Filling the Gap with Soft Convexity

Problem: Convex ostomy barriers help to solve pouching challenges and decrease leaking in areas of abdominal creases or folds and with retracted stomas. The increase in obesity and BMI in the US has likely contributed to the reported doubling of incidence of stomal retraction in recent decades. Until recently, there are few covnvex options available and ostomates continue to experience leaking

Past Management: Convex barriers are often recommended with retracted stomas to help with protrusion.  Convexity can also help keep peristomal skin flat within creases and folds.

Current Approach: Light or firm convexity may provide the right depth and curvature to provide a good seal, however, a more flexible convex barrier may be needed to conform to the abdominal contours, prevent the barrier from popping off, decrease pressure on peristomal tissue, and be more comfortable for the patient.  

Patient Outcomes: Three case studies demonstrate use of flexible, soft convex barrier to fill the gap in current options.

#1: transverse colostomy in deep abdominal crease. Frequent leaks with traditional convexity and was uncomfortable in belt. Soft convex one-piece appliance appreciated 2-4 day wear time increased comfort without belt.

#2: flush, end-ileostomy; downward-pointing os within firm bowl. Leaking 1-2 times daily with traditional convexity two piece. One-piece, precut, soft convex appliance increased to 3 day wear time and significant comfort.

#3: flush, end-colostomy in soft, obese abdomen. Five days wear time with traditional convexity. Deep, purple ring noted at appliance change. With soft convexity one-piece, reports increase comfort and no pressure ring was visible on next appliance change.

Conclusions: The soft convex barrier was found to provide an improved fit in many clinical applications. All patients found the barrier to be more comfortable. Further research would be indicated to determine in which clinical situations soft convexity would provide the best outcome.