The way one person changes an ostomy can differ greatly from another person’s method, but there are some simple basics that almost everyone follows. These are the steps I follow to get the longest wear-time out of my bags and to keep my skin healthy!
Laying out everything you need prior to peeling the old bag off cuts down on changing time. Ensure your wafer is cut to your stoma’s size and shape. Most ostomy companies provide templates to help you measure, but another method is saving a previous wafer’s backing as your template. A rounded pair of scissors makes it easy to cut circular shapes. Adding paste or barrier rings is a common method to prevent leaks. The paste should be applied after the backing is removed from the wafer, around where the stoma will go through. This creates an extra seal so output is less likely to seep onto skin.
Cleaning Peri-stomal Skin
Peri-stomal skin (the skin around your stoma) is very susceptible to breakdown. It it so important to clean that skin thoroughly every time you do a bag change. Yes – that means cleaning off all of the icky, goopy paste stuck to your skin. My favorite method is to plan my bag changes for after showers. I can peel the bag off at the start of a shower and clean the skin with an non-oily soap. Something like Irish Spring works well because it leaves the skin feeling “squeaky clean”. This also reduces the time that my stoma is open to air (aka time it will spurt and ruin my clothing). If this isn’t an option, carrying cleanser wipes with you can assist in cleaning skin when running water isn’t around. If needed, an extra step to take is tucking a paper towel or toilet paper into your waistband. This prevents any “dribble” from your stoma hitting clothing. This is your first step in making a surface your wafer will stick to.
Creating a Barrier
Not everyone follows this step, but it is a way to protect your skin should a leak occur. I start with a barrier wipe that quite literally makes a barrier between the wafer and your skin. In the medical world, they use this with many procedures requiring adhesive. It makes a smooth surface that adhesive will stick better to, but also makes it more comfortable when it comes time to pull the adhesive off.
Another option, particularly if you notice redness and irritation starting, is to add a stoma powder. I do not recommend using this for every bag change as it can reduce the stickiness of a wafer. If you find yourself needing to use it, however, there is a way to increase the adhesiveness. Start with a layer of skin barrier, dust a thin layer of stoma powder onto irritation. I start with the bottle upside-down to get the product out and onto skin. I then turn it right-side-up and squeeze bottle to blow air onto skin. This air helps to thin out thick layers of powder. I follow this with another layer of skin barrier, patting rather then rubbing the product on.
Placing the Wafer
After letting the skin dry for an adequate amount of time, you are ready to place the bag. I use a two-piece and find this easier in placing a wafer on. Looking into a mirror, I can visualize the stoma going through the cut-out wafer. Press firmly onto skin, going around wafer’s edge and stoma. Then click the bag into place (if needed). If you have a one-piece system, you will need to look down at your stoma to see it going through opening of wafer. Remember to make sure the end of your bag is closed if you have the emptying kind!
These are the very basic steps of changing an ostomy bag. There are many different methods in doing this, and a variety of products that can be used. If you have any questions about my above directions or on varying methods, please leave a comment below!