Pre-cut Pouching Systems
Question:
I have had a stoma for several years, but recently I developed arthritis in my hands. It’s getting difficult to use scissors to cut my flanges. Is there anything else I can use?
Answer:
Preparation of pouching systems can be a cause of concern for individuals with ostomies. There can be fear of making mistakes and causing complications to the stoma or the surrounding skin. If you are using a cut-to-fit product, there are alternatives that you might want to try.
Pre-cut Pouching Systems
If your stoma has a regular round shape, then a pre-cut pouching system may be a good choice for you. Most of the major ostomy supply companies have a variety of systems that are pre-cut, both in flat and convex styles. There is usually a wide range available, often starting as small as a ¾-inch (19mm) flange opening, increasing in size with 1/8-inch (3-4 mm) increments, and typically ending with a 1¾ (44mm) or 2-inch (51mm) opening.
Remember when selecting a pre-cut system that the opening of the flange should be 1/8-inch ( 3-4 mm) larger than the base of your stoma. When the opening is the same size as your stoma or smaller, it could cause trauma to your stoma. This is particularly important with convex flanges, as these tend to be firmer than their flat counterparts. Not all styles of pouches come in a pre-cut option, so depending on your pouching needs and preferences, you might need to consider switching to a different product line if pre-cut is desirable.
Using Scissors
If using scissors to cut the opening of your flange is your primary concern, then a flange cutter may be helpful. Nu-Hope Laboratories®, based out of California, (www.nu-hope.com) makes round and oval shaped flange cutters. These tools are essentially like cookie cutters – a cylindrical metal device with a sharp blade-like edge that can cut through the flange. The fine motor movements needed when cutting with scissors are not necessary with this tool, so using it may be easier. Cut the flanges on a solid surface, like a chopping board, to prevent damage to underlying surfaces.
New Technology
A new product, called ConvaTec Moldable Technology™ (CMT), might be an option for your ostomy care. The barrier portion of this product does not require any cutting, but rather uses a special pliable technology which allows you to form the opening to the desired shape and size. Using your fingers, gently roll the inner edge of the flange outward until it matches the shape and size you need. Once the flange is applied, the rolled edge will unravel, eventually stopping when it touches your stoma. It forms a soft cuff around the stoma, which moves with it as it enlarges and shrinks during normal function. Unlike the traditional barriers, you do not need to worry about the direct contact of the barrier against your stoma, as this will not cause any trauma to the stoma itself.
This product is only an option for those with protruding stomas, since without a raised stoma, there is no physical barrier to stop the rolled edge from unravelling, and it will cover over your stoma. It only comes in a 2-piece system, so if your preference is for a 1-piece appliance then this might not be suitable for you. If trying this product interests you, call the ConvaTec customer service line (1-800-465-6302) and ask for samples.
Getting Help
Some pharmacies or medical supply stores offer flange-cutting services, either free or for a small charge. Check with your local supplier to see if this is a possibility for you. Alternatively, you could ask a friend or family member to help you prepare by cutting several flanges in advance for you. There might even be a volunteer, perhaps from a local ostomy support group, who could help with this task. Multiple options exist to help you manage, even with your challenging needs. Your ET can help you to determine which option might be best for you.