There is minimal research and literature available in relation to ostomy belts. The most basic ostomy care routine requires a skin barrier or wafer that goes over the stoma to protect the skin and an ostomy pouch to collect waste expelled by the stoma.
Ostomy pouching systems are available as a 1 piece or 2 piece system
A 1 piece system simply means that the skin barrier and the pouch are integrated and inseparable, whereas a 2 piece system just means that the skin barrier and pouch can be separated by a built in coupling system.
Anything else after these two basic components are considered accessories that may or may not be necessary for patient care.
There are a whole range of accessories that may be appropriate for ostomate care that offer a wide spectrum of uses and solutions for potential needs of patients.
However, by adding accessories to your ostomy care arsenal, you also add cost, complexity and time required in order for the patient to complete their routine ostomy change.
It is critical to understand why certain accessories are being added to a patient’s daily life. The majority of accessories are made to protect the peristomal skin and the stomas themselves from effluent and mechanical trauma from day to day wear.
Because these principles have been incorporated into ostomy care both from a clinician and manufacturers’ standpoint, other considerations such as preserving patient dignity is extremely valuable as an ostomy is a life altering procedure for patients and often affects their body image and general sense of well-being.
Promotion of simplicity in order to ensure the patient can replicate self-ostomy care easily is the ultimate goal as well as containing costs for the patient as these can be quite high when viewed over a years’ time.
Ostomy belts play a part in support
The role of ostomy belts is to add support to the pouching system they are being used on, especially in the case of ostomy hernias. Ostomy belts are elastic and most are about 1 inch in width and have a variety of lengths and sizes with the longest being around 154 inches in length, though they can be adjusted to shorter lengths.
At either end of the elastic there are hooks where the ostomy belt can be attached to the belt tabs that are either on the barrier or pouches, depending on the type of ostomy system.
Belts can sometimes be confused with binders which are much larger. There are a wide variety of bands and binders that have been developed for better concealment and to better assist in the prevention of hernias though these have different advantages and disadvantages that will not be covered in this article.
So why ostomy belts? Primarily to support pouching systems in a variety of ways. By using a belt you can enhance convexity of flanges, so when you use a belt, you pull that convexity into the abdomen, enhancing its effects.
Also, by securing the weight of the pouch caused by high output stools filling the stoma pouch, patients feel much safer and comfortable knowing their ostomy belt is providing support.
Some individuals are very active and when they contort or move from side to side, many fear their ostomy system will lose its grip so belts provide that sense of security.
It is nearly impossible to find belt tabs on flat 1 piecepouching systems and for good reason since there is no rigidity present in the coupling mechanism like you would see in a 2 piece system.
As such, the ostomy belt might distort the entire flat 1 piece pouch opening, making a round hole distort into an oval shape when pulling an ostomy belt with a belt tab. However, there are 1 piece convex systems with belt tabs but as mentioned they are rare.
Belt tabs are located on the barrier itself or on the ostomy pouch. When belt tabs are on the barrier in a 2 piece ostomy pouching system, it’s actually easier for someone when switching their type of pouch because the ostomy belt can simply stay attached and support the flange without having to remove the belt in order to remove the pouch.
One of the most important aspects of ostomy belts is correct positioning. Belt tabs are located on the sides of pouching systems that run parallel to the ground, creating a natural plane of support around the waste. Hence, belt tabs are positioned at 3 and 9 o’clock in order to ensure proper use.
Besides positioning, the ostomy belt cannot be too tight or snug as it can distort the pouch and cause the pouch to pop off or leak from the sides where the belt tabs are.
Knowing how much is enough tension or not enough is actually difficult to describe but recognize the fact that different pouching systems will behave differently with regards to tension created by the use of ostomy belts.
Therefore, it is advised you carefully place the other end of the ostomy belt near the other belt tab before stretching around the waist in order to avoid the hooked side from causing an off center position.
If the belt is too loose or too tight simply make the adjustment in order to have the right amount of tension. To make sure the tension is just right, you should be able to very comfortably stick 2 or 3 fingers underneath the belt. If the belt is flapping around the waist then the patient is not getting any support from the belt.
Remember, wearing the ostomy belt should be in line with the belt tabs itself at 3 and 9 o’clock not off position or off center, this cannot be stressed enough.
The belt should also not be higher or lower from the belt tabs as overtime it can cause what is called ‘pouch drag’ and really damage the peristomal area with ulcerations area since ostomy belts sometimes ride up on the natural waistline during daily movements and shifts so it’s important to ensure secure and proper placement.
Excessive tension from the ostomy belt can also cause peristomal ulcerations due to the pressure from the belt tab connections themselves causing erosions into the surrounding skin.
Too much tension may also cause the belt itself to play a role in irritation into skin folds towards the sides or back of the patient as well. Gauzes or other soft material may be required around the ostomy belt to prevent that sort of frictional trauma from occurring.
Belts typically last between 2-3 months. Avoid hot water to cleanse them because it will break down the elastic as will using a dryer.
The basics of accessories is that whatever you are doing it is important to keep it simple and not do it without purpose as adding complexity to ostomy care is not recommended. Belts are common accessories and utilizing them on the principle of care is what is ideal.