Anatomy of a Pouch: Part 1. One Piece vs Two Piece
by Diane Mirlocca RN, WOCN
One piece, two piece, drainable, closed ended non-drainable, clip closure, velcro closure, pre-cut, cut to fit, opaque, transparent, flat, convex, concave, filtered, non-filtered, single chamber, multi chamber, mini, large output, cap, disposable liner or ... Sigh…
The decision as to the best pouching system may be overwhelming: We’re here to help. This series of articles explains the anatomy of an ostomy pouching system and sheds some light on to when to use the different options.
There are many factors to consider when choosing the right product. The right ostomy pouching system is dependent on the type of stoma you have, your abdominal shape and contour, where your stoma is placed, your lifestyle, the activities you do on a daily basis, your skin condition, budget, personal preference, and most importantly, comfort.
Ultimately, connecting with a nurse specializing in ostomy care is best to help you choose the right products for you.
In part 1 of this series, we will deal with the differences, advantages and disadvantages of the one- and two-piece pouching systems. So, let’s get started!
One-piece pouching systems include a wafer (also referred to as a flange, barrier or appliance) and pouch that is all-in-one.
Advantages of One-piece Pouching System
- Simple to use: just peel and stick
- A lower profile that is more discreet and less visible under clothing
- More flexible as the wafer is thinner making it easier to conform to your abdominal shape
- Less costly
Disadvantages of One-piece Pouching System
- The wafer has to be removed with each pouch change increasing the chance of skin irritation
- The pouch cannot be repositioned once it is applied
- The thinner wafer may breakdown quicker resulting in increased number of changes
- “Burping” to release gas buildup requires opening the bottom of pouch
Examples of One-Piece Pouching Systems
Two-piece pouching systems have the wafer and pouch as separate pieces.
Advantages of Two-piece Pouching System
- Allows the removal of pouch while keeping wafer intact on the skin
- Reduces risk of skin irritation since the wafer isn’t removed as often
- Easier to see the stoma during application
- A thicker wafer may provide longer wearing time
- “Burping” can be achieved by separating pouch from wafer then reapplying
- Greater flexibility in product selection: for example, changing a pouch size from small to large or a closed end to an open end for cleaning or emptying can be done without removing the wafer
- Able to add use flushable/bio-degradable liners
Disadvantages of Two-piece Pouching System
- Bulkier than a one-piece
- Not as easy to confirm to abdominal contours due to the increased thickness
- Risk of pouch separating from the wafer causing leakage
- There is more time and more steps for application
- Higher cost
Examples of Two Piece Pouching Systems
Now that you have a better understanding of a one-piece vs two-piece ostomy system, partnering with your nurse specializing in ostomy care will enable you to choose the best system that’s comfortable and meets your needs.
To learn more about the Ostomy Bag, check out Part 2 of the series here.
For more information on the Ostomy Flange, check out Part 3 of the series here.