Convex ostomy skin barriers (also known as wafers, baseplates or flanges) are so called because of the way the flange part of the system adheres to the peristomal skin area. In this case, the flange protrudes towards the skin which gives it a ‘convex’ appearance and hence the name. These products are not meant for every patient but mostly for those with certain stoma types. They are used under the recommendation of a doctor or a stoma nurse. Routine use without prescription from these professionals can lead to long-term stoma or peristomal area complications.
Patients who think they can benefit from using convex ostomy products should consult their ostomy nurse who will do a physical stoma and abdominal examination. The nurse will be interested in the physical appearance of the stoma, if any scars, the condition of the peristomal skin and the influence of abdominal folds and contours, if any. It is only after such an examination that the health professional will be able to advise the patient accordingly.
How Convex Ostomy Skin Barriers work
The protruding peristomal convex curvature forces the stoma out. The curvature also creates a more secure adhesive that conforms to the peristomal skin. This mechanism offers superior results in the management of complicated stoma than the standard flat barriers would give.
Convex Ostomy wafers can be part of:
- One-piece ostomy systems: the ostomy pouch and the flange cannot be separated.
- Two-piece ostomy systems: the flange and the pouch are separable. This way, you could change pouches without needing to remove the skin barrier.
Classification of convex barriers according to type
- Fixed convex flange. These are molded and strengthened flanges. Their design makes them ideal for many stoma issues. This type can further be divided into the deep or moderate convexity depending on the degree of protrusion.
- Non-fixed convex flanges. These are made with plastic rings which are fixed to standard flat flanges. The attachment creates a convex appearance which is usually not as deep as that seen in fixed convex flanges. However, non-fixed convex flanges tend to be soft and more malleable so that it easily adapts to the body’s contours.
A combination of these different types of convex flanges and the respective ostomy system they are a part of allows a wide variety of products for the health care giver and the patient to choose from.
Indications for ostomy convex products
In general, convex products are used in cases where a flat flange would not be effective in preventing stomal discharge and leakage. Six common situations include:
- Flat or introverted stomas
- Post loop-ostomy surgery. This type of stoma is almost always retracted
- Wrinkled peristomal skin
- Irregular surgical scars
- A Telescoping stoma. These are stomas that protrude when the patient is upright but retract when reclining.
- Flabby uneven abdomen
Complications associated with using Convex Ostomy Skin Barriers
The main mechanism of convex ostomy products is persistent pressure on the area around the stoma. This pressure can cause problems in the peristomal skin, including:
- Skin irritation,
- Redness and pain
- Skin lacerations
- Stomal injury and bleeding
- Infection and gangrene formation
- Peristomal hernia
To improve the efficiency of convex ostomy skin barriers, accessories such as ostomy belts can be used. These belts assist holding the convex flange more securely to the peristomal skin area.
As with standard flanges, convex types are manufactured as pre-cut or cut-to-fit and their use should be determined after consulting with your health care provider.