Overcome Difficult Pouching Situation Using Karaya Ring Drainable Pouch

There are some pouching situations that are extremely difficult to manage.  This may be a result of the location of the stoma, abdominal contour, and/or stomal and peristomal skin problems.  A wide variety of products have been tried yet the pouching system still leaks within 24 hours causing skin irritation and patient discouragement. This is a frustrating situation for all involved.

This poster presentation will highlight three cases using a one piece precut drainable pouch with an attached karaya ring with clip closure. This pouch has been available for over 20 years and is often overlooked as newer styles of pouches have become available.  Karaya is the natural product of trees of the genus Sterculia that grow in India and Africa.  This gummy exudation has been used for such diverse products as ostomy rings, denture adhesives, and as an ingredient in ice cream and laxatives.

The tape collar on this pouch can be trimmed to the karaya ring which then requires ¼” of attachment space making it ideal for small surface areas. The karaya seal tends to melt down quickly when exposed to watery effluent. Using additional skin barriers, either rings or custom cut washers, over the karaya helps to prevent this meltdown from occurring.

In our practice this one piece precut drainable pouch with attached karaya ring with clip closure is used in many difficult pouching cases. Situations in which this pouch has proven effective include body surfaces with limited adherent space such as close to open incisions, peristomal contours requiring very shallow convexity, or peristomal tissue needing a small to moderate degree of support. This pouch, along with the use of various skin barrier washers, pastes, powders, or belt, was able to maintain a satisfactory seal, protect the peristomal skin, and improve the patient’s quality of life.