Types of Pouching Systems l United Ostomy Association Of America (2025)

Can be either open-ended, requiring a closing device (traditionally a clamp or tail clip); or closed and sealed at the bottom. Open-ended pouches are called drainable and are left attached to the body while emptying. Closed end pouches are most commonly used by colostomates who can irrigate (see below) or by patients who have regular elimination patterns. Closed end pouches are usually discarded after one use.

Allow changing pouches while leaving the barrier/wafer attached to the skin. The wafer/barrier is part of a “flange” unit. The pouches include a closing ring that attaches mechanically to a mating piece on the flange. A common connection mechanism consists of a pressure fit snap ring, similar to that used in Tupperware™.

Consist of a skin barrier/wafer and pouch joined together as a single unit. Provide greater simplicity than two-piece systems but require changing the entire unit, including skin barrier, when the pouch is changed.

Some colostomates can “irrigate,” using a procedure analogous to an enema. This is done to clean stool directly out of the colon through the stoma. This requires a special irrigation system, consisting of an irrigation bag with a connecting tube (or catheter), a stoma cone and an irrigation sleeve. A special lubricant is sometimes used on the stoma in preparation for irrigation. Following irrigation, some colostomates can use a stoma cap, a one- or two-piece system which simply covers and protects the stoma. This procedure is usually done to avoid the need to wear a pouch.

You may need or want to purchase certain pouching accessories. The most common items are listed below.

Convex shaped plastic discs that are inserted inside the flange of specific two-piece products. Some barrier rings and strips (see below) can also be used to add convexity to a pouching system.

These materials can be used to smooth out irregularities of the peristomal skin or otherwise fill in space between the stoma and peristomal skin and the pouching system’s wafer. This may reduce leaks and improve wear time. Note that ostomy “paste” is used as a caulking material; it is not an adhesive. In fact, using too much paste can reduce adherence of a pouching system.

Belts that wrap around the abdomen and attach to the loops found on certain pouches. Belts can also be used to help support the pouch or as an alternative to adhesives if skin problems develop. A belt may be helpful in maintaining an adequate seal when using a convex skin barrier.

Made with a cotton or cotton blend backing, easily fit over the pouch and protect and comfort the skin. They are often used to cover the pouch during intimate occasions. Many pouches now include built-in cloth covers on one or both sides, reducing the need for separate pouch covers.

These products can be most useful when peristomal skin is irritated, moist or weepy. Powders can help skin to heal (excess powder should be wiped off after applying). Irritated skin can also be sealed with a liquid film barrier (applied with wipes, sprays or liquids, then allowed to dry) before applying the pouching system.

Tapes are sometimes used to help support the wafer or flange (faceplate) and for waterproofing. They are available in a wide range of materials to meet the needs of different skin sensitivities.

Adhesive removers may be helpful in removing wafers or tapes, or cleaning the residues that may remain after removing such adhesives.

The ostomy Pouch Replacement Cartridge (PRC) is a single-use, disposable cartridge used to assist with the ostomy pouching system replacement process. The PRC is placed over the stoma after the used system is removed to hygienically contain stomal output, reduce risks of effluent-to-skin contact and to allow sufficient time to clean and dry the peristomal skin during the replacement process.