The Ostomy Files: One-Piece vs. Two-Piece

Hello everyone and welcome to another hotly-anticipated edition of the Ostomy Files! The staff here at Medical Monks understands that becoming an ostomate can seem overwhelming. A new patient will be presented with many alternatives when it comes to products. Some of these choices will be pre-determined by their medical condition, but many more, in the end, come down to personal preference. Figuring out what works can be a long process of trial-and-error. Today, we’re going to help ease the transition by exploring one of the most basic choices faced by new ostomates: should I use a one or two-piece pouching system?

Components of a Pouching System

First, we’ll cover a little background for the uninitiated. When it comes to pouching systems there are two main components: the barrier and the pouch. The barrier is generally a flat or convex disc with adhesive on one side that sticks to a person’s peristomal area (the skin around the stoma). These come in a variety of shapes and sizes to accommodate different stoma and/or body shapes. The pouch, no less important, is the receptacle for the ostomy output. Pouches are also available in various sizes and can be drainable or closed for convenient disposal.

What’s the Difference?

A one-piece pouching system is exactly what is sounds like. It’s all… one piece. These systems take the two components and combine them into one inseparable product. The two-piece versions take the barrier and pouch and separate them into – you guessed it – two pieces. But why would someone choose one over the other? Is one inherently better? Let’s examine these questions in more detail.

One-Piece Pros and Cons

Patients choose a one-piece for a variety of situations. A common reason is simple familiarity. Many hospitals choose to stay stocked with mostly one-piece products for convenience and cost-saving purposes, and often patients choose to stick to what they’ve been given post-surgery.

For others, having the two parts attached can lend a sense of security – you can generally be sure the pouch will not detach from the barrier. Also, without the extra attachments they are generally lower-profile, meaning flatter on the tummy, which comes in handy when trying to hide your system under more form-fitting clothing.

The issue some folks run into is that one-piece products tend to need changing fairly often. Usually because the pouch, being attached, cannot be easily cleaned out. This can cause more irritation to the skin than might be experienced otherwise, and will also likely cause the patient to go through accessories, such as skin prep and remover wipes, more quickly.

Two-Piece Convenience

Two-piece is the convenient choice. It’s the modern choice. With these systems the barriers and pouches connect together via some kind of securement – typically a plastic flange that clicks or fits together like a Tupperware lid. This is convenient for many reasons. As noted above, it gives a patient the ability to remove and clean out a drainable pouch for re-use. It also offers more flexibility when draining in, say, a public restroom. It’s easy to imagine the difficulty of positioning a pouch affixed to your stomach into the correct place while inside a cramped stall.

A separate barrier also gives a colostomy patient the option of using closed-end, disposable pouches. For many folks, mainly those with consistently solid output, these pouches are the ultimate in convenience. They allow the user to simply remove the pouch when full, dispose, and replace with a new pouch onto the same barrier – no drainage required. While closed pouches are produced in one-piece form for special cases, they require a peel-and-replace process several times a day. Any ostomate will tell you that’s not very kind to your skin. A two-piece arrangement is what makes closed pouches possible.

That’s not to say two-piece systems don’t have their drawbacks. One is the cost. Barriers and pouches are generally sold separately. This doesn’t typically double the cost when compared to a one-piece, but it will certainly lighten the pocketbook a bit more for those paying out-of-pocket.

Which Option is Right for Me?

Patients should consider the pros and cons above. Do you value the security, cost savings, and style offered when the pouch and barrier are affixed? If so, you may want to use a one-piece system. If you prefer flexibility and ease of use, perhaps a two-piece system would be more to your liking.

Where to Buy?

Why, from Medical Monks, of course! As always, we’ve got the lowest prices around on both one and two-piece devices. Shop one-piece systems here, two-piece here.