A closed ostomy system is one of the types of ostomy pouches available to patients. The main considerations made when choosing this system include those listed below.
- Patient’s comfort
- Patient’s safety
- Patient’s ability to apply the pouch
- Frequency of pouch emptying
- Consistency of the discharge
- Location of the stoma
- Duration of wear
- Height of the patient
- Abdominal contours
- State of the peristomal skin
- Shape of the stoma
- Cost of the ostomy supplies
Nature of the closed-end ostomy systems
Available as one or two piece pouch systems. The closed-end ostomy system is disposed after each pouch change because it is completely sealed unlike the drainable type where the contents can be discharged. In the latter there is a feature for emptying the pouch, rinsing and reusing it. The closed ostomy bags are used mainly in patients with less discharge and one that has a more solid consistency. Most closed systems have a special filter that reduces odor and gas accumulation by absorbing target odors while allowing gas to escape. Closed pouch systems are also available with pre-cut or cut-to-fit flanges.
Advantages of Closed Ostomy Pouch Systems
- They are quick to change
- Some brands offer flushable options that are readily available and can therefore be environmentally friendly.
- Increases patient confidence as chances of accidental leakage diminishes. Complicated drainable systems increase the risk of something going wrong before it is time to drain the bag.
Closed Ostomy Pouch Systems are ideal for:
- Patients who perform stoma irrigation
- Ideal for patients who find cleaning and reusing too cumbersome.
- Patients with well-formed stools
Disadvantages of Closed Ostomy Pouch Systems
- Not ideal for liquid discharge. This makes it inappropriate for use in urostomy.
- Stressful for the patient when traveling or when in social settings. Appropriate disposal facilities may not be available in places away from home.
- If a one piece pouch system is used, the repeated changing of pouches can increase risk of skin irritation and inflammation.
Closed pouch systems are made in various sizes and shapes depending on the manufacturer. There are different colors and shades to cater for different patients’ tastes.
Precautions to take with a Closed Ostomy Pouch System
- Avoid the pouch from becoming distended with gas. An incorporated charcoal filter can help prevent this situation.
- If the discharge should change to a looser consistency, a switch to a drainable type is usually recommended. It is also important to identify the cause of changes in the discharge consistency by consulting with a physician whether it is due to a nutritional cause or a disease process.
- The pouch should ideally be emptied when 2/3 to 1/2 full.
A patient can feel overwhelmed at the options available in the search for the right ostomy pouch type. Speaking to an ostomy nurse before leaving the hospital will help the patient make a decision on whether a closed pouch system is the best for them or not. It also assists the patient in understanding why the ostomy nurse or physician has recommended a particular type of ostomy system instead of others.