Approximately 750,000 Americans have an ostomy — a surgically created opening connecting an internal organ to the abdominal wall for waste elimination. Colostomies (large intestine diversion), ileostomies (small intestine diversion), and urostomies (urinary diversion via ileal conduit) each present distinct management challenges. Quality ostomy care, including proper pouching system selection and peristomal skin management, directly impacts quality of life, complication rates, and healthcare utilization — patients with well-managed ostomies have hospitalization rates 60% lower than those with ongoing peristomal complications. Our urology and ostomy catalog includes over 19,000 products from Coloplast, ConvaTec, Hollister, Salts Healthcare, and Cymed.
Stomal and Peristomal Assessment
Stoma assessment documents: stomal type (end vs. loop), color (should be beefy red — pale suggests ischemia, purple/black suggests necrosis), mucocutaneous junction integrity, height and diameter, and output characteristics. Peristomal skin should be assessed using the Ostomy Skin Tool (OST) or Discoloration-Erosion-Tissue (DET) scoring system. The most common peristomal complication is peristomal moisture-associated skin damage (PMASD) — erosive dermatitis from leakage under the skin barrier. A properly fitted and maintained pouching system prevents the vast majority of PMASD episodes.
Pouching System Selection
Pouching systems consist of a skin barrier (wafer) and a pouch, which may be integrated (one-piece system) or separate (two-piece system with coupling flange). System selection depends on stoma characteristics, abdominal contours, output volume and consistency, activity level, and patient dexterity. One-piece systems are lower-profile and simpler to apply; two-piece systems allow pouch changes without disturbing the skin barrier, reducing peristomal skin disruption. Convex barriers — with inward curvature that improves the seal on flush or retracted stomas — are indicated for stomas below skin level. Coloplast SenSura Mio, ConvaTec Natura, and Hollister Moderma Flex are leading product lines available through our ostomy catalog.
Skin Barrier Accessories
Barrier rings, strips, and pastes fill irregularities at the peristomal skin surface and extend wear time by preventing undermining at the barrier edge. Barrier rings (Coloplast Brava, ConvaTec Stomahesive) have largely replaced paste in modern practice for their ease of application and superior fit. Adhesive remover sprays or wipes reduce trauma during barrier removal — particularly important for thin, fragile peristomal skin in elderly patients or those on corticosteroids. Convex inserts can convert a flat barrier to mild or deep convexity without changing the full system.
Irrigation for Colostomy
Colostomy irrigation — instilling warm water via the stoma to stimulate regulated bowel evacuation — may allow select sigmoid colostomy patients to achieve 24–48 hour pouch-free intervals using only a stoma cap. Candidates must have formed stool output (sigmoid or descending colostomy), physical capability, motivation, and absence of Crohn's disease or radiation colitis. Irrigation kits include cone-tipped catheter, irrigation sleeve, and water reservoir — all available through our urology and ostomy catalog.
