Changing the Appliance


The following steps are for a two-piece system appliance change and are generic. All ostomy companies provide directions for their specific product on the packaging.

Gather All Your Supplies
If using a two-piece system you will require:

Appliance Removal

Stoma and Peristomal Cleansing

Observe the Stoma and Peristomal Skin

Prepare the Flange

Centre the Flange

Attach the Pouch

To Empty Pouch

Special ConsiderationsFor Individuals with an IleostomyAs the stool from an ileostomy tends to be more irritating than that of a colostomy, protection of the skin is very important. Protruding or raised stomas are ideal and help to facilitate protection of the skin. The type of barrier selected can also help to protect the skin as some barriers are more resistant to the effects of the stool and can be worn for longer periods of time (up to a week) without damage or irritation. These barriers are known as extended wear barriers. Regular wear barriers tend to "melt" or wash away more quickly with stool from an ileostomy, and so more frequent changes are required (about every four days).

Pouches for ileostomies tend to be drainable or open-ended. This means that the stool would be drained or emptied into the toilet through the tail portion of the pouch. The tail portion is closed either with a closure clip or a velcro style closure.

For Individuals with a ColostomyThe stool from a colostomy tends to be less irritating to the skin, and because it is usually formed it tends not to undermine the appliance. As a result, stomas for colostomies can be somewhat flush. Again, because the stool tends to be formed, the barrier will not melt or wash away as quickly and so regular wear barriers are usually sufficient to provide a seal. Initially, you may want to change the flange every four to five days, but as the stool becomes more formed and regulated, you may find that the wear-time can be stretched to six to seven days.

Pouches for colostomies can be either drainable (open-ended) or closed-end. Closed-ended pouches are generally discarded when half full of stool. You can discuss options with your ET to see which will best suit your needs and lifestyle. Colostomy pouches may also have the option of a gas filter which will allow the gas to pass out of the pouch deodorized by a charcoal filter. It will not prevent the sound of gas from escaping into the pouch. Using pouches with a gas filter is best when the stool is formed, as liquid stool tends to clog the filter and render it ineffective.