How to Choose the Best Ostomy Appliances and Accessories: A Professional Guide

One-Piece vs Two-Piece Appliances

When you first start using an ostomy appliance, one of the biggest decisions is whether to go with a one-piece or two-piece system.

Key takeaway

Choose a one-piece appliance for low profile and simplicity, or a two-piece system for adjustability and a floating flange that moves with you.

If you empty your pouch five to seven times daily, a drainable pouch will save you time, space and hassle.

One-Piece Systems

• Low profile: Fewer components mean a slimmer design under clothing.

• Fixed orientation: The pouch and flange are attached—once applied, you’re committed to that bag position until change time.

• Best for: Tight-fitting outfits or if you prefer a simpler routine.

Two-Piece Systems

• Adjustable orientation: Apply your base plate first, then attach and rotate the pouch as needed over several days.

• Floating flange: Many models feature a flexible zone between adhesive and pouch for greater movement—ideal if you’re active.

• Slightly higher profile: More layers can make the pouch more noticeable under clothes.

• Best for: Those who value flexibility in bag position and enhanced comfort during activity.

Drainable vs Non-Drainable Pouches

Next, consider how you’ll empty your pouch: drainable or closed (non-drainable).

Drainable Pouches

• Empty through a tail valve: Just open, drain, rinse (if desired), and reseal.

• Reusable for 3–4 days: Matches most flange wear times.

• Ideal if: You have frequent output and want to carry fewer spare pouches.

Non-Drainable (Closed) Pouches

• No emptying valve: Discard and replace when full.

• Can be one-piece or two-piece: Closed pouches attach directly to your flange or come as a single unit.

• Ideal if: You produce minimal output, seek extra sanitation, or prefer swapping bags less often.

Convex vs Flat Base Plates

Convexity refers to the dome-shaped adhesive on the base plate that presses gently into your skin.

Convex Barriers

• Push skin inward to help your stoma protrude, reducing leaks under the flange.

• Available in deep or shallow, firm or soft variants to suit your body shape and activity level.

• Recommended if: Your stoma retracts or you experience frequent edge leaks.

Flat Barriers

• Completely even adhesive—no bulge.

• Lower profile under clothes, easier to apply if your stoma already protrudes well.

• Recommended if: You have a well-protruding stoma or prioritise the slimmest profile.

Personal tip: Try a barrier ring (see next section) to add soft convexity before switching to a fully convex plate.

Common Accessories to Improve Seal and Comfort

Beyond your basic appliance, three accessories can dramatically reduce leaks and skin irritation.

1. Barrier Rings (Seals)

• Soft, malleable rings that sit between skin and flange.

• Build custom convexity around your stoma without changing your base plate.

• Use to: Fill minor gaps, test convexity levels, and prevent leaks at the edge.

2. Stoma Pastes

• Thick, toothpaste-like paste that fills deeper skin crevices (e.g. scar valleys).

• Applied directly to uneven areas before your flange goes on.

• Use to: Seal scar tissue, protect delicate skin, and smooth uneven surfaces.

3. Barrier Extenders (Strips)

• Adhesive strips that extend your flange’s perimeter.

• Provide a “safety net” around edges—perfect for swimming, heavy sweating or extended wear.

• Use to: Reinforce weak points, add extra days to wear time, and secure edges against moisture.

Bold step: Carry a small kit of rings, paste and extenders so you can customise your seal on the go.

Putting It All Together

1. Identify your priorities: profile vs flexibility, frequency of emptying, stoma shape.

2. Gather samples of one-piece and two-piece systems, drainable and closed pouches, convex and flat plates.

3. Test combinations with barrier rings, paste or extenders to fine-tune your fit.

4. Monitor your skin and seal—adjust as you learn what works best for your body and lifestyle.

Your next steps:

• Order a sampling pack of different base plates and pouches.

• Experiment with one accessory at a time to isolate its effect.

• Track wear times and leak incidents in a simple journal or app.

Conclusion & Call to Action

Choosing the right ostomy system is a personal journey. With the right appliance style and accessories—plus a little experimentation—you’ll find a combination that keeps you confident, secure and ready for anything.