Choosing between convex and flat ostomy skin barriers is an important part of finding the right fit for your pouching system. While both types of barriers are designed to protect your skin and create a secure seal around your stoma, the best option depends on several factors. Here, we'll explain how each barrier works, when each is typically recommended, and how the right ostomy supplies can help you achieve a more secure and comfortable fit.
Quick Overview: Convex vs. Flat Ostomy Skin Barriers: Which Type Do You Need?
- Flat ostomy barriers are typically recommended for stomas that protrude above the skin and have even surrounding skin.
- Convex ostomy barriers apply gentle pressure to help flush or retracted stomas protrude, creating a more secure seal.
- Stoma height, body contours, leakage, and skin health all influence which barrier is the best choice.
- Your ostomy barrier needs may change over time, and it's common to switch barrier types as your body or stoma changes.
- An ostomy nurse can help you choose the right barrier and ostomy supplies to improve comfort, wear time, and skin protection.
What Is an Ostomy Barrier?
An ostomy barrier is the part of an ostomy pouching system that adheres to the skin around your stoma. It creates a seal that helps prevent leaks while protecting the surrounding skin from coming into contact with stool or urine. The barrier itself is designed to be gentle on the skin while providing enough adhesion to keep your pouch securely in place throughout daily activities.
What's the Difference Between an Ostomy Barrier and a Wafer?
An ostomy barrier and an ostomy wafer are the same things, and the terms are often used interchangeably. Skin barriers or wafers are available in different shapes and styles to accommodate a variety of stoma types, body contours, and individual needs. The two main types are flat ostomy barriers and convex ostomy barriers, each designed to provide the best possible fit depending on the shape and position of the stoma.
Benefits of Choosing the Right Ostomy Barrier
Your ostomy nurse will help you understand the various ostomy supplies you'll need to use, and you'll be able to choose between options that fit your lifestyle and unique needs. When it comes to barriers, the most important thing is to get the right fit and prevent skin issues or irritation. When you choose the right type of ostomy skin barrier, you'll notice:
- Better leak prevention
- Healthier peristomal skin
- Longer wear time between barrier changes
- Improved adhesion throughout the day
- Greater comfort during daily activities
- Fewer unexpected pouch changes
- Reduced skin irritation and discomfort
- A better fit for your stoma and body contours
- Increased confidence at work, during exercise, and while traveling
- Improved overall quality of life
Convex vs. Flat Ostomy Barriers: What's the Difference?
Flat and convex ostomy barriers serve the same purpose; the difference lies in the shape of the barrier and how it fits against your body. While one option isn't inherently better than the other, the right choice depends on factors such as your stoma's height, the contours of your abdomen, and whether you've experienced issues like leaks or skin irritation.
Flat Skin Barriers
A flat barrier ring has a smooth, even surface that lies flush against the skin. It's the most commonly used type of barrier and is often recommended for people whose stoma extends above the surface of the skin and who have relatively flat, even abdominal contours. It can be used with both one-piece and two-piece appliances and may come in pre-measured or cut-to-fit sizes, depending on the manufacturer.
Since there's no added pressure around the stoma, flat barriers work well when the stoma naturally protrudes enough for output to flow directly into the pouch. This can help create a reliable seal while minimizing unnecessary pressure on the surrounding skin.
Flat ostomy barriers may be a good option if you:
- Have a stoma that protrudes above the skin
- Have smooth, even skin around your stoma
- Rarely experience leaks
- Consistently get good wear time from your pouching system
Convex Skin Barriers
A convex ostomy barrier has a curved shape, which applies gentle pressure to the skin surrounding the stoma. This gentle push against the abdominal skin helps the stoma protrude outward, further from the skin, allowing output to flow more directly into the pouch instead of collecting around the base of the stoma.
Convex barriers are commonly recommended for people with flush or retracted stomas, uneven skin surfaces, or abdominal folds that make it difficult to maintain a secure seal. By improving the fit of the barrier, convexity can help reduce leaks and better protect the peristomal skin.
Convex ostomy barriers may be a good option if you:
- Have a flush or retracted stoma
- Have creases, skin folds, scars, or uneven abdominal contours around the stoma
- Experience frequent leakage
- Have skin irritation caused by leaks
- Struggle with short wear times
There are also soft convex skin barriers, which are made with more flexible baseplates. These may be recommended by healthcare professionals if you need some additional support to improve your seal but don't require the firmer pressure of a deep convex barrier.
Can You Switch Between Flat and Convex Ostomy Barriers?
If your ostomy care needs change over time, it's perfectly fine to switch between flat and convex wafers. The key is to use the ostomy products that work best to help prevent leakage while protecting peristomal skin. Since your stoma can change in size and shape over time, it's important to make changes as necessary to ensure a secure fit. Some of the most common reasons that people make adjustments include:
- Frequent leaks or blowouts
- Shorter wear times than usual
- Skin irritation or breakdown around the stoma
- Changes in your stoma's size, height, or shape
- Weight gain or weight loss that affects your abdominal contours
- Scarring, creases, or folds that develop around the stoma
- A hernia near the stoma that changes the fit of your pouching system
- Changes that occur as swelling decreases after ostomy surgery
With that being said, you may want to first consult with your stoma care nurse, especially if you have a retracted stoma or skin complications.
Factors to Consider When Choosing a Barrier for Your Pouching System
Choosing the right ostomy barrier isn't just about deciding between a flat or convex design. Your stoma, skin, and lifestyle all play a role in determining which option will provide the best fit and help prevent leaks. Here are some of the most important factors to consider.
Stoma Height
The height of your stoma is one of the biggest factors when selecting a barrier. Stomas that protrude above the skin often work well with a flat barrier, while flush or retracted stomas may benefit from a convex barrier that helps encourage the stoma to extend further into the pouch.
Body Contours
Everyone's abdomen is different. Creases, folds, scars, hernias, or uneven skin around the stoma can make it difficult to achieve a secure seal with a flat barrier. In these situations, a convex barrier may provide a better fit and help reduce leakage.
Peristomal Skin Health
Take note of the skin surrounding your stoma. Frequent redness, irritation, or skin breakdown may indicate that your current barrier isn't creating an effective seal. Finding a barrier that fits properly can help protect the skin and promote healing. There are also great options for barriers made for sensitive peristomal skin.
Leakage and Wear Time
If you're regularly experiencing leaks or your barrier isn't lasting as long as expected, it may be time to reassess your pouching system. A different barrier style or level of convexity may improve wear time and provide a more reliable seal.
Type of Ostomy
Whether you have a colostomy, ileostomy, or urostomy can also influence your barrier selection. The consistency of your output and the location of your stoma may affect how well different barriers perform.
Lifestyle and Activity Level
Your daily routine also matters. If you're physically active, travel frequently, or have a job that involves bending, lifting, or extended periods of movement, you'll want a barrier that provides a secure fit throughout the day.
Recommendations From Your Ostomy Nurse
Every body is different, and no two stomas are exactly alike, which is why personalized guidance is so important. An ostomy nurse can evaluate your stoma, skin, and body contours to recommend the barrier that best meets your needs. They can also help troubleshoot any issues if they occur.
Finding an ostomy barrier may take some trial and error, but the right fit can make a significant difference in your overall quality of life. If you're looking for high-quality ostomy supplies, Byram Healthcare carries a wide selection of ostomy products designed to support your individual ostomy care needs. Contact us today to learn more.
