Ostomy Product Reviews-Flat Barriers (stoma pics)

 

I am sharing my personal experiences with the flat barrier appliances I tried; included are Hollister, Nu Hope, Convatec and Coloplast.

This is the Hollister pouching system I've been using since my surgery two months ago, which is the clear bag (just recently started using the one with filter, but to me makes no difference) and the flextend barrier. I was taught by my stoma nurse to use the Coloplast moldable barrier ring, but I'm recently finding that it works better without the ring and I just cut my wafer smaller to fit closer to my stoma. Now that Bob is almost half his size from surgery, the ring makes Bob shorter in the bag, and in the mornings it is already more inside/not protruding as much so the ring makes it more flush to my skin, causing premature leaking under the barrier. However, sometimes I accidentally cut the wafer a tad too big, in which case the moldable ring works well to fill the space so at least I'm not wasting products. I do love this wafer; the adhesive works well and is also great for my sensitive skin. Unfortunately, the plastic on these pouches is thin and rustly, and I've been having issues with the roll-up end leaking after a day or two also. I am currently trying different products and am hoping to find the "perfect" system for me.

1-26-2021: I just put the Nu Hope bag on. It is thicker plastic and I like how the end fastens better than the Hollister bags, seems more secure (I often get leaks at the roll-up end of the Hollister bags by day 2-3). I like that it's smaller barrier with no plastic flange and lays flatter, and the adhesive seems to be really sticking to my skin so far. But the foam is kind of weird because it doesn't lay flat around it like the tape barriers, but it is comfortable. I'll probably put waterproof tape around it before swimming or bath to see if it'll last....update to come

1-27-2021 I put this waterproof tape (ordered on Amazon, not an ostomy product) around the barrier of the Nu Hope one piece appliance before taking a bath, as I was afraid the foam may not be very waterproof. The pouching system is still in place perfectly, but the real test will be a swim and a run! So far it's comfortable and working out well!

1-28-2021:  So this appliance lasted two days before leaking behind the flange this morning....but you can see the waterproof tape does wonders for containing the leak so that it did not make a mess and allowed me to change the pouch system easily and mess free! Of course, you do not want to go long with the output against your skin as it can cause irritation, but at least this does allow time for the change. So I believe this bag would last longer, but I enjoyed a hot bath each night, plus an hour run and a few hour walks so two days isn't too bad, seeing how it held up through water and sweat. I did not get to try swimming yet, but today I put on my second sample of the same bag and am planning to swim with it, so we will see how it holds up with an hour in the pool. Even if it just lasts for two days with my active lifestyle, it is worth the comfort that it has provided! I didn't think I would like a one piece system as I have only used two pieces the past two months and enjoyed switching out between the mini and the full size pouches, but this is great for more comfort and flexibility of not having the plastic flange in the way, and also without the fear of the bag popping off the flange or leaking around it. Another thing worth mentioning is that the plastic is thick and I did not smell it at all; the Hollister plastic is thin and I can smell it after the first day, at least with the transparent pouches (according to ostomates I've met in support groups it seems there is an issue that we think we smell it but nobody around us can, but since I don't smell this one I think I was indeed smelling it thru the bag even if nobody else could). I still have other Hollister pouches to try and will post reviews on those below. Only, I was planning to try the Nu Hope barrier disk (pictured above) with this next sample, but I forgot! I am going to order a supply of these bags this month, though, so I will try it and post my review once I get my supplies 😃
1-29-2021:  I just want to update that the second Nu Hope 1-piece pouch that I put on yesterday morning held up through last night's bath and also an hour swim today (with the waterproof tape around the flange). It did start leaking behind the barrier about two hours after I got out of the pool, so this time was a little less than two days....although with the first sample I accidently cut the barrier too big and used a moldable ring to fill it in, and with the second sample I also cut the barrier a tad too big but closer than the first time and didn't use a moldable barrier. So the leaks could also be a bit of user error. I do like how these feel and the thicker plastic is nice, so I will order a box for a longer trial.

These Convatec barrier extenders are nice as they are thin and do not hold onto water when they get wet, unlike the Coloplast barrier strips. These also did the job of keeping a leak at bay when I had a leak behind the barrier [so I was able to change my appliance once I suspected the leak, without having a mess]. At first I did not think these extenders were going to work, because they didn't stick completely all around when I first put them on, but I held them down with my hands for a few minutes and then put my Hollister belt on my flange and went to bed (I put these around my barrier before bed, as my flange was starting to come up around the edges after my bath). Well, in the morning I was surprised to find these tape extenders were stuck onto my skin and barrier very well, great adhesive strength! They allowed my appliance to last another two days after the barrier started coming off my skin.

This is a Hollister skin barrier to wear under the wafer and protect the skin. I am trying this under a 1 piece Hollister pouch because I have some skin irritation. This should help my skin heal under the wafer and protect it from further irritation from output. To update, this only lasted a few hours on my skin because I ended up getting a major leak behind the barrier; Bob was playing peek-a-boo all night!(see explanation on Types of Skin Irritation post) I will have to try it again in the future to give a complete review, but for now I can say it was comfortable; my irritated skin didn't itch while it was on and it didn't create bulk under the wafer!

This is to show that the Convatec pouch works with the Hollister flange (although it takes a lot more pushing to get it to click on all the way around but is a great seal once on), and also this day you can see that the upper right corner of the barrier was starting to come off my skin; this is when I would use the barrier extenders to make the appliance last a bit longer, usually another two days and that's with swimming and bathing. I was using the Convatec pouches with the Hollister barriers because I got a handful of samples and like how the end of the bag can be rolled into a pocket at the end of the pouch and conceal the end as well as make the bag a bit shorter, and I like that the pouch isn't see through (for the first few months I was getting the clear Hollister pouches to keep an eye on Bob and learn about how foods affect my output, as a new ostomate). The Convatec barriers I tried were nice in that they were moldable to the stoma, so no cutting necessary and creates like a turtle neck fit around the stoma keeping leaks at bay, but the adhesive caused bad irritation on my sensitive skin after only a day! 

 

This is the first appliance I tried from Convatec. I love that there is no need to cut the barrier, it is moldable around the stoma. So just put it over the stoma and it molds itself around it like a turtle neck and the seal only gets better as the barrier around the stoma absorbs moisture. Therefore, a moldable ring is not necessary as this is a sort of two in one. This system wasn't for me, though, because the adhesive backing irritated my skin so badly after only a few hours of wearing. Also after coming home from a swim it was half falling off, but it ended up being a good thing since my skin was already getting raw underneath. Another thing I wasn't too keen on was that the plastic flange on the barrier that the bag clicks onto is fixed instead of floating; this is great to make it lower profile under clothing but it means you have to push onto your abdomen all around the stoma to get the bag to click on and it was a little difficult for me to get it completely clicked all around, especially since I tried this a few weeks after my surgery while I was still fairly sore. Perhaps it would be okay later on, after full healing, for someone who's skin doesn't react to the adhesive. Also, it didn't seem to be good for water sports since it started coming off right after a swim, though that could have been because my skin was not happy with it as well.

This was the second sample Convatec sent me, but I don't have any more of the pouches as I used them with the Hollister barriers. I couldn't figure out the difference between the flanges, this was the exact same as the first one (reviewed above). It's also a moldable barrier and has the same tape backing where the adhesive irritated my skin after only a day; I ended up taking it off prematurely because of itching and burning, though there was no leak my skin all around where the adhesive was around Bob was awful red and had a couple tiny areas of broken skin that were bleeding. Though the pouch was nice in that it was opaque and thick with a peek window to check on the stoma, and the roll-up tail end folds up into the bag. The adhesive just doesn't work for me. I have a urostomy friend who told me about a non tape barrier they have, so I will ask if I can get a sample of that one to try when I follow up with Convatec.

This is the Hollister Flextend flat wafer two piece system, shown with the mini pouch. This flextend barrier was great for extended wear and also lasted through a few swims, runs and long baths before it began to pull up on the edges. This was the best wafer I had tried that lasted the longest for my active lifestyle, and they didn't even need the barrier extenders or waterproof tape to last in the pool! Unfortunately, the flextend in convex barrier is not the same as it starts to pull up on the edges and come off completely with one swim or bath, even on the first day of wear! I don't know what makes it different as it's supposed to be the same tape border for extended wear, but it's not nearly as good in convex. This mini pouch is good for swimming in which the pouch is concealed better under a swimsuit, but also in outfits like more fitting dresses and shirts in which you are trying to conceal the bag. But super important, is that you must remember to empty the pouch more often as it doesn't hold as much and will cause an appliance failure quickly if left to fill too much. As I state in later reviews, I don't like the filter bags as much, and for swimming or bathing it's recommended to put the filter sticker or some waterproof tape over the filter first.

This is the Hollister system with the barrier that is good for helping to heal irritated skin and prevent further irritation, and it has a non tape border which is nice for sensitive skin. Instead, it has an adhesive over the entire barrier which helps it to stick better. The barrier is thicker and more rigid, and it swells and comes off prematurely with water exposure such as swimming and bathing, so I find it works much better with the large Coloplast barrier extenders (the last product review on this post). I actually have not tried this flat barrier because of Bob's peek-a-boo games causing leaks (explained in another post, "Peek-a-boo Bob"). But I'm currently using the convex version, which will be in the convex barriers product review post soon!

This is the same Hollister 1 piece appliance as reviewed right below, the only differences are that this bag does not have a filter or peek window. I prefer the peek window, but do not like the filter too much because they usually work too well the first few days, causing a vacuuming of the stoma and this leads to leakage under the barrier; there is no air to allow the output to drop to the bottom of the bag and this "pancakes" output puts pressure on and round the stoma allowing further output to push behind the flange and cause a leak. After the first few days, if it lasts that long, the filter will get clogged and not work at all. So, in my oppinion, the filter is pointless and only causes issues.

This is a 1 piece Hollister appliance, so the wafer and pouch are attached. Being the wafer is attached to the pouch without a flange, it has a lower profile under clothes and it is also more comfortable than the two piece with the plastic flange (in my oppinion). This pouch has a filter and a nice peek window at the top so that you can check the stoma when needed, which is nice since this is a beige bag instead of clear. I am trying the Hollister Flextend skin barrier underneath to help heal some skin irritation I have and also protect the skin from further damage. The next two pics below show how the pouch looks on and the peek view, also how the wafer is flat on the skin. It feels quite comfortable to me so far. As an update, this appliance only lasted a few hours because I ended up with a massive leak behind the barrier, but it was because Bob was playing peek-a-boo all night. I will be switching to the convex wafers due to the way Bob is moving in and out of my tummy so much lately.

This is the same Hollister 1 piece appliance as above, only there is no filter and the pouch is clear so you can keep an eye on the stoma and output. This transparent bag is recommended the first few months after surgery.

This is a Hollister pouch that uses a clip closure on the drainable end instead of the hook and loop type of closure. In my oppinion, this clip is more difficult to use than the hook and loop "velcro" type and the clip is bulkier and more rigid. The biggest thing is that the pouch end is hard to clean because it is floppy; because it doesn't have the rigid plastic of the hook and loop type end, it's harder to open and clean the end. The next thing is that I'm afraid of dropping the clip (what if it falls in the toilet?! Even the floor of a public bathroom is seriously gross, though) when I remove it and also afraid of it breaking. Getting the clip back on correctly is also challenging to me, but I've only tried this type once so far, possibly I just need more practice. But I prefer the other type closure.

Coloplast Sensura Mio 2 piece Click
I was unable to try this product as well as the 2 piece Flex below because Bob has been playing a new peek-a-boo game causing leakage under the flat barriers. Therefore, trying these products would be an unfair review since it will not last due to my stoma, not the fault of the appliance. I will be trying these products in the convex barriers and posting new reviews in a different blog post

This is the Sensura Mio 1 piece pouch from Coloplast.....I really wanted to love these, but the one I tried yesterday was a nightmare. I had a major leak after only three hours; the barrier below my stoma had completely come off. I made sure I cleaned my skin with only water and a washcloth after removing the prior pouch so that nothing would interfere, and after I put it on I didn't do anything except sit and talk with a friend who came to visit. Thank goodness I was home! I recently read a post on a support group saying to warm up the barrier before putting it on to help it adhere, so I will try that with the next one. For now, I'm back in my trusty Hollister and will try another Coloplast later after my swim. However, I do love the pouch which is different from all the others, as it does not have fabric over it so it would be more waterproof and dry quicker. Also it's so cool that the pouch can fold up into itself with velcro and make a mini pouch (this is shown in a pic above with a 2 piece system, but all the pouches are the same in construction, it's the barriers and how they adhere to the flange that is different). The plastic is very thick, the bag is opaque and there is a peek window at the top where you can pull it back to check on the stoma. 
Update on this Coloplast 1 piece: I realized the prior leak with the first sample I tried may have been Bob's fault because I went through three additional appliances that night due to Bob's peek-a-boo game!(explained in the "Types of Skin Irritation" and "Peek-a-Boo Bob" posts) So probably not the fault of the wafer, I am trying it again; Bob has been well behaved and it's usual protruding self today, so it should be safe! Because of all the prior leaks Bob created, I have some pretty serious skin irritation and therefore did a crusting technique with antifungal powder and Cavilon film before placing the Coloplast barrier. I also heated up the wafer same way I do with the moldable barrier ring, by placing it under my armpit for a few minutes, and I placed a barrier ring around Bob underneath also. Then I stuck the Coloplast barrier extenders around the wafer to help it stick better. Though, I must say heating up the wafer made a difference in how it adhered to my skin more smoothly.

This is the Coloplast Sensura Mio 1-piece with the large Coloplast barrier extender strips. Because the strips are so large around the rather large barrier, I had to cut a slit where it goes into my navel. 

Coloplast Brava Elastic Barrier Strips in two sizes: these barrier strips work well to extend the wear time of the wafer that starts to come off the skin at the edges, but that's still sealed around the stoma and not leaking, same as the Convatec barrier strips that I posted above. I like these better than the Convatec in that they seal to my skin and the wafer as soon as I put in on, but I don't like that the Coloplast strips swell a little when they get wet after a bath or swim; this is probably a good feature for a leak behind the barrier, but not for swimming when I'm planning to keep it on for at least a few days as having the moisture against the skin in the strips I think could cause skin breakdown. So I take off my appliance when the barrier strips get wet and swell up. As for the different sizes, I like the larger size best because it covers the entire wafer around the flange and also more of my skin for adhesion, whereas the smaller one covers just half the width of the wafer. I'll post pics comparing the sizes around the wafer and also an after swimming pic to show how they absorb water.

This is to show how much of the wafer the smaller barrier strip covers in comparison to the large strip, shown below:

This is the large Coloplast barrier strip; you can see it covers all the wafer to the plastic flange as well as my skin around it. 
The next two photos were taken after a 40 minute swim today, where you can see how the barrier strips absorb water and swell.