My experience of a one piece and two piece ostomy bag

Andy Fletcher

Andy Fletcher

I’ve used both one and two piece, and although I like them both, I now just stick to one piece, mainly for confidence more than anything else.

The very first Stoma Bag you used would have been fitted by the hospital immediately after your operation, and the chances are, it would have been a clear bag, with the contents visible.

This would be by design, so they can monitor your output and make sure things are working as they should be. The bag would also have been a “one piece bag” from a specific manufacturer. The reason they do this is because most manufacturers will have an exclusive deal with the hospital in that they supply the materials for the Ostomist (stoma bag, equipment etc) so that not only can the hospital use these whilst you are in their care, but you will probably be sent home with enough supplies to tide you over for a week or so,

The manufacturers are thus hoping you stick to their products and not those of a rival.

However, there is nothing to stop you switching styles or companies. Some stoma bags are more comfortable than other, some larger than others, and some are opaque rather than clear. Some are concave, others convex…… my notes here though are for people who have “flat” skin.

It’s natural for the Ostomist to want to “shop around”, but where do you start?

I would advise initially to Google “sample stoma supplies”, and you’ll see a plethora of companies who will fall over themselves to give you some supplies. Some companies are more generous than others in the quantity they give you – two or three (in my experience) is normal, but don’t be afraid to call them back for more if you wish. A couple of days in my opinion is not long enough for a “trial”.

What type of stoma bag do you use though? – they fall into two rough categories – one piece and two piece. Most manufacturers have a single model bag that is designed in both categories.

I’ve based this blog on my own observations with both types, and I’ve tried to be honest with the pitfalls I have encountered. This does not mean though that you may have the same problems. We are all different after all, and with different shapes and sizes, but hopefully they will at least give you a guiding point.

One Piece

A one piece stoma bag is exactly what it sounds like – it is a single contained appliance that is designed to be worn for anything up-to around 5 or 6 days (but no more) and emptied as and when required from the bottom.

Do you need a large bag, or are you happy with a mid-sized? – It’s not as silly as it sounds though … a larger bag can clearly hold more, but it will also hang lower on your body. If it can hold more faeces, the chances are you will be tempted not to empty out as often, but this will mean more “pull” on your skin from the weight.

A smaller bag may be more discreet, but you could need to empty out more often because of its limited capacity.

For me, the most important part of a stoma bag is the drain. This is the weak spot on the appliance. A failure here can have devastating consequences (I know this from experience).

The output area of a stoma bag is secured by one of the following three different categories

1 Clips

2 Rigid Plastic Velcro

3 Cloth Velcro

Each has its good and bad points. I have never got on with clips. For me, they resemble “food clips” or cable ties, and I can never get them connected right. Plus, I find them uncomfortable,

Rigid plastic Velcro is exactly what it sounds like – two bits of plastic – one male, one female – they require a bit of force to connect to each other. I’ve never trusted them, and always end up with splashes of excrement on them which is difficult to clean off.

That leaves the traditional cloth Velcro which is very similar to Velcro used in every day usage. I’ve found this uses minimal effort, and once the two sides are connected, the whole lot doubles into itself twice. Simple but effective. I’ve never had a leak using this style of closure.

Another aspect to consider is the filter at the top of the bag. Most contain charcoal to absorb nasty smells, but it creates a “weak spot” whereby liquid can enter (for example, when swimming).

You will be supplied with filter convers – little sticky labels which go over the filters which you can use if you want.

In my experience, the filters do absolutely nothing to deodorise any smells, and I have had several leaks through this area (but only with one type of stoma bag – others are fine). Naturally I expect there are other people who swear by them. Maybe I’m just a smelly person!

The feel of the material on the outside of the bag is very important, as is how well and how easy does it dry after a bath/shower. If (on the rare occasion) I shower with mine on, the brand I use is excellent at repelling water, so it requires only a quick rub down with a towel. It is also one of the most comfiest I have ever used. The difference between the type at the hospital and the one I now use is similar to having a thick and not very bendy material that rustled when you moved compared to a fresh cotton sheet!

That brings us onto two piece appliances. As I mentioned earlier, most manufacturers will have a two piece variant of a one piece. I’d suggest when getting samples, you ask for both.

Two Piece

A two piece has the advantage that you can “unsnap” a dirty bag and replace with a new one without affecting the adhesion of the backplate on the skin in any great way.

A word of warning though … make sure that if you are post op, you are fully healed and some of the bags require force applied against your skin to “snap” the bag in place.

All of the above comments for a one piece will apply to a two piece, so the only thing to consider is how the bag attaches to a base plate.

The base place is designed to stay on your skin for anything up to 5 or 6 days (but no longer) – a great advantage is that you can clear around the stoma thoroughly without touching the baseplate.

I’ve found (again in my experience) that sometimes the baseplate suffers whilst in the shower and starts to peel away slowly – as before though, I’ve only noticed this with one manufacturer – others have been fine.

Some manufacturers use a “clip” system whereas the bag is “clipped” onto the baseplate. Think how a jubilee clip works … this is pretty much the same idea.. These work well, but as I sit down all day at work, I have noticed that it tends to “unclip” itself with nasty consequences.

Another I have used utilises a “push fit” design whereas you simply push to fit the bag on the baseplate. This does work well, but it requires force to push into the grooves on the base plate. I can never fully trust it not to disconnect itself. In all fairness, it’s never happened to me though,

The third type is a sticky pad. The baseplate fits around your stoma and makes it look like your stoma is sticking through a large sheet of rigid plastic. The stoma bag gas a sticky pad which adheres to the plastic base. This does work, and once it’s in place, it stays there. However I’ve noticed that because of the design of the baseplate, the actual bag sits away from your skin somewhat, so it you had a bulge visible with a normal bag, this will be multiplied several times. It’s no good for me because I work in an office (suit and tie), but if you had baggy clothing, it could be ideal/ Another disadvantage is you have to be pretty accurate with “centering” the bag to the baseplate. There is a margin for error, but if you are too much out, some of the sticky parts of the bag will not be connected to anything.

I’ve used both one and two piece, and although I like them both, I now just stick to one piece, mainly for confidence more than anything else. At the moment I’ve found a stoma bag that suits me well, but I’ll keep my mind on trying a two piece again one day as the convenience it has in changing and cleaning is far superior from that of a one piece,

Meet Andy

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