Understanding the role of convex skin barriers in ostomy care
AN OSTOMY is a surgically created opening in the abdominal wall through which bowel has been pulled to allow for the drainage of stool or urine.1 For the patient with an ostomy, a pouching system is required to contain the effluent and to protect the skin.2,3 (See Glossary of ostomy terms.) Selecting the right pouching system for a patient with an ostomy is important but not necessarily easy; making a good choice from the multitude of products available isn't always intuitive.4 The right system will ensure that the effluent from the stoma is contained, the patient's peristomal skin is well protected, and the pouching system can be changed on a predictable schedule.2 Failure to achieve these hallmarks of care can negatively impact peristomal skin and the patient's quality of life with a stoma.2,5
Pouching systems include a skin barrier (usually a hydrocolloid base) that protects the skin, and a pouch that contains the effluent. These pouching systems can be either one-piece (the skin barrier and pouch are inseparable), or two-piece (the skin barrier and pouch are separate but attach to each other through a coupling mechanism).2
Skin barriers essentially come in two shapes: flat or convex. This article reviews the advantages of convex skin barriers and their role in ostomy care.