Stoma appliances

Patients are usually discharged from hospital with a two-week supply of a variety of stoma bags and no accessories (unless assessed and deemed essential). This allows time for the patient to try a variety of products, before a regular order can be placed.

There are two basic types of ostomy bag available as one-piece and two-piece appliances. The site and nature of stoma as well as cosmetic acceptability of appliance type by the patient will determine which bag is most appropriate to use.

The stoma care nurse specialists will provide each patient with a choice of appliances suitable for their individual needs.

One-piece systems consist of a pouch and a seal (adhesive flange) as one item which is placed around the stoma and attached directly to the skin and as such are easy to apply and are not bulky on the patient’s abdomen. This system comes either with a pre-cut opening or an opening that can be cut to fit the stoma.

Two-piece systems have two parts, a base plate (flange) which attaches to the skin onto which the patient can clip a separate pouch. The base plate is usually changed every 2-3 days, whereas the pouch is changed on average about 2 or 3 times a day. This system comes either with a pre-cut opening or an opening that can be cut to fit the stoma. This system has the benefit of protecting the skin because the base plate is changed less often than the ‘one piece’ systems.

Closed appliances are used for colostomy patients. These bags cannot be re-used and are discarded once filled.

Drainable appliances are used for ileostomy and urostomy patients and are either designed with Velcro or a clip fastening or “non-return” valve and tap for semi-liquid or liquid effluent respectively. These bags can be re-used once emptied

Accessory products can be useful for problematic stomas but, generally, stoma care should be kept as simple as possible.

Out of hours emergency supplies may be obtained from some Community Hospitals or according to local arrangements. The stoma care nurse specialist is responsible for maintaining an adequate supply of closed and drainable appliances.

Prescribing quantities of a stoma appliance

Stoma appliances should always be prescribed by brand and not generically; this generally takes the format of the manufacturer’s name, a description of the product and the manufacturer’s code.

Colostomy bags are changed 1-3 times daily, depending on the patient’s need. Average use per month would be 30-90 bags. (30-90 bags, one-piece and two-piece systems).

Ileostomy bags are designed to be changed every 1-3 days, average use of 15 bags per month but some patients may use a new bag daily. (15-30 bags, one-piece and two-piece systems).

Urostomy bags require emptying several times in a day. The bag can stay in place for up to three days but is usually changed every day or every other day. (10-20 bags, one-piece and two-piece systems).

Urostomy patients usually require a continuous drainable night bag to avoid the need to empty a bag during the night. Tubing and connectors for fixing a night bag will be required. A night bag should be emptied and washed through with warm water daily. Night drainable bags and tubing are usually changed 1-2 times a week.

  • Stoma bags can also be customised (cut to size) if requested, which is especially useful for elderly patients and those who have difficulties manipulating scissors.
  • Some appliance wholesalers may offer night bag stands and other products, e.g. mattress protective covers on request free of charge, although others may charge the patient

Some patients may require a higher or lower quantity than stated. If there are any prescribing concerns, please refer to stoma care nurse specialist for detail or further assessment.

Additional products such as barrier cream, skin protector wipes/spray, powders, adhesive remover, washer and pastes, deodorants, retention strips and support garments may be essential for problem solving with stoma complications or to extend wear time and increase confidence.

Stoma appliance supports


A belt is used to give extra support to the base plate to keep an appliance in place. Useful if the abdomen is uneven or rounded,

Normally replaced six-monthly, maximum three per year

Ostomy support garments

These garments can be beneficial for patients to prevent parastomal herniation or for added discretion with their appliance. If a patient requires a support garment they should be assessed, measured and fitted for this by a specialist stoma nurse.

Some manufacturers also produce light support garments and underwear which are available on prescription or to purchase.

Prescriptions for these items will only be made if there is an identified clinical need.

Patients who are a high risk of hernia may be prescribed these products as preventative treatment. If a hernia exists, there will be communication between the stoma care nurse specialist team and the patient's own GP. This communication will include the measurement and request for supply of one item only to check that patient is happy with the product.

Patients requiring light support garments should be advised to purchase these items directly from the manufacturer or other retail outlet.

Guidelines for changing a stoma appliance

Equipment Required

  • Disposal Bag
  • Tissues / Dry Wipes
  • Warm Tap Water
  • Measuring guide
  • A new appliance
  • Scissors
  1. Get all equipment ready before you start.
  2. If a drainable pouch is used, empty first.
  3. Gently peel the appliance away from the skin, using one hand to support the skin to prevent trauma.
  4. Fold the flange of the used pouch in two to seal and place in disposal bag.
  5. Using a dry tissue, first remove any soiling from skin and stoma.
  6. Using a wipe moistened with water, wash the stoma and surrounding skin.
  7. Dry the skin thoroughly.
  8. Measure stoma using measuring guide or template – cut the pouch to correct size.
  9. If using accessory products apply now.
  10. Remove adhesive backing from pouch and secure pouch over stoma. Hold in place with warm hand for a few minutes to encourage adhesion.

Disposal of Equipment

Stoma care equipment for patients in the community can be disposed of with household waste once tied in a disposal bag (or nappy sack).

Last updated: 06-01-2023


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