One piece or two piece appliance?

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One piece or two piece appliance?

Postby ellkay » Mon Sep 25, 2017 9:07 am


I'm not sure how active this forum is, but here goes my question. I have been using a one piece pouch, but my supplier suggested I try a two piece appliance. I do not "empty" my pouches (too messy), so I always just change them. I go through two, sometimes three per day. It really taps into my quota, but I refuse to shower with a "dirty" bag on, so I change it. Anyway, I tried the two piece (they sent me a sample), but I can't really find any advantages in them. I know with the two piece, you can use the liners, but I'm not seeing how those are an advantage either, since you have to remove the pouch to take the liner out! Can someone please enlighten me?

Thanks so much!

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Re: One piece or two piece appliance?

Postby MissMolly » Mon Sep 25, 2017 10:25 am

There is no right or wrong in choosing a one piece or two piece ostomy system. One system is not better than the other. What matters is selecting the system that is the best/optimal system for you.

I am a dedicated one-piece appliance user. I detest using a two-piece system. I do not like the bulkiness of the Tupperware click and lock nor do I like the adhesive coupling system. I prefer the one-piece system. And that is what I use.

The advantage of a two piece system is the ability to change to different sizes pouches on a whim. For someone with an ileostomy, it allows the flexibility to change to a larger capacity pouch during the hours of sleep and to use a small pouch that is more discrete during the day.

If you are using a closed-ended pouch it makes sense to keep to a one-piece system where you simply remove the entire pouch and wafer and toss it away after a bowel movement. Easy peezy, no mess, no fuss, and you are fresh and clean.

There are those who advocate for a two piece system as being less stressful to the skin (fewer wafer changes). I tend to disagree. I like being able to air my skin and shower every day without a wafer/pouch, a naked skin shower. I avoid skin irritation when removing a wafer by using my finger tips to press into the skin and pushing the wafer away from the skin in small increments (as opposed to pulling the wafer away from the skin, a no-no).

One piece systems are inherently lower in profile, less bulky, and more flexible. I use the Colopast Mio and CyMed Microskin product lines. They are both flexible and minimalist one-piece systems. I barely notice that I am wearing an ostomy pouch.

Bottom Line: Use the system that you prefer and that is the optimal choice for you. Anything that can bring peace of mind is a plus. There are people who prefer a two piece ostomy appliance and there are people who prefer a one-piece ostomy appliance. It is a matter of choice and preference. Not unlike the choice in purchasing an automobile or smart phone.
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

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Re: One piece or two piece appliance?

Postby mhf1986 » Mon Sep 25, 2017 5:11 pm

DH was introduced to a 1 piece system in the hospital last fall. Made him miserable emptying it. So he switched to a 2 piece, Coloplast Sensura Mio Click, just to see if it works better. Much better!!! Unclick the pouch, drop in special ziploc, click on new pouch. No liners. He normally replaces the pouch 3 times a day as he wears the midi (shorter) bag and then replaces the backplate every 3-4 days. On a rough chemo week, he'll replace the pouch more frequently.

Call or email some of the suppliers and they will send you samples to try. Mio Click comes in several plate sizes (40, 50, 60) and then you buy matching pouch sizes in either midi or maxi length (30 in a box). Some plate sizes you can trim the stoma opening, some are precut but can be further trimmed. Just experiment. We've tried all 3 sizes before settling on 50.

Another item we have found useful is the Cardinal Health "ziploc" disposal bags. Insurance doesn't cover them but for $13 for 60, what a great item! DH once left one on the side of bathtub and there was no smell when we got home that evening. The disposal bags included in the pouch boxes just don't do the trick, IMHO.

Good luck
Caregiver to DH, dx @ 50, mets to liver/lungs, MSS, wild
9/16 CEA 114, blockage, left hemi, perm. colostomy
11/16 port in, FOLFOX + Avastin
6/17 CEA 15, 5FU + A only due to neuropathy
11/17 CEA 38, CAPOX + A
1/18 CAPOX = hi bilirubin/bad hfs, back to FOLFOX + A
5/18 growth; Vectibex + 75% Irinotecan
7/18 CEA 23, shrinkage
10/18 CEA 28, growth of 2 liver tumors/shrinkage of few and lung nodes
11/18 Lonsurf, looking at spheres, proton, trials
11/19/18 Peace

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Re: One piece or two piece appliance?

Postby Jachut » Thu Oct 12, 2017 5:12 am

Its such a personal thing. For me, it was one piece all the way for both ileostomy and colostomy - drainable for the ileostomy, closed for the colostomy. I'm lucky that in Australia, our scheme is very generous so I put on a clean pouch every morning (even if there's been absolutely no output overnight, which is often the case) - I shower with nothing, and then put a clean one on after the shower. I cannot imagine that not being part of getting "clean". I also cannot stand a wet bag which is why I change it for a clean one after a shower - but I wouldnt switch to two piece because they're so bulky. I like that even bathing suits are no problem for me as there's no "hardware" to show through. I also hate the idea of the baseplate being one all week, getting wet, sticky at the edges, gathering fluff or getting bits of poo on it - which for me and the consistency of what I produce (I get a lot of pancaking) would be a big problem. I totally agree with Miss Molly about skin health - for me, there is no problem with peeling off a bag two or three times a day - I've had my colostomy four years now and no problem, ever. But poo sitting under the wafter, that hurts.

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Re: One piece or two piece appliance?

Postby James65 » Thu Oct 12, 2017 11:07 am

I tried a one piece with a disposable bag (why would anyone empty and wash rather than bag it and toss it out?) and there were some things I liked, but it made bag changes harder. I use Convatec and the bag pulls off easily, wipe, and pop a new one on easily. Done in less than a minute. The downside is you have to be good about wafer changes so you don't have a blowout.
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Full APR Surgery
Folfox Chemo
So far NED.
Oops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13. So far so good.
Oops again, one tumor in each lung diagnosed 8/8/16. One too small to deal with and the other resected in late September. Wait and watch for now.

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Re: One piece or two piece appliance?

Postby CRguy » Thu Oct 12, 2017 10:18 pm

I had very good success with a 2 piece system from Hollister .... BUTT
you need a great ostomy nurse to set things up and give you ongoing support.

just my 2 cents !

Best wishes
Caregiver x 4
Stage IV A rectal cancer/lung met
12 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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Re: One piece or two piece appliance?

Postby Aqx99 » Thu Oct 12, 2017 10:55 pm

I don't mind the one piece drainable pouch for my ileostomy. I'd never be able to use a two piece and just throw it away instead of emptying because my insurance only allows me 20 pouches per month. I use a small bottle of water to rinse my pouch when I drain it to clean it out and make wiping the opening easier. Everybody is different, find what works best for you. And definitely work with an ostomy nurse, they are amazing and finding the right system for your body and stoma.
Anne, 40
Stage IIIB Rectal Cancer
2/21/17 Dx, Age 39
2/21/17 CEA 0.9
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Dx w/ovarian cancer
9/6/17 CA 125 11.1
11/27/17 CEA 2.6
12/5/17 CT NED
12/13/17 CEA 2.9
1/11/18 CA 125 8.6
1/23/18 Reversal
3/21/18 CT enlarged thymus
4/6/18 PET NED
7/10/18 CT NED
7/11/18 CEA 2.6
9/18 Bilateral Prophylactic Mastectomy

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