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The Ostomy Files: Mixing and Matching 2-Piece Ostomy Systems

When choosing which ostomy system is best for you, it’s important to make sure, first and foremost, that all the elements are compatible. This is mainly important with two-piece systems, which consist of a barrier and a pouch that attach to each other in some way. There are many advantages to choosing this type of set-up, which we’ve enumerated elsewhere. Even so, there are some potentially stressful unknowns associated with choosing your initial products and matching up components.

This new edition of the Ostomy Files is designed to help in that process. We’ll review some major brands of two-piece pouches Medical Monks carries and clarify which product lines match and which don’t. We’ll also examine the various color-coding systems used by different brands, which are meant to streamline the process but can sometimes inadvertently cause a deeper sense of uncertainty.     

If all this sounds confusing, that’s because it is. But fear not! If you take our advice and keep this guide as a reference, you’ll be able to match barrier to pouch with confidence every time.


The magic question is – simply put – how do you know the barrier and pouch you’re purchasing will fit together? This is a query we field at Medical Monks on a daily basis, so clearly it’s something that confounds many new ostomates. 

It’s easy to understand why. Two-piece components listed in a catalog or website inevitably appear daunting to an uninitiated person. That’s why it’s important to educate yourself on the details of the products and follow the recommended procedures for choosing and matching them.   


The barrier is where to start. Catalogs tend to list an abundance of measurements for barriers, which can lead to confusion. Most will have a minimum of two: one for the barrier opening and one for the flange. As we’ve seen, the flange is what matters for matching. But we’ll discuss the barrier opening first. That’s what will determine which size you select. 

You’ll want to start by confirming your stoma size. If you don’t already know the size, you’ll want to measure the diameter of the stoma at its widest point. If you like, you can choose to select a barrier with a pre-cut opening that matches your stoma size. For various reasons, though, this isn’t recommended for new ostomates. Usually, it’s preferable for the uninitiated to start with cut-to-fit barriers. 

Now, you’ll want to match up the barrier size (either the exact size of the pre-cut, or the size range of the cut-to-fit) to your stoma size. You want to ignore the flange size at this point. No matter if you’re using flat, convex, standard wear or CeraPlus, the flange measurement is irrelevant to you at this stage in the game. 


Once you’ve got your barrier, you’ll need to go about matching your pouch. There are lots of options in this realm – drainable/closed, with/without filter etc… Whichever you choose, this is when the flange measurement comes into play.

Almost all of the major ostomy lines use a color-code system to help match their flanges. So, in most cases, all you need to do is match the colors to be sure they will work together. Red goes with red, blue goes with blue, and so on. This is a fairly simple concept, of course. However, things can get tricky if you’re not familiar with the different ostomy brands and product lines. 

An important rule of matching barriers to pouches is that you ALWAYS have to make sure the two pieces are made by the same manufacturer. A Hollister barrier will never fit with a Convatec pouch. Another good rule of thumb is that alike product lines will generally fit together. For example, any Hollister New Image pouch will fit with any Hollister New Image barrier with a matching flange. Likewise, any Sensura Mio Click barrier by Coloplast will fit any Mio Click pouch with an alike flange.

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