouching supplies so you know you have everything you need. Changing the pouch in front of a mirror can help you see what you’re doing.
     
  3. Make sure the skin is clean and dry around the stoma. The adhesive on the ostomy pouch/skin barrier will not stay in place well if the skin is wet. Check the skin for any signs of irritation.
     
  4. Determine what kind of skin barrier you will be using. Right after ostomy surgery, it will take time for your stoma to settle into its regular size, usually about six weeks. If you have an irregularly shaped stoma you will probably need to measure your stoma using a measuring card and then cut the barrier to match the shape (these are called cut-to-fit barriers). Once your stoma remains at the same size and shape, then you’ll probably be able to use a pre-cut skin barrier.
     
  5. There are flat skin barriers if your stoma sticks out at least an inch from the body and convex skin barriers that curve inward if your stoma is recessed, flush or nearly flush to the skin. 
  6. For a one-piece ostomy pouching system, simply remove the skin barrier cover paper and attach the pouching system to the skin, carefully pressing the skin barrier around your stoma and smoothing it into place.
     
  7. For a two-piece ostomy pouching system, the skin barrier is not attached to the pouch. The pouch attaches to the skin barrier using either an adhesive or a plastic locking mechanism, called a flange. The advantage of a two-piece system is that you don’t have to remove the skin barrier each time you change the pouch; you simply release the pouch and attach a new one.
     
  8. No matter which kind of pouching system you’re using, gently press on the skin barrier for 30 seconds to two minutes to help it adhere properly. The heat from your hand when you press on the barrier will help strengthen the bond to your skin.


The type of ostomy pouching system you need will be determined by your personal preferences, as well as your activities and lifestyle. You may find having different pouches available is the best approach so you can match your pouch with your needs at the time.

*Talk to your WOC (Wound, Ostomy and Continence) nurse to determine what your best options are when it comes to ostomy pouching systems.