One-Piece Ostomy Bags vs Two-Piece Ostomy Bags

Everyone remembers the first day of school or your first day at work, you are told a million things, and you know you need to remember them, you know everyone expects you to be able to accomplish the job.  It can be very challenging to remember all the details!  When it comes to having a new ostomy, I am sure it feels like having a new job and there is a lot to learn and apply.  I am going to highlight some of the big differences between a One-Piece Ostomy Pouch System and a Two-Piece Ostomy Pouch System.  I am going to try and look at the pros and cons for both and what situations would benefit from either variation.  Obviously, it is going to take time and the help of a trained WOCN nurse to find the system that works best for you.

A One-Piece Ostomy System is where the bag and the adhesive base plate are one system.  The base plate is called several different things, it is known as a flange, wafer, skin barrier, and/or a base plate.  Basically, it is the piece of the ostomy bag that attaches to the skin around your stoma.  In a One-Piece Ostomy bag, the bag and wafer is one item, you can not separate them. 

The advantages to the One Piece Ostomy Pouch are as follows:

• They have a lower profile which means they are less visible under clothes. This can be helpful when you are wearing a more fitted style of clothing.
• The bag and wafer/flange can not be separated so this can feel more secure, since there is zero chance of the bag and flange coming apart.
• One-Piece systems are generally less expensive than Two-Piece Ostomy systems.

The disadvantages to the One Piece Ostomy Bags are:

• Changing the wafer or flange at every bag change can make your skin tender and cause some irritation.
• Anytime you change the bag, you have to get everything positioned around your stoma right, which can take time, and be cumbersome in a public restroom.
• You will go through skin barrier pastes, tapes, and adhesive removers more often.

A Two-Piece Ostomy System is where the ostomy bag and the wafer (flange) are two separate items.  With most manufacturers you order your ostomy bag and your flanges/base plates separately.  However, they do come in kits as well. This makes the Two-Piece Ostomy System more versatile.  You have more options for the style of the wafer you prefer as well as choosing which size or style ostomy bag works for you depending on the activity you are involved with at the time.

The advantages to the Two-Piece Ostomy System are as follows:

• Flanges or Wafers can remain in place for two to four days, which is gentler on the skin.
• You can change the size of the bag you are using; smaller bags can be great for intimacy or swimming.  You could then change to a regular size bag when your activity was completed.
• Bag changes are fast, the old bag can be removed and a new one attached quickly and easily. This is perfect for running errands, parties, or anytime you are away from home.

The disadvantages to the Two-Piece Ostomy System:

• Can be more bulky than a One-Piece making it more visible under clothing.
• Bag and flange (wafer) can come apart and cause leaks.
• If the stoma output gets behind the flange, it can be harder to see since you are changing the flange less often.
• Generally the Two-Piece System is more expensive.

When caring for your ostomy, there is a lot to consider and it will take time to discover which option works best for you.  Do not be scared to try new products and styles, your WOCN nurse is an excellent resource for advice and tips on which system works the best for you.  If you want to experiment with a new system it is best to try it out on a day when you can be close to home, just in case it doesn’t work out well for you.  I hope this break down on One-Piece ostomy pouches vs Two-Piece Ostomy pouches was helpful.  Next time I will discuss closed pouches vs drainable pouches.